Clinical and immunological effects of azithromycin in Behçet''s disease

Background: The aim of this study was to evaluate the effects of azithromycin on mucocutaneous manifestations, oral health and immune response in Behçet's disease (BD). Methods: Eight BD patients with active mucocutaneous symptoms were treated with azithromycin for 4 weeks. Oral health, clinical manifestations and in vitro interleukin (IL)‐12, interferon (IFN)‐γ, IL‐10 and monocyte chemotactic protein (MCP)‐1 responses were evaluated before and after treatment. Results: The number of folliculitic lesions, healing time of oral ulcers and scores of plaque indexes (PLIs) were lower after azithromycin treatment (P < 0.05). Scores of PLIs correlated positively with the healing time of oral ulcers (P = 0.02). Although a trend towards increased stimulated IL‐10 responses with azithromycin was observed, no statistically significant difference was found. Stimulated and unstimulated MCP‐1, IFN‐γ and IL‐12 responses were similar before and after treatment (P > 0.05). Conclusion: Azithromycin was observed to be effective in decreasing folliculitic lesions and fastening the healing time of oral ulcers in BD.     

Post-polio syndrome patients treated with intravenous immunoglobulin: a double-blinded randomized controlled pilot study

Post-polio syndrome (PPS) is characterized by new muscle weakness, atrophy, fatigue and pain developing several years after the acute polio. Some studies suggest an ongoing inflammation in the spinal cord in these patients. From this perspective, intravenous immunoglobulin (IvIg) could be a therapeutic option. We performed a double-blinded randomized controlled pilot study with 20 patients to investigate the possible clinical effects of IvIg in PPS. Twenty patients were randomized to either IvIg 2 g/kg body weight or placebo. Primary endpoints were changes in pain, fatigue and muscle strength 3 months after treatment. Surrogate endpoints were changes in cerebrospinal fluid (CSF) cytokine levels. Secondary endpoints were pain, fatigue and isometric muscle strength after 6 months. Patients receiving IvIg reported a significant improvement in pain during the first 3 months, but no change was noted for subjective fatigue and muscle strength. CSF levels of tumour necrosis factor- α (TNF- α ) were increased compared with patients with non-inflammatory neurological disorders. In conclusion, in this small pilot study no effect was seen with IvIg treatment on muscle strength and fatigue, however IvIg treated PPS patients reported significantly less pain 3 months after treatment. TNF- α was increased in the CSF from PPS patients. The results are promising, but not conclusive because of the low number of patients studied.     

Evaluation of the antinociceptive activity of extracts of Sonchus oleraceus L. in mice

Ethnopharmacological relevance

Sonchus oleraceus L. has been used to relieve pain in Brazilian folk medicine.

Aim of the study

Sonchus oleraceus L. has been used to relieve pain in Brazilian folk medicine. This study was conducted to establish the antinociceptive properties of hydroethanolic and dichloromethane extracts from aerial parts of Sonchus oleraceus in mice using chemical and thermal models of nociception.

Materials and methods

The formalin, hot plate, and tail immersion tests as well as acetic acid-induced writhing were used to investigate the antinociceptive activity in mice.

Results

Given orally, the extracts at test doses of 30–300 mg/kg, produced significant inhibitions on chemical nociception induced by intraperitoneal acetic acid and subplantar formalin since decreased the number of writhing episodes and the time licking. Treatment with the extracts in the same doses produced a significant increase of the reaction time in tail immersion and in the hot plate test. The extracts administered at 300 mg/kg, p.o. had a stronger antinociceptive effect than indomethacin (5 mg/kg, p.o.) and morphine (10 mg/kg, p.o.).

Conclusion

The extracts of Sonchus oleraceus markedly demonstrated antinociceptive action in mice, which supports previous claims of its traditional use.     

胰腺肿块性炎性病变的临床病理特征

目的:探讨胰腺肿块性炎性病变的临床病理特征。方法:回顾性分析肿块性慢性胰腺炎37例的临床资料。符合慢性胰腺炎临床诊断标准者为A组,共17例。行Whipple或胰体部分切除5例,各类内引流术12例。缺乏A组特点、曾拟诊为胰腺癌者为B组,共20例。行Whipple手术4例,胆肠内引流术16例。结果:A组除见胰腺局部质硬的肿块外,全部胰腺质硬者占88.2%;病理见胰腺纤维化瘢痕及少量炎细胞浸润,并有腺泡萎缩、减少,有残余胰岛及导管扩张或局灶钙盐沉积。B组中95.0%仅见胰腺局部质硬肿块,病理见胰腺纤维组织增生伴有不同程度的慢性炎细胞浸润。33例随访1~12年,均未发现胰腺癌变。结论:胰腺局灶性慢性炎症病变具有假瘤性胰腺炎的特点,行胆管空肠吻合术是有效的治疗方法。     

柴黄复方颗粒抗炎镇痛作用及机制研究

目的:观察柴黄复方颗粒抗炎镇痛作用及其作用机制。方法:采用角叉菜胶致大鼠足肿胀法、醋酸致小鼠毛细血管通透性增加法、羧甲基纤维素钠(CMC-Na)致小鼠腹腔白细胞数增多法评价药物的抗炎作用及其机制;采用热板致痛法和醋酸致痛法评价药物的镇痛作用;用Elisa法测定炎性组织中白介素1(IL-1)和肿瘤坏死因子α(TNF-α)含量,放免法检测前列腺素E₂(PGE₂)的含量,紫外分光光度法测定丙二醛(MDA)含量。结果:柴黄复方颗粒能抑制大鼠足肿胀程度和CMC-Na所致小鼠腹腔白细胞游走,降低肿胀足中IL-1,TNF-α,PGE₂和MDA的含量及小鼠毛细血管通透性,对抗热板和醋酸刺激引起的小鼠疼痛反应。结论:柴黄复方颗粒具有一定的抗炎和镇痛作用,其作用机制与降低炎性组织中的IL-1,TNF-α,PGE₂和MDA的含量有关。     

Cytokine production, activation marker, and skin homing receptor in children with atopic dermatitis and bronchial asthma

T cells are known to develop a critical role in the pathogenesis of atopic dermatitis (AD) and bronchial asthma. T cells involved in AD express the skin homing receptor CLA, but no lung homing receptor has been identified in bronchial asthma. We compared different cell markers and the cytokine production in T cells from children with AD or bronchial asthma. We studied the involvement of CLA+ and CLA- T-cell subpopulations in these diseases. We studied 20 children with acute AD lesions, 15 with mild persistent asthma, and 15 non-atopic controls. All patients were sensitized to house dust mite (DP) and evaluated during the acute phase. Total and specific IgE were measured by immunoassay and the expression of different cell markers and the cytokine production was analyzed by flow cytometry in peripheral blood mononuclear cells. Total IgE was significantly higher in AD children and IgE to DP in the asthmatic children. There was a significant increase in CD25+ CD4+ cells in asthmatic children and in HLA-DR+ CD4+ and HLA-DR+ CD8+ cells in AD. In the CD4+ subsets, there was an increase in IL-13, IL-5 and TNF-alpha in AD compared to controls, a decrease in IFN-gamma in asthmatic children compared to controls, and an increase in IL-13, IL5, IL2, TNF-alpha, and IFN-gamma in the AD compared to asthmatic children. Changes in cytokine production were mainly detected in CLA+ cells in AD and in CLA- cells in asthma. Differences exist in total and specific IgE, activation markers, and cytokine patterns between AD children and children with asthma, with the former expressing a Th2 pattern whereas in asthmatic children we only detected a decrease in IFN-gamma. Moreover, the subpopulations (CLA+ vs. CLA-) expressing these changes were different, indicating that the underlying mechanisms in the two diseases are not exactly the same.     

Common human Toll-like receptor 9 polymorphisms and haplotypes: association with atopy and functional relevance

BACKGROUND: Toll-like receptor 9 (TLR9) is a pattern-recognition receptor that detects unmethylated CpG motifs prevalent in bacterial and viral DNA. TLR9 stimulation is a key event after bacterial infection, triggering innate immunity and T-helper type 1 skewed adaptive immunity. Synthetic CpG-oligodeoxynucleotides (CpG-ODNs) represent a promising and novel class of immune adjuvants for allergy treatment, vaccination, and cancer therapy. However, common functional TLR9 gene variants could interfere with the clinical utilization of CpG-ODN in immunotherapy. Recently, a possible association of TLR9 polymorphism C-1237T with asthma has been reported. OBJECTIVE: The aim of the present study was to investigate whether TLR9 polymorphisms or haplotypes have functional relevance and are associated with atopy. METHODS: We genotyped five common TLR9 single-nucleotide polymorphisms (SNPs) in promoter, exon, and intron regions of the gene in 527 healthy blood donors, and estimated four common haplotypes. The total IgE and specific IgE levels against the most common aeroallergens were measured (n=303). IFN-alpha production by plasmacytoid dendritic cells (pDCs) was analysed after stimulation with TLR9 ligand CpG-ODN (n=220). RESULTS: No significant influence of common TLR9 polymorphisms and haplotypes on the total and specific IgE levels was found. Functional analysis of CpG-ODN-induced IFN-alpha did not indicate a significant role for common TLR9 gene polymorphisms in TLR9 function. CONCLUSION: We conclude that common genetic differences in the TLR9 gene exert no major influence on allergy susceptibility, and are unlikely to have on impact on clinical application of CpG-ODNs.     

高强度聚焦超声致大鼠急性肝损伤后机体炎症反应及乌司他丁的保护效应

目的 探讨高强度聚焦超声(HIFU)所致的大鼠急性肝损伤后血清炎性因子水平的变化及乌司他丁(UTI)对其的保护效应.方法 建立高强度聚焦超声致大鼠急性肝损伤模型,Wistar大鼠24只随机均分为单纯高强度聚焦超声致伤组(H组)、乌司他丁处理组(U组)和空白对照组(D组).在致伤后1、3、6、12和24h分别检测三组血清中白细胞介素-2(IL-2)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)三种炎性细胞因子的含量.结果 与D组比较,H组致伤3h后IL-2和TNF-α开始明显升高,并分别于致伤后6h和12h达到峰值.U组IL-2和TNF-α升高幅度明显低于H组(P<0.01),且于致伤后24h基本恢复正常,而IL-10水平显著高于H组.结论 高强度聚焦超声致大鼠急性肝损伤后大鼠机体发生显著炎症反应,乌司他丁能下调致炎因子水平,并可上调抑炎性因子水平,阻断炎症反应,显示出一定的保护效应,改善预后.     

危重病患者血浆胰岛素水平与细胞因子含量的关系

目的探讨危重病患者是否存在高胰岛素血症、胰岛素抵抗(IR)及与肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)的关系.方法测定危重病患者123例和对照组30例的空腹血糖(FBG)、空腹胰岛素(FINS)、TNF-α、IL-6的水平,并计算胰岛素敏感性指数(IAI),以评估危重病患者IR的严重程度,并分析各参数之间的相关性.结果危重病组与对照组的IAi分别为-1.95±0.38和-1.5±0.29,两者差异显著(P＜0.01).危重病按病因分组后各组IAI相比无显著差异(P＞0.05).IAI与危重病严重程度、TNF-α及IL-6的直线回归分析,直线关系r分别为0.86,-0.89,-0.87,差异有显著性(P＜0.01).结论危重病患者存在高胰岛素血症及IR.IR的程度与危重病程度、TNF-α、IL-6的水平有显著相关性.危重病患者的IR与TNF-α的升高有关,提示IAI可作为危重病患者病情严重程度的预测指标.