孟鲁斯特对哮喘模型IL-5mRNA和IL-5蛋白表达的影响

目的 探讨白三烯受体拮抗剂孟鲁斯特(MK)对哮喘小鼠IL-5mRNA、IL-5蛋白表达的影响。方法 采用原位杂交、免疫组化LSAB法,检测哮喘小鼠及孟鲁斯特治疗后哮喘小鼠骨髓细胞IL-5mRNA的表达及肺、骨髓、脾IL-5蛋白的表达情况。 结果 孟鲁斯特可显著减轻哮喘小鼠肺组织炎症细胞浸润、细支气管痉挛、粘液分泌等;亦可减少骨髓IL-5mRNA阳性细胞数(P<0.02),并使骨髓、肺、脾IL-5蛋白表达下降。 结论 白三烯受体拮抗剂孟鲁斯特不仅使肺部炎症显著减轻,也抑制骨髓细胞表达IL-5mRNA、IL-5蛋白,提示白三烯可能通过调节炎症细胞、细胞因子合成来应答过敏原反应。     

Anti-T-cell strategies in the treatment of allergic disease

Specific allergen immunotherapy (SIT) has been shown to be effective in modulating allergic responses in diseases such as rhinitis and asthma. However, the ability of whole allergen to cross link mast cell bound IgE, resulting in release of mediators such as histamine, has limited the application of this therapy to carefully selected patients who have failed conventional pharmacotherapy. The use of peptide sequences corresponding to T cell epitopes of the allergen has been postulated as an alternative to SIT in which high molar doses of T cell epitope can be delivered over a shorter time period and with improved safety. Using peptides from the sequence of the major cat allergen, Fel d 1, we have demonstrated the ability to induce transient T cell activation, resulting in isolated late asthmatic reactions, which are followed by prolonged periods of allergen-specific hyporesponsiveness, both to peptide re-challenge and to cutaneous challenge with whole allergen. Thus, peptide therapy may prove safe and efficacious in the treatment of allergic diseases.     

Effects of aerosol administration of a thromboxane receptor antagonist (S-1452) on experimental asthma in guinea pigs

The importance of thromboxane A₂(TXA₂), one of the arachidonate metabolites, in the pathogenesis of bronchial asthma has been emphasized recently. Because aerosolized administration of antiasthmatic drugs is effective and safe, this study examined the effect of aerosolized TXA-₂ receptor antagonist (S-1542) on allergic bronchoconstriction in passively sensitized and mechanically ventilated guinea pigs. Under the cover of antihistamine, antigen-induced bronchoconstriction was markedly inhibited by pretreatment with aerosolized S-1452 inhalation in a dose-dependent manner. Although aerosolized S-1452 itself provoked weak bronchoconstriction for its partial agonist effect, bronchial responsiveness to inhaled histamine did not change 10 min after S-1452 inhalation. These results indicate that aerosolized S-1452 may be useful in treating bronchial asthma.     

Cytokine pattern in allergic and non-allergic chronic rhinosinusitis in asthmatic children

BACKGROUND: Rhinosinusitis represents one of the most common chronic diseases. The association of rhinosinusitis with asthma has been frequently reported. Eosinophils and Th2 cells play a pathogenic mechanism in asthma. OBJECTIVE: The aims of the study were to evaluate the cytokine pattern in chronic rhinosinusitis in asthmatic children and to compare the findings in allergic vs. non-allergic asthmatics. METHODS: Thirty-five asthmatic children were evaluated, 19 males and 16 females, with an average age of 8.7 years. All children were asthmatic and suffered from chronic rhinosinusitis. Twenty were allergic and 15 were non-allergic. Ten healthy children were studied as normal controls. Evaluated parameters were the levels of the following cytokines: IL-1beta, IL-4, IL-6, IL-8, IL-12, IFN-gamma and TNF-alpha. Cytokines were recovered from rhinosinusal lavage and measured by immunoassays. Nasal cytology was also performed in all subjects and inflammatory cells were counted by conventional staining. RESULTS: Allergic subjects showed a significant increase of IL-4 (P < 0.01) and TNF-alpha (P < 0.05) and a significant decrease of IL-12 (P < 0.05) and of IFN-gamma (P < 0.0001), whereas IL-1beta, IL-6 and IL-8 were not significantly increased. Non-allergic children showed a significant increase of IL-4 (P < 0.05) and a significant decrease of IFN-gamma (P < 0.0001), IL-12 was not significantly decreased, and IL-1beta, IL-6 and IL-8 were not significantly increased. A significant inflammatory infiltrate was present in all asthmatic children. Significant correlations were demonstrated between IL-4 and IL-12 (P < 0.001), IL-12 and IFN-gamma (P < 0.001), IL-8 and neutrophils (P < 0.01), and TNF-alpha and monocytes/macrophages (P < 0.05), in allergic asthmatics. IL-4 and IL-12 were significantly correlated (P < 0.05) as well as IL-8 and neutrophils (P < 0.01) in non-allergic asthmatics. CONCLUSION: This study shows that allergic asthmatic children with chronic rhinosinusitis have a typical Th2 cytokine pattern, but also non-allergic asthmatic children share a similar pattern. These findings would suggest the existence of a common pathophysiological mechanism shared by upper and lower airways and are consistent with the concept of united airways disease.     

Medical treatment reverses cytokine pattern in allergic and nonallergic chronic rhinosinusitis in asthmatic children

A Th2 cytokine pattern has recently been reported both in allergic and nonallergic chronic rhinosinusitis in asthmatic children. The aim of the study was to evaluate the cytokine pattern in chronic rhinosinusitis in allergic and nonallergic asthmatic children before and after medical treatment. Thirty asthmatic children were evaluated, 18 males and 12 females (mean age 9.1 years). Sixteen were allergic and 14 were nonallergic. All children were asthmatic and suffered from chronic rhinosinusitis, whose diagnosis was confirmed by endoscopy. All of them were treated with amoxicilline-clavulanate (20 mg/kg b.i.d.) and fluticasone propionate aqueous nasal spray (100 µg daily) for 14 days; a short course of oral corticosteroid was also prescribed (deflazacort 1 mg/kg daily for 2 days, 0.5 mg/kg daily for 4 days and 0.25 mg/kg daily for 4 days). Rhinosinusal lavage and nasal cytology were performed in all subjects before and after medical treatment. IL4 and IFNγ were measured by immunoassay and inflammatory cells were counted by conventional staining. Thirteen allergic children and 12 nonallergic children showed a negative endoscopy after the treatment. Allergic subjects showed a significant decrease of IL4 (p = 0.0002) and a significant increase of IFNγ (p = 0.03) after the treatment. Nonallergic children showed a significant decrease of IL4 (p = 0.0007) and a nonsignificant increase of IFNγ. A significant reduction of the inflammatory infiltrate was detected in all asthmatic children (p < 0.05). This study confirms a Th2 polarization in chronic rhinosinusitis both in allergic and nonallergic asthmatic children. Moreover, the medical treatment of chronic rhinosinusitis reversed the cytokine pattern from a Th2 towards a Th1 profile both in allergic and nonallergic children.     

国产班布罗的平喘作用

目的　研究国产班布特罗的平喘作用。方法　采用豚鼠整体引喘法及兔肺溢流法。结果　班布特罗 (ig ,1 4、2 8、5 6mg·kg-1)同间羟叔丁肾上腺素作用相似 ,均具有平喘及松驰气管平滑肌的作用。结论　国产班布特罗具有明显的平喘作用     

中西医结合治疗支气管哮喘46例疗效观察

目的:观察中西医结合治疗支气管哮喘的临床疗效。方法:将92例患者随机分成治疗组与对照组各46例,2组均静滴抗生素,同时静滴氨茶碱,治疗组加服自拟祛痰平喘汤。结果:2组治疗2周后,治疗组治愈率为76.09%,对照组为47.83%。治疗组在平喘及减少复发次数方面优于对照组。2组比较,差异有显著性意义(p<0.05)。结论:中西医结合治疗本病能迅速改善症状,缩短病程,减少副作用发生,提高临床疗效。     

中西医结合治疗小儿喘息型支气管炎72例疗效观察

目的：探讨中西医结合治疗小儿喘息型支气管炎的临床疗效。方法：选取我院收治的72例喘息型支气管炎患儿，随机均分为对照组（传统西医治疗）和观察组（在对照组基础上加用定喘汤及支持调理治疗）。比较两组临床症状、体征消失时间、住院时间、治疗总有效率和不良反应发生率的差异。结果：观察组临床症状、体征消失时间和住院时间均显著短于对照组（P〈0.05）；观察组治疗总有效率显著高于对照组（P〈0.05）；两组患儿均无严重不良反应发生（P〈0.05）。结论：中西医结合治疗小儿喘息型支气管炎疗效确切。     

Respiratory Symptoms and Respiratory-Related Absence from Work among Health Care Workers in Sweden

Objective. To investigate respiratory symptoms and respiratory-related absence from work among Swedish health care workers (HCWs). Methods. From a postal questionnaire study among a general Swedish working population (n = 12,186), we identified 2156 HCW (555 assistant nurses, 377 nurses, 109 physicians, and 1115 others), including 429 with mainly cleaning tasks (HCW-cleaning). The remaining respondents were classified as non-HCW. Multiple logistic regressions with 95% confidence intervals (CIs) were used to compare respiratory symptoms and respiratory-related absence from work between HCW and non-HCW, adjusting for potential confounders. Results. The prevalence of adult onset asthma was 4.3% in HCW and 3.0% in non-HCW (p = .003). Asthmatic symptoms during the past year were reported mainly by HCW-cleaning, 14.7%, in comparison to 8.3% among non-HCW (p < .0001). HCW had an increased odds ratio (OR) for asthmatic symptoms during the past year (OR 1.3, 95% CI (1.1–1.5)) and more prominent among assistant nurses (OR 1.5, 95% CI (1.1–2.0)) and HCW-cleaning (OR 1.9, 95% CI (1.4–2.5)). Respiratory-related absence from work in the past year was reported by 1.4% of non-HCW, 3.0% of HCW-cleaning, 2.9% of nurses, and 1.6% of assistant nurses. Taking smoking and age into account, there was still significantly increased respiratory-related absence from work in nurses (OR 2.0, 95% CI (1.1–3.8)) and in HCW-cleaning (OR 2.1, 95% CI (1.2–3.7)). Conclusions. HCW in Sweden, especially those with cleaning tasks, reported more respiratory symptoms and respiratory-related absence from work than the general working population. There is a need for longitudinal studies with detailed information on both occupational exposures and socioeconomic factors to explore what influences respiratory-related absence from work among HCW.