The absence of eosinophils is associated with early metastatic lesions in Leishmania amazonensis-infected mice

BACKGROUND Eosinophils are granulocytes that rapidly increase frequency in the bloodstream during helminthic infections and allergic responses. They are found in tissue infected by Leishmania during early disease, but their role during infection is not entirely understood. OBJECTIVES We aim to compare the disease due to Leishmania amazonensis in BALB/c and Δdbl-GATA1 mice, which lack eosinophils. METHODS BALB/c and Δdbl-GATA1 mice infected with L. amazonensis were observed for several weeks. The parasite load and dissemination pattern were assessed. FINDINGS The Δdbl-GATA1 mice developed an anticipated dissemination of L. amazonensis and a worsening disease. No differences were found in the lesion development or the parasite load in the footpad among Δdbl-GATA1 mice and BALB/c eight weeks after infection. However, nine weeks after infection, massive growth of metastatic lesions appeared in several parts of the skin in Δdbl-GATA1 mice, weeks earlier than BALB/c. We observed increased parasites in the bloodstream, probably an essential dissemination route. Thirteen weeks after infection, metastatic lesions were found in all Δdbl-GATA1 mice. MAIN CONCLUSION These results suggest a protective role of eosinophils in delaying the disease caused by L. amazonensis, although several limitations of this mice strain must be considered.

Influence of airway mucus plugs on patients with bronchial asthma and its management / 中华健康管理学杂志

Objective:To explore the influence of airway mucus plugs on patients with bronchial asthma and its management.Methods:In this cross-sectional study, from January 2020 to June 2022, 100 patients who were diagnosed with asthma and underwent chest CT examination in the Outpatient Department of Peking University Third Hospital were included. The chest CT results and medical history, pulmonary function, fractional exhaled nitric oxide (FeNO), blood routine, total allergen IgE, Aspergillus fumigatus M3 allergen-specific IgE antibody test results were collected. According to the results of chest CT, the asthma patients were divided into group with mucus plugs and those without mucus plugs. Distribution of airway mucus plugs and the mucus plug scores based on lung segments were calculated. The relationships of mucus plugs with medical history, pulmonary function [These included before and after the bronchodilation test, forced vital capacity percent of predicted value (FVC%pred), forced expiratory volume in one second percent of predicted value (FEV 1%pred), FEV 1/FVC, peak expiratory flow percent of predicted value (PEF%pred), maximal mid-expiratory flow percent of predicted value (MMEF%pred), maximal expiratory flow at 25%, 50%, 75% of vital capacity remaining percent of predicted value (MEF 25%pred, MEF 50%pred, MEF 75%pred)], FeNO, and peripheral blood eosinophil (Eos) counts were analyzed. The logistic regression model was used to analyze whether airway mucus plug was a risk factor for asthma exacerbation, and the corresponding intervention strategies were explored. Results:Among the 100 patients with asthma, 24 cases were in the mucus plug group and 76 cases were in the non-mucus plug group. The distribution of mucus plug was more common in the lower lungs (30.53% and 9.16% in the lower and upper lobe of left lung, respectively; 29.01%, 14.50% and 16.80% in the lower, middle and upper lobe of right lung, respectively). The average score of mucus plug was (4.42±3.12) points. The body mass index (BMI), the number of visits to a doctor due to asthma exacerbations, FeNO, peripheral blood Eos counts in the mucus plug group were higher than those in the non-mucus plug group [(24.95±4.34) vs (23.22±2.91) kg/m 2, 0(0, 1) vs 0(0, 0), 97(37, 169) vs 31(18, 59) ppb (1 ppb=1×10 -9), 0.41(0.15, 0.70) vs 0.18(0.09, 0.37)×10 9/L](all P<0.05), and FVC%pred, FEV 1%pred, FEV 1/FVC, PEF%pred, MEF 50%pred, MEF 25%pred, MMEF%pred, MEF 75%pred were lower than those in the non-mucus plug group [(87.49±19.32)% vs (97.34±14.24)%, (76.49±19.58)% vs (91.07±18.33)%, (72.44±10.91)% vs (79.48±8.13)%, (82.36±24.46)% vs (93.83±18.27)%, (53.03±24.81)% vs (75.75±27.15)%, (46.47±22.92)% vs (64.09±25.90)%, (50.28±23.73)% vs (74.53±26.80)%, (71.30±27.55)% vs (89.92±26.82)%] (all P<0.05). In the group with mucus plug, the airway mucus plug score was positively correlated with the patient′s body weight and the number of peripheral blood Eos counts at enrollment ( r=0.413, 0.478; all P<0.05), and negatively correlated with FVC%pred and FEV 1%pred ( r=-0.576, -0.465; all P<0.05). Logistic regression analysis showed that airway mucus plug score was a risk factor for acute asthma attack ( OR=1.269, 95% CI: 1.031-1.562; P=0.024). Conclusions:Asthma patients have a high incidence of airway mucus plug, which is related to the level of Eos inflammation and body size. Airway mucus plugs can promote airflow obstruction and acute exacerbation of asthma. In clinical practice, appropriate asthma management policies can be formulated for airway mucus plugs to delay the progression of asthma and reduce the number of acute attacks.

Study of eosinophil to monocyte ratio and its association with arterial blood pressure in hypertensives

Background: Total white blood cell (WBC) count is an effective marker of chronic inflammation. Granulocyte, specifically eosinophil play significant role in endothelial dysfunction, vasoconstriction, inflammation, and thrombosis. Along with eosinophil, previous studies reported increased activity of monocytes in hypertension (HT). Nowadays, in a medical research, we are using mathematical calculations, which is more accurate in this study. Aim and Objectives: This study was conducted to find out association of total WBC count and eosinophil to monocyte ratio (EMR) in hypertensives and normotensives. Materials and Methods: In study group, 50 hypertensives aged 40–60 years, males and females with the history of previously diagnosed HT >1 year duration, or taking antihypertensive medications with blood pressure (BP) Systolic BP (SBP) >140 mm Hg, Diastolic BP >90 mmHg were taken. In control group, 50 normotensives aged 40–60, males and females with SBP <140 mmHg, DBP <90 mmHg were taken, who were matching socioeconomically with study group. BP was measured, and venous blood samples were collected with proper aseptic precautions. Results: Study shows significantly (P < 0.05) high total WBC count, Eosinophil count and Monocyte count in hypertensives. EMR is also high but it is statistically not significant. Conclusion: High total WBC count, eosinophil count and monocyte count predicts risk of adverse cardiovascular events but change in EMR is not associated with HT.

Significance of fecal calprotectin and eosinophil-derived neurotoxin in non-IgE-mediated food allergy / 国际儿科学杂志

Non-IgE-mediated food allergy most often presents with gastrointestinal symptoms such as diarrhoea, mucus stools, bloody stools, reflux and vomiting a few hours to days after exposure to the allergenic food.The pathogenesis may be related to the activation of intestinal T lymphocytes to secrete pro-inflammatory cytokines such as TNF-α and IL-4 by food allergens, leading to migration of neutrophils and eosinophils into the intestinal lumen, causing an intestinal inflammatory response and increased intestinal permeability.There is no rapid and specific diagnostic method.The diagnosis is mainly based on clinical manifestations combined with food avoidance and oral food challenge.In recent years, fecal biomarkers have been widely used as specific indicators for determining intestinal inflammation as an aid to diagnosis and condition assessment of intestinal infections and inflammatory bowel diseases, but their application in gastrointestinal allergic diseases is rarely reported.In this paper, we will focus on the significance of fecal calprotectin, fecal eosinophil-derived neurotoxin in non-IgE-mediated food allergy.

Role of eosinophil extracellular traps in the pathogenesis of chronic airway diseases / 中华微生物学和免疫学杂志

Eosinophil extracellular traps (EETs), an important pathway of eosinophil to exert its effects, are composed of DNA fibers, histone and eosinophil granule proteins. Recently, many researches have shown that EETs play an important role in the genesis and development of respiratory diseases including asthma, allergic bronchopulmonary aspergillosis and chronic obstructive pulmonary disease. EETs can directly damage airway epithelial cells, promote airway inflammation and airway hypersecretion, increase the stickiness of secretions and induce the generation of autoantibody, helping eosinophils and their products participate in a cascade of events leading to inflammation and disease. Researches on EETs can also be helpful in investigating new targets for the treatment of chronic airway diseases.

Clinical characteristics of children with atopic dermatitis and change in serum levels of Apo A1, 25(OH)D and EDN / 中国医师杂志

Objective:To investigate the clinical characteristics of children with atopic dermatitis (AD) and the changes in serum levels of apolipoprotein A1 (Apo A1), 25-hydroxyvitamin D [25(OH)D] and eosinophil derived neurotoxin (EDN).Methods:200 children with AD treated in Zhuzhou Central Hospital from January 2016 to December 2019 were selected retrospectively as AD group and 100 healthy children as control group. The clinical characteristics of children with AD were analyzed, and the differences in serum Apo A1, 25 (OH)D and EDN levels between two groups were compared. The relationships between serum Apo A1, 25(OH)D, EDN levels and severity of AD were explored.Results:The male to female composition ratio of 200 AD patients was 1.41∶1, and the age of onset <3 months was the highest (64.50%). Inhalation allergens were detected in 118 cases (59.00%) and ingestion allergens in 82 cases (41.00%). The levels of Apo A1 and EDN in AD group were significantly higher than those in control group, while the level of 25(OH)D was significantly lower than that in control group ( P<0.05). With the aggravation of the disease, the serum Apo A1 and EDN levels in AD children increased gradually, while the serum 25(OH)D level decreased significantly (all P<0.05). Severity Scoring of Atopic Dermatitis (SCORAD) was positively correlated with Apo A1 and EDN levels ( P<0.05), and was negatively correlated with 25(OH)D level (all P<0.05). Conclusions:Apo A1, 25 (OH)D and EDN are involved in the pathogenesis of AD in children, and their serum levels are closely related to the severity of AD.

Anti-Allergic Rhinitis Mechanism of Bikangfu via Regulation of IL-35/STAT3， Inhibition of Eosinophil Activation and Improvement of Immune Function / 中国实验方剂学杂志

ObjectiveTo investigate the mechanism of interleukin-35（IL-35）/signal transducer and activator of transcription 3（STAT3）inhibition of eosinophil activation against allergic rhinitis（AR） by Bifukang. MethodOne hundred patients were randomly divided into a control group and a treatment group，50 cases in each group. The control group was given mometasone furoate nasal spray，and the treatment group was given Bifukang by nasal packing. The course of treatment was 28 days. The clinical efficacy，nasal classification and visual analogue scale（VAS） score of the two groups were observed before and after treatment. Enzyme linked immunosorbent assay（ELISA） was used to detect the expression levels of inflammatory factors ［interleukin（IL）-4，IL-10，IL-17，IL-35］ and Eotaxin and CC chemokine receptor-3（CCR3）in serum and nasal secretion of the two groups. The expression levels of STAT1，STAT3 and STAT4 were detected by real-time polymerase chain reaction（Real-time PCR）.The content of immunoglobulin G（IgG） and the ratio of CD4+/CD8+were detected by ELISA and flow cytometry. ResultAfter treatment， compared with before treatment， the levels of IL-4 and IL-17 in serum and nasal secretion in 2 groups were decreased， while the levels of IL-10 and IL-35 were increased （P<0.05， P<0.01）. The expression of STAT1， STAT2 and STAT3 in nasal secretions were significantly decreased （P<0.05）. IgG and CD4+/CD8+ were decreased， and the differences were statistically significant （P<0.05， P<0.01）.After treatment，compared with the control group，the levels of IL-4 and IL-17 in serum and nasal secretions of the treatment group were decreased，while the levels of IL-10 and IL-35 were increased （P<0.05）. The expression of STAT1，STAT3 and STAT4 in the treatment group was significantly inhibited compared with the control group after treatment （P<0.05）. In addition， the post-treatment serum CD4+/CD8+ and immunoglobulin G （IgG） levels were reduced in the treatment group compared with those of the control group （P<0.05， P<0.01）. During the treatment，there were no abnormal changes in heart，liver，kidney function and routine blood and urine tests in the two groups. ConclusionBifukang has a good effect on allergic rhinitis，and its mechanism may be related to the regulation of IL-35/STAT3 pathway，the inhibition of eosinophil activation and the improvement of related immune function.

Changes of blood Eosinophil in patients with COVID-19 and clinical implications / 中华检验医学杂志

Objective:To investigate the clinical value of eosinophil count in predicting the progression and prognosis of COVID-19.Methods:In this retrospective cohort study, 115 patients confirmed COVID-19 were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang Province, China, from January 22, 2020 to February 12, 2020. The subjects were divided into non-severe ( n=90) and severe ( n=25) groups, of which medium age was 46 years old, including 65 male and 50 female subjects. The value of eosinophil count in reflecting the severity of COVID-19 was tested with a receiver operating characteristic curve (ROC) analysis; Correlation analysis of eosinophil count at the admission with length of stay (LOS) were studied. GraphPad Prism6 and SPSS 19.0 statistical software were applied to data analysis. Differences among groups were analyzed with the Mann-Whitney U test. Results admission, Eosinophil counts of severe patients were significantly lower than those of non-severe ( P<0.001). The eosinophil count remained below normal for 1-7 days after admission and rose to normal by 21 to 28 days; The area under the ROC curve (AUC) of eosinophil to COVID-19 severity was 0.781(95% CI:0.693-0.869); The Eosinophil count at admission was negatively correlated with the patient's length of stay. Conclusions:The decrease of Eosinophil count can serve as a risk factor for auxiliary diagnosis in severe COVID-19 patients. The dynamic monitoring of eosinophils is useful for prognostic purposes.

Clinical study of kidney-invigorating and asthma-relieving granules in treating kidney deficiency type of bronchial asthma patients in persistent / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of kidney-invigorating and asthma-relieving granules in treating kidney deficiency type of bronchial asthma patients in persistent.Methods:A total of 100 patients with bronchial asthma admitted to Shanghai Municipal Hospital of TCM from March 2020 to August 2020 were selected as the research subjects. The patients were divided into control group and treatment group by random and double blind method, 50 in each group. Both groups were treated by routine basic treatment. The control group was treated with Kidney-invigorating and asthma-relieving Placebo, while the observation group was treated with kidney-invigorating and asthma-relieving granules. All the treatment lasted for 6 weeks. The TCM syndromes scores, Asthma Control Test (ACT) scores, Peak expiratory flow/predicted value (PEF%) and eosinophil in peripheral blood before and after treatment were observed.Results:A total of 91 patients completed the clinical study. There were 45 patients in the control group and 46 in the treatment group. The total effective rate in the treatment group was 93.5% (43/46), while that in the control group was 77.8% (35/45), and the difference was statistically significant ( χ2=4.579, P=0.032). After the treatment, the scores of integral efficacy on syndromes in Chinese medicine, ACT and PEF% in the treatment group were significantly higher than those in the control group ( t values were 2.802, 3.420 and 8.938, respectively, all Ps<0.01). The eosinophil in peripheral blood of patients in the treatment group was significantly lower than that of the control group ( t=3.481, P=0.001). Conclusion:On the basis of conventional treatment of western medicine, kidney-invigorating and asthma-relieving granules can relieve the clinical symptoms of asthma, improve the control level of asthma, enhance the level of PEF, reduce airway inflammation.

Granulocyte-Macrophage colony stimulating factor in asthmatic patients infected with respiratory syncytial virus

@#Introduction: It is estimated that at least 30 to 40% of asthma attacks in adults are related to respiratory infections with viruses. The majority of asthma-related viruses include respiratory syncytial virus (RSV), rhinovirus, and parainfluenza. Inflammatory cytokines are supposed to play a vital role in causing inflammation of the respiratory tract as regulators of proliferation, chemotaxis, and activation of inflammatory cells. Objectives: The aim of this study is to assess the role of Granulocyte Macrophage-Colony Stimulating Factor (GMCSF) in asthmatic airway hyper-responsiveness associated with RSV infections. Materials and Methods: Forty five asthmatic cases and 45 healthy individuals were studied in a cross-sectional design. All asthmatics underwent symptom score assessment.GMCSF concentrations in sputum and RSV-IgM/IgG in serum samples were measured for all participants by Enzyme Linked Immuno-Sorbent Assay (ELISA). Results: The GM-CSF concentration level was significantly higher in asthmatics (270.27± 194.87pg/mL) especially among moderate and severe disease with mean concentration of 197.33±98.47 and 521.08± 310.04 respectively, compared to healthy controls (22.20±21.27 pg/ mL) (p=0.0001). The sputum level of GM-CSF in asthmatics is highly significant associated with positive anti-RSV IgG sera which represents 35/45(77.8%) with mean GM-CSF concentration of (276.99± 86.42) compared with controls at about 31/45 (68.9%) with GM-CSF mean concentration of (22.84±23.47). On the other hand, positive anti-RSV IgM in asthma cases was 8 out of 45(17.8 %) with GM-CSF mean concentration of (307.25± 306.65). Furthermore, GM-CSF sputum level was significantly correlated with eosinophil count especially in moderate and severe asthma. Conclusions: This study revealed that GM-CSF level is associated with eosinophilia and indicates asthma severity that might be evident during RSV infection .The distinctive GM-CSF features observed in the sputum from asthmatics with RSV may be useful as a diagnostic methods to help match patients with antibody therapy.

Nasal lavage cytology and mucosal histopathological alterations in patients with rhinitis / Citologia do lavado nasal e alterações histopatológicas na mucosa nasal de pacientescom rinite

Abstract Introduction The extent of epithelial lesion in allergic and non-allergic rhinitis and its association with inflammatory changes in nasal lavage has not been clarified. Objective To verify the association between the inflammatory cells in the nasal lavage, epithelial lesion extent and basement membrane thickness, in the nasal mucosa of patients with rhinitis; to determine the cutoff point of the percentage of eosinophils in the nasal lavage associated with the atopic patients. Methods Patients with rhinitis and indication for septoplasty and (or) turbinectomy for turbinate hypertrophy were selected, and were submitted to allergy skin tests, nasal lavage with measurement of albumin and interleukin-8 levels, total and differential counting of cells, and mucosal histopathological analysis to determine the extent of epithelial lesion, and degree of basement membrane thickening. Results Fifty-six patients with a median age of 24.5 years and a diagnosis of allergic rhinitis (n = 36) and non-allergic rhinitis (n = 20) were studied. In atopic subjects, allergy skin tests were positive for Dermatophagoides pteronyssinus in 35 (97.0%) and Lolium perenne in 18 (50.0%). Atopic subjects showed a higher clinical score index of rhinitis compared to non-atopic ones. The total count of cells, neutrophils, and levels of albumin and IL-8 were not different in the nasal lavage of atopic and non-atopic subjects. The cutoff point for eosinophil count in nasal fluid for the distinction between allergic rhinitis and non-allergic rhinitis was 4%. Some degree of epithelial lesion was more frequent in allergic rhinitis (94%) than in non-allergic rhinitis (65%) patients. In the presence of basement membrane thickness, as a marker of remodeling, there was no difference in the nasal lavage of patients with allergic rhinitis and non-allergic rhinitis. Conclusion In this series, 4% was the cutoff point for the number of eosinophils in the nasal lavage, for atopy differentiation. Upper airway remodeling accessed by basement membrane thickness showed similar inflammatory cell infiltrate in the nasal lavage, regardless of the presence of atopy.

Resumo Introdução A extensão da lesão epitelial na rinite alérgica e não alérgica e sua associação com alterações inflamatórias no lavado nasal ainda não estão esclarecidas. Objetivo Verificar a relação entre o processo inflamatório no lavado nasal, extensão da lesão epitelial e espessamento da membrana basal na mucosa nasal de pacientes com rinite; determinar o ponto de corte do percentual de eosinófilos no lavado nasal associado à presença de atopia. Método Foram selecionados pacientes com rinite e indicação de septoplastia e (ou) turbinectomia por hipertrofia de conchas nasais, os quais foram submetidos aos testes cutâneos alérgicos, lavado nasal com determinação das concentrações de albumina, interleucina-8 (IL-8), contagem total e diferencial de células, análise da extensão da lesão epitelial, e grau de espessamento da membrana basal por meio de histopatologia da mucosa. Resultado Foram estudados 56 pacientes, mediana de 24,5 anos com diagnóstico de rinite alérgica (n = 36) e rinite não alérgica (n = 20). Nos atópicos os testes cutâneos alérgicos foram positivos para D. pteronyssinus em 35 (97,0%) e L. perenne em 18 (50,0%). Atópicos apresentaram maior índice de escore clínico para rinite em comparação a não atópicos. A contagem total de células, neutrófilos e níveis de albumina e IL-8 não foi diferente entre o lavado nasal de atópicos e não atópicos. O ponto de corte da contagem de eosinófilos no fluido nasal para a distinção de rinite alérgica e rinite não alérgica foi de 4%. Algum grau de lesão epitelial foi mais frequente em pacientes com rinite alérgica (94%) do que em pacientes com rinite não alérgica (65%). Na presença de espessamento da membrana basal, como marcador de remodelamento, não houve diferença no lavado nasal entre pacientes com rinite alérgica e não alérgica. Conclusão Nesta casuística, 4% foi o ponto de corte do número de eosinófilos no lavado nasal, para diferenciação de atopia. Remodelamento da via aérea superior pelo espessamento da membrana basal revelou infiltrado semelhante de células inflamatórias no lavado nasal, independentemente da presença de atopia.

Effect of Antiasthma Medication on Blood Eosinophil Count and Serum Immunoglobulin E Levels: A Randomized Controlled Study

Background:Asthma is a chronic inflammatory condition of lung airways resulting in episodic airflow obstruction. Aims: The main objective of this study is tofind the effect of antiasthma medication on serum IgE levels and blood eosinophil count.Study Design:Thisrandomizedcontrolled trial studywas performed in children aged 6-15 years of age, with clinically stable and moderate persistent asthma.Results:The findings of this study indicate both group(Budesonide/formoterol group and budesonide group) patients experienced a significant decrease in serum IgE levels and blood eosinophil counts over the study period.However, the difference in two groups was not statistically significant.Conclusions:Inhaled steroids are effective in controlling systemic inflammation in asthma as evidenced by a decrease in IgE levels and eosinophil counts. However addition of LABA doesn’t have any additive effect.

Serum immunoglobulin E and absolute eosinophil count as markers of severity in childhood asthma

Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p<0.0001) with increasing severity of asthma.Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.

A Study on Total Serum IgE Levels and Absolute Eosinophil Count in Allergic Rhinitis Patients

Allergic rhinitis is an IgE mediated hypersensitivity disease of the mucous membrane of nasal airway characterized by sneezing, itching, watery nasal discharge and sensation of nasal obstruction.METHODSThe aim of the study was to evaluate the total serum IgE levels and absolute eosinophil counts in patients with allergic rhinitis, and rhinitis with asthma. In this study, 160 patients of allergic rhinitis attending ENT OPD were clinically examined and investigated with Total Serum IgE levels and absolute eosinophil counts. Statistical analysis was done using SPSS software.RESULTS160 study subjects with signs and symptoms of allergic rhinitis were investigated with total serum IgE levels and absolute eosinophil count. 46.25% were males and 53.75% were females. The patients included in the study were aged 10-60 years. Seasonal symptoms were observed in 44% of patients while perennial symptoms were experienced by 56% of the patients. As per ARIA classification, 66.3% had mild, 6.9% had moderate and 26.9% had severe allergic rhinitis. Bronchial asthma was found to be the most common comorbidity present in 13% of subjects, associated sinonasal polyps which was present in 13.8%. 71.9% had raised Total Serum IgE levels and eosinophilia was present in 59.4%. A significant relationship exists between total IgE levels and eosinophilia in patients with allergic rhinitis.CONCLUSIONSAllergic rhinitis is an IgE mediated inflammatory disease and raised total serum IgE levels and raised absolute eosinophil count in study subjects with clinical signs and symptoms of rhinitis are likely to correlate with allergic aetiology.

Clinical and Laboratory Features of 6 Cases of Pemphigoid Nodularis / 中国医学科学院学报

To investigate the clinical manifestations and laboratory characteristics of 6 cases of pemphigoid nodularis (PN). The clinical and laboratory data of 6 patients with PN admitted to the Department of Dermatology,Peking Union Medical College Hospital from January 2016 to August 2019 were retrospectively analyzed. PN mainly occurred in middle-aged and elderly people,with an average age of (58±16) years. Eosinophils were elevated in 4 patients. Immunoglobulin E (IgE) level was (530±672) kU/L in five patients. Direct immunofluorescence showed IgG and/or C3 deposition on basal membrane zone. Indirect immunofluorescence showed positive IgG anti-basement membrane zone,with a titer of 1:40-1:320. Enzyme-linked immunosorbent assay showed the anti-BP180 antibodies were positive [24-85 U/ml,average(43±26) U/ml] in 5 patients. None of the patients had neurological disorders. One patient was lost to follow-up. The disease recurred in 3 of 5 patients during the follow-up,and two patients still received maintenance corticosteroids. PN mainly occurs in middle-aged and elderly individuals. It is featured by elevated eosinophils and total IgE and relatively low anti-BP180 antibody titers. Recurrence is common but PN is less likely to be associated with neurological diseases.

Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19 / 中华内科杂志

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to Shanghai Jiao Tong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells were analyzed. Patients in COVID-19 group showed relatively lower absolute white blood cell (WBC) count 4.95(3.90,6.03)×109/L, lymphocyte absolute count 1.20(0.98,1.50)×109/L and eosinophil absolute count 0.01(0.01,0.01)×109/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20 (6.78,9.03) ×109/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×109/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×109/L(P=0.05). Lymphocytopenia occurred in (16.7%) patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non- COVID-19 patients.

The diagnostic usefulness and correlation of nasal eosinophil count and percentage in children with rhinitis

PURPOSE: Allergic rhinitis is the most common atopic disease and the most common chronic disease of children. Eosinophil count and percentage in nasal smear are useful for differential diagnosis of allergic rhinitis. The aim of this study is to investigate the correlation between nasal eosinophil count and percentage.METHODS: Between January 2017 and August 2018, 221 children patients with a clinical history of rhinitis were tested at the outpatient respiratory and allergy unit of the Department of Pediatrics, School of Medicine, The Catholic University of Korea. Nasal secretion was collected by swabbing a children's nasal inferior turbinate 3–4 times with a cotton swab and then placed on to a glass slide. Later, the smear was stained by Giemsa stain.RESULTS: This is the first study to assess the comparison of nasal eosinophil count and percent. There is a positive correlation between nasal eosinophil count and percent Y=1.02 X+2.82 (Y=Eosinophil count, X=Eosinophil percentage). To determine the usefulness of nasal eosinophil count and percentage in the diagnosis of allergic rhinitis, we analyzed receiver operating characteristic curves. The cutoff value of the nasal eosinophil count was 6.5/high-power field, and that of the nasal eosinophil ratio was 3% for the diagnosis of allergic rhinitis.CONCLUSION: In patients with suspected rhinitis, one of the values of nasal eosinophil count or percentage can be used in clinical practice.

Increased expression of pendrin in eosinophilic chronic rhinosinusitis with nasal polyps / Expressão aumentada de pendrina na rinossinusite crônica eosinofílica com pólipos

Abstract Introduction: Chronic rhinosinusitis with nasal polyps is a heterogeneous disease and appropriate diagnostic algorithms in individual cases are necessary for effective medical treatment. Objective: The purpose of this study was to clarify the relationship between the pendrin expression of nasal polyps and clinical and pathological characteristic features of eosinophilic chronic rhinosinusitis. Methods: A total of 68 patients were classified into eosinophilic chronic rhinosinusitis or non-eosinophilic chronic rhinosinusitis groups according to the degree of eosinophilic infiltration into the nasal polyps. Clinical, hematological, and immunohistochemical analyses were performed and statistically compared between both groups. Results: Thirty-eight were classified into eosinophilic chronic rhinosinusitis and 30 into non-eosinophilic chronic rhinosinusitis groups. There were no significant differences in age distribution, sex ratio, prevalence of asthma, or any other complications between the groups. The mean Lund-Mackay score and the number of serum eosinophils was significantly higher in the eosinophilic chronic rhinosinusitis than in the non-eosinophilic chronic rhinosinusitis groups. The pendrin expression was more frequently detected in the epithelial surface layer of nasal polyps in the eosinophilic chronic rhinosinusitis than in the non-eosinophilic chronic rhinosinusitis groups. In addition, mucin 5AC was more widely expressed in the eosinophilic chronic rhinosinusitis than in the non-eosinophilic chronic rhinosinusitis. Conclusion: Increased expression of pendrin and mucin 5AC in the nasal polyps would be associated with development of eosinophilic chronic rhinosinusitis. This finding could allow the development of a novel therapeutic agent targeted specifically to patients with eosinophilic chronic rhinosinusitis.

Resumo Introdução: A rinossinusite crônica com pólipos nasais é uma doença heterogênea e algoritmos diagnósticos apropriados em casos individuais são necessários para um tratamento médico eficaz. Objetivo: O objetivo deste estudo foi esclarecer a relação entre a expressão da pendrina de pólipos nasais e propriedades clínicas e patológicas características da rinossinusite crônica eosinofílica. Método: Um total de 68 pacientes foram classificados como tendo rinossinusite crônica eosinofílica ou rinossinusite crônica não eosinofílica de acordo com o grau de infiltração eosinofílica nos pólipos nasais. Análises clínicas, hematológicas e imunohistoquímicas foram realizadas e comparadas estatisticamente entre os dois grupos. Resultados: Entre os pacientes, 38 apresentavam rinossinusite crônica eosinofílica e constituíram o grupo 1; 30 tinham rinossinusite crônica não eosinofílica e constituíram o grupo 2. Não houve diferenças significantes na distribuição etária, razão entre os sexos, prevalência de asma ou qualquer outra complicação entre os grupos. O escore médio de Lund-Mackay e o número de eosinófilos séricos foram significantemente maiores no grupo com rinossinusite crônica eosinofílica do que no grupo com rinossinusite crônica não eosinofílica. A expressão da pendrina foi mais frequentemente detectada na camada epitelial superficial dos pólipos nasais na rinossinusite crônica eosinofílica do que no grupo com rinossinusite crônica não eosinofílica. Além disso, mucina 5AC foi mais amplamente expressa na rinossinusite crônica eosinofílica do que na rinossinusite crônica não eosinofílica. Conclusão: O aumento da expressão da pendrina e mucina 5AC nos pólipos nasais estaria associado ao desenvolvimento de rinossinusite crônica eosinofílica. Esse achado pode permitir o desenvolvimento de um novo agente terapêutico voltado especificamente para pacientes com rinossinusite crônica eosinofílica.

Eosinophil Count: Parameter to Assess the Psychological Stress

Human body is endowed with an enormous capacity to cope up with stress. Body’s entire machinery work together to achieve the goal of maintaining the homeostasis. Stressful situations have also become a part of life and both physical and psychological stress are subjected to body response in different ways.Stress is defined as nonspecific response of the body to any demand. Most of the time such stress is psychological one. Aims & Objectives: This study was conducted to see the effect of psychological stress in young students, to evaluate the magnitude of stress under different grades and to identify the students more vulnerable to stress. Methods: The present study was conducted on first year students of Medical College in Meerut. Pulse rate and Eosinophil count were measured of all the students during various periods. Results: Pulse rate was increased significantly in all the subjects of either sex before the examination and Eosinophil count was decreased significantly in all the subjects of either sex. Conclusion: In our study a compare of eosinophil count was made among the students in various phase of psychological stress. All the changes in stress occur probably due to stimulation of sympatho-adrenanl activation via hypothalamo-pituitary-adrenal axis (HPA axis). We must focus on stress-free environment in schools and colleges.

Study of eosinophil count in nasal smear and peripheral blood smear in children with allergic rhinitis

Background: Allergic respiratory disorders are the common cases seen in Pediatrics OPD. With an appropriate history and detailed examination, the diagnosis usually may not be problematic and routine investigations may not contribute much for the final diagnosis but may help in ruling other possibilities. The objectives of this study were done to know the eosinophil counts in nasal and blood smear and to assess the feasibility of nasal cytogram which is simple, economical and reliable investigation in patients of allergic respiratory disorders.Methods: A prospective clinical correlation study conducted in outpatient visiting Mysore Medical College and Research Institute, Cheluvamba hospital Department of Pediatrics and ENT Department KR hospital. 60 children of age group between 2 to 18 years were selected to estimate the eosinophil count in nasal and peripheral smear in allergic rhinitis. All allergic rhinitis cases based on clinical signs and symptoms were selected and investigated for nasal and blood eosinophilia. The nasal and blood eosinophilia were compared with each other and the clinical findings of allergic rhinitis were studied.Results: In this study peak age incidence is between 6-10 years and there is equal gender distribution. Seasonal variation and pollen allergens were the most common risk factors for allergic rhinitis. Running nose and the nasal obstruction were the most common symptoms in children with allergic rhinitis followed by sneezing and itching. One tenth of the children with allergic rhinitis had bronchial asthma. Nasal eosinophilia contributes to the diagnosis of allergic rhinitis as compared blood eosinophilia. Mild intermittent variety of allergic rhinitis was the most common form of allergic rhinitis.Conclusions: Among various risk factors for allergic rhinitis, seasonal variation and pollen allergens have significant association with the severity of allergic rhinitis. Among various symptomology, only itching had a significant relation to the severity of allergic rhinitis.