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Bachert C.,Ghent University | Bachert C.,University of Stockholm | Zhang L.,Capital Medical University | Zhang L.,Beijing Institute of Otolaryngology | Gevaert P.,Ghent University
Journal of Allergy and Clinical Immunology | Year: 2015

Chronic rhinosinusitis (CRS) affects more than 10% of the population in the United States and Europe. Recent findings point to a considerable variation of inflammatory subtypes in patients with CRS with nasal polyps and patients with CRS without nasal polyps. According to current guidelines, glucocorticosteroids and antibiotics are the principle pharmacotherapeutic approaches; however, they fail in a group of patients who share common clinical and laboratory markers. Several clinical phenotypes often leading to uncontrolled disease, including adult nasal polyposis, aspirin-exacerbated respiratory disease, and allergic fungal rhinosinusitis, are characterized by a common endotype: a TH2 bias is associated with a higher likelihood of comorbid asthma and recurrence after surgical treatment. As a consequence, several innovative approaches targeting the TH2 bias with humanized mAbs have been subjected to proof-of-concept studies in patients with CRS with nasal polyps with or without comorbid asthma: omalizumab, reslizumab, mepolizumab, and recently dupilumab. Future concepts using upstream targets, such as GATA-3, also focus on this endotype. This current development might result in advantages in the treatment of patients with the most severe CRS. © 2015 American Academy of Allergy, Asthma & Immunology.

Wang C.,Capital Medical University | Zhang L.,Capital Medical University | Zhang L.,Beijing Institute of Otolaryngology
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2014

Purpose of review: Allergic rhinitis is a highly prevalent inflammatory disease affecting 20-40% of the children worldwide. Allergen-specific immunotherapy (SIT) is an effective treatment for allergic rhinitis. This article reviews the recent advances in SIT for children. Recent findings: In current clinical practice, immunotherapy is delivered as either subcutaneous immunotherapy or sublingual immunotherapy (SLIT). Most meta-analyses and reviews concluded a trend that subcutaneous immunotherapy was better than SLIT in reducing symptoms of allergic rhinitis and rescue medication use, however, SLIT has a better safety profile than subcutaneous immunotherapy. Additionally, the absence of pain on administration of therapy is a character of SLIT, which is well suited for children. T regulatory cells, especially Tr1 cells that secrete interleukin-10 and induce production of immunoglobulin G4, play a role during SIT. Summary: Although there is substantial evidence for effectiveness of both subcutaneous immunotherapy and SLIT, safer and more effective SIT approaches are needed. New approaches to improve SIT include omalizumab pretreatment, use of recombinant allergens, and alternate routes of administration. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Fu Y.,Capital Medical University | Lou H.,Capital Medical University | Wang C.,Capital Medical University | Lou W.,Capital Medical University | And 4 more authors.
Pediatric Allergy and Immunology | Year: 2013

Background: This study aimed to investigate the influence of maternal allergy on cord blood regulatory and effector T cells and to evaluate their role as a predictor of atopic dermatitis (AD) during the first 2 yr of life. Methods: Seventy mother-infant pairs were recruited in this prospective birth cohort study (21 allergic and 49 non-allergic mothers). Cord blood samples were collected and assayed for the percentage of regulatory T cells (Treg), interferon-γ (IFN-γ), and interleukin-4 (IL-4) producing T cells (Th1 and Th2, respectively) using flow cytometry. Experiments were undertaken to assess the function of cord blood CD4+CD25+CD127- Treg cells by cell proliferation and cytokine responses. Their offspring at the age of 2 yr old were evaluated by dermatologists to determine whether they had AD. Results: During the first 2 yr of life, 15.7% of the children developed a physician-diagnosed AD. A significantly increased percentage of Th2 cell was observed in cord blood of newborns with maternal allergy. Treg/Th2 ratio significantly decreased among the offspring of allergic mothers. Treg cell-associated suppression of Th2 response was attenuated in Der p1-stimulated CD4+CD25- T cells from the offspring of allergic mothers. Children with reduced Th1/Th2 (p = 0.001, OR = 0.37) and Treg/Th2 (p = 0.001, OR = 0.47) ratio in cord blood had a higher risk of developing AD. Conclusion: Maternal allergic status is associated with increased percentage of IL-4+CD4+ T cells and a reduced Treg/Th2 ratio in cord blood at their children's birth, which may predispose to an increased risk for developing AD. © 2013 John Wiley & Sons A/S.

Wang C.,Capital Medical University | Han D.,Capital Medical University | Han D.,Beijing Institute of Otolaryngology | Zhang L.,Capital Medical University | Zhang L.,Beijing Institute of Otolaryngology
ORL | Year: 2012

Objectives: The endoscopic management of inverted papilloma (IP) has gained in popularity over the last 15 years. However, the appropriate management of lesions involving the anterior medial wall of the maxillary sinus still has to be determined. Methods: We performed a retrospective review of the surgical results for patients with IP attached to the anterior medial wall of the maxillary sinus in the Otolaryngology, Head and Neck Surgery Department, Beijing TongRen Hospital. The tumors were removed by using our surgical technique of modified endoscopic maxillary medial sinusotomy, which was defined as an extended endoscopic medial maxillectomy with preservation of the nasolacrimal duct and inferior turbinate. Sinus endoscopy was used to screen for disease after endoscopic resection and the clinical outcomes were analyzed. Results: A total of 7 patients (4 males and 3 females) were identified. Pre-and postoperative pathological examinations revealed inverted papilloma as the diagnosis. All tumors were defined as Krouse III lesions. There were no complications recorded as a result of surgery. All patients remain disease free with a mean follow-up of 35.7 months (range 20-68 months). Conclusion: Sinonasal IP with attachment to the anterior medial portion of the maxillary sinus can be treated successfully using modified endoscopic maxillary medial sinusotomy with preservation of the nasolacrimal duct and inferior turbinate. © 2012 S. Karger AG, Basel.

Zhao Y.,Capital Medical University | Zhao Y.,Beijing Institute of Otolaryngology | Zhang Y.,Capital Medical University | Zhang Y.,Beijing Institute of Otolaryngology | And 2 more authors.
International Forum of Allergy and Rhinology | Year: 2016

Background: Allergic rhinitis (AR) is a complex chronic inflammatory disease of the nasal mucosa, caused by an interaction between genetic and environmental factors. As evidence suggests that some genetic variants may increase susceptibility to both AR and asthma, the objective of this study was to identify asthma susceptibility variants associated with AR in the Chinese population. Methods: A cohort of 402 individuals with physician-diagnosed AR and 416 healthy controls were recruited from the Han Chinese population in Beijing. DNA was extracted from the peripheral blood and a total of 12 single-nucleotide polymorphisms (SNPs) shown to be associated with asthma in Japanese subjects were selected for genotyping using the SequenomMassARRAY technology platform. Results: Analysis of frequency differences of allele between the AR patients and control subjects showed that the C allele of rs204993 in the pre-B-cell leukemia homeobox 2 (PBX2) gene from the 6p21.3 locus was significantly associated with AR (p = 0.0006, pcorrected = 0.0340). Genotype analysis further confirmed the difference in distribution of this variant between AR patients and controls in the both the dominant (pT/C+C/C vs T/T = 7.37×10-5) and co-dominant (pT/C vs T/T = 1.98 × 10-4, pC/C vs T/T = 0.004) models. Conclusion: These results suggest that the PBX2 gene in the 6p21.3 asthma susceptibility locus may be associated with increased risk for both AR and asthma in Chinese subjects. © 2016 ARS-AAOA, LLC.

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