Xuekun Huang

Peripheral Th17/Treg cell-mediated immunity imbalance in allergic rhinitis patients,

Introduction: Allergic rhinitis (AR) is an IgE-mediated non-infectious disease of the nasal mucosa following contact with allergens. Objective: To investigate the peripheral Th17 cells and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells and the expression of cytokines in the serum of AR patients. Methods: The peripheral blood of 14 patients with AR (AR group) and six healthy subjects (control group) was collected from March to May of 2012. Flow cytometry was performed to detect the Th17 cells and Treg cells, and enzyme-linked immunosorbent assay (ELISA) to measure the serum levels of IL-17 and TGF-β1. Results: The proportion of Th17 cells in the AR group was markedly higher than that in the control group (p < 0.01). The proportion of Treg cells in the AR group was also dramatically reduced when compared with the control group (p < 0.01). In the AR group, serum IL-17 levels were markedly higher than those in the control group (p < 0.01). In the AR group, serum TGF-β1 levels were significantly lower than those in the control group (p < 0.01). Conclusion: The imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR.INTRODUCTION Allergic rhinitis (AR) is an IgE-mediated non-infectious disease of the nasal mucosa following contact with allergens. OBJECTIVE To investigate the peripheral Th17 cells and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells and the expression of cytokines in the serum of AR patients. METHODS The peripheral blood of 14 patients with AR (AR group) and six healthy subjects (control group) was collected from March to May of 2012. Flow cytometry was performed to detect the Th17 cells and Treg cells, and enzyme-linked immunosorbent assay (ELISA) to measure the serum levels of IL-17 and TGF-β1. RESULTS The proportion of Th17 cells in the AR group was markedly higher than that in the control group (p < 0.01). The proportion of Treg cells in the AR group was also dramatically reduced when compared with the control group (p < 0.01). In the AR group, serum IL-17 levels were markedly higher than those in the control group (p < 0.01). In the AR group, serum TGF-β1 levels were significantly lower than those in the control group (p < 0.01). CONCLUSION The imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR.

Desequilíbrio imunológico periférico mediado por células Th17/Treg em pacientes com rinite alérgica,

Introduction: Allergic rhinitis (AR) is an IgE-mediated non-infectious disease of the nasal mucosa following contact with allergens. Objective: To investigate the peripheral Th17 cells and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells and the expression of cytokines in the serum of AR patients. Methods: The peripheral blood of 14 patients with AR (AR group) and six healthy subjects (control group) was collected from March to May of 2012. Flow cytometry was performed to detect the Th17 cells and Treg cells, and enzyme-linked immunosorbent assay (ELISA) to measure the serum levels of IL-17 and TGF-β1. Results: The proportion of Th17 cells in the AR group was markedly higher than that in the control group (p < 0.01). The proportion of Treg cells in the AR group was also dramatically reduced when compared with the control group (p < 0.01). In the AR group, serum IL-17 levels were markedly higher than those in the control group (p < 0.01). In the AR group, serum TGF-β1 levels were significantly lower than those in the control group (p < 0.01). Conclusion: The imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR.INTRODUCTION Allergic rhinitis (AR) is an IgE-mediated non-infectious disease of the nasal mucosa following contact with allergens. OBJECTIVE To investigate the peripheral Th17 cells and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells and the expression of cytokines in the serum of AR patients. METHODS The peripheral blood of 14 patients with AR (AR group) and six healthy subjects (control group) was collected from March to May of 2012. Flow cytometry was performed to detect the Th17 cells and Treg cells, and enzyme-linked immunosorbent assay (ELISA) to measure the serum levels of IL-17 and TGF-β1. RESULTS The proportion of Th17 cells in the AR group was markedly higher than that in the control group (p < 0.01). The proportion of Treg cells in the AR group was also dramatically reduced when compared with the control group (p < 0.01). In the AR group, serum IL-17 levels were markedly higher than those in the control group (p < 0.01). In the AR group, serum TGF-β1 levels were significantly lower than those in the control group (p < 0.01). CONCLUSION The imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR.

Gene expression pattern of Treg and TCR Vγ subfamily T cells before and after specific immunotherapy in allergic rhinitis.

BackgroundT regulatory cell (Treg) plays a critical role in respiratory allergy and allergen-specific immunotherapy (SIT), and γδ T cells might participate in mediating Treg quantity and/or function in some immunological diseases. To further characterize whether γδ T cells could influence Treg in allergic rhinitis (AR) and SIT, we investigated the expression pattern of Treg’s Foxp3 gene and γδ T cell receptor (TCR) Vγ subfamily genes in peripheral blood mononuclear cells (PBMCs) of AR patients before and after SIT.MethodsEighteen AR patients undergoing effective SIT with house dust mite extract for one year were recruited. Visual Analogue Scale (VAS) was applied to evaluate the severity. Immunofluorescence quantification analysis was performed to determine the serum specific IgE (sIgE) content. Real-time PCR was used to detect the expression levels of Foxp3 and TCR Vγ subfamilies. Ten healthy volunteers were recruited as the controls.ResultsNasal uni-VAS score after SIT was significantly lower than that before SIT, while serum sIgE content was similar before and after SIT. Expression levels of Foxp3 and TCR Vγ subfamilies in AR patients before treatment were significantly lower than those in healthy subjects. Expression levels of VγI and II were similar before and after SIT, while expression levels of Foxp3 and VγIII after SIT were significantly higher than those before. Before SIT, the significant positive correlation was observed between expression levels of Foxp3 and VγI, II, III, while negative correlation was observed between Foxp3, VγIII and VAS. After SIT, the significant positive correlation between expression levels of Foxp3 and VγIII and negative correlation between Foxp3, VγIII and VAS were observed.ConclusionsTreg and Vγ subfamily T cells were in a dynamic equilibrium in AR patients before and after effective immunotherapy for one year. The early improvement of symptoms following immunotherapy might be independent of the serum sIgE content in AR patients, but associated with the reconstitution of T cell immunity.

Expressions of IL-17, IL-21 and IL-23 in the Serum of Allergic Rhinitis Patients

Expressions of IL-17, IL-21 and IL-23 in the Serum of Allergic Rhinitis Patients The present study aimed to investigate the expressions of interleukin-17 (IL-17), IL-21 and IL-23 in the serum of allergic rhinitis (AR) patients and to explore their relationship with special IgE (sFgE) in the serum. AR patients (n=24) and healthy subjects (n=12) were recruited and serum samples were collected. The serum level of IgE specific for inhalant allergens was determined using the automatic quantitative immunofluorescence analysis system, and the contents of IL-17, IL-21 and IL-23 in the serum were detected using ELISA. The level of serum IgE in the healthy individuals was categorized as grade 0 and that in the AR patients as grade 2-6. The mean contents of IL-17, IL-21 and IL-23 were 164.71 ±39.37 pg/mL, 199±97.86 pg/mL and 78.94±26.33 pg/mL, respectively, in the AR patients, and 67.75±18.24 pg/mL, 7.58±5.49 pg/mL and 13.58± 3.93 pg/mL, respectively, in the healthy subjects. Statistical analysis showed the serum levels of IL-17 and IL-23 in the AR patients were markedly higher than those in the healthy subjects, however, no significant difference was noted in the content of IL-21. Furthermore, the IL-17 level was positively related to the levels of IL-23 and IgE and the IL-23 level was positively related to the IgE level among AR patients, but no relations were observed between the IL-21 level and levels of IL-17, IL-23 and IgE. Our study indicates IL-17 and IL-23 may play an important role in the pathogenesis of AR and maybe IL-21 is not involved in the occurrence of AR. Ekspresija IL-17, IL-21 I IL-23 u Serumu Pacijenata sa Alergijskim Rinitisom Cilj ove studije bio je da se utvrdi ekspresija interleukina-17 (IL-17), IL-21 i IL-23 u serumu pacijenata sa alergijskim rinitisom (AR) kao i da se ispita njihov odnos sa specifičnim IgE u serumu. Obuhvaćeni su pacijenti sa AR (n=24) i zdravi ispitanici (n=12) od kojih su uzeti uzorci seruma. Nivo IgE specifičnog za inhalatorne alergene u serumu određen je pomoću sistema za automatsku kvantitativnu imunofluorescentnu analizu, dok su količine IL-17, IL-21 i IL-23 u serumu utvrđene pomoću ELISA. Nivo IgE u serumu zdravih osoba obeležen je kao nulti stupanj a kod pacijenata sa AR stupnjevima od 2 do 6. Srednje vrednosti IL-17, IL-21 i IL-23 bile su 164,71±39,37 pg/mL, 199±97,86 pg/mL i 78,94±26,33 pg/mL kod pacijenata sa AR, i 67,75±18,24 pg/mL, 7,58±5,49 pg/mL i 13,58±3,93 pg/mL kod zdravih ispitanika. Statistička analiza pokazala je da su nivoi IL-17 i IL-23 u serumu pacijenata sa AR bili značajno viši nego kod zdravih ispitanika, dok za vrednosti IL-21 nije uočena značajna razlika. Štaviše, nivo IL-17 pokazao je pozitivnost u odnosu sa nivoima IL-23 i IgE, dok je nivo IL-23 imao pozitivan odnos sa nivoom IgE kod pacijenata sa AR, ali nije utvrđena povezanost između nivoa IL-21 i nivoa IL-17, IL-23 i IgE. Naša studija ukazuje na potencijalno važnu ulogu IL-17 i IL-23 u patogenezi AR, dok IL-21 možda ne učestvuje u nastanku AR.

Prevalence and trends of sensitisation to aeroallergens in patients with allergic rhinitis in Guangzhou, China: a 10-year retrospective study

Objective To investigate the prevalence and trends of sensitisation to common aeroallergens among outpatients with allergic rhinitis (AR) in Guangzhou, China, over the past decade. Design A retrospective study; linear-by-linear association and simple linear regression were used to determine the trends in the prevalence of aeroallergen sensitisation. Setting One grade-A hospital in Guangzhou, the largest city in southern China. Participants A total of 5486 patients (2297 males and 2489 females) who visited the ear, nose and throat outpatient clinic, from January 2005 to December 2014, were enrolled. All patients who presented with nasal hyper-reactive symptoms and who completed serological allergy testing, measuring specific IgE (sIgE) in the serum, were included. Among them, 4085 participants (2269 males and 1816 females) were diagnosed as being patients with AR. Outcome measures Prevalence and trends of sensitisation to various types of aeroallergens were assessed. Results The overall prevalence of sIgE-mediated sensitisation to aeroallergens in these patients with AR were as follows: 84.4% for house dust mites (HDMs), 23.4% for pet allergens, 21.1% for cockroaches, 9.1% for mould allergens, 7.7% for tree pollen and 6.0% for weed pollen. When all patients with nasal hyper-reactivity were stratified by decade of age, increasing age was associated with a decrease in sIgE positivity by ∼5.13% (95% CI −7.28% to −2.98%, p<0.01). Within the past decade, the prevalence of sensitisation to pet allergens in patients with AR increased at an annual rate of 1.3% (95% CI 0.85% to 1.67%, p<0.01). Conclusions This study demonstrated that HDMs comprised the most common aeroallergen in Guangzhou. The prevalence of sensitisation to aeroallergens decreased with increasing age. During the past decade, the prevalence of sensitisation to pet allergens showed an upward trend, suggesting an urgent need for its prevention and treatment.

Effects of Immunotherapy on the Distribution and Clonality of TCR Vγ and Vδ Subfamily T Cells in Allergic Rhinitis Patients

Effects of Immunotherapy on the Distribution and Clonality of TCR Vγ and Vδ Subfamily T Cells in Allergic Rhinitis Patients The aim of this study was to investigate the changes in the peripheral specific IgE level, distribution of TCR Vg and Vd subfamily T cells and mRNA expressions of TCR Vg I-III following specific immunotherapy (SIT) with house-dust-mite extract in allergic rhinitis (AR) patients. Ten AR patients undergoing SIT with house-dust-mite extract for 1 year were recruited. Quantitative analysis of immunofluorescence was performed to detect the serum specific IgE (sIgE) level before and after SIT; RT-PCR-genescan analysis was employed to detect the mRNA expressions of TCR Vg (I-III) and Vd (1-8) in the peripheral mononuclear cells followed by analysis of T cell clonality. Real-time quantitative PCR was applied to detect the expressions of TCR Vg I-III genes. Ten healthy volunteers served as controls. For AR patients, SIT treatment could improve the symptoms, but the serum sIgE level was not markedly decreased. Before SIT, the expressions of TCR Vg I-III gene were similar between AR patients and controls (P>0.05) but markedly decreased after SIT in AR patients (P<0.05 in TCR VgI and VgII). The expressions of TCR Vd (1-8) before and after SIT were 5.3±0.82 and 4.9±0.57, respectively, and that in healthy controls was 5.2±1.40. Vd1, 2, 3 and 6 were the most common genes found in these patients. Significant difference in the TCR Vd6 subfamily T cells was found between the two groups. Polyclonal or biclonal proliferation was found in the T cells of patients before SIT and in healthy controls, but oligoclonal proliferation in only 1 subject before SIT. After SIT, the proportion of patients with oligoclonal proliferation of T cells (6/10) was markedly increased (P<0.05). SIT for 1 year could alter the expressions of TCR Vg I-III genes, the distribution of TCR Vg and Vd T cells and the ways in which T cells proliferate. The early improvement of symptoms following immunotherapy might not be related to the serum sIgE content in AR patients, but associated with the TCR gd T cells, especially the TCR V d6 T cells. Uticaj Imunoterapije na Distribuciju i Klonalnost T Ćelija iz Potporodice TCR Vγ I Vδ Kod Obolelih Od Alergijskog Rinitisa Cilj ove studije bio je da se istraže promene u nivou specifičnog IgE u perifernoj krvi, distribuciji T ćelija iz potporodice TCR Vg i Vd i ekspresiji TCR Vg I-III u mRNK posle specifične imunoterapije (SIT) sa ekstraktom grinja iz kućne prašine kod pacijenata sa alergijskim rinitisom (AR). Uključeno je 10 pacijenata sa AR lečenih specifičnom imunoterapijom sa ekstraktom grinja iz kućne prašine tokom 1 godine. Obavljena je kvantitativna analiza imunofluorescencijom kako bi se odredio nivo specifičnog IgE (sIgE) u serumu pre i posle SIT; primenjena je RT-PCR-genescan analiza radi određivanja ekspresije TCR Vg (I-III) i Vd (1-8) u mRNK u perifernim mononuklearnim ćelijama posle čega je obavljena analiza klonalnosti T ćelija. Kvantitativna PCR analiza u realnom vremenu sprovedena je kako bi se odredila ekspresija TCR Vg I-III gena. Deset zdravih dobrovoljaca služilo je kao kontrolna grupa. Kod pacijenata sa AR, tretman SIT olakšao je simptome, ali nivo sIgE u serumu nije se značajno snizio. Pre SIT, ekspresija TCR Vg I-III gena bila je slična kod pacijenata sa AR i kontrolnih subjekata (P>0,05), ali se značajno snizila posle SIT kod pacijenata sa AR (P>0,05 u TCR VgI i VgII). Ekspresija TCR Vd (1-8) pre i posle SIT bila je 5,3±0,82 i 4,9±0,57, a kod zdravih subjekata 5,2±1,40. Vd1, 2, 3 i 6 geni bili su najviše zastupljeni kod ovih pacijenata. Značajna razlika u T ćelijama TCR Vd6 potporodice utvrđena je između dve grupe. Poliklonalna ili biklonalna proliferacija nađena je u T ćelijama pacijenata pre SIT i kod kontrolnih subjekata, ali oligoklonalna proliferacija pronađena je samo kod 1 subjekta pre SIT. Posle SIT, proporcija pacijenata sa oligoklonalnom proliferacijom T ćelija (6/10) bila je značajno povišena (P<0,05). SIT tokom 1 godine može izmeniti ekspresiju TCR Vg I-III gena, distribuciju TCR Vg i Vd T ćelija kao i načine proliferacije T ćelija. Rano ublažavanje simptoma posle imunoterapije možda nije povezano sa sadržajem sIgE u serumu kod pacijenata sa AR, ali je u vezi sa TCR gd T ćelijama, naročito TCR V d6 T ćelijama.

Transnasal endoscopic and combined intra–extranasal approach for the surgical treatment of frontal sinus cerebrospinal fluid rhinorrhea

The aim of this study was to summarize and analyze the outcomes of frontal sinus cerebrospinal fluid rhinorrhea (FS-CSFR) treated by transnasal endoscopic and combined intra–extranasal approach. Clinical data on 20 cases of FS-CSFR patients from 2005 to 2013, with emphasis on the postoperative complications, clinical outcomes, and key technology involved in the combined intra–extranasal procedure, were retrospectively reviewed. Among the 20 cases, 12 were treated by combined intra–extranasal procedure; the other eight cases were initially treated by trans-nasal endoscopic approach alone, and five of them (5/8, 62.5%) were successfully treated and three failed. The three failed cases subsequently underwent combined intra–extranasal approach. A total of 15 cases, who received combined procedure, experienced fast recovery, had mild complications, and had no significant facial scars, and no CSFR recurrence was observed. Combined intra–extranasal approach offers advantages in not only overcoming the difficulty of insufficient exposure of defects during transnasal endoscopic procedure but also improving the success rate of repair.

Peripheral Th17/Treg cell-mediated immunity imbalance in allergic rhinitis patients**Please cite this article as: Huang X, Chen Y, Zhang F, Yang Q, Zhang G. Peripheral Th17/Treg cell-mediated immunity imbalance in allergic rhinitis patients. Braz J Otorhinolaryngol. 2014;80:152-5, ****Study conducted at Third Hospital, Sun Yat-sen University, Guangdong, China

Introduction: Allergic rhinitis (AR) is an IgE-mediated non-infectious disease of the nasal mucosa following contact with allergens. Objective: To investigate the peripheral Th17 cells and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells and the expression of cytokines in the serum of AR patients. Methods: The peripheral blood of 14 patients with AR (AR group) and six healthy subjects (control group) was collected from March to May of 2012. Flow cytometry was performed to detect the Th17 cells and Treg cells, and enzyme-linked immunosorbent assay (ELISA) to measure the serum levels of IL-17 and TGF-β1. Results: The proportion of Th17 cells in the AR group was markedly higher than that in the control group (p < 0.01). The proportion of Treg cells in the AR group was also dramatically reduced when compared with the control group (p < 0.01). In the AR group, serum IL-17 levels were markedly higher than those in the control group (p < 0.01). In the AR group, serum TGF-β1 levels were significantly lower than those in the control group (p < 0.01). Conclusion: The imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR.INTRODUCTION Allergic rhinitis (AR) is an IgE-mediated non-infectious disease of the nasal mucosa following contact with allergens. OBJECTIVE To investigate the peripheral Th17 cells and CD4 + CD25 + Foxp3 + regulatory T (Treg) cells and the expression of cytokines in the serum of AR patients. METHODS The peripheral blood of 14 patients with AR (AR group) and six healthy subjects (control group) was collected from March to May of 2012. Flow cytometry was performed to detect the Th17 cells and Treg cells, and enzyme-linked immunosorbent assay (ELISA) to measure the serum levels of IL-17 and TGF-β1. RESULTS The proportion of Th17 cells in the AR group was markedly higher than that in the control group (p < 0.01). The proportion of Treg cells in the AR group was also dramatically reduced when compared with the control group (p < 0.01). In the AR group, serum IL-17 levels were markedly higher than those in the control group (p < 0.01). In the AR group, serum TGF-β1 levels were significantly lower than those in the control group (p < 0.01). CONCLUSION The imbalance of peripheral Th17/Treg cells plays an important role in the pathogenesis of AR.