Azelastine intranasal spray reduces SP release into nasal lavage fluid of NAR patients immediately after hypertonic nasal saline challenge. Reduction of neuropeptide release may be an important aspect of the clinical efficacy of topical azelastine in perennial NAR patients.
Hymenoptera venoms are known to cause life-threatening IgE-mediated anaphylactic reactions in allergic individuals. Venom immunotherapy is a recommended treatment of insect allergy with still the mechanism not being completely understood. We decided to assess the serum CCL5/RANTES level in patients who experienced severe anaphylactic reaction to Hymenoptera venom and to find out changes in the course of immunotherapy. Twenty patients (9 men, 11 women, mean age: 31.91 ± 7.63 years) with history of anaphylactic reaction after insect sting were included into the study. Diagnosis was made according to sIgE and skin tests. All of them were enrolled into rush venom immunotherapy with bee or wasp venom extracts (Pharmalgen, ALK-Abello, Horsholm, Denmark). Serum levels of CCL5/RANTES were measured using a commercially available ELISA kit (R&D Systems, Minneapolis, MN). CCL5/RANTES serum concentration are higher in insect venom allergic patients than in healthy controls (887.5 ± 322.77 versus 387.27 ± 85.11 pg/ml). Serum concentration of CCL5/RANTES in insect venom allergic patient was significantly reduced in the course of allergen immunotherapy already after 6 days of vaccination (887.5 ± 322.77 versus 567.32 ± 92.16 pg/ml). CCL5/RANTES serum doesn't correlate with specific IgE. Chemokine CCL5/RANTES participates in allergic inflammation induced by Hymenoptera venom allergens. Specific immunotherapy reduces chemokine CCL5/RANTES serum level already after initial days of venom immunotherapy.
IntroductionA pathomechanism of allergic rhinitis is complex. A neurogenic mechanism seems to play a significant role in this phenomenon.AimThe evaluation of influence of specific immunotherapy of mugwort pollen allergic patients on the bradykinin concentration in the nasal lavage fluid.Material and methodsThe study included 22 seasonal allergic rhinitis patients. Thirty persons with monovalent allergy to mugwort pollen, confirmed with skin prick tests and allergen-specific immunoglobulin E, underwent a 3-year-long allergen immunotherapy with the mugwort extract (Allergovit, Allergopharma, Germany). The control group was composed of 9 persons with polyvalent sensitivity to pollen, who were treated with pharmacotherapy. Before the allergen-specific immunotherapy (AIT) and in subsequent years before the pollen seasons, a provocation allergen test with the mugwort extract was performed, together with collection of nasal fluids, where bradykinin concentration was determined according to Proud method.ResultsThere were similar levels of bradykinin in both groups at baseline prior to therapy (AIT group: 584.0 ±87.2 vs. controls 606.3 ±106.5 pg/ml) and changes after allergen challenge 1112.4 ±334.8 vs. 1013.3 ±305.9 pg/ml as well. The bradykinin concentration in nasal lavage fluid after mugwort challenge in 1 year was lower in the AIT group (824.1 ±184.2 pg/ml vs. 1000.4 ±411.5 pg/l; p < 005) with a further significant decrease after the 2nd and 3rd year of specific immunotherapy. Significant reduction of symptoms and medications use was observed in hyposensitized patients.ConclusionsA decreased level of bradykinin as a result of AIT suggests that some of the symptomatic benefits of AIT may be related to the reduced release of bradykinin into nasal secretions. These values correlate with clinical improvement within the course of treatment.
Artykuł oryginalny/Original research articleWpływ swoistej immunoterapii alergenowej na stężenie substancji P w popłuczynach nosowych chorych na alergiczny nieżyt nosa uczulonych na pyłek bylicy Substance P in nasal lavage fluid of mugwort pollen allergic rhinitis patients after three years course of specific immunotherapy
The nasal epithelium is considered to play an active role in the allergic inflammation through its capacity to synthesize and release a wide range of cytokines and mediators. Few studies have investigated the involvement of endothelin-1 in the pathogenesis of inflammatory diseases of the upper airways. To examine the release of endothelin-1 from nasal mucosa after allergen challenge we investigated 24 patients. 15 subjects (7 male, 8 female) allergic to birch pollen aged 37.1 +/- 4.9 years participated in the study. Nasal birch allergen provocation with following lavage was performed in all subjects. Endothelin-1 in the nasal secretion were assayed before and after challenge. Increase in concentration of endothelin-1 in nasal lavage fluid from allergic patients were significantly higher than in control group respectively from 18.33 +/- 5.47 fmol/ml to 26.41 +/- 6.92 fmol/ml versus 18.8 +/- 3.99 to 19.80 +/- 4.18 fmol/ml (p < 0.05) in controls. We conclude that endothelin-1 could be involved in the pathogenesis of seasonal allergic rhinitis.
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