Effects of sequential Dermatophagoides pteronyssinus antigen stimulation on anatomy and physiology of the larynx Response Paper

A great number of people nowadays experience various types of allergies to specific antigens like dust, dirt or animals and in many cases, such kind of allergies leave notable effects into the physical and physiological facets of the person. On the physical aspect, people with allergies exhibit coughing and difficulty of breathing while on the physiological aspect, the lungs and many other respiratory organs encounter abnormal changes that may lead to detrimental effects if not attended properly. One of the respiratory organs that are considered to be compromised during an allergy attack is the larynx, also called the voice box, but scientific evidence to support this claim has been lacking for the past 40 years (Dworkin et al., 2009).

In order to address this knowledge gap, the objective of this study was to investigate the effects of sequential dust mite antigen stimulation on the voice box of a person more specifically on  its morphology and function. The research design was composed of a randomized, placebo-controlled, double-blind, prospective study which made use of 20 healthy but dust-mite-allergic patients, aged 18-70, from the Wayne State Universitys Department of Otolaryngology -Head and Neck Surgery in Detroit (Dworkin et al., 2009). Informed consent was obtained from all of the participants before the experimentation, an event that was characterized of the exposure to D. pteronyssinus antigen which is also the confirmed allergen for the attacks of the participants as confirmed by screening skin-prick test and glycerin control. Other screening methods were employed to counter-check the fitness of the patients for the study and at the end of these tests, only three patients passed and completed the procedures. Two of the participants were part of the experimental group while the last one served as the control patient and received only placebo. Seven steps highlighted the laboratory testing battery for the two groups and these are composed of the following FEV spirometry test, Voice Handicap Index questionnaire completion, Sinus Symptom Questionnaire completion, videotroboscopic examinations of the larynx, acoustic characteristics of the larynx, recording of the digital audio voice, and finally, exposure to either the antigen or placebo (Dworkin et al., 2009). Early termination of the study was implemented after the two experimental patients manifested adverse effects after antigen exposure, however, this event did not hinder the authors from obtaining substantial amount of data for analysis.

Results showed that endolaryngeal secretions were produced in response to antigen exposure but the source of this mucus was not clear. Furthermore, due to the limited number of participants who were used in this study and the early termination of the procedures, a direct cause-and-effect relationship between laryngeal inflammation and allergy attack was not established in this study. However, present patophysiological findings regarding larynx inflammation after exposure to dust-mite antigen prove that a correlation exists between the two and are physically manifested through throat clearing and coughing (Dworkin et al., 2009).

In general, this study provides possible explanation on the relationship of chronic laryngitis, laryngeal dysfunction, and laryngopharyngeal reflux to allergic attacks. Future investigators may utilize the findings in this study to further explore if vocal abuse and other voice-related properties may be predisposing factors to laryngitis and if allergic attacks may play an essential part in the physiology of the patients. Aside from this, it is also noteworthy to emphasize the ethical decision of the investigators to stop the procedures when they found out that the wellness of the participants are being compromised. In a study that involved the utilization of humans as subjects, the authors made it a point to consider their patients prior to the concerns of the study. Moreover, this event did not prevent the authors to come up with a well-structured report that is clearly explained and was backed up by comprehensively gathered scientific literature. Consequently, the pitfalls on the methodology was compensated by producing a quality paper and maximizing every information that they were able to derive in the short span of experimentation process.


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