Comparison of sputum induction with bronchoalveolar lavage cell differential counts in patients with sarcoidosis

BACKGROUND AND AIM: Induced sputum (IS) has been proposed as a useful non-invasive method mainly for the assessment of airway diseases. The aim of this study was to evaluate IS cellular composition and T-lymphocyte subpopulations and to compare them with those of bronchoalveolar lavage fluid (BALF) in patients with sarcoidosis. METHODS: We studied prospectively 20 patients (12 female, 8 male) of median age 46 yr (range 25-65) with sarcoidosis and 10 normal subjects (5 female, 5 male) of median age 39 yr (range 26-60). IS was performed with hypertonic saline solution using an ultrasonic nebulizer (De Vilbis 2000). BALF was performed by conventional procedure using fiberoptic bronchoscopy. May-Giemsa-Grunewald stained preps were differentially counted and T-lymphocyte subsets were analyzed by flow activated cell sorter (FACS). RESULTS: The percentage of macrophages was significantly lower in IS than in BALF (p < 0.0001), the percentage of neutrophils was significantly lower in BALF than in IS (p < 0.0001), while there was no difference in the percentage of lymphocytes (p = 0.693) and eosinophils (p = 0.25) in IS vs BALF in patients with sarcoidosis. A significant correlation was found between BALF and IS lymphocyte counts (r = 0.61, p = 0.004), macrophages (r = 0.51, p = 0.02), and CD4+/CD8+ ratio (r = 0.700, p = 0.001). CONCLUSIONS: These results suggest that the inflammation in sarcoidosis could be effectively and non-invasively determined by the analysis of cell differential counts and T-lymphocyte subsets in IS. Further studies are needed to explore the role of IS vs BALF in the follow-up of these patients.     

Interactions between CYP1A1 polymorphisms and exposure to environmental tobacco smoke in the modulation of lymphocyte bulky DNA adducts and chromosomal aberrations

CYP1A1 plays an important role in the metabolic activation of polycyclic aromatic hydrocarbons (PAH), carcinogenic components of air pollution. The influence of CYP1A1 genotype (*2A, *2B and *4) on the levels of lymphocyte bulky DNA adducts and the frequency of cells with aberrant chromosomes was assessed in 194 non-smoking subjects in whom recent exposure to environmental tobacco smoke (ETS) and airborne particulate-associated PAH were measured during two consecutive seasons (winter and summer). While CYP1A1*4 had no consistent effect on either biomarker of genetic damage, the levels of both biomarkers responded in a parallel fashion to changes in exposure/CYP1A1*2A genotype combinations during both seasons. Specifically, the levels of both biomarkers were increased in carriers of at least one CYP1A1*2A allele, as compared with CYP1A1*1 homozygotes, in subjects with ETS exposures >0.8 h/day during the previous 4 days and mean personal exposure to benzo[a]pyrene <0.9 ng/m3 during the previous 24 h (all P < 0.05). Outside these exposure limits the differential effect in CYP1A1*2A variants was lost. Although the numbers of subjects with the CYP1A1*2B polymorphism was small, the same trend appeared to be followed in this case. These effects are interpreted as resulting from differential induction of CYP1A1 expression in CYP1A1*2A and CYP1A1*2A/*2B carriers by components of ETS-polluted air at levels of exposure readily suffered by large segments of the general population and suggest that subjects with these genotypes may have increased susceptibility to the genotoxic effects of ETS.     

Decreased Vision as Initial Presenting Symptom of Acute Lymphoblastic Leukemia: A Case Report

This case illustrates that hematologic disorders must be considered as a potentially life-threatening cause for vision loss. Proper laboratory workup and timely interdisciplinary approach are essential to ensure the best possible care for ophthalmic patients. Historically, before the use of bone marrow biopsy, the ophthalmologist was often asked to assist in the diagnosis of leukemia. Since ophthalmological symptoms may be the initial presenting signs of leukemia as highlighted in this case, the ophthalmogist is still of crucial importance.Key Words: Acute lymphoblastic leukemia, Visual disorder, Optical coherence tomography, Serous macular detachment     

VIP,PACAP‐38, BDNF and ADNP in NMDA‐induced excitotoxicity in the rat retina

Purpose:  To evaluate the effect of intravitreal injection of N‐methyl‐D‐aspartate (NMDA) on brain‐derived neurotrophic factor (BDNF), pituitary adenylate cyclase‐activating peptide‐38 (PACAP‐38), vasoactive intestinal peptide (VIP) and the VIP‐associated glial protein activity‐dependent neuroprotective protein (ADNP) in the rat retina. These elements have well‐documented neuroprotective properties and may thus be integrated in endogenous neuroprotective mechanisms in the retina which break down in NMDA excitotoxicity. Methods:  A volume of 2 μl of 100 nmol NMDA was intravitreally injected into one eye of rats, the untreated eye served as a control. Time‐dependent effects of NMDA on VIP, PACAP‐38 and BDNF were detected by radioimmunoassay and ELISA, and the effect on the expression of VIP, PACAP‐38 and ADNP was evaluated by quantitative RT‐PCR 20 days after NMDA injection. Topical flunarizine served to find out whether the effect of NMDA is counteracted. Results:  Compared to PACAP‐38, VIP levels significantly decreased on days 1, 7, 14, 28 and 56 after NMDA injection indicating that VIPergic cells are more vulnerable than PACAP‐38‐expressing cells. The expression of VIP and ADNP but not of PACAP‐38 was found to be reduced, and application of topical flunarizine counteracted the decrease of VIP. BDNF levels significantly increased after days 1 and 3. Conclusion:  The early upregulation of BDNF seems to act neuroprotectively and leads to a delay of ganglion cell loss. Although there is no direct evidence, the decrease of VIP and ADNP – the consequence of the presence of NMDA receptors on these peptide‐expressing cells – might contribute to the breakdown of endogenous neuroprotective mechanisms given that the decrease of the VIP‐related ADNP runs in parallel with the decrease of VIP. Activating and maintaining these mechanisms must be the primary aim in the therapy of diseases with retinal neuronal degeneration.     

Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry

Journal of Neurology - Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever...     

Population-Based Analysis of Cluster Headache-Associated Genetic Polymorphisms

Cluster headache is a disorder with increased hereditary risk. Associations between cluster headache and polymorphism rs2653349 of the HCRTR2 gene have been demonstrated. The less common allele (A) seems to reduce disease susceptibility. The polymorphism rs5443 of the GNB3 gene positively influences triptan treatment response. Carriers of the mutated T allele are more likely to respond positively compared to C:C homozygotes, when treated with triptans. DNA was extracted from buccal swabs obtained from 636 non-related Southeastern European Caucasian individuals and was analyzed by real-time PCR. Gene distribution for the rs2653349 was G:G?=?79.1%, G:A?=?19.2%, and A:A?=?1.7%. The frequency of the wild-type G allele was 88.7%. The frequencies for rs5443 were C:C?=?44.0%, C:T?=?42.6%, and T:T?=?13.4%. The frequency of the wild-type C allele was 65.3%. The frequency distribution of rs2653349 in the Southeastern European Caucasian population differs significantly when compared with other European and East Asian populations, and the frequency distribution of rs5443 showed a statistically significant difference between Southeastern European Caucasian and African, South Asian, and East Asian populations. For rs2653349, a marginal statistically significant difference between genders was found (p?=?0.080) for A:A versus G:G and G:A genotypes (OR?=?2.78), indicating a higher representation of male homozygotes for the protective mutant A:A allele than female. No statistically significant difference was observed between genders for rs5443. Cluster headache pathophysiology and pharmacotherapy response may be affected by genetic factors, indicating the significant role of genotyping in the overall treatment effectiveness of cluster headaches.