氮卓斯汀对哮喘豚鼠炎症细胞粘附功能的影响

目的研究组胺H1 受体拮抗剂氮卓斯汀(Azelastine ,AZT)对哮喘豚鼠炎症细胞粘附功能的影响,探讨氮卓斯汀拮抗哮喘气道炎症的可能机制。方法以卵白蛋白致敏豚鼠制备哮喘模型。采用密度梯度离心法分离并计数支气管肺泡灌洗液(BALF)中嗜酸性粒细胞(EOS)和淋巴细胞(LC)的数量;采用ELISA法检测血浆和BALF中可溶性细胞间粘附分子 1(sICAM 1)和可溶性P选择素(sP S)的含量。通过荧光酶标记法在pharmaciaCAPSystem中测定血清和BALF中嗜酸性粒细胞阳离子蛋白(ECP)的水平。结果氮卓斯汀能显著降低哮喘豚鼠BALF中Eos和LC的数量;在氮卓斯汀治疗组,哮喘豚鼠血浆和BALF中sICAM 1和sP S的含量均显著降低,血清和BALF中ECP的含量也显著降低,与模型组相比均有显著性差异。结论氮卓斯汀能降低哮喘豚鼠sICAM 1、sP S和ECP的水平,抑制Eos和LC的粘附,减少其在气道的浸润。这可能是组胺H1 受体拮抗剂氮卓斯汀拮抗哮喘气道炎症的重要机制之一。     

异位性皮炎血清嗜酸细胞阳离子蛋白水平的检测及意义

目的探讨异位性皮炎(AD)患者的血清嗜酸细胞阳离子蛋白(ECP)、总IgE和外周血嗜酸细胞计数(EOS)之间和疾病严重程度之间的相关性。方法选择门诊就诊的50例AD患者,设30例正常人为对照,同期检测ECP、TIgE和EOS,并对疾病严重程度评分。结果AD患者血清ECP和TIgE水平均明显高于正常对照组(P<0.05)。患者EOS在正常范围之内。ECP与TIgE、EOS之间无相关性,疾病严重程度评分与ECP之间呈正相关(r=0.764,P<0.05),而与TIgE和EOS则无相关性(P>0.05)。结论AD患者血清ECP水平是反映嗜酸粒细胞活化和过敏状态的敏感指标,可更为有效而可靠地监测AD患者病情活动及疗效。     

支气管哮喘患儿血清ECP及IgE水平的测定及其临床意义

目的：探讨血清嗜酸粒细胞阳离子蛋白（ECP）和免疫球蛋白E（IgE）水平在儿童哮喘发病过程中的相关性及意义。方法：实验共对80名哮喘患儿及20名健康儿童血清ECP及IgE进行测定,将实验结果进行统计比较从而得出结论。结果：哮喘患儿发作期血清ECP水平明显高于稳定期、缓解期及健康儿童,三者间比较,差异均具有统计学意义（P〈0.01）;哮喘患儿发作期IgE水平高于缓解期和健康儿童,差异均具有统计学意义（P〈0.01）;但与稳定期比较,差异无统计学意义（P〉0.05）。结论：ECP和IgE都可体现哮喘患儿的发病情况,但相比于IgE,ECP能更好地反映嗜酸性粒细胞的活化状态和气道炎症的发病情况。因此哮喘患儿血清ECP水平可作为诊断哮喘、判断病情发展状况及指导炎症治疗的可靠指标。     

支气管哮喘患者血清IL-10、IL-5和ECP的变化及其意义

目的 通过对支气管哮喘患者和正常对照组的血清IL-10, IL-5和 ECP水平的测定以及相互关系的研究,探讨它们在支气管发病中的作用.方法 应用Pharmacia UniCAP系统和ELISA方法分别测定支气管哮喘患者和正常对照组的血清E CP和IL-10、IL-5水平.结果 正常对照组和发作期的支气管哮喘患者的 ECP水平分别为(3.97±2.13) μg/L和(21.76±12.08) μg/L.正常对照组,支气管哮喘ECP 升高组和支气管哮喘ECP正常组的血清IL-5水平分别为(10.90±4.41) pg/mL,(20.62± 15.7 4) pg/mL和(9.24±7.16) pg/mL.正常对照组和支气管哮喘ECP升高组之间IL-5水平有显著差异(P＜0.01),正常对照组和支气管哮喘ECP正常组之间IL-5水平无差异(P＞0.05) ,支气管哮喘ECP正常组和ECP升高组之间IL-5水平有显著差异(P＜0.01),ECP与IL-5 明显相关 ,两者之间的相关系数r=0.465(P＜0.01).正常对照组,支气管哮喘ECP升高组和支气管哮喘ECP正常组的血清IL-10水平分别为(38.28±15.17) pg/mL,(22.76±15.25) pg/mL 和(42.32±14.61) pg/mL,支气管哮喘ECP正常组和ECP升高组之间IL-10水平有显著差异( P＜0. 01).结论 支气管哮喘的发生与嗜酸粒细胞有密切的关系,ECP和IL-5可反映嗜酸粒细胞的活化程度,在支气管哮喘发作时嗜酸粒细胞处于激活状态,易于释放蛋白颗粒;IL-5对嗜酸粒细胞有调控作用.支气管哮喘组的血清IL-10水平较正常对照组低,提示支气管哮喘患者IL-10分泌减少,不能有效抑制炎症或促炎症细胞因子的合成及释放,亦即不能有效抑制炎症反应,可能是导致或加重气道炎症的原因之一.     

Psychological stress affects response to sublingual immunotherapy in asthmatic children allergic to house dust mite

While the clinical and immunologic efficacy of sublingual immunotherapy (SLIT) in allergic diseases has been extensively demonstrated, some patients display a poor clinical response. Psychological stress has been shown to play a role in atopy and also to affect response to immunomodulating therapies such as vaccination with microbial antigens. This study addresses the possibility of response to SLIT being affected by psychological stress. Forty children with mild asthma caused by allergy to Dermatophagoides pteronyssinus and farinae were subjected to SLIT and then divided after 6 months into two groups based on the results of the stress integrated measure (SIM) test: group 1 (24 stressed patients, mean SIM value of 60.1) and group 2 (16 non-stressed patients, mean SIM value of 7.6). There was also a higher prevalence of psychosocial stressing factors (divorced/absent parents, low income households, non-working parents) among stressed patients. The symptom score, peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV(1)) and serum eosinophie cationic protein (ECP) concentration were evaluated at both times. The serum concentration of neuroendocrine parameters [prolactin, cortisol, adrenocorticotropic hormone (ACTH)] was also measured after 6 months of therapy. While all the clinical parameters and ECP concentration improved after SLIT, symptom score, PEF and ECP showed a significantly greater improvement in non-stressed patients. The concentration of neuroendocrine parameters was significantly increased in stressed patients. Our findings show that psychological stress can affect response to SLIT also in allergic subjects and are consistent with data recently reported showing a correlation between stress and poor response to antimicrobial vaccines. Our data also suggest that stress evaluation may become a useful prognostic factor in immunotherapy.     

过敏性紫癜患儿血清嗜酸细胞阳离子蛋白检测及意义

目的：探讨嗜酸细胞阳离子蛋白（ＥＣＰ）在过敏性紫癜（ＨＳＰ）中的作用。方法：应用ＰｈａｒｍａｓｉａＣＡＰＳｙｓｔｅｍＥＣＰＦＥＩＡ荧光酶标法测定４２例ＨＳＰ患儿血清ＥＣＰ水平。结果：急性发作期患儿血清ＥＣＰ水平显著高于正常对照组（Ｐ＜０００１），也显著高于经激素治疗缓解组（Ｐ＜０００１）；伴肾脏受累患儿血清ＥＣＰ明显高于无肾脏受累患儿（Ｐ＜００１）；而缓解组与对照组则差异无显著性。结论：ＥＣＰ参与了ＨＳＰ疾病的病理生理过程，血清ＥＣＰ测定对ＨＳＰ尤其是紫癜性肾炎临床诊断、病情评估及指导治疗有一定帮助     

Extracorporeal photopheresis in pediatric patients: Practical and technical considerations

In adults, extracorporeal photopheresis (ECP) is widely utilized for a variety of indications, most commonly cutaneous T‐cell lymphoma, acute or chronic graft‐versus‐host disease (GVHD), solid organ transplant rejection, and other autoimmune and T‐cell‐mediated disorders. In pediatric patients, the majority of case series and reports have focused on its use in the management of acute and chronic GVHD. Currently utilized ECP technologies were designed for adult patients and there are several challenges in adapting these technologies for use in children. In our review, we focus on practical considerations and procedural modifications for ECP use in pediatric patients, with special attention to patient safety.     

An alternative mini buffy coat preparation method for adult patients with extracorporeal photopheresis contraindications

Background : Extracorporeal photopheresis (ECP) is an important cell‐based therapy for various diseases but is limited to patients eligible for apheresis. We developed an alternative mini buffy coat (BC) preparation method using the Spectra Optia® apheresis system and compared its efficacy of white blood cell (WBC) recovery with the standard mini BC preparation method already established for pediatric patients. Methods : Whole blood (450 ± 45 mL) samples were collected from 30 randomly selected healthy volunteer blood donors and divided into two groups. In the first group, WBCs were separated with a fully automated separator device (Compomat G4^®). In the second group, BCs were separated with the bone marrow processing program of the Spectra Optia apheresis system. Results : There were no significant differences in total leukocyte counts per product between the two groups. In contrast, lymphocyte counts per product were significantly higher (P < 0.001) in BCs separated from apheresis. Conclusion : Our novel technique resulted in similar WBC yields but higher lymphocyte yields than the standard mini BC preparation method. This method can serve as an alternative to WBC collection in conventional ECP for adult patients with apheresis contraindications. J. Clin. Apheresis 32:12–15, 2017. © 2016 Wiley Periodicals, Inc.     

变应性鼻炎、哮喘患者血清嗜酸粒细胞阳离子蛋白水平的Meta分析

目的探讨变应性鼻炎、哮喘患者血清嗜酸粒细胞阳离子蛋白水平与正常人的差异。方法通过各种中文全文数据库全面检索国内已发表的相关文献,纳入符合选择标准要求的试验并进行Meta分析。结果Meta分析结果提示,儿童变应性鼻炎、哮喘患儿组较对照组升高0．87ug／L（95％可信区间0．63～1．11ug／L）,差异有统计学意义（P〈0．0001）：儿童急性发作组较缓解组升高8．02ug／L（95％可信区间7．62～8．42ug／L）,差异有统计学意义（P〈0．0001）。成人变应性鼻炎、哮喘患者组较对照组升高1．14ug／L（95％可信区间0．81～1．48ug／L,差异有统计学意义（P〈0．0001）;成人急性发作组较缓解组升高9．06ug／L（95％可信区间8．48～9．64ug／L）,差异有统计学意义（P〈0．0001）。结论变应性鼻炎、哮喘患者特别是急性发作期血清嗜酸粒细胞阳离子蛋白异常增高。     

Roles of angiopoietin-1 and angiopoietin-2 on airway microvascular permeability in asthmatic patients

BACKGROUND: Vascular endothelial growth factor (VEGF) increases microvascular permeability. Recently, considerable attention has been devoted to the physiologic roles of angiopoietin-1 and angiopoietin-2 as regulatory factors of VEGF. This study was designed to examine the roles of angiopoietin-1 and angiopoietin-2 in controlling airway microvascular permeability in asthma. METHODS: Levels of these angiogenic factors and airway vascular permeability index were examined in 30 asthmatics and 12 control subjects. After 2-week run-in period, all asthmatics were randomly assigned to receive fluticasone propionate (400 mug/d) or montelukast (10 mg) for 12 weeks. RESULTS: VEGF, angiopoietin-1, and angiopoietin-2 levels in induced sputum were significantly higher in asthmatics than in control subjects. We found an inverse correlation between angiopoietin-1 level and vascular permeability index in asthmatics, while there was a positive correlation between angiopoietin-2 level and that index. VEGF and angiopoietin-1 levels were significantly decreased after fluticasone therapy, while VEGF and angiopoietin-2 levels were significantly decreased after montelukast therapy. Although VEGF levels after treatment were different between two groups, vascular permeability index in the montelukast group was the same level as that in the fluticasone group. Moreover, improvement in vascular permeability index after fluticasone therapy was inversely correlated with decrease in angiopoietin-1 level, while that after montelukast therapy was positively correlated with decrease in angiopoietin-2 level. CONCLUSIONS: Angiopoietin-1 and angiopoietin-2 play complementary and coordinated roles in regulating microvascular permeability stimulated by VEGF in asthma. Combination of corticosteroids with leukotriene antagonists might effectively improve plasma leakage and provide a new strategy in treating bronchial asthma.