[Isoniazid acetylation in a group of Tunisian patients. Report of 620 patients]. / Profil acétyleur d'une population de tuberculeux Tunisiens. A propos de 620 cas.

Isoniazid is a first line antituberculosis drug metabolized mainly in the liver by the Nacetyltransferase. There are differences between individuals in acetylation metabolism. Subjects are thereby characterized as being rapid or slow acetylators. The purpose is to study the distribution pattern of acetylation in patients with tuberculosis followed up at the teaching Hospital of La Rabta. The determination of acetylator phenotype was carried out on 620 tuberculosis patients during a period of 12 years. There were 483 men and 137 women with a median age of 40.3 years. The test was investigated before drug regimen administration at the dose of 5 mg/kg. A blood sample was taken three hours after the first administration. The determination of acetylation profile was worked out by Vivien hypothesis. In our population 391 were low and 229 were fast acetylators. The median dose recommended within the test was 3.04 mg/kg/day. 56% of our patients were initially receiving high dose of isoniazid. An increase in serum transaminase was initially observed in 60 patients among whom 47 slow acetylators. After dose adaptation, 53 patients had improved their biological abnormalities. The majority of Tunisian population seem to belong to slow acetylators modal. The frequency of hepatotoxicity suggests reducing the recommended dose of isoniazid from 5 to 3 mg/kg/day.

[Respiratory effects of diesel exhaust emission]. / Impact des emissions diesel sur l'appareil respiratoire.

Adverse effects of diesel exhaust is being now a subject of many recent studies. These various outcomes and especially respiratory changes are due to high concentration of different polluants within diesel exhaust particles. To date, it have been demonstrated that diesel emission increase the airway allergic reaction as rhinitis and asthma. In addition, to those side effects, it is proved that diesel exhaust is a probable human carcinogen based on evidence. Many epidémiologic evidence found a significant increase in lung cancer risk. However, some studies have provided contradictory results due to concomittant exposure to other polluants, tobacco exposure and difficulties to extrapolate findings in animal models into humans.

[Anti-IGE therapy in asthma]. / L'anti-IgE thérapie dans l'asthme.

Immunoglobulin E (IgE) is the hallmark of allergic diseases and asthma. Regulating IgE production has been the focus over several years as an important strategy in the treatment of allergic diseases. Recently, nonanaphylactogenic antihuman IgE antibodies have been under clinical evaluation as a therapeutic agent against atopic disease. In asthmatic subjects, the administration of these monoclonal anti-IgE antibody has been shown to reduce plasma IgE levels, reduce early and late phase allergic responses after allergen provocation, improve symptoms and reduce rescue medication. No serious side effects were reported. Thus, the clinical effectiveness of these medications supports the viability of anti-IgE therapy as a potentially effective treatment option for asthma.