Monocyte chemotaxis under agarose: defects in atopic disease, aspirin therapy, and mucocutaneous candidiasis.

Using Ficoll-Hypaque-separated cells, monocyte chemotaxis was measured by an agarose technique in patients with increased susceptibility to infection, with atopic dermatitis, and in individuals taking aspirin. In vitro effects of aspirin, hydrocortisone, aminophylline, ephedrine, and diphenhydramine were also studied. Significantly decreased chemotaxis was found in one 9-year-boy with severe mucocutaneous candidiasis and three of 22 patients with atopic dermatitis. In the atopic group of patients greater than 10 years of age, mean monocyte chemotaxis was significantly decreased from the age-matched control group. This decrease did not correlate with serum IgE levels, absolute blood eosinophil counts, or clinical symptom scores. Following aspirin ingestion, mean monocyte chemotaxis significantly decreased whereas neutrophil chemotaxis was unaffected. Using therapeutic concentrations, drug levels of aspirin and aminophylline in vitro caused greater than 35% inhibition of monocyte movement.

Miconazole in the treatment of chronic mucocutaneous candidiasis: a preliminary report.

Miconazole, a new imidazole antimycotic agent, was given intravenously to five children with chronic mucocutaneous candidiasis over an 18-month period. There was marked improvement of mucosa and skin in two patients, moderate-to-milk improvement in two, and no improvement in one. Nail lesions were not improved in any patient. Adverse reactions included phlebitis, pruritus, nausea and dizziness, rash, wheezing, mild transient anemia, and mild transient transaminase (SGOT and SGPT) elevations; it was necessary to discontinue treatment in only one patient. No renal toxocity was noted. Miconazole appears to be a relatively safe and promising alternative to amphotericin B in chronic mucocutaneous candidiasis.

Comparison of aerosolized atropine sulfate and SCH 1000 on exercise-induced bronchospasm in children.

The new anticholinergic compound Sch 1000 (ipratropium bromide) has been reported to be an effective bronchodilator without significant atropine-like side effects. We evaluated the effectiveness of different doses of nebulized Sch 1000 (40 microgram and 80 microgram) aerosolized atropine sulfate (1 mg) and placebo in the prevention of exercise-induced bronchospasm (EIB) in 20 children with atopic bronchial asthma. A random, crossover double-blind protocol was used. Standard exercise on a cycloergometer was used to induce EIB. Pulmonary function was determined before and after drug administration and exercise. Following no treatment or placebo, exercise resulted in average reductions of 33% to 43% in plethysmographic specific airway conductance (SGaw), of 20% to 25% in forced expiratory volume in 1 sec (FEV1), and of 25% to 32% in maximal midexpiratory flow rate. Exercise following no treatment or placebo resulted in average increases of 23% to 30% in thoracic gas volume (Vtg). Prior to exercise atropine and either dose of Sch 1000 caused significant increases in SGaw (48% to 59%). After pretreatment with Sch 1000 or atropine, exercise caused SGaw to fall to values that were not significantly different from pretreatment medication values, but were significantly higher than values following exercise without pretreatment or after pretreatment with placebo. No significant differences were noted between the effects of atropine and Sch 1000 on EIB. We conclude that at the doses used atropine and Sch 1000 cause equivalent degrees of bronchodilation but neither drug specifically inhibits EIB.