新型骨植入材料多孔钽-骨结合界面成骨以及相关成骨因子的表达及意义北大核心

背景:具有自主知识产权的国产多孔钽材料具有无毒性及良好的生物相容性,前期体内外实验研究得出结论:国产多孔钽无毒性,具有良好的生物相容性,具有促成骨作用。此次实验是多孔钽-骨界面成骨机制的探讨。目的:观察多孔钽兔股骨植入后钽-骨结合界面成骨形态特点及成骨相关因子整合素β1及纤维粘连蛋白的表达,探讨多孔钽骨内植入钽-骨界面骨整合的生物学机制。方法:实验采用自身对照方法,取日本大耳白兔制备双侧股骨髁骨缺损模型,同一动物左侧股骨内植入多孔钽棒为实验组,右侧股骨内植入异体骨为对照组。术后2,4,8周于骨缺损部位取材,石蜡切片、硬组织切片光镜观察多孔钽与宿主骨交界处成骨形态特点;扫描电镜观察多孔钽-骨界面成骨特征;免疫组织化学检测整合素β1及纤维粘连蛋白的表达。结果与结论:(1)多孔钽棒植入后与宿主骨结合紧密。石蜡切片苏木精-伊红染色结果显示:界面纤维膜早期疏松、较厚,晚期致密较薄,界面出现片状成骨;(2)硬组织切片观察:2周时钽-骨界面已出现新生骨及小血管并向孔隙内生长;4、8周时钽-宿主骨界面新生骨增多并与宿主骨连接成片,骨小梁成熟;(3)扫描电镜下可见成骨细胞在多孔钽表面及孔隙内生长,晚期骨质成熟并见板层骨;(4)免疫组化结果显示:多孔钽骨植入2周时实验组整合素β1的表达显著低于对照组(P<0.05);而纤维粘连蛋白的表达在两组之间比较差异均无显著性意义(P>0.05);整合素及纤维粘连蛋白的表达在2,4,8周时均呈递减趋势;(5)结论:多孔钽有利于成骨细胞在其表面及孔隙内黏附,整合素β1及纤维粘连蛋白在成骨初期钽-骨界面表达增高,可能对早期成骨起促进作用,而在骨成熟期表达则降低,有利于骨整合及改建。     

明胶溶胀行为对自固化多孔骨水泥性能和结构的影响

目的 研究明胶溶胀行为对多孔骨水泥性能和结构的影响。方法 在α-磷酸钙骨水泥体系中加入生物明胶，研究明胶对骨水泥水化产物、抗压强度和产物微结构所产生的影响。结果利用明胶的溶胀行为与水化过程中体系pH值变化的相关性，可制备具有大孔和微孔结构的骨水泥。结论加入明胶促进羟基磷灰石的成核，提高骨水泥的抗压强度。     

纳米级多孔负载人骨形成蛋白2基因修饰支架对前成骨细胞株分化的影响

BACKGROUND: Bone tissue transplantation or osteogenic material filling is after used for bone defect repair. To remove autologous bone tissues can lead to additional damage and secondary deformity, therefore, it is extremely urgent to search for a new osteogenic material. OBJECTIVE: To construct the porous β-tricalcium phosphate (β-TCP)/collagen scaffold modified with human bone morphogenetic protein 2 (hBMP2) gene, and to observe its effects on differentiation of MC3T3-E1 cell lines. METHODS: The porous β-TCP/collagen scaffold modified with hBMP2 gene was prepared. Then in vitro culture system of MC3T3-E1 cell lines with composite scaffold was established. There were scaffold and plate groups, and each group was divided into two subgroups according to the different concentrations of plasmid. Samples were collected and observed morphologically by scanning electron microscope and light microscope after complex culture. After 1, 3, 7 and 14 days of induction, calcium nodules were observed through alizarin red staining, the cell cycle was detected by real-time PCR, and expressions of α I-chain collagen type I gene, Osterix and bone sialoprotein were observed. RESULTS AND CONCLUSION: The number of cells adhered, differentated and distributed on the composite scaffold was significantly higher than that of the single scaffold (P < 0.05). Alizarin red staining and real-time PCR detection showed that the osteogenesis ability of MC3T3-E1 cell lines in the scaffold group was stronger than that in the plate group. To conclude, the porous β-TCP/collagen scaffold modified with hBMP2 gene is an appropriate candidate for bone defect repair.     

多孔钽的理化/生物特性及其骨整合能力研究进展

近年来,以钛合金为主的骨骼材料得到了广泛的应用。临床研究中,植入体的腐蚀磨损和骨整合能力不足是造成其无菌性松动的主要原因,最终可导致手术失败。因此制备综合性能优越的植入体材料是骨组织工程研究的热点。多孔钽拥有良好的理化性质,耐腐蚀和抗磨损性能出色,其良好的生物相容性和多孔结构可以促进新骨的长入和成骨细胞的增殖,从而提高骨整合能力。并且表面改性技术的发展赋予了多孔钽更加优良的性能和功能,扩展了其临床应用。本文将针对多孔钽的理化/生物特性及其骨整合能力的研究进展进行综述。     

国产多孔钽复合骨形态发生蛋白7植入兔竖脊肌内的生物相容性

BACKGROUND: Bone morphogenetic protein 7 (BMP-7) can induce bone and cartilage formation in vivo, and induce chondrogenic and osteogenic differentiation of mesenchymal cells in muscles and around the vessels.     

可注射聚富马酸丙二醇酯/β-磷酸三钙骨水泥的体外生物活性及其降解性

BACKGROUND: Poly(propylene fumarate) (PPF) can crosslink at room temperature, and β-tricalcium phosphate (β-TCP) has good biocompatibility, but PPF/β-TCP composite bone cement has not yet been systematically studied. OBJECTIVE: To prepare PPF/β-TCP composite bone cement and to explore its in vitro bioactivity and degradability. METHODS: β-TCP and PPF were respectively synthesized by liquid-phase precipitation and a two-step method, and PPF/β-TCP composite bone cement was prepared through mixing PPF with β-TCP. The    in vitro bioactivity of PPF/β-TCP was compared with the commercial poly(methyl methacrylate) (PMMA) through the ability of forming hydroxyapatite after immersed in simulated body fluid for 7 days. The in vitro degradability of PPF/β-TCP was studied via investigating the transformation of pH values, water uptake and mass loss, compressive strength and morphology at each time point. RESULTS AND CONCLUSION: There were hydroxyapatites formed on the PPF/β-TCP material, but none on the commercial PMMA material. The pH values of the PPF/β-TCP were stable in PBS for 63 days, indicating its degradation is moderate; the mass loss was up to 13.5% after 84 days. Scanning electron microscope displayed the degraded PPF/β-TCP surface, and its compressive strength was decreased gradually, which good for the integrity and sustainability of mechanical properties during degradation. These results suggest that PPF/β-TCP bone cement holds mineralization and degradability in vitro.     

多孔材料应用在组织工程中的现状及前景CSCD

背景:近年来多孔材料体内植入的基础研究和临床应用均展示了良好的应用前景。目的:回顾近10年来组织工程多孔材料的基础与临床研究进展,总结存在的问题并展望未来。方法:由作者检索PubMed数据库和中国知网数据库获得文献,英文检索词为porous material,bone implantation",中文检索词为"多孔材料,骨移植"。纳入用于体内外及临床研究的多孔材料及其复合材料,以及与骨缺损修复或骨组织工程密切相关的多孔材料。结果与结论:目前研究较多的多孔材料有羟基磷灰石、钛及其合金、聚乙烯、磷酸钙类等,从大量的体内外实验结果来看,多孔材料展示了其良好的组织相容性和骨诱导特性,但有利于组织最快和最有效长入的孔隙尺寸尚无统一的标准,不规则异形多孔材料的孔隙率怎样获得和控制,材料的弹性模量如何调控,以及如何获得材料100%的有效孔隙率等问题尚未有明确的标准答案,另外临床应用过程中发生的炎症和暴露等并发症的问题是否与前述问题相关还无法确定。     

磷酸钙人工骨联合雷洛昔芬修复兔下颌骨缺损

背景：雷洛昔芬是第3代选择性雌激素受体调节剂,可减少骨量的丢失,增加骨组织中的矿物质含量,降低骨折风险。 目的：观察雷洛昔芬结合自固化磷酸钙人工骨修复兔下颌骨缺损的效果。 方法：在36只新西兰大白兔左侧下颌骨制作8 mm×4 mm×3 mm的缺损模型,随机分组,实验组12只植入自固化磷酸钙人工骨,并给予雷洛昔芬7.5 mg/(kg•d);药物组12只给予雷洛昔芬7.5 mg/(kg•d);人工骨组12只植入自固化磷酸钙人工骨。分别于治疗4,8,12周取下颌骨标本,免疫组织化学法观察骨形态发生蛋白2的表达,激光共聚焦显微镜观察转化生长因子β的表达。 结果与结论：实验组治疗后4,8周时的骨形态发生蛋白2免疫组织化学染色阳性细胞数明显高于药物组与人工骨组,治疗后12周时实验组骨改建基本完成,骨形态发生蛋白2免疫组织化学染色阳性细胞数目低于其他两组。实验组转化生长因子β免疫荧光染色表达为逐步升高,到第8周时达到峰值,而药物组和人工骨组的转化生长因子β免疫荧光表达从4-12周一直呈上升状态,趋近于最高峰。说明雷洛昔芬能够促进自固化磷酸钙人工骨在骨缺损过程中骨形态发生蛋白的早期表达及早期骨痂的形成,加快骨缺损修复。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

α-磷酸三钙骨移植材料在骨科领域应用的研究与进展

BACKGROUND: As one of the important bone substitute materials in bone tissue engineering, α-tricalcium phosphate (α-TCP) has been widely applied and researched. OBJECTIVE: To introduce the newest research progress about α-TCP as a kind of bone substitute material, and to prospect its development. METHODS: The first author searched the relative literatures addressing α-TCP as a bone substitute material published from January 1965 to August 2015 in PubMed, FMJS, CNKI, Wanfang and CBM databases. The keywords were “alpha tricalcium phosphate, composite material, bone graft, bone substitution material” in English and Chinese, respectively. According to the inclusion and exclusion criteria, finally 42 articles were reviewed. RESULTS AND CONCLUSION: α-TCP is one of calcium phosphate compounds which has been extensively applied and researched. It holds good bioactivity, biocompatibility, biodegradability, biodegradation and osteoconductivity except osteoinduction. Therefore, combining α-TCP with inorganic or organic factors to establish the composite material cannot only overcome the shortage of α-TCP in physicochemical characteristics, but also provide a mixed material with better resilience that is easy for cells to adhere, shorten bone reconstruction time, and even can carry antibacterial drugs. All these improvements will markedly shorten the bone repair time and provide a new idea for future development of bone graft materials.     

高黏度骨水泥椎体成形治疗Kümmell病

BACKGROUND: Percutaneous vertebroplasty has been gradually used to treat Kümmell disease because of less trauma and quick pain relief, but there is still a high rate of bone cement leakage. OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset for treatment of Kümmell’s disease. METHODS: The clinical data of 17 patients with Kümmell’s disease were retrospectively analyzed, including 5 males and 12 females, aged 55-83 years, and all underwent percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset. The visual analog scale, Oswestry disability index score, vertebral body height and vertebral kyphosis angle were determined. The bone cement leakage, pulmonary embolism, adjacent vertebral fractures and other complications were recorded. RESULTS AND CONCLUSION: At the 12th month of follow-up, the visual analog scale scores, Oswestry disability index scores and vertebral kyphosis angle of patients were significantly lower than those before treatment  (P < 0.05), the vertebral body height was significantly higher than that before treatment (P < 0.05). After treatment, there were three cases of bone cement leakage, which had no special discomfort and neurological symptoms, and one case of new fractures. These results demonstrate that hyperextension position reset combined with percutaneous vertebroplasty with high-viscosity bone cement in treatment of Kümmell’s disease can effectively relieve back pain, improve function of the lower back, partially restore vertebral height and reduce kyphosis angle.      

Obstructive sleep apnea syndrome. Effects of therapy on dyslipidemia

Summary Objective   Dyslipidemia is frequently observed in patients with obstructive sleep apnea syndrome (OSAS). The effects of OSAS treatment on lipid levels in these patients have been examined. Patients and Methods   95 consecutive patients (aged 56.6±9.5 years) with polysomnographically verified OSAS and LDL cholesterol levels of more than 130 mg per deciliter have been included in a prospective trial. Plasma total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride, apolipoprotein B, and lipoprotein (a) levels were determined in all patients at baseline and after long term therapy. Results   Total cholesterol (249.9 ± 31.4 vs. 240.0 ± 34.1 mg/dL; p = 0.01) and LDL cholesterol levels (179.4 ± 29.4 vs. 165.5 ± 32.5 mg/dL; p < 0.001) decreased significantly after 6 months in patients effectively treated, while they did not change significantly in those OSAS patients in whom treatment proved to be ineffective. Body mass index, HDL cholesterol, triglyceride, apolipoprotein B, and lipoprotein (a) levels did not change during follow-up. Both the change of total and LDL cholesterol levels were independently associated with treatment efficacy as indicated by the change of the apnea/hypopnea index. Conclusion   The results suggest that effective treatment of sleep-disordered breathing may have significant effects on the total and LDL cholesterol levels in OSAS patients.     

姜黄素对瘢痕疙瘩成纤维细胞周期及其核转录因子κB信号转导通路的影响

背景：有研究表明姜黄素具有抗器官纤维化的作用,具抑制增殖及诱导G0/G1期细胞累积的作用,但姜黄素可否影响瘢痕疙瘩成纤维细胞的细胞周期,活化核转录因子κB通路,从而抑制瘢痕增生至今少有报道。 目的：观察姜黄素对体外培养人瘢痕疙瘩成纤维细胞周期的影响及其核转录因子κ B信号转导通路的变化。 方法：瘢痕疙瘩成纤维细胞进行体外原代培养,待细胞融合后传代,取第6~8代对数生长期的成纤维细胞用于实验。将不同浓度姜黄素(10,20,30,40,50,60 µmol/L)分别对瘢痕疙瘩成纤维细胞干预。用流式细胞仪测定细胞周期;免疫组织化学法检测核转录因子κ B的表达。 结果与结论：姜黄素呈剂量和时间依赖性抑制成纤维细胞的增生(P < 0.05),使细胞周期停滞在G1期,核转录因子κB表达随姜黄素剂量的增大而减小(P < 0.05)。结果显示,姜黄素能抑制瘢痕疙瘩成纤维细胞的增殖,并使细胞周期停滞在G1期,姜黄素可能通过抑制核转录因子κB信号转导通路的活化,从而发挥其抗纤维化的作用。     

Effects on upper airway collapsibility of presence of a pharyngeal catheter

Catheters that traverse the pharynx are often in place during clinical or research evaluations of upper airway function. The purpose of this study was to determine whether the presence of such catheters affects measures of upper airway collapsibility itself. To do so, pharyngeal critical closing pressure (Pcrit) and resistance upstream of the site of collapse Rus) were assessed in 24 propofol‐anaesthetized subjects (14 men) with and without a multi‐sensor oesophageal catheter (external diameter 2.7 mm) in place. Anaesthetic depth and posture were maintained constant throughout each study. Six subjects had polysomnography(PSG)‐defined obstructive sleep apnea (OSA) and 18 either did not have or were at low risk of OSA. Airway patency was maintained with positive airway pressure. At intervals, pressure was reduced by varying amounts to induce varying degrees of inspiratory flow limitation. The slope of the pressure flow relationship for flow‐limited breaths defined Rus. Pcrit was similar with the catheter in and out (?1.5 ± 5.4 cmH₂O and ?2.1 ± 5.6 cmH₂O, respectively, P = 0.14, n = 24). This remained the case both for those with PSG‐defined OSA (3.9 ± 2.2 cmH₂O and 2.6 ± 1.4 cmH₂O, n = 6) and those at low risk/without OSA (?3.3 ± 4.9 cmH₂O and ‐3.7 ± 5.6 cmH₂O, respectively, n = 18). Rus was similar with the catheter in and out (20.0 ± 12.3 cmH₂O mL^?1 s^?1 and 16.8 ± 10.1 cmH₂O mL^?1 s^?1, P = 0.22, n = 24). In conclusion, the presence of a small catheter traversing the pharynx had no significant effect on upper airway collapsibility in these anaesthestized subjects, providing reassurance that such measures can be made reliably in their presence.     

The impact of nasal obstruction on obstructive sleep apnea syndrome

Summary Objective   Nasal obstruction is a predictive factor for snoring and may contribute to the development of obstructive sleep apnea syndrome (OSAS) by causing a higher negative intrapharyngeal pressure during inspiration. This may lead to obstructive apneas and hypopneas in predisposed people. The aim of this study was to further enrole the impact of nasal obstruction on OSAS. Patients and Methods   We investigated two groups of OSAS patients, matched pairs concerning gender, age, and BMI: OSAS patients with nasal obstruction (N, n = 28): total nasal airflow < 500 ml/s* (*referred to 150 pa pressure of difference; anterior rhinomanometry) or unilateral nasal resistance > 1 pa/ml/s*; and 28 OSAS patients without nasal obstruction (control-group C ; total nasal airflow > 700 ml/l/s*). All patients had routine examination including a standardized questionnaire, examination by an otorhinolaryngologist, anterior rhinomanometry, skin prick-testing with 18 common allergens, lung function testing, and full polysomnography. Results   We found the following significant differences: 1) In N more patients (n = 17) complained about nocturnal dyspnea than in C (n = 7; p < 0,05, (Chi²-test); 2) N had a higher apnea index (20,4 ± 19,0/h) than C (9,6 ± 10,0/h; p < 0,05, student's t -test). There were, however, no significant differences concerning lung function, skin prick test, otorhinolaryngologistical results, sleep architecture, number of hypopneas, nocturnal S_aO₂, heart rate, and level of CPAP pressure. Conclusion   Hence, beside pathophysiologically interesting effects increased nasal resistance has no clinically relevant importance in patients with OSAS.     

Influence of hyperthermal regimes on experimental teratoma development in vitro

We screened for the impact of hyperthermal regimes varying in the cumulative equivalent minutes at 43°C (CEM43°C) and media composition on tumour development using an original teratoma in vitro model. Rat embryos (three germ layers) were microsurgically isolated and cultivated at the air‐liquid interface. During a two week period, ectodermal, mesodermal and endodermal derivatives developed within trilaminar teratomas. Controls were grown at 37°C. Overall growth was measured, and teratoma survival and differentiation were histologically assessed. Cell proliferation was stereologically quantified by the volume density of Proliferating Cell Nuclear Antigen. Hyperthermia of 42°C, applied for 15 minutes after plating (CEM43°C 3.75 minutes), diminished cell proliferation (P ? .0001) and enhanced differentiation of both myotubes (P ? .01) and cylindrical epithelium (P ? .05). Hyperthermia of 43°C applied each day for 30 minutes during the first week (CEM43°C 210 minutes) impaired overall growth (P ? .01) and diminished cell proliferation (P ? .0001). Long‐term hyperthermia of 40.5°C applied for two weeks (CEM43°C 630 minutes) significantly impaired survival (P ? .005). Long‐term hyperthermia of 40.5°C applied from the second day when differentiation of tissues begins (CEM43°C 585 minutes) impaired survival (P ? .0001), overall growth (P ? .01) and cartilage differentiation (P ? .05). No teratomas survived extreme regimes: 43°C for 24 hours (CEM43°C 1440 minutes), hyperthermia in the scant serum‐free medium (CEM43°C 630 minutes) or treatment with an anti‐HSP70 antibody before long‐term hyperthermia 40.5°C from the second day (CEM43°C 585 minutes). This in vitro research provided novel insights into the impact of hyperthermia on the development of experimental teratomas from their undifferentiated sources and are thus of potential interest for future therapeutic strategies in corresponding in vivo models.     

应用铸型标本对下颌下腺导管系统的解剖学研究

目的　对正常下颌下腺导管塑料铸型研究，分析下颌下腺导管系统规律。　方法　用增塑的自凝塑料灌注10例正常人下颌下腺导管系统获得铸型，测量、分析铸型的导管长度和直径。　结果　腺门扩张状态下呈纵径大于横经的壶腹状。一级导管与主导管之间的关系有分叉型和线干型之分，前者较多见。　结论　自凝塑料能较好的显示下颌下腺主导管和一级分支导管，压力状态下腺门处扩张明显，分叉型导管系统其主导管和分支导管有利于内镜导入，线干型分支导管内镜导入困难。     

Sleep during the Antarctic winter: preliminary observations on changing the spectral composition of artificial light

Antarctic Base personnel live for 3 months in winter with no natural sunlight. This project compared sleep, by actigraphy, during periods of increased exposure to white light or blue enriched light in 2003. The primary aim was to help define the optimum spectral composition and intensity of artificial environmental light. Nine men and one woman (33 ± 7 years, mean ± SD), wore activity and light monitors continuously from 28.2 to 9.10, and kept sleep diaries. Extra light was provided by light boxes (standard white, 5300 K, or prototype blue enriched, 10 000K, Philips Lighting), which were turned on in bedrooms and in communal/work areas approximately 08.00–18.00 hours. After a no-treatment control period, 28.2–20.3, sequential 4–5 week periods of first white, then blue light, were imposed with a further control period 19.9–9.10. A limited baseline study in 2002 (no interventions) similarly measured light and activity in seven men and one woman (30 ± 7 years). Daily light exposure in winter (lux, mean ± SD) was doubled in 2003 (maximum 1039 ± 281, average 64 ± 21), compared to 2002 (572 ± 276 and 30 ± 11), P  < 0.05 and P  < 0.01, with no differences between white and blue light. There were no major differences in sleep between light conditions in 2003. A delay in sleep timing was found in midwinter compared to control (2003, bedtime, P  < 0.05, sleep start, P  < 0.05, sleep end, P  < 0.01) and sleep fragmentation increased ( P  < 0.05). Sleep efficiency was slightly higher during all blue light periods compared to all white periods ( P  < 0.05). The use of higher intensity light of suitable spectral composition is proposed.     

The Effect of Telephone-Administered Psychotherapy on Symptoms of Depression and Attrition: A Meta-Analysis

Increasingly, the telephone is being used to deliver psychotherapy for depression, in part as a means to reduce barriers to treatment. Twelve trials of telephone-administered psychotherapies, in which depressive symptoms were assessed, were included. There was a significant reduction in depressive symptoms for patients enrolled in telephone-administered psychotherapy as compared to control conditions ( d  = 0.26, 95% confidence interval [CI] = 0.14–0.39, p  < .0001). There was also a significant reduction in depressive symptoms in analyses of pretreatment to posttreatment change ( d  = 0.81, 95% CI = 0.50–1.13, p  < .0001). The mean attrition rate was 7.56% (95% CI = 4.23–10.90). These findings suggest that telephone-administered psychotherapy can produce significant reductions in depressive symptoms. Attrition rates were considerably lower than rates reported in face-to-face psychotherapy.     

Impact of allergic rhinitis on asthma: effects on bronchial hyperreactivity

Background:  Remarkable relationship exists between upper and lower airways. Bronchial hyperreactivity (BHR) is a paramount feature of asthma and may be considered a strong risk factor for the onset of asthma in patients with allergic rhinitis.
Objective:  This study is aimed at evaluating the presence of BHR in a large group of patients with moderate-severe persistent allergic rhinitis alone, and at investigating possible risk factors related to severe BHR.
Methods:  Three hundred and forty-two patients with moderate-severe persistent allergic rhinitis were prospectively and consecutively evaluated. Clinical examination, skin prick test, spirometry and bronchial methacholine (MCH) test were performed in all patients.
Results:  Twenty-two (6.4%) patients had severe BHR, 74 (21.6%) patients had mild BHR and 192 (56.2%) had borderline BHR; 54 (15.8%) patients had a negative MCH test. The logistic regression analysis evidenced that trees and house dust mites sensitization (OR_Adj: 8.1), rhinitis duration > 5 years (OR_Adj: 5.4) and FEV₁ ≤ 86% of predicted (OR_Adj: 4.0) were significantly associated with severe BHR. The discriminative ability of this model is appreciably satisfactory, being the AUC = 0.90.
Conclusion:  This study highlights the close link between upper and lower airways and the role of some risk factors, such as tree and mite sensitization, > 5-year duration, and ≤ 86% FEV₁ values, as risk factors for severe BHR in patients with moderate-severe persistent allergic rhinitis alone. Therefore, BHR is frequently present in patients with chronic rhinitis and should be suspected in the presence of defined risk factors.     

The effects of selected probiotic strains on the development of eczema (the PandA study)

Background:  Modification of the intestinal microbiota by administration of probiotic bacteria may be a potential approach to prevent allergic disease. We aimed to study primary prevention of allergic disease in high-risk children by pre- and postnatal supplementation of selected probiotic bacteria.
Methods:  In a double-blind, randomized, placebo-controlled trial, a mixture of probiotic bacteria selected by in-vitro experiments ( Bifidobacterium bifidum, Bifidobacterium lactis, and Lactococcus lactis ; Ecologic^® Panda) was prenatally administered to mothers of high-risk children (i.e. positive family history of allergic disease) and to their offspring for the first 12 months of life.
Results:  Parental-reported eczema during the first 3 months of life was significantly lower in the intervention group compared with placebo, 6/50 vs 15/52 ( P  = 0.035). After 3 months, the incidence of eczema was similar in both groups. Cumulative incidence of parental-reported eczema at 1 and 2 years was 23/50 (intervention) vs 31/48 (placebo) and 27 (intervention) vs 34 (placebo), respectively. The number needed to treat was 5.9 at age 3 and 12 months and 6.7 at age 2 years. The intervention group was significantly more frequently colonized with higher numbers of Lc. lactis. Furthermore, at age 3 months, in vitro production of IL-5 (146 pg/ml vs 72 pg/ml; P  = 0.04) was decreased in the probiotic-group compared with the placebo-group.
Conclusions:  This particular combination of probiotic bacteria shows a preventive effect on the incidence of eczema in high-risk children, which seems to be sustained during the first 2 years of life. In addition to previous studies, the preventive effect appears to be established within the first 3 months of life.