Serum interleukin-36γ levels in children with allergic rhinitis: a cross-sectional study

Background: Eosinophil cationic protein (ECP) is present in eosinophil granules. It has been associated with eosinophil-associated disorders. Objective: We compared serum ECP levels in allergic and non-allergic rhinitis patients and evaluated the association with the eosinophil count and the total IgE level. Method: We retrospectively reviewed medical records and categorized enrolled patients into the allergic (AR) and non-allergic rhinitis (NAR) groups. ECP, eosinophil count, and total IgE levels were reviewed in both groups. The association between ECP and the eosinophil count and total IgE level was further evaluated according to commonly detected specific antigens. Results: Six hundred and ten adults were included in the study. In the AR group (n=349), the median age was 27.0 (23.0-42.0) years and the female:male ratio was 0.26:1. In the NAR group (n=261), the median age was 32.0(24.0-45.5) years and the female:male ratio was 0.33:1. We found that ECP (AR: 18.8(9.9-31.4), NAR: 14.8(8.2-24.9), p=0.003), eosinophil count (AR: 191.0(112.0-308.5), NAR: 149.0(91.0-249.0), p=0.002) and total IgE (AR: 166.0(58.4-422.5), NAR: 68.8(24.5-141.0), p<0.001) were higher in AR than in NAR patients. The ECP level was associated with the eosinophil count in both the AR (p<0.001) and NAR groups (p<0.001). A significant correlation between the ECP level and eosinophil count was demonstrated in AR patients who were skin test positive against house dust mite, animal and pollen allergens. Conclusions: We suggest that ECP could be an important mediator in the pathogenesis of AR. The level of serum ECP was positively correlated with eosinophilia in AR patients regardless of the type of allergen sensitization. However, further study is warranted to verify the role of ECP in the clinical management of allergic rhinitis. Key words: eosinophil cationic protein, immunoglobulin E, eosinophil count, allergic rhinitis, MAST DOI 10.12932/AP0739

Objective Evaluating the serum level of IL-35, IL-36γ and CCL27 cytokines expression in patients with psoriasis and to explore their correlation with disease severity. To explore the role of these cytokines in the pathogenesis of psoriasis vulgaris and to guide clinical practice. Methods Thirty patients with psoriasis vulgaris (PV) were treated with routine drug treatment for7 weeks, and 30 healthy controls were used as control group. Peripheral blood of the PV group before and after treatment and control group were detected by double-antibody sandwich ELISA. The expression levels of IL-35, IL-36γ and CCL27 in peripheral blood were analyzed statistically. Results The expression of IL-35 in the peripheral blood of the pre-PV group (187.54 ± 172.41) was significantly lower than that of the control group (310.52 ± 174.22) and the PV treatment group (417.75 ± 47.07). The level of IL-36γ in peripheral blood of pre-PV group (295.11 ± 27.91) was higher than that of control group (155.40 ± 45.66) and PV treatment group (209.86 ± 27.91). The level of CCL27 in peripheral blood of patients pre-PV treatment (479.06 ± 285.80) was significantly higher than that of the control group (341.53 ± 98.72) and the group after PV treatment (316.56 ± 245.53). There was a negative correlation between IL-35 and IL-36γ levels in serum (r= –0.826, p < .001); IL-36γ was positively correlated with CCL27 level (r = 0.906, p < .001); IL-35 and CCL27 levels were negative correlation (r= –0.810, p < .001). Conclusion IL-36γ and CCL27 may be involved in the pathogenesis of psoriasis as a pro-inflammatory factor. IL-35 may be involved in the pathogenesis of psoriasis as an anti-inflammatory factor.

ObjectiveLong noncoding RNA nuclear enriched abundant transcript 1 (lnc‐NEAT1) and its target microRNA‐125a (miR‐125a) are reported to regulate immune and inflammation process in allergic rhinitis (AR). Hence, this study intended to investigate the correlation between lnc‐NEAT1 and miR‐125a expressions, as well as their clinical values in pediatric AR patients.MethodsPeripheral blood mononuclear cell samples from 80 pediatric AR patients, 40 disease controls (DCs), and 40 healthy controls (HCs) were collected to detect lnc‐NEAT1 and miR‐125a expressions by reverse transcription‐quantitative polymerase chain reaction. For pediatric AR patients only, serum interferon‐gamma (IFN‐γ) and interleukin (IL)‐10 were measured by enzyme linked immunosorbent assay; meanwhile, T helper (Th) 1 and Th2 cells in CD4+ T cells were analyzed by flow cytometry.ResultsLnc‐NEAT1 was overexpressed, while miR‐125a downregulated in pediatric AR patients compared to DCs and HCs (all p < 0.001). Moreover, lnc‐NEAT1 expression negatively correlated with miR‐125a expression in pediatric AR patients (p = 0.002), but not in DCs (p = 0.226) or HCs (p = 0.237). Furthermore, in pediatric AR patients, lnc‐NEAT1 expression positively associated with TNSS (p < 0.001), sneezing score (p = 0.006), and congestion score (p = 0.008); miR‐125a expression was negatively related to TNSS (p < 0.001), itching score (p = 0.040), and sneezing score (p = 0.005). Additionally, lnc‐NEAT1 expression positively, while miR‐125a expression negatively correlated with Th2 cells and IL‐10 (all p < 0.05), but they were not correlated with Th1 cells or IFN‐γ in pediatric AR patients.ConclusionCirculating lnc‐NEAT1 and miR‐125a are aberrantly expressed and linked with Th2 cells and symptom severity in pediatric allergic rhinitis.

Singapore is a unique blend of a tropical environment with a high standard of hygiene and public health care. The objective was to define the prevalence, clinical characteristics, and environmental risk factors of specific aeroallergen sensitization in pediatric allergic rhinitis patients in this unique environment. The method adopted was a retrospective analysis of allergic rhinitis patients, undergoing aeroallergen skin prick testing (SPT), in the outpatient specialty clinic of the KK Children's hospital, from July 2001 to June 2002. A total of 202 patients were included, 161 (80%) males, 167 (83%) Chinese, age mean 7.6 yr (range 2-14 yr). The most prevalent clinical symptoms were: watery rhinorrhea 61%, blocked nose 61%, sneezing 52%, snoring 17%, and epistaxis 12%. SPT results were positive for house dust mites in 97% of children, pets (20%), molds (19%), pollens (15%), and kapok (10%). Mold sensitization was significantly more prevalent in households without air-conditioning (aircon), 49% vs. 10% with aircon (odds ratio 9.4, 95% CI 3.8-22.9). Polysensitization (sensitization to three or more allergens) was similarly more prevalent in households without aircon, 51% vs. 14% with aircon (odds ratio 6.4, 95% CI 2.8-14.7). It was concluded that indoor aeroallergen sensitization is the major associated factor with clinical allergic rhinitis in children in Singapore. Patients living in households without air-conditioning are at increased risk of mold sensitization and polysensitization.

Objective: The aim of this study is to calculate the eosinophil-to-lymphocyte ratio (ELR) before and after the treatment with subcutaneous immunotherapy (SCIT) and to investigate if ELR decreases after the treatment. The results will support our hypothesis of using the ELR as a diagnostic and prognostic parameter in allergic rhinitis (AR) patients. Study Design: This study was planned and performed as a case–control study. Materials and Methods: In this prospective study, we have collected the data from 68 pediatric patients (aged between 9 and 18 years) who have been treated with 4-year SCIT and whose skin prick test was negative after treatment of AR. ELRs were compared based on the hemogram results before SCIT and approximately 4 years later. Patients who have the inflammatory disease were eliminated from the study since lymphocytes were increased in the blood biochemistry tests. Results: When the eosinophil counts were compared before and after the immunotherapy, it was observed that the eosinophil ratios were decreased from 7.14 ± 4.63 to 4.55 ± 2.98; (P = 0.000) after treatment. Lymphocyte count also decreased from 34.8 ± 10.3 to 32.9 ± 8.3 (P = 0.091). After SCIT, ELRs were significantly lower (P &lt; 0.001). While the mean ± standard deviation (SD) value of ELR was 0.18 (0–0.66) before the treatment, the mean ± SD value after SCIT was 0.11 (0.01–0.67). Total immunoglobulin E decreased from 96.9 ± 10 to 82 ± 11, which was not statistically significant (P = 0.058). Conclusion: A statistically significant decrease in ELR was observed in patients whose skin prick test was negative after immunotherapy. ELR would be as valuable as a skin prick test for diagnostic and prognostic purposes.

Crimean-Congo hemorrhagic fever (CCHF) is a severe viral disease. The scientific literature is growing, emphasizing the significance of the interleukin (IL)-36 family in the proinflammatory signaling pathway. However, to date, no research has explored the potential of IL-36 family members as biomarkers in CCHF. This study aims to bridge this gap by evaluating IL-36α, IL-36β, and IL-36γ levels in CCHF patients and healthy controls and investigating their association with disease severity and prognosis. Sixty confirmed CCHF patients and 29 healthy controls were enrolled in this case-control study. Serum levels of IL-36α, IL-36β, and IL-36γ were measured using enzyme-linked immunosorbent assays. Significantly higher levels of IL-36α and IL-36β were observed in CCHF patients compared to healthy controls (p < 0.05). However, no statistically significant changes were found in IL-36γ levels between the two groups. Among the CCHF patients, those who did not survive exhibited significantly elevated IL-36α and IL-36γ levels compared to survivors (p < 0.01). Positive correlations were identified between IL-36α and IL-36γ levels with activated partial thromboplastin time, and D-dimer (p < 0.01). Conversely, platelet levels showed a negative correlation with IL-36α and IL-36γ levels (p < 0.01). The increased levels of IL-36α, IL-36β, and IL-36γ in patients indicate their participation in proinflammatory reactions in CCHF patients. Understanding the role of IL-36 family members in CCHF pathogenesis could offer valuable insights into disease progression and facilitate the development of targeted therapeutic strategies.

Eosinophil cationic protein (ECP) is present in eosinophil granules. It has been associated with eosinophil-associated disorders. We compared serum ECP levels in allergic and non-allergic rhinitis patients and evaluated the association with the eosinophil count and the total IgE level. We retrospectively reviewed medical records and categorized enrolled patients into the allergic (AR) and non-allergic rhinitis (NAR) groups. ECP, eosinophil count, and total IgE levels were reviewed in both groups. The association between ECP and the eosinophil count and total IgE level was further evaluated according to commonly detected specific antigens. Six hundred and ten adults were included in the study. In the AR group (n=349), the median age was 27.0(23.0-42.0) years and the female:male ratio was 0.26:1. In the NAR group (n=261), the median age was 32.0(24.0-45.5) years and the female:male ratio was 0.33:1. We found that ECP (AR: 18.8(9.9-31.4), NAR: 14.8(8.2-24.9), p=0.003), eosinophil count (AR: 191.0(112.0-308.5), NAR: 149.0(91.0-249.0), p=0.002) and total IgE (AR: 166.0(58.4-422.5), NAR: 68.8(24.5-141.0), p<0.001) were higher in AR than in NAR patients. The ECP level was associated with the eosinophil count in both the AR (p<0.001) and NAR groups (p<0.001). A significant correlation between the ECP level and eosinophil count was demonstrated in AR patients who were skin test positive against house dust mite, animal and pollen allergens. We suggest that ECP could be an important mediator in the pathogenesis of AR. The level of serum ECP was positively correlated with eosinophilia in AR patients regardless of the type of allergen sensitization. However, further study is warranted to verify the role of ECP in the clinical management of allergic rhinitis.

Rhinitis: allergic or not?

&lt;b&gt;Background:&lt;/b&gt; Allergic rhinitis is a recurrent inflammation of the nasal mucosa that is triggered by various allergens and has an extremely negative impact on the quality of a patient's life. With the increasing morbidity of seasonal allergic rhinitis worldwide, the possibility of a deterioration in the course of the disease must be taken into account. Consequently, its prompt diagnosis is essential. High levels of total immunoglobulin E, eosinophil cationic protein and eosinophil count, along with appropriate clinical data, are associated with allergic rhinitis. However, studies regarding the relation of allergic reaction predictors with severity of allergic rhinitis symptoms are currently insufficient and inconsistent. &lt;b&gt;The objective of this study&lt;/b&gt; was to determine the total immunoglobulin E (IgE), eosinophil cationic protein (ECP) and eosinophil count in blood serum and to identify the relationship of each parameter with the severity of seasonal allergic rhinitis. &lt;b&gt;Methods:&lt;/b&gt; This cross-sectional study was conducted in the regional allergological center “DiVera” which is located in Karaganda city (central Kazakhstan). In order to perform statistical analysis, we used initial levels of seasonal allergic rhinitis markers and 4-point scale aspects for assessing symptoms (Daily Symptom Score). Allergic rhinitis markers were identified by using automatic modular and immunological analyzers. The study involved 49 patients aged 18-60 years with a diagnosis of seasonal allergic rhinitis. Verification of the diagnosis was carried out on the basis of a positive allergic anamnesis, objective and subjective patients data. Statistical analysis was performed using the “Statistica” software version 13.0 for Windows. The results were analyzed using descriptive statistics, and Spearman's rank correlation coefficient was applied to determine the relations between the studied parameters. &lt;b&gt;Results:&lt;/b&gt; The study revealed a positive direct, strong statistically significant relationship (p&lt;0.05) of all three serological markers - immunoglobulin E (r=0.96), eosinophilic cationic protein (r=0.91), and eosinophil count (r=0.86) with symptom severity of allergic rhinitis. &lt;b&gt;Conclusion:&lt;/b&gt; This correlation analysis revealed a relation of eosinophil count, total IgE and eosinophil cationic protein levels to symptom severity in seasonal allergic rhinitis. The concentration of serological markers could be an important predictor of allergic sensitization, particularly in adult patients.

Olfactory dysfunction in Japanese children with moderate-to-severe allergic rhinitis

Objectives: The primary objective of this study was to assess the prevalence of total serum IgE levels in patients with chronic spontaneous urticaria (CSU) attending the hospital, while the secondary goal was to evaluate the relationship between serum total IgE levels, disease severity, and disease duration. CSU is a common allergic skin disorder characterized by the recurrent appearance of itchy hives (wheals), angioedema, or both, occurring daily or at least twice weekly for 6 weeks or more. CSU presents with varying symptoms and has complex underlying causes. While its exact cause remains unclear, the prevailing hypothesis points to autoimmune dysfunction, where autoantibodies target immunoglobulin E (IgE) or its receptors, leading to histamine release from basophils and mast cells. Materials and Methods: This was a cross-sectional study that included 97 patients diagnosed with CSU. Total serum IgE levels and disease severity were assessed. Results: The total serum IgE levels ranged between 32 and 942 IU/mL, with a mean score of 200 IU/mL. The prevalence of elevated IgE levels (&gt;150 IU/mL) was 50.5% among patients. Patients with higher IgE levels tended to have more severe disease and longer disease duration. Significant positive correlations were seen between increased total IgE and chronic urticaria severity and the duration (r = 0.663, P &lt; 0.001), (r = 0.518, P &lt; 0.001), respectively. Conclusion: The total serum IgE levels were frequently elevated in patients with CSU, which were associated with a higher disease severity and duration.

Guillain-Barré syndrome (GBS) is an acute autoimmune neurological disorder mainly involving the peripheral nerves. Currently, various cytokines have been shown to be involved in the pathogenesis of GBS. Because of their similar biological structures, interleukin (IL)-36α, IL-36β, IL-36γ, and IL-36 receptor antagonist (Ra) were all renamed and collectively called IL-36 cytokines. The roles of IL-36 cytokines in GBS currently remain unclear.Forty-two patients with GBS and 32 healthy volunteers were included in our study. Serum IL-36α, β, γ, and interleukin-36 receptor antagonist (IL-36Ra) levels of patients with GBS in the acute and remission phases and healthy volunteers were measured by enzyme-linked immunosorbent assay (ELISA). In addition, we examined the serum levels of other inflammatory factors that have been shown to be involved in GBS pathogenesis, represented by IL-17 and tumor necrosis factor-α (TNF-α). Furthermore, the correlations between the serum levels of IL-36 cytokines and different clinical data or the serum levels of other inflammatory factors in GBS patients were analyzed.Significantly higher serum IL-36α and IL-36γ levels were measured in the acute phase than in the remission phase and in healthy control (HC) subjects (P < .05), while lower serum IL-36Ra levels were measured in the acute phase than in the remission phase and in HC subjects (P < .05). Serum IL-36α and IL-36γ levels were positively correlated with GBS disability scale scores (GDSs), while serum IL-36Ra levels were negatively correlated with GDSs. Correlation analyses among inflammatory factors showed that serum IL-36α and IL-36γ levels in GBS patients were positively correlated with serum IL-17 and TNF-α levels, while serum IL-36Ra levels were negatively correlated with the levels of these 2 inflammatory factors. Similar results were observed in cerebrospinal fluid (CSF), IL-36α and IL-36γ levels in CSF were positively correlated with GDSs, while IL-36Ra levels in CSF were negatively correlated with GDSs. Additionally, the serum and CSF levels of IL-36α and IL-36γ in the axonal subtype of GBS patients were higher than those in the demyelination subtype.Based on our findings, IL-36 cytokines may be involved in the pathogenesis of GBS and some of these cytokines may help predict the disease severity and other clinical characteristics of GBS.

Children with allergic and nonallergic rhinitis have a similar risk of asthma

Received December 20, 2011 Revised March 1, 2012 Accepted March 3, 2012 Address for correspondence Jae-Hoon Lee, MD Department of OtolaryngologyHead & Neck Surgery, Institute of Wonkwang Medical Science, School of Medicine, Wonkwang University, 895 Muwang-ro, Iksan 570-711, Korea Tel +82-63-859-1441 Fax +82-63-841-6556 E-mail coolnose@wmc.wonkwang. ac.kr Background and ObjectivesZZChitin is a recognition element for tissue infiltration by innate cells implicated in allergy and asthma. Chitinases are characterized by the ability to cleave chitin. YKL-40, the chitinase-like protein, was increased during Th2-type inflammation in an exaggerated manner in tissues of patients with asthma. However, the relationship of YKL-40 level to allergic rhinitis has not been evaluated. Hence, we evaluated the relationship between the YKL-40 level in the blood and nasal lavage fluid and allergic inflammation in nasal cavity. We also evaluated the nature of association between several important factors (eosinophil count and total IgE) in the blood and nasal lavage fluid of allergic rhinitis patients. Subjects and MethodZZThe concentrations of the YKL-40 levels in the blood and nasal lavage fluid were compared between allergic rhinitis patients and healthy controls. We evaluated the YKL-40 levels in the blood and nasal lavage fluid and also evaluated symptom severity, eosinophil count, and total IgE. ResultsZZThe blood YKL-40 level was not significantly increased in allergic rhinitis (49 pg/ mL) than in control (44 pg/mL)(p>0.05). The YKL-40 levels in the nasal lavage fluid was not significantly increased in allergic rhinitis (1568 pg/mL) than in control (1248 pg/mL)(p>0.05). The YKL-40 levels in blood and nasal lavage fluid were not associated with important factors such as symptom severity, eosinophil count, and total IgE in allergic rhinitis patients. ConclusionZZThere is no association between the YKL-40 level in the blood and nasal lavage fluid, allergic inflammation in nasal cavity. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:161-5

Background: Epithelial gene expression in allergic rhinitis patients has been evaluated by microarray. However, gene expression in patients with nonallergic rhinitis and suspected allergic rhinitis who reported allergen-related nasal symptoms but presented a negative atopic test was unknown. Objectives: The aim of this study was to observe and compare epithelial gene expression in patients with allergic rhinitis, suspected allergic rhinitis, and nonallergic rhinitis. Methods: Nasal brushings were collected from healthy controls and from patients with allergic rhinitis, suspected allergic rhinitis, and nonallergic rhinitis. The expressions of 20 genes selected from a previous microarray study were measured by real-time PCR. Associations of these genes with allergen type, disease duration and severity, the grade of nasal smear eosinophilia, and serum total IgE were analyzed. Results: Twelve genes were confirmed to be upregulated in current adult allergic rhinitis patients allergic to multiple allergens, and 10 of them were also increased in the suspected allergic rhinitis and nonallergic rhinitis groups. TFF3 and ITLN1 expressions were increased in allergic rhinitis and suspected allergic rhinitis, but not nonallergic rhinitis. Different expressions between the allergic rhinitis and nonallergic rhinitis groups were found for 3 genes: CST1, TFF3, and ITLN1. In the allergic rhinitis patients, all 12 genes were upregulated in the seasonal and perennial groups; 9 of these 12 genes were also upregulated in the mixed group. In suspected allergic rhinitis patients, all 12 genes were upregulated in the perennial group; 8 of these 12 genes were also upregulated in the seasonal group and only 5 in the mixed group. No gene expression was associated with disease duration and serum total IgE. GCNT3 was positively correlated with the grade of nasal smear eosinophilia in the suspected allergic rhinitis group. Different genes were found to be associated with disease severity in different rhinitis groups. Conclusions: Patients with allergic rhinitis, suspected allergic rhinitis, and nonallergic rhinitis showed much similarity with regard to epithelial gene expression; most genes were related to Th2 inflammation. CST1, TFF3, and ITLN1 might have the ability to differentiate allergic rhinitis from nonallergic rhinitis. Understanding the mechanisms underlying different types of rhinitis may be helpful for rhinitis diagnosis and treatment.