Mast cells: Re emergence of a pivotal role in asthma and chronic obstructive pulmonary disease [COPD]

Mast cells have long been thought to play a central role in asthma through their ability release proinflammatory mediators, but this role has been questioned by the lack of efficacy of antihistaminics and the so called mast cell stabilizing drugs. However, the evidenced increases of mast cells in the airway of asthmatics, especially the smooth muscles and the recent evidence of a more active role of smooth muscle in the pathogenesis of asthma has led to the re-emergence of mast sell as a pivotal role in asthma. This striking increase of mast cells in the airway was detected also in smokers and patients with COPD, thus drawn the attention towards the possibility of finding new treatment strategies. The aim of the current study was to investigate the presence of a relation between the number of mast sells in airway wall [smooth muscles and lamina propria] and severity of asthma and COPD. The mean number of mast cells in lamina propria and smooth muscles were higher the severer the disease, whether asthma or COPD. A positive correlation was detected between the mean number of mast cells in lamina propria and those in smooth muscles in all studied cases. Negative correlation was detected between mean number of mast cells in lamina propria and in smooth muscles and functional parameters in all studied cases.

Assessment of possible pulmonary involvement in patients with rheumatoid arthritis [RA] under methotrexate [MTX] therapy: comparison of clinical, functional, histopathological, high resolution computed tomography [HRCT] and laboratory features capability to detect pulmonary changes

Lung involvement in systemic disease may be a manifestation of the underlying pathological process, may be complication of the underlying disease or may be related to the treatment. Methotrexate [MTX], a folic acid antagonist is widely used in rheumatoid arthritis treatment; however, methotrexate-induced pulmonary drug toxicity occurs in 27% of patients. Difficulty in diagnosing these lesions had led-many researchers to assess the capability of every possible investigation [radiologic, functional, histopathologic, even 99mTc-DTPA scan] in reaching early diagnosis and differentiating it from those led by the original disease or that caused by infection, as early diagnosis and management carries good prognosis to an apparently fatal disease. Thus we compared in this study different diagnostic methods for detection of lung involvement due to MTX. We were able to detect pulmonary affection in some studies cases radiological and histopathologically, however, clinical and functional investigations lagged behind in their capabilieate the lung involvement.

Effect of long acting beta 2 agonists [LABA] on vascular remodeling in asthma

Research work studying the effect of anti-asthma drugs on indices of airway remodeling especially those concerned with the increased subepithelial airway vasculrity in asthma-emetics are still few. We studied the presence of increased vascularity and the effect of LABA on vascular remodeling on 33 asthmatics who were on inhaled steroids, however, only data of 29 patients at the end of the study period [6weeks] were available for statistical studies. We confirmed by patho- logical study of bronchoscopic biopsy that there was increased vasculrity of the airways in asthmatics, even in mild cases, and that this vascularity was higher the asthma. Moreover, there was a decrease in the number of vessels/mm2 of the lamina propria at the end of the study period in all of our patients whatever the severity of their asthma and this decrease was accompanied by functional improvement, however, more pronounced the less severe the asthma