A randomized double blind controlled trial comparing two amoxycillin regimens in the treatment of acute exacerbations of chronic bronchitis.

A randomized double blind trial comparing two amoxycillin regimens in the treatment of acute exacerbations of chronic bronchitis was performed. Forty-one patients were entered into the study. Twenty patients received amoxycillin sachets 3g twice daily for three days and 21 patients received amoxycillin capsules 500 mg three times daily for seven days. There was no significant difference between the two groups in terms of duration of hospital admission, reduction in sputum volume, clearance of pus from the sputum or the number of treatment failures. No patient developed unwanted effects from the treatment with high dose amoxycillin. Twenty-eight patients were followed for one year and there was no difference in the number of exacerbations experienced by patients treated with short course high dose therapy compared with low dose therapy. It is concluded that short course high dose amoxycillin may be as effective as conventional course amoxycillin in the treatment of acute exacerbations of chronic bronchitis.

Characterization of anti-cerebroside sulfate antisera using a theoretical model to analyse liposome immune lysis data.

Antisera to the acidic glycolipid cerebroside sulfate (sulfogalactosyl ceramide) were raised in rabbits by several different methods. Reactivity with cerebroside sulfate was detected from complement-mediated lysis of liposomes composed of phosphatidylcholine/cholesterol/cerebroside sulfate and containing the spin label tempocholine chloride as a marker substance. Both cholesterol rich particles and lipid bilayer liposomes containing phosphatidylcholine and cholesterol were effective carriers for cerebroside sulfate, in combination with methylated bovine serum albumin for intravenous immunization, and with Freunds complete adjuvant for subcutaneous immunization. The antisera raised by the different methods were characterized with respect to their cross reactivity with other lipids and the relative concn of specific antibodies and their affinities for cerebroside sulfate using a theoretical model developed earlier [Vistnes A. I. (1984) J. Immun. Meth. 68, 251] for analysis of data from immune lysis of liposomes. Differences in these properties, both of which can affect antibody titer, could be detected for antisera raised by different methods and obtained at different times after immunization. Some of the antisera also reacted non-specifically to varying degrees with other anionic lipids indicating that the anti-cerebroside sulfate antibodies could bind non-specifically to anionic lipids by electrostatic interactions. This suggested that basic amino acid residues may be an important part of the antibody receptor binding site for the glycolipid head group. An important implication of this result is that antibodies raised against anionic glycolipids should be tested for non-specific binding to anionic phospholipids.

Factors affecting surface expression of glycolipids: influence of lipid environment and ceramide composition on antibody recognition of cerebroside sulfate in liposomes.

The reactivity of the acidic glycolipid cerebroside sulfate (CBS) with antibody was studied as a function of its lipid environment in vesicles and of its ceramide composition. The lipid environment was varied by using phosphatidylcholine of varying chain length with cholesterol in a phosphatidylcholine:cholesterol:cerebroside sulfate molar ratio to glycolipid of 1:0.75:0.1. The ceramide structure of CBS was varied by using synthetic forms containing palmitic acid, lignoceric acid, or the corresponding alpha-hydroxy fatty acids. Reactivity with antibody was determined by measuring complement-mediated lysis of the vesicles containing a spin-label marker, tempocholine chloride. The data were analyzed by a theoretical model which gives relative values for the dissociation constant and concentration of antibodies within the antiserum which are able to bind to the glycolipid. If the phosphatidylcholine chain length was increased, increasing the bilayer thickness, only a small population of high-affinity antibodies were able to bind to cerebroside sulfate, suggesting decreased surface exposure of the glycosyl head group. A larger population of lower affinity antibodies were able to bind to it in a shorter chain length phosphatidylcholine environment. However, if the chain length of the cerebroside sulfate was increased, it could be recognized by more antibodies of lower affinity than the short chain length form, suggesting that an increase in chain length of the glycolipid increased surface exposure. Hydroxylation of the fatty acid inhibited antibody binding; only a smaller population of higher affinity antibodies was able to bind to the hydroxy fatty acid forms.(ABSTRACT TRUNCATED AT 250 WORDS)

New method for typing Staphylococcus aureus resistant to methicillin based on sulphur-35 methionine labelled proteins: its application in an outbreak.

Sodium dodecyl sulphate polyacrylamide gel electrophoresis of sulphur-35 methionine labelled cellular proteins of Staphylococcus aureus resistant to methicillin was used as a typing method during an outbreak on a cardiothoracic ward. This showed that the outbreak strain was indistinguishable from the epidemic strain of methicillin resistant S aureus prevalent in London. In contrast, 44 epidemiologically separate strains of S aureus gave individually distinct radiolabelled protein profiles. This method permitted rapid confirmation that an epidemic strain was responsible and indicated the need for urgent control measures.

De novo generation of histamine in sputum and the effect of antibiotics.

We have performed experiments to test the hypothesis that bacteria may contribute to the presence of histamine in sputum. Sputum samples obtained from 7 patients with exacerbations of chronic bronchitis and 7 patients with cystic fibrosis were incubated at 37 degrees C for 72 hours. Serial sputum histamine estimations, performed by a recently-developed HPLC technique, showed large, progressive increases in both groups of samples. Both the pre-heating of samples at 100 degrees C prior to incubation and the addition of antibiotics to the incubates substantially reduced these increases. These findings strongly suggest that bacteria may contribute to sputum histamine in infective lung disease.

Synthesis of histamine by Haemophilus influenzae.

Recent findings suggest that bacteria might contribute to histamine concentrations in the sputum of patients with infective lung disease. Ten isolates of Haemophilus influenzae from patients with acute exacerbation of chronic bronchitis and emphysema, together with two reference strains, were incubated at 37 degrees C for 72 hours. Serial estimations of histamine concentrations by high pressure liquid chromatography showed significant increases at 24 and 48 hours; no increases were evident in the control samples. These findings suggest that H influenzae might contribute to inflammation and limited airflow in infective lung disease by producing histamine.