TABLE VIII.I-2.
Studies investigating allergic rhinitis pathophysiology by nasal histology from biopsies
Study | Year | LOE | Study design | Study groups | Clinical endpoint | Conclusion |
---|---|---|---|---|---|---|
Sivam et al.1103 | 2010 | 1b | DBRPCT | SAR (n = 17):
|
Measurement of olfactory function and histological analysis of the olfactory region. | Mometasone use associated with reduced olfactory eosinophilic inflammation and improved AR symptoms. |
Uller et al.1104 | 2010 | 1b | DBRPCT | SAR to grass or birch (n = 21)
|
Mucosal eosinophilia, apoptotic eosinophils, and expression of CCL5 and CCL11 (eotaxin). | Inhibition of CCL5-dependent recruitment of cells to diseased tissue, reduced cell proliferation, and general cell apoptosis, but not increased eosinophil apoptosis, are involved in early phase steroid-induced resolution of AR. |
Yang et al.1105 | 2010 | 1b | DBRPCT | PAR to dust mite or animal epithelia (n = 100):
|
To determine the effectiveness of Xin-yi-san in the treatment of AR and investigation of its molecular mechanism of anti-allergic activity. | Xin-yi-san exerts diverse immunomodulatory effects, including suppression of serum IgE levels and increased production of IL-10, sICAM-1, and IL-8 compared to placebo group. |
Asai et al.1106 | 2008 | 1b | RPCT | SAR to ragweed (n = 19):
|
To determine the in vivo effect of short-course AIT on CD4+CD25+ regulatory T-cells in the nasal mucosa of ragweed-sensitive subjects. | AIT increases CD4+ CD25+ regulatory T-cell infiltration in the nasal mucosa following allergen challenge after seasonal ragweed-pollen. |
Rak et al.1107 | 2005 | 1b | DBRPCT (double dummy) | SAR to birch (n = 41):
|
Measurement of the number of CD1a+, IgE+, and FcεRI+ cells during birch pollen season. | Treatment with budesonide, but not AIT, decreased the number of CD1a+, IgE+, and FcεRI+ cells. |
Plewako et al.1108 | 2002 | 1b | SBRPCT | SAR to grass (n = 30):
|
Comparison of anti-CD4, CD8, anti-eosinophil peroxidase, anti-human neutrophil lipocalin, and antibodies against IgE and FcεRI. | The number of eosinophil peroxidase-positive staining cells significantly increased in the placebo-treated patients but not in the actively treated patients. |
Pullerits et al.1109 | 2001 | 1b | RPCT | SAR to grass pollen (n = 21):
|
Comparison of IL-16 expression during the pollen season in actively vs placebo-treated patients. | Local upregulation of IL-16 expression contributes to the inflammation observed in seasonal AR. |
Wilson et al.1110 | 2001 | 1b | RPCT | SAR to grass pollen (n = 37):
|
Relationship between symptomatic improvement after AIT and eosinophil numbers and IL-5 expression in the nasal mucosa during the pollen season. | Improvement in symptoms after grass pollen AIT may result from inhibition of IL-5-dependent tissue eosinophilia during the pollen season. |
Kujundzić et al.1111 | 2013 | 3b | Case-control | AR (n = 90):
|
Compare by histochemical staining with anti-CD31 and VEGF-C the vascularization of the nasal mucosa of non-allergic, non-treated allergic, and allergic patients treated with mometasone. | Significantly lower values of CD31 and VEGF-C expression were observed in non-allergic compared with non-treated allergic and patients treated with mometasone. |
Radulovic et al.1112 | 2008 | 3b | Case-control | SAR to grass pollen (n = 22):
|
Effect of AIT on the numbers of Foxp3(+) CD4(+) and Foxp3(+) CD25(+) T-cells in and out of season and expression of IL-10 in nasal mucosa. | The presence of local Foxp3(+)CD25(+) cells in the nasal mucosa, their increase after AIT, and their association with suppression of seasonal allergic inflammation support a role for T-reg cells in the induction of allergen-specific tolerance. |
Till et al.1113 | 2001 | 3b | Case-control | SAR to grass pollen (n = 46):
|
Effect of allergen exposure on nasal antigen-presenting cell and epithelial CD1a+ Langerhans cells, CD68+ macrophages, and CD20+ B-cells. | Recruitment of CD1a+ Langerhans cells to the nasal mucosa during seasonal allergen exposure may contribute to local T-cell responses. |
AIT = allergen immunotherapy; AR = allergic rhinitis; DBRPCT = double-blind randomized placebo-controlled trial; ICAM = intercellular adhesion molecule; IgE = immunoglobulin E; IL = interleukin; LOE = level of evidence; PAR = perennial allergic rhinitis; RPCT = randomized placebo-controlled trial; SAR = seasonal allergic rhinitis; SBRPCT = single-blind randomized placebo-controlled trial; T-reg = T-regulatory cell; VEGF = vascular endothelial growth factor.