Bronchial Asthma In Children Of Immune Tolerance

PartⅠEffect of long-term inhalation of allergens in asthmatic airway inflammation and remodelingObjective To explore the long-term inhalation of allergens in asthmatic airway inflammation and remodeling.Methods 32 healthy female Kunming mice were divided into four groups randomly,8 mice of each group,Normal control group(A),asthma group(B),short-term continuous inhalation allergen group(C),prolonged allergen inhalation group(D).The mice of B,C, D groups were established the models of asthma using ovalbumin,after building, according to the needs,the mice of C,D groups were inhaled 2W and 4W of allergens separately.Then observe the changes of Pathological in lung tissue and bronchoalveolar lavage fluid(BLAF) in cytology.Finally assay the levels of OVA-IgE in serum with enzyme-linked immunosorbent(ELISA) and the MMP-9,TIMP-1 and GATA-3 of lung tissue with immunohistochemical determination.Results①There were no wheezing symptoms and inflammatory pathological changes in group A,while B,C,D groups,were significantly heavier than that in control group A, at the same time there is a significant infiltration of inflammatory cells around the trachea in group B and C.but the airway wall thickened especially in group D.②The total number of cells in BLAF and the percentage of eosinophils,macrophages and lymphocytes were higher in group B,C,D than that in the control group A respectively, there was a significant difference(P＜0.01),while the data is lesser in group B and D than that in group C,the difference was statistically significant among different groups(P＜0.01);③The levels of OVA-IgE in serum were significantly heavier in group B,C,D than that in control group A the difference was significant(P＜0.01);while the data is lesser in group B and D than that in group C,the difference was statistically significant among different groups(P＜0.01);④The MMP-9,TIMP-1 of lung tissue were higher in group B,C,D than that in group A,there was a significant difference(P＜0.01),and group D was higher than group Band C,group C was higher than group B,there were significant differences between them;⑤The GATA-3 of lung tissues are higher in group B, C,D than that in group A,there was a significant difference(P<0.01),and group B,D were lesser than that in group C,the difference is also significant;above all there were no differences between group B and D in addition to MMP-9,TIMP-1;⑥The levels of OVA-IgE and the data of EOS are positively correlated with the GATA-3 of lung tissues. (r=0.94,P＜0.01;r=0.96,P＜0.01)。 Conclusions There were both airway inflammation and remodeling in mice of asthma early the airway inflammation were mainly performance,while the latter were mainly the performance of remodeling.so it is very important to treat asthma earlier. PartⅡClinical research of standardized dust mite allergen specific immunotherapy in children with asthmaObjective To investigate the effectiveness and safety of standardized dust mite allergen specific immunotherapy in children with asthma.Methods Use skin prick test for allergens determination.Of these 53 cases dust mite allergens in children with the use of dust mite allergen standardization to the specific immunotherapy. Then we observed the clinical effects,concluding different periods of inhaled steroid,the changes in lung function,asthma symptom score and the security in the process of injection of adverse reactions.Results The inhaled steroid dose reduced gradually in children with asthma,and in the treatment of 37 weeks beginning the inhaled steroid dose of SIT group is lower than the control group(P＜0.01),lung function gradually improved,in the treatment of 51 weeks beginning,the PEF(forced expiratory peak flow) of SIT group are better than the control group(P＞0.05),and FEV1 between the two groups had no significant difference (P＞0.05),asthma symptoms can be controlled.Conclusions The dust mite allergens standardization of SIT can significantly reduce the dose of inhaled steroid,improve lung function,improve clinical symptom score and is secure.