Effect and mechanism of extracorporeal photopheresis on preventing acute graft versus host disease in ice / 中国输血杂志

【Objective】 To investigate the preventive effects of early apoptotic splenic mononuclear cells induced by extracorporeal photopheresis (ECP) on acute graft versus host disease (aGVHD) in mice and explore the underlying mechanisms. 【Methods】 1) Splenic mononuclear cells were extracted from C57BL/6 mice and treated with different concentrations of 8-MOP (50 ng/mL, 100 ng/mL, 200 ng/mL, 300 ng/mL, 600 ng/mL). After treatment, irradiate the cells with 2 J/cm2 of ultraviolet light. Then, use the Annexin V-FITC/PI apoptosis detection kit to assess the early apoptosis rate of the cells and determine the optimal concentration of 8-MOP for the experiment.2) There were 35 SPF-grade female BALB/C mice (H-2Kd) aged 6-8 weeks. After whole-body irradiation with 8Gy X-rays, the mice were divided into five groups: sham irradiation group received intravenous infusion of 0.2 mL of normal saline, the syngeneic bone marrow transplantation group received intravenous infusion of 0.2 mL of BALB/C mouse bone marrow nucleated cell suspension (including a cell count of 1×107), the allogeneic bone marrow transplantation group received intravenous infusion of 0.2 mL of C57BL/6 mouse bone marrow nucleated cell suspension (including a cell count of 1×107), the aGVHD group received intravenous injection of a mixture of C57BL/6 mouse bone marrow nucleated cells (including a cell count of 1×107) and splenic mononuclear cells (including a cell count of 1×107) in 0.2 mL, the ECP prevention group received pre-transplant intravenous infusion of 0.2 mL of ECP-treated splenic mononuclear cells of C57BL/6 mice (including a cell count of 1×107 ) 48 hours before transplantation, and on the day of transplantation, intravenous injection of a mixture of C57BL/6 mouse bone marrow nucleated cells (including a cell count of 1×107) and splenic mononuclear cells (including a cell count of 1×107 ) in 0.2 mL.The preventive effects of ECP on aGVHD were observed, and the concentrations of IFN-γ, IL-2, TNF, IL-4 and IL-6 in mouse serum were measured using CBA. Th1 cell counts were determined by flow cytometry. 【Results】 Different concentrations of 8-MOP (50 ng/mL,100 ng/mL, 200 ng/mL, 300 ng/mL, 600 ng/mL) were used to treat mouse splenic mononuclear cells. The early apoptosis rates (%), observed after treatment were as follows: (14.18±0.865) vs (16.76±0.407) vs (18.83±0.404) vs (19.27±0.404) vs (14.5±0.529). The appropriate concentration of 8-MOP was determined to be 200 ng/mL.In vivo experiment, the results showed that the aGVHD group had decreased survival rate, reduced body weight, and increased clinical scores compared to the syngeneic and allogeneic bone marrow transplantation groups (P<0.01), and the chimerism of bone marrow cells in mice after transplantation was over 90%. ECP significantly improved the survival rate of mice after transplantation, reduced clinical scores (P<0.05), and decreased the concentrations of Th1 cell cytokines in serum (P<0.05) and the counts of Th1 cells in the spleen (P<0.05). 【Conclusion】 ECP-induced early apoptotic single nuclear cells from the spleen can prevent the occurrence of aGVHD by reducing the Th1 response in mouse.

Advances in extracorporeal photopheresis / 中国输血杂志

Extracorporeal photopheresis(ECP) is a bidirectional cellular immunomodulatory therapy based on leukapheresis, which can mediate not only immunopotentiation but also immunosuppression. Clinically, ECP has been observed to have good efficacy in the treatment of cutaneous T cell lymphoma(CTCL), graft versus-host disease(GVHD) and solid organ transplant rejection, also the US Food and Drug Administration(FDA) has approved ECP for the treatment of CTCL. The treatment guidelines for GVHD in the US and Europe also include ECP, however, there is a lack of relevant guidelines in China. Although the exact mechanism of ECP is not fully explained, recent studies provide a theoretical basis for a further understanding of the bidirectional regulation of ECP.The initial hypothesis was the combination of 8-methoxypsoralen(8-MOP) and ultraviolet A(UVA) to induce apoptosis of immune cells. As the research progressed, this idea was transformed into the differentiation of monocyte to dendritic cell(DC), cytokine alteration and the regulatory T cell(Treg) stimulation.In this article, the current exploration of the immunomodulatory mechanism in ECP and its clinical application were reviewed, also the latest molecular mechanism of ECP mediated immunopotentiation and immunosuppression was comprehensively analyzed, meanwhile the further promotion and clinical application of ECP in China had been prospected.

Parkinson disease patients performance in Theory of Mind (ToM) and decision-making tasks with and without Deep Brain Stimulation (DBS) / Desempeño de pacientes con Parkinson con y sin estimulación cerebral profunda (ECP) en Teoría de la Mente (ToM) y toma de decisiones

Abstract: Background: Patients with Parkinson's Disease (PD) show non-motor symptoms, such as cognitive impairment, disrupting executive functions, and mood alterations. Two processes currently researched in these areas are the Theory of Mind (ToM) and the decision-making in PD patients. The ToM is the ability to identify mental states (affective or cognitive) in others, and it is a necessary skill for successful communication in social situations. The decision-making process is researched in PD patients due to alterations in dopaminergic pathways involved in cortico-striatal circuits. These pathways have been linked to cognitive functions. Both processes could be altered in PD patients after the deep brain stimulation (DBS) therapy. Objective: To compare the performance of PD patients (with and without DBS) and healthy controls (HC) in the Theory of Mind and decision-making tasks. Methods: We applied to three groups of patients (PD, n = 4; PD-DBS, n = 5 and HC, n = 5) the Yoni task to identify affective and cognitive features in ToM and the Iowa Gambling Task (IGT) in decision-making. Results: There were no differences across the PD groups in ToM both in the affective and cognitive features. Regarding the decision-making, we obtained results consistent with previous findings, with PD patients showing impairments in this process. Conclusions: Some results suggest that DBS therapy affected PD patients' performance in decision-making when compared to the healthy control group. Our results describe some non-motor changes due to DBS often seen in PD patients.

Resumen: Los pacientes con enfermedad de Parkinson (EP) muestran síntomas no motores, como deterioro cognitivo, alteración de las funciones ejecutivas y alteraciones del estado de ánimo. Dos procesos que se investigan actualmente en este tipo de pacientes son la Teoría de la Mente (ToM) y la toma de decisiones. La Teoría de la Mente es la capacidad de identificar los estados mentales (afectivos o cognitivos) en los demás, y es una habilidad necesaria para la comunicación exitosa en situaciones sociales. El proceso de toma de decisiones se investiga en los pacientes con EP debido a las alteraciones en las vías dopaminérgicas implicadas en los circuitos corticoestriatales, las cuales se han vinculado a las funciones cognitivas. Ambos procesos podrían estar alterados en los pacientes con EP después de la terapia de estimulación cerebral profunda (ECP). Con el objetivo de comparar el rendimiento de pacientes con EP (con y sin ECP) y controles sanos (HC) en teoría de la mente y tareas de toma de decisiones, aplicamos a tres grupos de pacientes (PD, n = 4; PD-DBS, n = 5 y HC, n = 5) la tarea de Yoni para identificar las características afectivas y cognitivas en TM y la Tarea de Juego de Iowa (IGT) en la toma de decisiones. No hubo diferencias entre los grupos de EP en TM tanto en las características afectivas como en las cognitivas. En cuanto a la toma de decisiones, obtuvimos resultados consistentes con los hallazgos anteriores, con pacientes con EP que mostraron impedimentos en este proceso. Algunos resultados sugieren que la terapia de ECP afectó el desempeño de los pacientes con EP en la toma de decisiones cuando se comparó con el grupo de control sano. Nuestros hallazgos describen algunos cambios no motores debidos a la ECP que se observan a menudo en los pacientes con EP.

La Enfermedad de Parkinson: Etiología, Tratamientos y Factores Preventivos / Parkinson Disease: Etiology, Treatments and Preventive Factors

La enfermedad de Parkinson (EP) es la patología neurodegenerativa motora con mayor incidencia a nivel mundial, cuyas causas aún no son claras. Actualmente no existe cura, pero es posible contar con diferentes tratamientos que permiten aliviar algunos de sus síntomas y enlentecer su curso. Debido a la gran cantidad de informaciones, en ocasiones contradictorias sobre los llamados "factores de riesgo" (entendidos éstos como situaciones que pueden exacerbar la posibilidad de aparición de la enfermedad, incluyendo desde la predisposición familiar hasta la exposición prolongada a substancias exógenas), en esta revisión se pretende ofrecer una panorámica actual sobre factores asociados a la aparición de EP Se revisan también algunos tratamientos que buscan contrarrestar la pérdida de la función dopaminérgica de la substancia nigra (SN) y algunas de las aproximaciones terapéuticas tanto farmacológicas, como por estimulación cerebral profunda (ECP) o por implante celular. Se revisan también investigaciones sobre el potencial terapéutico de compuestos con alta especificidad a receptores colinérgicos (nAChRs) y antagonistas de receptores de adenosina, específicamente del subtipo A2A. Posiblemente durante las próximas décadas, nuestro conocimiento en epigenética pueda arrojar nuevas luces sobre esta interacción, así como sobre las relaciones entre ciertas líneas de microbios intestinales y aparición de EP. En este momento, la alternativa terapéutica que ofrece mayor eficacia es la ECP, sin embargo, a futuro se espera que el desarrollo de nuevas estrategias de implante cerebral pueda ofrecer una cura real de la EP.

Parkinson's disease (PD) is the most prevalent neurodegenerative motor pathology worldwide, the causes of which are still unclear. Currently there is no cure, but it is possible to have different treatments that allow to alleviate some of its symptoms and slow its course. Due to the large amount of information, sometimes contradictory, about the so-called "risk factors" (understood as situations that may exacerbate the possibility of the onset of the disease, from family predisposition to prolonged exposure to exogenous substances), in this review aims to provide a current overview of factors associated with the occurrence of PD. We also review some treatments that seek to counteract the loss of the dopaminergic function of the substance nigra (SN) and some of the therapeutic approaches both pharmacologically, by deep brain stimulation (DBS) or by cellular implantation. Also reviewed investigations on the therapeutic potential of compounds with high specificity to cholinergic receptors (nAChRs) and adenosine receptor antagonists, specifically the A2A subtype. Possibly, during the next decades, our knowledge in epigenetics may shed new light on this interaction, as well as on the relationships between certain lines of intestinal microbes and onset of PD. At this time, the most effective therapeutic alternative is DBS; however, in the future it is expected that the development of new brain implant strategies may offer a real cure for PD.

Comparison of the surgical outcome and cost effectiveness of autologous blood with electrocautery pen and fibrin glue in the limbal conjunctival autografting for the treatment of primary pterygium.

Introduction: There are various techniques available for securing limbal conjunctival auto graft in the treatment of primary pterygium. purpose of this study to compare the surgical outcome and cost effectiveness of a new techniqueautologous blood with electrocautery pen and current standard of fibrin glue. Materials and methods: This retrospective study was carried out in 76 patients presented with primarypterygia who underwent pterygium surgery using autologous blood with ecp (36 eyes) and fibrin glue (40 eyes). all patients were followed up post operatively on 1stday, 7thdayand 6th month. during follow up,patients were assessed for graft displacement or loss and comfort. cost of the surgery was also compared. Results: No intraoperative complications occurred in either group. out of 36 patients, 4 graft dislodgements occurred in autologous blood with ecp group on the immediate post-operative day. while none in fibrin glue group. during the 6 months follow-up, 6 eyes in group i (16.7%) and 1 eye in group 2 (2.5%) developed recurrence. Conclusion: Autologous blood with ecp in conjunctival autografting is as effective as fibrin glue in terms of graft adherence and post-operative patient comfort. however, this method is 3 times cost effective than the commercially available fibrin glue.

Efficacy of Seratrodast, a Thromboxane A2 Receptor Inhibitor in a Double Blind Comparative Clinical Trial with Monteluklast.

Aims: To assess the comparative efficacy, safety and tolerability of seratrodast versus montelukast in controlling mild to moderate asthma in adult patients. Study Design: Randomized, comparative, double blind, double dummy, multi-center, parallel group, non inferiority study. Methods: Patients (n=205) with mild to moderate asthma continuing on the lowest dose of inhaled corticosteroid were recruited from 3 different centers across India. Patients were randomly assigned to receive either seratrodast 80 mg (n=103) or montelukast 10 mg (n=102) once daily for 28 days. The treatments were compared for improvement from the baseline values, as per the changes in asthma symptom score (wheezing, shortness of breath, expectoration, cough and chest tightness), lung function parameters (PEF, FVC and FEV1), sputum and mucociliary parameters [fucose, eosinophil cationic protein (ECP) and albumin]. Results: Seratrodast and montelukast showed improvement in the clinical parameters of asthma as well as in the lung function tests and sputum parameters from baseline. Both the treatments significantly increased mean values of PEF, FVC and FEV1 from the baseline after a 4 week treatment but seratrodast produced significantly greater improvement in PEF (0.416 L/s, P=.01). Moreover, there was significantly more reduction in expectoration score (P=.01), sputum concentrations of ECP (P<.001) and albumin (P<.001) in seratrodast group, signifying improvement in asthma condition. The two treatment groups had similar tolerability profiles. Mild increase in hepatic enzymes was seen in both the groups with no clinical significance. No serious adverse events were observed during the study. Conclusions: Seratrodast, a Thromboxane A2 receptor antagonist, was found to be better in the improvement of PEF, reduction in expectoration, ECP and albumin levels as compared to montelukast. Seratrodast can be recommended as a controller medication in mild to moderate asthma.

The influence of Lactobacillus salivarius on IgE,eosinophil cationic protein and transforming growth factor-βin serum and lung tissue homogenates of asthmic Balb/c mouse / 中国小儿急救医学

Objective To explore the influence of Lactobacillus salivarius on IgE,eosinophil cationic protein(ECP)and transforming growth factor(TGF)-βof serum and lung tissue homogenates of asthmic Balb/c mouse.Methods Thirty female Balb/c mice weighing 16-18 g(4 weeks old),SPF grade,were ran-domly divided into three groups:normal control group(group A),asthma group(group B),asthma combined Lactobacillus salivarius group(group C).Acute asthma model was established applying ovalbumin,behavioral changes were observed in mice,the changes in airway inflammation and the number changes of tracheal cilia were observed by pathological HE staining and the electron microscope respectively.The levels of IgE,ECP and TGF-βin the serum and lung tissue homogenate were measured by ELISA method.Results (1 )The mice in group B presented obvious restlessness,head and facial itching,scratching,shortness of breath,peri-oral cyanosis with abdominal breathing,sneezing,stooping,forelimbs shrinkage,urine and feces incontinence and other asthma acute phase performances in 5-1 0 minuts after 4% ovalbumin saline solution atomization excitation,the above reaction alleviated in group C compared to group B.(2)Pathology of HE staining in group B showed the thickening bronchial wall,narrow lumen,peribronchial and perivascular infiltration with a large number of eosinophil-based inflammatory cells,lumen with many inflammatory secretions,pathological changes in lung tissue of mice in group C significantly alleviated compared with group B.Under the electron microscope,the number of cilia in group B significantly decreased compared with group A,while group C significantly increased compared with group B.(3)Expression levels of serum IgE and ECP in group C were sig-nificantly lower than those in group B[(0.86 ±0.14)μg/ml vs.(1.30 ±0.12)μg/ml;(2.30 ±0.15)ng/ml vs.(3.41 ±0.15)ng/ml,P <0.05,respectively].The contents of lung tissue homogenate IgE[(0.97 ± 0.06)μg/ml]and ECP[(5.88 ±0.13)ng/ml]in group C significantly decreased,respectively,compared with the IgE[(1.13 ±0.05)μg/ml]and ECP[(8.08 ±0.15)ng/ml]in group B(P<0.05).The levels of serum TGF-β[(0.17 ±0.01 )μg/ml]and lung tissue homogenates TGF-β[(0.18 ±0.01 )μg/ml]in group C were higher than the serum TGF-β[(0.13 ±0.01 )μg/ml]and lung tissue homogenates TGF-β[(0.15 ±0.01 )μg/ml]in group B,respectively,the differences were statistically significant(P<0.05 ). Conclusion Lavage with Lactobacillus salivarius before sensitization could alleviate clinical symptoms of asthmatic mice,as well as reduce airway inflammation in some degree,TGF-βmay be involved in the mecha-nism of Lactobacillus salivarius playing a protective role.

Knowledge attitude and practice (KAP) of emergency contraceptive pills among women of reproductive age group attending AIIMS OPD Raipur (C.G.).

India’s population as per 2011 census was 1.028 billion. Even though a wide variety of contraceptive choices are available in India, contraceptive prevalence in the country is only 56% as per the WHO global health statistics 2012. Most couples in India do not want to use a contraceptive method on a long-term basis hence unwanted and unplanned pregnancies are common. Emergency contraceptive Pills are largely underutilized in India resulting in women resorting to unsafe or illegal abortions contributing 8% to the cause of maternal mortality in India, which if taken correctly can reduce the risk of an unintended pregnancy to the range of 75-79%. The objective of the study is to assess knowledge, attitude& practice (preference &experience) of emergency contraceptive pills among women of child bearing age. Methods: A cross sectional study was conducted among 328 females of reproductive age group. Data was collected using an anonymous pretested structured questionnaire. Results: Out of 328 subjects 300 women gave consent for the study. Around 56% women had heard of emergency contraceptive pills but only 19.3% had ever used it. Detailed and specific knowledge of ECPs are poor and misinformation is high. This was because main source of information was through electronic media which are unreliable and gives limited information. Conclusion: The study concludes that in spite of having awareness about EC Pills there is great knowledge and attitude gap in the community. Public information strategy needs to be devised to generate awareness and bring attitudinal change among females for emergency contraceptive pills. Support from women advocacy groups is thus necessary and their views, apprehensions, doubts and perceptions have to be adequately addressed to make their occasional use to prevent unwanted pregnancy is likely to bring down the load on the therapeutic abortion services.

Effect of Asarone Injections on Expression of IL-25, Eosinophils Cationic Protein(ECP) and IL-27 in Ser-um of Asthma Patients / 中国药师

Objective:To monitor the effects of asarone injections on the expression of IL-25, IL-27 and eosinophils cationic pro-tein ( ECP) in the serum of asthma patients. Methods:Totally 100 patients with bronchial asthma were randomly divided into the ob-servation group ( 55 cases ) and the control group ( 45 cases ) . The control group was treated with the conventional symptomatic treat-ment ( oxygen inhalation, spasmolysis and anti-asthma, and anti-infection, etc) . The observation group was given asarone injections 24 mg in 250 ml 0. 9% sodium chloride infusions, once a day for 14 days on the basis of the conventional therapy. The changes in symp-toms, and pulmonary function in the patients were observed with simultaneous detection of IL-25, ECP and IL-27 levels. Results:To-tal effective rate of the observation group was 92. 7%,which was higher than that of the control group (P<0. 05). Asarone injections could decrease IL-25, ECP and IL-27 levels in the observation group compared with those in the control group with statistically signifi-cant difference (P<0. 05 or 0. 01). Conclusion:Asarone injections can decrease the levels of IL-25, IL-27and ECP in the serum of asthma patients and inhibit the formation of inflammatory cells to alleviate the symptoms of airway inflammation.

Qualidade microbiológica de lanches e salgados / Microbiological quality of finger food and snacks

Although finger food is convenient, it may be easily contaminated from the stage of preparation to themoment of consumption. This study aimed at evaluating the microbiological quality of finger food and sandwiches sold in Botucatu – SP, Brazil, by following the standards established by the Brazilian Health Surveillance Agency, ANVISA. The analysis was conducted according to APHA. A hundred and twenty two samples of meat, chicken, shrimp, cheese, and vegetable finger food and sandwiches were tested fromAugust 2008 to March 2009. Seventeen (13.9 %) samples of meat, cheese, vegetables and chicken were indisagreement with the ANVISA standards — some of them in more than one parameter. High counting of thermotolerant coliforms and coagulase-positive staphylococci were found in ten (8.2 %) and eight(6.5 %) samples, respectively. Salmonella spp. was detected in two samples (1.6 %). No Bacillus cereus andsulfite-reducing clostridia were isolated. Although only 10 samples (8.2 %) showed pathogenic bacteriacontamination, these results are relevant, since they indicate that the population is generally exposedto risks of acquiring foodborne diseases. Thus, the sanitary authorities might implement actions forsupervising the quality of the food sold in Botucatu, and to strengthen the food sellers to improve thehygienic conditions and be aware of the risks of food contamination.

Neste trabalho foi avaliada a qualidade microbiológica de salgados e sanduíches comercializados emBotucatu-SP, seguindo-se a legislação em vigor. As análises foram realizadas de acordo com APHA. Foramanalisadas 122 amostras de salgados de carne, frango, camarão, queijo e vegetais, e sanduíches no períodode agosto/2008 a março/2009. Dezessete (13,9 %) amostras de carne, queijo, vegetais e frango, e em algumasem mais de um parâmetro, estavam em desacordo com a legislação em vigor. Foram detectadas elevadascontagens de coliformes termotolerantes e estafilococos coagulase-positiva, respectivamente, em dez (8,2 %)e oito (6,5 %) amostras. Salmonella spp. foi isolada em duas amostras (1,6 %). As contagens de Bacillus cereuse de Clostrídio Sulfito Redutor não ultrapassaram os padrões da legislação. A maioria dos salgados mostrouresultados dentro dos padrões estabelecidos pela legislação. A presença de bactérias patogênicas comoS. aureus e Salmonella spp. foi demonstrada em 10 amostras (8,2 %); e este resultado é relevante, pois indicaque a população está exposta a riscos de doenças veiculadas por alimentos. Torna-se necessário colocarem prática a vigilância dos alimentos comercializados em Botucatu, incentivar a melhoria de condiçõesde higiene pelos comerciantes, e ter ciência dos riscos e das implicações da contaminação microbiológicados alimentos.

Knowledge and attitude towards the use of emergency contraceptive pills among college students.

Background: Emergency contraception is applied to prevent pregnancy after 72-120 hours of unprotected sexual intercourse. Emergency contraceptive (EC) pill is used to reduce unwanted pregnancy and unsafe abortion. EC pill is available as OTC in India since 2005. As EC pill highly used among adolescents we carried out to this study among college students. Methods: The study was conducted among female college students. A pre-validated questionnaire was used as tool for the study. It contains consent form and questions knowledge and attitude regarding EC pill. Results: We divided students into group A (medical, paramedical and pharmacy colleges) and group B (nonmedical colleges like science, arts and engineering). In group A 470 and group B 280 students were participated. Knowledge about appropriate time of taking EC pill (within 72 hours after sexual intercourse) was 44% in group A which is significant than 15% in group B. Knowledge about brand name, availability cost and side effects were more in group A than group B. Electronic media was the most common source of information mentioned by both the groups. Attitude regarding advice to use of EC pill to other was more in group A than group B. Conclusions: Knowledge about use of EC pill was higher in group A than group B. Attitude was not positive regarding availability of EC pill as OTC. So education about EC pill among young population is necessary.

Relationships between Fraction of Nitric Oxide, Airway Hyperresponsiveness, Blood Eoshinophil Counts and Serum Eosinophil Cationic Protein in Asthmatic Children / 소아알레르기및호흡기학회지

PURPOSE: The measurement of fraction of nitric oxide (FeNO) is a noticeable tool that reflects airway inflammation in asthmatic patients. We wanted to find out the relationship between pulmonary function, bronchial hyperresponsiveness (AHR), blood eosinophilic inflammatory markers and FeNO level before and after methacholine bronchoprovocation test in asthmatic patients. METHODS: Fifty-five children, who visited the Allergy Clinic of Korea University Anam Hospital from March 2011 to February 2012, due to asthmatic symptoms, such as history of episodic wheezing or dyspnea during the previous year and resolved after using bronchodilators, were enrolled. We performed the baseline pulmonary function and methacholine bronchoprovocation test in the enrolled patients. Blood eosinophil counts and blood eosinophil cationic protein (ECP) were measured. FeNO levels were measured before and after the methacholine bronchoprovocation test. RESULTS: The mean FeNO levels (36.3 ppb) fell after methacholine bronchoprovocation test (25.7 ppb). Forced expiratory volume in one second (FEV1) %pred inversely correlated both with FeNO level before (R2=0.07, P=0.029) and after (R2=0.059, P=0.01) methacholine bronchoprovocation test. The provocative concentration, causing a 20% decrease in FEV1 to methacholine (methacholine PC20) inversely correlated both with FeNO levels before (R2=0.086, P=0.001) and after (R2=0.141, P=0.001) the challenge. FeNO level measured at bronchoconstriction state significantly correlated with blood eosinophil counts (R2=0.112, P=0.028). Serum ECP levels correlated FeNO level, neither before nor after bronchoprovocation. CONCLUSION: The baseline FeNO levels were higher in asthmatic children. However, FeNO levels rather decreased after methacholine induced bronchoconstriction. Repeated spirometry maneuver was considered to have an effect on reducing FeNO levels. FeNO correlated with pulmonary function, airway AHR and blood eosinophil counts.

Clinical Investigation of Children with Severe Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: We attempted to investigate clinical characteristics of children with severe atopic dermatitis. METHODS: A total of 204 children diagnosed with Atopic dermatitis at the Pediatric Allergy Respiratory Center in Busan St. Mary's Medical Center from June 2006 to June 2008 were enrolled in this study. Cases were divided into 3 groups according to SCORAD index: severe, moderate and mild groups. We collected birth, environment, and allergic family history, and tested serum IgE, total eosinophil count, specific IgE, ECP (Eosinophil Cationic Protein) and the SCORAD index between the 3 groups. RESULTS: Of the 204 patients, 100 (49.02%) were included in the severe group, 51 (25.0%) in the moderate group, and 53 (25.98%) in the mild group. There were no differences in serum total IgE, serum total eosinophil counts and ECP between the severe and moderate groups. Serum total IgE, serum total eosinophil counts and ECP were relatively higher in the severe group than mild group. Food allergen sensitization rate was relatively higher in the infantile severe group than in the childhood severe group, while inhalant allergen sensitization rate was relatively higher in the childhood severe group than in the infantile severe group. There was no correlation between serum total IgE, serum total eosinophil counts, ECP and the number of sensitized allergens relative to SCORAD index in the severe group. CONCLUSION: Serum IgE, total eosinophil count, specific IgE and ECP may be specific indicators of children with severe atopic dermatitis. Further studies are needed to determine a clear distinction between severe and moderate atopic dermatitis patients.

Clinical Implication of Sputum CXCL13 in Children with Asthma / 소아알레르기및호흡기학회지

PURPOSE: CXCL13 is known to be a chemokine delivering B cell to the secondary lymphatic follicles, such as spleen, lymph nodes, and Peyer's patches. Recently, there have been some reports that CXCL13 is important for T cell inflammation and expressed by Th17 cell which produces IL-17. This study attempted to examine the clinical implication of CXCL13 in children with asthma. METHODS: This study included a total of 160 children aged 6 to 15 years who visited Severance Children's Hospital. There were 80 children with asthma and 80 children without. The pulmonary function test and the methacholine challenge test were performed. Total eosinophil count, eosinophil cationic protein (ECP) and total IgE in serum and eosinophils, ECP and CXCL13 in sputum were measured. RESULTS: The mean age of the subjects was 8.3+/-2.3 years for the asthma group and 9.3+/-2.5 years for the control group. The male to female ratio was 67.5% and 55.0% respectively. The sputum CXCL13 level for the asthma group was significantly higher than that level for the control group (P=0.003). This significance persisted even after adjustment for age and sex (P=0.010). The sputum CXCL13 level showed a positive correlation with that of sputum eosinophils (r=0.190, P=0.017) and ECP (r=0.285, P=0.002). CONCLUSION: Our results suggest that CXCL13 may play an important role in the pathophysiology of asthma related to eosinophilic inflammation. Further studies on sputum CXCL13 could help to reveal the role of chemokines in asthma.

Methacholine and adenosine 5'-monophosphate challenge tests in children with atopic asthma and with nonatopic asthma, and their relationships to blood eosinophil markers / 소아과

PURPOSE: Though atopic and nonatopic asthma have different clinical manifestations, bronchial hyperresponsiveness (BHR) and airway inflammations are common characteristics of them. We investigated BHR to both methacholine and adenosine 5'-monophosphate (AMP), and their relationships with blood eosinophil markers in nonatopic asthma as well as atopic asthma. METHODS: We studied 116 children (82 atopics; 34 nonatopics) with mild to moderate asthma. Methacholine and AMP challenge tests were performed and bronchial responsiveness was expressed as PC20 (provocative concentration causing a 20 percent fall in FEV1); blood eosinopil counts (ETCs) and serum eosinophil cationic protein (ECP) levels were gauged. RESULTS: In atopics, 95.1 percent and 90.2 percent showed hyperreactivity to methacholine (PC20<16 mg/mL) and AMP (PC20<200 mg/mL), respectively. Meanwhile, in nonatopics, 94.1 percent and 52.9 percent displayed hyperreactivity to methacholine and AMP, respectively. The geometric mean of AMP PC20 was lower in atopics (31.6 mg/mL) than in nonatopics (125.9 mg/mL); that of methacholine PC20 was similar in the two groups. AMP PC20 correlated with blood ETCs in both atopics(r=-0.30, P<0.01) and nonatopics (r=-0.57, P<0.01), and correlated with serum ECP levels (r=-0.23, P<0.01) in atopics, but not in nonatopics. Apart from AMP, methacholine PC20 was not associated with blood eosinophil markers in either group. CONCLUSION: Atopics more frequently displayed BHR to AMP than nonatopics. Furthermore, BHR to AMP was associated with not only blood ETCs, but serum ECP levels in atopics but was correlated with only blood ETCs in nonatopics. Those results suggest that BHR to AMP reflects airway inflammation in asthma and is more related to atopy.

Study on the Relationship between Asthma Patients with Abnormal Savda and Characteristics of ECP,IgE and FEV_1 / 中国中医药信息杂志

Objective To explore the relationship of asthmatic patients with Abnormal Savda and ECP,T-IgE,S-IgE and FEV1. Methods Seventy six cases of asthmatic patients were diagnosed according to the body fluid theory of Uygur Medicine. Among them,there were 30 cases of asthmatic patients with Abnormal Savda and 46 cases of asthmatic patients with non-abnormal Savda. The level of serum ECP,T-IgE,S-IgE and FEV1 were tested quantitively. Results There were significant differences on the level of serum ECP,T-IgE,S-IgE in all three groups (P

Relationship between deltaFVC (% fall in FVC at the PC20 Dose of Methacholine) and Serum Eosinophil Cationic Protein (ECP) in 6-8 Year Old Children with Asthma / 소아과

PURPOSE: Bronchial hyperresponsiveness (BHR) is considered a hallmark of asthma. Increased levels of eosinophil cationic protein (ECP) have been identified in serum of asthma patients. Several studies have examined the relationship between serum ECP and bronchial responsiveness, expressed as methacholine PC20 in asthmatic patients, with conflicting results. The aims of this study were to examine the relationship between serum ECP and deltaFVC, another index of bronchial responsiveness, which reflects increased maximal airway response. METHODS: Six to 8-year-old children with asthma (n=109) underwent methacholine bronchoprovocation testing. The PC20 dose of methacholine and deltaFVC were calculated for each individual from the methacholine dose response curves. Serum ECP levels and blood total eosinophil counts were also measured. RESULTS: Serum ECP correlated with deltaFVC (r=0.217, P=0.023), as well as PC20 (r=-0.208, P=0.030). However, blood eosinophil counts failed to show any correlations with deltaFVC (r=0.085, P=0.378) or PC20 (r=-0.148, P=0.125). deltaFVC did not correlate with PC20 (r=-0.079, P=0.417). CONCLUSION: Blood eosinophil activation is associated with both components of BHR including increased sensitivity and increased maximal response in 6-8 year old children with asthma.

Elevated Circulating ICAM-1 and Eosinophil Cationic Protein in Children with Chronic Urticaria / 소아과

PURPOSE: Chronic urticaria is characterized by recurrent, itchy, and evanescent wheals over a period of six weeks. The mechanisms of chronic urticaria in children have not been fully elucidated. However, urticaria lesions represent a dynamic inflammatory process involving a complex interplay of various inflammatory mediators, chemokines, adhesion molecules and cellular interaction. The aim of this investigation was to elucidate the possible role of intercellular adhesion molecule-1 (ICAM-1) in the promotion of eosinophil trafficking and the interaction of soluble ICAM-1 (sICAM-1) with eosinophil cationic protein (ECP) in chronic urticaria. METHODS: Twenty-three children with chronic urticaria and five healthy children were recruited into the study. Total IgE, sICAM-1 and ECP concentrations were measured in all the serum samples from the study subjects, and both skin prick tests and dermographisms were performed after counting peripheral blood eosinophil in each subject. RESULTS: Mean concentration of serum sICAM-1 was higher in the urticaria patient group than in the control (P<0.05), however, serum ECP levels were variable. In the urticaria group, there were statistically significant correlations between the levels of serum ICAM-1 and ECP (r=0.24, P<0.001), and between the levels of serum ICAM-1 and the grade of dermographism (r=0.313, P<0.001). On the other hand, serum ICAM-1 level was not significantly related to the number of peripheral blood eosinophil. CONCLUSION: These data suggest that ICAM-1 and ECP might play a certain important role in the cellular interactions of inflammation involved in chronic urticaria, and the role should be verified by further studies.

The Significances of Chest X-ray Findings and Serum IFN-gamma, IL-5, ECP as Predictors of Prognosis of Bronchiolitis and Bronchopneumonia in Infants

PURPOSE: Lower respiratory tract infections in infant and young children are often due to a virus, especially the Respiratory syncytial(RS) virus. Chest X-ray findings in bronchiolitis and bronchopneumonia are different. The radiographic hallmark of bronchiolitis is pulmonary hyperinflation and similar to that of bronchial asthma. Bronchiolitis is predisposed to later development of bronchial asthma. To evaluate the difference of immuno-pathophysiology between bronchiolitis and bronchopneumonia, we measured IFN-gamma (Th1 cytokine), IL-5(Th2 cytokine) and ECP. We also investigated whether X-ray findings in infants with viral infected respiratory disease are useful in predicting the development of asthma. METHODS: We measured IL-5, ECP, IFN-gamma levels in serum from 21 infants with bronchiolitis and 21 infants with bronchopneumonia and 16 infants without pulmonary viral diseases. RESULTS: IL-5 levels of bronchiolitis and bronchopneumonia were significantly higher than those of the control(P=0.02, P=0.042). IL-5 levels of bronchiolitis were higher than those of bronchopneumonia but there was no significant difference. IFN-gamma levels of bronchopneumonia were higher than those of bronchiolitis but there was no significant difference. ECP levels of bronchiolitis and bronchopneumonia were higher than those of the control but only those of bronchiolitis were significantly higher than those of the control(P=0.045). IL-5 and ECP levels did not show any significant correlation in bronchiolitis, bronchopneumonia and control groups. CONCLUSION: We cannot prove the distinct differences in serum Th1/Th2 cytokine profiles between bronchiolitis and bronchopneumonia in infants. These results suggest that the different findings on chest X-ray between bronchiolitis and bronchopneumonia could not be a predictor of later development of asthma.

Inhibiting effect of montelukast on eosinophilic airway inflammation of asthmatic guinea pigs / 中国药理学通报

Aim To study the effect of montelukast on eosinophilic airway inflammation of asthmatic guinea pigs,and explore possible mechanism of montelukast. Methods Experimental asthma model of guinea pigs was induced by ovalbumin in vivo. The eosinophils in BALF were separated by density gradient centrifugation. The apoptosis of eosinophils was labeled by TdT-mediated dUTP nick end labeling (TUNEL)technique. The content of IL-5 in BALF was detected by enzyme-linked immunosorbent assay (ELISA). The level of ECP in BALF was detected through fluorescence enzyme-labeled assay. Results In BALF of asthmatic guinea pigs model, the number of eosinophils and content of IL-5 and ECP increased obviously, while the apoptosis index of eosinophils was lowered. After treatment with montelukast, the number of eosinophils and content of IL-5 and ECP in BALF of asthmatic guinea pigs decreased significantly, while the apoptosis index of eosinophils was elevated significantly. Conclusion Montelukast can inhibit the eosinophilic airway inflammation of asthmatic guinea pigs. Lowering the levels of IL-5 and ECP in BALF, promoting apoptosis of eosinophils and relieving airway infiltration of eosinophils may be important mechanisms for montelukast to antagonize airway inflammation of asthma.