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- Bilateral Eyelid Contact Dermatitis and Toxic Conjunctivitis due to Acrylate-Containing Glue. [Journal Article]
- Ann Dermatol 2014 Aug; 26(4):543-4.
- Doxycycline exerts multiple anti-allergy effects to attenuate murine allergic conjunctivitis and systemic anaphylaxis. [JOURNAL ARTICLE]
- Biochem Pharmacol 2014 Aug 12.
Allergic diseases, which affect up to 20-30% of the world population, are still therapeutic challenge for allergists. Tetracyclines, which belong to an antibiotic drug family that possesses a striking variety of non-antibiotic properties, have been successfully applied to a wide range of diseases. However, their roles in allergic conjunctivitis and anaphylaxis and their underlying anti-allergy mechanisms remain elusive. Here, we reported that treatment with doxycycline significantly reduced IgE release from mouse B cells and the dergranulation and inflammatory cytokines production of mouse mast cells (MCs) activated by IgE-dependent way. Furthermore, doxycycline treatment significantly inhibited histamine-induced vascular hyperpermeability in vitro. Mechanistically, the doxycycline-mediated inhibition of B cells, MCs and histamine may occur via modulation of the PI3K/Akt pathway. In vivo, our results demonstrated that treatment with doxycycline significantly attenuated clinical symptoms of mouse models of experimental allergic conjunctivitis (EAC) with a significant decrease in inflammatory cell frequency, IgE production, histamine release, and a decrease in TNF-α and IL-4 production. Using mouse models of MCs-dependent passive systemic anaphylaxis (PSA), we further confirmed anti-allergy effects of doxycycline and doxycycline-mediated inhibitory effects on MCs. Furthermore, our results showed that doxycycline significantly attenuate histamine-induced systemic anaphylaxis-like reaction (HISA) with a significantly downregulation of PI3K/Akt/eNOS/VE-cadherin pathway. The doxycycline-mediated anti-allergy effects during EAC, PSA and HISA were abrogated when an Akt activator, SC79, was administered. These findings suggest that doxycycline inhibits B cell, MC and histamine function and attenuates experimental allergic conjunctivitis and systemic anaphylaxis by possible modulating the PI3K/Akt pathway.
- Trends in prevalence and treatment of ocular allergy. [JOURNAL ARTICLE]
- Curr Opin Allergy Clin Immunol 2014 Aug 11.
This review describes recent findings and trends in prevalence and treatment of allergic ocular diseases. Although the major focus is on seasonal and perennial allergic conjunctivitis, related disorders will also be considered.Published reports from countries around the world suggest that the spectrum of atopic diseases, including seasonal and perennial allergic conjunctivitis, is continuing its pattern of increasing prevalence, which has been well documented over the past few decades. In addition, although treatment modalities have focused on topical formulations including antihistamines and corticosteroids, there is a significant emphasis on immunotherapy as an alternative treatment modality, particularly in the USA.Allergic conjunctivitis is a key component in the spectrum of allergic diseases that is sometimes collectively referred to as rhinoconjunctivitis. Because of its high prevalence worldwide, it exacts an increasing toll in terms of patient discomfort, morbidity, and loss of productivity. Current estimates suggest that at least 20% of the overall population suffers from some form of allergic conjunctivitis, many without ever seeking treatments. In addition, a significant proportion of patients experience chronic forms of allergy that are less responsive to existing therapies. Recent approval of immunotherapy-based treatments may address this therapeutic gap.
- Atopic Diseases and Systemic Lupus Erythematosus: An Epidemiological Study of the Risks and Correlations. [JOURNAL ARTICLE]
- Int J Environ Res Public Health 2014; 11(8):8112-8122.
Both atopic diseases and systemic lupus erythematosus (SLE) are immune disorders that may lead to physical complications or multi-system comorbidities. This population-based case-control study was designed to evaluate the risk of SLE associated with atopic diseases. Using a national insurance claims dataset in Taiwan, we identified 1673 patients newly diagnosed with SLE and 6692 randomly selected controls frequency matched for gender, age and index date. The odds ratios (OR) for SLE were calculated for associations with allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. The SLE patients were predominantly female (82.5%) with a mean age of 40.1 (SD = 18.2). The patients with SLE had a higher rate of atopic dermatitis (6.81% vs. 3.06%), and asthma (10.6% vs. 7.64%) was approximately 2 times more common in the patients with lupus than in those without. The patients with atopic disease (atopic dermatitis, allergic rhinitis, allergic conjunctivitis and asthma) were at a significant risk for SLE. The overall risk for SLE increased as the number of atopic diseases increased from 1.46 to 2.29, compared with-individuals without the diseases (p < 0.0001). In conclusion, this population-based case-control study demonstrates a significant relationship between atopic diseases and the risk of SLE, especially for females. Atopic dermatitis plays a stronger role than other types of atopic disease in association with SLE.
- Knowledge and Awareness of Eye Flu among the Dentists and Dental Auxiliaries of Udaipur City, Rajasthan. [Journal Article]
- Int J Prev Med 2014 Jul; 5(7):920-3.
Conjunctivitis is the inflammation of the conjunctiva and has 4 main causes-viruses, bacteria, allergens, and irritants. Among these, bacterial conjunctivitis is most common and is contagious, especially when the dentist is working with the infected person, and that person spreads the same to the other patient.A pretested questionnaire survey was conducted among 152 subjects (those who were present at the time of survey) aged 18 to 60 years of Udaipur city, Rajasthan in March 2012. Ethical clearance was obtained from relevant authority. Written informed consent was obtained from study participants.All (80 dentists and 72 dental auxiliaries) the subjects returned the questionnaire. Regarding previous experience of eye flu, 67 (44.08%) participants reported that they had been infected with eye flu previously. Majority 123 (80.92%) of participants agreed that virus or bacteria caused eye flu. Majority of 145 (95.39%) of the participants agreed that the eye turns red during eye flu. One hundred and twenty three (80.92%) subjects replied that the dental treatment for a patient infected with eye flu should be delayed till the symptoms subside.Eye flu being an occupational hazard among dentists, personal ophthalmic prophylactic care is a must which helps in prevention of spread of infection to other patients and family members.
- Extranodal natural killer/T-cell lymphoma masquerading as conjunctivitis. [Letter]
- Can J Ophthalmol 2014 Aug; 49(4):e87-90.
- New Developments in the Treatment of Pediatric Allergic Rhinitis and Conjunctivitis. [JOURNAL ARTICLE]
- Pediatr Ann 2014 Aug 1; 43(8):e192-e200.
The primary care physician is the first line of treatment for allergic rhinitis, which affects approximately one-fourth of children in the United States. There is an increasing trend toward self-management by patients or parents due to high-deductible insurance plans and the over-the-counter availability of allergy medications. The primary care physician can offer guidance on appropriate selection of medications and potential adverse effects. Vitamin D deficiency has been proposed as a potential contributing factor in patients with allergic diseases, and studies are underway to determine whether supplementation with vitamin D is helpful for these conditions. Sublingual immunotherapy has recently received US Food and Drug Administration approval for grass and ragweed allergens; many children will be interested in this alternative to allergy shots. The relative advantages and disadvantages of sublingual vs subcutaneous immunotherapy are discussed. [Pediatr Ann. 2014;43(8):e192-e200.].
- Current options and emerging therapies for anterior ocular inflammatory disease. [JOURNAL ARTICLE]
- Curr Opin Allergy Clin Immunol 2014 Aug 7.
Ophthalmic disorders are highly prevalent in the United States, with approximately 3.5 million individuals aged at least 40 either blind or having impaired vision. This article reviews the current leading agents and pipeline therapies for the treatment of anterior ocular inflammatory disease (AOID).There has been great progress in the understanding of ocular pathophysiology in recent years. Although current treatments for AOID are effective and well tolerated in many patients, a continued demand persists for more efficacious alternatives to the limited modalities available to clinicians.Several promising modalities for AOID, particularly for allergic conjunctivitis, immune treatments for uveitis and dry eye syndrome are in late-stage development that could offer optimal treatment paradigm once available in the clinic.
- Maternal and neonatal risk factors associated with vertical transmission of ophthalmia neonatorum in neonates receiving health care in Blantyre, Malawi. [Journal Article]
- Middle East Afr J Ophthalmol 2014 Jul; 21(3):240-3.
Neonatal conjunctivitis is associated with poor prenatal care worldwide.Data on neonatal conjunctivitis is scarce in Malawi. This study describes risk factors associated with conjunctivitis in neonates born in a large tertiary care hospital in Blantyre, Malawi.Medical records of a retrospective cohort of 231 neonates diagnosed with conjunctivitis from January 2006 to December 2009 at a large tertiary hospital in Malawi were reviewed. All subjects were clinically diagnosed with ophthalmia neonatorum. Data were collected on patient demographics and clinical features. The frequencies were calculated of various risk factors in neonates with ophthalmia neonatorum and their mothers as well as the treatments administered.Mean age of the mother was 23.45 years (range, 15-40 years), and the mean number of previous deliveries was 2.3 (range, 1-7) children. Nearly, 80% of mothers delivered preterm infants via spontaneous vaginal delivery. The mean birth weight of neonates was 2869.6 grams (1100-5000 grams). Among mothers, premature rupture of membranes was the leading risk factor (24%) followed by sepsis during labor (9%), and history of sexually transmitted infections (STI) (7%). Neonates presented with low Apgar scores (19%), fever (8%), and/or meconium aspiration (5%). Providers treated patients empirically with a varied combination of benzyl penicillin, gentamicin, tetracycline eye ointment, and saline eye wash. Tetracycline with a saline eyewash was used frequently (34%) compared with combinations of benzyl penicillin and gentamicin.Improving prenatal care to reduce sepsis, traumatic deliveries, and early diagnosis of STI with appropriate treatment may potentially reduce vertical transmission of neonatal conjunctivitis in this understudied population.
- Cardiovascular safety of antihistamines. [Journal Article, Review]
- Postepy Dermatol Alergol 2014 Jun; 31(3):182-6.
Histamine is a mediator, which increases the permeability of capillaries during the early phase of allergic reaction, causes smooth muscle contraction of bronchi and stimulates mucous glands in the nasal cavity. Antihistamines are the basis of symptomatic treatment in the majority of allergic diseases, especially allergic rhinitis, allergic conjunctivitis, urticaria and anaphylaxis. The cardiotoxic effects of the two withdrawn drugs, terfenadine and astemizole, were manifested by prolonged QT intervals and triggering torsades de pointes (TdP) caused by blockade of the 'rapid' I Kr potassium channels. These phenomena, however, are not a class effect. This review deals with a new generation of antihistamine drugs in the context of QT interval prolongation risk.