吸入激素联合缓释茶碱与β_2-受体激动剂治疗儿童哮喘比较

目的比较吸入糖皮质激素(ICS)联合缓释茶碱(SRT)与ICS联合长效β2-受体激动剂(LABA)治疗中、重度儿童哮喘的疗效和安全性。方法141例4—14岁中、重度哮喘患者随机分成两组。A组73例,吸入丙酸氟替卡松气雾剂(FP),同时口服茶碱缓释片舒弗美。B组68例,沙美特罗/丙酸氟替卡松(SM／FP)干粉剂吸入治疗,疗程12周。比较A、B两组的临床疗效及安全性。结果治疗后两组患者晨间最大呼气峰流速(PEFam)与第1秒时间肺活量(FEV1)占预计值的百分比明显升高(P<0．01),两组间比较无显著性差异(P>0．05)。日、夜间症状评分较治疗前均显著降低(P<0．01),两组间比较无显著性差异(P> 0．05)。两组患者使用快速缓解药物(沙丁胺醇气雾剂)的揿数较治疗前均明湿减少(P<0．01),两组间比较无显著性差异(P>0．05)。结论ICS联合SRT治疗中、重度儿童哮喘,其疗效相似于ICS联合LABA,无严重不良反应。     

Identification of two novel immunodominant UreB CD4 T cell epitopes in Helicobacter pylori infected subjects

An epitope-based vaccine is a promising option for treating Helicobacter pylori (H. pylori) infection. Epitope mapping is the first step in designing an epitope-based vaccine. A pivotal role of CD4⁺ T cells in protection against H. pylori has been accepted, but few Th epitopes have been identified. In this study, two novel UreB CD4⁺ T cell epitopes were identified using PBMCs obtained from two H. pylori infected subjects. We determined the restriction molecules by antibody blocking and used various Epstein–Barr virus-transformed B lymphocyte cell lines (BLCLs) with different HLA alleles as APCs to present peptides to CD4⁺ T cells. These epitopes were DRB1*1404-restricted UreB_373–385 and DRB1*0803-restricted UreB_438–452. The T cells specific to these epitopes not only recognized autologous DCs loaded with recombinant UreB but also those pulsed with H. pylori whole cell lysates, suggesting that these epitope peptides are naturally processed. These epitopes have important value for designing an effective H. pylori vaccine.     

Hepatitis B specific T cell immunity induced by primary vaccination persists independently of the protective serum antibody level

In 2005, in accordance with recommendations made by the European Medicines Agency, the Italian Drug Agency ordered withdrawal of the hexavalent Hexavac^® vaccine (Sanofi Pasteur MSD) from the market. Concerns had been raised about the low immunogenicity of the hepatitis B virus component of the vaccine, assessed by measurement of serum antibody levels, and its potential consequences on long-term protection against hepatitis B infection. We evaluated memory T cell response to establish whether there are differences in the protective mechanisms among children who had received either Hexavac^® or Infanrix-hexa^® (GlaxoSmithKline) as their primary vaccination. Immunological memory was determined by measuring the ability of T cells to proliferate and secrete IFNγ by ELISA and intracellular cytokines (IFNγ and IL-2) when cultured with hepatitis B surface antigen (HBsAg). The different memory subsets of T cells were also measured.     

Is asthma a protective factor for dengue fever? In vitro experiment and nationwide population-based cohort analysis

BackgroundDengue fever (DF) is the most rapidly spreading mosquito-borne viral disease. Practical vaccines or specific therapeutics are still expected. Environmental factors and genetic factors affect the susceptibility of Dengue virus (DV) infection. Asthma is a common allergic disease, with house dust mites (HDMs) being the most important allergens. Asthmatic patients are susceptible to several microorganism infections.MethodsA nationwide population-based cohort analysis was designed to assess whether to determine whether asthma can be a risk factor for DF.ResultsUnexpectedly, our data from a nationwide population-based cohort revealed asthmatic patients are at a decreased risk of DF. Compared to patients without asthma, the hazard ratio (HR) for DF in patients with asthma was 0.166 (95% CI: 0.118–0.233) after adjustment for possible confounding factors. In the age stratification, the adjusted HR for DF in young adult patients with asthma was 0.063. Dendritic cell-specific intercellular adhesion molecule 3-grabbing non-integrin (DC-SIGN) of dendritic cells (DCs) is an important entry for DV. Through another in vitro experiment, we found that HDM can diminish surface expression of DC-SIGN in monocyte-derived DCs and further decrease the cellular entry of DV.ConclusionsDecreased DC-SIGN expression in DCs of allergic asthmatic patient may be one of many factors for them to be protected against DF. This could implicate the potential for DC-SIGN modulation as a candidate target for designing therapeutic strategies for DF.