Maria Angela Tosca

Induction of interleukin 10 by sublingual immunotherapy for house dust mites: a preliminary report

BACKGROUND Subcutaneous specific immunotherapy has been demonstrated to be capable of inducing T-cell regulatory response. Interleukin 10 (IL-10) plays a crucial role in inducing allergen-specific tolerance; however, no previous studies have examined IL-10 production after sublingual immunotherapy (SLIT). OBJECTIVE To evaluate T-cell proliferation and IL-10 production in patients successfully treated with SLIT for house dust mites (HDMs). METHODS Peripheral blood mononuclear cells were isolated from patients after at least 3 years of successful HDM SLIT and from matched untreated allergic patients and healthy control subjects. After 3 and 6 days of in vitro stimulation with phytohemagglutinin (PHA), Candida albicans, and Dermatophagoides farinae, proliferation and production of IL-10 were measured. RESULTS Patients treated with SLIT showed a significant reduction of proliferation induced by C albicans compared with untreated atopic patients (P < .001), but a significant reduction was also demonstrated in healthy controls compared with untreated atopic patients (P < .001). Patients treated with SLIT also showed a significant increase of IL-10 production after Candida and PHA stimuli compared with patients with untreated rhinitis (P < .001 for both). Patients with untreated rhinitis did not produce IL-10. CONCLUSION This preliminary study confirms reduced T-cell proliferation and preliminarily provides the first evidence, to our knowledge, of peripheral IL-10 production in allergic patients successfully treated with HDM SLIT.

Serum interleukin-17 levels are related to clinical severity in allergic rhinitis.

Background:  T helper (Th)‐17 cells are a subset of T helper lymphocytes that exert regulatory activities. Recently, it has been reported that serum interleukin (IL)‐17 levels are high in the most severe cases of birch allergy studied outside the pollen season.

Levocetirizine improves nasal obstruction and modulates cytokine pattern in patients with seasonal allergic rhinitis: a pilot study.

Background Allergic rhinitis is characterized by an IgE‐dependent inflammation. Nasal obstruction is related to allergic inflammation. Some antihistamines have been demonstrated to be capable of improving this nasal symptom.

Allergic children have more numerous and severe respiratory infections than non‐allergic children

Allergic disorders are characterized by Th2‐polarization, and hence physiological Th1‐dependent mechanisms for fighting respiratory infections (RI) may be defective. This study aimed at evaluating the number and duration of RI in allergic and non‐allergic children suffering from recurrent RI. One hundred seventeen children (4.02 ± 1.0 yr, 72 males and 45 females) were studied during the spring, 46 were allergic. Allergic children showed a significantly higher number (mean 1.26 ± 0.73) and longer duration of RI (8.92 days) in comparison with non‐allergic group (0.94 ± 1.37 and 4.85 days) (p = 0.0001 and p = 0.009, respectively). In conclusion, this study provides the evidence that allergic children have more numerous and severe RI than non‐allergic children.

Continuous antihistamine treatment controls allergic inflammation and reduces respiratory morbidity in children with mite allergy

Background: Allergic reaction is characterized by a complex inflammatory process. Some of the new antihistamines have antiallergic effects and can affect the inflammatory cell recruitment via adhesion molecule downregulation. We aimed to assess in a 12‐month study whether continuous treatment with an antihistamine (terfenadine) can reduce respiratory symptoms and local inflammation in children with mite allergy.

Nasal Obstruction in Patients with Seasonal Allergic Rhinitis: Relationships between Allergic Inflammation and Nasal Airflow

Background: Nasal obstruction is a typical symptom of allergic rhinitis. Allergic rhinitis is characterized by a Th2-dependent inflammation. The aim of this study was to evaluate the possible relationships between allergic inflammation, including inflammatory cells and cytokine pattern, and nasal airflow in patients with nasal obstruction due to seasonal allergic rhinitis. Methods: Fifty patients (31 males and 19 females, mean age 31.9 ± 4.8 years) with seasonal allergic rhinitis were evaluated during the pollen season. All of them had moderate to severe nasal obstruction. Total symptom score, rhinomanometry, nasal lavage, and nasal scraping were assessed in all subjects. Inflammatory cells were counted by conventional staining; IL-4, IL-5, IL-8, and IFNγ were measured by immunoassay on fluids recovered from nasal lavage. Results: Significant positive relationships were demonstrated between eosinophil infiltration and IL-4 levels (p < 0.0001), eosinophils and IL-5 levels (p < 0.0001), and eosinophils and IL-8 levels (p < 0.0001). Significant negative relationships were demonstrated between eosinophil infiltration and IFNγ levels (p < 0.0001) and eosinophil infiltration and nasal airflow (p < 0.001). Conclusions: This study demonstrates the close connection between Th2 cytokines and eosinophil infiltration. In addition, there is clear evidence concerning the relationship between eosinophil infiltration and nasal airflow. These findings constitute first evidence of the relationship between nasal airflow impairment and Th2-related inflammation in seasonal allergic rhinitis.

Cetirizine treatment of rhinitis in children with pollen allergy: evidence of its antiallergic activity

Background Cetirizine is an antihistamine, largely used in the treatment of allergic rhinoconjunctivitis, which also exerts anti‐allergic activity.

Relationships between allergic inflammation and nasal airflow in children with persistent allergic rhinitis due to mite sensitization

Background:  Allergic rhinitis is associated with Th2‐dependent inflammation. Nasal obstruction is the most typical symptom in children with mite allergy.

Bronchial hyperreactivity and spirometric impairment in patients with perennial allergic rhinitis.

Background: Allergic disorders are characterized by a systemic involvement of the immune response. There is a clear link between allergic rhinitis and asthma. Bronchial hyperreactivity (BHR) may be present in rhinitics. Smaller airways may also be impaired in mild asthma. This study aimed at evaluating a group of subjects suffering from perennial allergic rhinitis alone to investigate the presence of BHR and spirometric impairment. Methods: One hundred rhinitics sensitized only to perennial allergens were evaluated. Spirometry and methacholine bronchial challenge were performed. Results: Five rhinitics showed reduced values of forced expiratory volume/1 s (FEV1) without symptoms of asthma. Forty-eight rhinitics had reduced forced expiratory flow at 25 and 75% of pulmonary volume (FEF25–75) values. Seventy-two patients showed a positive methacholine challenge. In this group, reduced values of FVC (p < 0.05), FEV1 (p < 0.05), and FEF25–75 (p < 0.01) were demonstrated in comparison with BHR-negative rhinitics. There was a relationship between the degree of BHR and FEV1 values (p < 0.05) and FEF25–75 values (p < 0.01). Conclusions: This study evidences that an impairment of spirometric parameters may be observed in patients with perennial allergic rhinitis alone. A high percentage of these patients have BHR. Thus, new management strategies should be employed in rhinitics.

Cetirizine treatment of allergic cough in children with pollen allergy.

Cetirizine, an antihistamine widely used in the treatment of allergic rhinoconjunctivitis, also has antiallergic activity. The present study aimed to evaluate cetirizine as a treatment for children with allergic cough due to pollen allergy. This was a parallel‐group, double‐blind, placebo‐controlled, randomized study. Twenty children with pollinosis were enrolled: they were subdivided into two groups receiving a 1‐month treatment during the pollen season. The following variables were monitored: 1) clinical symptoms and respiratory data (spirometry and PEF) evaluated at baseline and at the end of the study by allergists and by a daily diary card, and 2) pollen count. This study shows that cetirizine treatment reduces cough intensity (P < 0.05) and frequency (p < 0.01). In conclusion, cetirizine does clinically improve cough due to pollen allergy.