The mechanism of human basophil activation through the low affinity IgG receptor (Fc γ RⅡ) : Analysis of calcium mobilization using a new flow cytometric method

A new method for flow cytometric analysis of calcium mobilization in human peripheral blood basophils without prior purification was developed. The method is based on dual color analysis of centrifugation-enriched mononuclear cell populations using fluo-3 and phycoerythrin (PE)-conjugated CD2, CD14, CD16, CD19 monoclonal antibodies (mAb) to stain contaminated cells. This technique allows the detection of fluo-3 fluorescence as a measure of an increase in the cytoplasmic free calcium concentration ([Ca(2+)]i) while simulataneously discriminating PE-mAb-unlabelled basophils. To clarify whether the human peripheral blood basophil is activated through the low affinity IgG receptor, Fc γ RⅡ, as well as the high affinity IgE receptor, Fc ε　RⅠ, calcium mobilization after Fc γ RⅡ stimulation was analyzed by this method. After cross-linking of Fc γ RⅡ, transient [Ca(2+)]i elevation was observed but there was no apparent difference with interleukin-3(IL-3)-treated cells, and no significant histamine release was observed with or without short pre-incubation of IL-3. These findings suggest that the cross-linking of Fc γ RⅡ, not only Fc ε　RⅠ, can activate human basophils which may result in mediator release other than histamine

Nintedanib can be used safely and effectively for idiopathic pulmonary fibrosis with predicted forced vital capacity <= 50%: A multi-center retrospective analysis

Background Nintedanib is a multi-kinase inhibitor approved for idiopathic pulmonary fibrosis (IPF); however, its efficacy and safety for patients with IPF and restricted pulmonary function remain unclear. Therefore, the objective of this study was to determine the efficacy and safety of nintedanib for patients with IPF and forced vital capacity (FVC) ≤ 50%. Methods This was a multi-center retrospective study performed by the Okayama Respiratory Disease Study Group. Patients were allocated into FVC ≤ 50% and FVC > 50% groups based on their predicted FVC. The primary endpoints were FVC changes from baseline after 6 and 12 months. Results 45 patients were eligible for the study. 18 patients had FVC ≤ 50%, and 27 patients had FVC > 50%. Overall, 31 and 19 patients underwent pulmonary function tests at 6 and 12 months after initiating nintedanib, respectively. FVC changes from baseline at 6 and 12 months after initiating nintedanib were comparable between the two groups. Adverse events were seen in all patients, and the rates of patients who discontinued nintedanib were also comparable (38.9% vs. 37.0%, p = 1.000). Multiple regression analysis showed that age and forced expiratory volume in 1 second (FEV1)/FVC were negatively correlated with changes in FVC at 6 months after initiating nintedanib. Conclusions Our data suggest that nintedanib can be a useful agent for IPF patients, including those with a low FVC, and that age and FEV1/FVC are predictive markers for changes in FVC following nintedanib treatment

Variant angina pectoris associated with FOLFOX4 therapy

The patient was a 71-year-old man who underwent a right hemicolectomy for ascending colon cancer (pT3, pN1, pM0) and who opted not to receive adjuvant chemotherapy. Eight months later, multiple liver metastases occurred. He therefore received FOLFOX4 (5-fluorouracil/leucovorin and 85 mg/m2 oxaliplatin) therapy, up to a total of 5 courses, and showed a partial response. While receiving the sixth course of FOLFOX4, he complained of chest pain and systemic itching approximately 15 min after the start of chemotherapy. An electrocardiogram revealed typical signs of ischemia. Coronary arteriography showed that the coronary arteries were intact. Believing the chest pain to be merely coincidental, we continued with the same therapy. However, he again developed the same chest pain during the seventh cycle of FOLFOX4 and treatment was stopped. We concluded that the patient’s symptoms were due to acute coronary syndrome (ACS) associated with the FOLFOX4 regimen. Variant angina as a type of ACS is a rare adverse effect of FOLFOX4. Clinicians should be aware of this potential adverse effect when monitoring patients receiving FOLFOX4