August 16, 2013

Diagnostic techniques for inflammatory eye disease: past, present and future: a review

Open Access
Review

Diagnostic techniques for inflammatory eye disease: past, present and future: a review

Stephen C Teoh12* and Andrew D Dick34
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BMC Ophthalmology 2013, 13:41 doi:10.1186/1471-2415-13-41
Published: 8 August 2013

Abstract

Investigations used to aid diagnosis and prognosticate outcomes in ocular inflammatory disorders are based on techniques that have evolved over the last two centuries have dramatically evolved with the advances in molecular biological and imaging technology. Our improved understanding of basic biological processes of infective drives of innate immunity bridging the engagement of adaptive immunity have formed techniques to tailor and develop assays, and deliver targeted treatment options. Diagnostic techniques are paramount to distinguish infective from non-infective intraocular inflammatory disease, particularly in atypical cases. The advances have enabled our ability to multiplex assay small amount of specimen quantities of intraocular samples including aqueous, vitreous or small tissue samples. Nevertheless to achieve diagnosis, techniques often require a range of assays from traditional hypersensitivity reactions and microbe specific immunoglobulin analysis to modern molecular techniques and cytokine analysis. Such approaches capitalise on the advantages of each technique, thereby improving the sensitivity and specificity of diagnoses. This review article highlights the development of laboratory diagnostic techniques for intraocular inflammatory disorders now readily available to assist in accurate identification of infective agents and appropriation of appropriate therapies as well as formulating patient stratification alongside clinical diagnoses into disease groups for clinical trials.
Keywords: 
Diagnosis; Uveitis; Ocular inflammation; Hypersensitivity; Polymerase chain reaction; Immunoglobulin; Cytokines; Autoimmunity; Autoregulation

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Different Genetic Associations of the IgE Production among Fetus, Infancy and Childhood

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PLoS One. 2013; 8(8): e70362.
Published online 2013 August 1. doi:  10.1371/journal.pone.0070362
PMCID: PMC3731352

Different Genetic Associations of the IgE Production among Fetus, Infancy and Childhood

Sunil K. Ahuja, Editor

Abstract

Elevation of serum IgE levels has long been associated with allergic diseases. Many genes have been linked to IgE production, but few have been linked to the developmental aspects of genetic association with IgE production. To clarify developmental genetic association, we investigated what genes and gene-gene interactions affect IgE levels among fetus, infancy and childhood in Taiwan individuals. A birth cohort of 571 children with completion of IgE measurements from newborn to 1.5, 3, and 6 years of age was subject to genetic association analysis on the 384-customized SNPs of 159 allergy candidate genes. Fifty-three SNPs in 37 genes on innate and adaptive immunity, and stress and response were associated with IgE production. Polymorphisms of the IL13, and the HLA-DPA1 and HLA-DQA1 were, respectively, the most significantly associated with the IgE production at newborn and 6 years of age. Analyses of gene-gene interactions indentified that the combination of NPSR1, rs324981 TT with FGF1, rs2282797 CC had the highest risk (85.7%) of IgE elevation at 1.5 years of age (P = 1.46×10−4). The combination ofIL13CYFIP2 and PDE2A was significantly associated with IgE elevation at 3 years of age (P = 5.98×10−7), and the combination of CLEC2DCOLEC11 and CCL2 was significantly associated with IgE elevation at 6 years of age (P = 6.65×10−7). Our study showed that the genetic association profiles of the IgE production among fetus, infancy and childhood are different. Genetic markers for early prediction and prevention of allergic sensitization may rely on age-based genetic association profiles.

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August 15, 2013

Manifestations of food protein induced gastrointestinal allergies presenting to a single tertiary paediatric gastroenterology unit.

Open Access
Original research

Manifestations of food protein induced gastrointestinal allergies presenting to a single tertiary paediatric gastroenterology unit

Rosan MeyerCatharine FlemingGloria Ortega-DominguezKeith LindleyLouise MichaelisNikhil ThaparMamoun ElawadVijay ChakravartiAdam T Fox and Neil Shah
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World Allergy Organization Journal 2013, 6:13 doi:10.1186/1939-4551-6-13
Published: 6 August 2013

Abstract (provisional)

Background

Food protein induced gastrointestinal allergies are difficult to characterise due to the delayed nature of this allergy and absence of simple diagnostic tests. Diagnosis is based on an allergy focused history which can be challenging and often yields ambiguous results. We therefore set out to describe a group of children with this delayed type allergy, to provide an overview on typical profile, symptoms and management strategies.

Methods

This retrospective analysis was performed at Great Ormond Street Children?s Hospital. Medical notes were included from 2002 ? 2009 where a documented medical diagnosis of food protein induced gastrointestinal allergies was confirmed by an elimination diet with resolution of symptoms, followed by reintroduction with reoccurrence of symptoms. Age of onset of symptoms, diagnosis, current elimination diets and food elimination at time of diagnosis and co-morbidities were collected and parents were phoned again at the time of data collection to ascertain current allergy status.

Results

Data from 437 children were analysis. The majority (67.7%) of children had an atopic family history and 41.5% had atopic dermatitis at an early age. The most common diagnosis included, non-IgE mediated gastrointestinal food allergy (n = 189) and allergic enterocolitis (n = 154) with symptoms of: vomiting (57.8%), back-arching and screaming (50%), constipation (44.6%), diarrhoea (81%), abdominal pain (89.9%), abdominal bloating (73.9%) and rectal bleeding (38.5%). The majority of patients were initially managed with a milk, soy, egg and wheat free diet (41.7%). At a median age of 8 years, 24.7% of children still required to eliminate some of the food allergens.

Conclusions

This large retrospective study on children with food induced gastrointestinal allergies highlights the variety of symptoms and treatment modalities used in these children. However, further prospective studies are required in this area of food allergy.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.


Nasally administered Lactobacillus rhamnosus strains differentially modulate respiratory antiviral immune responses and induce protection against respiratory syncytial virus infection

Open Access
Research article


Yohsuke TomosadaEriko ChibaHortensia ZelayaTakuya TakahashiKohichiro Tsukida,Haruki KitazawaSusana Alvarez and Julio Villena. 
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BMC Immunology 2013, 14:40 doi:10.1186/1471-2172-14-40
Published: 15 August 2013

Abstract (provisional)

Background

Some studies have shown that nasally administered immunobiotics had the potential to improve the outcome of influenza virus infection. However, the capacity of immunobiotics to improve protection against respiratory syncytial virus (RSV) infection was not investigated before.

Objective

The aims of this study were: a) to evaluate whether the nasal administration of Lactobacillus rhamnosus CRL1505 (Lr05) and L. rhamnosus CRL1506 (Lr06) are able to improve respiratory antiviral defenses and beneficially modulate the immune response triggered by TLR3/RIG-I activation; b) to investigate whether viability of Lr05 or Lr06 is indispensable to modulate respiratory immunity and; c) to evaluate the capacity of Lr05 and Lr06 to improve the resistance of infant mice against RSV infection.

Results

Nasally administered Lr05 and Lr06 differentially modulated the TLR3/RIG-I-triggered antiviral respiratory immune response. Lr06 administration significantly modulated the production of IFN-alpha, IFN-beta and IL-6 in the response to poly(I:C) challenge, while nasal priming with Lr05 was more effective to improve levels of IFN-gamma and IL-10. Both viable Lr05 and Lr06 strains increased the resistance of infant mice to RSV infection while only heat-killed Lr05 showed a protective effect similar to those observed with viable strains.

Conclusions

The present work demonstrated that nasal administration of immunobiotics is able to beneficially modulate the immune response triggered by TLR3/RIG-I activation in the respiratory tract and to increase the resistance of mice to the challenge with RSV. Comparative studies using two Lactobacillus rhamnosus strains of the same origin and with similar technological properties showed that each strain has an specific immunoregulatory effect in the respiratory tract and that they differentially modulate the immune response after poly(I:C) or RSV challenges, conferring different degree of protection and using distinct immune mechanisms. We also demonstrated in this work that it is possible to beneficially modulate the respiratory defenses against RSV by using heat-killed immunobiotics.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

S-Nitrosoglutathione Reductase Inhibition Regulates Allergen-Induced Lung Inflammation and Airway Hyperreactivity

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PLoS One. 2013; 8(7): e70351.
Published online 2013 July 25. doi:  10.1371/journal.pone.0070351
PMCID: PMC3723687

S-Nitrosoglutathione Reductase Inhibition Regulates Allergen-Induced Lung Inflammation and Airway Hyperreactivity

Padraic G. Fallon, Editor

Abstract

Allergic asthma is characterized by Th2 type inflammation, leading to airway hyperresponsivenes, mucus hypersecretion and tissue remodeling. S-Nitrosoglutathione reductase (GSNOR) is an alcohol dehydrogenase involved in the regulation of intracellular levels of S-nitrosothiols. GSNOR activity has been shown to be elevated in human asthmatic lungs, resulting in diminished S-nitrosothiols and thus contributing to increased airway hyperreactivity. Using a mouse model of allergic airway inflammation, we report that intranasal administration of a new selective inhibitor of GSNOR, SPL-334, caused a marked reduction in airway hyperreactivity, allergen-specific T cells and eosinophil accumulation, and mucus production in the lungs in response to allergen inhalation. Moreover, SPL-334 treatment resulted in a significant decrease in the production of the Th2 cytokines IL-5 and IL-13 and the level of the chemokine CCL11 (eotaxin-1) in the airways. Collectively, these observations reveal that GSNOR inhibitors are effective not only in reducing airway hyperresponsiveness but also in limiting lung inflammatory responses mediated by CD4+ Th2 cells. These findings suggest that the inhibition of GSNOR may provide a novel therapeutic approach for the treatment of allergic airway inflammation.

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Activation of Store-Operated Calcium Entry in Airway Smooth Muscle Cells: Insight from a Mathematical Model

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PLoS One. 2013; 8(7): e69598.
Published online 2013 July 25. doi:  10.1371/journal.pone.0069598
PMCID: PMC3723852

Activation of Store-Operated Calcium Entry in Airway Smooth Muscle Cells: Insight from a Mathematical Model

Laszlo Csernoch, Editor

Abstract

Intracellular An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e001.jpg dynamics of airway smooth muscle cells (ASMC) mediate ASMC contraction and proliferation, and thus play a key role in airway hyper-responsiveness (AHR) and remodelling in asthma. We evaluate the importance of store-operated An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e002.jpg entry (SOCE) in these An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e003.jpg dynamics by constructing a mathematical model of ASMC An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e004.jpg signaling based on experimental data from lung slices. The model confirms that SOCE is elicited upon sufficient An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e005.jpg depletion of the sarcoplasmic reticulum (SR), while receptor-operated An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e006.jpg entry (ROCE) is inhibited in such conditions. It also shows that SOCE can sustain agonist-induced An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e007.jpg oscillations in the absence of other An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e008.jpg influx. SOCE up-regulation may thus contribute to AHR by increasing the An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e009.jpg oscillation frequency that in turn regulates ASMC contraction. The model also provides an explanation for the failure of the SERCA pump blocker CPA to clamp the cytosolic An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e010.jpg of ASMC in lung slices, by showing that CPA is unable to maintain the SR empty of An external file that holds a picture, illustration, etc.
Object name is pone.0069598.e011.jpg. This prediction is confirmed by experimental data from mouse lung slices, and strongly suggests that CPA only partially inhibits SERCA in ASMC.

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The Presence of Asthma, the Use of Inhaled Steroids, and Parental Education Level Affect School Performance in Children


BioMed Research International
Volume 2013 (2013), Article ID 762805, 7 pages
http://dx.doi.org/10.1155/2013/762805
Research Article

The Presence of Asthma, the Use of Inhaled Steroids, and Parental Education Level Affect School Performance in Children

1Michalinio Pediatric Development Centre, Ministry of Employment, Athens, Greece
2Respiratory Unit, Department of Pediatrics, Academic General Hospital of Alexandroupolis, Dragana, Alexandroupolis, Thrace, Greece
3Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi, Greece
4Department of Statistics and Actuarial-Financial Mathematics, University of the Aegean, Samos, Greece
5Respiratory Department, General Hospital of Athens “ELPIS,” Athens, Greece
Received 22 April 2013; Accepted 17 June 2013
Academic Editor: Oscar Palomares
Copyright © 2013 A. Tsakiris 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

Objective. Childhood asthma is a frequent cause of absenteeism that affects school performance. We aimed to investigate the impact of asthma on absenteeism and school performance level of elementary and high school students. Methods. Data about sociodemographics, absenteeism, and academic achievement were obtained from 1539 students attending 98 schools in Greece. School performance was assessed for the last two years of school attendance using parents’ and teachers’ reports and grade point average promotion. Results. The mean of the days of absence of students with asthma was higher compared to the healthy students (6.2 ± 11.7 versus 0.3 ± 3.1, resp., ). Students with reduced healthcare use presented less absenteeism than those with increased healthcare use for asthma (4.3 ± 8.6 versus 12.4 ± 17.0 days, resp., ). Asthma and healthcare use for asthma accounted for an overall estimated variability in absence days of 13.8% and 9%, respectively. Absenteeism was associated with poor school performance for the last two years of school () and with lower grade point promotion in elementary school students () but not in high school students (). Higher level of parental education was associated with better school performance (). Asthma was associated with a decreased possibility for excellent performance (OR = 0.64, , 95%CI = 0.41–1.00) in elementary students. Students with asthma using inhalers were four times more likely to perform excellently in elementary school (OR = 4.3, , 95%CI = 1.17–15.95) than their asthmatic peers with alternative asthma treatments. Conclusions. Asthma and increased healthcare use enhance school absenteeism. Inhaled steroid use and the higher parental education level were the most important predicting factors for good school performance in elementary school asthmatic children.