Moderate Persistent Allergic Rhinitis Research Articles

Clinical, immunomodulating and anti-recidive effects of ozone therapy in persistent allergic rhinitis in children

Research оbjective.To determine the effect of ozone therapy on clinical indicators and the state of immunity in children with moderate persistent allergic rhinitis. Material and methods. The study included children aged 5-10 years with moderate persis-tent allergic rhinitis, which were divided into two groups depending on the therapy. The first group of patients with allergic rhinitis received complex conventional therapy, the second group of patients with allergic rhinitis received complex treatment in combination with ozone therapy. Clinical parameters were studied in patients with allergic rhinitis, parameters of im-munological reactivity were investigated during periods of exacerbation of the disease and clinical remission. Results. It was found that the inclusion of ozone therapy in the complex treatment of patients of the second group ensured a faster onset of complete clinical remission (3.7 days earlier than in the first group of patients) and normalization of most immunity parameters, and also increased the expression of toll-like receptors on leukocyte cells. The duration of complete clinical remission in the group of patients with allergic rhinitis who received complex treatment in combination with ozone therapy (9.3 + 2 months) more than doubled (2.4 times) its duration in the group of patients with allergic rhinitis who received complex conventional therapy (3.9 + 0.3 months).

A Randomized Controlled Clinical Trial of Treatment of Moderate and Severe Persistent Allergic Rhinitis of Spleen Deficiency Pattern by Herbal Cake-partitioned Moxibustion Combined with Rhinocort Nasal Spray

To evaluate the clinical effect of herbal cake-partitioned moxibustion combined with medication in the treatment of moderate and severe persistent allergic rhinitis (PAR) patients of spleen deficiency pattern. Sixty patients with moderate and severe PAR of spleen deficiency pattern were randomized into medication (Rhinocort) group and herbal cake-partitioned moxibustion combined with medication group (combination group, n=30 cases in each). Medicinal cake-partitioned moxibustion was applied to Yintang (GV 29, for about 20 min), Shenque(CV 8, about 50 min), bilateral Zusanli (ST 36, about 40 min)and Hegu(LI 4, about 40 min)once every other day for successive 8 weeks. All the patients received treatment with Rhinocort nasal spray, 2 jets/day for each nostril (64 µg/jet) for 8 weeks. The patients' conditions (symptoms of nasal sufferings, sleeping, sniffle, eye, emotion, etc.) were assessed by visual analogue scale (VAS) and rhino conjunctivitis quality of life questionnaire (RQLQ, 24 items of 7 aspects, 0-6 points/item), respectively. The spleen deficiency syndrome score was determined according to "Guiding Principles for Clinical Research of New Drugs of Chinese Materia Medica" (2002). The therapeutic effect was assessed by referring to "the Diagnostic and Therapeutic Principles and Recommended Schemes for Allergic Rhinitis" (2004). Following the treatment, the scores of VAS, RQLQ, spleen deficiency syndrome were significantly decreased on the 4thand the 8th week of treatment in both groups in comparison with those of their own individual pre-treatment (P<0.05, P<0.01). Four weeks' follow-up survey showed that the VAS score and RQLQ score of the combination group were obviously lower than those of the medication groups (P<0.05), suggesting a better post-effect of moxibustion. Of the two 30 cases in the medication and combination groups, 9 and 9 experienced marked improvement in their symptoms, 16 and 17 were effective, and 5 and 4 ineffective, with the effective rate being 83.3% and 86.7%, respectively. No significant differences were found between the two groups in the VAS and RQLQ scores on the 4th and 8th week during treatment and in the effective rate (P>0.05). Herbal cake-partitioned moxibustion combined with hormone (Rhinocort) nasal spray is effective in relieving symptoms of moderate and severe PAR patients of spleen deficiency syndrome, and has a better post-effect.

Efficiency of antihistamine medications for treatment of persistent allergic rhinitis in primary school children: clinical and immunological aspects

Background. Comparative study of clinical and immunological efficiency of systemic [with desloratadine (Aerius®, Bayer n=28)] and topical [with azelastin (Allergodil®, Meda Pharma) n=28] antihistamine single-agent treatment of persistent allergic rhinitis in primary school children (56 children from 6 to 11 years old) was carried out on the basis of monitoring the dynamics of nasal mucosa inflammatory biomarkers (IgE, sIgA, IL-4, IL-8, IL-13, IFN-y, TNFa). Materials and Methods. Questionnaires, selfmonitoring diaries with daily score-based assessment of the symptoms and the score of used pharmacologic agents, nasal discharge and touch smears of nasal cavity mucosa were used as investigative parameters in the study. The study was performed with the permission of the Biomedical Ethics Committee of the State Budgetary Educational Institution of Higher Professional Education «Pacific State Medical University» of the Ministry ofHealth of the Russian Federation. Results. A monthlong therapy with desloratadine enabled clinical control of the symptoms of mild and moderate persistent allergic rhinitis in primary school children in 92,8% of cases and allowed to stop local allergic inflammation intensity as was proved by increasing symptom-free number of days and the fact that symptomatic treatment was not required. The use of desloratadine in the course of the next three months ensured retention of the achieved control. Side and adverse effects in the given group were not registered.

Antihistamines (review of clinical researches)

Antihistamines (AGP) prevent histamine action by blocking H1 receptors which determines their wide use in allergic rhinitis (AR). The author provides an overview of scientific articles, clinical and experimental studies on various aspects of AGP: pharmacokinetics, indications for administration in ENT practice, efficiency and safety. The authors analyzed the practicability of antihistamines application in the treatment of severe and moderate persistent AR, including combinations with topical steroids and leukotriene antagonists. We describe the benefits of desloratadine, the active metabolite of loratadine. The numerous experimental and clinical studies of desloratadine have proven antioxidant effect, anti-inflammatory effect, significant effect on nasal congestion, rhinorrhea, and the severity of eye symptoms of AR. In one of these studies, ACCEPT­2, it was presented that desloratadine provides a proven long-lasting effect even in severe persistent perennial rhinitis, thus confirming the absence of addiction to this preparation.

Local cytokines and clinical symptoms in children with allergic rhinitis after different treatments

Local cytokines and clinical symptoms in children with allergic rhinitis after different treatments Gesmar RS Segundo1, Fab&iacute;ola A Gomes2, Karla P Fernandes1, Ronaldo Alves3, Deise AO Silva3, Ernesto A Taketomi31Department of Pediatrics, 2Department of Nursery, 3Laboratory of Allergy and Clinical Immunology, Universidade Federal de Uberlandia, Uberlandia, BrazilBackground: Therapy for allergic rhinitis aims to control symptoms and improve the quality of life. The treatment of allergic rhinitis includes allergen avoidance, environmental controls, pharmacologic treatment, and specific immunotherapy.Objectives: The aim of this study is to evaluate the clinical changes and the levels of interferon-&gamma; (IFN-&gamma;) and interleukin-5 (IL-5) in nasal lavage fluid from children with allergic rhinitis after different types of pharmacologic treatment (mometasone, montelukast, or desloratadine).Methods: Twenty-four children aged from six to 12 years with moderate persistent allergic rhinitis were randomized into three groups receiving monotherapy treatment over four weeks: nasal corticosteroid (mometasone), leukotriene modifier (montelukast), or antihistamine (desloratadine). The perception of symptom improvement during the medication use was evaluated at the end of the treatment. Samples of nasal lavage fluid were collected before and after treatment for measuring IFN-&gamma; and IL-5 cytokines by ELISA.Results: All parents perceived an improvement in symptoms. Significant enhancement was seen in the mometasone group compared to those with montelukast (P = 0.01) and desloratadine (P = 0.02). No significant differences were found among the three groups in the levels of IL-5 and IFN-&gamma; in nasal fluid at baseline or after treatment. Only the group treated with mometasone showed a slight but significant reduction in IL-5 levels after the treatment period as compared with levels before the treatment (P = 0.0469).Conclusion: The group treated with mometasone showed better improvement of clinical symptoms and a slight reduction in IL-5 levels in the nasal fluid. This may indirectly reflect the relative immunomodulatory effects of the drugs tested.Keywords: allergic rhinitis, cytokines, IL-5, IFN-&gamma;, nasal fluid, desloratadine, mometasone, montelukast, allergy

Local cytokines and clinical symptoms in children with allergic rhinitis after different treatments

Therapy for allergic rhinitis aims to control symptoms and improve the quality of life. The treatment of allergic rhinitis includes allergen avoidance, environmental controls, pharmacologic treatment, and specific immunotherapy. The aim of this study is to evaluate the clinical changes and the levels of interferon-gamma (IFN-gamma) and interleukin-5 (IL-5) in nasal lavage fluid from children with allergic rhinitis after different types of pharmacologic treatment (mometasone, montelukast, or desloratadine). Twenty-four children aged from six to 12 years with moderate persistent allergic rhinitis were randomized into three groups receiving monotherapy treatment over four weeks: nasal corticosteroid (mometasone), leukotriene modifier (montelukast), or antihistamine (desloratadine). The perception of symptom improvement during the medication use was evaluated at the end of the treatment. Samples of nasal lavage fluid were collected before and after treatment for measuring IFN-gamma and IL-5 cytokines by ELISA. All parents perceived an improvement in symptoms. Significant enhancement was seen in the mometasone group compared to those with montelukast (P = 0.01) and desloratadine (P = 0.02). No significant differences were found among the three groups in the levels of IL-5 and IFN-gamma in nasal fluid at baseline or after treatment. Only the group treated with mometasone showed a slight but significant reduction in IL-5 levels after the treatment period as compared with levels before the treatment (P = 0.0469). The group treated with mometasone showed better improvement of clinical symptoms and a slight reduction in IL-5 levels in the nasal fluid. This may indirectly reflect the relative immunomodulatory effects of the drugs tested.