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Background: Objective evaluation of allergic rhinitis (AR) requires in vivo and in vitro tests. In vitro tests are important to assist or ensure the main allergens in multi-allergen-sensitive patients. The aim of this study was to evaluate the utility of serum specific IgE (sIgE) in the diagnosis of AR patients with multi-allergens in the Chinese population., Methods: Combining a positive skin prick test (SPT) and clinical history as the diagnostic reference criteria of AR, we estimated concentrations of sIgE produced in response to the 7 most frequent allergens among 85 AR patients, using the UniCAP assay system., Results: Among 85 individuals with positive SPT results and allergen-specific nasal symptoms, sIgE concentration correlated well with SPT classes among all the tested allergens. Based on a clinical diagnosis and SPT results using a positive cut-off value of a class 1 score, the CAP test performed well and the sensitivity for different allergens ranged from 0.5 (giant ragweed) to 0.91 (Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f), while specificity ranged from 0.93 (Der f) to 1.0 (animal hair, Der p and mugwort). When the cut-off score was adjusted to class 2, the sensitivity showed an increase overall while the remaining assessed items, including specificity, positive predictive value, negative predictive value and efficiency, showed an unacceptable decline., Conclusions: Well-established serum sIgE tests correlated well with SPTs. Setting a class 1 cut-off for positivity of SPT results was better than a class 2 setting for assessing the AR diagnostic value.

Objective: To investigate the understanding among otolaryngologists and perspectives on the diagnosis and management of allergic rhinitis in major cities in China., Methods: A survey among otolaryngologists in mainland China was carried out through questionnaire, including the medical history, diagnosis and pharmacotherapy., Results: The survey was conducted in 508 otolaryngologists. In general otolaryngology head and neck surgery clinic, the patients with allergic rhinitis was about 19% +/- 14%, which was of 35% +/- 17% in rhinological clinic. Most of the otolaryngologists (61% +/- 29%) diagnosed AR based on medical history and nasal examination. Only 35% +/- 28% of the otolaryngologists used skin prick test or specific IgE serum test. 70% +/- 27% of the patients with AR were offered nasal steroids, 49% +/- 32% and 36% +/- 28% of the patients were offered oral or nasal antihistamines respectively. Only 24% +/- 17% of patients realized the importance of follow-up., Conclusions: Allergic rhinitis is a core component in the specialty of otolaryngology head and neck surgery. The diagnosis and management of allergic rhinitis is sub-optimal. Chinese otolaryngologists need continuous education in aspects of diagnosis and management of allergic rhinitis.

Objective: To evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis., Methods: Patients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life., Results: The individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01)., Conclusions: A four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.

Objective: To evaluate the association between single nucleotide polymorphisms (SNP) of GATA3 and Chinese with allergic rhinitis., Methods: This study included 109 patients with allergic rhinitis and 112 healthy control people. SNP of two loci with restriction fragment length polymorphism was detected, rs1269486 at promoter region and rs2229360 located 92 bp downstream of STOP codon. Total IgE and specific IgE of Der p and Der f with different genotypes of the two loci were compared., Results: There was SNP at both loci of rs1269486 and rs2229360. The genotypes of rs1269486 were GG, GA and AA, and the genotypes of rs2229360 were CC, CT and TT. The frequency of genotype GG and allele G in patient group was significantly higher than that in control group (chi2 = 13.75, P <0.01; chi2 = 12.91, P <0.01), and the frequency of genotype GA and allele A in patient group was significantly lower than that in control group (chi2 = 11.90, P <0.01; chi2 =12.91, P <0.01). There were no significant differences between patient group and control group for the frequencies of genotypes and alleles at rs2229360 (P > 0.05). The haplotype frequency of GC in patient group was significantly higher than that in control group (chi2 = 114.59, P < 0.01), and the haplotype frequency of AC in patient group was significantly lower than that in control group (chi2 = 87.52, P <0.01). There was no significant difference of the levels of serum total IgE and specific IgE to Der p and Der f with the genotypes at the two loci (P >0.05)., Conclusions: The SNP at rs1269486 of GATA3 is associated with allergic rhinitis in Chinese.

Objective: Recent findings suggest that environmental factors play important roles in the etiology of allergic rhinitis, however, data on the impacts of socioeconomic and environmental factors on self-reported prevalence of allergic rhinitis in China is sparse, which is the aim of this study., Methods: Telephone interviews were performed in 11 cities throughout the mainland of China, and the association between environmental factors and self-reported prevalence of allergic rhinitis were evaluated by multiple linear correlation tests., Results: In total, there was no association between the adjusted self-reported prevalence of allergic rhinitis and socioeconomic factors such as GDP, GDP per capita, gross output value of industry and gross output value of industry per capita, while the adjusted self-reported prevalence of allergic rhinitis was positively correlated with the concentration of SO2, and no association was found between adjusted self-reported rate of allergic rhinitis and either meteorological factors including annual average temperature, annual average relative humidity, annual hours of sunshine and annual precipitation or other air pollution factors including NO2 and PMl0., Conclusions: The study demonstrates that the self-reported prevalence of allergic rhinitis in 11 cities in China was positively correlated with the concentration of SO2, and the strategy of prevention for allergic rhinitis could be conducted according to the results. Prevalence;

Objective: The aim of this study is to investigate the self-reported prevalence and other epidemiological characteristics of allergic rhinitis from 11 cities throughout the mainland of China., Methods: Telephone interviews were conducted in the two main municipalities (Beijing, Shanghai) and eight capital cities (Changsha, Changchun, Hangzhou, Guangzhou, Nanjing, Shenyang, Wuhan, Urumqi and Xi'an) of main provinces throughout the mainland of China after sampling target phone numbers by the approach of random digital dialing (RDD) via computer., Results: In total, the survey had sampled 684 blocks of telephone numbers in 11 cities, and dialed 119 319 telephone numbers. Of the 38 203 respondents, 4253 subjects reported allergic rhinitis, while the other 33 950 were screened negative in the telephone interviews. The self-reported prevalence of allergic rhinitis was lowest in Xi'an (8.0%), and highest in Urumqi (21.4%), with Nanjing having intermediate value (11.5%). The gender-adjusted prevalence ranged from 8.5% in Xi'an to 21.3% in Urumqi, while the age-adjusted prevalence of self-reported allergic rhinitis ranged from 8.7% in Beijing to 24.1% in Urumqi., Conclusions: The study demonstrates that the self-reported prevalence of allergic rhinitis in 11 cities throughout the mainland of China has wide variations, and the strategy of prevention for allergic rhinitis should be conducted according to the epidemic features of it.

Background: Currently anti-inflammatory therapy with steroids for allergic rhinitis need long-term repeated administration, although it is effective. Gene therapy is being suggested to substitute it. The aim of this study was to investigate nonviral vector mediated exogenous gene expression in COS-7 cells in vitro and the effect of intranasal mouse interleukin (mIL)-12 transgene expression on allergen induced eosinophil infiltration of nasal mucosa in a murine model of allergic rhinitis., Methods: In vitro COS-7 cells were infected with Epstein-Barr virus (EBV)/lipoplex. The expression of IL-12 p70 in cell culture supernatant was examined by enzyme-linked immunosorbent assay (ELISA). In mice with ovalbumin (OVA) induced allergic rhinitis, EBV/lipoplex was administered by nasal drops before OVA challenge once a day from day 1 to day 10. The expression of IL-12 mRNA and protein, the change of eosinophil count in nasal mucosa and serum total IgE were measured 24 hours after the last challenge., Results: EBV/lipoplex could effectively transfect COS-7 cells. The expression of IL-12 p70 in cell culture supernatant was significantly more than in blank control. IL-12 via EBV plasmid vector transduction could be overexpressed in vivo. In pGEG.mIL-12 treated models, the nasal mucosa revealed a high level of widespread mIL-12 transduction by immunohistochemistry and in situ hybridization. Histological evaluation revealed marked suppression of eosinophil infiltration in nasal mucosa. The eosinophil count in allergic rhinitis group [(26.5 +/- 9.8)/high-power field (HPF)] was significantly increased over control group [(0.40 +/- 0.52)/HPF] (F = 56.94, P < 0.01), while the count in IL-12 gene therapy group [(4.60 +/- 2.63)/HPF] was significantly less than that of allergic group (F = 56.9, P < 0.01). Serum total IgE between in gene therapy mice [(88.83 +/- 6.71) ng/ml] and allergic rhinitis mice [(103.1 +/- 5.7) ng/ml] showed a significant difference (F = 1216, P < 0.05)., Conclusions: Nonviral EBV plasmid vector, pGEG.mIL-12 was able to overexpress exogenous gene both in vitro and in murine nasal mucosa in vivo. IL-12 overexpression via EBV/lipoplex could stem allergen induced eosinophil infiltration in nasal mucosa in murine models of allergic rhinitis, which may suggest a new cytokine immunogenetic therapy for allergic rhinitis.

Objective: To obtain the recombinant Eotaxin N Terminal Mutant (Met/Eotaxin) adenovirus, and to study its role in allergic diseases., Methods: A 400 bp DNA fragment of Eotaxin was cloned from human peripheral blood monocyte (PBMC), and the Met/Eotaxin DNA fragment was obtained by NH2-terminal mutant. Then, this DNA fragment was inserted into AdEasy transfer vector -pAdtrack-CMV plasmid. The plasmid pAdtrack-CMV-Met/Eotaxin was then linearized with Pme I and co-transformed into the E coli strain BJ5183 together with pAdEasy-1, the viral DNA plasmid. The recombinant Met/Eotaxin adenovirus vector was then transfected into 293 cells to produce and amplify viral particles. The allergic rhinitis in mice was induced by sensitization and challenging with ovalbumin (OVA). Fourty mice were equally divided into allergic rhinitis group (AR group) and Ad-Met/Eotaxin group. 2 ml Ad-Met/Eotaxin with titer of 5 x 10(9) pfu/ml was intraperitoneal injected in each mice in Ad-Met/Eotaxin group 30 min before each challenge. The symptom and the morphological change of nasal mucosa were compared in those two groups. The enhanced green fluorescence protein (EGFP) expression corresponding to the efficiency of transfection in the Ad-Met/Eotaxin group was observed under fluorescence microscope., Results: The results of sequencing and PCR showed that the Met/Eotaxin gene recombinant replication-deficient adenovirus was successfully constructed. The adenovirus marker of EGFP could be observed in a higher intensity after Ad-Met/Eotaxin intraperitoneal injection. Ad-Met/Eotaxin adenovirus significantly alleviated the symptoms and nasal histological changes of allergic rhinitis., Conclusion: Ad-Met/Eotaxin could be transfected efficiently with high titer in nasal mucosa of mice, and could alleviate the symptoms of allergic rhinitis in mice.

Objective: To explore a new immunotherapy against allergic rhinitis., Methods: The recombinant protein of CTLA4 extracellular domain was obtained through construction of CTLA4-yeast expression system. The allergic rhinitis in mice was induced by sensitizing and challenging with ovalbumin (OVA). The allergic rhinitis related symptoms and the morphological changes in nasal mucosa were compared between the allergic rhinitis group and the CTLA4 extracellular domain group treated with CTLA4 extracellular domain before each challenge by ways of intraperitoneal injection., Results: CTLA4 extracellular domain with a molecular weight of 28 000, which was confirmed by Western blot, could be generated through CTLA4-yeast expression system. The purified CTLA4 extracellular domain could inhibit T cells proliferation in mixed lymphocyte reaction with a inhibitory rate of 95.4%. The mice in allergic rhinitis group appeared typical allergic rhinitis symptoms after OVA challenge, such as rhinorrhea and sneeze. Meanwhile the nasal pathological studies showed edema and congestion in mucosa tissue and local influx of inflammatory cells. Whereas in CTLA4 extracellular domain group, the nasal symptoms were rarely observed, and the pathological change in nasal mucosa was significantly abated., Conclusions: The protein of CTLA4 extracellular domain could prevent the allergic rhinitis in mice. The underlying mechanism of which might be the inhibition of the T cell activation.

Objective: To investigate whether the local application of IL-12 gene with EBV-plasmid vector to nasal mucosa could prevent allergic inflammation in murine allergic rhinitis model., Methods: Thirty-six BALB/C mice were randomly divided into allergic rhinitis group gene therapy group and control group. In mice with OVA-induced allergic rhinitis, the EBV/lipoplex (a novel cationic lipid combined with EBV-plasmid vector, pGEG. mIL-12) was locally administered into nasal mucosa before OVA challenge. The expression of IL-12 mRNA and protein, the change of eosinophilia and mast cell, and Th2 cytokine production in the nasal mucosa were measured., Results: The amounts of IL-12 mRNA positive cells and IL-12 positive cells in nasal mucosa of gene therapy group were significantly higher than that of allergic rhinitis group (P < 0.01 and P < 0.05). The amount of eosinophils, mast cells, and the level of IL-5 expression in nasal mucosa in allergic rhinitis group were significantly higher than those in gene therapy group and control group (P < 0.01). The level of total IgE of peripheral blood in allergic rhinitis group was significantly higher than that in gene therapy group and control group (F = 1216.21, P < 0.01)., Conclusions: These findings indicated that IL-12 mRNA and protein were expressed effectively after the local administration of pGEG. mIL-12 in the nasal mucosa. The local application of pGEG. mIL-12 is effective in modulating nasal allergic response and may be a convenient method for future approach to allergic rhinitis.

Objective: To evaluate the relationship between GATA-3 and IL-4, IL-5 in patients with allergic rhinitis., Methods: The expression of GATA-3 was detected by immunochemistry and reverse transcriptase polymerase chain reaction (RT-PCR) in 23 patients with allergic rhinitis. IL-4, IL-5 were detected by enzyme-linked immunosorbent assay (ELISA)., Results: The positive rate of GATA-3 was 86.9% (20/23) and the relative density ratio of GATA-3 and glyceraldehyde phosphate dehydrogenase (GAPDH) were 0.602 +/- 0.11 in patients with allergic rhinitis. The concentrations of IL-4, IL-5 were (135.5 +/- 66.4) pg/mg, (77.5 +/- 29.4) pg/mg, respectively. The expressions of GATA-3 and IL-4, IL-5 had positive relationship (r = 0.45 and 0.62, P < 0.05)., Conclusions: GATA-3 contributed to the production of IL-4, IL-5 in patients with allergic rhinitis.

Objective: To elucidate the mechanism of bone marrow response regulated by interleukin-5 (IL-5) in the model of allergic rhinitis., Methods: Twenty SD rats were randomly divided into allergic rhinitis (AR) group and control group. The leucocytes in the smears of bone marrow and peripheral blood were counted, and the expression of IL-5 was detected by immunohistochemistry., Results: The ratio of eosinophils to white cells in bone marrow smears of AR group was significantly higher than that of control group(P < 0.01). The ratio of basophils to white cells in bone marrow smears of AR group was significantly higher than that of control group(P < 0.01). The ratio of eosinophils to white cells in peripheral blood smears of AR group was significantly higher than that of control group(P < 0.01). The ratio of IL-5 positive cells to white cells in bone marrow smears of AR group was significantly higher than that of control group (P < 0.05). The ratio of IL-5 positive cells to white cells was significantly positively correlated with the ratio of eosinophils to white cells in bone marrow smears of AR group (R = 0.85, P < 0.01)., Conclusion: IL-5 regulates the proliferation and differentiation of eosinophils in bone marrow.

Objective: To evaluate the correlation between upper and lower respiratory inflammation., Methods: Thirty rats were randomly divided into allergic rhinitis group (AR), asthma group (AS), and control group (Con). The pulmonary function was measured by pulmonary function instrument of animal model, the infiltration of eosinophils and mast cells was detected by hematotoxylin-eosin staining (HE staining) and toluidine blue staining respectively, the expression of VCAM-I and IL-13 was examined by immunohistochemistry. ELISA was used to measure the concentration of IL-5 in the peripheral serum., Results: The numbers of eosinophils and mast cells in nasal mucosa and lung tissue of AR were both significantly higher than those of Con, and similar results were observed between AS and Con. The forced expiratory volume in 0.3 second (FEV0.3)/forced vital capacity (FVC) of AR and AS was both significantly lower than that of Con. The numbers of VCAM-I and IL-13 positive vessels in lung tissue of AR were both significantly higher than those of Con, and similar results were observed between AS and Con. The concentration of IL-5 in the serum of AR and AS was both significantly higher than that of Con. The concentration of IL-5 in serum was positively correlated with the number of eosinophils in peripheral blood of AR and AS., Conclusion: The inflammation is similar between AR and AS, and repeatedly challenge upper respiratory tract can impact on lower respiratory response.

Objective: To evaluate the role of chloride channel ClC-3 in perennial allergic rhinitis., Methods: The nasal mucosa from 19 patients with perennial allergic rhinitis were studied by immunohistochemistric staining and reverse transcriptase polymerase chain reaction (RT-PCR) for the expression of ClC-3., Results: ClC-3 was positively stained in 17 cases of 19 patients, with a rate of 89.6%. It mainly distributed in cytoplasm of epithelium and submucosal gland. All tissues displayed expected DNA length after PCR. The relative density of ClC-3 in mucosa with allergic rhinitis was 0.685 +/- 0.114 and 0.140 +/- 0.075 in normal., Conclusion: ClC-3 played an important role in the over-secretion of liquor in allergic rhinitis.