Topical ketotifen treatment for allergic conjunctivitis:a systematic review and Meta-analysis

AIM:To assess the efficacy of ketotifen in treating allergic conjunctivitis.METHODS:A systematic search of systematic reviews and Meta-analyses was conducted on the Pub Med and Web Science of Science until October 2021 to address this knowledge gap.Mean difference with 95%CI and P values were used to assess the efficacy of ketotifen.The heterogeneity(I^(2))was used to evaluate the impact of heterogeneity.RESULTS:Eight randomized controlled trials(RCTs)involving 1589 patients were included in this Meta-analysis.The results revealed that after treating with ketotifen,itching(MD=-0.91,95%CI:-1.63 to-0.20,I^(2)=94%,P=0.01),tearing(MD=-0.40,95%CI:-0.61 to-0.18,I^(2)=75%,P=0.0003)and total signs and symptoms(MD=-0.85,95%CI:-1.12 to-0.58,I2=0,P<0.00001)showed better benefit effect compared to the placebo group.CONCLUSION:Topical ketotifen is an effective treatment for patients with allergic conjunctivitis.

Effects of vernal and allergic conjunctivitis on severity of keratoconus

AIM: To demonstrate the effects of two different types of allergic conjunctivitis on severity of keratoconus (KC). ·METHODS: We retrospectively reviewed the medical records of 171 KC patients referred between June 2010 and June 2011. The KC patients were divided into 3 groups as KC (group A), KC with vernal keratoconjunctivitis (VKC) (group B) and KC with allergic conjunctivitis (AC) (group C). Main outcome measures were demographic and ocular clinical features including age at presentation, gender, spherical equivalent (SE), best spectacle corrected visual acuity (BCVA), mean keratometric measurement (Km), central corneal thickness (CCT), and intraocular pressure (IOP). Groups were compared in term of study variables. · RESULTS: The median age at presentation was significantly lower in group B (P 【0.001). According to the median SE (P =0.003), BCVA(P =0.022), Km(P 【0.001), CCT (P =0.015) and Amsler-Krumeich classification (P 【 0.001), KC was more severe in group B. There was no significant difference in terms of IOP and corrected IOP among the groups (P =0.44), however there were 4 patients who had increased corrected IOP developed after topical corticosteroid use in group B. The differences among the groups persisted even after controlling for age and gender. · CONCLUSION: Our findings demonstrated a more severe KC in VKC patients despite their younger age which suggests evaluation of VKC patients as a separate group in keratoconus disease.

Semaphorin 3A controls allergic and inflammatory responses in experimental allergic conjunctivitis

AIM: To assess the efficacy of topical Semaphorin 3A(SEMA3A) in the treatment of allergic conjunctivitis.METHODS: Experimental allergic conjunctivitis(EAC)mice model induced by short ragweed pollen(SRW) in 4-week-old of BALB/c mice, mice were evaluated using haematoxylin and eosin(H&E) staining, immunofluor-escence and light microscope photographs. Early phase took the samples in 24 h after instillation and late phase took the samples between 4 to 14 d after the start of treatment. The study use of topical SEMA3A(10 U, 100 U,1000 U) eye drops and subconjunctival injection of SEMA3 A with same concentration. For comparison, five types of allergy eyedrops were quantified using clinical characteristics.· RESULTS: Clinical score of composite ocular symptoms of the mice treated with SEMA3 A were significantly decreased both in the immediate phase and the late phase compared to those treated with commercial ophthalmic formulations and non-treatment mice. SEMA3 A treatment attenuates infiltration of eosinophils entering into conjunctiva in EAC mice. The score of eosinophil infiltration in the conjunctiva of SEMA3 A 1000 U-treated group were significantly lower than low-concentration of SEMA3 A treated groups and non-treated group. SEMA3 A treatment also suppressed T-cell proliferation in vitro and decreased serum total Ig E levels in EAC mice. Moreover, treatment of SEMA3 A suppressed Th2-related cytokines(IL-5, IL-13 and IL-4)and pro-inflammatory cytokines(IFN-γ, IL-17 and TNF-α)release, but increased regulatory cytokine IL-10 concentration in the conjunctiva of EAC mice.CONCLUSION: SEMA3 A as a biological agent, showed the beneficial activity in ocular allergic processes with the less damage to the intraocular tissue. It is expected that SEMA3 A may be contributed in patients with a more severe spectrum of refractory ocular allergic diseases including allergic conjunctivitis in the near future.

Ragweed pollen induces allergic conjunctivitis immune tolerance in mice via regulation of the NF-κB signal pathway

AIM:To investigate the feasibility and mechanism of immune tolerance in allergic conjunctivitis.METHODS:The allergic conjunctivitis immune tolerance mice model was established by ragweed pollen(RW)and the related cytokines were detected.The mice were divided into 9 groups and the maslinic acid(MA)or PBS were given for different group after modeling.The expression levels of chemokine ligand 5(CCL5)and P-65 in the conjunctival tissue were analyzed by immunohistochemistry,quantitative reverse transcription polymerase chain reaction(q RT-PCR)and Western blot.The percentage of interleukin-17(IL-17)and CD4+CD25+in the splenocyte supernatant was analyzed by flow cytometry.Fur thermore,the serum and splenocyte supernatant concentration of total-IgE,interleukin-10(IL-10),and IL-17 was analyzed by enzyme linked immune response(ELISA).RESULTS:After the model was established,symptoms of conjunctivitis were alleviated,the level of P-65,CCL5,IL-17,and total-IgE was raised,while the expression of IL-10,CD4+CD25+was decreased.This result fully demonstrated that a typical IL-17/regulatory-T-cells(Treg cells)imbalance and NF-κB activation.When the NF-κB signal pathway was suppressed,it showed that there was a further relief of conjunctivitis in mice.At the same time,the expression of total-IgE,IL-17,and CCL5 was decreased and the expression of anti-inflammatory factor(IL-10,CD4+CD25+)was increased.CONCLUSION:In the state of immune tolerance,symptoms of conjunctivitis in mice are alleviated,the Th-17 cells of allergic conjunctivitis mice are inhibited,and Treg cells activity is enhanced.

Investigation of possible risk factors in the development of seasonal allergic conjunctivitis

AIM： To analyze the possible risk factors in the development of seasonal allergic conjunctivitis（SAC） through an evaluation of skin allergy tests and data obtained from questionnaires.METHODS： The study included a total of 75 SAC patients and 71 control subjects without SAC diagnosis who were admitted to the Abant Izzet Baysal University Medical Faculty Ophthalmology Clinic between March 2016 and December 2016. Skin prick tests were performed for all participants. Serum levels of total IgE and 25-OH vitamin D were also measured. In the tear, total IgE levels were measured. Moreover, possible risk factors for the onset of SAC（smoking, paracetamol exposure, vitamin D supplementation and environmental factors etc.） were examined for all patients by both prenatal and postnatal aspects.RESULTS： The patients with SAC were found to have a history of maternal paracetamol exposure during the prenatal period. Likewise, in the same patient group, the duration of postnatal vitamin D supplementation was shorter（P〈0.001）. However, no significant correlation was found between SAC and maternal antibiotic exposure, maternal smoking, the mode of delivery and birth weight, as well as presence of pets. Moreover, patients with SAC were more likely to have asthma, allergic rhinitis and oral allergy syndrome. We have also found that SAC patients＇ mothers and siblings were more likely to have allergic conjunctivitis. Likewise, their fathers were more likely to have allergic rhinitis. CONCLUSION： Prenatal maternal paracetamol exposure and shorter duration of vitamin D supplementation in the postnatal period may play a role in development of SAC. Therefore prevention of unnecessary gestational paracetamol intake and vitamin D supplementation during infancy could potentially reduce the onset and development of SAC.

Effect of olopatadine on the serum and tear related indicators in patients with allergic conjunctivitis

Objective: To explore the efficacy of olopatadine in the treatment of allergic conjunctivitis and the changes of ECP and IgE levels in the serum and tear before and after treatment. Methods:A total of 94 patients with allergic conjunctivitis were included in the study and randomized into the treatment group and the control group with 47 cases in each group. The patients in the control group were given sodium cromoglycate eye drops, while the patients in the treatment group were given olopatadine eye drops. After 2-week treatment, the clinical efficacy in the two groups was evaluated. The improvement of symptoms before and after treatment in the two groups was recorded and compared. The levels of serm and tear related indicators in the two groups were detected and compared. Results: When compared with before treatment, HA, ECP, and IgE levels in the serum and tear 1 and 2 weeks after treatment in the two groups were significantly reduced, and the reduced degree in the treatment group was significantly superior to that in the control group. Conclusions: Olopatadine in the treatment of allergic conjunctivitis can effectively reduce the serum and tear ECP and IgE levels, and rapidly alleviate the clinical symptoms of affected eye, with the clinical efficacy significantly superior to that by sodium cromoglycate eye drops.

Effects of olopatadine combined with pranoprofen eye drops on serum immunoglobulin, HA and ECP in patients with allergic conjunctivitis

Objective: To observe the clinical application of olopatadine eye drops alone or combination with pranoprofen eye drops in the treatment of allergic conjunctivitis (AC). The levels of serum immunoglobulin, histamine (HA) and eosinophil cationic protein (ECP) were analyzed. Methods: A total of 90 AC patients were randomly divided into control group (n=45) and observation group (n=45) according to the lottery method. The control group was treated with olopatadine hydrochloride eye drops. On the basis of the control group, the observation group was treated with pranoprofen eye drops. The levels of serum immunoglobulin, HA and ECP were measured in all subjects. Results: There was no significant difference in serum immunoglobulin level between the observation group and the control group before treatment. After treatment, the levels of serum IgG, IgA and IgE in the observation group and the control group were significantly lower than those before treatment. And the observation group was significantly lower than the control group after treatment. There were no significant differences in serum HA and ECP levels between the observation group and the control group before treatment. After treatment, the levels of serum HA and ECP in the observation group and the control group were significantly lower than those before treatment. And the observation group was significantly lower than the control group after treatment. Conclusion: Compared with olopatadine eye drops, olopatadine eye drops combined with pranoprofen eye drops in the treatment of AC patients, can effectively reduce the serum immunoglobulin, HA and ECP levels, which may be the clinical treatment of AC patients Of the effective reference program.

Efficacy of Sodium Cromoglicate Eye Drops Combined with Yupingfeng Granules in the Treatment of Allergic Conjunctivitis

Purpose:To observe the clinical efficacy of sodium cromoglicate eye drops combined with Yupingfeng granules in the treatment of allergic conjunctivitis.Methods:.A total of 118 patients with allergic conjunctivitis were randomly divided into a combined sodium cromoglicate and Yupingfeng Granule (treatment)group(n=74) and a sodium cromoglicate (control) group (n=44).Clinical efficacy of the two treatments was evaluated by observing the changes in patients'symptoms and physical signs before and after their respective treatments.Results:.Following treatment,.the symptoms and physical signs related to allergic conjunctivitis were significantly alleviated in all 118 cases.The total efficacy of the combined sodium cromoglicate and Yupingfeng granule treatment was91.9%,.which was significantly higher than the value of 75.0%obtained with sodium cromoglicate alone(P<0.05).Conclusion:.Combined therapy of sodium cromoglicate eye drops and Yupingfeng granules had a high efficacy and no significant adverse reactions..Therefore,.this treatment deserves to be considered for wide application in clinical settings.

Relationship between Foxp3-3279(rs376158) Polymorphism and Dust Mite Allergic Conjunctivitis

Purpose:To investigate the genotyping of Foxp3-3279(A /C,rs376158) genes in patients with dust mite-induced allergic conjunctivitis from Guangdong province and to explore the association between these genes and the susceptibility to dust mite allergic conjunctivitis.Methods:.In total,.80 patients with dust mite allergic conjunctivitis and 103 healthy Han Chinese were enrolled in the study and received genotyping of Foxp3-3279(A / C,rs376158)by PCR-SSP technique.Results: Genotype frequency of Foxp3-3279 AA,.CA,.and CC in patients with dust mite allergic conjunctivitis were 1.25%,25.00% and 73.75%,respectively. Gene frequency of C and A in patients with dust mite allergic conjunctivitis were 86.25%and 13.75% with no significant difference from healthy counterparts(both P>0.05).Conclusion:.Foxp3-3279 polymorphisms did not significantly differ between patients with dust mite allergic conjunctivitis and healthy controls, implying that this genetic locus is probably not an independent risk factor of the underlying pathogenesis of dust mite allergic conjunctivitis.

CLINICAL REPORT ON 142 CASES (278 EYES) OF AFRICAN EPIDEMIC HEMORRHAGIC CONJUNCTIVITIS TREATED WITH ACUPUNCTURE

This paper introduces the curative effects on 142 cases (278 eyes) of African epi-demic hemorrhagic conjunctivitis treated by acupuncture, and 128 (90. 1%) cases (250 eyes) of allpatients have been improved. Three groups were clinically observed in the present report. There were55 cases (104 eyes) in the first group for body acupuncture, of which 46 (83. 6%) cases were effec-tively treated; In the second group for auricular acupuncture, 34 (91. 6% ) cases (68 eyes) out of 37cases (74 eyes) were improved; There were 50 cases (100 eyes) in the third group for boyauricular-acupuncture, among which 48 (96. 0%) cases (96 eyes) were improved. The curative effects of thethird group were better than those of the other two groups.

Corneal biomechanical changes in allergic conjunctivitis

Background:To explore corneal biomechanical changes,identify related factors and determine early indicators of keratoconus(KC)development risk in allergic conjunctivitis(AC)patients.Methods:A total of 50 patients,including 20 eyes without AC and 30 eyes with AC were enrolled in this study.All patients underwent a complete ocular examination,including evaluations of clinical manifestations of AC,corneal tomography and densitometry by Pentacam,corneal biomechanics by Corvis ST,and corneal and epithelial thickness mapping by RTvue optical coherence tomography(OCT).Results:The index of surface variance(ISV),index of vertical asymmetry(IVA),keratoconus index(KI),index of height decentration(IHD)and Belin/Ambrosio enhanced ectasia total deviation index(BAD-D)were significantly higher in the AC group than in the non-allergic conjunctivitis(NAC)group(P<0.05).The tomography and biomechanical index(TBl)was also significantly higher in the AC group(P=0.04).The average epithelial thickness in the 2-7 mm annulus was significantly thinner in the AC group than in the NAC group(P<0.05).The average densitometry of the total cornea and the anterior layer were higher in the AC group than in the NAC group(P<0.001).The ISV,IVA,KI,IHD and BAD-D were significantly correlated with the TBI and changes in corneal epithelial thickness in AC patients(P<0.05).The changes in epithelial thickness were closely related to the eye rubbing frequency and allergic sign scores(P<0.05).Conclusions:AC patients should be advised to routinely undergo corneal tomographic and biomechanical measurements,and the TBl could be used as an indicator of KC development risk in AC patients.Trial registration:Corneal Biomechanical Changes of Allergic Conjunctivitis,NCT04299399.Registered March 3,2020-Retrospectively registered.

Corneal biomechanical changes in allergic conjunctivitis

Background:To explore corneal biomechanical changes,identify related factors and determine early indicators of keratoconus(KC)development risk in allergic conjunctivitis(AC)patients.Methods:A total of 50 patients,including 20 eyes without AC and 30 eyes with AC were enrolled in this study.All patients underwent a complete ocular examination,including evaluations of clinical manifestations of AC,corneal tomography and densitometry by Pentacam,corneal biomechanics by Corvis ST,and corneal and epithelial thickness mapping by RTvue optical coherence tomography(OCT).Results:The index of surface variance(ISV),index of vertical asymmetry(IVA),keratoconus index(KI),index of height decentration(IHD)and Belin/Ambrosio enhanced ectasia total deviation index(BAD-D)were significantly higher in the AC group than in the non-allergic conjunctivitis(NAC)group(P<0.05).The tomography and biomechanical index(TBI)was also significantly higher in the AC group(P=0.04).The average epithelial thickness in the 2-7mm annulus was significantly thinner in the AC group than in the NAC group(P<0.05).The average densitometry of the total cornea and the anterior layer were higher in the AC group than in the NAC group(P<0.001).The ISV,IVA,KI,IHD and BAD-D were significantly correlated with the TBI and changes in corneal epithelial thickness in AC patients(P<0.05).The changes in epithelial thickness were closely related to the eye rubbing frequency and allergic sign scores(P<0.05).Conclusions:AC patients should be advised to routinely undergo corneal tomographic and biomechanical measurements,and the TBI could be used as an indicator of KC development risk in AC patients.

CLINICAL OBSERVATION ON TREATMENT OF ALLERGIC BRONCHIAL ASTHMA WITH ACUPOINT APPLICATION THERAPY

In the present paper, the therapeutic effect of acupoint application of Chinese Materia Medica in the treatment of allergic asthma was observed. The results revealed that topical application of drug paste [mixture of powder of Mahuang (Herba Ephedrae), Xixin (Herba Asari), Baijiezi (Semen Sinapis Albae), etc.] at the acupuncture points could improve symptoms and signs of allergic asthma patients, with the total effective rate being 69.57% (16/23) for the short term effect, and 52.17%(12/23) for the long term effect. In medication (Aminophylline) group, of the 25 cases of allergic asthma, 16 (64.0%) were effective after 4 weeks of treatment, while 6 (24.0%) were still effective that was shown by 6 months’ follow up. The therapeutic effect of acupoint application group was significantly better than that of medication group in the long term effect. Results also showed that no obvious interrelation between the short term therapeutic effect and the duration or the severity of the disease. Results also display that acupoint application therapy is an effective, safe and handy method with fewer side effects for asthma.

Study on Cytokines IL-2,IL-6,IL-10 in Patients of Chronic Allergic Rhinitis Treated with Acupuncture

OBJECTIVES: To observe the plasmatic concentration of IL-6, IL-10 and IL-2 in the patient of chronic allergic rhinitis before and after acupuncture therapy. METHODS: Cytokine levels were determined before and after treatment in 30 healthy volunteers (Group A) and 90 patients of chronic allergic rhinitis (Group B) with an increased plasma IL-10 level. Group B was then divided into 3 subgroups: 30 patients treated with real acupuncture (Group B1); 30 patients treated with sham acupuncture (Group B2); 30 non-treated patients (Group B3). RESULTS: The allergic subjects of group B1, compared with controls, showed a significant reduction of IL-10 after a specific treatment with acupuncture (P

A CLINICAL OBSERVATION ON THERAPEUTIC EFFECTS OF ACUPUNCTURE FOR ALLERGIC RHINITIS

The author applied acupuncture to treat52 cases of allergic rhinitis with certaintherapeutic effectiveness confirmed by afollowing-up for one year and more.The resultis reported as follows.

Contrast of the Effect of Alomide and Sodium Cromoglycate in the Treatment of Allergic Eye Diseases

Purpose: To observe the clinical effect of alomide and sodium cromoglycate eyedrops in the treatment of atopic conjunctivitis, vernal conjunctivitis and giant papillary conjunctivitis.Methods: Randomized control study was used. Alomide and sodium cromoglycate eyedrops used to treat two groups of patients for two weeks. The effects of the two groups were compared.Results: With respect of comprehensive therapeutic effect, the effectiveness rate was 83. 6% in alomide group, and 63. 3% in sodium cromoglycate group, which was not significantly different statistically. With respect of itching alleviation, alomide is more effective than sodium cromoglycate. No adverse effects were found in both groups. Conclusion: Our study suggests that alomide is a safe and effective drug in the treatment of allergic conjunctivitis. Eye Science 2000; 16: 214-216.

Mechanism of Magnoliae Flos and Xanthii Fructus herb pair in treatment of allergic rhinitis based on network pharmacology

Drug Combination Therapy has retracted this article because the data is falsified,the core targets are wrong and this English article has a high repetition rate compared with a Chinese article.Drug Combination Therapy received the author’s manuscript on 13 April 2022.After the plagiarism check on 13 April 2022,the similarity rate of this article was 15%(Supplementary 1),which was qualified.Then the manuscript was started to be sent for peer-review at 10:10 on 19 April 2022.

止敏方口服联合雾化治疗过敏性结膜炎湿热夹风证的临床研究

目的观察止敏方口服联合雾化治疗湿热夹风证过敏性结膜炎(AC)的临床疗效。方法纳入2021年1月—2021年12月苏州市中医医院诊治的湿热夹风证AC患者90例(180只眼),随机分成联合组、雾化组和对照组,每组30例(60只眼)。联合组予止敏方口服及雾化,雾化组单予止敏方雾化,对照组予盐酸氮卓斯汀滴眼液滴眼,均治疗14 d。观察3组患者治疗前后的症状积分、体征积分、泪液免疫球蛋白E(Ig E)抗体值,评价临床疗效。结果3组治疗前症状、体征积分和泪液Ig E抗体比较,差异均无统计学意义(P>0.05)。(1)症状积分:治疗后3组症状积分均较治疗前降低,差异均有统计学意义(t_(联合组)=-18.199、t_(雾化组)=-15.715、t对照组=-13.739,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=8.594,P=0.000)。与对照组比较,联合组和雾化组症状积分均较低,差异均有统计学意义(t_(联合组)=-3.640,P=0.000;t_(雾化组)=-3.156,P=0.002),联合组与雾化组比较,差异无统计学意义(P>0.05)。(2)体征积分:治疗后3组体征积分均较治疗前降低,差异均有统计学意义(t_(联合组)=-18.887、t_(雾化组)=-17.742、t对照组=-15.556,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=16.959,P=0.000)。与对照组比较,联合组和雾化组体征积分均较低,差异均有统计学意义(t_(联合组)=-5.157,P=0.000;t_(雾化组)=-4.409,P=0.000),联合组与雾化组比较,差异无统计学意义(P>0.05)。(3)泪液Ig E抗体:治疗后3组Ig E抗体指标均较治疗前降低,差异均有统计学意义(t_(联合组)=-48.276、t_(雾化组)=-38.164、t对照组=-34.129,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=1937.535,P=0.000)。与对照组比较,联合组和雾化组均较低(t_(联合组)=-56.682、t_(雾化组)=-21.667,均P=0.000)。联合组低于雾化组(t=-49.470,P=0.000),差异均有统计学意义。(4)临床疗效:3组临床疗效比较,差异有统计学意义(Z=14.887,P=0.001)。与联合组比较,雾化组和对照组均较低(Z_(雾化组)=-16.483,P=0.024;Z对照组=-23.267,P=0.001),差异均有统计学意义,雾化组和对照组比较,差异无统计学差异(P>0.05)。(5)复发率:3组复发率比较,差异有统计学意义(χ^(2)=22.816,P=0.000)。与对照组比较,联合组和雾化组均较低(χ^(2)_(联合组)=22.500,P=0.000;χ^(2)_(雾化组)=6.696,P=0.010),联合组低于雾化组(χ^(2)=5.963,P=0.015),差异均有统计学意义。结论止敏方口服加雾化的联合疗法治疗湿热夹风证AC有效,且较单一疗法优势显著。

从亚洲VKC专家共识看我国VKC的防治

亚洲专家工作组完成了2022年春季角结膜炎(VKC)共识,对亚洲VKC的定义、分类、临床表现、诊断与治疗等做出了详细介绍,确定了尚未满足的临床需求,包括:(1)VKC患者的诊断和治疗尚无明确的标准,该病的发病机制尚不清楚,且抗变态反应治疗对中度或重度患者往往无效;(2)治疗和管理亟待规范,亚洲各国对相同严重程度的患者所采用的治疗和管理策略差别很大,缺乏明确的、标准化的指南和分级系统;(3)安全性以及药物相关并发症;(4)药物治疗的最佳剂量方案。本文将对上述内容进行解读,并结合《我国过敏性结膜炎诊断和治疗专家共识(2018年)》进行分析,以期对我国VKC防治有所帮助。

饮食对变应性鼻炎影响的研究进展

综述饮食对变应性鼻炎影响的现有证据,关注非营养素的潜在益处,以期为变应性鼻炎的防治和食疗护理提供新思路。