支气管哮喘血清IgE和ECP的水平及相关性分析

目的探讨支气管哮喘血清IgE和ECP的水平,并分析IgE和ECP的相关性.方法对象为54例支气管哮喘患者和20例健康正常人,采用酶联免疫法测定其血清IgE和ECP的水平.结果支气管哮喘血清TIgE和ECP水平明显高于正常对照组(P<0.01);血清中TIgE含量与屋尘螨SIgE水平存在直线相关(r=0.296,P<0.05);血清中的TIgE与ECP和屋尘螨SIgE与ECP之间并无明显相关性.结论屋尘螨是引起支气管哮喘的重要变应原;血清TIgE和SIgE与ECP均无相关,初步解释为IgE表示患者变应体质的水平,但不能反映气道炎症的病理过程;而ECP水平可以客观地反映变应性哮喘患者体内炎性细胞激活的程度,可作为哮喘气道炎症监测的指标.     

白三烯受体拮抗剂对哮喘患儿血清ECP的影响

目的:观察白三烯受体拮抗剂在治疗哮喘患儿过程中抗炎作用的临床效果。方法:对60例哮喘患儿随机分为观察组和对照组各30例。观察组吸入布地奈德(普米克)气雾剂同时口服孟鲁司特,对照组只吸入布地奈德气雾剂。所有病例治疗前及治疗4周后测定血清嗜酸细胞阳离子蛋白浓度(ECP)水平。结果:治疗前两组患儿血清ECP水平较高,两组之间无差异(P<0.05)。治疗4周后,两组ECP水平均较治疗前降低,但观察组ECP水平下降明显,差异具有显著性意义(P<0.01)。结论:白三烯受体拮抗剂在治疗哮喘患儿中起抗炎作用。     

穴位贴敷治疗过敏性哮喘患儿的疗效观察

[目的]观察穴位贴敷治疗过敏性哮喘患儿的临床疗效.[方法]将128例过敏性哮喘患儿随机分为观察组和对照组,每组各64例,对照组给予雾化吸入布地奈德混悬液及口服孟鲁司特片治疗,观察组在对照组治疗的基础上,给予穴位贴敷治疗,2组均连续治疗2周.治疗2周后,评价2组患儿的临床疗效,观察2组患儿治疗前后1 s用力呼气容积(FE...     

Effects of psychotropic drugs on the cerebral energy state and glycolytic metabolism in the rat: diazepam,clomipramine and chlorpromazine

Phosphocreatine (PCr), 1ATP, ADP, AMP, glucose, glucose-6-phosphate (G-6-P), lactate, and pyruvate were measured with the cerebral cortex tissues frozen in situ by liquid nitrogen after the intravenous administration of psychotropic drugs in rats, i.e. diazepam (0.25 mg/kg), clomipramine (2.0 mg/kg), and chlorpromazine (0.5 mg/kg). There were no significant changes in the levels of cerebral high energy phosphates or energy charge potential (ECP). There were also no significant changes in the levels of glycolytic intermediates or the lactate/pyruvate ratio (L/P ratio), except for an increase in glucose after the administration of chlorpromazine. Thus, none of these drugs appeared to impede the cerebral energy state in a therapeutic dose     

Bronchial hyper-responsiveness to hypertonic saline and blood eosinophilic markers in 8–13-year-old schoolchildren

BACKGROUND: In adult asthma, bronchial hyper-responsiveness (BHR) to indirect stimuli reflects eosinophilic activation more closely than BHR to stimuli that directly cause smooth muscle contraction. AIM: To assess the relationship between BHR to the indirect stimulus hypertonic saline (HS), blood eosinophil numbers, and serum eosinophilic cationic protein (ECP) in children with and without current wheeze. METHODS: A cross-sectional survey among 8-13-year-old schoolchildren, using the International Study of Asthma and Allergic disease in Childhood questionnaire, bronchial challenge with HS, skin prick tests, serum IgE, blood eosinophil counts and ECP (in a subset). Based upon the presence of current wheeze (WHE) and BHR, we defined three case groups (WHE+BHR+, WHE-BHR+, WHE+BHR-) and the reference group (WHE-BHR-). By regression analyses, each case group was compared with the reference group for differences in atopic sensitization, blood eosinophil counts and serum ECP. RESULTS: Complete data were obtained for 470 children. BHR was present in 103 children (22%), 66 being asymptomatic and 37 symptomatic. Children of all three case groups were more often atopic. Sensitization to indoor allergens particularly occurred in children with BHR, irrespective of symptoms (P < 0.05). Children with WHE+BHR+ had highest values for blood eosinophils and serum ECP (P < 0.05). Children with WHE-BHR+ had less severe responsiveness. In atopic children with WHE-BHR+, serum ECP was higher than in children with WHE-BHR-(P < 0.05). CONCLUSIONS: BHR to HS is associated with blood markers of eosinophilic activation, particularly in atopic children.     

Immunomodulation during sublingual therapy in allergic children

The clinical efficacy of sublingual immunotherapy (SLIT) has been demonstrated, but its mechanism of action is still controversial. The most recent experimental observations suggest that a critical role in the modulation of immune response is sustained by Th2 cytokines, such as interleukin-4 (IL-4), IL-5 and IL-13, by co-stimulatory molecules, such as CD40 on B cells, and by hormones and neuropeptides. To better understand whether SLIT affects immune responses we used a double-blind placebo-controlled design. Eighty-six children with mild asthma due to allergy to Dermatophagoides pteronyssinus (33 of whom also had rhinoconjunctivitis) were randomly assigned SLIT (n = 47) or placebo (n = 39). We assessed symptom scores using diary cards of each patient and determined the expression of CD40 on B cells and the serum concentration of ECP, IL-13, prolactin (PRL) and ACTH at enrolment and after 6 months of therapy. We observed a significant reduction in asthma and rhinitis scores in the immunotherapy group compared with the placebo group, no variation in CD40 and ACTH, but a significant decrease in ECP, IL-13 and PRL after 6 months of therapy (p <0.01). Our results confirm the efficacy and safety of SLIT, and lead us to believe that it could modulate the synthesis of Th2 cytokines, as revealed from the decrease of IL-13. In addition, the reduction of PRL might be a signal of reduced activation of T lymphocytes.     

Hypereosinophilic syndrome in a child mosaic for a congenital triplication of the short arm of chromosome 8

An 11-year-old boy with mental retardation, malformations, and the mosaic karyotype 47,XY,+i(8p)/46,XY presented with fever, headache and petechiae. Peripheral blood WBC was 190 ×10⁹/l; and contained > 90% mature eosinophils. Cytogenetic analysis of the eosinophils revealed no aberrations except the constitutional karyotype. The patient was diagnosed as having a hypereosinophilic syndrome. Shortly after initiation of therapy he died from extensive mural thrombi of the heart and thrombi of several other organs. This is the first case of congenital triplication of the short arm of chromosome 8 associated with hypereosinophilic syndrome, suggesting involvement of genes on chromosome 8p in the regulation of eosinopoiesis.     

Eosinophil cationic protein, myeloperoxidase and tryptase in children with asthma and atopic dermatitis

Serum levels of eosinophil cationic protein (ECP), myeloperoxidase (MPO), tryptase, total IgE and differential blood cell counts were studied in atopic children with: 1) moderate to severe asthma using inhaled steroids and symptom-free for the last 3 weeks (n= 13), 2) mild asthma with sporadic symptoms, using only inhaled β₂-agonists < 3 times/week (n= 15), 3) acute asthmatic attacks admitted to hospital (n= 12), 4) mild to moderate atopic dermatitis (n= 14). Fifteen children without any history of atopy served as controls. ECP, MPO, tryptase and IgE were measured in serum by radioimmunoassays (RIA). The symptom-free children with inhaled steroids had similar median ECP and MPO values as the controls, 8.0 and 360 μg/l, vs. 9.0 and 310 μg/l, while both ECP and MPO were significantly (p < 0.001) increased in the symptom-free children without anti-inflammatory treatment, 32 and 887 μg/l and in those with acute asthma, 28 and 860 μg/l. The children with atopic dermatitis had increased ECP but normal MPO levels, 16.0 and 455 μg/l. Tryptase in serum was not measurable in any patient. All groups except the control group had significantly elevated total IgE levels. The results indicate that in atopic children serum ECP is a good marker of ongoing asthma or atopic dermatitis. The normal levels of ECP and MPO in the children with asthma using inhaled steroids seem to reflect successful anti-inflammatory treatment. The increased levels of ECP and MPO in the children with mild asthma and no anti-inflammatory treatment may indirectly reflect airway inflammation.     

Extracorporeal photochemotherapy in heart transplant rejection: A single-center experience

Background

The addition of extracorporeal photochemotherapy (ECP) to standard immunosuppressive therapy has been suggested to be beneficial in the treatment of recurrent/persistent heart rejection.