Effects Of Allergic Rhinitis In Children On Quality Of Life And Its Pathogenesis

PART Ⅰ EFFECTS OF ALLERGIC RHINITIS ON QUALITY OF LIFE IN PRESCHOOL CHILDRENOBJECTIVE: To investigate the incidence of Allergic Rhinitis(AR)in preschool children and its effect on quality of life.METHODS:From April to June 2011,11 kindergartens were randomly selected from Hongkou District of Shanghai.All children and their parents in the kindergartens were investigated.Children’s personal and family social environment questionnaires and the Pediatric Quality of Life Inventory Measurement Models(Peds QL 4.0)were used to assess children’s basic personal information and quality of life.RESULTS: A total of 1789 children were enrolled,and 49.98% of them were boys,307 cases of AR(17.16%).Compared with non-AR children,the overall quality of life of AR children [(82.00±11.88)vs.(85.58±10.72),P<0.001] and the four dimensions of school performance [(77.39±15.60)vs.(81.92±14.58),P<0.001],social function [(85.76±14.48)vs.(88.27±12.92),P<0.01],emotional function [(79.00±16.39)vs.(82.67±15.48),P<0.001] and physiological function [(84.32±13.25)vs.(87.26±12.18),P<0.001] were all lower(P<0.01).CONCLUSIONS: Preschool children have a high incidence of AR and poor quality of life.PART Ⅱ RISK FACTORS OF EARLY ATOY IN OFFSPRING BASED ON MATERNAL AND INFANT COHORTOBJECTIVE: To explore the risk factors of early atopy in offspring based on maternal and infant cohort.METHODS: From August2012 to July 2013,a total of 277 pregnant women were recruited and enrolled from renji hospital in pudong new district,Shanghai.The cohort was followed up at the third trimester,9 months and 2 years old.The State Trait Anxiety Inventory,Life Events Scale for Pregnant Women and the Center for Emotional Studies Depression Scale were used to assess the anxiety,the impact of life events and depression of women in the late pregnancy.The general situation questionnaire compiled by Shanghai Children’s Medical Center was used to investigate the basic situation of pregnant women’s individual and family.Infant feeding was investigated by infant feeding questionnaire.In addition,at the age of 9 months,the results of the Skin Prick Test(SPT)were used to determine the early sensitization status,and specialized clinicians diagnosed whether they have allergic diseases.Total Immunoglobulin E(t Ig E)in peripheral blood was measured at the age of 2 years.Therefore,prenatal and early environmental factors were set up to study the risk factors related to early atopy in offspring.RESULTS: After controlling the confounding factors,the binary logistic regression analysis showed that the risk factors of the9-month-old children’s clinical diagnosis allergic diseases were weaning age less than 6 months(adjusted OR: 2.378;95% CI: 1.071-5.279)and born in autumn and winter(adjusted OR: 2.047;95% CI: 1.047-4.004).The risk factors of sensitization in the 9-month-old children were maternal trait anxiety(adjusted OR: 3.826;95% CI: 1.100-13.313)in the third rimester.This study did not find any risk factors for positive t Ig E test results in the offspring at the age of 2 under binary logistic regression analysis.CONCLUSIONS: Weaning age less than 6 months and birth in autumn and winter are risk factors for clinical diagnosis of allergic diseases in offspring at 9 months of age.Trait anxiety of mothers in late pregnancy is a risk factor for offspring early sensitization at 9 months of age.PART Ⅲ TH1 AND TH2 CYTOKINES EXPRESSION IN UMBILICAL CORD BLOOD CD4+ T CELLS FROM GENETICALLY SUSCEPTIBLE CHILDREN WITH ALLERGIC DISEASESOBJECTIVE: To investigate the differences in Th1 and Th2 cytokines expression in umbilical cord blood CD4+ T cells from genetically susceptible children with allergic diseases.METHODS: From September 2018 to November 2019,a total of 40 pairs of mothers and infants were collected at a second-level maternal and child health hospital in Shanghai.Umbilical cord blood was divided into allergic disease susceptible group and normal control group according to the sensitization status of pregnant women.The percentage of Th1 and Th2 cytokines IFN-γ and IL-4 in umbilical cord blood CD4+ T cells were detected by flow cytometry,and the difference in Th1/Th2 ratio between the two groups was analyzed.RESULTS: The percentage of IFN-γ+CD4+ T and IL-4+ CD4+ T in cord blood CD4+ T cells in allergic disease susceptible group was(0.82±0.69)% and(2.58±2.68)% respectively,and the ratio of Th1/Th2 was 0.41±0.31.The percentage of IFN-γ+ CD4+ T and IL-4+ CD4+ T in cord blood CD4+ T cells of normal control group was(2.00±1.28)% and(1.45±1.21)% respectively,and the ratio of Th1/Th2 was 1.97±1.13.Independent sample t-test found that the percentage of IFN-γ+ CD4+ T(t=3.245,P<0.01)and Th1/Th2 ratio(t=5.187,P<0.001)in cord blood CD4+ T cells between allergic disease susceptible group and normal control group were significantly different,and there was no significant difference in the percentage of IL-4+ CD4+ T(t=-1.512,P=0.140)in cord blood CD4+ T cells between the two groups.CONCLUSIONS: The percentage of IFN-γ CD4+ T cells and Th1/Th2 atio in umbilical cord blood CD4+ T cells in children susceptible to allergic diseases were lower than those in normal control children,which resulted in Th2-polarized immunity.