ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00602.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00603.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00604.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00605.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryBackgroundAn increased nutnber of eosinophils in the bronchial mucosa has been demonstrated both in asthma and in exacerbations of chronic bronchitis.OiyectiveTo investigate whether the airway eosinophilia present in asthma and in chronic bronchitis during exacerbations is associated with interleukin (IL)‐5 protein expression in the bronchial mucosa.MethodsWe obtained bronchial biopsies in 18 subjects with asthma (four intrinsic, seven extrinsic and seven occupational) and in II subjects with chronic bronchitis examined during an exacerbation. The findings were compared wilh those of bronchial biopsies from 10 subjects with chronic bronchitis examined under baseline conditions and from seven normal subjects, taken as controls. By immunohistochemistry, we assessed the expression of IL‐5 protein and the number of eosinophils (EG2), mast cells ftryptase), and T‐lymphocytes (CD3) in the submucosa.ResultsAs compared with controls, the number of eosinophils was increased to a similar degree in both asthma (P<0.001) and in exacerbations of ehronic bronchitis (P<0.001). whereas the number of I L‐5 immunopositive cells was increased significantly only in asthma (P<0.01). No diflerences were observed in the number of tnast cells and T‐lymphocytes between the four groups of subjects examined.ConciusionsThis study shows that the degree of airway eosinophilia is similar in asthma and in exacerbations of ehronic bronchitis, but only in asthma is it associated with an increased expression of I L‐5 protein in the bronch

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00606.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryBackgroundThe imtnune responses which underlie the expression of allergic symptotns in childhood are believed lo be initiated in infancy and early childhood. The kinetics of this response have hardly been researched.ObjectiveTo analyse, in an environment with low house dust mite (HDM) exposure levels, the relationship between house dust mite (HDM)‐specific T‐cell reactivity as expressed byin vitroproliferation of blood mononuclear cells.MethodsThe study comprised a prospective analysis of patterns of allergen‐specific T‐cell reactivity in a cohort of 19 children, from whom blood samples were obtained in the spring during their second and third years of life. Blood mononuclear cell cultures were established in 200 μLAIM‐V serum free medium. Crude house dust mite (HDM) and purified Der p 1 and Der p 2 extracts were used at optimal concentrations, i.e. 100μg/mL for HDM and 30μg/mL for the purified allergens. Tetanus toxoid (0.5 μglrnL) and ovalbumin (10 μg/mL) served as positive controls. A clinical diagnosis of allergy was verified with skin‐prick tests. Dust samples were collected from a mattress and/or carpet or sofa in homes, day care centres and day care homes. Major mite allergen levels (Der p 1/Der f 1) in dust were analysed by an enzyme linked immunosorbent assay (ELISA).ResultsSpecific T‐cell responses were seen in the majority of the children against house dust mite (crude HDM extract. Der p 1 and Der p 2). The levels of the house dust mite allergens Der p 1 and Der f I were low, i.e.<0.68 μg/g fine dust in the homes of the children and the day care centres that they were attending. This indicates that doses of mite antigen well below the suggested sensitization threshold level of 2 μg/gdust can induce mite‐specific T‐cell responses in young children. None of them showed clinical reactivity to house dust mites as indicated by negative skin‐prick tests.ConclusionsThe findings suggest that active immunological recognition of environmental allergens and the ensuing initiation of allergen‐specific T‐cell responses, is a normal part of the ‘education’ of the immune system in early childhood and can occur even at very low exposure levels. Primingper sedoes not imply clinicall

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00607.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryBackgroundRaised peripheral blood mononuclear cells (PBMCs) proliferative responses to food allergens have been demonstrated in children with established atopic dermatitis.ObjectiveIn this report we investigate the PBMC proliferative responses to inhalant and food allergens from babies at birth, 6 months and 1 year of age, born to atopic and non‐atopic parents.MethodsPBMCs, separated by density gradient centrifugation. were cultured for 6 days with autologous plasma and a range of allergens (house dust mite [HDM], cat, grass pollen, tree pollen, betalactoglobulin and ovalbumin). Proliferative responses were measured by the uptake of [3H] thymidine added for the final 18 h of culture.ResultsAt birth, infants born to atopic parents who developed allergic disease by 1 year of age had significantly more positive responses (stimulation index ± 2 with a value of ± 1000 cpm above background) to HDM (P =0.0091), betalactoglobulin (P= 0.0166) and ovalbumin (P =0.0035) than newborns who did not develop allergy. Tnfants who developed allergy also had significantly more positive responses to HDM (P ‐0.03) and ovalbumin (P =0.0057) than babies, born to non‐atopic parents, who did not develop allergies. At 6 months of age a significant fall in response to HDM (P =0.003) and cat fur extract (P =0.006) was seen in infants who developed allergic disease by 1 year of age. A similar pattern was seen for proliferative responses to betalactoglobulin and ovalbumin (P =0.0006.P= 0.004). Conversely, proliferations to grass and tree pollen extracts increased at 6 months (P =0.04.P =NS) and 1 year (P= NS.P= 0.01) compared with birth which was significant for infants who did not develop allergic disease.ConclusionProliferative responses to seasonal allergens increased over the first year of life whilst those to perennial allergens, both inhalant and food, fell. This suggests either the induction of a systemic immune tolerance by perennial exposure to antigens or movement of sensitized cells to target organs where allergen exposure occurs. This process may be independent of the development allergic

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00608.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryBackgroundLung function tests, including forced expiratory volume in one second (FEV1), forced expiratory flow at 25–75% of vital capacity (FEF25–75%) and provocation concentrations of histamine which reduce FEV] by 20% (PC20), are used as indicators of airway form and function in bronchial asthma. Recently, markers of eosinophil activation in bronchial lavage and serum have been suggested as a measure of eosinophil mediated inflammation in the airways. These include eosinophil cationic protein (ECP), eosinophil protein X (EPX) (also known as eosinophil derived neuro‐toxin) and eosinophil peroxidase (EPO). Similarly, serum tryptase has been used as a marker of mast cell activation in systemic anaphylaxis.ObjectivesWe measured both sets of indices in a group of children with moderately severe asthma to assess the contribution of eosinophil and mast cell mediated events to airflow limitation and bronchial hyperresponsiveness.MethodsForty‐eight children aged 5–10 years had spirometric assessments, histamine challenges and blood sampling on the same occasion. After analysis of sera, the indices were compared.ResultsThe eosinophil markers ECP and EPX correlated very well with each other. They showed a moderate negative correlation with PC20for histamine. EPX was also found to negatively correlate with FEV, and FEF25–75%. Serum tryptase levels showed no such correlates with airway function.ConclusionThese results suggest that serum markers of eosinophil activation correlate with airway function in childhood asthma, and may be of value in assessing the severity of the disease. It further supports the notion that childhood asthma has a similar immunopathology to that occurring in adults, with predominance of eosinophil mediated i

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00609.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryOf 1218 children born on the Isle of Wight in 1989/90, and followed for atopy at age 4 years, 981 were skin‐prick tested witha battery of allergens. Of these 61 (6%) reacted positively toAlternaria alternataandCladosporium herbarum(47 toAlternaria, 21 toCladosporiumand seven to both). Twenty‐four (39%) were asymptomatic (latent atopy) of which 12 had a single positive reaction either toAlternariaorCladosporium. Asthma was the most common disease in children sensitized to moulds,Alternariasensitization correlated positively with clinical diagnosis of asthma (P<0.01), eczema (P<0.001) and rhinitis (P<0.05), Likewise,Cladosporiumsensitivity correlated with a diagnoses of asthma, eczema and rhinitis (allP<0.05). Age of the house correlated with reported damp and lack of central heating (bothP<0.001), but not with sensitization to moulds. An association between the presence of damp or age of the house and mould allergy was confounded by 21 children moving house in the first 4 years. Exposure to pets, passive tobacco smoking and season of birth had no bearing on mould sensitivity. At 4 years of ageAlternariaandCladosporiumwere the third most common causes of sensitization, i.e. after house dust mite and grass pol

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00610.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryBackgroundBronchoscopic bronchoalveolar lavage in children to investigate bronchia disorders such as asthtna has both ethical and procedural difficulties.ObjectiveThe aim of this study was to establish a standardized non‐bronchoscopic method to perform bronchoalveolar lavage in children attending for elective surgery to obtain normal cellular data.MethodsBronchoalveolar lavage was performed on normal children (n= 55) by infusing saline (20 mL) through an 8 FG suction catheter passed after endotracheal intubation. Oxygen saturation, heart and respiratory rate were monitored during the bronchoalveolar lavage procedure. Cellular analysis and total protein estimation of the lavage fluid were performed. Epithelial lining fluid volume was calculated (n =15) using the urea dilution method.ResultsThe procedure was well tolerated by all children. Total cell count and differential cell count for children (macrophages 70.8 ± 2.3%, lymphocytes 3.8 ± 0.6%, neutrophils 5,7 ± 1.0%, eosinophils 0.14 ± 0.03%. epithelial cells 19.6 ± 2.1%, mast cells 0.21 ± 0.02%) were similar to those reported for adults. Age and sex comparisons revealed no differences between groups. The mean total protein recovered in the cell free supernatant was 49.72 ± 4.29 mg/L and epithelial lining fluid volume was 0.82 ± 0.11% of return lavageate.ConclusionThis method allows bronchoalveolar lavage to be performed safely and quickly on children attending for routine elective surgery. Using this method and taking the ‘window of opportunity’ of elective surgery, the presence or absence of airway inflammation could be studied in children with various patterns of asthma during relatively asympto

ISSN:0954-7894    

DOI:10.1111/j.1365-2222.1996.tb00611.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY