Anti-Inflammatory CDGSH Iron-Sulfur Domain 2: A Biomarker of Central Nervous System Insult in Cellular, Animal Models and Patients

Spinal cord injury (SCI) promotes brain inflammation; conversely, brain injury promotes spinal neuron loss. There is a need to identify molecular biomarkers and therapeutic targets for central nervous system (CNS) injury. CDGSH iron-sulfur structural domain 2 (CISD2), an NF-κB antagonist, is downregulated after injury in vivo and in vitro. We aimed to examine the diagnostic value of CISD2 in patients with CNS insult. Plasma and cerebrospinal fluid (CSF) CISD2 levels were decreased in 13 patients with CNS insult and were negatively correlated with plasma IL6 levels (associated with disease severity; r = −0.7062; p < 0.01). SCI-induced inflammatory mediators delivered through CSF promoted mouse brain inflammation at 1 h post-SCI. Anti-CISD2 antibody treatment exacerbated SCI-induced inflammation in mouse spine and brain. Lipopolysaccharide-stimulated siCISD2-transfected EOC microglial cells exhibited proinflammatory phenotypes (enhanced M1 polarization, decreased M2 polarization, and increased intranuclear NF-κB p65 translocation). Plasma and CSF CISD2 levels were increased in three patients with CNS insult post-therapeutic hypothermia. CISD2 levels were negatively correlated with plasma and CSF levels of inflammatory mediators. CISD2 inhibition and potentiation experiments in cells, animals, and humans revealed CISD2 as a biomarker for CNS insult and upregulation of CISD2 anti-inflammatory properties as a potential therapeutic strategy for CNS insult.

In vitro anti-microbial and in vivo cytokine modulating effects of different prepared Chinese herbal medicines

The toxicity, antimicrobial and cytokine modulating effects of herbal medicines in treating periodontal diseases were evaluated in this study. Using the broth dilution method and disc agar diffusion test, in individual and combined decocted preparations, different concentrations of Ching-Wei-San and its individual herbal components, Coptidis rhizoma, Angelicae sinensis radix, Rehmanniae radixet rhizom, Moutan radicis cortex, and Cimicifuga foetida, were tested for in vitro inhibitory effects on three well-known plaque-causing bacteria, Porphyromonas gingivialis, Streptococcus sanguis, and Streptococcus mutans, and two common pathogens, Staphylococcus aureus and Escherichia coli. The cytokine modulating effects were evaluated in Balb/c mice. The results suggested that one milliliter Ching-Wei-San at the 25,000 mg/mL concentration daily for the mice had significantly high levels in the liver function indexes in the 3-day acute toxicity test and in both the liver and kidney function indexes in the 28-day subacute toxicity test (P<0.01). The 250 mg/mL Ching-Wei-San is comparable to 250 mg/mL of tetracycline, and had similar inhibitory effects on the tested bacteria. Coptidis rhizoma (62.5 mg/mL) was the only individual herbal component to show 100% inhibitory effects. The mean cytokine ratios of IL-2, IL-4, IFN-gamma, and TNF-alpha in Balb/c mice treated with individual herbal components were shown to be different from each other. Ching-Wei-San modulated the immunity of mice, up-regulated IL-2, IL-4 and TNF-alpha, but down-regulated IFN-gamma. The effects of none of the individual herbal components alone can substitute for the cumulative effect of Ching-Wei-San.

Child-rearing antecedents of intergenerational relations in young adulthood: a prospective study

Data gathered from mothers on parenting and family climate when almost 1,000 children in the Dunedin, New Zealand, longitudinal study were 3, 5, 7, 9, 13, and 15 years of age were used to predict intergenerational relations between young adult children (age 26) and their middle-aged parents. Analyses focused on distinct developmental epochs revealed greater prediction from the middle-childhood and early-adolescent periods than from the early-childhood years: most indicated that more supportive family environments and child-rearing experiences in the family of origin forecasted more positive and less negative parent-child relationships (in terms of contact, closeness, conflict, reciprocal assistance) in young adulthood, though associations were modest in magnitude. Some evidence indicated that (modestly) deleterious effects on intergenerational relations of experiencing relatively unsupportive child-rearing environments in 1 but not 2 (of 3) developmental periods studied could be offset by relatively supportive family environments in the remaining developmental periods.

Child-rearing antecedents of intergenerational relations in young adulthood: a prospective study

Data gathered from mothers on parenting and family climate when almost 1,000 children in the Dunedin, New Zealand, longitudinal study were 3, 5, 7, 9, 13, and 15 years of age were used to predict intergenerational relations between young adult children (age 26) and their middle-aged parents. Analyses focused on distinct developmental epochs revealed greater prediction from the middle-childhood and early-adolescent periods than from the early-childhood years: most indicated that more supportive family environments and child-rearing experiences in the family of origin forecasted more positive and less negative parent-child relationships (in terms of contact, closeness, conflict, reciprocal assistance) in young adulthood, though associations were modest in magnitude. Some evidence indicated that (modestly) deleterious effects on intergenerational relations of experiencing relatively unsupportive child-rearing environments in 1 but not 2 (of 3) developmental periods studied could be offset by relatively supportive family environments in the remaining developmental periods.

Dietary fat reduction strategies used by a group of adults aged 50 years and older

OBJECTIVE

To investigate the fat-reduction strategies used by a group of older adults who successfully made and maintained positive dietary changes for 5 years or longer.

DESIGN

Participants completed 2 copies of a self-administered food frequency questionaire: The first copy assessed diet before they began making changes and the second copy assessed diet after initiation of healthful dietary changes. Positive food changes were identified from the food frequency questionnaires. During in-person interviews, participants placed food changes onto a time line according to the nearest estimated date of initiation of the change.

SUBJECTS

Participants were 65 free-living older adults (aged >50 years) who had maintained substantial changes to decrease fat intake in their diet for at least 5 years. Statistical analyses performed Quantitative and qualitative data were used to identify the fat-reduction strategies and to confirm and validate the fat-reduction strategy model. Confirmatory factor analysis was performed to confirm the new model. The Kuder-Richardson-20 reliability coefficient (kr) was used to determine internal consistency of the scales developed for the study.

RESULTS

The majority of participants decreased their fat intake gradually, at different time points in their lives, and over a long period of time (5 to 43 years). Mean percent energy intake from fat decreased from 44.3 +/- 5.9% before dietary improvement to 25.9 +/- 7.1% at the time of the study. The final model consisted of 5 fat-reduction strategies with 63 food changes. The strategies were: increase summer fruits (4 items; kr=0.66), increase vegetables and grains (14 items; kr=0.79), decrease recreational foods (14 items; kr=0.76), decrease cooking fat (20 items; kr=0.86), and use fat-modified foods (11 items; kr=0.80).

APPLICATIONS/CONCLUSIONS

Dietetics professionals should base their advice on the dietary strategies used by consumers rather than hypothetical premises such as food or nutrient groupings. Nutrition education interventions will have better chances for success if they are based on a set of customized programs that guide appropriate consumer segments through a series of small, comfortable, and sustainable dietary changes over a prolonged period of time.

Development of a totally implantable pulsatile centrifugal pump as a ventricular assist device

The Taita No. 1 ventricular assist device (T-VAD) is a totally implantable pulsatile impeller centrifugal pump driven by a magnetically suspended motor. The flow can achieve 2.01 +/- 0.17 L/min against a pressure of 100 mm Hg under 0.266 +/- 0.017 amp and 13.55 +/- 0.41 voltage. The speed was around 3,500 rpm. It consumed less than 6 W of power, resulting in less heat production and mechanical bearing complications. The impeller vane was designed to have both radial and axial curves according to the stream surface and stream lines to reduce thrombosis and hemolysis. Eight calves weighing 80 to 100 kg (mean 87 +/- 12 kg) were used for experiments. With the calves under general anesthesia, left posterolateral thoracotomy was performed to connect the inflow tube with the atrial appendage and to anastomose the outflow tube with the descending aorta. The calves usually awoke and stood up within hours after discontinuation of anesthetics. The mean survival of the calves was 75 +/- 42 days (range 33-148 days). The terminations of experiments were mainly due to infection. During the course of pumping, no significant deterioration of liver or renal function was noted. The evaluation of serum samples from the implanted calves indicated that hemolysis was not associated with use of the T-VAD. The average daily free hemoglobin level was 8.08 +/- 3.05 mg/dl, which was less than the set limit of 20 mg/dl. The red blood cell and platelet count and hemoglobin of implanted animals were within the normal range. In our results, the T-VAD provided competent pulsatile function without severe blood damage or organ dysfunction.

Growth of endothelial cells on different concentrations of Gly-Arg-Gly-Asp photochemically grafted in polyethylene glycol modified polyurethane

To improve endothelial cell adhesion and growth on the surface of polyethylene glycol modified polyurethane (PU-PEG), cell adhesive peptide Gly-Arg-Gly-Asp (GRGD) was photochemically grafted to the surface. The surface grafted GRGD-N-Succinimidyl-6-[4'-azido-2'-nitrophenylamino]hexanoate (SANPAH) on a PU-PEG surface was performed by adsorption and subsequent ultraviolet irradiation. Fourier transform infrared spectra (FTIR) and electron spectroscopy for chemical analysis (ESCA) confirmed the GRGD grafted to form a PU-PEG-GRGD surface. The composition fraction of nitrogen calculated from ESCA analysis for the PU-PEG-GRGD surface was well correlated with the concentration of GRGD to be immobilized. Human umbilical vein endothelial cells (ECs) were well adhered and growing on the PU-PEG-GRGD surface. Moreover, the viability of ECs growing on PU-PEG-GRGD surfaces, analyzed by MTT test, was also well correlated with the GRGD concentrations immobilized on the surface. With photochemical techniques, we could manipulate different contents of GRGD to form multiple regions of PU-PEG-GRGD surface that could enhance the growth of ECs on the surface, and the enhancement efficiency was well correlated with GRGD contents.

Evaluation of Th1/Th2 ratio and cytokine production profile during acute exacerbation and convalescence in asthmatic children

BACKGROUND

Th2-type cytokines, such as IL-4 and IL-5, are generally believed to play an important role in the pathogenesis of allergic asthma. In contrast, Th1-type cytokine, especially interferon (IFN)-gamma, is thought to have a downregulatory effect on Th2 immune response cells. Thus, the imbalance of Th1 and Th2 cells may be a key factor in relation to disease severity.

OBJECTIVE

The aim of this study is to examine the changes in the Th1/Th2 ratios and cytokine production profiles of asthmatic children at acute attacks and convalescent stages.

METHODS

Twelve asthmatic patients were included in this study. The percentages of IFN-gamma- or IL-4-producing cells were determined with a flow-cytometric method of intracellular protein detection. Fresh whole blood obtained from normal controls and patients at two stages was stimulated with brefeldin A, phorbol myristate acetate, and ionomycin for 4 hours. Cells were fixed and stained intracellularly with fluorescein isothiocyanate- or phycoerythrin-conjugated antibody specific to each cytokine in combination with anti-CD4. ELISA assays were applied to measure cytokine concentrations of supernatant from peripheral blood mononuclear cells (PBMC) activated with phorbol myristate acetate and ionomycin for 24 hours.

RESULTS

Among CD4+ cells, the percentage of IL-4+ cells decreased significantly from 8.18 +/- 4.77% at acute attacks to 4.18 +/- 1.26% (P < .020) at convalescence. The percentage of IFN-gamma+ cells also decreased from 13.49 +/- 4.21% to 9.03 +/- 5.42% (P < .052). The Th1/Th2 ratios of patients at the two stages were similar, and both were lower than the normal controls. Significantly higher IL-5 and lower IFN-gamma production were detected from activated PBMC of asthmatic patients than normal controls.

CONCLUSIONS

The decrease of IFN-gamma+ and IL-4+ cells detected at the single-cell level may explain the potential mechanism of convalescence from acute asthma attacks. High Th1/Th2 ratio and low IL-5 production from the PBMC of normal controls support the idea of a biased Th2 immune response in asthmatic patients.

Exposure to a high concentration of mite allergen in early infancy is a risk factor for developing atopic dermatitis: a 3-year follow-up study

The cause of allergy is multi-factorial, and the development of an allergic disease seems to be the result of an interaction between genetic and environmental factors. The goal for preventing the development of allergic diseases is to avoid sensitization to allergens. The aim of this work was to study whether or not exposure to environmental allergens early in infancy would influence the occurence of various allergic diseases in later life. On an annual basis, a total of 931 healthy newborns were followed-up until they reached 3 years of age. The occurence of allergic diseases was recorded by trained medical students during visits. Measurement of Dermatophagoides pteronyssinus (Der p 1) concentration in house dust was performed when each baby was 18 and 36 months old. Total and specific immunoglobulin E (IgE) antibodies against Der p 1, cow's milk, and egg white were evaluated at birth and at 18 months of age. The following results were obtained: at 3 years of age, 10.4% had bronchial asthma (BA), 21.4% atopic dermatitis (AD), 7.0% urticaria, and 46.8% had experienced wheezing; higher family allergy scores led to a higher incidence of AD (p=0.0012); exposure to a mite allergen concentration of 1 microg/g of dust may be associated with a higher incidence of AD (p=0.0156); the presence of Der p 1 IgE antibody at 18 months of age was associated with a higher incidence of BA (p=0.0001); and children sensitized to egg whites at 18 months of age had an increased risk of developing AD at 3 years of age (p=0.0187). Hence, early exposure to mite allergen is a risk factor for the development of atopic dermatitis, but seems not to be related to the development of bronchial asthma. Early sensitization to egg whites increases the risk of developing AD. The early detection of serum Der p 1 IgE antibody is associated with a higher incidence of bronchial asthma.

Testing a core emotion-regulation prediction: does early attentional persistence moderate the effect of infant negative emotionality on later development?

To test the hypothesis that early attentional persistence will moderate the effect of infant negative emotionality on social competence, problem behavior, and school readiness at age 3, data collected as part of the NICHD Study of Early Child Care were subject to structural equation modeling analyses (N = 1,038). Consistent with Eisenberg et al.'s data on older children, high levels of negative emotionality were associated with low levels of social competence only when attentional persistence was poor. No such moderating effects of attentional persistence emerged in the case of behavior problems. And in the case of school readiness, findings indicated that high levels of negative emotionality predicted high levels of school readiness when attentional persistence was high, a result opposite to that found with respect to the prediction of social competence.

HLA DPB1*0201 allele is negatively associated with immunoglobulin E responsiveness specific for house dust mite allergens in Taiwan

BACKGROUND

House dust mite (HDM) Dermatophagoides pteronyssinus is the most important source of indoor allergens that cause allergic diseases in Taiwan. We prepared purified HDM allergens (Der p 1, Der p 2 and Der p 5) to detect allergen-specific immunoglobulin (Ig) E responsiveness among a large number of test subjects. The robust genetic typing system for HLA class II genes also facilitated the study on association of HLA and allergic response toward HDM.

OBJECTIVE

This study intended to investigate the association between HLA class II alleles and the IgE responsiveness to the major allergens from HDM, D. pteronyssinus.

METHODS

Two hundred and forty-eight subjects were selected for HLA association study. Plasma HDM allergen (Der p 1, Der p 2, Der p 5) -specific IgE and Der p 2-specific IgG antibodies were detected by ELISA, while HLA class II -DRB1, -DQA1, -DQB1, -DPB1 genetic polymorphism was determined by polymerase chain reaction/sequence-specific oligonucleotide probe hybridization (PCR/SSOPH). Statistical comparison of the allelic distribution of each HLA class II genes among the individuals with/without HDM allergen-specific IgE and IgG antibodies were performed.

RESULTS

There was no significant association between HLA DRB1, DQB1, DQA1 alleles and HDM-specific IgE responsiveness noted. Only DRB1*0803 and the linked DQA1*0103 alleles showed positive association with Der p 5-specific IgE responsiveness. However, we found that HLA-DPB1*1301 predisposed subjects to IgE responsiveness to HDM Der p 5. HLA DPB1*0501 was weakly associated with the IgE responsiveness to HDM Der p 1 and Der p 5. There was a strong negative association between the HLA-DPB1*0201 allele with IgE responsiveness to Der p 1 (OR: 0.30, P </= 0.0001, P </= 0.0007, Pc </= 0.010).

CONCLUSION

We clearly observed the association between HLA DPB1 alleles and specific IgE responsiveness to HDM major allergens. The molecular mechanism of HLA-DPB1*0201 involvement in protecting subjects from HDM-specific IgE responsiveness awaits further investigation.

Changes of serum levels of interleukin-2, intercellular adhesion molecule-1, endothelial leukocyte adhesion molecule-1 and Th1 and Th2 cell in severe atopic dermatitis after intravenous immunoglobulin therapy

OBJECTIVE

To evaluate the effect of intravenous immunoglobulin (IVIG) in the treatment of severe intractable atopic dermatitis (AD) in children and to investigate the inflammatory markers used to measure their disease activity.

MATERIALS AND METHODS

Serum levels of interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (ICAM-1), endothelial leukocyte adhesion molecule (ELAM-1), and eosinophil cationic protein (ECP) were measured in five children with AD (group A) who had a mean age of 9.4 months (range 7 to 12 months) before and after IVIG therapy. Seven age-matched patients with similar severity of AD who only received topical corticosteroid therapy served as the control group (group B). Ten normal control serum samples were collected from well-baby clinic (group C). T helper 1 (Th1) was defined by IFN-gamma/CD4+ and Th2 by IL4/CD4+, using 3-colored flow cytometry. Clinical severity of AD was evaluated with the SCORAD index. Intravenous immunoglobulin (2 g/kg/dose) was administered monthly for a total of 3 doses.

RESULTS

The serum levels of ICAM-1, ELAM-1, and IL-2R in patients with AD were significantly higher than normal control infants. After IVIG therapy, the SCORAD index and the inflammatory markers (ICAM-1, ELAM-1, and ECP) in group A were significantly decreased (P = .01 for SCORAD index; .034, .043, and .03 for ICAM-1, ELAM-1 and ECP, respectively). The serum levels of ICAM-1, ELAM-1, ECP and IL-2R in group B did not show a significant reduction after 3 months of topical corticosteroid therapy. In comparison to normal healthy children, patients with AD had decreased Th2 cells (P = .009) and higher ratio of Th1/Th2 (P = .009) in peripheral blood mononuclear cells (PBMC). There was no significant difference of Th1, Th2 cells, and ratio of Th1/Th2 in PBMC before and after IVIG therapy in patients with AD.

CONCLUSION

Intravenous immunoglobulin can be safely and effectively given for the treatment of severe intractable AD. The determination of ICAM-1, ELAM-1, and ECP levels may be useful in monitoring disease activity of AD in childhood. The IVIG may play a role in treatment.

Cyclic and linear bradykinin analogues: implications for B2 antagonist design

Bradykinin (BK, Arg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg) antagonists are potentially useful for treating inflammation, pain and severe trauma. To identify what chemical features might promote effective antagonism, we replaced Arg1 and Pro7 with structurally constrained and proteolytic-resistant residues, such as Bip (biphenylalanine), Dip (diphenylalanine) or 2Ind (indane amino acid). To determine which BK folding might lead to favourable interactions with receptors, the effects of cyclo(3,8) vs. cyclo(5,8) analogues were compared. The resulting BK analogues were examined for their agonistic and antagonistic activities in guinea pig ileum, rat uterus and depressor assays. The results suggest that co-planarity of the residue-7 side chain with its backbone NH is important for potent agonism as well as antagonism, and a D-directed side chain is crucial for antagonism. For residue-1 an L-orientation is important, and Dip1 may mimic a folded Arg1 side chain to elicit agonistic activities, with Bip1 mimicking an extended Arg1 side chain to elicit inhibitory activities. However, ileal and uterine receptors appear to prefer differently folded BK. For ileum, a BK conformation in which residues-3 and -8 are proximal to each other, but apart from residue-5, led to improved pA2.

Reduced IL-12 level correlates with decreased IFN-gamma secreting T cells but not natural killer cell activity in asthmatic children

BACKGROUND

Accessory cells such as macrophages and natural killer cells, and their cytokines such as IL-10, IL-12, and IFN-gamma have been suggested to play a critical role in the development of T helper cells.

OBJECTIVE

Both natural killer cells and peripheral blood mononuclear cells were isolated and stimulated for their ability in producing cytokines. In addition, the percentage of IFN-gamma-secreting cells was analyzed with the method of intracellular staining.

RESULTS

The data suggested (1) no significant difference between asthmatic children and normal controls in number, cytotoxicity, and IFN-gamma production of purified NK cells; (2) decreased secretion of IL-12 by stimulated peripheral blood mononuclear cells in asthmatic children compared with normals (P < .05); (3) decreased production of IFN-gamma by PBMC from asthmatic children compared with normals (P < .05); and (4) intracellular expressed IFN-gamma level was lower in CD4+ T cells of asthmatic children (P < .05).

CONCLUSION

The results suggested that IL-12 produced predominantly by macrophages and associated decreased IFN-gamma-secreting CD4+ T cells play a critical role in the pathogenesis of asthma.

Successfully treated sulphasalazine-induced fulminant hepatic failure, thrombocytopenia and erythroid hypoplasia with intravenous immunoglobulin

We report the simultaneous development of fulminant hepatic failure, thrombocytopenia and erythroid hypoplasia in a child treated with sulphasalazine. A 12-year-old girl with juvenile rheumatoid arthritis developed fulminant hepatic failure, thrombocytopenia and erythroid hypoplasia, which was confirmed by liver histology and bone marrow examination, 2 weeks after initiation of sulphasalazine therapy. The patient recovered after administration of high doses of intravenous immunoglobulin. This is the first reported case of the concurrent development of these complications associated with sulphasalazine hypersensitivity. The use of intravenous immunoglobulin may have helped in the treatment of this rare adverse effect of sulphasalazine.

Orthopedic manifestation in a child with hyperimmunoglobulin E syndrome

We report a 12-year-old girl with hyperimmunoglobulin E (HIE) syndrome who presented with genu vulgus of left knee, joint deformities involving both hands, and frequent fractures. She had had chronic eczema and recurrent skin and soft tissue infections since infancy, and was found to have a pneumatocele during admission. Immunologic abnormalities included extremely elevated serum IgE levels (18989 IU/ml) and cutaneous anergy to candida, purified protein derivative, and tetanus toxoid. The results of polymorphonuclear leukocyte function tests including the nitroblue tetrazolium test and chemotaxis were normal. A high index of suspicion for HIE syndrome should be given in patients with recurrent skin infections and orthopedic complaints. The physician should anticipate orthopedic problems in caring for patients with HIE syndrome, and optimal antibiotics prophylaxis should be used.

Hodgkin's disease in a child with hyperimmunoglobulin E syndrome

A 10-year-old boy with hyperimmunoglobulin E (HIE) syndrome was admitted to the hospital due to intermittent fever and a growing neck mass noted for 3 months. He had had chronic eczema and recurrent skin infections since infancy. At age 8, the diagnosis of HIE was established when a pneumatocele was found in the presence of extremely elevated serum IgE levels (7842 IU/mL). He also had defective T-lymphocyte function, manifested by cutaneus anergy, as well as abnormal proliferative response to mitogenic stimuli. Chemotactic function of neutrophils was normal. Pathological examination of the lymph node disclosed Hodgkin's disease (nodular sclerosis). A high index of suspicion for lymphoma should be given in patients with HIE syndrome who present with lymph node enlargement.

Mothering, fathering, and infant negativity as antecedents of boys' externalizing problems and inhibition at age 3 years: differential susceptibility to rearing experience?

To examine the effects of infant negative emotionality and of mothering and fathering during the toddler years on 3-year-old boys' externalizing problems and inhibition, as well as explore the proposition that children vary in their susceptibility to rearing influence, 125 first-born, Caucasian boys from maritally intact families were studied. Results revealed that when infant negativity is measured with objective, replicable, and discriminantly valid procedures, no relation obtains between it and externalizing problems (nor inhibition). Moreover, as hypothesized on the basis of prior work, parenting was a stronger predictor of externalizing problems and inhibition in the case of children who were highly negative as infants. Mothering proved a stronger predictor of externalizing problems and fathering of inhibition, with more negative mothering in the 2nd and 3rd year forecasting higher CBCL-externalizing scores and less negative fathering in the 2nd and 3rd year and more positive fathering in the 2nd year forecasting more inhibition at age 3 Implications of these findings for studies of parental influence are considered.

In vitro production of cytokines and allergen-specific IgE in bronchial asthmatic children with different disease activity

The aim of this study was to further investigate the cytokine profile and the level of allergen-specific immunoglobulin E (IgE) and IgG4 in asthmatic children of different disease activity. Peripheral blood mononuclear cells were isolated from seventy asthmatic children who had been newly diagnosed (N = 21), had good (N = 20) or poor response (N = 12) to immunotherapy or during acute attack (N = 17) and from twenty normal children. Cytokines produced by both PHA and mite allergen stimulated peripheral blood mononuclear cells (PBMCs) were assayed. Resulting data suggested: 1) the level of IgE anti-house dust mite (HDM) antibody was higher in asthmatic children with poor response to immunotherapy; in contrast, among the five groups the level of IgG4 anti-HDM antibody was the highest in asthmatic children with good response to immunotherapy among the five groups; 2) the level of interferon-gamma (IFN-gamma) produced by mite-stimulated PBMCs was the highest in asthmatic children with good response to immunotherapy among the five groups; in contrast, the level of interleukin-4 (IL-4) was the highest in the group of newly diagnosed asthmatic children; 3) the level of IL-13 was higher in asthmatic children with poor response to immunotherapy compared to those of the other groups; 4) a higher level of IL-10 and lower level of IL-12 were noted in groups of both good and poor response to immunotherapy compared to those of other groups. Although more studies are needed, the change of cytokines in asthmatic children with different disease activity or response to immunotherapy might shed light on further understanding of the regulatory mechanisms of atopic diseases.

Immunologic changes during immunotherapy in asthmatic children: increased IL-13 and allergen-specific IgG4 antibody levels

BACKGROUND

The prevalence of allergic diseases such as asthma, allergic rhinitis, and atopic diseases has increased in recent years. Immunotherapy with allergens is a treatment documented to have an effect on regulating cytokine production and allergen-specific antibody production.

OBJECTIVE

The aim of this study was to further investigate immunologic changes during immunotherapy and to explore the possible more efficient approach of immunotherapy.

METHODS

Asthmatic children receiving house dust mite immunotherapy were followed to learn immunologic parameters such as allergen-specific antibody levels, proliferative response of peripheral blood mononuclear cells, and cytokine change during immunotherapy.

RESULTS

The data suggested (1) IgG4 anti-mite antibody increased 8 months after immunotherapy while IgE antibody level remained the same; (2) allergen-induced, in vitro production of certain cytokines such as IL-4 and IL-10 decreased after immunotherapy; (3) IL-13 (which can induce IgG4 and IgE antibody production by B cells) increased after immunotherapy.

CONCLUSION

Although this needs more study, IL-13 might play an important role in the generation of IgG4-blocking antibody during immunotherapy.

Comparison of epoxides on grafting collagen to polyurethane and their effects on cellular growth

The current study investigated the effects of vary epoxides on linking capacity of collagen to carboxyl-group-enriched polyurethane (PU) and the consequent effects on the growth of endothelial cells. Epoxides of EX-810, 1,4BDE, DER732, DER331, and DER332 were initially reacted with the carboxyl groups of PU substrates at 110 degrees C for 20 h. Free epoxy rings of epoxide-PU substrates, characterized by Fourier transform infrared spectroscopy and quantified by titration with HCl and NaOH, were available for collagen grafting. The amounts of collagen grafted were in accordance with the amounts of free epoxy rings detected and correlated with the growth of endothelial cells on the substrates. Our results indicated that epoxides with shorter aliphatic intermediate chain can graft more collagen to the epoxide-PU substrates than epoxides with longer intermediate chain or with aromatic groups. Epoxides were also demonstrated to be nontoxic linking agents for biomaterials.

Clinical and laboratory correlation of acute Henoch-Schönlein purpura in children

The clinical and laboratory features of 72 children with Henoch-Schönlein purpura (HSP) were examined to determine if there were associations between the laboratory indices--including white blood cell (WBC) counts, serum C-reactive protein (CRP) levels, platelet (PLT) counts--and the clinical manifestations of acute HSP. Marked leukocytosis (WBC > 15,000/mm3), elevation of serum CRP levels (> 10 mg/L) and thrombocytosis (PLT > 400 x 10(3)/mm3) were associated with gastrointestinal (GI) bleeding, but not associated with abdominal pain in the absence of GI bleeding. None of the three parameters was associated with arthritis and nephritis. Elevated serum CRP levels alone was associated with prolonged hospital course, and may serve as an indicator of disease severity in patients with HSP. GI bleeding did not occur in patients with normal WBC counts, serum CRP levels, PLT counts (0/19), but occurred in 21.7% (5/23), 50% (8/16), and 85.7% (12/14) in patients with only one, two of the three and all three laboratory abnormalities, respectively. Patients with GI bleeding had higher mean WBC, PLT counts and serum CRP levels than those with abdominal pain in the absence of GI bleeding, and than those without abdominal pain. Routine measurement of these parameters is warranted to monitor children with acute HSP.

Demonstration of tracheal bronchus associated with tracheal stenosis using direct coronal computed tomography

A 2-year-old boy presented with chronic wheezes and was refractory to medical treatment. A high carina with bilateral bronchial stenosis was erroneously diagnosed by bronchoscopic examination. Serial direct coronal computed tomographic scans showed a displaced right upper lobe tracheal bronchus associated with tracheal stenosis below the abnormal bronchus. A direct coronal computed tomographic scan of the tracheobronchial tree is a useful imaging technique for the delineation of airway configuration when the bronchoscope fails to pass beyond a stenotic region. A coronal computed tomographic scan may make invasive tracheobronchography unnecessary.

Allergen gene transfer

DNA-based immunization induces a biased Th1 immune response, and offers a novel strategy for modulation of the Th2-associated response. Recent studies have provided evidence that antigen-induced allergic responses can be modulated in rodents immunized with plasmid DNAs encoding the sensitizing antigens. Further understanding of the regulatory mechanism involved and optimization of gene transfer/expression systems will assist greatly in proving the clinical utility of this process.

Acetaminophen overdose in children and adolescents

From 1982 to 1997, 12 Chinese children were admitted to Chang Gung Memorial Hospital with acetaminophen overdose. Six subjects (one young child, and five adolescents) developed liver damage which was severe in three cases (AST > 1000 IU/L). Acetaminophen-induced liver function abnormalities were characterized by elevation of transaminase levels with ALT higher than AST(6/6), coagulopathy(5/6), thrombocytopenia (1/6), but absence of jaundice(6/6). Fortunately, none of the six patients with liver damage developed fulminant liver failure, and all recovered completely. Acetaminophen overdose can cause significant morbidity in children and adolescents. Caretakers should be well instructed to give the drug correctly. So far, acetaminophen is still considered as the drug-of-choice for antipyresis in pediatric practice. However, multicentered collaborative study is necessary to determine whether acetaminophen intoxication causes less hepatic failure in Chinese children than in Western children.

Purification and characterization of a 94 KD high molecular weight allergen from house dust mite, Dermatophagoides pteronyssinus

House dust mite allergens from Dermatophagoides pteronyssinus is an important cause of severe allergic asthma and rhinitis in many countries. Although several low to medium molecular weight allergens had been well characterized, limited studies on the high molecular weight IgE-binding components were reported. In this study, a 94 kD high molecular weight allergen from crude mite body extract of D. pteronyssinus was purified and characterized. Monoclonal antibody (mAb) affinity chromatography and high performance liquid chromatography were used to purify 94 kD allergen. Its antigenicity and allergenicity were confirmed by in vitro and in vivo studies. Two mAbs 2205-3.45 and 2220-7.25 specific to 94 kD high molecular weight component of D. pteronyssinus were generated. The epitopes recognized by these mAbs were species-specific. Enzyme-linked immunosorbent assay (ELISA) of IgE reactivity in the sera from 40 asthmatic children allergic to D. pteronyssinus showed that 37.5% of them had significantly higher optical density values (range 0.011 to 0.452) than normal (range 0.013 to 0.035). In in vivo skin test showed that 9 out of 20 (45%) asthmatic children were positive to 94 kD allergen. The results demonstrate that 94 kD high molecular weight component is an important allergen existing in house dust mite in Taiwan.

Serum osteocalcin levels of normal children in Taiwan

Osteocalcin is mainly secreted by osteoblasts, and then diffuses into blood which can be detected by several experimental methods. This study determined the osteocalcin level by solid phase fluorescent immunosorbent assay (Pharmacia CAP; Sweden), a well-established and accurate laboratory method for determining the minor concentration of substances in blood. A total of 332 healthy children were enrolled in the study, including 176 boys and 156 girls ranging in age from one to fifteen years. It was concluded that (1) quantitative osteocalcin (OCs) value varies between 30.2 to 41.0 ng/ml; (2) there is an incremental tendency in both sexes until puberty; (3) girls generally have a higher osteocalcin level than boys before mid-puberty (2-12 years old). The differences are statistically significant.

The frequency of food allergy in Australia and Asia

A review of the development of food allergy in a birth cohort of 620 Australian infants at high risk for development of atopic disease has recently been completed. Extrapolating to a random community population showed that at the age of two, egg appears the most frequent food allergen (3.2%), while cow milk (2.0%), and peanut are of similar frequency (1.9%). The prevalence of hypersensitivity to wheat and soy appears similar to sesame seed, cashew nut, hazelnut and walnut, but allergy to fish, brazil nut and shell fish are uncommon. Despite a different methodology, reports from several Asian centres suggest a similar frequency of hypersensitivity to these foods in young children although hypersensitivity to shellfish and seafood was more common than for nuts, peanut and wheat, if seafoods are part of the staple infant diet. Rice hypersensitivity was rare in both Australia and Asian countries.

Analysis of total IgE and allergen-specific IgE antibody levels of allergic children in Taiwan

With advances in technology, several in vitro screening tests such as MAST and CAP system have been used for analyzing the allergens involved in allergic diseases such as bronchial asthma (BA), allergic rhinitis (AR), atopic dermatitis (AD) and urticaria. In this study, CAP system (Pharmacia, Sweden) was used to screen the prevalence of allergens responsible for these atopic diseases. A total of 392 children were enrolled in this study retrospectively, all these atopic children visited the allergy clinic of the Department of Pediatrics, National Taiwan University Hospital during the period March 1995 and August 1995. Our results showed: (1) Among these 392 allergic children, included 82 BA, 70 AR, 22 AD, 156 BA + AR. 8 BA + AD, 12 AR + AD, and 42 AD + AR + AD: (2) House dust mites (Dermatophagoides pteronyssinus: D. p and Dermatophagoides farinae: D. f) are the most common allergens triggering atopic disease in the Taiwan area. (3) Total IgE level is the highest in three combined allergic disease (BA + AR + AD) [2179.9 +/- 504.2KU/L] and lowest in single disease (AR) [503.1 +/- 84.8 KU/L]. Mite-specific IgE (D. p + D. f-specific IgE) concentration is also the highest in three combined disease (BA + AR + AD) [499.1 +/- 86.0KU/L] and lowest in AR [159.5 +/- 47.5 KU/L], (4) elevated specific IgE antibody to egg white and milk were found in 68.4% and 47.4% of patients with AD and/or urticaria. In conclusion, these data suggest that house dust mites, are the most important allergens in respiratory allergy as well as in atopic dermatitis, while food allergens play relatively important roles only in skin allergy. Furthermore, the highest IgE level was noted in children with combined allergic diseases.

Serial single photon emission computed tomography imaging in patients with cerebral lupus during acute exacerbation and after treatment

Single photon emission computed tomography (SPECT) with [99mTc] HMPAO was performed sequentially every week in 4 patients with systemic lupus erythematosus (SLE), from the acute phase of neurologic involvement until normal cerebral blood flow (CBF) was detected by the scan. SPECT accurately reflects central nervous system (CNS) abnormalities in patients with SLE and correlates with subsequent improvement. Correlated with the patients' rapid clinical improvement, the brain SPECT blood flow scan demonstrated homogeneous distribution in 1 to 9 weeks. In these four patients, the defect in CBF could be reversed by optimal treatment. Brain SPECT blood flow scan may be used as a biologic marker of pathologic activity in the brain of patients with SLE.

Characterization of the allergen Der f 7 from house dust mite extracts by species-specific and crossreactive monoclonal antibodies

BACKGROUND

The group 7 mite allergens react with IgE in 50% of sera from allergic patients.

OBJECTIVE

To determine the molecular and antigenic characteristics and heterogeneity of Der f 7 in mite extracts.

METHODS

Monoclonal antibodies (MoAbs) produced from mice immunized with recombinant Der f 7 were examined for crossreactivity to Der p 7 and then used for immunoblotting of 1 and 2-D gel electrophoresis. Deglycosylation was studied with N-glycosidase-F and N-terminal sequencing by Edman degradation. The epitopes of the monoclonal antibodies were compared by cross-inhibitory immunoassays.

RESULTS

Immunoblotting of D. farinae extracts with all the anti Der f 7 MoAbs showed major reactivities at 31, 30 and 25 kDa. The strongest immunostaining was at 25 kDa which contrasted with Der p 7 where the 31 and 30 kDa bands were strongest. The relative strength of staining however varied between extracts. The 31 and 30 kDa components were glycosylation products of the 25 kDa form which had the N-terminal sequence predicted from cDNA analysis. Two MoAbs stained an 18 kDa band consistent with a degradation product. The 2-D gels showed that different components with pIs from 5.6-6.4. Both species-specific and Der p 7 crossreactive MoAbs were produced and a two-site ELISA assay for detecting group 7 allergen was developed with MoAbs recognizing different epitopes.

CONCLUSIONS

Der f 7 has been defined by its natural N-terminal sequence and MoAbs. It apparently exists as different glycosylation and degradation products in mite extracts, the relative abundance of which differs with different preparations. A two-site ELISA to measure the allergen was developed.

Sulphasalazine therapy in chronic uveitis of children with chronic arthritis

Four children with chronic arthritis (3 juvenile rheumatoid arthritis and 1 juvenile ankylosing spondylitis) and poorly controlled chronic uveitis, were given sulphasalazine (SASP) therapy for a mean period of 3.3 years. Three patients showed an excellent response, as evidenced by a reduction of inflammatory cells in the anterior chamber of the eyes and improvement of visual acuity. The response occurred after a mean of 7.7 weeks. These data suggested SASP therapy may have a role in the treatment of chronic anterior uveitis in children with chronic arthritis.

Functional assessment for shoulder impingement syndrome after anterior acromioplasty

BACKGROUND

Impingement syndrome is a common cause of shoulder pain. Conservative treatment should always be initially considered. But for those patients with persistent symptoms, open acromioplasty is a reliable method to relieve pain and improve function.

METHODS

From May 1989 to September 1994, a series of 36 anterior acromioplasties for impingement syndrome of the shoulder in 34 patients was retrospectively analyzed. Among them, rotator cuff tear was found in 25, and concomitant cuff repair was performed in 20. Five shoulders were not repaired because of a massive tear with marked cuff retraction. Neer's functional criteria and Constant's functional score were used to evaluate the results of anterior acromioplasty. The postoperative evaluation included patient satisfaction, relief of pain, range of motion and full use of the shoulder.

RESULTS

Thirty-four patients with an average follow-up of 34 months were available for assessment. The average Constant's functional score was 94.7 points in the excellent group (55.5%), 77.2 points in the good group (30.5%) and 58.6 points in the poor group (13.9%).

CONCLUSIONS

Overall there was an 86% satisfactory rate by Neer's criteria. Anterior acromioplasty appears to be an effective procedure for shoulder impingement syndrome.

Latex allergy in hospital employees

The purpose of this study was to investigate the prevalence and risk factors of latex-allergy in hospital personnel and the presence of latex-specific IgE in a latex-allergic group in Taiwan. A total of 1,021 hospital employees were initially screened for latex allergy with a questionnaire, which included sex, age, job categories, number of years of employment, daily working hours, frequency of latex glove wearing, symptoms of immediate reactions to latex gloves and history of previous atopic diseases. Among them, 70 hospital employees (6.8%; 95% confidence interval 1.9%-11.8%) had symptoms associated with glove wearing. The frequencies in different job categories were 28.3% of surgical nurses, 9.2% of surgeons, 5.8% of regular floor nurses, 5.2% of technicians, 4.6% of physicians, and 4.5% of laboratory researchers. The symptoms were significantly related to the frequency of latex glove exposure, surgical work, current hand eczema and history of atopic dermatitis. In contrast, the number of years of employment, daily working hours and previous history of hand eczema were not correlated with the symptoms of latex allergy. Latex-specific IgE was assayed by the dot blot method in 36 hospital employees of the latex allergic group (positive rate, 55.6%). We concluded that the prevalence of latex-allergy among hospital personnel was 6.9% and certain predisposing factors such as atopic dermatitis, current hand eczema ad surgical work may play a critical role in triggering and aggravating the symptoms.

Intravenous immunoglobulin therapy in juvenile dermatomyositis

To investigate the effects of intravenous immunoglobulin (IVIG) on patients of juvenile dermatomyositis (JDM), seven children with JDM were given monthly IVIG in conjunction with other treatments. The indications included disease exacerbation, inability to reduce dose of steroid, replacing cytotoxic drug because of complication and remission-induction for those with severe initial manifestations. Two patients were reported to improve slowly and maintained improved status while on a markedly reduced dose of steroid. One patient responded favorably to the first three courses only. Three patients had evident and quick responses, which could be seen as early as two or three days after the infusion. One patient failed to experience any beneficial effect by IVIG. Four initial responders had an aggravation some time after discontinuing the monthly regimen. The untoward reactions included only two occasions of fever, and another two occasions of fever associated with transient proteinuria. In conclusion, IVIG may be of value in terms of its quick, pulsatile effect and the adjuvant potential to reduce the side effect resulting from exposure to steroid or other immunosuppressive agents as well. However, its long-term efficacy is doubtful, based on this observation.

Immune effector cells induced by complete Freund's adjuvant exert an inhibitory effect on antigen-specific type 2 T helper responses

BACKGROUND

It has been well documented that environmental factors such as antigenpresenting cells and related cytokines could affect the development of T helper cells.

OBJECTIVE

The purpose of this study is to investigate the effect of different adjuvants on T cell development.

METHODS

Ovalbumin (OVA) combined with aluminum hydroxide (Alum) plus pertussis toxin (PT) or complete Freund's adjuvant (CFA) were used to sensitize mice; the production of IgG and IgE anti-OVA antibodies was then followed. In addition, OVA-specific proliferative responses and cytokine production by spleen cells were also investigated.

RESULTS

The data showed that the adjuvants themselves could modify the pattern of immune response: (1) IgG2a anti-OVA antibody was higher in mice sensitized with OVA + CFA compared to that of mice sensitized with OVA + Alum + PT; (2) the ratio of IFN-gamma/IL-4 produced by OVA-stimulated spleen cells was higher in mice sensitized with OVA + CFA than that of mice sensitized with OVA + Alum + PT: (3) increased percentage of gamma delta T cells was noted in the peritoneal exudate cells of OVA + CFA immunized mice; and (4) the immune response of mice sensitized with OVA + Alum + PT was inhibited by the adoptively transferred ascitic cells from OVA + CFA immunized mice.

CONCLUSION

In general, the data suggested higher IgG2a and the ratio of IFN-gamma/IL-4 was noted in mice sensitized with OVA + CFA. Further elucidation of the regulatory mechanism of allergen-specific T helper cells development and exploration of possible agents for immunotherapy might shed light on the management of atopic diseases.

Asthma induced by ice water ingestion in ethnic Chinese asthmatic children: a challenge

The purpose of this study was to investigate the relationship between ice water ingestion and the induction of asthmatic symptoms and signs in ethnic Chinese asthmatic children. Sixty asthmatic children with a positive history of exacerbation of symptoms after drinking ice water were divided randomly into two groups: 34 children were instructed to drink 250 ml of 0-4 degrees C ice water within one minute, and 26 to drink 250 ml of 25 degrees C warm water. All of the asthmatic children were stable when studied. Twenty-three healthy children as controls were asked to drink 250 ml of 0-4 degrees C ice water. The three groups had forced expiratory volume in one second (FEV1) performed at baseline and at 5, 15, 30, 60, and 90 minutes after challenge. After the spirometric test at 90 minutes the patients of the two asthmatic groups received three puffs (0.6 mg) of hexoprenaline MDI and a further spirometric test was performed 5 min after the inhalation. Cough and wheeze were monitored throughout the course of the test. The mean FEV1 after challenge decreased significantly only in the ice-water asthmatic group (p = 0.004). Compared with the baseline data, the mean FEV1 at various periods after challenge was only significantly decreased at 60 min (p = 0.035). After hexoprenaline inhalation the FEV1 significantly increased in the two asthmatic groups (p < 0.001). A significant difference in FEV1 change was noted among the three groups (p = 0.015). Nine cases (26%) from the ice water asthmatic group, three (12%) from the warm-water asthmatic group, and none of the ice-water normal control group showed a decrease of FEV1 greater than 15% (p = 0.018). The greatest difference occurred between the two ice water groups. All six cases who developed symptoms after challenge, accompanied by a simultaneous decrease of FEV1 greater than 15%, belonged to the ice-water asthmatic group. Forty-seven percent of the ice-water asthmatic group and 4% each of the two other groups had cough and/or wheeze after challenge (p = 0.0002).

IN CONCLUSION

Ice water ingestion may induce or exacerbate asthma in ethnic Chinese asthmatic children.

2-hydroxyethyl methacrylate-terminated polyurethane/polyurethane interpenetrating polymer networks

The interpenetrating polymer networks (INPs) of polyurethane (PU) and 2-hydroxyethyl methacrylate (MEHA)-terminated polyurethane (HPU) were prepared by solution polymerization. PU prepolymer was synthesized from 4,4-diphenyl methane diisocyanate (MDI) and poly(propylene oxide) glycol (PPG). HPU prepolymer was synthesized from MDI, poly(tetramethylene oxide) glycol and HEMA. Dynamic mechanical analysis showed that the resultant IPN membranes have good compatibility between their constituents. As the HPU content increased, the tensile strength of the IPNs first increased and then decreased. For the highest tensile strength, the optimum HPU content was about 25 wt %. The value of surface tension of IPNs varied from 44.4 to 50.5 dyne/cm, and polarity ranged from 0.59 to 0.91. The relative index of platelet adhesion (RIPA) of the IPN membranes was measured by the dynamic thrombosis test at constant shaking speed and temperature. By the criteria of this test, the IPN membranes with HPU content of about 25 wt% to the minimum platelet adhesion. When measured by the angular dependent ESCA technique on the surface of IPN samples, the variation in the RIPA correlated to the change in the surface soft segment to hard segment ratio. Higher HPU content resulted in more migration of soft segments toward the surface. The platelet adhesion was observed to be minimized when the surface O/N ratio was around 12.

Double-blind placebo-controlled study of oxatomide in the treatment of childhood asthma

Oxatomide is an orally active H1-histamine receptor antagonist. It has been demonstrated to have therapeutic efficacy in the treatment of allergic diseases in adults. The aim of this study was to evaluate the efficacy and safety of oxatomide in the treatment of asthma in children. Sixty-four asthmatic children of both sexes, aged between 5 and 16 years, were enrolled in this double-blind, placebo-controlled trial with a duration of 4 months. Patients were randomized chosen to receive either oxatomide with a daily dose of 1 to 2 mg/kg body weight or a placebo twice daily. Clinical evaluations including pulmonary function tests and immunological studies. The patients' impression on the effect of treatment also were recorded during the study. The effects of bronchodilatation and normalizing pulmonary function were observed 2 months after oxatomide treatment. The levels of eosinophil cationic protein and total asthma symptom scores were significantly reduced during treatment with oxatomide. There was no significant change in total IgE or IgG4 before or after treatment in either the treatment or control groups. During the study, two (5.8%) oxatomide treated patients reported slight drowsiness and one (2.9%) reported body weight gain. Routine laboratory tests showed no significant alterations. In conclusion, oxatomide was generally well tolerated in this study and may have the potential of being an effective treatment for childhood asthma.

Effect of forms of collagen linked to polyurethane on endothelial cell growth

Collagen has been widely coated or grafted onto polymer surfaces to improve the biocompatibility of materials. To better support the growth of endothelial cells on polyurethane (PU), collagen was grafted to the carboxyl group enriched PU through 1,2-bis(2,3-epoxypropoxy)ethane linking. Our results demonstrated that collagen in various conditions may result in different forms being grafted to the PU substrate, which subsequently affected the growth of endothelial cells. Collagen predialyzed against physiological phosphate buffered saline (PBS) could be reconstituted into native type fibrils with a bigger diameter at 37 degrees C than could collagen neutralized by titration with NaOH. At low temperature, titrated collagen formed floss-like fibrils packed in a ball with cobblestone-like morphology. The amount of collagen grafted was related to the condition of the collagen used, which in consequence affected the diameter of the collagen fibril formed and the growth of endothelial cells. In conclusion, reconstituted collagen fibrils formed from collagen in PBS at 37 degrees C grafted in the highest amounts to an epoxy-PU substrate and that optimally supported the growth of endothelial cells. Such prepared materials may be potentially good vascular bioprosthetic materials and may provide a wide range of biological applications.

Different kinds of antigen-presenting cells exert different effects on T-helper cells development

It has been well documented that environmental factors such as antigen-presenting cells and related cytokines can affect the development of T-helper cells. The purpose of this study was to investigate the role of different antigen-presenting cells on T-cell development. Ovalbumin (OVA) combined with complete Freud's adjuvant (CFA) was used to sensitize mice subcutaneously or intraperitoneally, and then to follow-up production of IgG and IgE anti-OVA antibodies. In addition, semiquantitative PCR was used to determine the level of cytokine mRNA of different antigen-presenting cells. Resulting data showed that antigen-presenting cells expressed with different characteristics: (1) IgG2a anti-OVA antibody was higher in mice sensitized subcutaneously compared to those sensitized intraperitoneally. (2) The levels of cytokine mRNA were higher in antigen-stimulated spleen cells of mice immunized subcutaneously compared to those of mice immunized intraperitoneally. (3) Langerhans cells expressed a high level of IL-12; in contrast, peritoneal B cells expressed a high level of IL-10, but not IL-12. In summary, cytokine levels such as IL-10 and IL-12 were different among different kinds of APC, and their role in production of different isotypes of antibodies needs further elucidation.

Isolation of type 1 and type 2 cloned mite allergen-specific T cells from an asthmatic child

Allergen-specific T cells have been thought to play a central role in the pathogenesis of asthma. It has been well documented that allergen-specific T cells derived from atopic patients are predominantly of type 2 T helper cell pattern. However, allergen-specific T cells derived in nonatopic normals are of type 1 in contrast to atopic patients. The purpose of the study was to develop and characterize both mite allergen-specific TH1 and TH2 clones from the same asthmatic child. With exogenous supplemental cytokine, both TH1 and TH2 clones from the same patient have been developed and maintained in this laboratory for more than one year. All these T cell clones showed dose dependent allergen-specific proliferative response and expressed with CD4+, CD45RA- markers. Elucidation of the origin and interaction between these two different types of T helper cells might shed light on understanding the pathogenesis of atopic diseases and the mechanisms of hyposensitization in atopic patients.

Glutathione-S-transferase induces murine dermatitis that resembles human atopic dermatitis

BACKGROUND

The molecular and functional basis of allergen-induced inflammation seen in atopic dermatitis (AD) remains undefined.

OBJECTIVE

The objective of this study is to establish a murine model to dissect the pathological mechanisms of inflammatory reactions leading to the development of AD.

METHODS

An inbred strain of mice, BALB/c, when injected peritoneally with 30 micrograms of recombinant Sj26 protein (rSj26), a glutathione-S-transferase of Schistosoma japonicum worm, developed systematic dermatitis 21 days after immunization. The pathology of the dermatitis was examined by histological evaluation and immunostaining. The immediate skin hypersensitivity was demonstrated by serum transfer and skin test. Epicutaneous patch test was used to demonstrate the antigen-specific late phase response.

RESULTS

Significant responses of rSj26-specific IgE were detected 2 weeks after immunization, and such changes paralleled formation of skin lesions. The diseased skin pathology showed inflammatory changes such as infiltration of mononuclear cells and eosinophils in the dermis and mild spongiosis in the epidermis. Numerous IgE bearing cells were also detected in the dermis. Peripheral blood showed eosinophilia at the same time. In addition, rSj26-specific positive skin test and epicutaneous patch test could be demonstrated in rSj26-sensitized mice.

CONCLUSIONS

These results suggest that rSj26 is capable of eliciting atopic dermatitis-like lesions in BALB/c mice. This can be a useful animal model for elucidating allergen-induced immune responses and the development of various therapeutic interventions of atopic dermatitis in humans.

Effects of Microstop-treated anti-mite bedding on children with mite-sensitive asthma

Seventy-one children with mite-sensitive asthma were randomly divided into three groups. Group 1 was comprised of 28 patients who were provided with new Microstop-treated bedding including matresses, quilts, pillows, bed linens and quilt covers. The Microstop mattresses and pillows were made of impermeable Polyurethane coated nylon ticking. Group 2 included 28 patients who were provided with new, conventional, mat Polyurethane mattresses, quilts, pillows, bed linens and quilt covers made of cotton and polyester which had not been Microstop treated. Group 3 included 15 patients who used their old bedding. Mite counts were performed on samples of dust collected from the old mattresses, pillows and quilts before the bedding was changed. After changing the bedding, mite counts were performed on dust from the same three bed sites at the end of months 1, 2, 3, 6, 9, and 12. Morning and evening peak expiratory flow, asthma symptom scores, were recorded by each patient at least 1 month before entering the study and every month during the one-year study period. Mattress mite counts were significantly reduced in Group 1 but not in Groups 2 or 3. However, quilt mite counts were significantly reduced in both Group 1 and Group 2 throughout the 12-monthstudy while mite counts in Group 3 quilts remained unchanged. The results provide evidence that the PU-coated nylon material was effective in reducing house dust mites, but do not demonstrate that the Microstop treatment had an obvious anti-mite effect. One-year follow-up of asthma symptom scores showed significant improvement in Group 1, but not in Groups 2 or 3. This suggests that the Microstop-treated bedding, as a system, was effective in asthma prevention.

Side reactions in solid-phase peptide synthesis and their applications

Side reactions in peptide synthesis indicate steps needing improvement as well as opportunities for structural diversification in combinatorial design. Among the side reactions observed in this study, transesterification of Boc-Glu(OBzl) occurred in TMAH-catalyzed resin attachment, leading to Boc-DKKREE(OMe) in solid-phase synthesis of Boc-DKKREE. Acetylation of Boc-Arg(NO2)-resin occurred during resin capping with Ac2O/Et3N, leading to GPR (Ac) in GPR synthesis. His- and Lys-modification occurred during GHRPLDKKREE cleavage from resin by Pd(OAc)2-catalyzed hydrogenation in DMF. To verify these side reactions, model experiments were performed, which indicated rapid transesterification of Boc-Glu(OBzl) in methyl, isopropyl, or tert-butyl alcohol into the corresponding ester by TMAH, but studies of acetylation showed that both Boc-Arg(NO2) and Boc-Arg(Tos) were stable to Ac-Im treatment, but were modified by Ac2O/Et3N. Since transfer hydrogenation of Boc-His(Bzl) and Boc-Lys(Z) in HCOOH or ammonium formate did not generate the formylated side-products of catalytic hydrogenation, DMF and not its decomposed product, HCOOH, appeared involved in side-chain modification. Elimination of the side reactions, by using Cs-derived Boc-Glu(OBzl)-resin for peptide synthesis and catalytic hydrogenation in NMP-HOPr for peptide cleavage, increased the GHRPLDKKREE yield by 1/3. On the other hand, the side reactions provided modified peptides, whose bioassays revealed different importance of the modified side-chains.

Immunotherapy suppresses the production of monocyte chemotactic and activating factor and augments the production of IL-8 in children with asthma

BACKGROUND

Histamine-releasing factor consists of a group of cytokines that can cause basophils or mast cells to release histamine. However, the composition of histamine-releasing factor remains undefined.

OBJECTIVE

This study was done to measure the concentrations, in plasma and mononuclear cell culture supernatants from children with asthma, of chemokines that are known to contribute to histamine-releasing factor activity.

RESULTS

Plasma and mononuclear cell culture supernatants were obtained from 25 children newly diagnosed with asthma, 25 good responders to immunotherapy, 23 poor responders, 25 patients with acute attacks, and 13 normal subjects. All the patient groups produced, spontaneously and after stimulation with phytohemagglutinin and mite allergen, greater amounts of monocyte chemotactic and activating factor, macrophage inflammatory protein-1 alpha, and RANTES (beta chemokines) and IL-8 and growth-related gene alpha (alpha chemokines) than did normal subjects. Successful immunotherapy resulted in decreased production, especially the spontaneous type, of beta chemokines that cause histamine release and in increased production of a chemokines that inhibit histamine release.

CONCLUSION

Abnormal chemokine production may contribute to the pathogenesis of bronchial asthma, and restoration of normal chemokine production may be used to explain, in part, the clinical efficacy of immunotherapy.

Impaired immune function in a premature infant with zinc deficiency after total parenteral nutrition

The report describes a premature infant with necrotizing enterocolitis who developed symptoms of zinc (Zn) deficiency after three to four weeks of total parenteral nutrition (TPN). Clinical presentations included characteristic skin rash, alopecia, retarded growth, generalized edema and decreased serum alkaline phosphatase (ALP). Immune function studies revealed impaired neutrophil adhesion and mitogen-induced lymphoproliferation, whereas phagocytosis, chemotaxis and lymphocyte subsets remained normal. A high dose of elemental Zn (2.5 mg/kg/day), administered orally, improved the clinical symptoms and restored the immune function. In patients with Zn deficiency, impaired neutrophil adhesion and lymphocyte function may contribute to immunodeficiency which can be reversed with adequate Zn supplementation.

Inhibition of specific IgE response in vivo by allergen-gene transfer

DNA immunization has been an attractive approach in altering the host immune response to antigen. To examine the utility of DNA immunization in allergic response, we examined the in vivo efficacy of an 'allergen-gene immunization' approach in the modulation of allergen-specific IgE responses in mice. Our results showed first that I.m. injection of a gene construct (pCMVD) containing an important house dust mite allergen gene (Dermatophagoides pteronyssinus group 5 allergen; Der p 5) results in the induction of Der p 5-specific IgG antibodies, but not IgE antibody. We next examined the effect of transduced allergen gene on the expression of specific IgE response in mice after i.p. challenge with recombinant Der p 5 (rDer p 5). Both vector (mock) control- and pCMVD-treated mice were i.p. sensitized with rDer p 5 at 3 weeks after injection of gene construct. Results showed that there is a 90% reduction in the level of specific IgE in pCMVD-treated mice when compared with mock-treated mice. Furthermore, the suppression of specific IgE response can be adoptively transferred with CD8+ T cells from pCMVD-treated mice and such inhibition is in an antigen-specific manner, since the level of specific IgE to an irrelevant allergen, Der p 1, remained unchanged in comparison to that of the mock-treated group. In addition, Der p 5-specific CD8+ T cells could produce high levels of IFN-gamma which probably inhibit allergen-specific IgE responses. Taken together, our results suggest that allergen-gene transfer is effective in the modulation of allergen-specific IgE responses and may provide a novel therapeutic approach.

Change of chemokines during immunotherapy in asthmatic children

Histamine-releasing factor (HRF) consists of a group of cytokines that can cause basophil/mast cell to release histamine, however, the composition of HRF still remains undefined. This study was designed to measure the concentrations of chemokines in asthmatic children receiving immunotherapy. Peripheral blood mononuclear cells culture supernatants were obtained from six asthmatic children before and four, eight months after immunotherapy (IT). The levels of monocyte chemotactic and activating factor (MCAF), macrophage inflammatory protein-1a (MIP-1a), regulated on activation normal T-cell expressed and secreted (RANTES) and interleukin-8 (IL-8) spontaneously and after stimulation with PHA and mite allergen in the supernatants. The data showed: 1) The levels of MCAF and MIP-1a increased four months, and decreased eight months, after IT; 2) By contrast, the level of RANTE increased after IT; 3) The level of IL-8 also tended to increase after IT. Abnormal chemokine production may contribute to the pathogenesis of bronchial asthma and restoration of normal chemokine production may be used to partially explain the clinical efficacy of immunotherapy.