Rika Osada

Increased nitric oxide production in nasal epithelial cells from allergic patients – RT‐PCR analysis and direct imaging by a fluorescence indicator: DAF‐2 DA

Background Nitric oxide (NO) is believed to participate in the regulation of airway clearance and non‐specific cellular immunity. Recent studies have suggested that airway epithelial cells of allergic and non‐allergic individuals may differ in their ability to produce this molecule.

Nuclear Factor-Kappa B Activation in the Nasal Polyp Epithelium: Relationship to Local Cytokine Gene Expression†

Objectives A panel of cytokines has been found to be important for eosinophil accumulation and activation in nasal polyps. The aims of this study were to ascertain whether the activation of nuclear factor‐kappa B (NF‐κB) occurred in the polyp epithelium, and to examine the relationship between the degree of activation and local cytokine gene expression.

Laser surgery of the inferior turbinate for allergic rhinitis with seasonal exacerbation: an acoustic rhinometry study.

Laser surgery has been used to successfully treat patients with perennial allergic rhinitis. We examined whether the numbers and types of sensitized allergens influence the effects of surgery. Two different groups (those allergic to house dust mites only, and those allergic to house dust mites and Japanese cedar pollen) prospectively underwent the same course of laser turbinectomy during the pollen dispersion season. The symptom scores for nasal obstruction significantly decreased in both groups, but the improvement of sneezing and rhinorrhea was less pronounced in the pollen group. We used acoustic rhinometry to measure postoperative changes in the nasal dimensions. Four months after treatment, the minimum cross-sectional area and nasal cavity volume had increased, respectively, by 61.7% and 30.7% in the house dust group, and by 30.7% and 16.2% in the pollen group. We conclude that laser surgery can be successfully applied to patients whose allergies show seasonal exacerbation by airborne pollen.

Analysis of local cytokine gene expression in patients with allergic rhinitis treated with CO2 laser surgery.

Objectives/Hypothesis Laser surgery of the inferior turbinates has become a popular surgical treatment for patients with allergic rhinitis, particularly for those who have persistent nasal obstruction and do not respond well to pharmacological therapy. The aim of this study was to investigate the effects of the laser surgery on local cytokine gene expression at the mucosal surface in relation to the improvement of nasal symptoms.

Study of eosinophil activation in nasal mucosa in patients with perennial nasal allergy: effects of CO2 laser surgery.

Carbon dioxide (CO2) laser surgery has been shown to be clinically effective in the treatment of nasal allergy. To investigate the mechanisms of eosinophil infiltration and activation underlying the therapeutic effects of CO2 laser surgery, we examined changes in the cytological profile of nasal mucosa after surgery. Twenty-two patients with perennial nasal allergy against house-dust mites underwent two or three rounds of laser surgery at 1-month intervals on an outpatient basis. The following parameters were evaluated at each visit: (i) improvement of clinical symptoms (nasal obstruction, rhinorrhea, and sneezing), (ii) percentage of infiltrating eosinophils in nasal mucosa, and (iii) the degree of EG2+ cells and intracellular adhesion molecule 1 (ICAM-1) expression by immunocyto-chemistry. All clinical symptoms significantly decreased after surgery. Significant reductions in eosinophil infiltration (p < 0.01) and the percentage of EG2+ cells (p < .005) were observed also. However, the degree of ICAM-1 expression in epithelial cells was not changed. These results suggest that CO2 laser surgery partially reduced the allergic reactions, leading to improvement of clinical symptoms.

Angioedema Potentially Induced by Angiotensin Converting Enzyme Inhibitors.

We report two cases of angioedema probably due to a side effect of angiotensin converting enzyme (ACE) inhibitors. In the first case, angioedema of the tongue was so severe that we had to perform a tracheotomy. In the second case, angioedema of the left arytenoid region and entire face was moderate and intubation was not required as the administration of high doses of corticosteroids and antihistamines effectively reduced the edema. Angioedema associated with ACE inhibitors has rarely been reported. Recent use of ACE inhibitors has increased however and the incidence of angioedema as a side effect of ACE inhibitor administration may be greater than generally estimated. Since angioedema can cause upper airway obstruction, we must be aware of this side effect and should be aware of the possible need to maintain an airway, and especially to be prepared for the possibility of surgical intervention. Detailed anamnesis regarding the use of ACE inhibitors will lead to a correct and prompt diagnosis.