Lin Xi

Evaluation of the Psychological Status in Seasonal Allergic Rhinitis Patients

Objective: To investigate the psychological status of Chinese adults with seasonal allergic rhinitis (SAR) in the allergic season, and evaluate the effects of nasal symptoms on their psychological status. Methods: The Symptom Checklist 90 (SCL-90) or Self-Reporting Inventory was employed to analyze the psychological status of 337 SAR patients. Results: The SCL-90 scores of the SAR patients were statistically higher than those of nonallergic adults in terms of somatization, depression, anxiety, hostility and psychosis. No statistical discrepancies existed in gender or age, the impact of disease course was limited to somatization, compulsion and phobic disorders and the impact of the educational level was that the lower the level of education, the more obvious the hostility. The behavior of somatization, compulsion, depression and anxiety in patients with a history of eczema or asthma was much more obvious than in patients without such a history. Nasal obstruction had a conspicuous impact on somatization, compulsion, interpersonal sensitivity, depression, anxiety and psychosis, while nasal itching contributed to somatization, depression and anxiety. Conclusion: The psychological status of SAR patients is evidently worse than that of nonallergic adults. Symptoms such as nasal obstruction and nasal itching had an obvious impact on the psychological status of the patients.

Psychological Aspects of Female Patients with Moderate-to-Severe Persistent Allergic Rhinitis

Background: Allergic rhinitis (AR) has been shown to impair social life and psychological functioning. The objective of our study was to explore the relationships between moderate-to-severe persistent AR and personality traits in non-psychiatric female outpatients. Methods: Female subjects were assigned to the allergic (n = 52, 24 singletons and 28 non-singletons) or non-allergic group (n = 28, 11 singletons and 17 non-singletons) on the basis of skin prick tests (SPT) and allergic symptoms. Individuals in this study were only allergic to Dermatophagoides pteronyssinus and/or D. farinae. The psychological aspects of the female subjects were assessed by using the Minnesota Multiphasic Personality Inventory (MMPI). Results: The allergic group scored significantly higher than the non-allergic group on 6 clinical scales [hypochondriasis (Hs), depression (D), hysteria (Hy), psychasthenia (Pt), schizophrenia (Sc), social introversion (Si)] and 1 validity scale [infrequency (F)]. Analysis of female singleton outpatient MMPI profiles showed that allergic subjects scored significantly higher on D, Hy, masculinity/femininity (Mf), Pt, and F. In addition, the grade of skin index (resulting from an SPT) was positively correlated with T-scores on the Hs, Hy, Pt, and Sc scales. Conclusion: Women with moderate-to-severe persistent AR, especially singleton patients, show poorer psychological functioning, indicating the close relationship between moderate-to-severe persistent AR and psychological functioning.

A Multicenter Randomized Double-Blind 2-Week Comparison Study of Azelastine Nasal Spray 0.1% versus Levocabastine Nasal Spray 0.05% in Patients with Moderate-to-Severe Allergic Rhinitis

Objective: To compare the onset of action, efficacy, and safety of azelastine and levocabastine in the treatment of allergic rhinitis. Subjects and Methods: In a multicenter, randomized, double-blind, parallel-group trial, 244 patients with moderate-to-severe allergic rhinitis were randomized to receive either azelastine hydrochloride nasal spray (ANS) 0.1% or levocabastine hydrochloride nasal spray (LNS) 0.05% for 14 consecutive days. A visual analog scale was used to record total nasal symptom score (TNSS) changes. Indexes for further assessment included onset of action, total effective rate, and evaluation of therapeutic effect. Results: Statistically significant changes from baseline in TNSS were seen in both the LNS group and the ANS group. No significant differences were seen between the two groups in terms of evaluation of therapeutic effect, total effective rate, and onset of action, except for a higher symptom relief rate in the LNS group than in the ANS group within 30 min of administering the first dose. Adverse reactions were mild to moderate, with an incidence of 0.9% for LNS and 2.5% for ANS. Conclusion: Both ANS and LNS were effective and safe in the treatment of moderate-to-severe persistent allergic rhinitis. Moreover, LNS reached a higher symptom relief rate within 30 min of administering the first dose.

Expression of the Foxp3 Gene in Spleen Mononuclear Cells of a Mouse Model with Allergic Rhinitis

Objective: There is growing speculation that the impairment inregulatory-T-cell (Treg)-mediated dominant tolerance may play an important role in the pathogenesis of allergic rhinitis (AR). The aim of this study was to investigate whether the changes in the forkhead transcription factor 3 (Foxp3) gene expression may aggravate nasal mucosal inflammation in allergic mice, and whether or not these features result from the loss of Tregs. Methods: AR was induced by both intraperitoneal injection and intranasal administration of ovalbumin in BALB/c mice, while the control mice were treated with saline. A comparison of the frequency of CD4+CD25+Foxp3+ Tregs in peripheral blood mononuclear cells of the AR and control mice was made by flow cytometry. Spleen mononuclear cells were used for RNA extraction and RT-PCR was used to measure Foxp3 mRNA expression. Results: The expression of the Foxp3 gene was significantly reduced in spleen mononuclear cells in AR mice compared with the control. Moreover, a significant decrease in the percentage of CD4+CD25+Foxp3+ Tregs was exhibited in peripheral blood mononuclear cells of AR mice compared with the control mice. Conclusion: The insufficiency of Tregs and the Foxp3 gene may contribute to the development of AR in mice.

Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.

Severity of nasal obstruction can predict the anxiety status of patients with allergic rhinitis but not patients with vasomotor rhinitis.

Allergic rhinitis (AR) is a chronic systemic allergic disease with an association reported between allergy and anxiety. The objective of the current study was therefore to investigate and retrospectively evaluate the factors that may possibly induce state and trait anxiety among patients with AR and vasomotor rhinitis (VMR).

Contents Vol. 71, 2009

R.L. Alford, Houston, Tex. M. Anniko, Uppsala D.D. Backous, Seattle, Wash. Y.A. Bayazit, Ankara H.H. Birdsall, Houston, Tex. P.J. Bradley, Nottingham J. Califano, Baltimore, Md. P.F. Castellanos, Bimingham, Ala. C. Cernea, São Paulo F.-L. Chi, Shanghai A. Chiu, Philadelphia, Pa. N. Cohen, Philadelphia, Pa. M.D. Eisen, Hartford, Conn. E. Ferekidis, Athens A. Ferlito, Udine R.L. Ferris, Pittsburgh, Pa. L.L. Gleich, Cincinnati, Ohio D.-M. Han, Beijing J.P. Harris, San Diego, Calif. R. Häusler, Bern I. Hochmair, Innsbruck K. Hörmann, Mannheim W. Hosemann, Greifswald K.-B. Hüttenbrink, Köln S. Iurato, Bari A. Kakigi, Tokyo B.N. Landis, Geneva T. Linder, Luzern W.J. Mann, Mainz J.J. Manni, Maastricht J.B. Nadol, Jr., Boston, Mass. J.N. Palmer, Philadelphia, Pa. G.J. Petruzzelli, Chicago, Ill. R. Probst, Zürich A. Rinaldo, Udine R.J. Ruben, Bronx, N.Y. I. Salahuddin, Karachi A. Schrott-Fischer, Innsbruck A. Shiotani, Saitama G.A. Tavartkiladze, Moscow T.N. Teknos, Columbus, Ohio K. Tomoda, Osaka R.P. Tufano, Baltimore, Md. R.T. Younis, Miami, Fla. P. Zbären, Bern Journal for Oto-Rhino-Laryngology, Head and Neck Sugery