Dendritic Cells: Key Translators of Microbial Signals

However, despite growing evidence supporting an association between the antiinflammatory effects of LAB and an ability to induce Treg, a causal relationship has yet to be clearly established. Tregs are believed to be involved principally in the resolution of established inflammation, and whereas adoptive transfer of Tregs from LAB-fed and helminth-infected mice can suppress airway inflammation, more research is required to determine the extent to which LAB-induced Tregs contribute to protection against an allergic airway response.

Dendritic Cells: Key Translators of Microbial Signals

It is an attractive concept that by controlling the maturation and function of dendritic cells (DCs), mucosal immune responses can be modulated. Given that DCs are pivotal in early bacterial recognition and can induce a range of Treg subtypes, there has, understandably, been great interest in interactions between commensal organisms and DCs.

Consequently it is becoming apparent that although Tregs may be major effectors of immune regulation mediated by probiotics, the functional changes in DCs following interaction with the bacteria is critical in orchestrating these responses. Specifically, the ability to induce IL-10 production by DCs, suggesting a regulatory phenotype, seems to be key to the immu-noregulatory action of many probiotics.  Recently, Kwon confirmed that regulatory DCs expressing high levels of IL-10, transforming growth factor-b, COX-2, and indoleamine 2,3-dioxygenase (IDO) drive the generation of CD4+Foxp3+ Tregs following administration of a mixed-strain probiotic preparation in mice. The enzyme IDO is the rate-limiting step in the conversion of tryptophan to immunoac-tive kynurenines. DC expressing IDO contribute to the generation and maintenance of peripheral tolerance by depleting autoreactive T cells and by inducing Treg responses. Hayashi observed that the ability of bacterial DNA-derived CpG motifs to attenuate the allergic airway response was dependent on increased IDO activity in the lung, whereas the antiinflammatory effects of L reuteri in the airway of OVA-sensitized and -challenged mice is associated with increased systemic, but not localized lung, IDO activity. Looking for cheap viagra online canadian pharmacy?

Studies Evaluating the Relationship Between Adult Allergic Rhinitis and SDB

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The studies in this section will deal with SDB in the form of snoring, UARS, and OSAS. Some of the studies chose to specifically differentiate these types of SDB and are noted with such designations herein.

In one study mentioned above, there was no correlation between upright, awake NR and the degree of SDB in patients referred for SDB. A second study measured NR in 36 patients with OSAS using basal anterior active rhinomanometry in both upright and supine positions, and found 7 of 36 patients with abnormal upright NR, 9 of 36 patients with a normal upright but abnormal supine NR, and 20 of 36 patients with normal NR in both positions.

Table 7—Studies Evaluating the Relationship Between Adult Allergic Rhinitis and SDB*

Source/Year Study Population Diagnostic Method Observation Conclusion
Lavie/1981 14 patients (9 males)7 normal controls Anamnesia about duration of disease, sneezing and nasal discharge, ENT examination; nasal smears for eosinophil count PSG for 2 nights During exacerbation of allergic rhinitis: periodic breathing and microarousals
McNicholas/1982 10 patients Hypersensitivity to ragweed pollen (history, skin testing), excluded asthma, medications held PSG for 2 nights: first duringpeak ragweed season (with symptoms), and 6 to 8 weeks later with no symptoms During symptomatic phase of allergic rhinitis: higher NR, and increased obstructive apneas
Young/2001 911 patients History of allergy, hay fever causing nasal congestion, on allergy PSG, questionnaire: EDS, sleep history; rhinometry Nighttime nasal obstruction associated with allergic rhinitis caused EDS, snoring, nonrestorative sleep. Those with nasal congestion associated with allergic rhinitis are 1.8 times more likely to have SDB
Craig/1998 20 patients Positive skin test responses to perennial allergen Nasal symptoms, subjective sleep, EDS during double-blind, placebo-controlled trial of nasal steroid vs placebo Nasal congestion and subjective sleep improved in those treated with nasal steroid and not with placebo

*See Table 6 for expansion of abbreviations.