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by Lit Choi Wan. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 119-127). / ACKNOWLEDGEMENTS / SUMMARY / LIST OF TABLES / LIST OF FIGURES / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Terminology & Overview --- p.2 / Chapter 1.2 --- Gell & Coombs Classification of Hypersensitivity --- p.3 / Chapter 1.2.1 --- Type I - Immediate Hypersensitivity --- p.4 / Chapter 1.2.2 --- Type II - Antibody Dependent Cytotoxic Hypersensitivity --- p.4 / Chapter 1.2.3 --- Type III - Immune-Complex Mediated Hypersensitivity --- p.6 / Chapter 1.2.4 --- Type IV - Cell-Mediated (Delayed-Type) Hypersensitivity --- p.6 / Chapter 1.3 --- Historical Review of IgE-Mediated Hypersensitivity --- p.7 / Chapter 1.4 --- The Clinical Biochemistry of IgE --- p.8 / Chapter 1.4.1 --- Structure and Properties --- p.9 / Chapter 1.4.2 --- The Fcε Receptors --- p.11 / Chapter 1.4.3 --- Production and Tissue Localisation --- p.11 / Chapter 1.4.4 --- Turnover in Blood and on Mast Cells --- p.13 / Chapter 1.4.5 --- Control of Synthesis --- p.13 / Chapter 1.4.6 --- The Role of IgE in Health and Disease --- p.14 / Chapter 1.5 --- Pathophysiology of IgE-Mediated Hypersensitivity --- p.20 / Chapter 1.5.1 --- Cell Activation and IgE Synthesis --- p.20 / Chapter 1.5.2 --- Activation of Mast Cells and Basophils --- p.22 / Chapter 1.6 --- Allergens --- p.25 / Chapter 1.7 --- Factors Predisposing to Allergy --- p.30 / Chapter 1.7.1 --- Genetic Predisposition --- p.30 / Chapter 1.7.2 --- Environmental Exposure --- p.32 / Chapter 1.7.3 --- Underlying Infection and Immune Status --- p.32 / Chapter 1.8 --- Epidemiology --- p.33 / Chapter 1.8.1 --- Allergic Diseases Worldwide --- p.33 / Chapter 1.8.2 --- Allergic Diseases in Hong Kong --- p.34 / Chapter 1.9 --- Diagnosis of IgE-Mediated Allergy --- p.36 / Chapter 1.9.1 --- Medical History and Physical Examination --- p.36 / Chapter 1.9.2 --- Introduction to Diagnostic Tests --- p.36 / Chapter 1.9.3 --- Skin Tests --- p.37 / Chapter 1.9.4 --- In Vitro Tests --- p.38 / Chapter 1.9.5 --- Serum Total IgE Assay --- p.41 / Chapter (1) --- Test Principle --- p.41 / Chapter (2) --- Normal Values of Serum Total IgE Concentration --- p.42 / Chapter 1.9.6 --- Allergen Specific IgE Concentration --- p.44 / Chapter (1) --- Principle of RAST --- p.44 / Chapter (2) --- Clinical Usefulness of RAST --- p.44 / Chapter 1.9.7 --- The CAP System --- p.46 / Chapter 1.9.8 --- Mixed Aeroallergen Specific IgE Assay (Phadiatop´ёØ) --- p.46 / Chapter 1.10 --- Further Notes on Allergic Rhinitis --- p.48 / Chapter 1.10.1 --- A Prevalent and Costly Health Problem --- p.48 / Chapter 1.10.2 --- Epidemiology --- p.48 / Chapter 1.10.3 --- Symptoms of Allergic Rhinitis --- p.49 / Chapter 1.10.4 --- ENT Examination --- p.49 / Chapter 1.11 --- Aims of This Study --- p.51 / Chapter CHAPTER 2 --- MATERIALS AND METHOD I Evaluation of The Pharmacia CAP System --- p.52 / Chapter 2.1 --- Materials --- p.53 / Chapter 2.1.1 --- Pharmacia Reagents --- p.53 / Chapter 2.1.2 --- Abbott Reagents --- p.54 / Chapter 2.1.3 --- In-House Reagents --- p.54 / Chapter 2.2 --- Apparatus and Equipment --- p.55 / Chapter 2.2.1 --- Components and Accessories of the CAP System --- p.55 / Chapter 2.2.2 --- Abbott IMx Analyser --- p.55 / Chapter 2.3 --- Methods for Evaluation of the Pharmacia CAP System --- p.56 / Chapter 2.3.1 --- Principle of the Pharmacia CAP System RAST FEIA Fluorescence Enzyme Immunoassay --- p.56 / Chapter 2.3.2 --- Assay Preparation and Procedure --- p.58 / Chapter 2.3.3 --- Evaluation Experiments --- p.59 / Chapter (1) --- Elution Efficiency of Assay Washer96 --- p.59 / Chapter - --- Gross Assessment of Assay Washer96 --- p.59 / Chapter - --- Precision of Elution Volume in Each Well --- p.60 / Chapter - --- Overall Precision and Accuracy of Elution through ImmunoCAP --- p.60 / Chapter (2) --- Precision of RAST FEIA --- p.60 / Chapter (3) --- Accuracy --- p.61 / Chapter (4) --- Linearity and Detection Limits --- p.61 / Chapter (5) --- Recovery Study --- p.61 / Chapter CHAPTER 3 MATERIALS --- AND METHOD II Aetiology of Allergic Rhinitis in Hong Kong --- p.62 / Chapter 3.1 --- Patients and Controls --- p.63 / Chapter 3.2 --- Blood Samples --- p.63 / Chapter 3.3 --- Serum Total IgE Assay --- p.65 / Chapter 3.4 --- Mixed Aeroallergen Specific IgE (Phadiatop) --- p.67 / Chapter 3.5 --- Statistical Analysis --- p.67 / Chapter CHAPTER 4 --- RESULTS I Evaluation of The Pharmacia CAP System --- p.70 / Chapter 4.1 --- Elution Efficiency of Assay Washer96 --- p.71 / Chapter 4.1.1 --- Gross Assessment of Elution Volume --- p.71 / Chapter 4.1.2 --- Precision of Elution Volume in Each Well --- p.72 / Chapter 4.1.3 --- Overall Precision and Accuracy of Elution through ImmunoCAP --- p.75 / Chapter 4.2 --- Precision of RAST FEIA --- p.75 / Chapter 4.3 --- Accuracy --- p.75 / Chapter 4.4 --- Linearity and Detection Limit --- p.79 / Chapter 4.5 --- Recovery --- p.79 / Chapter CHAPTER 5 --- RESULTS II Aetiology of Allergic Rhinitis in Hong Kong --- p.83 / Chapter 5.1 --- Patients and Controls --- p.84 / Chapter 5.2 --- "Serum Total IgE, Mixed Aeroallergen IgE (Phadiatop) and Specific IgE Concentrations in Patients and Controls" --- p.84 / Chapter 5.2.1 --- Total IgE Concentration --- p.84 / Chapter 5.2.2 --- Phadiatop´ёØ --- p.84 / Chapter 5.2.3 --- Specific IgE Concentration --- p.93 / Chapter 5.2.4 --- Degree and Severity of Sensitization --- p.93 / Chapter 5.2.5 --- Single and Multiple Allergy --- p.94 / Chapter 5.2.6 --- Usefulness of Phadiatop´ёØ --- p.94 / Chapter CHAPTER 6 --- DISCUSSION I Evaluation of the Pharmacia CAP System --- p.95 / Chapter 6.1 --- Elution Efficiency of Assay Washer96 --- p.96 / Chapter 6.2 --- "Within-Batch and Between-Batch Precision, Accuracy, Linearity and Detection Limit, and Recovery of FEIA" --- p.97 / Chapter 6.3 --- Overall Evaluation --- p.98 / Chapter CHAPTER 7 --- DISCUSSION II Aetiology of Allergic Rhinitis in Hong Kong --- p.100 / Chapter 7.1 --- Patients and Controls --- p.101 / Chapter 7.2 --- Serum Total IgE Concentration --- p.102 / Chapter 7.3 --- Efficiency of Phadiatop´ёØ Screening Test --- p.103 / Chapter 7.4 --- Serum Specific IgE Assay and Aetiology of Allergic Rhinitis in Hong Kong --- p.107 / Chapter 7.4.1 --- Major Allergens in Allergic Rhinitis --- p.107 / Chapter 7.4.2 --- House Dust Mite --- p.108 / Chapter 7.4.3 --- Cockroach --- p.111 / Chapter 7.4.4 --- Cat and Dog --- p.111 / Chapter 7.4.5 --- Pollens --- p.112 / Chapter 7.4.6 --- Moulds --- p.113 / Chapter 7.4.7 --- Summary --- p.115 / REFERENCES --- p.118

Background: Persistent allergic rhinitis (PAR) is a common disorder affecting substantial number of people worldwide. In Australia, allergic rhinitis affects 16% of the population. Increasingly, patients are seeking alternative therapies especially acupuncture for allergic diseases. Objective: This study aimed to evaluate the effectiveness and safety of acupuncture in the treatment of persistent allergic rhinitis. Methods: Eighty (80) subjects aged between 16 and 70 were randomly assigned to either real or sham acupuncture groups. Each patient received either real or sham acupuncture treatments twice per week for the period of eight weeks. Daily symptom scores by subjects using five-point scale was employed as the primary outcome measure to assess the severity of nasal symptoms every day. The secondary outcome measures were rhinoconjunctivitis quality of life questionnaire (RQLQ) and relief medication scores. Relief medication scores were recorded every day by subjects whereas RQLQ assessment was monitored fortnightly throughout the trial and at the end of three-month follow-up period. Results: Compared to the control group, the real acupuncture group demonstrated more improvement of nasal symptoms after eight-week treatment and significant after the follow-up periods. Significant differences between the two groups were also shown in terms of RQLQ. While there were not significantly Relief medication scores were more reduced in real acupuncture group than those in control group, although the differences were not significant. Both real and sham acupuncture treatments were well tolerated. Conclusion: The findings of this study suggest that acupuncture is potentially an effective and safe option of treatment for persistent allergic rhinitis and it may improve patients' quality of life.

M.Tech.

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Die Allergische Rhinitis als Allergie vom Typ I (Soforttyp) ist nicht nur in Deutschland und Europa weit verbreitet, sondern eine weltweit auftretende Erkrankung. Als Verursacher werden neben bereits bekannten Aeroallergenen wie Hausstaubmilben, Gräser oder Pollen auch luftgetragene Algen diskutiert, die als möglichen Mechanismus über eine T-Zell-abhängige Stimulation Antigen-bindender B-Zellen zur IgE-Produktion führen. Diese Arbeit befasst sich mit der Untersuchung des allergenen Potentials der luftgetragenen Algenspezies S. bacillaris, T. aeria und X. montanum. Dafür wurden mittels direkter und indirekter Sandwich-ELISA-Verfahren Seren von Patienten mit der Diagnose Allergische Rhinitis oder Idiopathische Rhinitis auf enthaltene IgE-Antikörper getestet, die spezifisch an festphasengebundene Algenproteine binden. Des Weiteren wurden Kompetitionstestungen zur Untersuchung der Kreuzhemmbarkeit der drei Algen sowie SDS-Gelelektrophoresen und Western Blots zur Bestimmung der Molmasse der Algenproteine und zum Nachweis der Spezifität des algenbindenden IgEs durchgeführt. Die Ergebnisse belegen, dass die getesteten Algenproteine in der Lage sind, eine entsprechende Immunantwort mit IgE-Produktion auszulösen. Diese neue Gruppe von Allergenen konnte hinsichtlich der Entstehung einer Allergie vom Soforttyp und der damit verbundenen klinischen Bedeutung bewertet werden.

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