Effect of intranasal fluticasone proprionate on the immediate and late allergic reaction and nasal hyperreactivity in patients with a house dust mite allergy

Background Patients with perennial allergic rhinitis develop nasal symptoms not only after allergen exposure, but generally also after non-specific stimuli. Objective To evaluate the effect of 2 week's treatment with fluticasone propionate aqueous nasal spray (FPANS) on the nasal clinical response, inflammatory mediators and nasal hyperreactivity. Methods Twenty-four rhinitis patients allergic to house dust mite (HDM). participated in a douhle-blind. placebo-controlled crossover study. After 2 week's treatment with placebo or 200 μg FPANS twice daily, patients were challenged with HDM extract. Symptoms were recorded and nasal lavages were collected for up to 9.5 h after challenge. Nasal hyperreaclivity was determined by histamine challenge 24 h later. Results Because of a carry-over effect for the immediate symptom score, for this variable only the data from the first treatment period were used. FPANS treatment resulted in a significant decrease of nasal symptoms with 70%. 69% and 63% after 100. 1000 and 10000 Biological Units (BU)/mL of HDM extract respectively. Active treatment resulted in a 76% decrease of the late-phase symptoms. FPANS treatment significantly reduced albumin influx after HDM 1000 BU/mL with 62% and tended to reduce tryptase release after HDM 1000 BU ml. (P 0.0629). During the late phase FPANS treatment reduced albumin influx with 67% and eosinophil cationic protein (ECP) release with 83%. No effect of FPANS was seen on histamine levels. FPANS significantly decreased histamine-induced symptom score with 34%, secretion with 32%, and sneezes with 41%. Conclusion FPANS significantly inhibits the immediate and late allergic response, and nasal hyperreactivity, probably by suppressing mast cells and eosinophils in the nasal mucosa.     

INFLUENCE OF STEROID HORMONES ON PROLIFERATION OF PERIPHERAL BLOOD MONONUCLEAR CELLS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Sex steroids are believed to modulate the immune system in rheumatoidarthritis (RA). Since receptors for sex steroids are presenton T-lymphocytes, which are thought to play a major role inthe pathogenesis of RA, it is suggested that gonadal steroidscan mediate their immunomodulating effect directly on T-lymphocytes.Recently a specific method for activating T-lymphocytes withimmobilized anti-CD3 monoclonal antibodies was described. Weinvestigated the influence of oestradiol, progesterone, testosteroneand cortisol on lymphocytes stimulated by anti-CD3 mAb and PHAof postmenopausal women, comparing female patients with rheumatoidarthritis and age-matched control patients. The results showthat oestradiol, progesterone and testosterone do not influencelymphocyte proliferation when stimulated with anti-CD3 mAb orphytohaemagglutinin (PHA). Cortisol, however, can suppress lymphocyteproliferation even at physiological concentrations in both patientswith RA and controls. Inhibition of proliferation by cortisolis dose-related and has no significant correlation with RA diseaseactivity. This inhibition differs individually and might explainthe often variable response to corticosteroids in vivo. KEY WORDS: Rheumatoid arthritis, T-Lymphocyte, Oestradiol, Progesterone, Testosterone, Cortisol, PHA, Anti-CD3 mAb     

Population Dynamics of CD4+ T Cells Lacking Thy-1 in Murine Retrovirus-Induced Immunodeficiency Syndrome (MAIDS)

Increased numbers of CD4⁺ Thy-1 cells have been described in the spleen (SP) of mice with retrovirusinduced immunodeliciency (MAIDS). Since this phenotypic abnormality might have considerable functional importance, the expansion of the CD4⁺ Thy-1 subset in MAIDS was characterized further. CD4⁺ Thy-1⁻ and Thy-1⁺ T-cell is from infected mice expressed similar densities of CD3 and TCR γ/β. In contrast, the Thy-I⁻ subset was uniformly CD44^hi, even early in the disease when part of Thy-I⁺ cells were still CD44¹⁰. The emergence of CD4⁺ Thy-1⁻cells occurred first in SP and lymph nodes and was observed later in thymus. The important fraction ofCD4⁺ cells lacking Thy-1 normally present in Peyer's patches was only weakly modified. Despite the major expansion of the CD4⁺ Thy-1⁻ phenotype. the proliferating fraction was not higher in this subset than in CD4⁺ Thy-1⁺ cells from infeeted miee. Persistence after hydroxyurea administration was identical in both subsets, indicating similar mean cell lifespans. Taken together, these results show that the major expansion of CD4⁺ Thy-I⁻ T-cells in MAIDS is not ascribable solely to increased proliferation within this subset. Phenotypic analysis suggests that CD4⁺ Thy-I⁻ cells result from the differentiation of Thy-I⁺ cells induced by activation signals related to retroviral infection.     

Effect of lateral positioning on gastroesophageal reflux (GER) and underlying mechanisms in GER disease (GERD) patients and healthy controls

Background Posture has been shown to influence the number of transient lower esophageal sphincter relaxation (TLESRs) and gastroesophageal reflux (GER), however, the physiology explaining the influence of right lateral position (RLP), and left lateral position (LLP) is not clear. The aim of this study was to determine the influence of RLP and LLP on TLESRs and GERD after a meal in GER disease (GERD) patients and healthy controls (HC) while monitoring gastric distension and emptying. Methods Ten GERD patients and 10 HC were studied for 90 min (30 min test meal infusion, 30 min postprandial in either RLP or LLP (randomly assigned) and 30 min in alternate position). The study was repeated on a separate day in reverse position order. TLESRs, GER, and gastric emptying rate were recorded using manometry, multichannel intraluminal impedance, and ¹³C‐octanoate breath tests. Gastric distension was visualized by five serial gastric volume scintigraphy scans during the first 30 min. Key Results Gastroesophageal reflux, (GER) disease patients had increased numbers of TLESRs in RLP compared to LLP in the first postprandial hour [5 (4–14) and 4.5 (2–6), respectively, P = 0.046] whereas the number of TLESRs was not different in RLP and LLP [4 (2–4) and 4 (3–6), respectively, P = 0.7] in HC. Numbers of GER increased similar to TLESRs in GERD patients. In GERD patients, gastric emptying reached peak ¹³CO₂ excretion faster and proximal gastric distension was more pronounced. Conclusions & Inferences In GERD patients, TLESRs, GER, distension of proximal stomach, and gastric emptying are increased in RLP compared to LLP. This effect is not seen in HC.     

Nasal allergy to avian antigens

This study describes the case of a patient who developed symptoms of rhinoconjunctivitis on exposure to budgerigars and parrots. An IgE-mediated allergy to budgerigar, parrot and pigeon antigens was demonstrated using both in-vivo challenge tests (skin and nasal provocation tests) and in-vitro investigations (radio-allergo-sorbent test, histamine release test). The study shows that the development of nasal disease can be associated with allergy to avian antigens.     

Comparison of nasal responsiveness to histamine, methacholine and phentolamine in allergic rhinitis patients and controls

In a selected group of rhinitis patients with an IgE-mediated allergy to house dust mites the nasal response to insufflation of histamine chloride, methacholine and phentolamine was demonstrated to be higher than in a control group. With the methods used histamine chloride was better at discriminating between healthy subjects and patients than methacholine or phentolamine. This discrimination was shown by assessing the severity of reflex-mediated symptoms such as the number of sneezes and the amount of secretion, and not by differences in nasal airway resistance.     

A comparative study of flexible (Polyactive®) versus rigid (hydroxylapatite) permucosal dental implants. II. Histological aspects

summary Of the many materials that are applied in dental implantology, most have a high Young's modulus. In the concept of osseointegration, which is generally preferred, chewing forces are therefore directly transmitted from rigid implant materials to the relatively flexible surrounding bone. Polyactive® is an elastomeric polyethylene-oxide polybutylene-terephthalate (PEO:PBT) copolymer, with a low modulus of elasticity, that exhibits bone-bonding characteristics. Previous finite-element analysis emphasized the benefit of the application of flexible implant materials. To assess the validity of this finite element model, one dense and two porous types of flexible Polyactive® permucosal dental implants and one rigid hydroxylapatite (HA) implant were clinically tested in a beagle dog study and were compared during 30 weeks of loading. In an earlier report, it was concluded that dense Polyactive® implants function clinically adequately and resemble the mobility of natural teeth. In the current study, the amount of bone contact was quantitatively assessed. Polyactive® implants showed a statistically significantly higher bone contact, as compared to the HA implants, probably due to a significant water uptake and a subsequent increase in the volume of the denser Polyactive®. Morphological analysis, based on back-scatter electron microscopy and light microscopy, revealed little remodelling activity of the bone surrounding the Polyactive® implants. Few remodelling lacunae were seen and de novo bone formation was rarely observed. At some locations, a continuity between calcification zones with the polymer surface and the surrounding interfacial bone was observed, indicating the occurrence of bone-bonding. Also, the bone surrounding the HA implants showed little remodelling activity, although large resorption lacunae were observed, in which HA particles were present. Based on the observations of this study, flexible bone bonding implants might be more capable of transferring stresses to the surrounding bone and are therefore promising alternatives to ‘routine’ rigid implants.