Reduced expression of CD69 and adhesion molecules of T lymphocytes in asthmatic children receiving immunotherapy

T lymphocytes play a fundamental role in the initiation and regulation of chronic inflammatory responses in patients with asthma. CD69 is an early marker of T‐cell activation. The levels of intercellular adhesion molecule‐1 (ICAM‐1, CD54) and L ‐selectin have been reported to increase in patients with allergic diseases and asthma. The present study was therefore undertaken to investigate the expression of CD69, CD54, and L ‐selectin by T lymphocytes of children with asthma, before and after immunotherapy. Eighteen children newly diagnosed with asthma, 11 good and nine poor responders to immunotherapy, and 16 normal subjects, were enrolled in this study. The percentages of CD69⁺, CD54⁺, and CD62L⁺ cells in T lymphocytes were measured by using flow cytometry. The levels of CD69, CD54, and CD62L in serum and culture supernatants were determined by using enzyme‐linked immunosorbent assay (ELISA). The expression of CD69 and CD54 on CD3⁺ T lymphocytes was significantly higher in children with asthma than in control patients. All the patient groups expressed (spontaneously and following stimulation with phorbol myristate acetate and ionomycin together with mite‐extract proteins) greater amounts of CD69 and CD54 than did control subjects. With long‐term immunotherapy, the percentages of CD69⁺ and CD54⁺ T lymphocytes were significantly lower in patients with a good response to immunotherapy. Our results also showed significantly lower serum L ‐selectin levels following immunotherapy. In conclusion, successful immunotherapy resulted in decreased expression and production of CD69 and CD54. These results may explain, in part, the clinical efficacy of immunotherapy.     

脉冲振荡技术在儿童支气管舒张试验中的应用

目的：探讨脉冲振荡方法(IOS)在儿童支气管舒张试验中的应用及其与常规肺量计法结果的相关关系。方法：发作期的哮喘患儿同时应用两种方法做吸入支气管扩张剂前后肺功能测定，以FEV1改善≥15％判断为阳性，应用统计学处理对两种方法各指标作相关性分析。结果：IOS各指标舒张后改善明显，△Zrs、△R5与金标准△FEV1密切相关，经多元回归得出方程△FEV1=-1．527△Zrs 0．883△R5。结论：IOS法可以作为不能配合用力呼气动作的儿童行支气管舒张试验。     

Prevalence of occupational allergy due to live fish bait

BACKGROUND: Larvae of insects and worms, used as live fish bait (LFB), are a common source of allergy in anglers and occupationally exposed workers, but the prevalence and predictors have not yet been investigated. OBJECTIVE: This study assessed the prevalence and associated factors of occupational allergy in workers exposed to LFB. METHODS: We assessed the prevalence of sensitization to LFB and work-related symptoms (WRS) in 76 workers occupationally exposed to it. All workers completed a case history questionnaire and underwent skin prick tests (SPT) for common aeroallergens and bluebottle (Calliphora vomitoria), bee moth (Galleria mellonella), mealworm (Tenebrio molitor), and gusano rojo (Cilecomadia moorei). Specific IgE were tested in 64 subjects. Two-thirds of the workers had a high level of LFB exposure. RESULTS: Sensitization to LFB was found in 24 workers (31.6%). Seven subjects (9.2%) reported WRS (asthma in 3, rhinoconjunctivitis in 5, and contact urticaria in 1), and 5 were positive for SPT and serum IgE to one or more LFB extracts. One was also exposed to LFB while fishing. Sensitization to LFB extracts and WRS were strongly associated (Odds Ratio = 6.6, P < 0.05). The 7 subjects with WRS had been exposed longer than asymptomatic subjects with positive skin tests to LFB (P < 0.05). No differences in sex, age, smoking habit, duration or level of exposure, and atopy were detected in symptomatic or in sensitized subjects, compared with normal workers. CONCLUSION: Sensitization to LFB and WRS are relatively frequent in occupationally exposed workers. No associated factors of occupational allergy to LFB could be detected.     

安徽省农村居民哮喘病现况调查

本文通过对安徽省农村居民哮喘病的现况调查发现，哮喘病患病率为１．３３％，男性为１．４８％，女性为１．１９％；成人患病率为１．３４％，儿童为１．３２％。儿童哮喘患病率随年龄增长而下降，而成人哮喘病患病率随年龄增长而增加；儿童大部分婴幼儿起病，各年龄组中男性起病较女性晚，成人女性５０％起病２０岁前，而男性５０％起病３０岁前。农村哮喘以感染型为主，发病以冬季多见，发作主要诱因是感冒，哮喘病具有明显家族聚集性。     

胸导管引流对慢性哮喘病人外周血淋巴细胞内环核苷酸代谢的影响

观察7例慢性哮喘病人胸导管引流治疗前后外周血淋巴细胞内 cAMp/cGMP 值的变化。结果发现,慢性哮喘病人外周血淋巴细胞内 cAMP/cGMP 的值较正常人低(P<0.001);胸导管引流治疗后,哮喘病人外周血淋巴细胞内 cAMP/cGMP 值较治疗前升高(P<0.01)。提示,慢性哮喘病人外周血淋巴细胞功能异常、活性增强,这可能是哮喘发病的重要原因之一。胸导管引流引起的免疫抑制作用,一个重要的机理就是影响淋巴细胞内环核苷酸的代谢,而使淋巴细胞的活性降低,这可能也是胸导管引流治疗慢性哮喘的机理之一。     

地塞米松对哮喘豚鼠肺组织Giα、Gqα的抑制作用

目的　研究糖皮质激素对豚鼠哮喘模型肺组织G蛋白α亚族表达的影响。方法　 18只豚鼠随机分为正常对照组(NS) ,哮喘组 (AS)和地塞米松治疗组 (DEX)。AS组用卵蛋白皮下及腹腔注射致敏 ,卵蛋白重复雾化吸入激发复制豚鼠哮喘模型。DEX组在每次激发前腹腔内注射地塞米松 2mg/kg进行干预。用Westernblot分析法测定豚鼠肺组织G蛋白α亚族的表达水平。结果　三组豚鼠肺组织Giα水平分别为NS组 10 0 % ,AS组 (15 3± 18) % ,DEX组 (113± 18) % ,AS组与NS组比较、DEX组与AS组比较差别显著 (P <0 .0 5 )。三组豚鼠肺组织Gqα水平分别为NS组 10 0 % ,AS组 (15 1± 19) % ,DEX组 (98± 4 ) % ,AS组与NS组比较、DEX组与AS组比较差别显著 (P <0 .0 5 )。在同样的条件下Gsα水平无显著变化 (P >0 .0 5 )。地塞米松能够显著抑制哮喘豚鼠肺组织中Giα、Gqα的高表达。结论　肺组织Giα ,Gqα的高表达变化参与了豚鼠哮喘模型的病理性信号传导 ,抑制哮喘肺组织Giα、Gqα的高表达可能是糖皮质激素治疗哮喘的机制之一。     

Reduced levels of IgG subclasses and IgA in young children with asthma

Serum immunoglobulins including IgG subclasses were measured in 73 unselected children with asthma. The results showed that 22 (30%) had partial IgA and/or IgG₄ subclass deficiency. Clinical assessment showed that 21 children were infection-prone, and 52 were not. Further analysis showed that infection-prone children were significantly different from non-infection-prone children with regard to familial history of allergy (29% vs 60%, p = 0.015), elevated IgE (62% vs 33%, p = 0.021), IgA deficiency (38% vs 15%, p = 0.38) and IgG subclass deficiency (24% vs 4%, p = 0.018). These results suggest that there may be subgroups of children with asthma who are also immunodeficient.     

Menstrual-Linked Asthma

This study was conducted to determine the occurrence of menstrual-linked asthma (MLA) in India in 100 consecutive female asthmatics in the reproductive age group. The patients were required to respond to a questionnaire concerning the relationship between their asthma and the menstrual cycle. Twenty-three patients had subjective perception of deterioration in symptoms of asthma in relation to the menstrual cycle. Ten patients from both groups were also required to maintain a daily peak expiratory flow rate (PEFR) diary for 2 consecutive menstrual cycles. The mean total duration of illness in patients with MLA was significantly longer than in patients without cyclic exacerbation. Cough and breathlessness were also significantly more severe as was the disease. This was evidenced by the more frequent emergency room visits and hospitalizations in these patients. Menstrual-linked worsening of asthma was most common in the premenstrual week (17 patients). In 8 of these 17 patients, this phenomenon continued to occur during the menstrual week also. Interestingly, 1 patient complained of deterioration of asthma 2 days after menstruation was over. Such an observation is yet to be recorded. Fourteen patients reported an increase in symptoms with almost every cycle while 3 had worsening related to specific season only. Sixteen patients often required extra medication during the premenstrual and/or menstrual weeks. A significant association was also observed between severity of premenstrual syndrome and MLA. The mean PEFR values over 2 cycles revealed a significant fall in the morning as well as evening values in the premenstrual and menstrual weeks as compared to the midcycle week in patients with MLA. This fall was maximal in the premenstrual week. Such a fall was not observed in asthmatics without menstrual exacerbation of symptoms. MLA was detected in about a fourth of the female asthmatics in India and it appears to represent a more severe form of the disease. This study also documented that MLA was associated with an increase in airway resistance and was not simply due to an increased perception of symptoms during the premenstrual or menstrual weeks.     

肝素雾化治疗小儿哮喘性疾病的疗效观察

应用肝素雾化治疗小儿哮喘性疾病（包括以喘为主的支气管肺炎）１６例，其咳喘症状消失和肺部体征消失时间校对照组快，总显效率高。文中还就７例肝素雾化治疗前后血气结果对照，进一步阐述肝素雾化有利于改善通气功能，促进二氧化碳排出和炎症吸收，从而解除支气管痉挛的机理。具有疗效显著，安全可靠，无任何副作用的特点，值得临床推广应用。     

Visualization of left bronchial-to-coronary artery communication after distal bronchial artery embolization for bronchiectasis

We present a 44-year-old woman in whom a bronchialto-coronary artery communication via the conus branch was discovered after distal bronchial artery embolization with gelatin sponge for hemoptysis. If this bronchial-to-coronary artery anastomosis, not visible prior to embolization, had been inadvertently embolized, the patient could have developed a myocardial infarction. To reduce the likelihood of a serious complication, the possibility of this anastomosis should be kept in mind and angiography should be repeated before attempting proximal bronchial artery embolization.