Persistent airway obstruction after virus infection is not associated with airway inflammation

BACKGROUND: This study examined the contribution of airway inflammation to the delayed lung function recovery that occurs in some people following virus-induced asthma exacerbations. METHODS: Subjects (n = 40) were recruited at hospital admission for acute asthma exacerbation. Respiratory virus infection was diagnosed by viral nucleic acid detection and/or cell culture, using induced sputum, nasal, or throat swabs. Data collected included lung function, answers to common cold and asthma control questionnaires, and induced sputum cellular profiles. Subjects were reexamined 4 to 6 weeks postexacerbation and were compared with stable asthmatic subjects (n = 26) who had been recruited from ambulatory care clinics. RESULTS: Persistent airway obstruction, defined as lung function improvement at follow-up (ie, change in FEV1 percent predicted [Delta%FEV1]) of <15%, was observed in 10 subjects (25%). Airway recovery (Delta%FEV1, > or = 15%) was observed in the remaining subjects (30 subjects; 75%). During the acute episode, the airway-recovery group had increased total cell count (p = 0.019), increased number of neutrophils (p = 0.005), and increased percentage of neutrophils (p = 0.0043) compared to the group of stable subjects with asthma. Postexacerbation, the airway-recovery group had reduced numbers of neutrophils and an increased percentage of eosinophils. In contrast, during exacerbation, subjects with persistent airway obstruction showed no differences in inflammatory cell counts compared to stable subjects with asthma, nor did cell counts change postexacerbation. Symptoms improved in both groups postexacerbation. However, in the persistent-airway-obstruction group, asthma remained uncontrolled. CONCLUSION: Persistent airway obstruction and uncontrolled asthma are observed in some people after viral asthma exacerbations. These abnormalities are not associated with inflammatory cell influx into the airway lining fluid during the exacerbation and may reflect the involvement of noncellular elements. Further work should explore other mechanisms leading to incomplete airway recovery.     

Eosinophilic cholangitis coexisted with idiopathic thrombocytopenic purpura: Report of a case

Eosinophilic cholangitis is a rare disease of which only 31 cases have been reported. Eosinophilic infiltration causes stricture of the bile duct diffusely or locally, and the imaging of eosinophilic cholangitis resembles primary sclerosing cholangitis or cancer of the bile tract. For eosinophilic cholangitis, treatment with steroid is effective and the prognosis is good. Therefore, its accurate diagnosis is very important. Here, we describe a patient with eosinophilic cholangitis who was also diagnosed with idiopathic thrombocytopenic purpura (ITP). He was treated for ITP using prednisolone, the unexpected sudden interruption of which caused severe deterioration of eosinophilic cholangitis and acute cholecystitis. Cholecystectomy and choledochojejunostomy were performed, and the addition of treatment by prednisolone resulted in a good clinical course. This is the first report on eosinophilic cholangitis coexisting with ITP.     

Analysis of T cell receptor V(beta) gene expression and clonality in bronchoalveolar fluid lymphocytes from a patient with chronic eosinophilic pneumonitis

Chronic eosinophilic pneumonitis (CEP) is characterized by longstanding respiratory symptoms accompanied by a massive pulmonary eosinophil infiltration. T lymphocytes in bronchoalveolar lavage (BAL) from patients with chronic eosinophilic pneumonitis are considered to recognize unknown antigens. To analyze the pathogenesis of CEP, we examined the T cell receptor (TCR) repertoire and T cell clonotype of BAL lymphocytes and peripheral blood lymphocytes (PBLs) in a 66-year-old woman patient with CEP. The expression of TCR BV gene was analyzed by the family PCR method using specific primers for 20 TCR BV genes and BC gene. The clonotype of BAL and peripheral T cells was examined by the PCR-single-strand conformation polymorphism (SSCP) method. Functional sequences of some T cell clones were also carried out. A TCR repertoire of BAL T cells was heterogeneous as well as PBLs. However, SSCP analysis showed that distinct T cell clonotypes were detected in BAL T cells, TCR BV3, BV4, BV6, BV8, BV9, BV14, and BV18-positive T cell clones especially, expanded clonally in BAL from the patient. Sequencing analysis showed that GVD, LGG, RDXS, and SSG amino acid sequence motif were found in the CDR3 in lung-specific T cells. BAL-specific T cell clones accumulated in the patient with CEP. Thus, we can conclude that BAL T cells are induced by the antigen-driven stimulation and these cells might play a crucial role in the generation of CEP. Accepted for publication: 27 February 2001     

嗜酸细胞性胃肠炎研究进展

嗜酸细胞性胃肠炎(eosinophilic gastroenteritis,EG)是一种少见的胃肠道疾病,以胃肠道某些部位弥漫性或局限性嗜酸性粒细胞(Eos)浸润为特征。胃和小肠为最常受累部位,可发生于任何年龄,其好发年龄为30～50岁,儿童时期较罕见,男性发病率高于女性。由于许多EG患者被误     

90例苯暴露者T淋巴细胞核仁组成区嗜银蛋白检测

目的检测苯暴露者外周血T淋巴细胞核仁组成区嗜银蛋白（Ag-NORs）,评价其作为苯暴露者早期的效应生物标志物的价值。方法采用KL型肿瘤免疫图像分析系统及配套试剂分析接触苯的高暴露者、低暴露者和对照者Ag-NORs区面积与细胞核仁区的百分比（I.S%）。结果 I.S%在高暴露者组为（6.2±0.7）,低暴露组为（7.5±0.8）,正常对照组为（7.6±0.7）,3组差异有统计学意义（F=2.36,P=0.013）,其中高暴露组低于低暴露组和对照组,低暴露组与对照组比较差异无统计学意义（P〉0.05）。结论 Ag-NORs检测能反映个体的苯接触水平,对职业健康检查早期筛查易感人群有一定的意义。     

Evolution of norovirus

Norovirus (NoV) is now the dominant aetiological agent of acute gastroenteritis, and, with the recent introduction of rotavirus vaccines in many countries, this is likely to remain the case. NoV has a significant impact on human wellbeing in terms of morbidity, economic costs and mortality in developing countries. NoVs are divided into six genogroups (GI–GVI), but only GI, GII and GIV are known to infect humans, with GII being the most prevalent, causing >95% of human infections. The immune system is thought to drive selection of emerging pandemic NoVs through both antigenic drift and shift. This phenomenon results in the replacement of dominant circulating viruses approximately every 3 years, with new variants able to re-infect hosts previously infected with earlier viruses. This review explores the evolutionary aspects of contemporary NoVs.