Clin Exp Research Articles

Ingestion of honey improves the symptoms of allergic rhinitis: evidence from a randomized placebo-controlled trial in the East Coast of Peninsular Malaysia

BACKGROUND AND OBJECTIVESThe role of honey in the treatment of allergic rhinitis (AR) is controversial. We studied the complementary effect of ingestion of a high dose of honey, in addition to standard medications, on AR.DESIGN AND SETTINGSProspective randomized placebo-controlled study. Subjects were recruited from an otolaryngology clinic in 2 tertiary referral centers in the East coast of Peninsular Malaysia. The study period ranged from April 2010-April 2011.METHODSForty AR patients were divided equally into a case group and a control group. All the subjects received a daily dose of 10 mg of loratadine for 4 weeks. The case group ingested 1 g/kg body weight of honey daily in separate doses for the 4-week period. The control group ingested the same dose of honey-flavored corn syrup as placebo. AR symptoms were scored at the start, week 4, and week 8 of the study.RESULTSThere were no significant differences between the mean total symptom score of the case and the control groups at the start of the study. At week 4, both groups showed progressive improvement in the symptoms; at week 8, only the case group showed a continuous improvement in the symptom score. Only the group that ingested honey showed a significant improvement in individual AR symptoms. The improvement persisted for a month after the cessation of the treatment.CONCLUSIONHoney ingestion at a high dose improves the overall and individual symptoms of AR, and it could serve as a complementary therapy for AR.

Regarding comments by Persson et al. (Airway, apoptosis, and asthma) to J. L. Simpson, P. G. Gibson, I. A. Yang, J. Upham, A. James, P. N. Reynolds, S. Hodge and AMAZES Study Research. Impaired macrophage phagocytosis in noneosinophilic asthma. Clin Exp Allergy 2013; 43:29–35.

Regarding comments by Persson et al. (Airway, apoptosis, and asthma) to J. L. Simpson, P. G. Gibson, I. A. Yang, J. Upham, A. James, P. N. Reynolds, S. Hodge and <scp>AMAZES</scp> Study Research. Impaired macrophage phagocytosis in noneosinophilic asthma. <i>Clin Exp Allergy</i> 2013; 43:29–35.

The Editor takes a closer look at some of this month's articles

Clinical & Experimental AllergyVolume 43, Issue 9 p. 977-977 Editor's ChoiceFree Access The Editor takes a closer look at some of this month's articles First published: 20 August 2013 https://doi.org/10.1111/cea.12174AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat T cells and asthma: complexity rather than duality The Th2 paradigm of asthma has gained considerable traction based largely on the allergen challenge model of asthma in mice which is a Th2 dominant. The mutual inhibition of Th1 and Th2 subsets led to a persuasive if in retrospect over-simplistic view of asthma as Th2 disease, where Th1 immune responses were suppressed. However, a more sophisticated awareness of the degree of heterogeneity in asthma together with the proliferation in the number of T cells subsets, their plasticity and complexity of interaction demands a re-evaluation of this concept 1. Seys et al. (pp. 1009-1017) contribute to this debate by demonstrating complex patterns of T cell associated cytokines in asthma based on measurement of sputum mRNA. Strikingly, they found in some subjects combined Th2 and Th17 related cytokines and this was associated with more severe disease. Studies such as this linking patterns of T cell activation with clinical phenotypes will allow us to describe endotypes of asthma with greater confidence 2. Sven Seys Radar plot representing the proportion of patients (%) with increased sputum mRNA of a particular cytokine [see Figure 1 in S. F. Seys et al. (pp. 1009-1017)]. T cells and asthma: how important are Th17 cells? Continuing the theme of T cells and asthma a subset that is gaining increasing attention in asthma are Th17 cells that release the cytokines IL-17A and IL-17F 3. Tsai et al. (pp. 1018-1026) have investigated expression of Th17 cells in childhood asthma of varying severity by measuring the number of Th17 cells in peripheral blood and serum IL-17 concentrations. They related this to production of exhaled nitric oxide (eNO) and severity of disease. They found an increased concentration of IL-17 in the serum in asthma as well as an increased percentage of Th17 cells, particularly in those with more severe disease. This correlated with eNO. This study provides further support for the idea that Th17 mediated inflammation is important in asthma. Dr. Jien-Wen Chien Associations between serum IL-17 and fractional exhaled nitric oxide [see Figure 2 in J.-W. Chien et al. (pp. 1018-1026)]. Nasal polyps: interaction between infection and vascular proliferation Nasal polyposis is a common and very unpleasant condition, the cause of which remains obscure. Nasal polyps are part of a group of conditions that cause chronic rhino sinusitis, and there is considerable interest in the interplay between sinus infection and the chronic inflammation, including the increased vascularity, that characterizes nasal polyps. Cho et al. (pp. 1038-1047) have studied this relationship in vitro by investigating the interaction between LPS and vascular endothelial growth factor (VEGF) production in nasal polyp fibroblasts. They show that LPS dramatically induced VEGF production via a TLR4-Akt-dependent pathway, providing evidence that bacterial infection can mediate the dramatic remodelling of the nasal mucosa seen in this disease. Professor Heun-Man Lee VEGF protein expression level was examined by immunofluorescence staining. [see Figure 3 in J.-S. Cho et al. (pp.1038-1047)]. References 1Poon AH, Eidelman DH, Martin JG, Laprise C, Hamid Q. Pathogenesis of severe asthma. Clin Exp Allergy 2012; 42: 625– 37. Wiley Online LibraryCASPubMedWeb of Science®Google Scholar 2Lotvall J, Akdis CA, Bacharier LB et al. Asthma endotypes: a new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol 2010; 127: 355– 60. CrossrefWeb of Science®Google Scholar 3Weaver CT, Elson CO, Fouser LA, Kolls JK. The Th17 pathway and inflammatory diseases of the intestines, lungs, and skin. Annu Rev Pathol 2013; 8: 477– 512. CrossrefCASPubMedWeb of Science®Google Scholar Caption to cover illustration: miRNA biogenesis. Following the transcription of the pri-miRNA transcript (1), the pre-miRNA is excised by Drosha (2) and transported by Exportin-5 into the cytoplasm (3). Splicing of the pre-miRNA by Dicer generates the miRNA duplex (4) that contains the mature miRNA strand, which together with several accessory proteins assembles into the RISC complex (5) to enable post-transcriptional regulation of target mRNA translation (6). [See figure 1 in M. Plank et al. (981-999)]. This logo highlights the Editor's Choice articles on the cover and the first page of each of the articles. Volume43, Issue9September 2013Pages 977-977 ReferencesRelatedInformation

A case of infliximab-induced lupus in a patient with ankylosing spondylitis: is it safe switch to another anti-TNF-α agent?

Anti-TNF-α therapies are the latest class of medications found to be associated with drug-induced lupus, a distinctive entity known as anti-TNF-α-induced lupus (ATIL) (Williams et al., Rheumatology (Oxford) 48:716-20, 2009; De Rycke et al., Lupus 14:931-7, 2005; De Bandt et al., Clin Rheumatol 22:56-61, 2003). With the widespread use of these agents, it is likely that the incidence of ATIL will increase. The onset of ATIL in patients with rheumatoid arthritis and Crohn's disease has been described, but the literature regarding the occurrence of this entity in patients with ankylosing spondylitis (AS) is scarce (De Bandt et al., Clin Rheumatol 22:56-61, 2003; Ramos-Casals et al., Autoimmun Rev 9:188-93, 2010; Perez-Garcia et al., Rheumatology 45:114-116, 2006). To our knowledge, few reports of switching anti-TNF-α therapy after ATIL in AS have been reported (Akgül et al., Rheumatol Int, 2012). Therefore, it is not clear whether the development of ATIL should prohibit switch to another therapy, since patients may respond to another anti-TNF-α agent (Akgül et al., Rheumatol Int, 2012; Bodur et al., Rheumatol Int 29:451-454, 2009; Mounach et al., Clin Exp Rheumatol 26:1116-8, 2008; Williams and Cohen, Int J Dermatol 50:619-625, 2011; Ye et al., J Rheumatol 38:1216, 2011; Wetter and Davis, Mayo Clin Proc 84:979-984, 2009; Cush, Clin Exp Rheumatol 22:S141-147, 2004; Kocharla and Mongey, Lupus 18:169-7, 2009). A lack of published experience of successful anti-TNF-α switching is a cause of concern for rheumatologists faced with this challenging clinical scenario. We report the case of a 69-year-old woman with AS who developed infliximab-induced lupus, which did not recur despite the subsequent institution of etanercept. The authors review and discuss ATIL and the possible implications for subsequent treatment with alternative anti-TNF-α agents.

Are magnetic resonance imaging findings influenced by genetic background in multiple sclerosis patients?

The genetic contribution to multiple sclerosis susceptibility is undeniable, and genetic background could influence clinical characteristics including magnetic resonance imaging findings. Huang et al. (Clin Exp Neuroimmunol, 4, 2013, 173–180) showed that genetic profiles differ between Japanese multiple sclerosis patients with and without Barkhof brain lesions seen on magnetic resonance imaging.

The Editor takes a closer look at some of this month's articles

The Editor takes a closer look at some of this month's articles

A Randomized Controlled Trial of Brief Motivational Interviewing in Impaired Driving Recidivists: A 5‐Year Follow‐Up of Traffic Offenses and Crashes

BackgroundIn a previously published randomized controlled trial (Brown et al. Alcohol Clin Exp Res 2010; 34, 292–301), our research team showed that a 30-minute brief motivational interviewing (BMI) session was more effective in reducing percentages of risky drinking days in drunk driving recidivists than a control information–advice intervention at 12-month follow-up. In this sequel to the initial study, 2 main hypotheses were tested: (i) exposure to BMI increases the time to further arrests and crashes compared with exposure to the control intervention (CTL) and (ii) characteristics, such as age, moderate the benefit of BMI.MethodsA sample of 180 community-recruited recidivists who had drinking problems participated in the study. Participants gave access to their provincial driving records at baseline and were followed up for a mean of 1,684.5 days (SD = 155.7) after randomization to a 30-minute BMI or CTL session. Measured outcomes were driving arrests followed by convictions including driving while impaired (DWI), speeding, or other moving violations as well as crashes. Age, readiness to change alcohol consumption, alcohol misuse severity, and number of previous DWI convictions were included as potential moderators of the effect of the interventions.ResultsFor arrests, Cox proportional hazards modeling revealed no significant differences between the BMI and the CTL group. When analyses were adjusted to age tertile categories, a significant effect of BMI in the youngest age tertile (<43 years old) emerged. For crashes, no between-group differences were detected.ConclusionsBMI was better at delaying DWI and other dangerous traffic violations in at-risk younger drivers compared with a CTL similar to that provided in many remedial programs. BMI may be useful as an opportunistic intervention for DWI recidivism prevention in settings such as DWI courts. Treatment effectiveness studies are needed to ascertain how the present findings generalize to the real-world conditions of mandated relicensing programs.

An Unusual Cause of Colonic Swelling

An Unusual Cause of Colonic Swelling

Gender Differences in Natural Language Factors of Subjective Intoxication in College Students: An Experimental Vignette Study

Examining the natural language college students use to describe various levels of intoxication can provide important insight into subjective perceptions of college alcohol use. Previous research (Levitt etal., Alcohol Clin Exp Res 2009; 33: 448) has shown that intoxication terms reflect moderate and heavy levels of intoxication and that self-use of these terms differs by gender among college students. However, it is still unknown whether these terms similarly apply to other individuals and, if so, whether similar gender differences exist. To address these issues, the current study examined the application of intoxication terms to characters in experimentally manipulated vignettes of naturalistic drinking situations within a sample of university undergraduates (n=145). Findings supported and extended previous research by showing that other-directed applications of intoxication terms are similar to self-directed applications and depend on the gender of both the target and the user. Specifically, moderate intoxication terms were applied to and from women more than men, even when the character was heavily intoxicated, whereas heavy intoxication terms were applied to and from men more than women. The findings suggest that gender differences in the application of intoxication terms are other-directed as well as self-directed and that intoxication language can inform gender-specific prevention and intervention efforts targeting problematic alcohol use among college students.

Mimicry of sugar tumor and minute pulmonary meningothelial-like nodule to metastatic lung deposits in a patient with rectal adenocarcinoma

Several reports have described different lung lesions mimicking primary or metastatic neoplasms. In this paper, we describe the different features of two uncommon and benign lung lesions mimicking metastasis from a primary large bowel adenocarcinoma. Our patient is a 75-year old female with a history of invasive rectal adenocarcinoma. One month after her surgery, she started complaining of coughing and shortness of breath. Clear cell sugar tumor and minute meningothelial-like nodules had been found incidentally and simultaneously during her chest x-ray. The diagnosis had been made based on morphology and was supported by a positive staining to a panel of immunohistochemical stains including CD34, vimentin, HMB45, melan A and S100. An ultra-structural examination was also performed and confirmed the presence of melanosomes in sugar tumor. The coexistence of lung sugar tumor and minute pulmonary meningothelial-like nodules has never been reported in the literature and an awareness of these lesions is essential to correctly diagnose and stage patients.

Circadian genes differentially affect tolerance to ethanol in Drosophila.

There is a strong relationship between circadian rhythms and ethanol (EtOH) responses. EtOH consumption has been shown to disrupt physiological and behavioral circadian rhythms in mammals (Alcohol Clin Exp Res 2005b, 29, 1550). The Drosophila central circadian pacemaker is composed of proteins encoded by the per, tim, cyc, and Clk genes. Using Drosophila mutant analysis, we asked whether these central components of the circadian clock make the equivalent contribution toward EtOH tolerance and whether rhythmicity itself is necessary for tolerance. We tested flies carrying mutations in core clock genes for the capacity to acquire EtOH tolerance. Tolerance was assayed by comparing the sedation curves of populations during their first and second sedation. Animals that had acquired tolerance sedated more slowly. Movement was also monitored as the flies breathe the EtOH vapor to determine if other facets of the EtOH response were affected by the mutations. Gas chromatography was used to measure internal EtOH concentration. Constant light was used to nongenetically destabilize the PER and TIM proteins. A group of circadian mutations, all of which eliminate circadian rhythms, do not disrupt tolerance identically. Mutations in per, tim, and cyc completely block tolerance. However, a mutation in Clk does not interfere with tolerance. Constant light also disrupts the capacity to acquire tolerance. These lines did not differ in EtOH absorption. Mutations affecting different parts of the intracellular circadian clock can block the capacity to acquire rapid EtOH tolerance. However, the role of circadian genes in EtOH tolerance is independent of their role in producing circadian rhythmicity. The interference in the capacity to acquire EtOH tolerance by some circadian mutations is not merely a downstream effect of a nonfunctional circadian clock; instead, these circadian genes play an independent role in EtOH tolerance.

The Editor takes a closer look at some of this month's articles

The Editor takes a closer look at some of this month's articles

Component-resolved diagnosis of peach allergy and its relationship with prevalent allergenic pollens in China

Component-resolved diagnosis of peach allergy and its relationship with prevalent allergenic pollens in China

Gly m 2S albumin is a major allergen with a high diagnostic value in soybean-allergic children

Gly m 2S albumin is a major allergen with a high diagnostic value in soybean-allergic children

The role of C-reactive protein genetic variability in the onset of carotid artery disease and renal function impairment in patients with diabetes mellitus type 2

The role of diabetes mellitus (DM) in cardiovascular disease is well established and currently is considered as an equivalent of coronary artery disease. Studies have also reported that DM is associated with the prevalence of occlusive carotid artery disease (AD) [ [1] Kuebler T.W. Bendick P.J. Fineberg S.E. et al. Diabetes mellitus and cerebrovascular disease: prevalence of carotid artery occlusive disease and associated risk factors in 482 adult diabetic patients. Diabetes Care. 1983; 6: 274-278 Crossref PubMed Scopus (21) Google Scholar ] as well as the grade carotid artery stenosis [ [2] Göksan B. Erkol G. Bozluolcay M. Ince B. Diabetes as a determinant of high-grade carotid artery stenosis: evaluation of 1,058 cases by Doppler sonography. J Stroke Cerebrovasc Dis. 2001; 10: 252-256 Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar ]. In addition, DM is related to impaired renal function via several mechanisms [ [3] Vallon V. Thomson S.C. Renal function in diabetic disease models: the tubular system in the pathophysiology of the diabetic kidney. Annu Rev Physiol. 2012; 74: 351-375 Crossref PubMed Scopus (237) Google Scholar ]. During the last years novel data have arisen for the role of genetics in the initiation and progression of carotid AD [ 4 Pessi T. Eklund C. Huhtala H. et al. CRP and FCGR2A genes have an epistatic effect on carotid artery intima-media thickness: the Cardiovascular Risk in Young Finns Study. Int J Immunogenet. 2009; 36: 39-45 Crossref PubMed Scopus (6) Google Scholar , 5 Jylhävä J. Eklund C. Pessi T. et al. Genetics of C-reactive protein and complement factor H have an epistatic effect on carotid artery compliance: the Cardiovascular Risk in Young Finns Study. Clin Exp Immunol. 2009; 155: 53-58 Crossref PubMed Scopus (16) Google Scholar , 6 Bleil M.E. Ferrell R.E. Sutton-Tyrrell K. Muldoon M.F. Manuck S.B. Apolipoprotein E polymorphism and preclinical carotid artery disease in untreated hypertensive men. Eur J Cardiovasc Prev Rehabil. 2006; 13: 98-100 Crossref PubMed Scopus (4) Google Scholar , 7 Losito A. Selvi A. Jeffery S. Afzal A.R. Parente B. Cao P.G. Angiotensin-converting enzyme gene I/D polymorphism and carotid artery disease in renovascular hypertension. Am J Hypertens. 2000; 13: 128-133 Crossref PubMed Scopus (16) Google Scholar , 8 Diamantopoulos E.J. Andreadis E. Kakou M. et al. Atherosclerosis of carotid arteries and the ace insertion/deletion polymorphism in subjects with diabetes mellitus type 2. Int Angiol. 2002; 21: 63-69 PubMed Google Scholar ] as well as for impaired renal function [ 9 Hung A.M. Ikizler T.A. Griffin M.R. et al. CRP polymorphisms and chronic kidney disease in the third national health and nutrition examination survey. BMC Med Genet. 2011; 12: 65 Crossref PubMed Scopus (11) Google Scholar , 10 Cooper Worobey C. Fisher N.D. Cox D. Forman J.P. Curhan G.C. Genetic polymorphisms and the risk of accelerated renal function decline in women. PLoS One. 2009; 4: e4787 Crossref PubMed Scopus (12) Google Scholar ]. However, scarce data exist regarding genetic polymorphisms in patients with diabetes mellitus and their role in carotid artery disease and renal function. Thus, in the present study we examined the potential role of a single nucleotide polymorphism (SNP) on C-reactive protein (CRP) gene in the onset of carotid AD and impaired renal function in patients with diabetes mellitus type 2.

SAT0562 The Consort Criteria for Eligibilty, Study Settings, Locations, and Center Effects are Seldom Met in Randomised Clinical Trials

BackgroundThe internal and external validity of randomised controlled trials require detailed analyses of modes of patient recruitment, description of the settings and locations of the study and the individual center...

AB1248 Which joints to scan by sonography to aid diagnosing early RA and remission of RA? a systematic literature review

BackgroundRecently, new classification criteria and new remission criteria for RA have been published, requiring accurate detection of arthritis, which could be improved using ultrasonography (US) when compared to assessment by...

AB0907 The prevalence of vertebral fractures and their relationship with bone mineral density in mild ankylosing spondylitis men pacients

BackgroundOsteoporosis (OP) is a frequent complication of ankylosing spondylitis (AS), even in early stages of the disease.ObjectivesDual x-ray absorptiometry for assessing bone mineral density (BMD) has limitations in patients with...

AB1206 Use of questionnaires for life quality assessment of JIA patients in actual clinical practices

BackgroundLife quality is one of the objective criteria of JIA patients treatment efficiency.ObjectivesTo examine comparability of assessment results in terms of the degree of motor disturbance and presence of psychological...

AB0637 Ultrasonography joint hand in systemic lupus erytematosus (SLE): a comparison with rheumatoid arthritis (RA)

BackgroundApproximately 1-2% of patients with SLE have joint inflammation similar to rheumatoid arthritis (RA). There are no well-designed studies comparing SLE ultrasonography with RA.Objectivesto evaluate the ultrasound (US) of the...