PurposeNasal polyposis is a chronic inflammatory disease of the upper airways often associated with asthma and characterized by markedly increased numbers of eosinophils, Th2 type lymphocytes, fibroblasts, goblet cells and mast cells. Previous studies have shown elevated levels of thymic stromal lymphopoietin (TSLP) in atopic diseases like asthma, atopic dermatitis and mainly in animal models of allergic rhinitis (AR). Here, we investigated the expression of TSLP in nasal polyps from atopics and non-atopics in comparison with the nasal mucosa and its potential role in nasal polyposis.MethodsMessenger RNA expression for TSLP, thymus and activation-regulated chemokine (TARC) and macrophage derived chemokine (MDC) in nasal polyps and nasal mucosa of atopics and non-atopics was analyzed by real time PCR. Immunoreactivity for TSLP in nasal polyps and in the nasal mucosa of patients with AR and non-allergic rhinitis (NAR) was analyzed by immunohistochemistry. Eosinophil counts was analyzed by Wright-Giemsa staining and nasal polyp tissue IgE, by ELISA.ResultsMessenger RNA expression for TSLP,TARC and MDC was markedly higher in nasal polyps as compared to the allergic nasal mucosa. Immunoreactivity for TSLP was detected in epithelial cells, endothelial cells, fibroblasts and inflammatory cells of the nasal mucosa and nasal polyps. The number of TSLP+ cells was significantly greater in the nasal mucosa of AR than NAR patients. The number of TSLP+ cells in nasal polyps from atopics was significantly greater than that of non-atopics and that in the allergic nasal mucosa. The number of TSLP+ cells correlated well with the number of eosinophils and the levels of IgE in nasal polyps.ConclusionsThe high expression of TSLP in nasal polyps and its strong correlation to eosinophils and IgE suggest a potential role for TSLP in the pathogenesis of nasal polyps by regulating the Th2 type and eosinophilic inflammation.

No abstract

No abstract

Objective: Sublingual immunotherapy (SLIT) for allergic rhinitis due to Japanese cedar ( JC) pollisosis was investigated to examine its clinical efficacy and adverse effects, as well as the changes of serum antibodies.Research design and methods: A placebo-controlled, double-blind study was performed with 12 patients in the SLIT group and 16 patients in the placebo group. Treatment was started before the JC pollen season and was continued until after the pollen season. The SLIT group received daily up-titration of a JC pollen allergen extract over 2 weeks, followed by maintenance therapy twice weekly. The placebo group received the vehicle of the allergen extract at the same dosage. Subjects kept symptom diaries during the JC pollen season.Main outcome measures: Scores were assigned for nasal symptoms (sneezing, itching, rhinorrhea, and obstruction) and the total nasal symptom score (TNSS) was calculated during the pollen season. Immunoglobulin levels were measured before and after treatment.Results: During the 90-day period from February 1 to April 30, the sneezing score, nasal itching score, rhinorrhea score, nasal congestion score, and TNSS were significantly lower in the SLIT group than the placebo group for 15, 15, 33, 22, and 37 days, respectively. Serum levels of JC allergen-specific IgG and IgE showed no significant difference between the 2 groups before treatment, but were significantly higher in the SLIT group than the placebo group after the pollen season. Although JC allergen-specific IgG4 was also higher in the SLIT group after the pollen season, there was no significant difference. The IgG4/IgG ratio showed no significant difference between the two groups either before treatment or after the pollen season. Adverse events were only Grade 1 in both groups and resolved spontaneously.Conclusions: SLIT suppressed symptoms of JC pollinosis and increased the JC-specific IgG4/IgG ratio in the first season of treatment.

ObjectiveThis double-blind, placebo-controlled comparative study was designed to investigate whether pranlukast dry syrup, a leukotriene receptor antagonist, has a protective effect against priming, controlled pollen exposure, and natural pollen exposure in children with Japanese cedar pollinosis.Research design and methodsThirty children aged 12–15 years with Japanese cedar pollinosis (positive skin test for Japanese cedar pollen), who had suffered from pollinosis for at least 2 years and developed severe nasal obstruction when exposed to Japanese cedar pollen, were enrolled in this study. They were randomly allocated to treatment with pranlukast or placebo orally after breakfast and dinner for 8 weeks during the Japanese cedar pollen season. Soon after the start of the pollen season, all subjects underwent a challenge by exposure for 3 h to Japanese cedar pollen (8000 grains/m3) in an artificial exposure chamber (OHIO chamber).Clinical trial registrationThe University Hospital Medical Information Network in Japan (UMIN000009840).Main outcome measuresThe effect of pranlukast was evaluated using self-rating of nasal symptoms by the subjects and measurement of eosinophil cationic protein in nasal discharge specimens.ResultsScores for the symptoms of pollinosis were lower in the pranlukast group than in the placebo group during treatment in the priming state, as well as after controlled pollen exposure and natural pollen exposure. Pranlukast significantly improved the score for nasal obstruction, compared with placebo. A correlation was found between changes of the scores for symptoms of pollinosis and changes of the eosinophil cationic protein level.ConclusionsThese results confirm a protective effect of pranlukast against both priming and challenge (controlled and natural) with Japanese cedar pollen. The present findings suggested that pranlukast dry syrup may be useful for prophylaxis against pollinosis in children.