ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The link between upper and lower respiratory tracts has been repeatedly observed in the past 50 years but only carefully investigated during the past decade. Several clinical and experimental observations suggested the hypothesis of the unity of upper and lower airways (allergic rhinobronchitis or united airways disease). The relationships between rhinitis (and sinusitis) and asthma also include non-epidemiological aspects such as viral infections and bronchial hyperreactivity. The hypotheses have been confirmed by means of epidemiological observations, functional and immunological evidence and, indirectly, by observing the effects of drugs used mainly for rhinitis on asthma symptoms. In this article, therefore, we collected and reviewed the most relevant experimental results available to support the hypothesis for united airways disease and the studies conducted on the possible mechanisms of nose-lung interaction.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Patients in the rhinitis clinic with negative skin prick tests present a challenge. Non-allergic rhinitis consists of a variety of conditions including infection, hormonal changes, drugs and autonomic dysfunction. There is also a range of systemic disorders to be considered. The pathogeneses of many of these are less well understood than that of allergic rhinitis, diagnosis and treatment pathways are also more complex. A detailed accurate history needs to be taken followed by relevant investigations which may include allergen challenge, because skin prick and RAST-negative allergic rhinitis is now recognised. Nitric oxide levels may prove helpful: elevated levels suggest inflammation, very low levels indicate the possibility of primary ciliary dyskinesia or cystic fibrosis. Treatment is of the underlying cause when found: for those without obvious pathology a trial of combined therapy with topical corticosteroids plus antihistamine or plus anti-cholinergic may be worth while. A complex inter-relationship between allergic and infectious rhinitis is becoming apparent.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Upper respiratory tract infections are among the most common infectious diseases. Approximately 80% of the common colds are caused by rhinoviruses. Recently, rhinovirus colds have been linked with lower airway illnesses such as asthma exacerbations resulting in a considerable interest in the pathogenesis of lower respiratory tract pathology. The important role that allergic airway disease plays in virally induced changes in airway function has been experimentally shown in several studies. Unfortunately, the precise mechanisms by which viruses could induce lower airway symptoms have not yet been determined.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Interesting findings relating to aspirin-induced asthma recently emerged. In this distinct clinical syndrome, aspirin and most other nonsteroidal anti-inflammatory drugs that inhibit cyclooxygenase precipitate rhinitis and asthma attacks. Aspirin-induced asthma affects 5-10% of adult asthmatics, but remains largely underdiagnosed. The natural history of aspirin-induced asthma has been described, based on an extensive pan-European survey. All over Europe the disease develops according to a pattern in a similar, characteristic way, which might suggest a common underlying principle. Aspirin provocation tests with improved diagnostic accuracy have been developed, although no in-vitro test has been found to be of diagnostic value. At the biochemical level, aspirin-induced asthma is characterized by a chronic overproduction of cysteinyl leukotrienes. The key enzyme, LTC4 synthase, is overexpressed in bronchi and its mRNA is upregulated in peripheral blood eosinophils. The gene coding for LTC4 synthase exists in two common alleles, one of which appears to be associated with a severe, steroid-dependent type of aspirin-induced asthma. Preliminary observations indicate that new, highly specific cyclooxygenase-2 inhibitors may soon become a safe alternative for aspirin-intolerant patients with asthma.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The incidence of allergic diseases has increased dramatically over recent years in most industrialized countries of the world. Air pollution from motor vehicles has been implicated as one of the factors that are responsible for this increase. Epidemiological studies carried out in different geographical regions in the world have shown a significant and consistent association between ambient levels of pollutants and increased asthma and rhinitis symptoms. Recent human and animal exposure studies, as well as laboratory-based studies, have demonstrated that diesel particles, ozone and nitrogen dioxide induce an inflammatory response that involves various inflammatory cells, mediators and adhesion molecules, which could contribute to worsening of the allergic disorders. The present review describes our current understanding of the mechanisms by which pollutants such as diesel exhaust and ozone enhance the underlying allergic inflammatory response, and possibly explain the associations between pollutants and increasing allergic diseases noted in epidemiological studies.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The scope of this review is to highlight important and interesting articles in the field of allergen-specific immunotherapy in allergic rhinitis published within the past year. The review is not intended to give a full overview of published literature but rather to focus on some subjects that I find significant in relation to the understanding of the specific treatment of allergies and to the selection of different treatment modalities. The most important aspects are how to define the most suitable candidates for the specific treatment, the mechanisms of action of immunotherapy and how to optimize treatment, and finally I include some reflections on the optimal presentation of the allergen to the immune system.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Allergic diseases such as atopic dermatitis, rhinitis and asthma are thought to result from a dysregulated immune response to commonly encountered antigens in genetically predisposed individuals. This response leads to chronic eosinophil-rich allergic inflammation and is controlled by Th2 lymphocytes. The first step in the allergic immune response is the uptake and presentation of allergen by professional antigen presenting cells such as dendritic cells, macrophages and B lymphocytes. Immature dendritic cells reside in the epithelia of the skin, upper and lower airways and gut and have the potential to sense foreign antigens and non-specific inflammatory tissue damage. Following recognition and uptake of Ag, mature dendritic cells migrate to the T-cell rich area of draining lymph nodes, display an array of Ag-derived peptides on the surface of major histocompatibility complex molecules and acquire the cellular specialization to select and activate naive Ag-specific T cells. By the nature of the signals they provide to naive T cells, mature dendritic cells are critical for polarizing Th0 helper cells into either Th1 or Th2 effector cells and for inducing long-lived memory Th cells. This article reviews recent information implying dendritic cells in the pathogenesis of allergic disease.

ISSN:1528-4050    

出版商:OVID    

年代:2001

数据来源: OVID