Asthma Allergy Centre Research Group is actively engaged in clinical research involving areas such as asthma, chronic sinus problems, and back flow of nasal secretion into tear ducts during
nose blowing.
In recent years we have made several important discoveries.
We and our colleagues at Kaiser Permanente have discovered one kind of asthma that was previously unknown. In some asthmatic patients, the asthma usually started with a cold or sinus infection, and the asthma episodes, which can be mild or very severe requiring hospitalizations, lasted for a few months to many years. The asthma then gradually became milder and finally recovered. However, after an asthma-free period of a few months to several years, another prolonged episode occurred again following another cold or sinus infection. The research results were published in a medical journal CHEST.
We and our colleagues at Kaiser Permanente also have investigated the accuracy of the diagnosis of asthma. In a group of patients who were referred to us for the diagnosis and management of their difficult to control asthma symptoms, we found that 20% of them did not have asthma. So, many diseases can mimic asthma and present to us with diagnostic and management difficulty. The research results were presented at the Annual Meeting of the American Academy of Allergy, Asthma and Immunology, and appeared in the Journal of Allergy and Clinical Immunology.
In March 2006, we presented a research result that was previously unknown at the Annual Meeting of the American Academy of Allergy, Asthma and Immunology at Miami Beach, Florida. We found that
the tear duct is not a one-way duct just to drain tears into nose, as it has always been assumed. We discovered that in over 50% of subjects, the fluorescent eye solution that was instilled into their nose appeared in the eyes when the nose was blown. The research found that there is a back flow of nasal secretion into eyes through tear ducts when a person blows his or her nose. The research results also appeared in Journal of Allergy and Clinical Immunology.
In clinical practice, we have “cured” many patients’ chronic or recurrent red, itchy eyes, particularly with crusty eyelashes at arising when they stopped blowing their nose. They were asked not to blow nose, instead sniff backward. Nasal snot may also be removed with buffer saline irrigation.
In March 2008, we reported two research papers at the American Academy of Allergy, Asthma and Immunology Annual Meeting of the advance for the medical treatment of chronic sinus problem. We utilized topical nasal decongestant, such as Afrin, 2 times a day for several months. This would make sinus openings stay opened all the time similar to sinus surgery. We use nasal steroids
along with the topical nasal decongestant to prevent to often feared “rebound” effects of topical nasal decongestants. With added buffered salty saline nasal irrigation and low dose “macrolide” (like azithromycin) along with the topical nasal decongestant/nasal steroids. With in an average of 4 months, we are able to heal the sinus symptoms in about 50% of patients, and another 38% became very mild, with only minor thin mucus drainage remains.
The major feature of chronic sinus problem is the inflammation of the linings of the sinuses, not “pus pocket” as it was thought many years ago.
The low dose “macrolide” has anti-inflammatory effects on sinus linings, which helps nasal steroids and the salty buffered saline irrigation help the sinuses to ventilate and heal.
We also found that about 7.5% of the patients with chronic sinus problem have immunity defects. The immunity defects contributed to the treatment failure and the recurrence of chronic sinus problem once it was heal.
