The Acute Phase Proteins Reaction in Children Suffering from Pseudocroup.

The aim of the study was to evaluate the inflammatory reaction in children with pseudocroup and compare it with other laryngological diseases according to the available literature data. The study group included 51 children hospitalized because of pseudocroup. The measurements of the acute phase proteins (APP), such as C-reactive protein (CRP), alpha-1-antitrypsin (AT), alpha-1-antichymotrypsin (ACT), alpha-1-acid glycoprotein (AGP), ceruloplasmin (Cp), transferrin (Tf), alpha-2-macroglobulin (A2M), and haptoglobin (Hp) were obtained at 3 time points. The glycosylation profiles of AGP, ACT, and Tf were completed. An increased AGP level was observed in girls. The AGP glycosylation revealed the advantage of the W0 variant over the W1 variant. W1 and W2 were decreased in boys. W3 emerged in boys. The Tf concentration and T4 variant were lower compared to the control group. The A2M level was lower after treatment. The Hp and AT levels were decreased a few weeks later. The ACT glycosylation revealed a decrease of the A4 variant in boys. In conclusion, the inflammatory reaction during pseudocroup was of low intensity. The APP glycosylation suggested a chronic process. In a follow-up investigation, no normalization of the parameters was noted, but signs of persistent inflammation were observed.

Efficacy of nebulized L-epinephrine for treatment of croup: a randomized, double-blind study.

The objective of this study was to compare the effect of L-epinephrine plus dexamethasone vs. dexamethasone for treatment of croup in children. A randomized, double-blind clinical trial was implemented on 174 patients with croup, aged from 6 months to 6 years, and admitted to the Amir Kabir Pediatric Hospital (Arak, Iran). After randomized allocation, patients were administered dexamethasone, and then, they received either saline or L-epinephrine. Westley croup scores, heart rate, respiratory rate, and blood pressure were recorded every half an hour for a total of 120 min. There was a significant difference in mean of croup scores between two groups (P < 0.009). In addition, a significant difference was seen on mean of heart rate between two groups (P < 0.026). Our results showed a considerable difference in reduction of velocity of croup scores in patients who received nebulized L-epinephrine compared to patients who received placebo.

Human parainfluenza virus type 2 V protein inhibits and antagonizes tetherin.

Tetherin (BST-2/CD317/HM1.24) is an antiviral membrane protein that prevents the release of enveloped viruses from the cell surface. We found that the growth of human parainfluenza virus type 2 (hPIV-2), but not that of V protein-deficient recombinant hPIV-2, was inhibited by tetherin. V protein immunoprecipitates with tetherin, and this interaction requires its C-terminal Trp residues. The glycosyl phosphatidylinositol attachment signal of tetherin, but not its cytoplasmic tail, was necessary for its binding with V. The distribution of the V protein clearly changed when co-expressed with tetherin in plasmid-transfected cells. hPIV-2 infection of HeLa cells reduced cell surface tetherin without affecting total cellular tetherin. This reduction also occurred in HeLa cells constitutively expressing V, whereas mutated V protein did not affect the cell surface tetherin. Our results suggest that hPIV-2 V protein antagonizes tetherin by binding it and reducing its presence at the cell surface.

About the Therapy of Laryngotracheitis (Croup): Significance of Rectal Dosage Forms.

Glucocorticoids are drugs of choice for treatment of laryngotracheitis (croup). They may be administered orally as tablets or juice, locally as inhalation or rectally as suppository or capsule. If doctors decide to use a rectal administration for practical reasons, it is obvious from a pharmacokinetic and pharmacodynamic point of view that prednisolone capsules have an earlier and stronger anti-inflammatory effect than a prednisone suppository.

Correlation between laryngobronchoscopy and pepsin in the diagnosis of extra-oesophageal reflux.

OBJECTIVE: This study aimed to investigate pepsin as a marker of extra-oesophageal reflux disease by examining its presence in tracheal aspirates and correlating it with macroscopic changes on laryngobronchoscopy, along with the results of standard tests for gastro-oesophageal reflux disease and clinical features. METHODS: A retrospective review was undertaken of a cohort of 188 paediatric patients who underwent laryngobronchoscopy at a tertiary children's hospital and for whom pepsin assay results of tracheal aspirates were available. An association analysis was performed. RESULTS: The mean patient age was 3.99 (3.40-4.58) years, with a male preponderance (55 per cent). Positive changes on laryngobronchoscopy were significantly associated with positive tracheal pepsin findings (p < 0.0001) but not with positive standard gastro-oesophageal reflux disease investigations. A positive pepsin assay was significantly associated with a history of recurrent croup (p = 0.0385) and a diagnosis of cystic fibrosis (p = 0.0232). CONCLUSION: Macroscopic changes on laryngobronchoscopy were significantly associated with positive tracheal pepsin findings in this paediatric population, suggesting that extra-oesophageal reflux disease may be a contributing aetiology.

[Evaluation of chosen parameters of acute-phase reaction in children during pseudocroup according to their age]. / Analiza wybranych parametrów reakcji ostrej fazy w przebiegu podglosniowego zapalenia krtani w zaleznosci od wieku dziecka.

INTRODUCTION: Acute subglottic laryngitis (pseudocroup) usually occurs in infants and small children between 1 and 3 years of age. Due to the viral etiology there are autumn-winter and winter-spring peaks of frequency of this disease observed. Acute-phase proteins are a group of proteins whose concentration in the serum changes following variety of injuries such as bacterial, viral or parasitic infection. These changes are one of the features of an early, non-specific and highly complex reaction of the organism called acute-phase response. The purpose of this reaction is to restore homeostasis. Almost all acute-phase proteins are glycoproteins and changes in their microheterogeneity (glycosylation profile: structure of side suger chains) were also reported during different inflammatory conditions. MATERIAL AND METHODS: 51 children admitted to the Pediatric ENT Dept in Poznan because of an incident of pseudocroup were divided into 3 groups according to their age: I (0-3 years of age), II (between 3 and 5 years old) and III (over 5 years old). In all children levels of selected acute-phase proteins such as a1-antitrypsin [AT], al-antichymotrypsin [ACT], al-acid glycoprotein [AGP], ceruloplasmin [Cp], transferrin [Tf] and haptoglobin [Hp] were measured in three time points: at the beginning of the disease, after treatment and 3 weeks later during control examination. In all sera samples also glycosylation profile of AGP, ACT and Tf was performed. RESULTS: Analysis of AGP glycosylation profile revealed the highest levels of microheterogeneity variants: W2 and W3 in the group of children over 5 years old. Also AGP-RC was significantly increased in this group. The Tf variant T4 reached the highest level in children between 3 and 5 years of age. In all age groups increased level of Hp was observed during treatment and decreased 3 weeks later during control examination. CONCLUSIONS: Acute-phase reaction is the most intensive in the youngest children. Analysis of glycosylation profile revealed acute inflammatory process during episode of pseudocroup in the oldest children (over 5 years old) and chronic inflammation in group of the youngest children.