Wk Lam

Magnetic Resonance Imaging in Mild Recessive RYR1 Gene-related Congenital Myopathies: Genetic and Histopathological Correlation

Objective: To review and evaluate the pattern of muscle involvement evidenced on magnetic resonance imaging (MRI) in patients with mild recessive mutations in ryanodine receptor type 1 (RYR1) gene–related congenital myopathies, and to compare the consistency with those previously reported, and correlate with genetic and histological analysis. Methods: The thigh and calf MRI (axial T1-weighted and short-tau inversion recovery / T2-weighted) of three Chinese patients who presented with early-onset congenital myopathy and were subsequently confirmed to have a heterozygous autosomal recessive RYR1 gene mutation were retrospectively reviewed by two paediatric radiologists. Pattern of muscle involvement was documented, with correlation of focused mutational genetic analysis and histological analysis of muscle biopsies. Results: All three patients showed selective involvement of the thigh muscles with relative sparing of the rectus femoris, gracilis, semitendinosus and adductor longus, consistent with a previously reported pattern. A more diverse pattern was noted within calf muscles, although the soleus still showed a generally more severe degree of fat infiltration than the gastrocnemius. One muscle biopsy confirmed rod bodies on Gomori trichrome staining and nemaline rods on electron microscopy. Mutational analysis of the RYR1 gene revealed three novel mutations (c.1675dupA, c.10615delC, and c.11956dupG), and two known missense mutations (c.3523G>A, c.3800C>G). The missense mutation c.3523G>A (p.Glu1175Lys) was identified in two patients, suggesting that this variant is probably a hotspot mutation in the Chinese population. Conclusion: With characteristic and consistent patterns of muscle involvement and fat infiltration, muscle MRI of the thigh and calf is useful in establishing the diagnosis of RYR1-related congenital mypopathy in a Chinese population, thereby guiding more focused mutational analysis and management.

Evaluation of Congenital Mitral-aortic Intervalvular Fibrosa Aneurysm: Role of Multidetector Computed Tomography in Congenital Heart Disease

Mitral-aortic intervalvular fibrosa aneurysm is a rare disease entity whose aetiology remains uncertain. Most of the cases reported are believed to be a sequela of infective endocarditis. We present a case of congenital mitralaortic intervalvular fibrosa aneurysm, representing the first patient to be diagnosed at birth in the literature. This report illustrates the imaging features of mitral-aortic intervalvular fibrosa aneurysm and the role of multidetector computed tomography in the diagnostic process.

Anomalous Systemic Arterial Supply to the Normal Basal Segments of the Left Lower Lobe of the Lung

Anomalous systemic arterial supply to the normal basal segments of the lower lobe of the lung without sequestration is a rare congenital abnormality. Whether the condition belongs to the broad spectrum of sequestration disorders remains controversial. This report is of a patient with anomalous systemic arterial supply to the normal basal segments of the left lower lobe, together with an attenuated pulmonary artery and normal tracheobronchial tree.

The relationship of insulin resistance, obesity and sleep-disordered breathing

for the 9th Congress of the Asian Pacific Society of Respirology 10–13 December 2004, Hong Kong Editors: Dr K.S. Chan Dr P.C. Wong A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF HOUSE DUST MITE IMMUNOTHERAPY IN ASTHMATIC PATIENTS IN CHINA HONGYU WANG1, XIAOPING LIN2, CHUANGLI HAO3, CHUNQING ZHANG1, BAOQING SUN1, JINGPING ZHENG1, PING CHEN2, JINYUN SHENG3, ADRIAN WU4, NANSHAN ZHONG1 1Guangzhou Institute of Respiratory Diseases, 2Shenyang General Military Hospital, 3Suzhou Children’s Hospital, 4Department of Medicine, The University of Hong Kong Background The purpose of this study was to determine if house dust mite immunotherapy is effective in improving symptom control and reducing rescue medication use in Chinese patients with mild to moderate allergic asthma. Methods This is a double-blind, placebo-controlled study involving 132 asthmatic subjects aged 6 to 45 years recruited from 3 different regions of Mainland China. Subjects were given a 52-week course of Alutard Der P (ALK-Abello, Horsholm, Denmark) treatment or placebo while the dose of inhaled corticosteroids (ICS) was maintained. Results 129 subjects (64 active) completed the study. The symptom scores began to diverge at week 25 with the immunotherapy group showing a significantly lower score until week 48 (P = 0.018). Immunotherapy resulted in a significant decline in symptom (P = 0.003) and medication (P = 0.044) scores during the second half of the treatment period only in subjects who were taking ICS. Subjects on ICS also showed significant improvement in PEF after immunotherapy, but no difference in histamine PC20 was found. Serum ECP and blood eosinophils decreased after immunotherapy in subjects not using ICS. Skin test response decreased in immunotherapy subjects only, and Der P-specific IgE decreased in placebo but not immunotherapy subjects. Immunotherapy resulted in a significantly greater improvement in self-evaluation scores (P < 0.01). Conclusions One year of immunotherapy with Alutard Der P significantly reduced symptoms and medication use in asthmatic subjects, particularly in those who were already using ICS. This was associated with a greater subjective improvement in asthma control. 002 Respirology (2004) 9, (Suppl.) A79–A164 ASSOCIATION OF TOTAL PLASMA IGE LEVELS AND ASTHMA IN ASIAN POPULATIONS WD ZHANG, XZ ZHANG, DW QIU, WC TAN Department of Medicine, National University of Singapore Background Previous studies demonstrated that high levels of serum IgE was associated with asthma and other allergic diseases. Objectives To determine and compare the total plasma IgE levels in both asthmatics and healthy controls in Chinese, Malay and Indian in Singapore. Methods Both 311 asthmatics (Chinese 150; Malay 74; Indian 87) and 355 healthy subjects (Chinese 156; Malay 98; Indian 101) were being participated in a genetic study of asthma. Total plasma IgE levels were determined by Enzyme-linked immunosorbent assay (ELISA). A binary logistic model was used to detect the association between total plasma IgE levels and asthma. Results Plasma total IgE was significantly higher in patients group than that of control group in each ethnicity (Chinese: P = 0.049; Malay: P = 0.002; Indian: P = 0.000). Plasma total IgE (Geometric mean) in Chinese (382 IU/ml) was significantly lower than that in Malay (584 IU/ml) and Indian (990 IU/ml) in the patient group (P = 0.000). However, there was no difference for plasma total IgE among Chinese (256 IU/ml), Malay (226 IU/ml) and Indian (323 IU/ml) (P = 0.385) in the control group. Conclusion High level of plasma total IgE may be a risk factor for asthma in Chinese, Malay and Indian. Total plasma IgE levels showed homogeneous among the three ethnicities. TIME TRENDS IN THE PREVALENCE OF ALLERGIC DISEASES IN GUANGZHOU CHILDHOOD HONGYU WANG, JINGPING ZHENG, NANSHAN ZHONG Guangzhou Institute of Respiratory Disease 510120 Guangzhou, China Objective To examine time trends in the prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood. Methods 3575 Children aged 13–14 years were randomly selected from ten middle schools in the four central districts of Guangzhou city in 2001. The selection followed the methods used for ISAAC Phase I in 1994–1995. All subjects completed the written questionnaire on asthma, rhinitis and eczema, then finished the video questionnaire about asthma. Results The response rate was 96%, 50.9% of them were female. With the written questionnaire /video questionnaire, the prevalence of wheezing ever, wheezing in the past year, wheezing related to exercise were 8.6%/5.9%, 4.8%/3.8%, 23.4%/11.3% respectively, revealed significantly higher than that were 6.2%/3.2%, 3.4%/2.0%, 17.4%/6.9% in the Phase I (P < 0.001). The prevalence of asthma ever were 4.6%, similar as 3.9% in the Phase I (P > 0.05). The positive response rate to all the questions related to rhinitis and eczema (P < 0.05) except eczema ever (P > 0.05) were significantly higher than that in Phase I. Conclusions The prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood were increasing during 7 years periods in Guangzhou. STUDY OF ROLE OF INSULIN AND INSULIN RECEPTOR IN ALLERGIC AIRWAY INFLAMMATION OF RATS YL MA, QY HE Department of Pulmonary Medicine People’s Hospital, Peking University, Beijing, P.R.C. 100044 Background Bronchial asthma and type 1 diabetes mellitus (IDDM) are rarely associated in the same subject although the mechanism is still unclear. Methods Streptozotocin and ovalbumin (OVA) were respectively used to induce diabetes mellitus and allergic airway inflammation. 64 male SD rats were divided into 8 groups: group A (asthma); group D (diabetes); group I (insulin treated); group AD (asthma + diabetes); group AI (asthma + insulin treated); group DI (diabetes + insulin treated); group ADI (asthma + diabetes + insulin treated); group C (control). Blood glucose measurements, serum insulin measurements, total and differential leukocyte counts of blood and BALF, HE stained paraffin section of lung tissue were carried out. Immunohistochemistry method was used to describe the distribution of insulin receptor, and the expression of insulin receptor mRNA were measured by RT-PCR. Results After antigen challenge, rats of group A, AI, ADI exhibited airway inflammation characterized by significantly elevated eosinophils and neutrophils, group AD only exhibited mild airway inflammation. Serum insulin levels were higher in groups ADI, AI and A. Immunohistochemistrical staining revealed a diffused distribution pattern of insulin receptor in the lung tissue. Positive cells infiltrating in the lung were increased significantly in groups A, AI and ADI. In groups induced diabetes the expression of insulin receptor mRNA was elevated. Conclusion Administration of low dose insulin aggravated airway inflammation to antigen provocation in rats. Insulin secretion was increased in the presence of inflammation. In the lung of antigen-challenged rats, insulin receptors on the surface of the infiltrating inflammatory cells and bronchial secretory cells were increased. 004 005 003 Saturday 5 April – Respiratory Nurses SIG Oral Presentations (1030–1200) Asthma A80 Respirology (2004) 9, (Suppl.)

Transforming growth factor (TGF)-beta 1 gene common polymorphisms and plasma TGF-beta 1 levels in patients with lung cancer

for the 9th Congress of the Asian Pacific Society of Respirology 10–13 December 2004, Hong Kong Editors: Dr K.S. Chan Dr P.C. Wong A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF HOUSE DUST MITE IMMUNOTHERAPY IN ASTHMATIC PATIENTS IN CHINA HONGYU WANG1, XIAOPING LIN2, CHUANGLI HAO3, CHUNQING ZHANG1, BAOQING SUN1, JINGPING ZHENG1, PING CHEN2, JINYUN SHENG3, ADRIAN WU4, NANSHAN ZHONG1 1Guangzhou Institute of Respiratory Diseases, 2Shenyang General Military Hospital, 3Suzhou Children’s Hospital, 4Department of Medicine, The University of Hong Kong Background The purpose of this study was to determine if house dust mite immunotherapy is effective in improving symptom control and reducing rescue medication use in Chinese patients with mild to moderate allergic asthma. Methods This is a double-blind, placebo-controlled study involving 132 asthmatic subjects aged 6 to 45 years recruited from 3 different regions of Mainland China. Subjects were given a 52-week course of Alutard Der P (ALK-Abello, Horsholm, Denmark) treatment or placebo while the dose of inhaled corticosteroids (ICS) was maintained. Results 129 subjects (64 active) completed the study. The symptom scores began to diverge at week 25 with the immunotherapy group showing a significantly lower score until week 48 (P = 0.018). Immunotherapy resulted in a significant decline in symptom (P = 0.003) and medication (P = 0.044) scores during the second half of the treatment period only in subjects who were taking ICS. Subjects on ICS also showed significant improvement in PEF after immunotherapy, but no difference in histamine PC20 was found. Serum ECP and blood eosinophils decreased after immunotherapy in subjects not using ICS. Skin test response decreased in immunotherapy subjects only, and Der P-specific IgE decreased in placebo but not immunotherapy subjects. Immunotherapy resulted in a significantly greater improvement in self-evaluation scores (P < 0.01). Conclusions One year of immunotherapy with Alutard Der P significantly reduced symptoms and medication use in asthmatic subjects, particularly in those who were already using ICS. This was associated with a greater subjective improvement in asthma control. 002 Respirology (2004) 9, (Suppl.) A79–A164 ASSOCIATION OF TOTAL PLASMA IGE LEVELS AND ASTHMA IN ASIAN POPULATIONS WD ZHANG, XZ ZHANG, DW QIU, WC TAN Department of Medicine, National University of Singapore Background Previous studies demonstrated that high levels of serum IgE was associated with asthma and other allergic diseases. Objectives To determine and compare the total plasma IgE levels in both asthmatics and healthy controls in Chinese, Malay and Indian in Singapore. Methods Both 311 asthmatics (Chinese 150; Malay 74; Indian 87) and 355 healthy subjects (Chinese 156; Malay 98; Indian 101) were being participated in a genetic study of asthma. Total plasma IgE levels were determined by Enzyme-linked immunosorbent assay (ELISA). A binary logistic model was used to detect the association between total plasma IgE levels and asthma. Results Plasma total IgE was significantly higher in patients group than that of control group in each ethnicity (Chinese: P = 0.049; Malay: P = 0.002; Indian: P = 0.000). Plasma total IgE (Geometric mean) in Chinese (382 IU/ml) was significantly lower than that in Malay (584 IU/ml) and Indian (990 IU/ml) in the patient group (P = 0.000). However, there was no difference for plasma total IgE among Chinese (256 IU/ml), Malay (226 IU/ml) and Indian (323 IU/ml) (P = 0.385) in the control group. Conclusion High level of plasma total IgE may be a risk factor for asthma in Chinese, Malay and Indian. Total plasma IgE levels showed homogeneous among the three ethnicities. TIME TRENDS IN THE PREVALENCE OF ALLERGIC DISEASES IN GUANGZHOU CHILDHOOD HONGYU WANG, JINGPING ZHENG, NANSHAN ZHONG Guangzhou Institute of Respiratory Disease 510120 Guangzhou, China Objective To examine time trends in the prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood. Methods 3575 Children aged 13–14 years were randomly selected from ten middle schools in the four central districts of Guangzhou city in 2001. The selection followed the methods used for ISAAC Phase I in 1994–1995. All subjects completed the written questionnaire on asthma, rhinitis and eczema, then finished the video questionnaire about asthma. Results The response rate was 96%, 50.9% of them were female. With the written questionnaire /video questionnaire, the prevalence of wheezing ever, wheezing in the past year, wheezing related to exercise were 8.6%/5.9%, 4.8%/3.8%, 23.4%/11.3% respectively, revealed significantly higher than that were 6.2%/3.2%, 3.4%/2.0%, 17.4%/6.9% in the Phase I (P < 0.001). The prevalence of asthma ever were 4.6%, similar as 3.9% in the Phase I (P > 0.05). The positive response rate to all the questions related to rhinitis and eczema (P < 0.05) except eczema ever (P > 0.05) were significantly higher than that in Phase I. Conclusions The prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood were increasing during 7 years periods in Guangzhou. STUDY OF ROLE OF INSULIN AND INSULIN RECEPTOR IN ALLERGIC AIRWAY INFLAMMATION OF RATS YL MA, QY HE Department of Pulmonary Medicine People’s Hospital, Peking University, Beijing, P.R.C. 100044 Background Bronchial asthma and type 1 diabetes mellitus (IDDM) are rarely associated in the same subject although the mechanism is still unclear. Methods Streptozotocin and ovalbumin (OVA) were respectively used to induce diabetes mellitus and allergic airway inflammation. 64 male SD rats were divided into 8 groups: group A (asthma); group D (diabetes); group I (insulin treated); group AD (asthma + diabetes); group AI (asthma + insulin treated); group DI (diabetes + insulin treated); group ADI (asthma + diabetes + insulin treated); group C (control). Blood glucose measurements, serum insulin measurements, total and differential leukocyte counts of blood and BALF, HE stained paraffin section of lung tissue were carried out. Immunohistochemistry method was used to describe the distribution of insulin receptor, and the expression of insulin receptor mRNA were measured by RT-PCR. Results After antigen challenge, rats of group A, AI, ADI exhibited airway inflammation characterized by significantly elevated eosinophils and neutrophils, group AD only exhibited mild airway inflammation. Serum insulin levels were higher in groups ADI, AI and A. Immunohistochemistrical staining revealed a diffused distribution pattern of insulin receptor in the lung tissue. Positive cells infiltrating in the lung were increased significantly in groups A, AI and ADI. In groups induced diabetes the expression of insulin receptor mRNA was elevated. Conclusion Administration of low dose insulin aggravated airway inflammation to antigen provocation in rats. Insulin secretion was increased in the presence of inflammation. In the lung of antigen-challenged rats, insulin receptors on the surface of the infiltrating inflammatory cells and bronchial secretory cells were increased. 004 005 003 Saturday 5 April – Respiratory Nurses SIG Oral Presentations (1030–1200) Asthma A80 Respirology (2004) 9, (Suppl.)

Non-small cell lung cancer in Chinese is associated with disturbance in systemic antioxidants profiles

for the 9th Congress of the Asian Pacific Society of Respirology 10–13 December 2004, Hong Kong Editors: Dr K.S. Chan Dr P.C. Wong A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF HOUSE DUST MITE IMMUNOTHERAPY IN ASTHMATIC PATIENTS IN CHINA HONGYU WANG1, XIAOPING LIN2, CHUANGLI HAO3, CHUNQING ZHANG1, BAOQING SUN1, JINGPING ZHENG1, PING CHEN2, JINYUN SHENG3, ADRIAN WU4, NANSHAN ZHONG1 1Guangzhou Institute of Respiratory Diseases, 2Shenyang General Military Hospital, 3Suzhou Children’s Hospital, 4Department of Medicine, The University of Hong Kong Background The purpose of this study was to determine if house dust mite immunotherapy is effective in improving symptom control and reducing rescue medication use in Chinese patients with mild to moderate allergic asthma. Methods This is a double-blind, placebo-controlled study involving 132 asthmatic subjects aged 6 to 45 years recruited from 3 different regions of Mainland China. Subjects were given a 52-week course of Alutard Der P (ALK-Abello, Horsholm, Denmark) treatment or placebo while the dose of inhaled corticosteroids (ICS) was maintained. Results 129 subjects (64 active) completed the study. The symptom scores began to diverge at week 25 with the immunotherapy group showing a significantly lower score until week 48 (P = 0.018). Immunotherapy resulted in a significant decline in symptom (P = 0.003) and medication (P = 0.044) scores during the second half of the treatment period only in subjects who were taking ICS. Subjects on ICS also showed significant improvement in PEF after immunotherapy, but no difference in histamine PC20 was found. Serum ECP and blood eosinophils decreased after immunotherapy in subjects not using ICS. Skin test response decreased in immunotherapy subjects only, and Der P-specific IgE decreased in placebo but not immunotherapy subjects. Immunotherapy resulted in a significantly greater improvement in self-evaluation scores (P < 0.01). Conclusions One year of immunotherapy with Alutard Der P significantly reduced symptoms and medication use in asthmatic subjects, particularly in those who were already using ICS. This was associated with a greater subjective improvement in asthma control. 002 Respirology (2004) 9, (Suppl.) A79–A164 ASSOCIATION OF TOTAL PLASMA IGE LEVELS AND ASTHMA IN ASIAN POPULATIONS WD ZHANG, XZ ZHANG, DW QIU, WC TAN Department of Medicine, National University of Singapore Background Previous studies demonstrated that high levels of serum IgE was associated with asthma and other allergic diseases. Objectives To determine and compare the total plasma IgE levels in both asthmatics and healthy controls in Chinese, Malay and Indian in Singapore. Methods Both 311 asthmatics (Chinese 150; Malay 74; Indian 87) and 355 healthy subjects (Chinese 156; Malay 98; Indian 101) were being participated in a genetic study of asthma. Total plasma IgE levels were determined by Enzyme-linked immunosorbent assay (ELISA). A binary logistic model was used to detect the association between total plasma IgE levels and asthma. Results Plasma total IgE was significantly higher in patients group than that of control group in each ethnicity (Chinese: P = 0.049; Malay: P = 0.002; Indian: P = 0.000). Plasma total IgE (Geometric mean) in Chinese (382 IU/ml) was significantly lower than that in Malay (584 IU/ml) and Indian (990 IU/ml) in the patient group (P = 0.000). However, there was no difference for plasma total IgE among Chinese (256 IU/ml), Malay (226 IU/ml) and Indian (323 IU/ml) (P = 0.385) in the control group. Conclusion High level of plasma total IgE may be a risk factor for asthma in Chinese, Malay and Indian. Total plasma IgE levels showed homogeneous among the three ethnicities. TIME TRENDS IN THE PREVALENCE OF ALLERGIC DISEASES IN GUANGZHOU CHILDHOOD HONGYU WANG, JINGPING ZHENG, NANSHAN ZHONG Guangzhou Institute of Respiratory Disease 510120 Guangzhou, China Objective To examine time trends in the prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood. Methods 3575 Children aged 13–14 years were randomly selected from ten middle schools in the four central districts of Guangzhou city in 2001. The selection followed the methods used for ISAAC Phase I in 1994–1995. All subjects completed the written questionnaire on asthma, rhinitis and eczema, then finished the video questionnaire about asthma. Results The response rate was 96%, 50.9% of them were female. With the written questionnaire /video questionnaire, the prevalence of wheezing ever, wheezing in the past year, wheezing related to exercise were 8.6%/5.9%, 4.8%/3.8%, 23.4%/11.3% respectively, revealed significantly higher than that were 6.2%/3.2%, 3.4%/2.0%, 17.4%/6.9% in the Phase I (P < 0.001). The prevalence of asthma ever were 4.6%, similar as 3.9% in the Phase I (P > 0.05). The positive response rate to all the questions related to rhinitis and eczema (P < 0.05) except eczema ever (P > 0.05) were significantly higher than that in Phase I. Conclusions The prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood were increasing during 7 years periods in Guangzhou. STUDY OF ROLE OF INSULIN AND INSULIN RECEPTOR IN ALLERGIC AIRWAY INFLAMMATION OF RATS YL MA, QY HE Department of Pulmonary Medicine People’s Hospital, Peking University, Beijing, P.R.C. 100044 Background Bronchial asthma and type 1 diabetes mellitus (IDDM) are rarely associated in the same subject although the mechanism is still unclear. Methods Streptozotocin and ovalbumin (OVA) were respectively used to induce diabetes mellitus and allergic airway inflammation. 64 male SD rats were divided into 8 groups: group A (asthma); group D (diabetes); group I (insulin treated); group AD (asthma + diabetes); group AI (asthma + insulin treated); group DI (diabetes + insulin treated); group ADI (asthma + diabetes + insulin treated); group C (control). Blood glucose measurements, serum insulin measurements, total and differential leukocyte counts of blood and BALF, HE stained paraffin section of lung tissue were carried out. Immunohistochemistry method was used to describe the distribution of insulin receptor, and the expression of insulin receptor mRNA were measured by RT-PCR. Results After antigen challenge, rats of group A, AI, ADI exhibited airway inflammation characterized by significantly elevated eosinophils and neutrophils, group AD only exhibited mild airway inflammation. Serum insulin levels were higher in groups ADI, AI and A. Immunohistochemistrical staining revealed a diffused distribution pattern of insulin receptor in the lung tissue. Positive cells infiltrating in the lung were increased significantly in groups A, AI and ADI. In groups induced diabetes the expression of insulin receptor mRNA was elevated. Conclusion Administration of low dose insulin aggravated airway inflammation to antigen provocation in rats. Insulin secretion was increased in the presence of inflammation. In the lung of antigen-challenged rats, insulin receptors on the surface of the infiltrating inflammatory cells and bronchial secretory cells were increased. 004 005 003 Saturday 5 April – Respiratory Nurses SIG Oral Presentations (1030–1200) Asthma A80 Respirology (2004) 9, (Suppl.)

The effects of gelomyrtol forte on human ciliary beat frequency in vitro

for the 9th Congress of the Asian Pacific Society of Respirology 10–13 December 2004, Hong Kong Editors: Dr K.S. Chan Dr P.C. Wong A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF HOUSE DUST MITE IMMUNOTHERAPY IN ASTHMATIC PATIENTS IN CHINA HONGYU WANG1, XIAOPING LIN2, CHUANGLI HAO3, CHUNQING ZHANG1, BAOQING SUN1, JINGPING ZHENG1, PING CHEN2, JINYUN SHENG3, ADRIAN WU4, NANSHAN ZHONG1 1Guangzhou Institute of Respiratory Diseases, 2Shenyang General Military Hospital, 3Suzhou Children’s Hospital, 4Department of Medicine, The University of Hong Kong Background The purpose of this study was to determine if house dust mite immunotherapy is effective in improving symptom control and reducing rescue medication use in Chinese patients with mild to moderate allergic asthma. Methods This is a double-blind, placebo-controlled study involving 132 asthmatic subjects aged 6 to 45 years recruited from 3 different regions of Mainland China. Subjects were given a 52-week course of Alutard Der P (ALK-Abello, Horsholm, Denmark) treatment or placebo while the dose of inhaled corticosteroids (ICS) was maintained. Results 129 subjects (64 active) completed the study. The symptom scores began to diverge at week 25 with the immunotherapy group showing a significantly lower score until week 48 (P = 0.018). Immunotherapy resulted in a significant decline in symptom (P = 0.003) and medication (P = 0.044) scores during the second half of the treatment period only in subjects who were taking ICS. Subjects on ICS also showed significant improvement in PEF after immunotherapy, but no difference in histamine PC20 was found. Serum ECP and blood eosinophils decreased after immunotherapy in subjects not using ICS. Skin test response decreased in immunotherapy subjects only, and Der P-specific IgE decreased in placebo but not immunotherapy subjects. Immunotherapy resulted in a significantly greater improvement in self-evaluation scores (P < 0.01). Conclusions One year of immunotherapy with Alutard Der P significantly reduced symptoms and medication use in asthmatic subjects, particularly in those who were already using ICS. This was associated with a greater subjective improvement in asthma control. 002 Respirology (2004) 9, (Suppl.) A79–A164 ASSOCIATION OF TOTAL PLASMA IGE LEVELS AND ASTHMA IN ASIAN POPULATIONS WD ZHANG, XZ ZHANG, DW QIU, WC TAN Department of Medicine, National University of Singapore Background Previous studies demonstrated that high levels of serum IgE was associated with asthma and other allergic diseases. Objectives To determine and compare the total plasma IgE levels in both asthmatics and healthy controls in Chinese, Malay and Indian in Singapore. Methods Both 311 asthmatics (Chinese 150; Malay 74; Indian 87) and 355 healthy subjects (Chinese 156; Malay 98; Indian 101) were being participated in a genetic study of asthma. Total plasma IgE levels were determined by Enzyme-linked immunosorbent assay (ELISA). A binary logistic model was used to detect the association between total plasma IgE levels and asthma. Results Plasma total IgE was significantly higher in patients group than that of control group in each ethnicity (Chinese: P = 0.049; Malay: P = 0.002; Indian: P = 0.000). Plasma total IgE (Geometric mean) in Chinese (382 IU/ml) was significantly lower than that in Malay (584 IU/ml) and Indian (990 IU/ml) in the patient group (P = 0.000). However, there was no difference for plasma total IgE among Chinese (256 IU/ml), Malay (226 IU/ml) and Indian (323 IU/ml) (P = 0.385) in the control group. Conclusion High level of plasma total IgE may be a risk factor for asthma in Chinese, Malay and Indian. Total plasma IgE levels showed homogeneous among the three ethnicities. TIME TRENDS IN THE PREVALENCE OF ALLERGIC DISEASES IN GUANGZHOU CHILDHOOD HONGYU WANG, JINGPING ZHENG, NANSHAN ZHONG Guangzhou Institute of Respiratory Disease 510120 Guangzhou, China Objective To examine time trends in the prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood. Methods 3575 Children aged 13–14 years were randomly selected from ten middle schools in the four central districts of Guangzhou city in 2001. The selection followed the methods used for ISAAC Phase I in 1994–1995. All subjects completed the written questionnaire on asthma, rhinitis and eczema, then finished the video questionnaire about asthma. Results The response rate was 96%, 50.9% of them were female. With the written questionnaire /video questionnaire, the prevalence of wheezing ever, wheezing in the past year, wheezing related to exercise were 8.6%/5.9%, 4.8%/3.8%, 23.4%/11.3% respectively, revealed significantly higher than that were 6.2%/3.2%, 3.4%/2.0%, 17.4%/6.9% in the Phase I (P < 0.001). The prevalence of asthma ever were 4.6%, similar as 3.9% in the Phase I (P > 0.05). The positive response rate to all the questions related to rhinitis and eczema (P < 0.05) except eczema ever (P > 0.05) were significantly higher than that in Phase I. Conclusions The prevalence of asthma, allergic rhinoconjunctivitis and atopic eczema in childhood were increasing during 7 years periods in Guangzhou. STUDY OF ROLE OF INSULIN AND INSULIN RECEPTOR IN ALLERGIC AIRWAY INFLAMMATION OF RATS YL MA, QY HE Department of Pulmonary Medicine People’s Hospital, Peking University, Beijing, P.R.C. 100044 Background Bronchial asthma and type 1 diabetes mellitus (IDDM) are rarely associated in the same subject although the mechanism is still unclear. Methods Streptozotocin and ovalbumin (OVA) were respectively used to induce diabetes mellitus and allergic airway inflammation. 64 male SD rats were divided into 8 groups: group A (asthma); group D (diabetes); group I (insulin treated); group AD (asthma + diabetes); group AI (asthma + insulin treated); group DI (diabetes + insulin treated); group ADI (asthma + diabetes + insulin treated); group C (control). Blood glucose measurements, serum insulin measurements, total and differential leukocyte counts of blood and BALF, HE stained paraffin section of lung tissue were carried out. Immunohistochemistry method was used to describe the distribution of insulin receptor, and the expression of insulin receptor mRNA were measured by RT-PCR. Results After antigen challenge, rats of group A, AI, ADI exhibited airway inflammation characterized by significantly elevated eosinophils and neutrophils, group AD only exhibited mild airway inflammation. Serum insulin levels were higher in groups ADI, AI and A. Immunohistochemistrical staining revealed a diffused distribution pattern of insulin receptor in the lung tissue. Positive cells infiltrating in the lung were increased significantly in groups A, AI and ADI. In groups induced diabetes the expression of insulin receptor mRNA was elevated. Conclusion Administration of low dose insulin aggravated airway inflammation to antigen provocation in rats. Insulin secretion was increased in the presence of inflammation. In the lung of antigen-challenged rats, insulin receptors on the surface of the infiltrating inflammatory cells and bronchial secretory cells were increased. 004 005 003 Saturday 5 April – Respiratory Nurses SIG Oral Presentations (1030–1200) Asthma A80 Respirology (2004) 9, (Suppl.)