July 20, 2013

Rhinitis patients with sputum eosinophilia show decreased lung function in the absence of airway hyperresponsiveness.

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Original Article  Open Access


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Allergy Asthma Immunol Res. 2013 Jul;5(4):232-238. English.
Published online 2013 May 03.  http://dx.doi.org/10.4168/aair.2013.5.4.232 
Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease
Rhinitis Patients With Sputum Eosinophilia Show Decreased Lung Function in the Absence of Airway Hyperresponsiveness
Min-Suk Yang,1,2,3 Hyun-Seung Lee,3 Min-Hye Kim,2,3 Woo-Jung Song,2,3 Tae-Wan Kim,4 Jae-Woo Kwon,5 Sae-Hoon Kim,2,3,6 Heung-Woo Park,2,3 Yoon-Seok Chang,2,3,6 Sang-Heon Cho,2,3 and Kyung-Up Min2,3
1Department of Internal medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.
2Department of Internal medicine, Seoul National University College of Medicine, Seoul, Korea.
3Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.
4Department of Internal Medicine, Korean Armed Forces Capital Hospital, Seongnam, Korea.
5Division of Allergy and Clinical Immunology, Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Korea.
6Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

 Correspondence to: Sang-Heon Cho, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-2971; Fax: +82-2-764-3954; Email:shcho@snu.ac.kr 
Received August 23, 2012; Revised November 13, 2012; Accepted December 04, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract

Purpose
Sputum eosinophilia is observed frequently in patients with rhinitis. Sputum eosinophilia in patients with non-asthmatic allergic rhinitis has been suggested to be related to nonspecific airway hyperresponsiveness (AHR). However, the clinical significance of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR has not been determined. We conducted a retrospective study examining the influence of sputum eosinophilia in patients with non-asthmatic rhinitis without AHR on pulmonary function and expression of fibrosis-related mediators.
Methods
Eighty-nine patients with moderate-to-severe perennial rhinitis without AHR were included. All underwent lung function tests (forced expiratory volume in 1 second [FEV1] and forced vital capacity [FVC]), skin tests to inhalant allergens, methacholine bronchial challenge tests, and hypertonic saline-induced sputum to determine eosinophil counts. Sputum mRNA levels for transforming growth factor-β (TGF-β), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) were also examined. Patients were divided into two groups according to the presence of sputum eosinophilia (≥3%, eosinophilia-positive [EP] and <3 eosinophilia-negative="" groups="" p="">
Results
FEV1 was significantly lower (P=0.04) and FEV1/FVC tended to be lower (P=0.1) in the EP group than in the EN group. In sputum analyses, the MMP-9 mRNA level (P=0.005) and the ratio of MMP-9 to TIMP-1 expression (P=0.01) were significantly higher in the EP group than in the EN group. There was no significant difference in TGF-β mRNA expression between the two groups.
Conclusions
Sputum eosinophilia in patients with moderate-to-severe perennial rhinitis without AHR influenced FEV1 and the expression pattern of fibrosis-related mediators.
Keywords: Sputumeosinophilrhinitisforced expiratory volumematrix metalloproteinase-9.

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Differential epigenome-wide DNA methylation patterns in childhood obesity-associated asthma


Differential epigenome-wide DNA methylation patterns in childhood obesity-associated asthma

Scientific Reports
 
3,
 
Article number:
 
2164
 
doi:10.1038/srep02164
Received
 
Accepted
 
Published
 

While DNA methylation plays a role in T-helper (Th) cell maturation, its potential dysregulation in the non-atopic Th1-polarized systemic inflammation observed in obesity-associated asthma is unknown. We studied DNA methylation epigenome-wide in peripheral blood mononuclear cells (PBMCs) from 8 obese asthmatic pre-adolescent children and compared it to methylation in PBMCs from 8 children with asthma alone, obesity alone and healthy controls. Differentially methylated loci implicated certain biologically relevant molecules and pathways. PBMCs from obese asthmatic children had distinctive DNA methylation patterns, with decreased promoter methylation of CCL5IL2RA and TBX21, genes encoding proteins linked with Th1 polarization, and increased promoter methylation of FCER2, a low-affinity receptor for IgE, and of TGFB1, inhibitor of Th cell activation. T-cell signaling and macrophage activation were the two primary pathways that were selectively hypomethylated in obese asthmatics. These findings suggest that dysregulated DNA methylation is associated with non-atopic inflammation observed in pediatric obesity-associated asthma.







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  1. Volcano plots comparing DNA methylation in obese asthmatics (OA) to (a).
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Introducing solid food: Age of introduction and its effect on risk of food allergy and other atopic diseases

Introducing solid food

Age of introduction and its effect on risk of food allergy and other atopic diseases

  1. Elissa Michele Abrams, MD FRCPC
  1. Senior Pediatric Allergy and Clinical Immunology Fellow at the University of Manitoba in Winnipeg.
  1. Correspondence: Dr Elissa Michele Abrams, Section of Allergy and Clinical Immunology, University of Manitoba, FE125-685 William Ave, Winnipeg, MB R3E 1B2; telephone 204 787-2470; e-mail umabrams@cc.umanitoba.ca
  1. Allan B. Becker, MD FRCPC

This Article

    1. Canadian Family Physicianvol. 59 no. 7721-722

July 19, 2013

TSE Diagnostics: Recent Advances in Immunoassaying Prions

Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 360604, 8 pages
http://dx.doi.org/10.1155/2013/360604
Review Article

TSE Diagnostics: Recent Advances in Immunoassaying Prions

Department for Production of Diagnostic Reagents and Research, Blood Transfusion Centre of Slovenia, Šlajmerjeva 6, 1000 Ljubljana, Slovenia
Received 15 March 2013; Revised 27 May 2013; Accepted 2 July 2013
Academic Editor: Benaissa El Moualij
Copyright © 2013 Anja Lukan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transmissible spongiform encephalopathies (TSEs) or prion diseases are a group of rare fatal neurodegenerative diseases, affecting humans and animals. They are believed to be the consequence of the conversion of the cellular prion protein to its aggregation-prone, β-sheet-rich isoform, named prion. Definite diagnosis of TSEs is determined post mortem. For this purpose, immunoassays for analyzing brain tissue have been developed. However, the ultimate goal of TSE diagnostics is an ante mortem test, which would be sensitive enough to detect prions in body fluids, that is, in blood, cerebrospinal fluid, or urine. Such a test would be of paramount importance also for screening of asymptomatic carriers of the disease with the aim of increasing food, drugs, and blood-derived products safety. In the present paper, we have reviewed recent advances in the development of immunoassays for the detection of prions.

Obesity and Asthma: Physiological Perspective

Journal of Allergy
Volume 2013 (2013), Article ID 198068, 11 pages
http://dx.doi.org/10.1155/2013/198068
Review Article

Obesity and Asthma: Physiological Perspective

Chest Research Foundation, Marigold Complex, Kalyani Nagar, Pune, Maharashtra 411014, India
Received 20 February 2013; Revised 27 May 2013; Accepted 3 July 2013
Academic Editor: Anurag Agrawal
Copyright © 2013 Bill Brashier and Sundeep Salvi. This is an open access article distributed under theCreative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Obesity induces some pertinent physiological changes which are conducive to either development of asthma or cause of poorly controlled asthma state. Obesity related mechanical stress forces induced by abdominal and thoracic fat generate stiffening of the lungs and diaphragmatic movements to result in reduction of resting lung volumes such as functional residual capacity (FRC). Reduced FRC is primarily an outcome of decreased expiratory reserve volume, which pushes the tidal breathing more towards smaller high resistance airways, and consequentially results in expiratory flow limitation during normal breathing in obesity. Reduced FRC also induces plastic alteration in the small collapsible airways, which may generate smooth muscle contraction resulting in increased small airway resistance, which, however, is not picked up by spirometric lung volumes. There is also a possibility that chronically reduced FRC may generate permanent adaptation in the very small airways; therefore, the airway calibres may not change despite weight reduction. Obesity may also induce bronchodilator reversibility and diurnal lung functional variability. Obesity is also associated with airway hyperresponsiveness; however, the mechanism of this is not clear. Thus, obesity has effects on lung function that can generate respiratory distress similar to asthma and may also exaggerate the effects of preexisting asthma.

July 18, 2013

Risk factor-dependent dynamics of atopic dermatitis: modelling multi-scale regulation of epithelium homeostasis

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Interface Focus. 2013 April 6; 3(2): 20120090.
PMCID: PMC3638487

Risk factor-dependent dynamics of atopic dermatitis: modelling multi-scale regulation of epithelium homeostasis

ABSTRACT

Epithelial tissue provides the body with its first layer of protection against harmful environmental stimuli by enacting the regulatory interplay between a physical barrier preventing the influx of external stimuli and an inflammatory response to the infiltrating stimuli. Importantly, this interdependent regulation occurs on different time scales: the tissue-level barrier permeability is regulated over the course of hours, whereas the cellular-level enzymatic reactions leading to inflammation take place within minutes. This multi-scale regulation is key to the epithelium's function and its dysfunction leads to various diseases. This paper presents a mathematical model of regulatory mechanisms in the epidermal epithelium that includes processes on two different time scales at the cellular and tissue levels. We use this model to investigate the essential regulatory interactions between epidermal barrier integrity and skin inflammation and how their dysfunction leads to atopic dermatitis (AD). Our model exhibits a structure of dual (positive and negative) control at both cellular and tissue levels. We also determined how the variation induced by well-known risk factors for AD can break the balance of the dual control. Our model analysis based on time-scale separation suggests that each risk factor leads to qualitatively different dynamic behaviours of different severity for AD, and that the coincidence of multiple risk factors dramatically increases the fragility of the epithelium's function. The proposed mathematical framework should also be applicable to other inflammatory diseases that have similar time-scale separation and control architectures.
Keywords: multi-scale modelling, epithelium, time-scale separation, atopic dermatitis, risk factors

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Anaphylaxislike cholinergic urticaria

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Can Fam Physician. 2013 July; 59(7): 745-746.
PMCID: PMC3710039

Anaphylaxislike cholinergic urticaria

Darío Antolín-Amérigo, MD
Physician in the Allergy Division at the Hospital Universitario Ramón y Cajal in Madrid, Spain.
Petruta Cristina Vlaicu, MD
Physician in the Allergy Division at the Hospital Universitario Ramón y Cajal in Madrid, Spain.
Belén De La Hoz Caballer, MD PhD
Physician in the Allergy Division at the Hospital Universitario Ramón y Cajal in Madrid, Spain.
Cholinergic urticaria (CU) can be defined as itching and whealing associated with exercise, hot showers, sweating, anxiety, or any other condition that increases the body’s core temperature. Cholinergic urticaria might present in a local or generalized form. The latter is characterized by the abrupt appearance of small wheals surrounded by a pronounced erythematous flare reaction beginning over the upper thorax and neck and subsequently spanning practically the entire body. Exercise-induced anaphylaxis should be ruled out.

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Acute treatment of anaphylaxis in children

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Can Fam Physician. 2013 July; 59(7): 740-741.
PMCID: PMC3710037

Acute treatment of anaphylaxis in children

Traitement d’urgence de l’anaphylaxie chez les enfants

Ran D. Goldman, MD FRCPC

Abstract

Question A 3-year-old was rushed to my office after eating a friend’s chocolate bar that contained nuts. He immediately developed urticaria on his face and swelling of his lips, and he had a persistent cough. What is the best treatment for a child with anaphylaxis? Should this family receive a prescription for an epinephrine autoinjector device?
Answer Intramuscular epinephrine injection is a safe and effective treatment of anaphylaxis in children. Children with systemic allergic reactions should carry epinephrine autoinjectors at all times, and should certainly have one with them at school. In order for epinephrine autoinjectors to be effective, children and their families need to be educated on how to properly use the devices, as well as keep in mind the product’s expiration date.

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