Tae Young Jang

Anti-IL-33 antibody has a therapeutic effect in a murine model of allergic rhinitis.

To cite this article: Kim YH, Yang TY, Park C‐S, Ahn S‐H, Son BK, Kim JH, Lim DH, Jang TY. Anti‐IL‐33 antibody has a therapeutic effect in a murine model of allergic rhinitis. Allergy 2012; 67: 183–190.

Poloxamer/Cyclodextrin/Chitosan-Based Thermoreversible Gel for Intranasal Delivery of Fexofenadine Hydrochloride

To enhance permeation and solubility of an intranasal delivery system of fexofenadine hydrochloride (FXD HCl), a new formulation using poloxamer 407 (P407)/hydroxypropyl-β-cyclodextrin (HP-β-CD)-based thermoreversible gels with chitosan, was developed. Prepared gels were characterized by gelation temperature, viscosity, viscoelasticity, and drug release profile. The in vitro permeation study was performed in primary human nasal epithelial cell monolayers cultured by air-liquid interface method. The addition of chitosan caused the slight elevation of gelation temperature and viscosity-enhancing effect. Viscosity enhancement by the incorporation of chitosan caused the retardation of drug release from P407 gels in in vitro release test. The in vitro permeation profile showed that the increase in chitosan content (0.1% and 0.3%, w/v) significantly enhanced the permeation of FXD HCl. After intranasal administration of P407/HP-β-CD-based thermoreversible gels containing 0.1% and 0.3% of chitosan in rabbits at 0.5 mg/kg dose, plasma concentrations of FXD HCl were significantly higher than those of nasal solutions (p < 0.05). In particular, the bioavailability of the optimized thermoreversible gel containing 0.3% chitosan was about 18-fold higher than that of the solution type. These results suggested the feasibility that thermosensitive gels could be used as an effective dosage form to enhance the nasal absorption of FXD HCl.

A comparison of the effects of botulinum toxin A and steroid injection on nasal allergy

Objectives To compare the effects of botulinum toxin A (BTX-A) with intranasal steroid injections on nasal symptoms in patients with allergic rhinitis (AR). Study Design A randomized, placebo-controlled, single-blinded clinical trial (patients were blinded). Material and Methods Thirty-nine patients were included in the study. AR was diagnosed by means of history, clinical examination, and skin prick test. Patients were randomly divided into three subgroups as follows: in group A, 25 units of BTX-A were injected into each inferior turbinate (total 50 units); in group B, 1 cc (20 mg/mL) of triamcinolone was injected into each inferior turbinate; and in group C, 1 cc of isotonic saline was injected as placebo. The symptoms of AR were scored by the patient on a six-point scale. Results At all time points, group A was significantly better than group C. In the nasal obstruction and rhinorrhea scores, group A was significantly better than group B after 8 weeks. Conclusion BTX-A may provide better AR symptom relief in terms of duration and degree than a steroid injection.

Effect of Nasal Tip Surgery on Asian Noses Using the Transdomal Suture Technique

The past two decades have ushered in a new era of nasal tip surgery. The new philosophy focuses on preserving and reorienting nasal tip structures. Modern suture techniques can give predictable results because of more precise suture placement. Only a few reports, however, have objectively evaluated the suture techniques for Asians. Accordingly, the authors aimed to assess the efficacy of the tip suture technique through projection and rotation analysis. We focused on transdomal sutures because they involve one of the most popular suture techniques. Preoperative and postoperative photographs of 85 patients who underwent rhinoplasty at Inha University Hospital between June 2002 and June 2004 were analyzed. The patients were categorized into four groups according to the techniques used. Tip projection was measured by the modified Heuzinger’s method and tip rotation by the nasolabial angle. The pre- and postoperative indexes were compared within each group and among the four groups. Paired and unpaired t tests were used for statistical analysis. When the pre- and postoperative indexes were compared within each group, only the combined technique (transdomal suture with onlay graft) showed significant tip projection improvement. All tip surgeries resulted in insignificant tip rotation increase. Comparison among the four groups showed no significant difference based on the type of tip surgery performed. The suture technique has many advantages, although it has some limitations with Asian noses, especially if used alone. Therefore, we recommend using the suture technique in combination with other tip surgical procedures, such as onlay grafts, to achieve significant tip projection.

Beneficial Effect of Anti-Interleukin-33 on the Murine Model of Allergic Inflammation of the Lower Airway

Objective. Interleukin (IL)-33, which mediates the Th2 allergic pathway, may play a key role in allergic airway inflammation. This study was conducted to evaluate the therapeutic potential of anti-IL-33 antibody for treatment of allergic inflammation of the lower airway in a murine model. Methods. Twenty-four BALB/c mice were used in this study. Saline was used for sensitization and challenge of mice in Group A (control group, n = 6). Mice in Group B (ovalbumin (OVA) group, n = 6) received intraperitoneal (ip) and intranasal OVA challenge. In Group C (control IgG group, n = 6), mice received ip injection with control IgG prior to OVA challenge. Mice in Group D (anti-IL-33 group, n = 6) received an ip injection of anti-IL-33 prior to challenge. Measurements of serum total and OVA-specific IgE and the number of eosinophils, neutrophils, and lymphocytes in bronchoalveolar lavage (BAL) fluid were performed. We performed histopathologic examination to evaluate the degree of eosinophilic infiltration in lung tissue. Airway hyperreactivity was measured according to change of enhanced pause (Penh). Results. A significant decrease in serum total and OVA-specific IgE and the number of eosinophils and neutrophils in BAL fluid was observed in Group D, compared with Group B or Group C (p < .05). In Group D, treatment with anti-IL-33 resulted in a significant decrease in eosinophilic infiltration in lung tissue, compared with Group B and Group C (p < .05). Degree of airway hyperreactivity, measured by Penh, showed a significant decrease in the anti-IL-33 treatment group, compared with the OVA group or the control IgG treatment group (p < .01, at 50 mg/mL of methacholine). Conclusions: Anti-IL-33 has therapeutic potential for treatment of allergic inflammation of the lower airway.

Nasal provocation test is useful for discriminating allergic, nonallergic, and local allergic rhinitis.

Background No standard study protocol or diagnostic criteria based on nasal provocation test (NPT) and acoustic rhinometry (AR) results are available for allergic rhinitis. Objective We aimed to evaluate the usefulness of NPT plus AR for the differential diagnosis of local allergic rhinitis (LAR), allergic, and nonallergic rhinitis. Methods The medical records and skin-prick test (SPT) and NPT results of 262 patients with symptoms of chronic rhinitis were reviewed. Patients were allocated to one of three groups, that is, group A [n = 110, negative SPT result for Dermatophagoides pteronyssinus (DP)], group B (n = 53, weakly positive result), or group C (n = 99, strongly positive result). Results Twelve patients had a negative SPT result and provoked response in NPT [29% decrease of minimal cross-sectional area (MCA) after DP challenge] were diagnosed to have LAR. After DP challenge, group C showed significant aggravation of nasal symptoms and a greater decrease in acoustic parameters than groups A and B (p < 0.01). In patients with a more than or equal to 2 visual analog scale (VAS) increase in nasal obstruction (NO) after DP challenge, the criterion “a change of total nasal symptom score (TNSS) of more than or equal to 6.5” had 90.6% sensitivity and 77.4% specificity for the diagnosis of allergic rhinitis, whereas the diagnostic criterion “a total nasal volume (TNV) change at 30 minutes after DP challenge of more than or equal to 27.6%” had 73.4% sensitivity and 58.1% specificity. Conclusion NPT with AR could be a useful tool for the differential diagnosis of allergic, nonallergic, and local allergic rhinitis.

Evaluation of acoustic rhinometry in a nasal provocation test with allergic rhinitis

Objective The nasal provocation test is not widely available due to lack of standardized methods and related research. We evaluated the clinical utility of the nasal provocation test using acoustic rhinometry. Study Design All patients underwent skin tests and were graded according to severity of reaction. Methods We performed nasal provocation tests using acoustic rhinometry in patients with allergic rhinitis from January 2003 to December 2006. A total of 836 patients participated in our study. The mean age was 36 years and the male:female ratio was 5:4. Results The mean nasal volume was 10.86 cm3 and the mean minimal cross-sectional area (MCA) was 0.66 cm3 before the study. Relationship between the severity of the reaction and change in mean nasal volume and MCA was statistically significant. The relationship between the severity of the reaction against the antigen and the severity of clinical symptoms was also statistically significant. Conclusion The nasal provocation test can be helpful in evaluating the severity of allergic rhinitis. However, we must be careful in interpreting the results alone.

Effects of α‐Toxin of Staphylococcus aureus on the Ciliary Activity and Ultrastructure of Human Nasal Ciliated Epithelial Cells

Objective: The in vitro effects of staphylococcal α‐toxin on ciliary activity were investigated at different concentrations and exposure times.

Long-Term Effectiveness and Safety of Endoscopic Vidian Neurectomy for the Treatment of Intractable Rhinitis

Objectives Vidian neurectomy could be considered the treatment of choice for intractable rhinitis, because it is the only method that can permanently block the pathophysiological mechanism of rhinitis. The goal of this study was to evaluate the effect of vidian neurectomy on nasal symptoms and tear production, and to assess for possible complications. Methods Six patients with intractable rhinitis who underwent endoscopic transnasal vidian neurectomy were enrolled. The degree of symptom improvement and complications were assessed through retrospective review of medical records prior to, and 1 year following surgery, and telephone survey after 6.9±2.1 years. Schirmers test was performed before surgery, and these values were compared to postoperative results at 1 day, 1 month, and 2 months. Results Changes in the visual analogue scale were significant in nasal obstruction (8.5±2.5 to 3.0±2.0, P<0.05) and rhinorrhea (9.0±2.2 to 2.0±1.6, P<0.05). Improvements persisted for up to 7 years after the primary surgery. Patients complained of mild dry eyes for 1 month after vidian neurectomy. However, five out of six reported marked improvement of xerophthalmia after 2 months. Aside from mild crusting of the nasal cavity and mild postoperative pain, there were no major complications. During the entire follow-up period, no patient needed additional treatment, such as antihistamines or corticosteroids. Conclusion Vidian neurectomy is effective in alleviating nasal symptoms in patients with intractable rhinitis refractory to other treatments. This effect is sustained for at least 7 years with minimal postoperative complications.

Histologic study of Gore-Tex removed after rhinoplasty.

Gore‐Tex is known to be a relatively safe material. However, it leads to complications. Although widely used, the reasons complications occur are poorly understood. Thus, this study attempted to investigate histological changes between the Gore‐Tex, removed within a certain period of time after rhinoplasty, and its neighboring tissues.