January 24, 2015

Efficacy of Add-on Montelukast in Nonasthmatic Eosinophilic Bronchitis: The Additive Effect on Airway Inflammation, Cough and Life Quality

ORIGINAL ARTICLE
Year : 2015  |  Volume : 128  |  Issue : 1  |  Page : 39-45


1 Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
2 Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080; Department of Respiratory Medicine, Tongji Hospital, Tongji University, School of Medicine, Shanghai 200065, China
3 Department of Respiratory Medicine, Tongji Hospital, Tongji University, School of Medicine, Shanghai 200065, China
4 Department of Respiratory Medicine, Shanghai Putuo People's Hospital, Shanghai 200060, China
Date of Submission28-Oct-2014
Date of Web Publication26-Dec-2014
    

DOI: 10.4103/0366-6999.147805
PMID: 25563311

  Abstract 
Background: The efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.
Methods: A prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.
Results: The control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P - 0.05). Similar results were seen at 4-week assessment (both P - 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (-2.5%) and greater decrease of ECP (both P - 0.05).
Conclusions: MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.
Keywords: Budesonide; Cough; Quality of Life; Montelukast; Bronchitis

How to cite this article:
Bao W, Liu P, Qiu Z, Yu L, Hang J, Gao X, Zhou X. Efficacy of Add-on Montelukast in Nonasthmatic Eosinophilic Bronchitis: The Additive Effect on Airway Inflammation, Cough and Life Quality. Chin Med J 2015;128:39-45

How to cite this URL:
Bao W, Liu P, Qiu Z, Yu L, Hang J, Gao X, Zhou X. Efficacy of Add-on Montelukast in Nonasthmatic Eosinophilic Bronchitis: The Additive Effect on Airway Inflammation, Cough and Life Quality. Chin Med J [serial online] 2015 [cited 2015 Jan 24];128:39-45. Available from: http://www.cmj.org/text.asp?2015/128/1/39/147805

January 19, 2015

Delayed Anaphylaxis to Red Meat Associated With Specific IgE Antibodies to Galactose

Abstract
Case Report  Open Access


      

Allergy Asthma Immunol Res. 2015 Jan;7(1):92-94. English.
Published online Jun 09, 2014.  http://dx.doi.org/10.4168/aair.2015.7.1.92 
Copyright © 2015 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease
Liping Wen,1, Junxiong Zhou,1, Jia Yin,1 Jin-lu Sun,1 Yi Sun,2 Kai Wu,1 and Rohit Katial3
1Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
2State Key Laboratory Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
3Department of Allergy and Immunology, National Jewish Medical and Research Center, University of Colorado, Denver, CO, USA.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

A novel delayed anaphylactic reaction to red meat, associated with tick bites and IgE antibodies against galactose-α-1, 3-galactose (α-gal), was reported in 2009 in the US, Australia and Europe. In this case, serum specific IgE to galactose-α-1, 3-galactose (>100 kU/L) and IgE to multiple non-primate mammalian proteins were positive. However, the pathogenesis of this disease remains unclear. We report the first case in Asia of delayed anaphylactic reaction to red meat, which was induced by bites from the hard tick, Hematophagous ixodidae. We confirmed the increased concentration of IgE reactive epitopes in non-primate mammalian organs, which may be rich in α-gal proteins in lymphatic and endothelial tissues. All confirmed ticks associated with this disorder in the literature and in our case belonged to the hard tick family. We hypothesize that hard tick saliva is enriched with blood-type substances, such as oligosaccharides, from the non-primate mammal victim's blood after days to weeks of blood sucking, which sensitizes humans through the injection route while blood sucking.
Keywords: Food allergyanaphylaxisred meat allergytick.

Case Report  Open Access


      

January 18, 2015

A retrospective study of the clinical benefit from acetylsalicylic acid desensitization in patients with nasal polyposis and asthma

Research

Open Access

Christine Ibrahim1*Kulraj Singh1Gina Tsai12David Huang12Jorge Mazza12Brian Rotenberg13Harold Kim12 and David William Moote12*

Quality of life in relation to the traffic pollution indicators NO2 and NOx: results from the Swedish GA2LEN survey

  1. Bertil Forsberg1
+Author Affiliations
  1. 1Occupational and Environmental Medicine, Department of Public Health and Clinical MedicineUmeå UniversityUmeå, Sweden
  2. 2Experimental Asthma and Allergy Research UnitInstitute of Environmental Medicine, Karolinska InstitutetStockholm, Sweden
  3. 3The Centre for Allergy Research, Karolinska InstitutetStockholm, Sweden
  4. 4The Institute of Environmental Medicine, Karolinska InstitutetStockholm, Sweden
  5. 5Department of Internal Medicine and Clinical Nutrition, Sahlgrenska AcademyKrefting Research Centre, University of GothenburgGöteborg, Sweden
  6. 6Department of Medical Sciences: Respiratory Medicine and AllergologyUppsala UniversityUppsala, Sweden
  1. Correspondence toDr Johan Nilsson Sommar; johan.n.sommar@envmed.umu.se

January 16, 2015

Fifty years of allergy: 1965–2015

Journal of Paediatrics and Child Health


Keywords:

  • advances;
  • allergy;
  • future;
  • history

Abstract

The last 50 years in allergy could almost be considered the first 50 years. Over this time period, we have witnessed the emergence of allergy as a subspecialty, have seen and continue to observe a tremendous change in prevalence of allergic disease and have gained insight into the mechanisms that underlie allergic predisposition and disease manifestation. We have improved the care of children with many forms of allergic disease and now sit poised to be able to alter the natural history of allergic disease with the use of specific immunotherapy. There is much left to do in the next 50 years including understanding what underlies both the predisposition to atopic disease and its natural resolution and identifying the environmental cofactors involved in the ‘allergic epidemic’ and therefore targets for effective primary prevention.

Evidence-based medicine: What has happened in the past 50 years?


  • Craig Mellis*
    1. Article first published online: 24 DEC 2014


      Keywords:

      • clinical epidemiology;
      • evidence based medicine;
      • general paediatrics;
      • history

      Abstract

      Although the phrase ‘evidence-based medicine’ (EBM) was used for the first time in the medical literature less than 25 years ago, the history of EBM goes back for centuries. What is remarkable is how popular and how globally accepted the EBM movement has become in such a short time. Many famous, past clinicians have played major roles in the disciplines that preceded EBM, particularly ‘clinical epidemiology’. It soon became clear to the early EBM champions that ‘evidence’ was only part of the clinical decision-making process. Consequently, both clinical expertise and the patient's values and preferences were rapidly incorporated into the concept we now know as ‘EBM’. The current need for high-quality, easily accessible ‘evidence-based summaries’ for busy clinicians is now apparent, as traditional EBM requires both considerable time and skill. Consequently, there is a progressive move away from the primary literature (such as randomised controlled trials) to systematic reviews and other ‘evidence-based summaries’. The future of EBM will almost certainly involve widespread utilisation of ‘clinical (computer)-based decision support systems’.