Circadian variations in serum eosinophil cationic protein, and serum and urine eosinophil protein X

Biochemical evaluation of inflammation may be a useful adjunct to measures of pulmonary function and symptoms in children with asthma. However, little data have been provided to validate the markers in children. The aim of the present study was to assess circadian variations in serum eosinophil cationic protein (ECP), and serum and urine eosinophil protein X (EPX) in children. Five girls and two boys aged 10–14 years were studied. The first sample of urine consisted of urine collected from 24.00 hours the night before until 08.00 hours on the morning of the day of investigation. Thereafter urine was collected at 4-h intervals until 24.00 hours and in another 8-h interval from 24.00 to 08.00 hours. Blood samples for assessment of serum ECP and serum EPX were collected every 2 h during the 24 h. Statistically significant circadian variations in serum ECP (F=3.2, p=0.002), serum EPX (F=3.1, p=0.002) and in urine EPX/creatinine (F=5.4, p=0.003) were detected. The concentrations were higher during the night compared to daytime. Peak levels of serum ECP (mean [± SEM]) were found at 06.00 hours (16.3 [5.3] µg/l), trough levels at 08.00 hours (3.9 [0.7] µg/l) (p=0.01). Peak levels of serum EPX were seen at 06.00 (43.7 [9.5] µg/l) with trough levels at 12.00 hours (22.0 [3.5] µg/l) (p=0.01). Peak levels of urine EPX/creatinine occurred in urine collected from 24.00 to 08.00 hours (90.0 [27.7] µg/mmol), trough levels in the 16.00–20.00 hours sample (29.7 [8.9] µg/mmol) (p=0.02). Serum ECP, serum EPX and urine EPX exhibit a circadian variation in children with nocturnal and early morning peak levels. To avoid confounding influence from circadian variations in ECP and EPX in clinical studies blood or urine should be sampled at consistent times.     

儿童哮喘患者血清Eotaxin、ECP的测定及其临床意义

目的 探讨嗜酸粒细胞趋化酞（Eotaxin）、嗜酸粒细胞阳离子蛋白（ECP）在儿童支气管哮喘发病机制中的作用。并评价其反映哮喘气道炎症的临床价值。方法 收集23例哮喘急性发作患者、22例哮喘缓解期患者及17名健康儿童的外周血标本。用ELISA法测定血清Eotaxin的水平。以Pharmacia CAP系统检测血清中ECP的含量。结果 哮喘急性发作患儿血清中Eotaxin、ECP水平明显高于缓解期患儿和健康对照组，Eotaxin、ECP水平的升高程度与病情严重程度相关，且两者相互之间呈正相关。结论 Eotaxin在哮喘的发病过程中对气道的嗜酸粒细胞炎症有影响作用。ECP可作为支气管哮喘气道炎症发生发展的重要指标之一。动态监测血清Eotaxin、ECP的变化。可以较好地反映气道嗜酸粒细胞炎症的反应过程。     

Assessment of intracellular cytokines and regulatory cells in patients with autoimmune diseases and primary immunodeficiencies — Novel tool for diagnostics and patient follow-up

Serum and intracytoplasmic cytokines are mandatory in host defense against microbes, but also play a pivotal role in the pathogenesis of autoimmune diseases by initiating and perpetuating various cellular and humoral autoimmune processes.     

American council on ECP (ACE): Why now?

Stimulated by the scientific progress in deciphering the principal elements contributing to the clinical efficacy of extracorporeal photochemotherapy (ECP), the American Council on ECP (ACE) was formed, under the auspices of the American Society for Apheresis (ASFA), to develop a field‐guiding Consensus Report. ACE is composed of thirty nationally recognized ECP experts, clinically spanning cancer, transplantation, and autoimmunity and scientifically bridging immunology, bioengineering, and hematology. The two‐day meeting took place in Manhattan, April 13‐14, 2017, and unanimous consensus on nine pivotal points is herein reported. (1) ECP's clinical evolution must now enter a scientifically driven phase. (2) ECP is currently a bidirectional therapy, both immunizing and tolerizing simultaneously, via a single one‐size‐fits‐all inflexible medical device. (3) To preclude inadvertent tolerization in the cancer setting, or immunization in the transplant rejection setting, polarization of ECP to either immunization or tolerization mode to match the clinical need is now possible and necessary. (4) Cutaneous T cell lymphoma (CTCL) is a genetically driven cancer, whose response to ECP is due to enhanced anti‐cancer immunity. (5) ECP is a dendritic antigen‐presenting cell (DC) based therapy. (6) ECP's efficacy can now be tested in a broad array of cancers. (7) ECP's capacity to tolerize to allotransplants via processing of donor leukocytes merits expedited human investigation. (8) UVA‐8‐MOP‐impacted ECP‐induced DC are potent antigen‐specific tolerizing agents, while UVA‐8‐MOP(8‐Methoxypsoralen)‐spared ECP‐induced DC are potent antigen‐specific immunizing agents. (9) Six pilot clinical trial areas (CTCL, graft‐vs.‐host disease, ovarian carcinoma, anti‐graft cytotoxic antibodies, pemphigus vulgaris, and haplotype mismatched stem cell transplants) are advised. ACE will be an ongoing advisory group for the field, with the goal of overseeing coordinated clinical and fundamental research efforts.     

Releasability of human hypereosinophilic eosinophils is related to the density of the cells

The activity of eosinophils and neutrophils with respect to the release of granule proteins was studied in 11 patients with the hypereosinophilic syndrome (HES). Granulocytes or purified eosinophils were stimulated with serum-opsonized Sephadex particles (C3b-induced release), and the released amounts of eosinophil cationic protein (ECP), eosinophils protein-X (EPX) and myeloperoxidase (MPO) were measured by means of specific radioimmunoassays (RIA). Eosinophils obtained from patients with HES released significantly more ECP ( P <0·002) and EPX ( P <0·01) after 20 min of incubation than cells from the control group. The cellular content of ECP and EPX in eosinophils obtained from the patients with HES was significantly reduced to 50% and 62%, respectively, of the content of these granule proteins of eosinophils from the control group. In separated eosinophils light-density eosinophils released more of both ECP and EPX than normal density eosinophils. There was no difference in MPO release between the patients and the control group. We conclude that the eosinophils from patients with HES have an increased propensity to release their granule proteins and the releasability seems to be related to the density of the cells.     

Effusive-Constrictive Pericarditis After Pericardiocentesis: Incidence,Associated Findings,and Natural History

Objectives

This study sought to investigate the incidence, associated findings, and natural history of effusive-constrictive pericarditis (ECP) after pericardiocentesis.

桂龙咳喘宁胶囊联合福多司坦治疗慢性阻塞性肺疾病急性加重期的临床研究

目的探讨慢性阻塞性肺疾病急性加重期应用桂龙咳喘宁胶囊联合福多司坦治疗的效果。方法 2015年2月-2018年4月天津市宝坻区人民医院呼吸科收治的114例慢性阻塞性肺疾病急性加重期患者,随机分成对照组(n=57)和治疗组(n=57)。对照组口服福多司坦片,0.4 g/次,3次/d,餐后服用。治疗组患者在对照组基础上口服桂龙咳喘宁胶囊,3粒/次,3次/d。两组均连续治疗14 d。比较两组临床疗效和呼吸系统症状体征的缓解时间,治疗前后肺功能参数[第1秒用力呼气容积(FEV1)占预计值百分比(FEV1占预计值%)、FEV1与用力肺活量(FVC)比值(FEV1/FVC)、呼气峰值流量(PEF)]值、慢性阻塞性肺疾病患者自我评估测试问卷(CAT)评分、外周血嗜酸性粒细胞绝对值(EOS#)及中性粒细胞(NEUT)与淋巴细胞(LYM)比值(NLR)和血清学相关指标[嗜酸性粒细胞阳离子蛋白(ECP)、白介素(IL)-13、8-羟基脱氧鸟苷(8-OHdG)、总抗氧化能力(TAC)]水平变化,不良反应发生情况。结果对照组和治疗组的总有效率分别是86.0%、96.5%,两组比较差异有统计学意义(P<0.05)。与对照组相比,治疗组咳嗽、咳痰等急性加重的呼吸系统症状体征的缓解时间均显著更短(P<0.05)。与治疗前对比,两组治疗后FEV1占预计值%、FEV1/FVC及PEF值均显著增高(P<0.05),CAT评分则均显著降低(P<0.05);但治疗后,治疗组上述肺功能参数值较对照组同期均显著更高(P<0.05),而CAT评分显著更低(P<0.05)。两组治疗后外周血EOS#、NLR值及血清ECP、IL-13、8-OHdG水平均显著低于治疗前(P<0.05),血清TAC水平则均显著升高(P<0.05);且治疗后,治疗组以上指标(EOS#、NLR、ECP、IL-13、8-OHdG、TAC)的改善效果均更显著(P<0.05)。两组均无严重不良反应发生。结论桂龙咳喘宁胶囊联合福多司坦治疗慢性阻塞性肺疾病急性加重期的整体疗效显著,能有效缩短稳定患者病情的时间,改善肺通气功能,缓解气道炎症及全身炎症状态,纠正氧化/抗氧化失衡,具有一定的临床推广应用价值。     

喘嗽宁片联合丙酸氟替卡松治疗咳嗽变异性哮喘的临床研究

目的研究喘嗽宁片联合丙酸氟替卡松吸入气雾剂治疗咳嗽变异性哮喘的临床疗效。方法选取2017年3月—2019年1月宝鸡市中医院收治的100例咳嗽变异性哮喘患者为研究对象,采用随机对照组法将所有患者随机分为对照组和治疗组,每组各50例。对照组患者雾化吸入丙酸氟替卡松吸入气雾剂,2揿/次,2次/d;治疗组患者在对照组的基础上口服喘嗽宁片,4片/次,3次/d。两组患者持续治疗4周。观察两组的临床疗效,比较两组的肺功能指标、嗜酸性粒细胞(EOS)计数、嗜酸性粒细胞阳离子蛋白(ECP)水平和炎性因子水平。结果治疗后,对照组和治疗组的总有效率分别为78.00%、92.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者用力肺活量(FVC)、第一秒用力呼气容积(FEV1)和FEV1/FVC均明显升高,同组治疗前后比较差异有统计学意义(P0.05);并且治疗组患者肺功能指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者EOS计数和ECP水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者EOS计数和ECP水平明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平均显著降低,白细胞介素-10(IL-10)水平显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组患者hs-CRP、TNF-α、IL-10水平明显优于对照组,两组比较差异有统计学意义(P0.05)。结论喘嗽宁片联合丙酸氟替卡松吸入气雾剂治疗咳嗽变异性哮喘具有较好的临床疗效,能改善肺功能,降低血清炎性因子水平,具有一定的临床推广应用价值。     

细辛脑对成人哮喘患者血清IL-25、ECP、IL-27的影响

目的：观察细辛脑治疗成人哮喘患者血清白细胞介素-25（IL-25）、嗜酸性粒细胞阳离子蛋白（ECP）、白细胞介素-27（IL-27）的影响。方法：100例支气管哮喘患者随机分为观察组（55例）和对照组（45例）,对照组给予常规对症治疗（吸氧、解痉平喘、抗感染等）,观察组在常规治疗基础上加用细辛脑注射液24mg加入0．9％氯化钠注射液250ml,ivd,qd,疗程14d。比较两组临床疗效,检测两组患者血清IL-25、ECP、IL-27治疗前后水平的变化。结果：观察组总有效率为92．7％,高于对照组（P〈0．05）。细辛脑可以降低支气管哮喘患者血清IL-25、ECP、IL-27浓度的浓度,差异有统计学意义（P〈0．05或0．01）。结论：细辛脑注射液可降低哮喘患者血清中IL-25、ECP、IL-27浓度,抑制炎症细胞生成,可以减轻哮喘患者的气道炎症反应。