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Objective To explore the effects of theophylline plus salmeterol/fluticasone propionate combination product (SFC) on clinical control,lung function and airway inflammation in asthmatics.Methods A total of 146 asthmatics received 200 mg theophylline plus 50/250 μg SFC twice daily for 24 weeks.The level of asthma control was assessed by the asthma control test.Testing of lung function and inflammatory markers in induced sputum were performed.And 142 asthmatics received 50/250 μg SFC twice daily for 24 weeks as control.Results Asthma was completely controlled in 61 and 59 in the theophylline plus SFC and SFC groups respectively after a 24-week treatment period (P ＞ 0.05).Theophylline plus SFC improved the FEF25％ 75％ value,indicating small airway function,to a greater extent than SFC [(66.7 ± 18.2) ％ & (56.6 ± 17.4) ％,P ＜ 0.01].Percentage of eosinophil and concentration of eosinophil cationic protein in induced sputum were significantly lower in the theophylline plus SFC group than those in the SFC group [(4.1 ±2.3)％ vs.(6.2±2.7)％ & (63.9±39.4) vs.(90.3 ±46.2) μg/Lrespeetively] (all P ＜ 0.01).Conclusion The therapy of theophylline plus SFC may provide greater improvements in small airway function and airway inflammation.
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Objective:To investigate the effect of type ⅡNKT cells activated by sulfatide on airway inflammation in a murine model of asthma.Methods:Thirty-two BALB/c mice were randomly divided into four groups:normal control group ( n=8 ) , asthma group (n=8),sulfatide treatment group (n=8) and adoptive transfer group (n=8).The murine model of asthma was established by sensitization with intraperitoneal injection of ovalbumin ( OVA) and intranasal challenge in all animals except for the normal control group where PBS was used instead.Intraperitoneal injection of sulfatide in a sulfatide treatment group, adoptive transfer of sulfatide-activated typeⅡNKT cells in adoptive transfer group and PBS in asthma group were carried out 1 hour before the first challenge.PBS was used for intraperitoneal administration in the normal control group.Lung histology and goblet cell hyperplasia were analyzed by HE or PAS staining.Differential cell count in bronchial alveolar lavage ( BALF) was measured by May-Gruenwald Giemsa;levels of OVA-specific IgE in serum and L-4,IL-5 in BALF were measured by ELISA.The percentages of lung type Ⅱ NKT cells,IL-4+and IFN-γ+typeⅡNKT cells were detected by flow cytometry.Results:Inflammatory cell infiltration in lung tissue and goblet cell hyperplasia in the airway were decreased in sulfatide treatment group and adoptive transfer group.Percentages of eosinophil in BALF,level of OVA-specific IgE in serum,and levels of IL-4,IL-5 in BALF in sulfatide treatment group and adoptive transfer group were significantly lower than those in asthma group (all P<0.05).The percentages of lung IL-4+and IFN-γ+typeⅡNKT cells in sulfatide treatment group was significantly higher than those in asthma group ( P<0.01 ).Conclusion: Type Ⅱ NKT cells activated by sulfatide may inhibit airway inflammation in a murine model of asthma.
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To explore the clinical significance of changes in maximal expiratory flow in 50％ and 25％ vital capacity (Vmax50％ & Vmax25％) before and after bronchodilator reversibility testing in patients with asthma.Forced expiratory volume in one second (FEV1),Vmax50％ and Vmax25％ were measured before and after bronchodilator reversibility testing in 118 patients with asthma and 82 with chronic obstructive pulmonary disease (COPD).The rate of positive reversibility in Vmax50％ was significantly higher than that in FEV1 in 118 asthmatics (x2 =7.995,P =0.007).The rates of positive reversibility in Vmax50％ and Vmax25％ were significantly higher in asthmatics than those in COPD patients (x2 =9.335,P =0.009).
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Plasma level of N-terminal pro brain natriuretic peptide (NT-proBNP) was measured for 362 elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), including 97 of AECOPD complicated with left-heart failure and 265 of isolated AECOPD.Results indicated that there was significant difference in plasma level of NT-proBNP between the two groups ( P = 0.000).With a cut-off value of 1643.5 ng/L NT-proBNP, its sensitivity, specificity and accuracy for identifying AECOPD complicated with left-heart failure in the elderly were 84.4%, 85.3% and 85.1%, respectively.It is suggested that assay for plasma NT-proBNP may be helpful to identify left-heart failure in elderly patients with AECOPD.
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Objective To investigate clinical significance of small airway function and eosinophil (Eos) percentage,levels of eosinophil cationic protein (ECP) and IL-5 in induced sputum among patients with clinically controlled asthma. Methods Sixty-two patients with clinically controlled asthma were selected for the study. Lung function was performed and percentage of Eos, levels of ECP and IL-5 in induced sputum were measured by Wrights' stain, fluorescence immuno-CAP system and ELISA,respectively. Thirty patients of asthma at acute exacerbation period and 20 healthy subjects were selected as controls. Results In 62 patients with clinically controlled asthma, 43 (69. 4% ) showed abnormal small airway function and 19(30. 6% ) normal one. Percentage of Eos [(5. 6 ±2. 9)%], levels of ECP [( 129 ±100) μg/L] and IL-5 [(21± 12) μg/L] in induced sputum were significantly lower in patients with clinically controlled asthma than those of asthma at acute exacerbation period [( 16. 2 ± 9. 7 ) %, ( 362 ±182) μg/L and IL-5(51 ±26) μg/L, respectively] (all P ＜0. 01 ), but significantly higher than those in healthy controls ( all P ＜ 0. 01 ). Percentage of Eos, levels of ECP and IL-5 in induced sputum were significantly higher in patients with clinically controlled asthma with abnormal small airway function than those with normal ane [(6.9±3.1)% vs. (2.0±1.1)%, (148±90) μg/Lvs. (54±29) μg/L and (24 ±12) μg/L vs. ( 13 ± 5 ) μg/L, respectively] ( all P ＜ 0. 01 ). Conclusions Abnormal small airway function and airway inflammation persistently exist in patients with clinically controlled asthma and it may be helpful to guild treatment during clinical control to determine small airway function and inflammatory markers in their induced sputum.
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AIM: To investigate the effects of low-dose theophylline on differentiation of the naive T lymphocyte. METHODS: Naive T lymphocytes and monocytes were isolated from cord blood in neonate. Theophylline (10 mg?L-1 ) was added in naive T lymphocytes and monocytes which stimulated by PHA (200 mg?L-1 ) for 3 days, and the differentiation of T cells was analyzed by flow cytometry. Cytokines were measured by enzyme linked immune-sorbent assay ( ELISA ). RESULTS: Theophylline significantly promoted differentiation fromTh1 cells to naive T cells ( P
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0. 05). However, the serum CYFRA21-1 level was related to the histologic classification (P
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AIM: To investigate the mechanism of anti inflammatory action of theophylline on asthma. METHODS: Nineteen asthmatic patients were administered 200 mg sustained release theophylline twice daily for 4 weeks. The numbers or levels of CD4 +T lymphocytes, eosinophils, interleukin(IL) 5 and interferon gamma (IFN ?) in sputum pre and post administration were measured by direct immunofluorescene technique, Wright's stain and enzyme linked immunosorbent assay, respectively. The symptom scores and lung function were also evaluated. RESULTS: Theophylline treatment significantly improved symptom scores, FEV 1.0 and FEV 1.0 %(P 0.05 ). The mean (range) serum theophylline concentration in final steady state was 7.9 ( 3.9 - 14.7 ) mg?L -1 . CONCLUSION: The anti inflammatory action of theophylline in asthma may result from reduction of IL 5 production in the airways.
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Objective To investigate the relationship between the number of eosinophil(Eos)and level of eosinophil cationic protein(ECP)in induced sputum and asthma severity and their value of differential diagnosis.Methods From July 2002 to June 2004,59 asthmatic patients were selected in the People Hospital of Wuhan University.The number of eosinophil and level of ECP were measured by Wrights' stain and Immuno-CAP System.The lung function was also evaluated.The same index was measured in 20 patients with COPD and 10 healthy subjects as control.Results The number of eosinophil in induced sputum in asthmatic patients negatively correlated with FEV_1%(r=-0.65,P
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Objective To investigate the relationship between the eosinophil (Eos) percentage and levels of eosinophil cationic protein (ECP) in induced sputum and the severity of late onset asthma(LOA) and differential diagnosis. Methods Fifty-four patients with LOA were selected. The percentage of eosinophil and levels of ECP were measured by Wrigbt′s stain and immuno-CAP system respectively. The lung function was also evaluated. The same indexes were measured in 25 elderly patients with chronic obstructive pulmonary disease (COPD) and 10 healthy elderly subjects as control. Results The percentage of Eos and levels of ECP in induced sputum in patients with LOA were significantly and negatively correlated with FEV_1/FVC (r=-0.68,-0.61, respectively, P