Comparison of the effects of fluticasone propionate, aqueous nasal spray and levocabastine on inflammatory cells in nasal lavage and clinical activity during the pollen season in seasonal rhinitics

BACKGROUND: Treatment options for allergic rhinitis include antihistamines, decongestants, anticholinergics, cromolyn sodium and corticosteroids. As the nose is a small organ, comprising less than 1% of total body mass and surface area, it seems logical to confine treatment of rhinitis to the diseased organ. OBJECTIVE: To evaluate the effects of therapy with intranasal fluticasone propionate (FP), both on subjective symptoms and pathophysiological mechanisms, in rhinitis patients during pollen season when the patients were symptomatic. METHODS: We used a double-blind, placebo (PLA)-controlled, randomized, double dummy, parallel group study of the effect of 6 weeks treatment. The double-blind comparison was made between the following three treatments: FP aqueous nasal spray, 200 microg taken once daily, levocabastine (LEV) nasal spray, 200 microg taken twice daily and PLA nasal spray. Clinical evaluation and the levels of cells and mediators in nasal washing were performed before and after treatments. Twenty-four patients (11 men and 13 women, aged 17-50 years, mean age 30.1 +/- 8.5) with strictly seasonal allergic rhinitis to Parietaria entered the study. Clinical evaluation and the levels of inflammatory cells (eosinophils and activated eosinophils, i.e. EG2+) and their mediators (tryptase, eosinophil cationic protein, eosinophil protein X and neutrophil myeloperoxidase) in nasal-lavage were performed before and after treatments. RESULTS: Treatment with FP significantly increased, with respect to placebo, the percentage of days without sneezing (P < 0. 001), nasal blockage (P < 0.001), rhinorrhea (P < 0.001), nasal itching (P < 0.001). Furthermore, treatment with FP showed additional benefits with respect to LEV. The percentage of days without nasal blockage was significantly higher in the FP group that in the placebo group (P = 0.018). The same applied to rhinorrhea (P = 0.009). The percentages of days without sneezing and itching were instead not significantly different between the two groups. As expected, no significant differences were observed in baseline medians of the rhinitis symptom scores as well as in mean values of all mediators and eosinophils in nasal lavages of the various groups under study. After treatment the mean of subjective symptoms as well as all values in nasal lavage level fell significantly only in the FP group, whereas no significant changes were observed either in LEV or PLA groups. Accordingly, significant differences were observed at the end of the treatments between the values of fluticasone group vs LEV and PLA group values. Significant correlations between these values and symptom scores were found, according with literature data suggesting a pathogenetic role for these mediators and eosinophils in rhinitis. CONCLUSION: FP (200 microg once daily) affords a significant degree of improvement in rhinitis control during pollen season, as measured by subjective and objective parameters, compared with LEV (200 microg twice daily) and PLA. The therapeutic benefits of intranasal FP are reflected in, and may be caused by, the decrease in nasal inflammatory cells.     

Testosterone-induced changes in testicular antioxidant system

Summary. In order to investigate the role of testosterone propionate (TP) on the antioxidant system of the rat testis, lipid peroxidation (LPX) and activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) of the testis of testosterone-treated and control rats were compared. The results indicate that TP administration to intact adult rats resulted in a significant decline in protein content of various subcellular fractions. This is accompanied with significant elevation in LPX levels of various sub-cellular fractions suggesting induction of oxidative stress. Activities of three enzymes related to the metabolism of superoxide radical (SOD) and hydrogen peroxide (CAT and GPx) of testis, were found to be significantly decreased in response to TP treatment. The role of testosterone in regulating testicular spermatogenesis through oxidative stress is discussed.     

去势Beagle犬前列腺增生模型的建立

目的 :利用Beagle犬建立前列腺增生模型。　方法 :2年龄雄性Beagle犬 2 4只 ,随机分成对照组和 3个剂量的实验组共 4组 ,每组 6只 ,去势 2个月后 ,肌注给药。实验组分别给予丙酸睾酮 (TP) 0 .8、2 .5、7.5mg/kg ,对照组给予等体积溶剂。 2个月后 ,处死 12只动物 ,取前列腺组织 ,称重测量体积 ,放免法测定血清及前列腺组织中双氢睾酮 (DHT)水平 ,组织切片观察前列腺腺腔面积及腺上皮细胞高度。B超测量去势前、后 2个月及给予TP 2个月时犬前列腺体积。　结果 :B超结果显示 ,去势 2个月后 ,各组犬前列腺体积较去势前均明显缩小 (P均 <0 .0 1) ;给予TP 2个月后 ,各实验组犬前列腺体积明显大于对照组 (P均 <0 .0 1)。各实验组犬前列腺湿重及实际体积与对照组相比 ,均明显增重增大 (P均 <0 .0 5 ) ,并存在剂量依赖关系。犬血清及前列腺中DHT含量随TP剂量的增大而增加。显微图像分析结果显示 ,犬前列腺腺腔面积随TP剂量增大而增加 ,腺上皮细胞高度也随TP剂量增大而增高。　结论 :给予去势Beagle犬TP 2个月后 ,可成功建立前列腺增生模型。     

长期吸入丙酸氟替卡松对支气管哮喘患者肾上腺皮质功能的影响

目的　评价长期吸入丙酸氟替卡松 (FP)对哮喘患者肾上腺皮质功能的影响。方法非急性发作期支气管哮喘患者 80例 ,中度 42例 ,重度 38例。使用FP治疗前 1周为筛选期 ,测定早晨 8时血浆皮质醇。中度患者吸入FP气雾剂 50 0 μg/d ,重度患者吸入FP 750 μg/d。治疗期至少 1年以上。治疗结束时测定FEV1 %与PEF ,同时测定早晨 8时的血浆皮质醇。结果　吸入FP50 0 μg/d组治疗前、后早晨 8时血浆皮质醇值分别为 (1 0 8 5± 50 7) μg/L和 (1 0 3 8± 48 1 ) μg/L(P >0 0 5) ;吸入FP 750 μg/d组分别为 (1 0 2 4± 48 6) μg/L和 (1 0 0 5± 51 4) μg/L(P >0 0 5)。两组比较无显著性差异 (P >0 0 5)。两组患者吸入FP 1年后血浆皮质醇值均在正常范围内。结论　长期吸入FP 50 0 μg/d和 750 μg/d对于中、重度哮喘患者均可达到有效的治疗效果 ,而对肾上腺皮质功能无明显的抑制作用     

Biochemical profile of propionyl-L-carnitine

This article briefly discusses biochemical reactions involved in the metabolism of propionate, propionylCoA, and propionyl-L-carnitine in the heart. The aim is to understand the way in which propionyl-L-carnitine can exert a protective effect on the ischemic/reperfused heart. The protection of the plasmalemma by propionyl-L-carnitine during acidosis of the heart is also discussed. One protective mechanism is based on the ability of propionate to replenish mitochondria with dicarboxylic acid intermediates of the citric acid cycle and to increase the cellular content of carnitine, both of which may stimulate the generation of energy in the postischemic reperfusion phase. Another mechanism presumes a stabilizing action of acylcarnitines upon biomembranes.     

复方丙酸氯倍他索软膏联合UVB治疗寻常型银屑病的临床疗效及护理

目的探讨用复方丙酸氯倍他索软膏联合UVB照射，并配合护理措施治疗寻常型银屑病的临床疗效。方法治疗组于患处外涂复方丙酸氯倍他索软膏，每天2次，行UVB全身照射，1周2～3次，并配合适当的护理措施。对照组于患处外涂复方丙酸氯倍他索软膏，每天2次。根据PASI评分标准评价疗效。结果治疗组有效率88．46％，对照组有效率65．38％，经统计学处理，x^2=7．8000，P〈0．01；治疗组复发率19．05％，对照组复发率53．85％，经统计学处理，x^2=4．4472，P〈0．05。结论复方丙酸氯倍他索软膏联合UVB照射并配合适当的护理措施是治疗寻常型银屑病的有效方法。     

吸入糖皮质激素对哮喘儿童血清IgE的影响

Objective To discuss the significance of serum IgE before and after inhale glucocorticoid treat-ment of children's asthma. Methods 520 children with asthma were seleceted from the outpatient. Different type of fluticasone propionate were given to different age groups: Aerosol type by a spacer in less than 5 years old,and in-halant (Seretide) 5 years and the above. The dosage was between 200 μg/day to 375 μg/day. IgE was tested before and 3 months after the treatment. Results Serum IgE decreased significantly in 3 months treatment [ from (496.12±24.75) kU/L to (390.71±18.71) kU/L] (t=7.337,P<0.01). The change of IgE was related to clinical effect and age. The level increased in those less than 3 years [(307.05±34.71)kU/L vs (483.09±41.78) kU/L] (t=2.963,P=0.004),but decreased between 4 to 5 years old group [(543.46±51.03) kU/L vs (316.93±29.30) kU/L] (t=3.368,P=0.000) ,and decreased between 6 to 14 years old group[ (586.30±37.19)kU/L vs (387.61±27.60) kU/L] (t=4.827,P=0.000). In fluticasone group IgE level changed from (468.91±32.81) kU/L to (359.03±22.79) kU/L after treatment (t=5.988,P<0.01),which decreased from (586.30±37.19) kU/L to (387.6±27.60) kU/L in Salmeterol group (t=4.827,P<0.01). In 260 cases of IgE below 300 kU/L 109 cases (41.92%,109/260) increased while in 260 cases of IgE above 300 kU/L,total IgE lev-el increased in 45 cases (16.15% ,45/260) after treatment,with statistical significance(χ<'2>=37.789,P=0.000). Conclusion Inhale glucocorticoid can make the level of IgE decreased.     

Treatment with mPEG-SPA improves the survival of corneal grafts in rats by immune camouflage

We investigated the immune camouflage effects of methoxy polyethylene glycol succinimidyl propionate (mPEG-SPA) on corneal antigens and explored a novel approach for reducing corneal antigenicity, thereby decreasing corneal graft rejection. Importantly, this approach did not alter normal local immunity. Corneal grafts were treated with mPEG-SPA 5KD or 20KD (3% W/V), which could shield major histocompatibility antigen class I molecules (RT1-A) of corneal grafts. Skin grafts of Wistar rats were transplanted to SD rats. Then the splenic lymphocytes were isolated from SD rats. Subsequently, the lymphocytes were co-cultured with autologous corneal grafts or untreated corneal grafts and PEGylated grafts treated with mPEG-SPA 5KD or 20KD obtained from the counterpart skin donors, which were used as autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group, respectively. Lymphocyte proliferation was lower in mPEG-SPA 5KD group and mPEG-SPA 20KD group than in the allogeneic control. SD rats with corneal neovascularisation were used as recipients for high-risk corneal transplantation and were randomly divided into four groups: autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group. The recipients received corneal grafts from Wistar rats. Corneal graft survival was prolonged and graft rejection was reduced in the mPEG-SPA 5KD group and the mPEG-SPA 20KD group compared to the allogeneic control. Thus, we think that mPEG-SPA could immunologically camouflage corneal antigens to prolong corneal grafts survival in high-risk transplantation.     

经鼻吸入丙酸氟替卡松同步治疗儿童变应性鼻炎合并哮喘的临床观察

[目的]探讨采用面罩储雾罐方式给药,经鼻吸入丙酸氟替卡松气雾剂,同步治疗儿童变应性鼻炎合并哮喘的临床疗效及安全性。[方法]将80例中、重度变应性鼻炎合并轻、中度持续性哮喘的患儿随机分为实验组和对照组。实验组以面罩储雾罐经鼻吸入丙酸氟替卡松气雾剂(200μg/d);对照组经口吸入丙酸氟替卡松气雾剂(200μg/d)联合使用丙酸氟替卡松鼻喷雾剂(200μg/d)。之后进行鼻炎症状、儿童哮喘控制测试(C-ACT)评分,比较晨起呼气峰流速值(PEF,L/min)。[结果]经16周临床观察,实验组和对照组的鼻炎症状评分、哮喘症状评分均明显下降(F=71.22～277.41,P均<0.00),实验组和对照组的PEF均逐渐升高,治疗前后实验组差别有统计学意义(F=4.79,P<0.009),而对照组差别无统计学意义(F=1.49,P=0.19);不良反应比较,实验组鼻腔出血的发生数低于对照组(χ2=4.80,P<0.05),但激素使用量实验组仅为对照组的1/2。[结论]面罩式储雾罐经鼻吸入丙酸氟替卡松气雾剂可同时有效控制儿童变应性鼻炎和哮喘,并有依从性高、不良反应少的特点,激素使用剂量明显少于对照组,应用于轻、中度持续性哮喘合并变应性鼻炎患儿效果良好。