Heart Rate Variability Analysis in Patients with Allergic Rhinitis

The Scientific World Journal
Volume 2013 (2013), Article ID 947385, 4 pages
http://dx.doi.org/10.1155/2013/947385

Clinical Study

Heart Rate Variability Analysis in Patients with Allergic Rhinitis

Ming-Ying Lan,^1,2,3 Guo-She Lee,^3,4 An-Suey Shiao,^1,3 Jen-Hung Ko,^3,4 and Chih-Hung Shu^1,3

¹Department of Otolaryngology, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei 11217, Taiwan
²Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan
³School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
⁴Department of Otolaryngology, Taipei City Hospital, Taipei 103, Taiwan

Received 18 December 2012; Accepted 28 January 2013

Academic Editors: M. Armengot and M. Schloss

Copyright © 2013 Ming-Ying Lan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Very few studies investigate the role of the autonomic nervous system in allergic rhinitis. In this study, we evaluated the autonomic nervous system in allergic rhinitis patients using heart rate variability (HRV) analysis. Methods. Eleven patients with allergic rhinitis and 13 healthy controls, aged between 19 and 40 years old, were enrolled in the study. Diagnosis of allergic rhinitis was based on clinical history, symptoms, and positive Phadiatop test. Electrocardiographic recordings on the sitting and supine positions were obtained for HRV analysis. Results. In the supine position, there were no significant statistical differences in very-low-frequency power (VLF, ≤0.04 Hz), low-frequency power (LF, 0.04–0.15 Hz), high-frequency power (HF, 0.15–0.40 Hz), and the ratio of LF to HF (LF/HF) between the patient and control groups. The mean RR intervals significantly increased, while LF% and LF/HF significantly decreased in the patient group in the sitting position. Moreover, mean RR intervals, LF, and LF/HF, which were significantly different between the two positions in the control group, did not show a significant change with the posture change in the patient group. Conclusion. These suggest that patients with allergic rhinitis may have poor sympathetic modulation in the sitting position. Autonomic dysfunction may therefore play a role in the pathophysiology of allergic rhinitis.

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Blomia tropicalis Blo t 5 and Blo t 21 recombinant allergens might confer higher specificity to serodiagnostic assays than whole mite extract

Kellyanne Anjos dos Carvalho, Oswaldo Pompílio de Melo-Neto, Franklin Barbalho Magalhães, João Carlos Ponte, Filipe Adriano Felipe, Mariese Conceição dos Santos, Givaneide dos Santos Lima, Álvaro Augusto Cruz, Carina Silva Pinheiro,Lain Carlos de Pontes Carvalho and Neuza Maria Alcântara Neves

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BMC Immunology 2013, 14:11 doi:10.1186/1471-2172-14-11

Published: 27 February 2013

Abstract (provisional)

Background

Blomia tropicalis is a dust mite and an important source of allergens in tropical regions. Up to now, the assays to diagnose atopy to this mite use whole body extract as antigens. However, anti-B. tropicalis IgE antibodies cross-react with Ascaris lumbricoides antigens, hindering the diagnosis of allergy to this mite. In this study, B. tropicalis recombinant allergens were evaluated with the purpose of developing an immunodiagnostic assay for allergy to this mite with greater specificity than those commercially available.

Methods

Two B. tropicalis allergens (Blo t 5 and Blo t 21) were cloned into a plasmidial expression vector, expressed in Escherichia coli and purified by affinity chromatography. Sixty-three sera containing anti-B. tropicalis extract (BtE) IgE antibodies were used to investigate IgE reactivity to the recombinant Blot 5 and 21 allergens. Inhibition assays with 20 sera pre-adsorbed with A. lumbricoides extract were performed using rBlo t 5, rBlo t 21, and BtE as antigens. All the assays were carried using indirect ELISA.

Results

Eighty-two point nine percent and 80.0 % of the sera with anti-BtE antibodies from 35 children reacted with rBlo t 5 and rBlo t 21, respectively, whereas 92.8% and 89.3% of the 28 sera with anti-BtE antibodies from adult asthma patients reacted with the same allergens, and 96.4% of these sera reacted with a mixture of rBlo t 5 and rBlo t 21. In an inhibition ELISA, the absorption of sera by A. lumbricoides extract affected less the reaction with rBlo t 5 and rBlo t 21 than with BtE.

Conclusions

The rBlo t 5 and rBlo t 21 allergens contain important epitopes recognized by IgE antibodies of individuals allergic to B. tropicalis antigens. Moreover, the assays using the recombinant allergens had lower IgE cross-reactivity with A. lumbricoides antigens, a fact which would confers higher specificity to serodiagnostic assays than the crude mite extract. However, additional recombinant allergens should be evaluated in order to reach the same sensitivity of the commercially available assays based on mite extract.

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Evaluation of Adipokines: Apelin, Visfatin, and Resistin in Children with Atopic Dermatitis

Mediators of Inflammation
Volume 2013 (2013), Article ID 760691, 8 pages
http://dx.doi.org/10.1155/2013/760691

Clinical Study

Evaluation of Adipokines: Apelin, Visfatin, and Resistin in Children with Atopic Dermatitis

Edyta Machura,¹ Maria Szczepanska,¹ Katarzyna Ziora,¹ Dariusz Ziora,² Elzbieta Swietochowska,³ Małgorzata Barc-Czarnecka,¹ and Alicja Kasperska-Zajac⁴

¹Department of Pediatrics, Medical University of Silesia, Ulica 3-go Maja 13-15, 41-800 Zabrze, Poland
²Department of Pneumonology and Tuberculosis, Medical University of Silesia, Ulica Koziołka 1, 41-803 Zabrze, Poland
³Department of Biochemistry, Medical University of Silesia, Ulica Jordana 19, 41-808 Zabrze, Poland
⁴Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Ulica Ceglana 35, 40-952 Katowice, Poland

Received 9 July 2012; Revised 27 December 2012; Accepted 28 December 2012

Academic Editor: Wilco de Jager

Copyright © 2013 Edyta Machura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Very little is known about the role of adipokines in atopic dermatitis (AD) in children. This study aimed at analyzing the serum levels of resistin, apelin, and visfatin in children with AD in relation to body weight, AD severity, and gender. Serum concentration of adipokines was measured in 27 children with AD and in 46 healthy subjects. Selected biochemical parameters were evaluated and skin prick test was performed. Serum levels of resistin and apelin were significantly higher, whereas serum visfatin concentration was significantly lower in children with AD versus healthy controls, although an increase in resistin levels was exclusively demonstrated in boys. In AD group, a significant increase in apelin levels in girls was documented. There was no relationship between adipokines levels and the degree of allergic sensitization. Receiver operating characteristic curve analysis demonstrated that the serum apelin cutoff value differentiating children with AD from those without was >137.8 pg/mL. Resistin and visfatin cutoff values were >3.8 ng/mL and ≤ 2.13 ng/mL, respectively. Apelin and visfatin can serve as excellent indicators to distinguish children with AD from those without disease.

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The Short Stature in Atopic Dermatitis Patients: Are Atopic Children Really Small for Their Age?

Annals of Dermatology 2013 Feb; 25(1): 23~27

Annals of Dermatology 2013 Feb; 25(1): 23~27  The Short Stature in Atopic Dermatitis Patients: Are Atopic Children Really Small for Their Age? Mi Kyung Park, Kui Young Park, Kapsok Li, Seong Jun Seo, Chang Kwun Hong Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: Short stature is sometimes seen in children with atopic dermatitis (AD); however, the topic has never been studied systematically. Objective: The aim of this study was to show whether AD itself affects stature in children and to evaluate the influence of other relevant factors such as genetic background, diet restrictions, and sleep disturbance on the stature of children with AD. Methods: The study population included Korean children 7 to 8 years of age who live in one district of Seoul, Korea. We used a questionnaire as an investigating tool to survey genetic backgrounds, environmental factors, and comorbidities. Student's t-test and linear regression were employed for statistical analysis. Results: In univariate analysis, the average stature in the AD group was short compared with the normal control group. Parental stature, dietary habit, and sleep patterns were also relevant factors with respect to stature. However, in multivariate analysis, AD itself had no influence on stature. Significant correlations were found for such factors as parental height, sleep disturbance, presence of asthma, and dietary restrictions, in decreasing magnitude. Conclusion: These results suggest that AD itself may not be the causative factor for short stature in children with AD. Therefore, consideration of other relevant factors related to short stature in patients with AD will be important for the proper management of the disease. (Ann Dermatol 25(1) 0∼27, 2013) Annals of Dermatology 2013 Feb; 25(1): 23~27

Comparison of Three Multiple Allergen Simultaneous Tests: RIDA Allergy Screen, MAST Optigen, and Polycheck Allergy

BioMed Research International
Volume 2013 (2013), Article ID 340513, 6 pages
http://dx.doi.org/10.1155/2013/340513

Research Article

Comparison of Three Multiple Allergen Simultaneous Tests: RIDA Allergy Screen, MAST Optigen, and Polycheck Allergy

Minje Han, Sue Shin, Hyewon Park, Kyoung Un Park, Myoung Hee Park, and Eun Young Song

Department of Laboratory Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul 110-744, Republic of Korea

Received 12 October 2012; Revised 14 November 2012; Accepted 19 November 2012

Academic Editor: Mina Hur

Copyright © 2013 Minje Han et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We compared the performances of 3 Multiple Allergen Simultaneous Test (MAST) assays: RIDA Allergy Screen (R-Biopharm, Darmstadt, Germany), MAST Optigen allergy system (Hitachi Chemical Diagnostics, Mountain View, CA), and Polycheck Allergy (Biocheck GmbH, Munster, Germany). Forty sera that tested positive with the RIDA Allergy Screen (20 for food and 20 for inhalant panel) were subjected to MAST Optigen and Polycheck Allergy. For 26 available sera with discrepant results, 62 ImmunoCAP allergen-specific IgE tests (Pharmacia Diagnostics, Uppsala, Sweden) were performed. Percent agreements (kappa value) were 87.6% (0.59) and 91.3% (0.60) between RIDA and MAST; 89.9% (0.55) and 88.3% (0.46) between RIDA and Polycheck; and 86.8% (0.51) and 90.6% (0.61) between MAST and Polycheck. Compared with ImmunoCAP, agreements (kappa value) of inhalant and food panels were 51.7% (0.04) and 33.3% (−0.38) for RIDA; 60.7% (0.27) and 81.8% (0.59) for MAST; and 65.5% (0.26) and 45.5% (0.07) for Polycheck. The agreements between RIDA, MAST, and Polycheck and ImmunoCAP-positivity were 45.7%, 88.2%, and 28.6%, respectively, and the agreements for ImmunoCAP-negativity were 37.0%, 51.9%, and 88.9%. MAST Optigen showed better agreement with ImmunoCAP than other assays in the food panel. Better sensitivity of MAST Optigen and better specificity of Polycheck Allergy were suspected.

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RESEARCH ARTICLE

The Role of IgE-Receptors in IgE-Dependent Airway Smooth Muscle Cell Remodelling

• Michael Roth mail,
 
• Jun Zhong,
 
• Celine Zumkeller,
 
• Chong Teck S’ng,
 
• Stephanie Goulet,
 
• Michael Tamm

Abstract

Background

In allergic asthma, IgE increases airway remodelling but the mechanism is incompletely understood. Airway remodelling consists of two independent events increased cell numbers and enhanced extracellular matrix deposition, and the mechanism by which IgE up-regulates cell proliferation and extracellular matrix deposition by human airway smooth muscle cells in asthma is unclear.

Objective

Characterise the role of the two IgE receptors and associated signalling cascades in airway smooth muscle cell remodelling.

Methods

Primary human airway smooth muscle cells (8 asthmatics, 8 non-asthmatics) were stimulated with human purified antibody-activated IgE. Proliferation was determined by direct cell counts. Total collagen deposition was determined by Sircol; collagen species deposition by ELISA. IgE receptors were silenced by siRNA and mitogen activated protein kinase (MAPK) signalling was blocked by chemical inhibitors.

Results

IgE dose-dependently increased extracellular matrix and collagen deposition by airway smooth muscle cells as well as their proliferation. Specifically in cells of asthma patients IgE increased the deposition of collagen-type-I, -III, –VII and fibronectin, but did not affect the deposition of collagens type-IV. IgE stimulated collagen type-I and type-VII deposition through IgE receptor-I and Erk1/2 MAPK. Proliferation and deposition of collagens type-III and fibronectin involved both IgE receptors as well as Erk1/2 and p38 MAPK. Pre-incubation (30 minutes) with Omalizumab prevented all remodelling effects completely. We observed no changes in gelatinase activity or their inhibitors.

Conclusion & Clincal Relevance

Our study provides the molecular biological mechanism by which IgE increases airway remodelling in asthma through increased airway smooth muscle cell proliferation and deposition of pro-inflammatory collagens and fibronectin. Blocking IgE action prevents several aspects of airway smooth muscle cell remodelling. Our findings may explain the recently described reduction of airway wall thickness in severe asthma patients treated with humanised anti-IgE antibodies.

Citation: Roth M, Zhong J, Zumkeller C, S’ng CT, Goulet S, et al. (2013) The Role of IgE-Receptors in IgE-Dependent Airway Smooth Muscle Cell Remodelling. PLoS ONE 8(2): e56015. doi:10.1371/journal.pone.0056015 Open access.

Stratified medicine: drugs meet genetics

Eur Respir Rev March 1, 2013 vol. 22 no. 127 53-57

Stratified medicine: drugs meet genetics

1. Ian P. Hall⇓

+Author Affiliations

1. Division of Therapeutics and Molecular Medicine, Queen's Medical Centre, Nottingham, UK

1. I.P. Hall, Division of Therapeutics and Molecular Medicine D floor south block, Queen's Medical Centre, Nottingham, NG7 2UH, UK. E-mail:Ian.Hall@nottingham.ac.uk

Abstract

It is well recognised that genetic factors play a major role in the development of respiratory diseases such as asthma and chronic obstructive pulmonary disease. However, whilst extensive data exist on diseases caused primarily by single gene defects, such as α₁-antitrypsin deficiency, the genetic factors responsible for the development of complex disease are only now being defined. Once the gene(s) responsible for the heritable element of disease risk are known, the next step is to identify the mechanisms underlying the pathophysiological effects of the causal mutations in these genes. This process can be time consuming, but allows a full understanding of the mechanisms underlying disease development to be obtained. This knowledge can then potentially be used to stratify patient groups within (or even across) disease boundaries and then to target therapy more effectively.

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The impact of personalised therapies on respiratory medicine

Eur Respir Rev March 1, 2013 vol. 22 no. 127 72-74

The impact of personalised therapies on respiratory medicine

1. J. Stuart Elborn⇓

+Author Affiliations

1. Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK

1. J.S. Elborn, Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Health Sciences Building 97 Lisburn Road BelfastBT9 7BL, UK. E-mail: s.elborn@qub.ac.uk

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Abstract

Stratified approaches to treating disease are very attractive, as efficacy is maximised by identifying responders using a companion diagnostic or by careful phenotyping. This approach will spare non-responders form potential side-effects. This has been pioneered in oncology where single genes or gene signatures indicate tumours that will respond to specific chemotherapies. Stratified approaches to the treatment of asthma with biological therapies are currently being extensively studied. In cystic fibrosis (CF), therapies have been developed that are targeted at specific functional classes of mutations. Ivacaftor, the first of such therapies, potentiates dysfunctional cystic fibrosis transmembrane conductance regulator (CFTR) protein Class III mutations and is now available in the USA and some European countries. Pivotal studies in patients with a G551D mutation, the most common Class III mutation, have demonstrated significant improvements in clinically important outcomes such as spirometry and exacerbations. Sweat chloride was significantly reduced demonstrating a functional effect on the dysfunctional CFTR protein produced by the G551D mutation. Symptom scores are also greatly improved to a level that indicates that this is a transformational treatment for many patients. This stratified approach to the development of therapies based on the functional class of the mutations in CF is likely to lead to new drugs or combinations that will correct the basic defect in many patients with CF.

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