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Brinkman P, van de Pol MA, Gerritsen MG, Bos LD, Dekker T, Smids BS, Sinha A, Majoor CJ, Sneeboer MM, Knobel HH, Vink TJ, de Jongh FH, Lutter R, Sterk PJ, Fens N. Cover Image. Clin Exp Allergy 2017. [DOI: 10.1111/cea.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Brinkman P, van de Pol MA, Gerritsen MG, Bos LD, Dekker T, Smids BS, Sinha A, Majoor CJ, Sneeboer MM, Knobel HH, Vink TJ, de Jongh FH, Lutter R, Sterk PJ, Fens N. Exhaled breath profiles in the monitoring of loss of control and clinical recovery in asthma. Clin Exp Allergy 2017. [PMID: 28626990 DOI: 10.1111/cea.12965] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Asthma is a chronic inflammatory airway disease, associated with episodes of exacerbations. Therapy with inhaled corticosteroids (ICS) targets airway inflammation, which aims to maintain and restore asthma control. Clinical features are only modestly associated with airways inflammation. Therefore, we hypothesized that exhaled volatile metabolites identify longitudinal changes between clinically stable episodes and loss of asthma control. OBJECTIVES To determine whether exhaled volatile organic compounds (VOCs) as measured by gas-chromatography/mass-spectrometry (GC/MS) and electronic nose (eNose) technology discriminate between clinically stable and unstable episodes of asthma. METHODS Twenty-three patients with (partly) controlled mild to moderate persistent asthma using ICS were included in this prospective steroid withdrawal study. Exhaled metabolites were measured at baseline, during loss of control and after recovery. Standardized sampling of exhaled air was performed, after which samples were analysed by GC/MS and eNose. Univariate analysis of covariance (ANCOVA), followed by multivariate principal component analysis (PCA) was used to reduce data dimensionality. Next paired t tests were utilized to analyse within-subject breath profile differences at the different time-points. Finally, associations between exhaled metabolites and sputum inflammation markers were examined. RESULTS Breath profiles by eNose showed 95% (21/22) correct classification for baseline vs loss of control and 86% (19/22) for loss of control vs recovery. Breath profiles using GC/MS showed accuracies of 68% (14/22) and 77% (17/22) for baseline vs loss of control and loss of control vs recovery, respectively. Significant associations between exhaled metabolites captured by GC/MS and sputum eosinophils were found (Pearson r≥.46, P<.01). CONCLUSIONS & CLINICAL RELEVANCE Loss of asthma control can be discriminated from clinically stable episodes by longitudinal monitoring of exhaled metabolites measured by GC/MS and particularly eNose. Part of the uncovered biomarkers was associated with sputum eosinophils. These findings provide proof of principle for monitoring and identification of loss of asthma control by breathomics.
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Affiliation(s)
- P Brinkman
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - M A van de Pol
- Department of Experimental Immunology, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - M G Gerritsen
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - L D Bos
- Department of Intensive Care, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - T Dekker
- Department of Experimental Immunology, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - B S Smids
- Department of Experimental Immunology, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - A Sinha
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - C J Majoor
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - M M Sneeboer
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - H H Knobel
- Philips Research, Eindhoven, The Netherlands
| | - T J Vink
- Philips Research, Eindhoven, The Netherlands
| | - F H de Jongh
- Department of Pulmonary Function, Medisch Spectrum Twente, Enschede, The Netherlands
| | - R Lutter
- Department of Experimental Immunology, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - P J Sterk
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - N Fens
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
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Sneeboer MMS, Fens N, van de Pol MA, Majoor CJ, Meijers JCM, Kamphuisen PW, Lutter R, Sterk PJ, Bel EHD. Loss of asthma control and activation of coagulation and fibrinolysis. Clin Exp Allergy 2016; 46:422-7. [PMID: 26509255 DOI: 10.1111/cea.12667] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/19/2015] [Accepted: 10/24/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND Epidemiologic studies have shown that patients with severe asthma have increased risk of pulmonary embolism, in particular patients with frequent asthma exacerbations. Therefore, we hypothesized that asthma exacerbations are associated with increased haemostatic activity. OBJECTIVE To investigate whether induced loss of asthma control is associated with changes in coagulation and fibrinolytic parameters in peripheral blood. METHODS We performed a prospective, inhaled steroid withdrawal study in 23 patients with moderate to moderately severe asthma, consisting of a baseline visit and a visit after loss of asthma control. During the visits, we measured asthma control questionnaire (ACQ), atopy, lung function, inflammatory markers (eosinophils and neutrophils), and haemostatic parameters in plasma. RESULTS Complete cessation of inhaled corticosteroids led to a loss of asthma control in 22 of 23 patients. We found increased asthma symptoms (ACQ 0.9 vs. 2.9, P < 0.01), significantly reduced lung function (forced expiratory volume in 1 s (FEV1) 3.51L vs. 3.13L, P < 0.01) and increased levels of eosinophils in plasma (0.26 × 10(E9)/L vs. 0.16 × 10(E9)/L, P = 0.03) in patients after loss of asthma control. However, we observed no significant changes in the coagulation and fibrinolysis parameters. CONCLUSION Loss of asthma control after cessation of inhaled corticosteroids does not lead to increased haemostatic activation in patients with moderate to moderately severe asthma. This suggests that more severe inflammation or additional risk factors are required for activation of coagulation or reduction of fibrinolysis in asthma.
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Affiliation(s)
- M M S Sneeboer
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - N Fens
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - M A van de Pol
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - C J Majoor
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - J C M Meijers
- Department of Experimental Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Plasma Proteins, Sanquin Research, Amsterdam, The Netherlands
| | - P W Kamphuisen
- Department of Vascular Medicine, University Medical Center Groningen, The Netherlands
| | - R Lutter
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.,Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, The Netherlands
| | - P J Sterk
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
| | - E H D Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, The Netherlands
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Utsch L, Folisi C, Akkerdaas JH, Logiantara A, van de Pol MA, van der Zee JS, Krop EJM, Lutter R, van Ree R, van Rijt LS. Allergic sensitization is associated with inadequate antioxidant responses in mice and men. Allergy 2015; 70:1246-58. [PMID: 26081441 DOI: 10.1111/all.12674] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Allergies arise from aberrant Th2 responses to allergens. The processes involved in the genesis of allergic sensitization remain elusive. Some allergens such as derived from house dust mites have proteolytic activity which can induce oxidative stress in vivo. A reduced capacity of the host to control oxidative stress might prime for allergic sensitization. METHODS Two different strains of mice were compared for their antioxidant and immune response to HDM. Protease activity of the HDM extract was reduced to investigate its role in oxidative stress induction in the airways and whether this induction could determine allergic sensitization and inflammation. The role of oxidative stress in allergic sensitization was also investigated in humans. An occupational cohort of animal workers was followed for the development of sensitization to rodent urinary proteins. Levels of oxidative stress in serum and antioxidant responses by PBMCs were determined. RESULTS Susceptibility to allergic sensitization to mite allergens in mice was highly dependent on host genetic background and was associated with oxidative stress in the lungs before allergen exposure and poor antioxidant response after allergen exposure. Reduction in mite protease activity limited its capacity to induce oxidative stress and allergic inflammation in mice. We showed that also in human subjects, oxidative stress before allergen exposure and poor antioxidant responses were associated with predisposition to occupational allergy. CONCLUSION Our study indicates that oxidative stress condition before allergen exposure due to an inadequate antioxidant response may prime for allergic Th2 responses.
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Affiliation(s)
- L. Utsch
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | - C. Folisi
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
- Department of Respiratory Medicine; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | - J. H. Akkerdaas
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | - A. Logiantara
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | - M. A. van de Pol
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
- Department of Respiratory Medicine; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | | | - E. J. M. Krop
- Institute for Risk Assessment Sciences; Utrecht University; Utrecht the Netherlands
| | - R. Lutter
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
- Department of Respiratory Medicine; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | - R. van Ree
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
- Department of Otorhinolaryngology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
| | - L. S. van Rijt
- Department of Experimental Immunology; Academic Medical Center/University of Amsterdam; Amsterdam the Netherlands
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Hofstra JJ, Matamoros S, van de Pol MA, de Wever B, Tanck MW, Wendt-Knol H, Deijs M, van der Hoek L, Wolthers KC, Molenkamp R, Visser CE, Sterk PJ, Lutter R, de Jong MD. Changes in microbiota during experimental human Rhinovirus infection. BMC Infect Dis 2015; 15:336. [PMID: 26271750 PMCID: PMC4659412 DOI: 10.1186/s12879-015-1081-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 08/04/2015] [Indexed: 01/25/2023] Open
Abstract
Background Human Rhinovirus (HRV) is responsible for the majority of common colds and is frequently accompanied by secondary bacterial infections through poorly understood mechanisms. We investigated the effects of experimental human HRV serotype 16 infection on the upper respiratory tract microbiota. Methods Six healthy volunteers were infected with HRV16. We performed 16S ribosomal RNA-targeted pyrosequencing on throat swabs taken prior, during and after infection. We compared overall community diversity, phylogenetic structure of the ecosystem and relative abundances of the different bacteria between time points. Results During acute infection strong trends towards increases in the relative abundances of Haemophilus parainfluenzae and Neisseria subflava were observed, as well as a weaker trend towards increases of Staphylococcus aureus. No major differences were observed between day-1 and day 60, whereas differences between subjects were very high. Conclusions HRV16 infection is associated with the increase of three genera known to be associated with secondary infections following HRV infections. The observed changes of upper respiratory tract microbiota could help explain why HRV infection predisposes to bacterial otitis media, sinusitis and pneumonia. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1081-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J J Hofstra
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,Department of Anaesthesiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - S Matamoros
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - M A van de Pol
- Department of Experimental Immunology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - B de Wever
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - M W Tanck
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - H Wendt-Knol
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - M Deijs
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - L van der Hoek
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - K C Wolthers
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - R Molenkamp
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - C E Visser
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - P J Sterk
- Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - R Lutter
- Department of Experimental Immunology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
| | - M D de Jong
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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van de Pol MA, Lutter R, van Ree R, van der Zee JS. Increase in allergen-specific IgE and ex vivo Th2 responses after a single bronchial challenge with house dust mite in allergic asthmatics. Allergy 2012; 67:67-73. [PMID: 21958117 DOI: 10.1111/j.1398-9995.2011.02722.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Airway responsiveness to allergen in patients with allergic asthma is studied by bronchial allergen challenge. Although the typical features of the early and late responses on lung function and bronchial inflammation after allergen challenge are well known, little has been reported as yet on any changes in systemic allergic and immunologic parameters after 4-6 weeks. METHODS In a clinical study, 27 subjects with allergic asthma and house dust mite (HDM) allergy underwent a bronchial allergen challenge with HDM. Blood samples were collected before and 5 weeks after allergen challenge. Serum levels of total IgE and allergen-specific IgE were measured, and peripheral blood mononuclear cells were isolated and stimulated ex vivo with HDM to determine the allergen-specific T-cell cytokine response. RESULTS Five weeks after bronchial allergen challenge with HDM, the amount of circulating IgE against HDM and the major allergenic components Der p1 and Der p2 was significantly increased (10.8% and 8.8%, respectively). IgE antibodies against other environmental allergens decreased (grass pollen) or remained unchanged (cat dander). Allergen-induced Th2-cytokine production was also significantly increased (P< 0.001, P=0.014, and P=0.006 for IL-4, IL-5, and IL-13, respectively). The increase in Der p1- and Der p2-specific IgE in serum correlated with increased numbers of Th2-cytokine-producing cells (Rs=0.56, P=0.002 and Rs=0.54, P=0.004 for IL-4 and IL-13, respectively). CONCLUSIONS A single bronchial allergen challenge with HDM is accompanied by increased levels of allergen-specific IgE for HDM in serum and an enhanced Th2 response to HDM still detectable 5 weeks after challenge.
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Affiliation(s)
- M A van de Pol
- Departments of Pulmonology Experimental Immunology Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
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van de Pol MA, Lutter R, Smids BS, Weersink EJM, van der Zee JS. Synbiotics reduce allergen-induced T-helper 2 response and improve peak expiratory flow in allergic asthmatics. Allergy 2011; 66:39-47. [PMID: 20716319 DOI: 10.1111/j.1398-9995.2010.02454.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies suggest that pre/probiotics can be used in the prevention and treatment of early allergic disease in newborns and young children. OBJECTIVE To determine the effect of treatment with synbiotics (90% short-chain galacto-oligosaccharides, 10% long-chain fructo-oligosaccharides: Immunofortis(®) and Bifidobacterium breve M-16V) on allergic responses in adults with established allergic asthma. Primary outcome was allergen-induced bronchial inflammation as represented by eosinophil counts. METHODS Twenty-nine patients with asthma and house dust mite (HDM) allergy were randomized in a double-blind, parallel design to receive placebo or synbiotics for 4 weeks. At study entry and after treatment, a bronchial allergen challenge with HDM was performed, followed by lung function tests, collection of blood (in/ex vivo IL-5) and induced sputum (inflammatory parameters). During treatment, a diary was kept with peak expiratory flow (PEF) and asthma scores. RESULTS Treatment did not affect the allergen-induced increase in sputum eosinophils at 6 and 24 h after challenge. Likewise, other parameters for bronchial inflammation and early and late changes in lung function did not differ upon treatment. Both the morning and evening PEF, however, significantly increased during synbiotics treatment (morning P = 0.003, evening P = 0.011). Also, the increase in serum IL-5 after allergen challenge was significantly inhibited by synbiotics (P = 0.034), as was ex vivo allergen-induced Th2-cytokine (IL-5 and IL-4+ IL-13) production by PBMCs (P = 0.046). In vivo (24 h) and ex vivo IL-5 production were associated. CONCLUSION Four-week treatment with synbiotics had no effect on bronchial inflammation and LAR, but did significantly reduce systemic production of Th2-cytokines after allergen challenge and improved PEF.
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Affiliation(s)
- M A van de Pol
- Department of Pulmonology, Academic Medical Center (University of Amsterdam), Amsterdam, the Netherlands
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Krop EJM, van de Pol MA, Lutter R, Heederik DJJ, Aalberse RC, van der Zee JS. Dynamics in cytokine responses during the development of occupational sensitization to rats. Allergy 2010; 65:1227-33. [PMID: 20121760 DOI: 10.1111/j.1398-9995.2009.02323.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Occupational allergy forms an attractive model to study the development of allergic responses, as in some occupations it has a high incidence and develops quickly. In a cohort of starting laboratory animal workers, we previously found 20% sensitization to animal allergens within 2 years. METHODS We compared cellular responses of incident laboratory animal workers who developed rat-specific sensitization (cases, n = 18) during 2 years of follow-up to control animal workers matched for atopic status but without sensitization after follow-up (controls, n = 18). Practically, this is a case-control study, nested within the cohort. Rat-specific IgE antibodies were measured in sera, and allergen-specific and nonspecific cytokine responses were measured in whole blood and in isolated peripheral blood mononuclear cells. RESULTS Self-reported allergic symptoms were related to the presence of rat-specific IgE (P ≤ 0.01). Cases developed a rat allergen-specific interleukin (IL)-4 response during sensitization, while controls did not show an increased IL-4 response (at visit D: 33 vs 5 IL-4 producing cells/10(6) cells, P < 0.001). The IL-4 response was related to the levels of rat-specific IgE in cases (visit D: rho = 0.706, P < 0.001). By contrast, allergen-specific IL-10 and interferon γ (IFNγ) responses as well as nonspecific cytokine responses were comparable between cases and controls. CONCLUSION This study is the first to show the development of an allergen-specific IL-4 response in adult human subjects during allergen-specific sensitization. This IL-4 response was quantitatively associated with the development of the specific IgE antibodies. Allergen-specific or nonspecific IL-10 and IFNγ responses showed no protective effect on the development of allergic sensitization.
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Affiliation(s)
- Esmeralda J M Krop
- Department of Pulmonology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Abstract
A beneficial effect of long-term corticosteroid treatment in patients with COPD may be linked to suppressing inflammation, in particular neutrophilic inflammation. Effects on neutrophilic and eosinophilic inflammation and on lung function of long-term inhaled budesonide treatment (800 microg daily, 6 months, double-blind, randomised, cross-over versus placebo) were studied and compared to the effects of 3 weeks oral prednisolone (30 mg daily) in 19 patients with COPD (mean age 63 y, FEV(1) 65% of predicted). Neither treatment influenced neutrophilic inflammation. Inhaled budesonide compared to placebo significantly reduced sputum % eosinophils at 3 months (-42%, p = 0.036), but not significantly at 6 months (-31%, p = 0.78). Eosinophil count per g sputum was decreased with 30% at 3 months (p = 0.09) and with 9% at 6 months (p = 0.78). FEV(1) was slightly higher after 6 months budesonide (+2.5% predicted, p = 0.09). Prednisolone significantly reduced sputum % eosinophils (-87%, p = 0.007), but did not affect eosinophil count per g sputum and did not improve FEV(1) (-0.6% predicted, p = 0.40). A higher baseline FEV(1) (%) correlated with effects of budesonide on FEV(1) (p < 0.001), effects on sputum interleukin-8 and eosinophil cationic protein (both p < 0.05) and tended to correlate with effects on sputum % eosinophils (p = 0.056). Baseline inflammatory data and effects of prednisolone did not correlate with effects of budesonide. Effects of inhaled budesonide in COPD are not restricted to patients with severe disease and may be linked to a suppression of eosinophilic inflammation. Investigating effects of prednisolone has no predictive value for long-term treatment.
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Affiliation(s)
- M Boorsma
- Department of Pulmonology, Academic Medical Center, University of Amsterdam, Amsterdam, DE, The Netherlands.
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