Inhaled heparin in cystic fibrosis

Cystic fibrosis (CF) is characterised by inspissated airway secretions and chronic endobronchial infection associated with exuberant neutrophilic inflammation. Unfractionated heparin may be mucolytic and has demonstrated a number of anti-inflammatory properties; however, further safety data are needed in these subjects who are at risk of airway bleeding. The current study aimed to assess the medium-term safety and tolerability of moderately high-dose inhaled heparin in CF adults and to explore possible in vivo mucolytic and anti-inflammatory outcomes. A randomised, double-blind, placebo-controlled crossover study of twice daily inhalation of 50,000 IU of heparin for 2 weeks was undertaken in CF adults, with a 1-week washout period. Eighteen subjects were randomised and 14 (mean±SD age 23±7.8 yrs and percentage-predicted forced expiratory volume in one second 52.1±15.56%) completed the study protocol. Heparin neither affected blood coagulation parameters nor resulted in any increase in adverse events. Heparin inhalation had no significant effect upon forced expiratory volume in one second, symptoms of sputum clearance or sputum inflammatory markers. The current pilot study demonstrated no evidence of improved sputum clearance with 50,000 IU of inhaled heparin given twice daily to adult cystic fibrosis subjects. However, inhaled heparin was safe and the future evaluation of larger doses over a longer period may be warranted

Interaction between neutrophils and Schistosoma mansoni larvae in vivo: a transmission electron-microscopic study Interação entre neutrófilos e larvas de Schistosoma mansoni in vivo: estudo ao microscópio eletrônico de transmissão

Schistosoma mansoni cercariae were inoculated into the peritoneal cavity of naive mice and recovered 30 minutes later. Ultrastructural studies showed that neutrophils adhere to the larval surface and participate in the removal of glycocalyx by phagocytosis. This finding suggests that the neutrophils can play a role on the cercaria-schistosomulum transformation process.<br>Cercárias de Schistosoma mansoni foram inoculadas na cavidade peritoneal de camundongos normais e recuperadas 30 minutos depois. Estudos ultra-estruturais mostraram que neutrófilos aderem à superfície da larva, participando da remoção do glicocálice através de fagocitose. Este achado sugere que neutrófilos possam ter papel no processo de transformação de cercária em esquistossômulo