| Allergic rhinitis(AR) is an allergic reaction which happens when the immune system overreacts to certain substances that you are inhaled. It is mainly composed of specific IgE mediated noninfectious inflammatory disease of nasal mucosa, and its pathogenesis is the imbalance between T cells and cytokines. It has become a frequent and most serious public health problem. On the one hand, it seriously affected the quality of life in children with AR. On the other hand, childhood is the golden age of growth and development, but the common treatment drugs for AR had some limitations in children’s growth and development. Our previous studies mostly focused on the effects of drugs, but the children’s special psychologies were neglected. The quality of life in children with AR was comparatively little investigation in domestic research. By learning and referencing the related results in domestic and foreign researches, this project used the quality of life questionnaire with good validity and reliability to analyze the relevant factors in children with AR, which from the demographics, lifestyle and the incentive.In terms of drug therapies, although anti-allergic drugs(such as anti-histamine agents, mast cell stabilizer, decongestants and corticosteroid) are commonly used in the clinical treatment, the effects are transient and they can suppress only terminal branches of allergic responses. A novel therapeutic strategy for allergic rhinitis that strikes at the root of its pathogenesis is desired.Astragalus membranaceus(AM), which is a traditional Chinese medicinal herb, has a long history of medicinal use for AR treatment in China. Astragaloside IV(3-O-β-D-xylopyranosyl-6-O-β-D- glucopyranosyl-cycloastragenol, AST), the primary pure saponin isolated from the root of AM, is an effective compound with distinct pharmacological effects including anti-inflammation, immunoregulation and anti-fibrosis. Previous studies showed that AST could markedly inhibit airway inflammation and exhibited profound immunoregulatory activities in vivo. However, the effect and related mechanism of AST on AR are not yet clear. In this context, we undertook to investigate the the protective effects and critical mechanisms of AST against AR.Objective1. To investigate the distribution characteristics of inhaled allergens and evaluate the quality of life in children with allergic rhinitis in Chongqing, provide some scientific advice for prevention of AR in children and improve their quality of life.2. To study the effect and related mechanism of AST on AR.Methods1. All cases were collected from otorhinolaryngological department of the Children’s Hospital of Chongqing Medical University from April, 2014 to June, 2015. Evaluated the quality of life in children with AR by its related scale questionnaire, and collected the results of children’s skin prick tests and blood routine tests, the population demographics. Then, analyzed the characteristics of allergen spectrum and the related factors which influence the children’s quality of life.2. In this study, we examined whether AST is capable of controlling IgE-mediated allergic reactions in vivo by using the AR mouse models that were established by repetitive sensitization and intranasal challenge with ovalbumin(OVA). Concentrations of OVA-specific IgE and total IgG were evaluated using corresponding ELISA kits. The transcriptions of T-bet, GATA-3, Foxp3 and RORγt mRNA were detected by Real time-PCR. The expressions of T-bet, GATA-3, Foxp3, STAT3 protein were examined by immunohistochemical and Western blotting.Results1. Of the 332 AR patients, 322(97.0%) were atopic. Dermatophagoides Pteronyssinus(89.8%), Dermatophagus farinae(84.3%) and cat’s fur(39.8%) were the top three prevalent inhalant allergens.2. The Cronbach’s α coefficient of total scale was 0.897, and the spilt-half reliability was 0.872, the quality of life scale could be appropriate for children with AR in Chongqing. The correlation coefficient between total scale scores and all dimensions scores were bigger, and all had statistical significance(P<0.01).3. The better quality of life in children with AR accounted for 27.4%, and only 37.3% of households could bear its medical costs. The total score of life quality scale between different gender and age were statistically significant(P<0.05). Nasal symptoms daily cumulative time, duration of nasal symptoms, history of contact dermatitis, age and the impact of family economy were the main factors of quality of life.4. Intragastric administration with AST(25 mg/kg or 50 mg/kg) significantly inhibited inflammatory response, nasal symptoms and mucosa remodeling, as well as the serum OVA-specific IgE level of AR in mice. And the Curative effects were similar to DEX.5. AST treatment could significantly suppress the synthesis of GATA-3, STAT3 protein and the transcription of GATA-3, RORγt mRNA. While increasing the expressions of T-bet, Foxp3 mRNA and protein in both spleen tissues and nasal mucosa by AST.Conclusion1. Dermatophagoides Pteronyssinus, dermatophagus farinae and cat’s fur were the main inhaled allergens of children with allergic rhinitis in Chongqing. AR could affect the patient’s quality of life seriouslily, and the main influence factors were nasal symptoms daily cumulative time, duration of nasal symptoms, history of contact dermatitis, age and the impact of family economy. AR prevention should be considered in many aspects.2. These results indicated that AST treatment could inhibit OVA-induced AR by modulating the key master switches T-bet, GATA-3, Foxp3 and RORγt, which result in committing T helper cells to a Th1 phenotype. Although the effect of AST on OVA-induced AR mouse model act the same way as DEX, but it has fewer side effects. |
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