Does Helicobacter pylori have a pathogenic role in bronchiectasis?

SummaryAimTo investigate the presence of Helicobacter pylori (H. pylori) in bronchial biopsies of patients with bronchiectasis, by histochemical and immunochemical staining.Setting800-bed tertiary university hospital.MethodsObservational study. Patients: forty-six patients with bronchiectasis in a stable clinical condition and 8 control patients. Interventions: Serum samples determination of IgG levels for H. pylori by ELISA. Inmunostaining with an anti-H. pylori antibody (NCL-HPp, Novocastra) of bronchial mucosa obtained by fiberoptic bronchoscopy from both patients with bronchiectasis and controls.ResultsTwenty-one out of 46 patients with bronchiectasis (46%) had positive serologies for H. pylori. We obtained 40 bronchial biopsies in patients with bronchiectasis and 8 bronchial biopsies in control patients. No evidence of H. pylori was obtained in the bronchial samples of both patients and controls.ConclusionsThe results of our study could not demonstrate the presence of H. pylori in bronchial specimens from patients with bronchiectasis

Marine and Transitional Middle/Upper Eocene Units of the Southeastern Pyrenean Foreland Basin (NE spain)

The stratigraphic basis of this work has allowed the use of larger foraminifers in the biostratigraphic characterisation of the new Shallow Benthic Zones (SBZ). This part of the volume presents a description of the sedimentary cycles formed by the transgressive-regressive systems of the Lutetian and Bartonian in the southeastern sector of the Ebro Foreland Basin.Concerning the Lutetian deposits studied in the Amer-Vic and Empordà areas, four sedimentary cycles have been characterised. The first and second are found within the Tavertet/Girona Limestone Formation (Reguant,1967;Pallí,1972), while the third and fourth cycles cover the Coll de Malla Marl Formation (Clavell et al.,1970), the Bracons Formation (Gich,1969,1972), the Banyoles Marl Formation (Almela and Ríos,1943),and the Bellmunt Formation (Gich,1969,1972). In the Bartonian deposits studied in the Igualada area,two transgressive-regressive sedimentary cycles have been characterised in the Collbàs Formation (Ferrer,1971),the Igualada Formation (Ferrer,1971),and the Tossa Formation (Ferrer,1971). The Shallow Benthic Zones (SBZs)recognised within the Lutetian are the following:SBZ 13, from the Early Lutetian, in the transgressive system of the first cycle;SBZ 14,from the Middle Lutetian, in the second cycle and the lower part of the transgressive system of the third cycle; SBZ 15,from the Middle Lutetian, in the remaining parts of the third system; SBZ 16, from the Late Lutetian,throughout the fourth cycle.The association of larger foraminifers in the first and second cycles of the Bartonian in the Igualada area has been used as the basis for the definition of SBZs 17 and 18 recognised in the Bartonian of the western Tethys

An inventory of the Marine and Transitional Middle/Upper Eocene Deposits of the Southeastern Pyrenean Foreland Basin (NE spain)

In the southeastern Ebro Foreland Basin, the marine deposits of Lutetian and Bartonian age show excellent outcrop conditions, with a great lateral and horizontal continuity of lithostratigraphic units. In addition, the rich fossil record -mainly larger foraminifers-, provides iostratigraphic data of regional relevance for the whole Paleogene Pyrenean Basin, that can be used for the Middle Eocene biocorrelation of the western Tethys. This contribution is a sedimentary and biostratigraphic synthesis of the basic outcrops and sections of the Lutetian and Bartonian marine and transitional deposits in the southeastern sector of the Ebro Foreland Basin

Redefinition of the Ilerdian Stage (early Eocene)

The Ilerdian Stage was created by Hottinger and Schaub in 1960 to accommodate a significant phase in the evolution of larger foraminifera not recorded in the northern European basins, and has since been adopted by most researchers working on shallow marine early Paleogene deposits of the Tethys domain. One of the defining criteria of the stage is a major turnover of larger foraminifera, marked by the FO’s of Alveolina vredenburgi (formerly A. cucumiformis) and Nummulites fraasi. There is now conclusive evidence that this turnover was coeval with the onset of the Carbon Isotope Excursion (CIE) and, consequently, with the Paleocene-Eocene (P-E) boundary, a temporal correspondence that reinforces the usefulness of the Ilerdian as a chronostratigraphic subdivision of the early Eocene in a regional context. However, in addition to the paleontological criteria, the definition of the Ilerdian was also based on the designation of two reference sections in the southern Pyrenees: Tremp (stratotype) and Campo (parastratotype). In both sections, the base of the stage was placed at the lowest marine bed containing A. vredenburgi specimens. Using the CIE as a correlation tool we demonstrate that these two marine beds occur at different chronological levels, being older in Campo than in Tremp. Further, we show that both beds are in turn younger than the lowest strata with Ilerdian larger foraminifera at the deep-water Ermua section in the Basque Basin (western Pyrenees). Since the age of stage boundaries must be the same everywhere, the choice of these stratotype sections was misleading, since in practice it resulted in the Ilerdian being used as a facies term rather than as a chronostratigraphic unit. To eliminate that conflict, and yet be respectful with established tradition, we propose to redefine the Ilerdian Stage following a procedure similar to the one used by the International Commission on Stratigraphy to establish global chronostratigraphic standards, namely: by using a “silver spike” to be placed in the Tremp section at the base of the Claret Conglomerate, a widespread lithological unit that in the Tremp Graus Basin coincides with the onset of the CIE. The redefined regional Ilerdian Stage becomes thus directly correlatable to the lower part of the global Ypresian Stage, as currently defined by the International Commission on Stratigraphy

An inventory of the marine and transitional Middle/Upper Eocene deposits of the Southeastern Pyrenean Foreland Basin (NE Spain)

In the southeastern Ebro Foreland Basin, the marine deposits of Lutetian and Bartonian age show excellent outcrop conditions, with a great lateral and horizontal continuity of lithostratigraphic units. In addition, the rich fossil record -mainly larger foraminifers-, provides iostratigraphic data of regional relevance for the whole Paleogene Pyrenean Basin, that can be used for the Middle Eocene biocorrelation of the western Tethys. This contribution is a sedimentary and biostratigraphic synthesis of the basic outcrops and sections of the Lutetian and Bartonian marine and transitional deposits in the southeastern sector of the Ebro Foreland Basin

Haemophilus influenzae Infection Drives IL-17-Mediated Neutrophilic Allergic Airways Disease

A subset of patients with stable asthma has prominent neutrophilic and reduced eosinophilic inflammation, which is associated with attenuated airways hyper-responsiveness (AHR). Haemophilus influenzae has been isolated from the airways of neutrophilic asthmatics; however, the nature of the association between infection and the development of neutrophilic asthma is not understood. Our aim was to investigate the effects of H. influenzae respiratory infection on the development of hallmark features of asthma in a mouse model of allergic airways disease (AAD). BALB/c mice were intraperitoneally sensitized to ovalbumin (OVA) and intranasally challenged with OVA 12–15 days later to induce AAD. Mice were infected with non-typeable H. influenzae during or 10 days after sensitization, and the effects of infection on the development of key features of AAD were assessed on day 16. T-helper 17 cells were enumerated by fluorescent-activated cell sorting and depleted with anti-IL-17 neutralizing antibody. We show that infection in AAD significantly reduced eosinophilic inflammation, OVA-induced IL-5, IL-13 and IFN-γ responses and AHR; however, infection increased airway neutrophil influx in response to OVA challenge. Augmented neutrophilic inflammation correlated with increased IL-17 responses and IL-17 expressing macrophages and neutrophils (early, innate) and T lymphocytes (late, adaptive) in the lung. Significantly, depletion of IL-17 completely abrogated infection-induced neutrophilic inflammation during AAD. In conclusion, H. influenzae infection synergizes with AAD to induce Th17 immune responses that drive the development of neutrophilic and suppress eosinophilic inflammation during AAD. This results in a phenotype that is similar to neutrophilic asthma. Infection-induced neutrophilic inflammation in AAD is mediated by IL-17 responses

Roflumilast in moderate-to-severe chronic obstructive pulmonary disease treated with longacting bronchodilators: two randomised clinical trials

Background Patients with chronic obstructive pulmonary disease (COPD) have few options for treatment. The efficacy and safety of the phosphodiesterase-4 inhibitor roflumilast have been investigated in studies of patients with moderate-to-severe COPD, but not in those concomitantly treated with longacting inhaled bronchodilators. The effect of roflumilast on lung function in patients with COPD that is moderate to severe who are already being treated with salmeterol or tiotropium was investigated. Methods In two double-blind, multicentre studies done in an outpatient setting, after a 4-week run-in, patients older than 40 years with moderate-to-severe COPD were randomly assigned to oral roflumilast 500 mu g or placebo once a day for 24 weeks, in addition to salmeterol (M2-127 study) or tiotropium (M2-128 study). The primary endpoint was change in prebronchodilator forced expiratory volume in 1s (FEV(1)). Analysis was by intention to treat. The studies are registered with ClinicalTrials.gov, number NCT00313209 for M2-127, and NCT00424268 for M2-128. Findings In the salmeterol plus roflumilast trial, 466 patients were assigned to and treated with roflumilast and 467 with placebo; in the tiotropium plus roflumilast trial, 371 patients were assigned to and treated with roflumilast and 372 with placebo. Compared with placebo, roflumilast consistently improved mean prebronchodilator FEV(1) by 49 mL (p<0.0001) in patients treated with salmeterol, and 80 mL (p<0.0001) in those treated with tiotropium. Similar improvement in postbronchodilator FEV(1) was noted in both groups. Furthermore, roflumilast had beneficial effects on other lung function measurements and on selected patient-reported outcomes in both groups. Nausea, diarrhoea, weight loss, and, to a lesser extent, headache were more frequent in patients in the roflumilast groups. These adverse events were associated with increased patient withdrawal. Interpretation Roflumilast improves lung function in patients with COPD treated with salmeterol or tiotropium, and could become an important treatment for these patients