Asthma and lung function in adulthood after a viral wheezing episode in early childhood.

BACKGROUND: Viral aetiology of infection has a significant role in the long-term outcome of early-childhood wheezing. OBJECTIVE: This study examines asthma and lung function in adulthood after early-childhood wheezing induced by respiratory syncytial virus (RSV) and rhinovirus (RV). METHODS: A total of 100 children were hospitalized for a wheezing episode at less than 24 months of age from 1992 to 1993 in Kuopio University Hospital (Finland). Adenovirus, influenza A and B virus, parainfluenza (1-3) virus, and RSV were tested on admission using antigen detection and antibody assays, and RSV and RV were tested by polymerase chain reaction (PCR). In 2010, 49 cases and 60 population controls attended a follow-up study, which included spirometry with bronchodilation test and fractionally exhaled nitric oxide (FENO ) measurements. RESULTS: Current asthma was present in 64% of the cases with RV-induced wheezing (OR 17.0 [95%CI 3.9-75.3] vs controls), in 43% of the cases with RSV-induced wheezing episode (6.1 [1.5-24.9] vs controls), and in 12% of the controls. The RV group showed significantly higher mean FENO values than the RSV group and controls. RV-positive cases had lower MEF50 before bronchodilation and higher MEF50, FEV1, and FEV1/FVC bronchodilation responses than controls. RSV-positive cases had lower FVC than controls before bronchodilation. CONCLUSION: Cases with RV- and RSV-induced early-childhood wheezing had increased risk for asthma in adulthood, and RV-positive cases had significantly higher FENO values than RSV-positive cases and controls. Compared to controls, RV-positive cases showed more bronchial reactivity, and RSV-positive cases showed lower FVC before bronchodilation in lung function testing. CLINICAL RELEVANCE: Children with RV- or RSV-induced wheezing in early childhood have an increased risk for asthma and lung function abnormalities in adulthood.

A randomized phase II study of stem cell mobilization with cyclophosphamide+G-CSF or G-CSF alone after lenalidomide-based induction in multiple myeloma.

The most common means of mobilizing autologous stem cells is G-CSF alone or combined with cyclophosphamide (CY) to obtain sufficient CD34+ cells for one to two transplants. There are few prospective, randomized studies investigating mobilization regimens in multiple myeloma (MM), especially after lenalidomide-based induction. We designed this prospective, randomized study to compare low-dose CY 2 g/m2 +G-CSF (arm A) and G-CSF alone (arm B) after lenalidomide-based up-front induction in MM. Of the 80 initially randomized patients, 69 patients were evaluable, 34 and 35 patients in arms A and B, respectively. The primary end point was the proportion of patients achieving a yield of ⩾3 × 10(6)/kg CD34+ cells with 1-2 aphereses, which was achieved in 94% and 77% in arms A and B, respectively (P=0.084). The median number of aphereses needed to reach the yield of ⩾3 × 10(6)/kg was lower in arm A than in arm B (1 vs. 2, P=0.035). Two patients needed plerixafor in arm A and five patients in arm B (P=0.428). Although CY-based mobilization was more effective, G-CSF alone was successful in a great majority of patients to reach the defined collection target after three cycles of lenalidomide-based induction.

Autologous stem cell transplantation versus novel drugs or conventional chemotherapy for patients with relapsed multiple myeloma after previous ASCT.

High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) is the most common first-line treatment for patients with multiple myeloma (MM) under 65 years of age. A second ASCT at first relapse is frequently used but is challenged by the use of novel drugs. We retrospectively studied the outcome of second-line treatment in MM patients from the Nordic countries with relapse after first-line HDT and ASCT. Patients that underwent a second ASCT (n=111) were compared with patients re-treated with conventional cytotoxic drugs only (n=91) or with regimens including novel drugs (proteasome inhibitors and/or immunomodulatory drugs) (n=362) without a second ASCT. For patients receiving a second ASCT median overall survival was 4.0 years compared with 3.3 years (P<0.001) for the group treated with novel drugs and 2.5 years (P<0.001) for those receiving conventional cytotoxic drugs only. A second ASCT also resulted in a significantly longer second time to progression and a significantly longer time to next treatment. We conclude that, irrespective of the addition of novel drugs, MM patients in first relapse after ASCT still appear to benefit from a second ASCT. A second ASCT should be considered for all physically fit patients.

Autocrine production and synergistic growth-promoting activity of interleukin-6 and oncostatin M in a new human myeloma cell line TU-1.

Human myeloma cell lines are difficult to establish, and they usually originate from patients with extramedullary disease. We describe a new human myeloma cell line, TU-1, which was established from the bone marrow of a patient without extramedullary myeloma. The myeloma cells were initially maintained in a conditioned medium derived from another well-known myeloma cell line U-266. This conditioned medium contained interleukin-6 (IL-6) and oncostatin M (OSM), and possibly other unknown growth factors as well. In 3 months the TU-1 cell line proliferated autonomously and secreted IL-6 and OSM with a synergistic growth response. As we have previously shown the cell line acquired a p53 mutation in vitro, which may be an important factor causing autonomous proliferation. In patients with multiple myeloma OSM is frequently found in the serum and OSM has been associated with serum IL-6 and progressive disease. Our study demonstrates the close relationship of OSM and IL-6 also in vitro.

p53 gene mutations are rare in patients but common in patient-originating cell lines in multiple myeloma.

We have shown previously that detectable serum concentration of p53 protein is associated with poor prognosis in multiple myeloma (MM). In this study, we studied p53 gene mutations in 29 bone marrow samples of MM patients using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and direct sequencing. No p53 mutations were found in these patients although 41% of the patients had an elevated serum p53 protein concentration. This result indicates that the detectable serum level of p53 protein is not associated with p53 mutations. In addition, we have also analysed three MM cell lines established from bone marrow samples. All the cell lines contained p53 mutations in exon 5. However, bone marrow samples of the patients associated with the cell lines did not have these mutations at the time of diagnosis, nor did the original samples which were used to establish the cell lines. This indicates that p53 mutations can arise during the cell passages.

Liposomal targeting of bcl-2 antisense oligonucleotides with enhanced stability into human myeloma cell lines.

Cationic liposomes improve the delivery of antisense oligonucleotides (ODNs) into cells. However, there is marked variability in the cellular uptake of ODNs into different cell lines. We used liposomes containing dimethyloctadecylammonium bromide (DDAB) and dioleoylphosphatidylethanolamine (DOPE) to increase the delivery of phosphodiester ODNs into four different myeloma cell lines. The delivery by cationic liposomes increased the delivery of bcl-2 antisense ODNs by a factor of 9 to 45 as compared to plain ODNs. The stability of ODNs was increased with liposomes both in the culture medium and within the cells. Intact liposomal ODNs were detected inside the cells up to 24 hours with gel electrophoresis and phosphor imager analysis. Antisense ODNs had no effect on bcl-2 mRNA levels. Also the proliferation of myeloma cells remained unchanged during the 3-day incubation period. Our study shows that liposomal antisense ODNs targeting bcl-2 of human myeloma cells result in increased stability of ODNs with minimal toxicity. However, further modifications are needed to gain biological effects of antisense ODNs on human myeloma cells.

Attitudes, norms, intentions and hedonic responses in the selection of low salt bread in a longitudinal choice experiment.

A total of 61 subjects selected a type of bread twice a week, 15 times in all, to be used in their families at home. Four bread types were available: white, wheat, rye and sour rye, each with two sodium chloride levels (normal salt = NS, low salt = LS, half of the normal level). The subjects' attitudes, norms and buying intentions concerning the LS bread were measured at the beginning and at the end of the experimental period. The data were used to test the feasibility of the Fishbein model for the prediction of buying intention and actual selection. In addition, hedonic responses to the breads were measured. The LS bread was selected in 32-39% of cases in all, depending on the bread type. However, there were large individual differences. The proportion of LS breads chosen decreased during the experimental period for all the four bread types. In accordance with this, buying intentions, attitudes and hedonic responses were less favorable to the LS breads by the end of the experiment. Low salt content was best accepted in sour rye breads. The Fishbein model predicted 38% of the buying intentions and 21% of the actual selections (end measurements). When the hedonic response was inserted into the model, the values were improved to 52 and 32%, respectively. It is concluded that the Fishbein model is a useful frame of reference for human food selection studies, and that its predictive power in this particular field of behavior appears to improve substantially when the hedonic response is included in the model.

The relationship of attitudes and experiences of Finnish youths to their hedonic responses to sweetness in soft drinks.

Attitudes to sugar and previous experience (liking and use at present and in childhood) of sweet foods as well as hedonic responses to two levels of sweetness in soft drinks were determined in a young adult population (112 males, 112 females). Females were more negative in their attitudes but they reported greater liking of sweet foods. Sugar attitudes were not related to hedonic responses to normal sweetness (9%) in either sex group, but in the case of lower sweetness (5%) negative attitudes increased along with the rated pleasantness, particularly among males. Reported liking and use of soft drinks had some significant correlations with hedonic responses to both sweetness levels, but experiences of other sweet foods were not related to the hedonic responses to sweetness in soft drinks.