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Li J, Wu H, Xing W, Li X, Han Z, Ji R, Deng Z, Jung M, Sun S, Chung BI, Cardenas A, Langston ME. Air pollution mixture associated with oxidative stress exacerbation and symptoms deterioration in allergic rhinitis patients: Evidence from a panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 930:172688. [PMID: 38663627 DOI: 10.1016/j.scitotenv.2024.172688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/06/2024]
Abstract
With allergic rhinitis (AR) on the rise globally, there has been a growing focus on the role of environmental pollutants in the onset of AR. However, the potential mechanisms by how and which these pollutants exacerbate AR conditions remain unknown. This panel study of 49 patients diagnosed with AR over one year aimed to assess the individual and combined effects of short-term exposure to multiple ambient pollutants on oxidative stress, symptoms, and quality of life among patients with AR. All participants underwent four repeated assessments of health conditions and personal environmental exposures (PM2.5, O3, SO2, and NO2) over warm and cold seasons during 2017-2018. We evaluated two oxidative stress biomarkers (malondialdehyde [MDA], and superoxide dismutase [SOD]) via nasal lavage. We collected information on self-reported symptoms and quality of life using the Rhinitis Symptom Scale (SRS), the Visual Analog Scale (VAS), and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) through in-person interviews. Bayesian kernel machine regression (BKMR) was used to evaluate the joint effects of pollutant mixture and identify key contributors. The results revealed a significant association of the pollutant mixture when all four pollutants were at or above their median levels, with increased oxidative stress. This was evidenced by elevated MDA and reduced SOD. We found a joint detrimental effect of the pollutant mixture on AR symptoms with a strong association with increased SRS scores, but a non-significant positive association with VAS and RQLQ scores. PM2.5, O3, and SO2 presented as the potentially primary contributors to the adverse health effects associated with the pollutant mixture in Taiyuan city. Patients with AR exposed to short-term air pollutant mixture are more likely to have greater nasal symptoms and worse quality of life from increased oxidative stress and reduced antioxidant capacity. Further research is warranted to better elucidate the underlying mechanisms.
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Affiliation(s)
- Jinhui Li
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA.
| | - Haisheng Wu
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Weiwei Xing
- Beijing Institute of Basic Medical Sciences, Beijing, China
| | - Xin Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanxi Provincial People's Hospital, Taiyuan, China
| | - Zheshen Han
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Renyue Ji
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Zhengyi Deng
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Minji Jung
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Shengzhi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
| | - Benjamin I Chung
- Department of Urology, Stanford University Medical Center, Stanford, CA, USA
| | - Andres Cardenas
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Marvin E Langston
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
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Biénès T, Lyssens A, Machiels H, Hercot ME, Fastres A, Alexandru-Cosmin T, Deville M, Charlier C, Billen F, Clercx C. Intranasal and Serum Gentamicin Concentration: Comparison of Three Topical Administration Protocols in Dogs. Vet Sci 2023; 10:490. [PMID: 37624277 PMCID: PMC10457901 DOI: 10.3390/vetsci10080490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Antimicrobials' topical administration efficacy has not been assessed in dogs with upper respiratory tract disease. The aim was to compare the concentration of gentamicin in nasal lavage fluid (NALF) and in serum after three topical protocols. This was a prospective crossover study of ten healthy dogs. Gentamicin was nebulized for a duration of 1 week, twice a day, for 10 min in the first protocol (10-min protocol) and for 3 min in the second protocol (3-min protocol), while the third protocol consisted of the administration of 0.25 mL of gentamicin in each nostril (drop protocol). Median concentrations of gentamicin in NALF were 9.39 µg/mL (8.12-19.97 interquartile range), 4.96 µg/mL (4.60-6.43) and 137.00 µg/mL (110.5-162.00) in the 10-min protocol, 3-min protocol and drop protocol, respectively. The result for the drop protocol was significantly higher than those of both nebulization protocols in NALF (p = 0.039). In serum, the gentamicin concentration was 0.98 µg/mL (0.65-1.53) and 0.25 µg/mL (0.25-0.44) in the 10-min and 3-min protocols, respectively. Gentamicin was not detected in the serum of seven out of ten dogs in the drop protocol, and gentamicin was significantly higher in the 10-min protocol compared to the drop protocol (p = 0.001). This study found that the 10-min, 3-min and drop protocols achieved superior concentrations in NALF compared to the minimum inhibitory concentration for gentamicin-sensitive bacteria, while remaining below the toxic values in blood.
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Affiliation(s)
- Tom Biénès
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Aurélie Lyssens
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Hélène Machiels
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Marie Eve Hercot
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Aline Fastres
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Tutunaru Alexandru-Cosmin
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Marine Deville
- Laboratory of Clinical, Forensic, Industrial and Environmental Toxicology, Center for Interdisciplinary Research on Medicines (CIRM), University Hospital of Liege, 4130 Liege, Belgium; (M.D.); (C.C.)
| | - Corinne Charlier
- Laboratory of Clinical, Forensic, Industrial and Environmental Toxicology, Center for Interdisciplinary Research on Medicines (CIRM), University Hospital of Liege, 4130 Liege, Belgium; (M.D.); (C.C.)
| | - Frédéric Billen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
| | - Cécile Clercx
- Department of Clinical Sciences, Faculty of Veterinary Medicine, B67 Sart Tilman, University of Liege, 4000 Liege, Belgium; (A.L.); (H.M.); (M.E.H.); (T.A.-C.); (F.B.)
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Cohen O, Kaufman AE, Choi H, Khan S, Robson PM, Suárez-Fariñas M, Mani V, Shah NA. Pharyngeal Inflammation on Positron Emission Tomography/Magnetic Resonance Imaging Before and After Obstructive Sleep Apnea Treatment. Ann Am Thorac Soc 2023; 20:574-583. [PMID: 36476449 PMCID: PMC10112411 DOI: 10.1513/annalsats.202207-594oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/07/2022] [Indexed: 12/12/2022] Open
Abstract
Rationale: There is upper airway inflammation in patients with obstructive sleep apnea (OSA), which reduces with continuous positive airway pressure (CPAP) therapy. Objectives: Validate the use of positron emission tomography (PET)/magnetic resonance imaging (MRI) to quantify metabolic activity within the pharyngeal mucosa of patients with OSA against nasal lavage proteomics and assess the impact of CPAP therapy. Methods: Adults with OSA underwent [18F]-Fluoro-2-deoxy-D-glucose PET/MRI of the neck before and 3 months after initiating CPAP. Nasal lavage samples were collected. Inflammatory protein expression from samples was analyzed using the Olink platform. Upper airway imaging segmentation was performed. Target-to-background ratio (TBRmax) was calculated from target pharyngeal maximum standard uptake values (SUV) and personalized background mean SUV. Most-diseased segment TBRmax was identified per participant at locations with the highest PET avidity. Correlation analysis was performed between baseline TBRmax and nasal lavage proteomics. TBRmax was compared before and after CPAP using linear mixed-effect models. Results: Among 38 participants, the baseline mean age was 46.3 years (standard deviation [SD], 12.5), 21% were female, the mean body mass index was 30.9 kg/m2 (SD, 4.6), and the mean respiratory disturbance index measured by peripheral arterial tonometry was 31 events/h (SD, 16.4). There was a significant positive correlation between pharyngeal mucosa most-diseased segment TBRmax and nasal lavage proteomic inflammation (r = 0.41 [P < 0.001, false discovery rate = 0.002]). Primary analysis revealed a reduction in the most-diseased segment TBRmax after a median of 2.91 months of CPAP therapy (-0.86 [standard error (SE) ± 0.30; P = 0.007]). Stratified analysis by smoking status revealed a significantly decreased most-diseased segment TBRmax after CPAP therapy among never-smokers but not among ever-smokers (-1.01 [SE ± 0.39; P = 0.015] vs. -0.64 [SE ± 0.49; P = 0.201]). Conclusions: CPAP therapy reduces metabolic activity measured by PET/MRI within the upper airway of adults with OSA. Furthermore, PET/MRI measures of upper airway metabolic activity correlate with a noninvasive marker of inflammation (i.e., nasal lavage inflammatory protein expression).
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Affiliation(s)
- Oren Cohen
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | | | - Hyewon Choi
- Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Samira Khan
- Division of Pulmonary, Critical Care, and Sleep Medicine
| | | | - Mayte Suárez-Fariñas
- Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Neomi A. Shah
- Division of Pulmonary, Critical Care, and Sleep Medicine
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Abstract
Work-related rhinitis and laryngeal disorders are common and can significantly contribute to work absences and presenteeism. Each can cause respiratory symptoms that may be misdiagnosed as asthma symptoms, and each may occur as an isolated disorder or may also accompany asthma. Suspicion of these disorders and correct management require a careful medical and occupational history. Investigations for work-related rhinitis include examination of the nose, allergy skin tests, and in some cases, monitoring of peak inspiratory nasal flows at work and off work, or specific challenge tests. Work-related laryngeal disorders require assistance from an otolaryngologist and speech language pathologist.
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Affiliation(s)
- Ambrose Lau
- Department of Medicine, Toronto Western Hospital, St Michael's Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada
| | - Susan M Tarlo
- Department of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto Western Hospital, St Michael's Hospital, EW7-449, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.
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Vandenplas O, Hox V, Bernstein D. Occupational Rhinitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3311-3321. [PMID: 32653647 DOI: 10.1016/j.jaip.2020.06.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Abstract
There is convincing evidence that tight relationships between the upper and lower airways also apply to the workplace context. Most patients with occupational asthma (OA) also suffer from occupational rhinitis (OR), although OR is 2 to 3 times more common than OA. OR most often precedes the development of OA, especially when high-molecular-weight protein agents are involved, and longitudinal cohort studies have confirmed that OR is associated with an increased risk for the development of OA. The level of exposure to sensitizing agents at the workplace is the most important determinant for the development of IgE-mediated sensitization and OR. Atopy is a risk factor for the development of IgE-mediated sensitization only to high-molecular-weight agents. In workers with work-related rhinitis symptoms, documentation of IgE-mediated sensitization to a workplace agent via skin prick testing or serum specific IgE confirms a diagnosis of probable OR, whereas specific nasal provocation testing in the laboratory remains the reference method to establish a definite diagnosis of OR. Complete avoidance of exposure to the causal agent is the most effective therapeutic option for controlling work-related nasal symptoms and preventing the development of OA. If complete elimination of exposure is expected to induce meaningful adverse socioeconomic consequences, reduction of exposure can be considered as an alternative approach, but it is important to consider the individual risk factors for the development of OA to implement a more personalized management of OR.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
| | - Valérie Hox
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc and Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - David Bernstein
- Division of Immunology, Allergy and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Castano R, Yucesoy B, Johnson VJ, Castellanos L, Cartier A. Inflammatory proteins in nasal lavage of workers exposed to occupational agents. Clin Exp Allergy 2017; 47:1566-1573. [DOI: 10.1111/cea.13039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/04/2017] [Accepted: 09/02/2017] [Indexed: 12/26/2022]
Affiliation(s)
- R. Castano
- Department of Otolaryngology; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
| | - B. Yucesoy
- Formerly of the Health Effects Laboratory Division; CDC/NIOSH; Morgantown WV USA
| | - V. J. Johnson
- Burleson Research Technologies, Inc.; Morrisville NC USA
| | - L. Castellanos
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
| | - A. Cartier
- Department of Chest Medicine; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
- Research Center; Axe Maladies Chroniques; Hôpital du Sacré-Coeur de Montréal; Montreal QC Canada
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Abstract
PURPOSE OF REVIEW Work-related asthma is a common disorder among adult asthma patients, and in the case of occupational asthma, it is induced by workplace exposures. RECENT FINDINGS Occupational asthma provides an excellent model and benchmark for identifying and testing different allergy or inflammatory biomarkers associated with its inception or progression. Moreover, specific inhalation challenge with the incriminated agent represents an experimental setting to identify and validate potential systemic or local biomarkers. Some biomarkers are mainly blood-borne, while local airway biomarkers are derived from inflammatory or resident cells. Genetic and gene-environment interaction studies also provide an excellent framework to identify relevant profiles associated with the risk of developing these work-related conditions. Despite significant efforts to identify clinically relevant inflammatory and genomic markers for occupational asthma, apart from the documented utility of airway inflammatory biomarkers, it remains elusive to define specific markers or signatures clearly associated with different endpoints or outcomes in occupational asthma.
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Lipińska-Ojrzanowska A, Marcinkiewicz A, Walusiak-Skorupa J. Usefulness of Biomarkers in Work-Related Airway Disease. CURRENT TREATMENT OPTIONS IN ALLERGY 2017; 4:181-190. [PMID: 28680796 PMCID: PMC5488075 DOI: 10.1007/s40521-017-0121-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Determination of biomarkers may be useful in the surveillance of occupational exposure and workers' health. The possibility of predicting development/clinical course of specific disorders or current disease, diagnosing in early steps, and health condition monitoring is a real necessity. Various agents present in the workplace environment (or their metabolites) can be measured in samples possessed from human body (blood and urine, saliva, etc.). On the other hand, inhalant exposure may induce specific or non-specific, local or systemic, acute or chronic biological response expressed by synthesis or releasing specific or non-specific substances/mediators that also can be determined in blood, nasal and bronchial lavage or sputum, tear fluid, exhaled breath, etc. The least is known about genetic markers which may predict individual susceptibility to develop some work-related disorders under the influence of occupational exposure. Due to common exposure to inhalant agents at workplace, researches on biomarkers that allow to inspect the impact of exposure to humans' health are still needed. The authors of this article summarize the utility of biomarkers' determination in work-related airway diseases in a recent clinical approach.
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Affiliation(s)
- Agnieszka Lipińska-Ojrzanowska
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
| | - Andrzej Marcinkiewicz
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 8 St. Teresy, 91-348 Lodz, Poland
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Zhang Y, Wang Q, Xie Y, Wang Z, Li D, Ma L, Pang X, Yu W, Zhong N. The normative value of inflammatory cells in the nasal perfusate of Chinese adults: a pilot study. J Thorac Dis 2014; 6:905-12. [PMID: 25093086 DOI: 10.3978/j.issn.2072-1439.2014.06.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 06/09/2014] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To establish stable, well-accepted nasal perfusion and a normative value of classifying cells in the nasal perfusate of Chinese adults. METHODS A total of 500 healthy adults were divided into two groups of 250 people per group (group A, 16-30 years old and group B, 31-60 years old; male-to-female ratio, 1:1). All volunteers were non-smokers; they were irrigated with saline, and multiple inflammatory cells in the perfusate were analyzed. RESULTS Irrigation was successfully performed in 479 cases, a success rate of 95.80%. The types of inflammatory cells showed a skewed distribution. The median number and interquartile range (IQR) of eosinophils were 0 and 0.2, respectively. These values were 0.4 and 2.2, respectively, for neutrophils and 0 and 0, respectively, for both lymphocytes and macrophages. There was no significant difference between males and females (P>0.05). There was a significant difference in the numbers of neutrophils and lymphocytes in the different age groups (P=0.000), but there was no significant difference in the numbers of eosinophils and macrophages (P>0.05). The 95% unilateral upper limited values (UULVs) of eosinophils and neutrophils in the nasal perfusates were 2.99 and 14.94, respectively, for group A and 1.41 and 17.08 for group B. As a result, the total 95% UULVs of eosinophils and neutrophils in the nasal perfusate were 2.00 and 16.80. CONCLUSIONS We established stable, well-accepted nasal perfusions and normal values for classifying the cells in the nasal perfusate of Chinese adults; the normative values of the inflammatory cells in nasal perfusate are 2.00 for the 95% UULV of eosinophils and 16.80 for neutrophils. Age might be one of the factors affecting the cells in rhinitis.
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Affiliation(s)
- Yong Zhang
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Qiuping Wang
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Yanqing Xie
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Zhiyi Wang
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Derong Li
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Li Ma
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Xinju Pang
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Weidong Yu
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
| | - Nanshan Zhong
- 1 Department of ENT & Head & Neck Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China ; 2 The First Affiliated Hospital of Guangzhou Medical School, Guangzhou Institute of Respiratory Diseases, Guangzhou 510120, China
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Pelikan Z. Cytological Changes in Nasal Secretions Accompanying Delayed Nasal Response to Allergen Challenge. Am J Rhinol Allergy 2013. [DOI: 10.2500/ajra.2013.27.3933a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Patients with allergic rhinitis when challenged with allergen develop various types of nasal response, such as an immediate nasal response (INR), late nasal response (LNR), dual late nasal response (DLNR), or delayed nasal response (DYNR), probably because of different hypersensitivity mechanisms. This study was designed to investigate the cytological changes in the nasal secretions (NSs) during the DYNR, beginning 24–32 hours, reaching maximum at 32–36 hours, and resolving within 56 hours after the nasal provocation tests (NPTs) with allergens. Methods In 45 allergic rhinitis patients developing 45 positive DYNRs (p < 0.01), the NPTs and the phosphate-buffered saline (PBS) controls were repeated and supplemented with cytological examination of the NSs and determination of interferon (IFN) γ and IL-4 in nasal lavage fluid (NLF). Results The repeated DYNR (p < 0.001) was accompanied by significant changes (p < 0.05) in the counts of neutrophils, monocytes, lymphocytes, epithelial and goblet cells, and, to a limited extent, of plasma cells and platelets in the NSs and increased concentrations of IFN-γ but not of IL-4, in NLF between 24 and 48 hours after the NPT. No significant cytological changes were found in NSs during the PBS controls (p > 0.1). Conclusion The DYNR is associated with cytological profiles in the NS different from those observed during the INR or LNR. The significant count changes of neutrophils, monocytes, lymphocytes, epithelial and goblet cells in NSs, and increased IFN-γ but not of IL-4 concentrations in the NLF, suggest a possible involvement of the cell-mediated hypersensitivity in the DYNR. These results also emphasize the diagnostic value of NPTs combined with cytological examination of the NSs in patients with nasal allergy.
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Challenge Exposure to Isocyanates Induces Changes in Nasal Patency in Patients Reporting Work-Related Respiratory Symptoms. J Occup Environ Med 2013; 55:954-9. [DOI: 10.1097/jom.0b013e318293aef9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Prospective Outcome Assessment of Occupational Rhinitis After Removal From Exposure. J Occup Environ Med 2013; 55:579-85. [DOI: 10.1097/jom.0b013e318289ee17] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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13
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Castano R, Miedinger D, Maghni K, Ghezzo H, Trudeau C, Castellanos L, Wattiez M, Vandenplas O, Malo JL. Matrix metalloproteinases and tissue inhibitors of metalloproteinases in nasal lavage after an inhalation challenge with flour. Laryngoscope 2012; 122:730-5. [PMID: 22374842 DOI: 10.1002/lary.23206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 12/15/2011] [Accepted: 12/22/2011] [Indexed: 12/22/2022]
Abstract
OBJECTIVES/HYPOTHESIS The existence of nasal mucosa remodeling in allergic rhinitis is controversial. Few data are available on the dynamics of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in nasal fluid after an allergen challenge. We examined whether an immediate allergic reaction that induces nasal congestion and inflammation is able to also induce changes in remodeling parameters in nasal fluid. STUDY DESIGN Controlled experimental study. METHODS Ten patients with allergic occupational rhinitis due to flour underwent a control and active inhalation challenge with serial monitoring of nasal congestion and nasal symptoms with acoustic rhinometry and a visual analogue scale. Levels of remodeling markers (MMP-2, MMP-7, MMP-9, MMP-13, TIMP-1, TIMP-2) and inflammatory cells in nasal fluid were measured before the challenge and at 30 minutes, 6 hours, and 24 hours following the challenge. RESULTS In contrast to the control challenge, the flour challenge induced nasal symptoms and significant decreases in nasal volume in all subjects. After the flour challenge, a significant increase in nasal levels of TIMP-2 and a nonsignificant increase in TIMP-1 levels were observed, whereas no significant changes in nasal levels of MMPs were documented. CONCLUSIONS This study showed that after an inhalation challenge with an occupational allergen, the nasal mucosa displayed an imbalance in favor of TIMPs enzymes activity as compared to MMPs enzymes activity, represented in an increase in nasal levels of TIMP-2 during the course of the early reaction following the allergen challenge.
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Affiliation(s)
- Roberto Castano
- Department of Surgery/Otolaryngology, Sacre-Coeur Hospital, Montreal, Quebec, Canada.
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14
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Abstract
Accumulating evidence indicates that the workplace environment substantially contributes to the global burden of asthma and rhinitis. Work-related asthma and rhinitis represent a public health concern due to their health and socioeconomic impacts. This article summarizes the scientific evidence on sensitizer-induced occupational asthma and rhinitis that has been published during the past 5 years. The review addresses the strategies for diagnosing and managing these highly prevalent occupational diseases.
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Affiliation(s)
- Olivier Vandenplas
- Department of Chest Medicine, Mont-Godinne Hospital, Avenue Gaston Therasse 1, Yvoir, Belgium.
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15
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Gautrin D, Malo JL. Risk factors, predictors, and markers for work-related asthma and rhinitis. Curr Allergy Asthma Rep 2010; 10:365-72. [PMID: 20589483 DOI: 10.1007/s11882-010-0131-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The burden of asthma attributable to occupational exposures is significant. A better evaluation of markers of asthma and rhinitis in occupational settings may help reduce the frequency of occupational asthma (OA) and rhinitis (OR). This publication reviews articles published in 2008 and 2009 to provide an update on aspects related to markers of asthma and rhinitis. Markers derived from occupational exposure assessment, questionnaires, clinical data, and noninvasive tests such as functional tests or measures of serum antibodies are used to develop prediction models for the likelihood of OA and OR development. Findings from prospective studies highlight the course of preclinical signs and markers of airway inflammation in the natural history of OA and OR. Airway inflammation, evaluated by quantification of cells and mediators in induced sputum or nasal lavage and by exhaled nitric oxide, is associated with OA and OR; however, the sensitivity and specificity of these means, especially exhaled nitric oxide, have not been sufficiently assessed.
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Affiliation(s)
- Denyse Gautrin
- Université de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin Boulevard West, Montreal, Quebec, Canada.
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Castano R, Malo JL. Occupational rhinitis and asthma: where do we stand, where do we go? Curr Allergy Asthma Rep 2010; 10:135-42. [PMID: 20425505 DOI: 10.1007/s11882-010-0092-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This review provides an overview of current and emerging issues regarding occupational rhinitis (OR) and occupational asthma (OA), focusing on studies discussing concepts and results that are relevant to both diseases. OA and OR are conditions that affect the upper and lower airways, are characterized by reduced airway caliber and hyperresponsiveness and by inflammation, and are caused by agents present in the workplace. To explain disease expression, research is moving from the T-helper type 1/type 2 cells paradigm to consider the contribution of diverse alternative pathways such as neural inflammation, a dysfunctional epithelial barrier, and autoimmune mechanisms, among others. Objective assessment of OR and OA has been improved and tested for research and, currently, clinical application. Further developments in the field of OR are expected to lead to more generalized clinical applications, following the example of what has been achieved for OA.
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Affiliation(s)
- Roberto Castano
- Department of Otolaryngology/Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin Ouest, J-3185, Montréal, Québec, H4J 1C5, Canada.
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Quirce S, Lemière C, de Blay F, del Pozo V, Gerth Van Wijk R, Maestrelli P, Pauli G, Pignatti P, Raulf-Heimsoth M, Sastre J, Storaas T, Moscato G. Noninvasive methods for assessment of airway inflammation in occupational settings. Allergy 2010; 65:445-58. [PMID: 19958319 DOI: 10.1111/j.1398-9995.2009.02274.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present document is a consensus statement reached by a panel of experts on noninvasive methods for assessment of airway inflammation in the investigation of occupational respiratory diseases, such as occupational rhinitis, occupational asthma, and nonasthmatic eosinophilic bronchitis. Both the upper and the lower airway inflammation have been reviewed and appraised reinforcing the concept of 'united airway disease' in the occupational settings. The most widely used noninvasive methods to assess bronchial inflammation are covered: induced sputum, fractional exhaled nitric oxide (FeNO) concentration, and exhaled breath condensate. Nasal inflammation may be assessed by noninvasive approaches such as nasal cytology and nasal lavage, which provide information on different aspects of inflammatory processes (cellular vs mediators). Key messages and suggestions on the use of noninvasive methods for assessment of airway inflammation in the investigation and diagnosis of occupational airway diseases are issued.
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Affiliation(s)
- S Quirce
- Department of Allergy, Hospital La Paz, Madrid, Spain
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Pignatti P, Pala G, Pisati M, Perfetti L, Banchieri G, Moscato G. Nasal blown secretion evaluation in specific occupational nasal challenges. Int Arch Occup Environ Health 2009; 83:217-23. [DOI: 10.1007/s00420-009-0459-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 08/04/2009] [Indexed: 11/27/2022]
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:177-84. [DOI: 10.1097/aci.0b013e328329f9ca] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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