OBJECTIVETo explore the effect of endotoxin concentration in dwellings on the prevalence of atopic asthma in children.

METHODSStandardized questionnaires of asthma were distributed to the parents of 2986 school children aged between 8 and 12 years and endotoxin content in children's mattress was measured by a kinetic limulus assay. A radioallergosorbent technique--fluorescence enzyme immunoassay (RAST-FEIA) was used to measure the level of specific IgE in serum.

RESULTSComplete data was available for 904 children with males more than females. There were both negative associations seen between endotoxin levels and both atopic asthma (OR = 0.48, 95% CI: 0.32-0.72, P < 0.05) and atopic sensitization (OR = 0.65, 95% CI: 0.49-0.94, P < 0.05) but not with non-atopic asthma and wheeze. Comparing with normal people, patients with atopic sensitization, atopic wheeze and atopic asthma had a higher levels of endotoxin (M-W U: 15 138.0, P < 0.01, M-W U: 4858.0, P < 0.01, M-W U: 4041.0, P < 0.01).

CONCLUSIONExposure to endotoxin in early lives of children might have a protective effect on atopic asthma and sensitization.

Asthma ; epidemiology ; prevention & control ; Child ; China ; epidemiology ; Data Collection ; Endotoxins ; blood ; Environmental Exposure ; Humans ; Hypersensitivity, Immediate ; epidemiology ; Immunoglobulin E ; blood ; Respiratory Sounds

OBJECTIVE: To investigate aeroallergen spectrum and allergy positive rates of patients with child allergic rhinitis and analyze its related factors. METHOD: Skin prick test was carried out in 562 cases with child allergic rhinitis using 13 inhaled allergens, and detailed history was collected in all cases. RESULT: Four hundred and fifty-seven (81.3%) of 562 cases showed positive reaction to at least one allergen out of 13 allergens. The most common allergens found in patients was Dermatophagoides farinae and Dermatophagoides pteronyssinus, and positive reaction was 93.1% in child allergic rhinitis, followed by tropical mite, Periplaneta americana, Blattella germanica and dog hair. The pollen allergen, most common in American and European, was pretty rare in this study. The prevalence of child allergic rhinitis was significantly higher in urban than in rural (P<0.01). There was no adverse effect appeared in children with allergic rhinitis underwent skin prick test. CONCLUSION The major allergen of allergic rhinitis is mite for child allergic rhinitis, and relates to housing enviroment. Most of patients with child allergic rhinitis can be treated by the mite specific immunotherapy. The skin prick test is a safe technique for diagnosis of children with allergic rhinitis.
Allergens ; immunology ; Animals ; Asthma ; epidemiology ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Hypersensitivity, Immediate ; immunology ; Male ; Mites ; immunology ; Rhinitis, Allergic, Perennial ; epidemiology ; immunology ; Skin Tests

The bronchial pathology of asymptomatic airway hyperreponsiveness (AHR) subjects is not well understood, and the role of atopy in the development of airway remodeling is unclear. The aim of this study was to evaluate whether atopy is associated with airway remodeling in asymptomatic AHR subjects. Five groups, i.e., atopic or non-atopic subjects with asymptomatic AHR, atopic or non-atopic healthy controls, and subjects with mild atopic asthma, were evaluated by bronchoscopic biopsy. By electron microscopy, mean reticular basement membrane (RBM) thicknesses were 4.3+/-1.7 micrometer, 3.4+/-1.8 micrometer, 2.5+/-1.5 micrometer, 2.6+/-1.1 micrometer, and 2.3+/-1.2 micrometer in the mild atopic asthma, atopic and non-atopic asymptomatic AHR, atopic and nonatopic control groups, respectively (p=0.002). RBM thicknesses were significantly higher in the mild atopic asthma group and in the atopic asymptomatic AHR group than in the other three groups (p=0.048). No significant difference in RBM thickness was observed between the atopic asymptomatic AHR group and the mild atopic asthma group (p>0.05), nor between non-atopic asymptomatic AHR group and the two control groups (p>0.05). By light microscopy, subepithelial layer thicknesses between the groups showed the same results. These findings suggest that RBM thickening occurs in subjects with atopic asymptomatic AHR, and that atopy plays an important role in airway remodeling.
Adult ; Asthma/epidemiology/*pathology ; Basement Membrane/*pathology/ultrastructure ; Biopsy ; Bronchi/pathology ; Bronchial Hyperreactivity/epidemiology/*pathology ; Bronchoscopy ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Hypersensitivity, Immediate/*epidemiology ; Male ; Microscopy, Electron ; Respiratory Mucosa/*pathology/ultrastructure ; Risk Factors

Interleukin (IL)-12 activates T helper (Th) 1 cells to produce interferon (IFN)-gamma which inhibits atopic inflammation. IL-12 acts through interaction with its receptor, especially beta2 subunit. In several studies, the low production of IFN-gamma in peripheral mononuclear cells of atopic patients on response to IL-12 stimulation has been reported. Therefore we investigated the IL-12 receptor beta2 (IL-12R beta2) mRNA expression and RNA editing, nucleotide 2451 C-to-U conversion, to find the cause of low responsiveness to IL-12 in atopy. Quantitative real time PCR for mRNA expression and sequence analysis for RNA editing were performed in 80 atopic patients and 54 healthy controls. The expression of IL-12R beta2 mRNA was significantly lower in atopic patients than healthy controls (p<0.05). In sequence analysis, RNA editing on nucleotide 2451 was not found from either atopic patients or healthy controls. In additional evaluation, there was no relationship between expression of IL-12R beta2 mRNA and serum total IgE or blood eosinophil count. Reduced IL-12R beta2 mRNA expression in atopic patients indicate the reduced capacity to respond to IL-12 which induce IFN-gamma production and this may contribute to Th2-skewed immune response in atopy.
Sensitivity and Specificity ; Risk Factors ; Risk Assessment/*methods ; Reproducibility of Results ; Receptors, Interleukin-12/*genetics/metabolism ; RNA, Messenger/*genetics/*metabolism ; RNA Editing/genetics ; Male ; Korea/epidemiology ; Hypersensitivity, Immediate/*epidemiology/*genetics/metabolism ; Humans ; Genetic Predisposition to Disease/epidemiology/genetics ; Female ; Biological Markers/metabolism ; Adult

BACKGROUND: An association between obesity and asthma has been reported. The prevalence of airway hyperresponsiveness (AHR), results of skin prick tests, body mass index (BMI), and asthma symptoms were examined in schoolchildren. METHODS: The results of BMI (kg/m2) determination, skin prick testing, spirometry, asthma questionnaires, and methacholine challenge tests were obtained in a cross-sectional survey of 667 schoolchildren. The methacholine concentration causing a 20% fall in FEV1 (PC20) was used as the threshold of AHR. If the PC20 was less than 16 mg/mL, the subject was considered to have methachloine mediated AHR. RESULTS: The mean BMI was 17.1+/-0.09 kg/m2. The prevalence of AHR was 42.7%. The sensitization rate to common inhalant allergens was 30.3%. PC20 in children with BMIs >or=17.1 kg/m2 was significantly lower than that in children with BMIs 17.1 kg/m2. The mean BMIs of boys and girls were not significantly different. The levels of PC20 by sex were not different. The children were grouped by sex into percentile of BMI. PC20 in boys was lower in the obese group than in the non-weight and overweight groups (p<0.05). PC20 in boys and girls with atopy was significantly lower than in those without atopy. In a multiple logistic regression model that included all of the children and adjusted for confounding variables, independent associations with AHR were seen with BMI, asthma symptoms, and atopy . CONCLUSIONS: BMI had an association with AHR in school-age boys.
Sex Factors ; *Schools ; Risk Factors ; Questionnaires ; Obesity/*physiopathology ; Methacholine Chloride/*pharmacology ; Male ; Korea/epidemiology ; Hypersensitivity, Immediate/epidemiology/physiopathology ; Humans ; Health Surveys ; Female ; Comorbidity ; Child ; Bronchial Hyperreactivity/epidemiology/*physiopathology ; Body Mass Index ; Asthma/*physiopathology ; Age Factors

OBJECTIVE: To investigate aeroallergen spectrum of patients with allergic rhinitis in Enshi area and analyze its related factors. METHOD: Skin prick test was carried out in 463 patients with allergic rhinitis with 13 inhaled allergens. Detailed history was collected in all cases. RESULT: Three hundred and eighty-seven cases (83.6%) showed positive reaction to at least one allergen of 13 allergens. The most common allergens found in patients were Dermatophagoides farinae and Dermatophagoides pteronyssinus, followed by tropical mite, Periplaneta americana, Blattella germanica and dog hair. The positive reaction rate of single specie allergen were 51.9%, and most of them was positive to mites (49.6%). The positive reaction degree was significantly related to family history, asthma, age and housing enviroment. CONCLUSION The major allergen of allergic rhinitis was mite. The positive reaction degree related to genetics, asthma, age and housing enviroment.
Adolescent ; Adult ; Aged ; Allergens ; immunology ; Animals ; Asthma ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Hypersensitivity, Immediate ; immunology ; Male ; Middle Aged ; Mites ; immunology ; Rhinitis, Allergic, Perennial ; epidemiology ; immunology ; Skin Tests ; Young Adult

BACKGROUND: Some bacterial and viral infections may reduce the risk of atopy, and this is based on the concept of their ability to divert the immune system towards the Th1 responses. Most of the hepatitis B virus (HBV) infections occur in the developing countries and this is where atopic disorders are least prevalent. Th1 responses are important for the viral clearance of HBV and also for antibody production. The aim of the study is to investigate whether the presence of antibodies to the hepatitis B surface antigen (anti-HBs) is inversely associated with atopy in adults. METHODS: A random sample of 358 subjects, who were without hepatitis B surface antigen, was recruited; they were aged from 18 to 79 years (105 young adults aged < or=40 years and 253 older adults aged > 40 years). Determinations of the anti-HBs and skin prick tests using aeroallergens were performed. Those subjects with one or more positive skin reactions (a mean wheal diameter > or=3 mm) were considered atopic. RESULTS: The prevalence rate of atopy (p=0.035) or the sensitization to Dermatophagoides farinae (p=0.01) was significantly lower in the subjects with anti-HBs than in those subjects without anti-HBs for the young adults, but not for the older adults. The logistic regression analysis that was done on the young adults showed that the presence of anti-HBs was associated with a significantly lower risk of atopy (the odds ratio adjusted for confounding variables=0.40 [95% CI 0.16-0.98], p=0.046) or with the sensitization to D. farinae (0.20 [0.06-0.65], p=0.008). CONCLUSION: The presence of anti-HBs produced by a natural HBV infection or vaccination might be inversely associated with atopy in young adults.
Risk Factors ; Prevalence ; Middle Aged ; Male ; Korea/epidemiology ; Immunologic Factors ; Immunoglobulin E/biosynthesis ; Hypersensitivity, Immediate/*immunology ; Humans ; *Hepatitis B virus ; Hepatitis B Surface Antigens/*immunology ; Hepatitis B Antibodies/*immunology ; Hepatitis B/*virology ; Female ; Cross-Sectional Studies ; Aged ; Age Factors ; Adult ; Adolescent

OBJECTIVETo investigate the incidence of local reactions (LRs) and systemic reactions (SRs) of subcutaneous immunotherapy (SCIT) and to analyze the potential risk factors of such reactions in Chinese population.

METHODThis is a retrospective study on 234 dust mite sensitized patients with allergic rhinitis and asthma who received allergen immunotherapy in our hospital from 2003 to 2010. Chart review was conducted to capture clinical data of reactions to immunotherapy. Parameters included signs and symptoms, the onset of reaction, and interventions in treating such reactions, particularly, the administration of epinephrine (EPI) and adjustment of vaccine dosage due to LRs and SRs.

RESULTThe 234 patients received a total of 7679 injections. Among them, 4973 LRs (64.8%) and 235 SRs (3.1%) were observed in 67 patients (28.6% of all patients). SRs included respiratory symptoms (205 events, 88.4%) and cutaneous symptoms (31.5%). Of the total of 235 SR events, 212 (90.2%) were presented as mild SRs and 23 (9.8%) were in severe SR category (grade III and grade IV, EAACI grading system). Overall, severe SRs accounted for 0.3% of total injections. Seventeen of the 23 SR events required epinephrine treatment (0.2% of total injections). Of the 67 patients, 61 completed the course of treatment after dose adjustment; 36 patients had their doses decreased prior to further advancing to target dose. Nineteen subjects tolerated splitting two injections at 30 minutes interval. Six patients advanced the dose based on protocol and another 6 had to stop immunotherapy. Most of the SRs (77.4%) occurred during the maintenance phase of immunotherapy. The levels of TIgE, SIgE D1 and SIgE D2 were found to be significantly higher in patients with SRs comparing to patients without SRs (P < 0.05). SRs more commonly occurred in patients with age less than 14 years than their older counterparts (95.5% vs. 85.6%, OR = 3.58, 95%CI = 1.040 - 12.322, P < 0.01). The incidence of SRs were significantly higher in asthma patients who received SCIT than non-asthma patients (OR = 2, 95%CI = 1.136 - 4.624).

CONCLUSIONOur study suggests that risk factors of SRs include maintenance phase (higher allergen vaccine doses), patients with asthma, age of less than 14 years, higher levels of TIgE, and SIgE D1 and SIgE D2. Effective management includes proper dose adjustment, splitting doses into 2 injections at 30 min apart, and strictly following immunotherapy indications.

Adolescent ; Adult ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; immunology ; Asthma ; immunology ; therapy ; Child ; Child, Preschool ; Desensitization, Immunologic ; adverse effects ; methods ; Female ; Humans ; Hypersensitivity, Immediate ; epidemiology ; etiology ; therapy ; Injections, Subcutaneous ; Male ; Middle Aged ; Mites ; immunology ; Retrospective Studies ; Rhinitis, Allergic, Perennial ; immunology ; therapy ; Risk Assessment ; Treatment Outcome ; Young Adult