Browsing by Publisher "American College of Allergy, Asthma and Immunology"
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Item Sensitization to cat allergens in non-cat owner patients with respiratory allergy(American College of Allergy, Asthma and Immunology, 2003) Gulbahar O.; Sin A.; Mete N.; Kokuludag A.; Kirmaz C.; Sebik F.Background: Cats represent one of the most important sources of indoor allergens. The sensitization rate can reach up to 60% in western countries. Keeping cats indoors is uncommon in big cities in Turkey, but cats living in the streets are common. Objective: To investigate the prevalence of sensitization to cats in patients with respiratory allergy from Izmir, Turkey, and its relationship to home cat allergen levels. Methods: A total of 387 patients (70.8% female; mean age, 34.3 years) with respiratory allergic diseases (rhinitis and/or asthma) were included in this study. Skin prick test to cat was performed. House dust samples were collected from the living room of 25 patients and 14 healthy subjects. The major cat allergen (Fel d 1) levels were measured by Dustscreen. Fel d 1 levels given by the manufacturer were as follows: 0.05, 0.13, 0.40, 1.1, and 6.2 mU/mL. Results: The prevalence of cat sensitivity was 44.7% (n = 173). Only 6 patients (1.6%) had a history of feeding a cat in their houses. Thirty-six (92%) of 39 houses had detectable levels of cat allergen (mean Fel d 1 level, 2.24 ± 2.69 mU/mL). The mean Fel d 1 levels were 1.58 ± 2.51 mU/mL in the healthy group, 1.91 ± 2.61 mU/mL in the asthmatic group, and 3.26 ± 2.85 mU/mL in the group with allergic rhinitis (P = 0.12). The prevalence of cat sensitivity in patients who had 1.1 mU/mL of Fel d 1 in their homes was 57.1%. This rate was five times lower (11.1%) in patients who had the highest Fel d 1 level (6.2 mU/mL) in their homes. Conclusions: The prevalence of cat sensitivity in Izmir, where cats are generally not kept within homes, is as high as in western countries. The sampled houses have measurable levels of Fel d 1 even in the absence of indoor cats. High prevalence of cat sensitivity in Izmir is probably due to indirect exposure.Item Sexual dysfunction in patients with allergic rhinoconjunctivitis(American College of Allergy, Asthma and Immunology, 2005) Kirmaz C.; Aydemir O.; Bayrak P.; Yuksel H.; Ozenturk O.; Degirmenci S.Background: Sexual dysfunction in chronic diseases has recently attracted attention owing to its impact on quality of life (QoL). Allergic rhinoconjunctivitis (ARC) affects QoL, causing limitations in many areas. However, there has not been research on changes in sexual function in patients with ARC. Objective: To report the effect of ARC and its treatment on sexual function in men and women. Methods: Forty-three sexually active patients with seasonal ARC aged 22 to 49 years were included in the study. The control group was composed of 40 healthy individuals aged 22 to 46 years. Conjunctival symptom scores (CSSs) and nasal symptom scores (NSSs) of patients with symptomatic ARC were determined, as were sexual function scores (SFSs) using the Female Sexual Function Index and the International Index of Erectile Function during allergen exposure in the pollination period and after treatment with oral desloratadine, 5 mg/d, for 30 days. The SFSs were evaluated in the control group. Results: The CSSs and NSSs significantly improved in treated ARC (P < .001). In women, Female Sexual Function Index results in symptomatic ARC were significantly lower than in treated ARC and controls (P = .003). In men, International Index of Erectile Function results in treated ARC (P = .001) and controls (P < .001) were significantly higher than in symptomatic ARC. Furthermore, correlation between improvement in CSSs and NSSs and that of SFSs was determined (P = .007 for women; P = .001 for men). Conclusion: Improvement in sexual function as a variable of QoL may accompany the treatment of symptoms in patients with ARC.Item Lower respiratory tract complications during nasal provocation: Nonspecific stimulant or specific allergen?(American College of Allergy, Asthma and Immunology, 2007) Kirmaz C.; Degirmenci P.B.; Tunali D.; Yuksel H.Background: Allergic rhinitis (AR) is an allergic inflammatory disease in which allergen exposure leads to the appearance of symptoms in sensitized individuals because of histamine liberation from nasal mucosal mast cells. Comorbidity of this disease with allergic asthma is common. Therefore, the one airway one disease theory has been put forward. Lower respiratory tract provocation tests with both nonspecific (methacholine) and specific stimulants (allergen) have yielded positive results in nonasthmatic patients with AR. However, not enough research is available to demonstrate whether there is a response in the lower respiratory tract during nasal provocation tests (NPTs) performed to evaluate only nasal airway in these patients. Objectives: To determine if the lower respiratory tract was affected as a result of NPTs with nonspecific and specific stimulants in nonasthmatic patients with AR and to determine the frequency of lower respiratory tract obstruction due to NPT with nonspecific and specific stimulants. Methods: Thirty-six participants were enrolled in the study between November 2005 and January 2006 (18 AR patients and 18 healthy control subjects). Patients underwent 2 sessions of NPT. The first session was performed with nasal methacholine as a nonspecific stimulant, and the second session was performed with nasal Olea europaea extract as a specific stimulant. The control group underwent only nonspecific nasal provocation with methacholine. Basal nasal opening and nasal pressures were evaluated spirometrically by rhinomanometric measurements and basal respiratory function tests in both groups before methacholine nasal provocation. Whether or not nasal provocation was achieved, spirometric measurements were performed in all patients and controls after NPTs. Results: NPTs with methacholine resulted in a similar frequency of nasal provocation in the patient and control groups (P = .63). However, the mean methacholine dose was lower in patients with AR (P = .049). There was a decrease in parameters of asthma, including the ratio of forced expiratory volume in 1 second to forced vital capacity (P = .04), peak expiratory flow (P = .01), and forced expiratory flow between 25% and 75% (P = .004), as a result of NPTs with methacholine in the patient group. However, NPTs with allergen did not cause a change in lower respiratory tract obstruction criteria. Conclusions: Lower respiratory tract obstruction can occur after NPTs with nonspecific stimulants; therefore, tests performed with specific allergens can be regarded as safer.Item Nasal mucosal expression of nitric oxide synthases in patients with allergic rhinitis and its relation to asthma(American College of Allergy, Asthma and Immunology, 2008) Yuksel H.; Kirmaz C.; Yilmaz O.; Pinar E.; Vatansever S.; Degirmenci P.B.; Ozbilgin K.Background: Nitric oxide (NO) has contradictory roles in the pathophysiology of allergic inflammation in both allergic rhinitis (AR) and asthma. Small amounts of NO produced by constitutive NO synthase (NOS) is anti-inflammatory, whereas large amounts produced by inducible NOS (iNOS) are proinflammatory. Objective: To investigate the difference in constitutive endothelial NOS (eNOS) and iNOS expression in nonallergic and allergic mucosa and the possible relation of this to the coexistence of asthma in seasonal AR. Methods: Seventeen patients (10 women and 7 men) with seasonal AR and 9 nonallergic patients (5 women and 4 men) with nasal septum deviation were enrolled. Inferior turbinate nasal biopsy specimens were obtained in all. Levels of eNOS and iNOS expressed as immunohistochemical scores (HSCOREs) were determined immunohistochemically from the specimens. Results: The mean ± SD HSCOREs for eNOS in patients with seasonal AR were not significantly different from those of the nonallergic controls (1.85 ± 0.78 vs 1.63 ± 0.54; P = .12). On the other hand, the mean ± SD HSCOREs for iNOS were significantly higher in patients with seasonal AR (1.75 ± 0.75 vs 0.71 ± 0.6; P = .004). Furthermore, although eNOS expression was not different between seasonal AR patients with and without asthma, the mean ± SD HSCOREs for iNOS were significantly higher in the patients with asthma (1.93 ± 0.78 vs 1.65 ± 0.55; P = .01). Conclusion: Increased expression of iNOS might have a role in the development of allergic inflammation in upper and lower airways and in comorbidity of AR and asthma.Item Sleep actigraphy evidence of improved sleep after treatment of allergic rhinitis(American College of Allergy, Asthma and Immunology, 2009) Yuksel H.; Sogut A.; Yilmaz H.; Yilmaz O.; Dinc G.Background: Children with allergic rhinitis (AR) are reported to have disturbed sleep and daytime fatigue due to nasal obstruction. Objective: To evaluate sleep impairment in children with AR using actigraphic evaluation. Methods: Fourteen children aged 7 to 16 years with grass pollen-sensitized seasonal AR were enrolled. They completed the Total 4-Symptom Score (T4SS) scoring system for AR symptom score and the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, and they underwent actigraphy for 3 days in the pretreatment period. After topical corticosteroid and antihistaminic treatment for 8 weeks, actigraphy, the T4SS, and the PSQI were repeated. Fourteen healthy children aged 8 to 16 years underwent actigraphy and completed the PSQI questionnaire as controls. Results: There were no significant age or sex differences between the AR and control groups. Pretreatment PSQI and actigraphy scores were worse in the AR group vs the control group. After treatment, sleep quality improved, and there were no differences in actigraphy and PSQI scores between the 2 groups. Before treatment, the T4SS was significantly correlated with the sleep efficiency, daytime napping episodes, and total nap duration variables of actigraphy (r = -0.53, P = .004; r = 0.43, P = .02; and r = 0.39, P = .04, respectively). The T4SS was correlated with the total PSQI score (r = 0.67, P < .001). Conclusions: Sleep can be compromised in children with AR. There is a significant correlation of clinical symptom score with the actigraphic and PSQI variables. Therefore, actigraphy may be used as an objective tool to evaluate sleep disturbance in children with AR.