Association of parental eczema, hayfever, and asthma with atopic dermatitis in infancy: birth cohort study.

OBJECTIVE: To evaluate the association of parental history of atopic disease with childhood atopic dermatitis, and to examine the relative strength of associations with maternal and paternal disease. DESIGN: Mothers were recruited to the Avon longitudinal study of parents and children (ALSPAC) from the eighth week of pregnancy. Before parturition, both parents were asked, separately, to report their lifetime history of eczema, asthma, and hayfever. Parents reported symptoms of atopic dermatitis in their children at ages 6, 18, 30, and 42 months. RESULTS: Of 8530 children with complete information on rash at ages 6, 18, 30, and 42 months, 7969 had complete information on maternal atopic disease and 5658 on maternal and paternal atopic disease. There was a strong association between parental eczema and childhood atopic dermatitis: odds ratio 1.69 (95% confidence interval, 1.47 to 1.95) for maternal eczema only, 1.74 (1.44 to 2.09) for paternal eczema only, and 2.72 (2.09 to 3.53) for eczema in both parents. Associations with parental asthma or hayfever were attenuated after controlling for parental eczema. There was no evidence that associations with maternal atopy were stronger than with paternal. CONCLUSIONS: Associations between parents' atopic disease and the risk of atopic dermatitis in offspring vary according to the type of atopic disease in the parents, but not according to parental sex. These results are at variance with previous studies reporting stronger associations with maternal than paternal atopy, and suggest that there is no "parent-of-origin" effect in atopic dermatitis. Parental eczema may be a better marker than parental asthma/hayfever in predisposing to childhood eczema.     

Interleukin 4 receptor expression on human lung tumors and normal lung.

Interleukin 4 (IL-4) receptors were detected by a monoclonal antibody on tumor cells of 10 of 29 squamous cell carcinomas and 6 of 17 adenocarcinomas of the lung. None of the small cell carcinomas or carcinoid tumors stained. Parallel sections stained for epidermal growth factor receptors showed that all but 2 of the IL-4 receptor-positive tumors also expressed epidermal growth factor receptors. Positive labeling for IL-4 receptors was also obtained on nonneoplastic bronchial epithelium and on lymphocytes and macrophages infiltrating the tumor stroma. The role of IL-4 and its receptor in normal human lung is unknown, but the expression of IL-4 receptors on particular subtypes of lung tumors suggests that they may have a role in differentiation or proliferation of squamous and adenocarcinomas.     

Effect of ventilation with positive end-expiratory pressure on the development of lung damage in experimental acid aspiration pneumonia in the rabbit

Sixteen anaesthetized rabbits were subjected to tracheostomy and lung damage produced by the instillation of 4.5 ml/kg hydrochloric acid (pH 1.5) into the trachea. Half of the animals were ventilated with a positive end-expiratory pressure (PEEP) of 3 cmH₂O and half with a PEEP of 10 cmH₂O for 5 h, the mean airway pressure being kept at 12 cmH₂O by adjustment of the end-inspiratory pause time. Pressure-volume curves were recorded every hour. Although the arterial PO₂ values and compliance above the inflection point on the pressure-volume curve were greater in the group submitted to 10 cmH₂O PEEP, there were no significant differences between the groups in terms of survival and histological findings.     

The contribution of morphology to the study of chronic obstructive lung disease

Chronic bronchitis is a condition in which there is an increase in the bronchial mucous gland volume with resultant hypersecretion of mucus. Infection is a secondary phenomenon. Airways obstruction occurs as a result of (1) exudate in the lumen of the small bronchi and bronchioles, (2) high viscosity of the exudate, (3) interference with mucosal ciliary action, and (4) peribronchiolar fibrosis. Cigarette smoking is an important factor in the etiology of hypersecretory states.Emphysema comprises a group of diseases in which there is a permanent increase in size of that portion of the lung distal to the terminal bronchiole accompanied by destructive changes. The two most important entities are (1) centrilobular emphysema occurring predominantly in males and characterized by dilatation and destruction of the respiratory bronchioles, a predilection of the disease for the upper zones of the lungs and close association with cigarette smoking, and (2) panacinar destructive emphysema occurring in males and females equally and affecting predominantly the lower zones of the lung. Chronic bronchitis is not usually present. The disease may be familial and associated with alpha₁ antitrypsin deficiency. Other forms of emphysema may be due to abnormal lung growth or associated with pulmonary fibrosis.Airways obstruction when present in emphysema is associated with bronchiolar plugging by exudate and peribronchiolar fibrosis. These two processes contribute to the alveolar hypoventilation which may result in cor pulmonale.