Treatment Of Japanese Cedar Pollinosis Research Articles

Long-term treatment of Japanese cedar pollinosis with Japanese cedar pollen SLIT drops and persistence of treatment effect: A post-marketing clinical trial

BackgroundThere have been no reports of treatment effect persistence after long-term sublingual immunotherapy (SLIT) in patients with Japanese cedar (JC) pollinosis. Therefore, we conducted a post-marketing clinical trial to investigate the efficacy, safety, and effect persistence of JC pollen SLIT drops after approximately 3 years of treatment. MethodsThis was an open-label trial of 233 patients with JC pollinosis who were treated with JC pollen SLIT drops for approximately 3 years (2015–2017) and followed-up for an additional 2 years (2018–2019). Efficacy and effect persistence were evaluated using nasal and ocular symptom scores, daily use of rescue medication, and Japanese Rhinoconjunctivitis Quality of Life Questionnaire scores recorded during the JC pollen dispersal season of each year. Safety was evaluated by monitoring adverse events and adverse drug reactions. ResultsThe mean combined total nasal symptom and medication score (range 0–18) during the peak symptom periods of 2015 through 2019 were 5.47 ± 3.38, 4.52 ± 3.13, 3.58 ± 2.63, 5.28 ± 4.01, and 6.83 ± 4.65, respectively. The percentage of patients who used no rescue medications during the same periods was 64.8%, 75.2%, 80.3%, 63.7%, and 50.3%, respectively. A total of 138 adverse drug reaction incidents were recorded in 73 of the 233 patients (31.3%), of which 134 incidents (97.1%) were mild in severity. ConclusionsJC pollen SLIT drops demonstrated treatment duration-dependent efficacy with effects that persisted for 2 years after cessation of treatment. The drug had a favorable safety profile over the 5-year study period.

Transcutaneous Peptide Immunotherapy of Japanese Cedar Pollinosis Using Solid-in-Oil Nanodispersion Technology.

Peptide immunotherapy is an attractive approach to relieve allergic symptoms such as rhinitis and asthma. Treatment of Japanese cedar pollinosis (Cryptomeria japonica; Cj), from which over one quarter of Japanese population suffer, is becoming a great concern. Recently, oral feeding of a peptide (7crp) consisting of seven immunodominant human T cell epitopes derived from two enzymes present in Cj pollen was demonstrated to have a benefit in treating Cj pollinosis. In this work, we aimed to apply a novel transcutaneous administration system as a simple and easy peptide delivery for an immunotherapy using a T cell epitope peptide. A modified 7crp peptide (7crpR) which contained triarginine linkers between each epitopes was designed to increase water solubility and was encapsulated in a unique solid-in-oil (S/O) nanodispersion. The S/O nanodispersion consists of a nano-sized peptide-surfactant complex dispersed in an oil vehicle. The S/O nanopartilces having an average diameter of 230 nm facilitated the permeation of the peptide 7crpR into the skin and suppressed serum total IgE and antigen-specific IgE levels in a Cj pollinosis mouse model. Transcutaneous administration of the T cell epitope peptide using the S/O nanodispersion system has potential for future simple and easy immunotherapy of Cj pollinosis.

スギ花粉症初期療法におけるモメタゾンフランカルボン酸エステルの有効性

スギ花粉症初期療法におけるモメタゾンフランカルボン酸エステルの有効性

Use of a patient-centered medical questionnaire in the treatment of Japanese cedar pollinosis

Use of a patient-centered medical questionnaire in the treatment of Japanese cedar pollinosis

Comparison of fluticasone furoate and fluticasone propionate for the treatment of Japanese cedar pollinosis

Fluticasone furoate nasal spray (FFNS) is a novel, enhanced-affinity glucocorticoid administered in a unique side-actuated device for the treatment of allergic rhinitis. No previous clinical studies have compared the efficacy of FFNS with another intranasal steroid. The purpose of this study was to compare the efficacy and safety of FFNS, 110 microg/day, once daily with fluticasone propionate nasal spray (FPNS), 200 microg/day, twice daily in patients with Japanese cedar pollinosis to support the regulatory filing in Japan. In this multicenter, randomized, placebo-controlled, double-blind, parallel-group study, patients (>or=16 years old) were randomized to receive 2 weeks of treatment with FFNS (n = 151), FFNS placebo (n = 72), FPNS (n = 148), or FPNS placebo (n = 75). FFNS once daily was noninferior to FPNS twice daily in mean change from baseline in three total nasal symptom scores (3TNSS; sneezing, rhinorrhea, and nasal congestion; -1.23 +/- 0.140 and -1.06 +/- 0.142, respectively). Compared with placebo, FFNS was superior in reducing 3TNSS (p < 0.001). Both FFNS and FPNS showed similar mean changes from baseline in 4TNSS (3TNSS and nasal itching) and individual nasal symptom scores. The onset of action for FFNS was observed from the 1st day of treatment, whereas in the FPNS group it was observed on the 2nd day. There were similar improvements in rhinoscopy findings, activity of daily life interference, and patient-rated overall evaluation to therapy in the FFNS and FPNS groups. FFNS was well tolerated. Treatment with once-daily FFNS was effective and noninferior to twice-daily FPNS in reducing nasal symptoms. Faster onset of action for FFNS was observed.

Effects of Polysaccharide Derived from Black Currant on Relieving Clinical Symptoms of Japanese Cedar Pollinosis: A Randomized Double-Blind, Placebo-Controlled Trial

We investigated the efficacy of the polysaccharide derived from black currant, named cassis polysaccharide (CAPS), for inhibiting Japanese cedar pollinosis symptoms and improving quality of life by a randomized double-blind, placebo-controlled trial in 2006. A total of 28 subjects were enrolled in the study, and 10 subjects in each group completed the trial. Although there was no significant difference between the CAPS and placebo group in the weekly mean value of any symptom in the daily symptom diary at any time, a smaller degree of final symptom aggravation was found in the CAPS group. Significant aggravation of the score was finally observed in the placebo group with inferior conch swelling and with sneezing, itchy nose, itchy eye and watery eye in the Japan rhino-conjunctivitis quality of life questionnaire assessment, while the changes observed in the CAPS group were not significant. In conclusion, our findings clearly indicate that CAPS would be useful as a food supplement in assisting the treatment of Japanese cedar pollinosis.

EFFECTS OF THE NOVEL SYMBIOTIC IMMUBALANCE AS A FOOD SUPPLEMENT IN RELIEVING CLINICAL SYMPTOMS OF JAPNESE CEDAR POLLINOSIS: A PILOT STUDY

SUMMARY 1Probiotics have been suggested to have potential for treating food allergy in small children. Although oral probiotics have been studied extensively in animals and humans for various allergies, their effects on the prevention and/or treatment of pollinosis have not been adequately investigated. 2The aim of the present study was to examine the effects of the novel symbiotic food supplement ImmuBalance (a koji fungus (Aspergillus oryzae) and lactic acid bacteria (Pediococcus parvulus and Enterococcus faecium) soybean fermentation product; Nichimo Co. Ltd, Tokyo, Japan) on the prevention and treatment of allergic reactions in Japanese cedar pollinosis (JCP) during the pollen season. 3An open-label pilot study on seven individuals with JCP was conducted. Each participant received oral administration of 1.0–2.0 g ImmuBalance daily for 3 months, which contained 1.8 ¥ 1010/g heat-killed lactobacteria. Six participants (four men, two women; 26–55 years of age) completed the 3 months of supplementation. One participant was excluded from the study because the JCP-specific IgE in RAST scores was lower than 2 UA/mL. The clinical severity of JCP in past year for each participant was self-evaluated on a five-point scale from 0 to 4, in accordance with the guidelines of the Nasal Allergy Clinic 2002, Japan. 4Self-evaluated overall average symptom scores (1.7 ± 0.8) in the peak pollen season showed significant improvement compared with the past year (3.5 ± 0.5; P = 0.001). Furthermore, the average scores for sneezing and runny nose in the peak pollen season showed significant improvement compared with the past year. The scores for swelling and colour of the mucosa and snivel in the nasal cavity did not increase significantly in the peak pollen season compared with baseline. 5Our studies suggest that dietary ImmuBalance may be effective in the prevention and treatment of JCP. The underlying mechanisms of action and the possibility of a randomized, placebo-controlled trial are being investigated.

PS2-4 Antigen-specific treatment of Japanese cedar pollinosis by the immunosuppressive liposomes containing CD1d ligand and recombinant Cry j1/2 fusion protein(Part-2 &quot;New strategies for the treatment of allergic diseases&quot;,New approach to treatment of allergic diseases,English session)

PS2-4 Antigen-specific treatment of Japanese cedar pollinosis by the immunosuppressive liposomes containing CD1d ligand and recombinant Cry j1/2 fusion protein(Part-2 &quot;New strategies for the treatment of allergic diseases&quot;,New approach to treatment of allergic diseases,English session)

Peptide immunotherapy for allergic diseases using a rice-based edible vaccine

Plant pollens are the most common cause of seasonal allergic disease. The number of patients undergoing treatment for allergies to the pollen of Japanese cedar (major antigens: Cry j 1 and Cry j 2) has increased steadily each year. Integration of an effective, safe and inexpensive clinical program would be greatly improved by addressing deficiencies in systemically delivered immunotherapy. We have demonstrated that feeding mice transgenic rice seeds accumulating the T-cell epitope peptides of Cry j 1 and Cry j 2 before systemic challenge with total protein of cedar pollen inhibits the development of allergen-specific IgE, IgG and CD4 T-cell proliferative responses. The levels of allergen-specific CD4 T-cell-derived allergy-associated T-helper 2 cytokine of IL-4, IL-5, and IL-13 and histamine release in serum were also significantly decreased. Moreover, clinical symptoms were inhibited in an experimental sneezing-mouse model. Plant-based edible vaccine has been shown to be effective for treatment of Japanese cedar pollinosis. When rice seeds containing T-cell epitopes derived from cedar pollen allergens were orally administered to mice, immune tolerance leading to reduction of allergen-specific IgE, T-cell proliferative reaction and histamine could be induced, resulting in suppression of allergic-specific symptoms such as sneezing.

Probiotics in the treatment of Japanese cedar pollinosis: a double‐blind placebo‐controlled trial

Probiotic bacteria may be effective in the treatment of allergic inflammation and food allergy, but efficacy and underlying mechanisms remain unclear. The present study investigated the effects of probiotic strain Bifidobacterium longum BB536 in the treatment of Japanese cedar pollinosis (JCPsis). In a randomized, double-blind, placebo-controlled trial, 44 JCPsis subjects received BB536 or placebo for 13 weeks during the pollen season. Subjective symptoms and self-care measures were recorded daily and blood samples were taken before and during intervention to measure blood levels of parameters related to JCPsis. BB536 intake was associated with a significant reduction in number of subjects prematurely terminated due to severe symptoms and pollinosis medication (P=0.0057 vs. placebo group). Comparison of subjective symptom scores indicated significant decreases in rhinorrhea, nasal blockage and composite scores in the BB536 group compared with the placebo group. Comparison of medical scores showed marked improvements in all symptoms on BB536 intake. A T-helper type 2 (Th2)-skewed immune response occurring along with pollen dispersion was observed. BB536 significantly suppressed increases in plasma thymus- and activation-regulated chemokine and tended to suppress elevations of Japanese cedar pollen (JCP)-specific IgE. These results suggest the efficacy of BB536 in relieving JCPsis symptoms, probably through the modulation of Th2-skewed immune response.

Development of New Immunotherapies for Japanese Cedar Pollinosis

We developed new immunotherapies (peptide and DNA vaccines) for treatment of Japanese cedar pollinosis. In the first place, oral administration of a dominant T cell epitope of a major Japanese cedar allergen (Cry j 2) in mice induced immunologic tolerance in both T-helper (Th) 1 and Th2 cell responses against the whole protein allergen. We found that peptide-based oral immunotherapy has a potential efficacy for treatment of the allergic immune response. Further, we developed a hybrid peptide comprising 7 T cell epitopes for human patients. It is expected that the hybrid peptide will downregulate allergen-specific T cells. We are planning a clinical study with the hybrid peptide in the near future. In the second place, we evaluated the use of DNA immunization by inoculating mice with plasmid DNA encoding a major Japanese cedar allergen (Cry j 1) gene. This DNA vaccination suppressed the IgE and IgG1 responses to subsequent alum-precipitated Cry j 1 injections. These results suggest that the DNA vaccination effectively induced Cry j 1-specific Th1-type immune responses, resulting in inhibition of the IgE responses to Cry j 1. Further, we developed DNA vaccine encoding both T cell epitope in Cry j 2 and invariant chain for the delivery of the epitope peptide into major histocompatibility complex (MHC) class II loading pathway. This DNA vaccination also suppressed the IgE responses to subsequent alum-precipitated Cry j 2 injections. DNA vaccine encoding T cell epitope and invariant chain induced epitope-specific T cell responses without allergic side effects.

The efficacy of olopatadine and pranlukast in the treatment of Japanese cedar pollinosis

The efficacy of olopatadine and pranlukast in the treatment of Japanese cedar pollinosis

スギ花粉症のタリオンの初期治療効果

The clinical effect of Bepotastine in patients with Japanese cedar allergy was investigated before and after the start of the pollen season. Symptom score, medication score and symptom-medication score were significantly lower in patients treated before the pollen season than in those treated after it started.These results indicate that Bepotastine is useful for the treatment of Japanese cedar pollinosis.

スギ花粉症に対する予防的レーザー手術 トラニラスト季節前投与との比較

Clinical evaluation of pre-seasonal Cot laser surgery was performed to compare pre-seasonal and seasonal administration of the antiallergic drug, Tranilast, for patients with Japanese cedar pollinosis during the cedar pollen season in 1996. Sixteen cases (the laser group) received Cot laser surgery 2-3 months before the pollen began to scatter. Seventeen cases (the Tranilast group) received Tranilast, at least 2-4 weeks before and during the scattering. In the laser group, nasal symptoms were suppressed more effectively than those of the Tranilast group throughout the pollen season. In the laser group, the rate of effectiveness was as high as 70% in patients with sneezing attacks, 56% in patients with rhinorrhea and 82% in patients with nasal obstruction, whereas the rates were 60%, 50% and 67% respectively in the Tranilast group. Comparison of the two groups for seasonal variations of cedar specific IgE antibody, the amount of plasma histamine, the number of eosinophils in the nasal smear and the response to the nasal provocation test, suggested that the allergic reaction in the inferior turbinate was inhibited by the laser surgery. Based on these results, we conclude that laser surgery was useful for the prophylactic treatment of Japanese cedar pollinosis.

アルデシンＡＱネーザルでのスギ花粉症治療

Management of Japanese cedar pollinosis is often difficult because of the continuing annual increase in patients and the worsening severity of symptoms. Many clinical trials focus on symptom relief, but some patients show little or a poor response to anti-allergic agents.Aqueous beclomethasone dipropionate (BDP) nasal spray has recently been used in the treatment of nasal allergies, however, the prophylactic or therapeutic effects of BDP nasal spray in the treatment of Japanese cedar pollinosis have not yet been evaluated.We conducted this clinical trial on patients with Japanese cedar pollinosis to evaluate the efficacy of BDP nasal spray in preventing or attenuating sneezing, rhinorrhea and nasal obstruction.Pre-seasonal nasal spray treatment suppressed the onset of symptoms over the course of the study.Patients who were symptomatic at the start of the treatment showed significant improvement in one week after initiation of treatment, and improvement was sustained throughout the pollen season. No severe adverse reactions were observed.These results suggest that aqueous BDP nasal spray is safe and useful for the treatment of Japanese cedar pollinosis.

スギ花粉症に対するダレンの臨床効果 予防および治療効果の検討

A comparative study was performed for the purposes of studying the prophylactic effectiveness of an antecedent treatment for Japanese cedar pollinosis with DAREN® (emedastine difumarate), an anti-allergic drug. Thirty-five cases (A group) received the drug at 4mg/day at least 2-4 weeks before the day when the pollen began to scatter. Another thirty-nine patients received the treatment after the scattering (B group). A significant inter group difference was observed in the global improvement rate for pollinosis. These findings suggest that DAREN® produces a slow, long-acting effect such as the inhibition of the release of chemical mediators. Prophylactic medication seems to be suitable for the treatment of Japanese cedar pollinosis, because sufficient anti-allergic action is obtained a few weeks later. Side effects occurred in 6.9% of all of the cases, but the incidence was lower than with any other anti-allergic drug previously reported.In summary, a prophylactic treatment with DAREN® is effective in treating Japanese cedar pollinosis.

レミカットのスギ花粉症予防と治療効果

Japanese cedar pollinosis has been a social and clinical problem in the otolaryngeal field because of the increase in patients and the severity of the symptoms.A multicentered, clinical trial was performed to evaluate the efficacy of pre-seasonal administration of Emedastine difumarate (ED) in the treatment of Japanese cedar pollinosis. The total airborne pollen count in 1995 was 7454/cm2, the highest level in the last decade.Pre-seasonal treatment with ED suppressed clinical symptoms more effectively throughout the pollen season than non-treatment.

オキサトミドによるスギ花粉症初期治療

The effect of Oxatomide in the initial treatment of Japanese cedar pollinosis was examined in 11facilities in Kyoto prefecture. This study examined the most appropriate starting time and period of administration for the highest effect of the initial treatment. The following results were confirmed by administre ring Oxatomide during the initial treatment for Japanese cedar pollinosis on 1991.The effect of Oxatomide was obtained after administering for one week or more, including the highest effect after two weeks for sneezing and three weeks for nasal discharge. However, no effect on sniffling. These results suggest that two to three weeks is the best administration period for Oxatomide in the treatment of Japanese cedar pollinosis.In addition, a close relation between pollen information facilities and practical medicine in the region, is necessary for the initial treatment of pollinosis.

花粉症へのエメダスチンの予防，治療効果 多施設による二重盲検群間比較試験

To evaluate the effectiveness, safety and utility of Emedastine difumarate (ED) in the treatment of Japanese cedar pollinosis, a multicentered, double-blind comparative study was performed in 290 patients in 1994.Patients with Japanese cedar pollinosis were divided into two groups; the first group was treated with ED at a dose of 4mg/day starting two weeks before the season and continuing for the whole season. The second group was given an inactive placebo instead of ED during the pre-season and the early portion of the season and then replaced with ED during the later portion of the season.As a result, the final improvement rate was significantly higher in the first group than that in the second group.All subjective symptoms such as sneezing, nasal discharge, nasal obstruction and eye itching were suppressed due to ED treatment.In conclusion, it was better to continuously administer ED to patients with pollinosis from the preseasonal period till the end of the season.However, when the ED treatment was started in the midseason, the outcome was good, although less satisfactory than the outcome of continuous treatment given throughout the entire pollen season.

スギ花粉症季節前投薬における血清ＥＣＰ値

Serum ECP values, in addition to subjective symptom scores, blood eosinophil counts and serum total IgE values, were examined for the objective evaluation of the prophylactic treatment of Japanese cedar pollinosis with ketotifen.Subjective symptom scores were significantly and serum total IgE values were slightly elevated in the non-treated group during the pollen season. Serum ECP values were significantly elevated during the season with or without prophylactic treatment and were still elevated two weeks after the season.We concluded that 1) prophylactic treatment of Japanese cedar pollinosis with ketotifen was effective, 2) serum ECP values remained elevated during and after the pollen season, and 3) serum ECP values are not related to subjective symptom.