Mometasone furoate and fluticasone furoate are equally effective in restoring nasal epithelial barrier dysfunction in allergic rhinitis

Rinitis alérgica; Integridad epitelial; Furoato de mometasonaRinitis al·lèrgica; Integritat epitelial; Furoat de mometasonaAllergic rhinitis; Epithelial integrity; Mometasone furoateTight junction defects (TJ) have been associated with a defective epithelial barrier function in allergic rhinitis (AR). Intranasal corticosteroids are potent drugs frequently used to treat AR and are shown to restore epithelial integrity by acting on TJs and by reducing type 2 cytokine production. However, the effect of different classes of intranasal corticosteroids on the epithelial barrier has not been studied. Therefore, we compared the effect of 2 intranasal corticosteroids, ie, fluticasone furoate (FF) and mometasone furoate (MF) on epithelial barrier function. Both FF and MF similarly increased trans-epithelial electrical resistance of primary nasal epithelial cell cultures from AR patients. In a house dust mite-induced allergic asthma mouse model, FF and MF had similar beneficial effects on fluorescein isothiocyanate–dextran 4 kDa mucosal permeability, eosinophilic infiltration and IL-13 levels. Both molecules increased mRNA expression of the TJ proteins occludin and zonula occludens-1, thereby restoring epithelial barrier function. Lastly, we showed that long-term FF treatment also increased expression of occludin in AR patients compared to controls. In conclusion, both FF and MF effectively restore epithelial barrier function by increasing expression of TJ proteins in AR patients.This work was supported by an unrestricted grant from GSK. BS is supported by the Fund for Scientific Research Flanders (FWO), Belgium

Multiple reasons underlaying uncontrolled disease in the majority of chronic rhinosinusitis patients

BackgroundUp to 40% of patients with chronic rhinosinusitis (CRS) remain uncontrolled despite guidelines of care being available, with an enormous socio-economic impact. The reasons for uncontrolled disease can be arbitrarily divided into disease-related, diagnosis-related, treatment-related, and patient-related factors. The relative contribution of each factor in uncontrolled CRS remains speculative. This explorative study aimed at determining the factors responsible for uncontrolled CRS in a tertiary care center, thereby identifying the most commons reasons for uncontrolled disease in CRS.MethodsPatients with uncontrolled CRS (n = 187) were asked to fill out a questionnaire and underwent a clinical examination at the outpatient clinic of the University Hospital of Leuven, Belgium. Two independent physicians evaluated the (multiple) reason(s) for uncontrolled disease.ResultsIn uncontrolled CRS, 66% of patients showed two or more reasons for uncontrolled disease according to the physicians' evaluation. Disease-related factors (70%) were most often considered the reason for uncontrolled disease, followed by treatment- (45%), patient- (42%), and diagnosis- (32%) related factors.ConclusionIn case of uncontrolled CRS, the different contributing factors to the uncontrolled nature need to be carefully addressed during diagnostic and therapeutic actions in order to define strategies to improve CRS care. Most uncontrolled CRS patients have multiple reasons contributing to their disease status, with disease-related factors being the most common factor

De oorlog maakt school. Herinneringspraktijken in het Belgische onderwijs na de Eerste Wereldoorlog

Immediately after the First World War, the Belgian government attached great importance to the dissemination of a unified and patriotic war narrative. In primary as well as in secondary education, the memory of the war had to be cultivated in the history class, but also outside the regular courses, in a more affective vein. Textbooks and notebooks, classroom walls, playgrounds and field trips, they all referred to the war. In many instances, the government encouraged or supported these initiatives. The specific outlook of these practices of remembrance was however locally determined. In this contribution, two types of local remembrance practices are presented: the school commemoration of fallen students or former students, and the organization of field trips to the former front region. Both practices involved different concepts of memory. In the case of commemorative monuments, the main aim was to link different generations to each other. The dead – who were presented as real individuals - were supposed to stand as a model for the living. Students who had died for their fatherland and who had behaved courageously had to inspire the soldiers of the future. In field trips to the front region, a different type of memory was conceptualized. Not the connection between the dead and the living, but abhorrence at the sight of so much destruction was stimulated. Here, the past couldn’t possibly be a model for the future. Thanks to this negative approach, this remembrance practice would remain successful in the long run. In an era in which education on the war became immersed in peace education, such field trips could remain meaningful.status: publishe

Beyond narratives of conflict : modern medicine, reproduction and Catholicism in contemporary historiography

Over the last two decades, the topic of Western biomedicine and religion has gained firm ground among historians. While taking distance from both confessional approaches and interpretations of the past that were implicitly informed by a narrative of conflict between medicine and religion, historians have recently integrated phenomena of separate coexistence and examples of mutual influence and collaboration in their work. In this article, we discuss the state of the art and the future agenda of the historiography of Catholicism and biomedicine in Europe and the United States, with a special interest in questions of reproduction. We thereby take into account the different levels on which this encounter has been studied: from the Vatican's prescriptions to the collective reproductive behavior of Catholic populations, from the negotiations of medical professionals such as Catholic doctors and nurses to individual bodily experiences of the faithful

Beyond narratives of conflict : modern medicine, reproduction and Catholicism in contemporary historiography

Over the last two decades, the topic of Western biomedicine and religion has gained firm ground among historians. While taking distance from both confessional approaches and interpretations of the past that were implicitly informed by a narrative of conflict between medicine and religion, historians have recently integrated phenomena of separate coexistence and examples of mutual influence and collaboration in their work. In this article, we discuss the state of the art and the future agenda of the historiography of Catholicism and biomedicine in Europe and the United States, with a special interest in questions of reproduction. We thereby take into account the different levels on which this encounter has been studied: from the Vatican's prescriptions to the collective reproductive behavior of Catholic populations, from the negotiations of medical professionals such as Catholic doctors and nurses to individual bodily experiences of the faithful

Multiple reasons underlaying uncontrolled disease in the majority of chronic rhinosinusitis patients

BACKGROUND: Up to 40% of patients with chronic rhinosinusitis (CRS) remain uncontrolled despite guidelines of care being available, with an enormous socio-economic impact. The reasons for uncontrolled disease can be arbitrarily divided into disease-related, diagnosis-related, treatment-related, and patient-related factors. The relative contribution of each factor in uncontrolled CRS remains speculative. This explorative study aimed at determining the factors responsible for uncontrolled CRS in a tertiary care center, thereby identifying the most commons reasons for uncontrolled disease in CRS. METHODS: Patients with uncontrolled CRS (n = 187) were asked to fill out a questionnaire and underwent a clinical examination at the outpatient clinic of the University Hospital of Leuven, Belgium. Two independent physicians evaluated the (multiple) reason(s) for uncontrolled disease. RESULTS: In uncontrolled CRS, 66% of patients showed two or more reasons for uncontrolled disease according to the physicians' evaluation. Disease-related factors (70%) were most often considered the reason for uncontrolled disease, followed by treatment- (45%), patient- (42%), and diagnosis- (32%) related factors. CONCLUSION: In case of uncontrolled CRS, the different contributing factors to the uncontrolled nature need to be carefully addressed during diagnostic and therapeutic actions in order to define strategies to improve CRS care. Most uncontrolled CRS patients have multiple reasons contributing to their disease status, with disease-related factors being the most common factor

Mometasone furoate and fluticasone furoate are equally effective in restoring nasal epithelial barrier dysfunction in allergic rhinitis

Tight junction defects (TJ) have been associated with a defective epithelial barrier function in allergic rhinitis (AR). Intranasal corticosteroids are potent drugs frequently used to treat AR and are shown to restore epithelial integrity by acting on TJs and by reducing type 2 cytokine production. However, the effect of different classes of intranasal corticosteroids on the epithelial barrier has not been studied. Therefore, we compared the effect of 2 intranasal corticosteroids, ie, fluticasone furoate (FF) and mometasone furoate (MF) on epithelial barrier function. Both FF and MF similarly increased trans-epithelial electrical resistance of primary nasal epithelial cell cultures from AR patients. In a house dust mite-induced allergic asthma mouse model, FF and MF had similar beneficial effects on fluorescein isothiocyanate–dextran 4 kDa mucosal permeability, eosinophilic infiltration and IL-13 levels. Both molecules increased mRNA expression of the TJ proteins occludin and zonula occludens-1, thereby restoring epithelial barrier function. Lastly, we showed that long-term FF treatment also increased expression of occludin in AR patients compared to controls. In conclusion, both FF and MF effectively restore epithelial barrier function by increasing expression of TJ proteins in AR patients