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

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Conclusions. SBL showed its efficacy in treating the animal model of allergic rhinitis. Its mechanisms may be related to its suppressive action on PCA reaction, the production of TXB2 and the expression of eNOS, as well as its modulation of cytokines, including IL-4, IL-6, IL-8, GM-CSF and TNF-alpha, release from mast cells. The clinical trial showed that SBL had more beneficial action on the quality of life, in comparison to the placebo, in the domains of RE and BP. Some symptoms evaluations of PAR patients, including GF, NB and SF were more markedly improved in the SBL group when compared with the placebo group. Furthermore, the use of SBL, with the study dose and treatment period, was safe. However, the accurate efficacy and mechanisms of SBL are largely unknown and need further investigation. (Abstract shortened by UMI.) / Introduction. Although great progress in treatment of allergic rhinitis have made in recent years, remarkably increasing prevalence and cost in epidemiology studies strongly suggest the difficulties in the management of allergic rhinitis. Shi-Bi-Lin (SBL) is a formula modified from the traditional Chinese herbal formula Cang-Er-Zi-San (CEZS) and a classic European formula SinupretRTM. CEZS has been used for the treatment of allergic rhinitis for several centuries in East Asia communities, and SinupretRTM has been used in treating paranasal sinusitis and rhinitis widely in Europe for decades. However, its therapeutic mechanisms remain unclear. We examined the efficacy and the possible mechanism of SBL in an animal model of allergic rhinitis and in cell culture study using Human Mast Cell Line (HMC-1) and Peripheral Blood Mononuclear Cells (PBMC). In addition, a clinical trial was conducted to examine its clinical efficacy and safety. / Results. In the animal study, SBL showed a potent effect in relieving the symptoms of nasal obstruction, sneezing and nasal scratching (P<0.05 or P<0.01), but had no convincing effect in decreasing the nasal discharge (P>0.05). In PCA test, IgG1 increased in a modest manner in the SBL-treated group when compared with the sham group (P<0.05 or P<0.01). Eosinophil infiltration and the expression of eNOS in nasal mucosa, but not iNOS, were obviously lower in the SBL treated group (P<0.05 or P<0.01) in comparison to the sham group. The levels of thromboxane B (TXB)2 in the nasal lavage fluid, but not histamine and peptide leukotrienes (p-LTs), showed significantly lower than that of the sham group (P<0.05). In vitro study showed that SBL modulated the cytokines, including interleukin (IL)-4, IL-6, IL-8, Granulocyte/Macrophage Colony-Stimulating Factor (GM-CSF) and tumor necrosis factor (TNF)-alpha, release from human mast cell line (HMC-1). However, the mRNA expressions of these cytokines were not significantly altered. As the controls, dexamethasone, desloratadine and budesonide had more potently inhibitory effects on cytokines release from HMC-1. The component herbs generally had stimulatory effects on the cytokine release from HMC-1 and variable effects on PBMC. In the clinical trial, a total of 84 patients were recruited in the clinical trial and 77 of them completed the trial. Although no significant differences of each domain between the SBL and placebo groups were detected, findings supported the efficacy of SBL were obtained. / by Zhao Yu. / "July 2005." / Advisers: C. A. Van Hasselt; Ping-Chung Leung; Kong-Sang Woo. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0172. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Made available in DSpace on 2015-07-22T20:49:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-03-30 / Objetivos: Comparar a avaliação objetiva da obstrução nasal, mensurada por rinometria acústica (RnA) (volume dos cinco primeiros centímetros da cavidade nasal, V5) e rinomanometria anterior ativa (RMAA) (resistência nasal total, RNT), com a avaliação subjetiva dada pelo escore de obstrução (EO, escala de 0 a 10) em crianças e adolescentes com rinite alérgica e controles. Método: Trinta pacientes, entre sete e 18 anos, com rinite alérgica persistente e trinta controles participaram do estudo. As variáveis objetivas foram mensuradas em triplicata e de acordo com recomendações mais utilizadas. O EO foi referido para a cavidade nasal total e para as narinas em separado. RNT, V5 e EO foram mensurados nos momentos basal e após indução de obstrução nasal (100% aumento RNT após provocação nasal com histamina). Os pacientes com rinite alérgica foram tratados com corticosteroide tópico nasal (mometasona 100 mcg/dia por 15 dias) e avaliados 21 (±5) dias após. Resultados: Houve correlações significantes e negativas entre RNT e V5 em todos os grupos e situações de avaliação. Os valores de r encontrados variaram de -0,73 a -0,32, sendo a correlação encontrada no grupo rinite, no momento basal, na avaliação da narina mais obstruída a mais forte (r= -0,727). Para a cavidade nasal total não houve correlação significante entre EO e RNT e entre EO e V5 em todos os momentos estudados. Em relação à narina mais obstruída, verificamos correlação significante e negativa para EO e RNT (r= -0,51) e significante e positiva para EO e V5 (r= 0,29), avaliando-se o grupo total no momento basal. Não houve diferenças nítidas nos coeficientes de correlação encontrados nos paciente e nos controles. Os coeficientes de correlação não se alteraram após a indução de obstrução nasal e após tratamento com corticosteroide nasal. De forma semelhante, as crianças mais novas apresentaram coeficientes de correlação semelhantes aos dos adolescentes mais velhos. Conclusões: Assim como já fora descrito para adultos, a avaliação objetiva da obstrução nasal por RnA (V5) e RMAA (RNT) não apresentou correlação significativa em relação à avaliação subjetiva (escore de obstrução), em crianças e adolescentes, ao avaliar-se a cavidade nasal como um todo, fato que ocorreu na avaliação unilateral da cavidade nasal. Houve forte correlação entre as avaliações objetivas. A presença de doença nasal crônica (rinite alérgica) não interferiu na correlação entre as avaliações objetivas e subjetivas da obstrução nasal. A indução aguda de obstrução nasal, o tratamento com corticosteroide nasal e a idade também parecem não induzir alterações nessa correlação. Sugere-se, portanto, utilidade no acréscimo de um método objetivo para avaliação da obstrução nasal nas pesquisas em rinologia e, na sua impossibilidade, a avaliação das narinas em separado. / Objectives: Compare the objective assessment of nasal obstruction, measured by acoustic rhinometry (ARM) (volume of the first five centimeters of the nasal cavity, V5) and active anterior rhinomanometry (AARMM) (total nasal resistance, TNR), with the subjective evaluation given by obstruction scores (OS, scale from 0 to 10) in children and adolescents with allergic rhinitis and controls. Method: Thirty patients, aged 7 to 18 years, with persistent allergic rhinitis and thirty controls were enrolled. The objective variables were measured in triplicate and according to existing recommendations. The OS was reported for the total nasal cavity and nostrils separately. TNR, V5 and EO were measured at baseline and in the moments after the induction of nasal obstruction (100% increase in NTS after nasal challenge with histamine). Patients with allergic rhinitis were treated with topical nasal corticosteroids, mometasone 100mcg/day for 15 days and assessed 21 (± 5) days later. Results: There were significant and negative correlations between TNR and V5 in all groups and evaluation situations. The r values ranged from -0.73 to -0.32, and the association found in rhinitis group, at baseline, to evaluate the strongest and most obstructed nostril (r = -0.727). For the nasal cavity, of no significant correlation between OS and TNR and between OS and V5 at all studied times. Regarding the most obstructed nostril, we found significant negative correlation for OS and TNR (r = -0.51) and significant and positive for OS and V5 (r = 0.29), evaluating the total group at baseline. There were no clear differences in the coefficients of correlation found in patients and controls. The correlation coefficients were not changed after the induction of nasal obstruction and after treatment with nasal corticosteroids. Similarly, younger children showed a correlation coefficient similar to those of older adolescents. Conclusions: As has been described for adults, the objective assessment of nasal obstruction ARM (V5) and RMAA (TNR) showed no significant correlation in relation to the subjective evaluation (obstruction score) in children and adolescents, when assessing the nasal cavity as a whole, which has been seen in the assessment of unilateral nasal cavity. There was strong correlation between the objective evaluations. The presence of chronic nasal disease (allergic rhinitis) did not affect the correlation between objective and subjective assessments of nasal obstruction. The acute induction of nasal obstruction, nasal corticosteroid treatment and age also seem to induce changes in this correlation. It is suggested, therefore, usefulness in adding an objective method for evaluating nasal obstruction in the polls in rhinology and, failing which, the evaluation of the nostrils separately. / TEDE / BV UNIFESP: Teses e dissertações