Oral tolerance inhibits pulmonary eosinophilia in a cockroach allergen induced model of asthma: a randomized laboratory study

<p>Abstract</p> <p>Background</p> <p>Antigen desensitization through oral tolerance is becoming an increasingly attractive treatment option for allergic diseases. However, the mechanism(s) by which tolerization is achieved remain poorly defined. In this study we endeavored to induce oral tolerance to cockroach allergen (CRA: a complex mixture of insect components) in order to ameliorate asthma-like, allergic pulmonary inflammation.</p> <p>Methods</p> <p>We compared the pulmonary inflammation of mice which had received four CRA feedings prior to intratracheal allergen sensitization and challenge to mice fed PBS on the same time course. Respiratory parameters were assessed by whole body unrestrained plethysmography and mechanical ventilation with forced oscillation. Bronchoalveolar lavage fluid (BAL) and lung homogenate (LH) were assessed for cytokines and chemokines by ELISA. BAL inflammatory cells were also collected and examined by light microscopy.</p> <p>Results</p> <p>CRA feeding prior to allergen sensitization and challenge led to a significant improvement in respiratory health. Airways hyperreactivity measured indirectly via enhanced pause (Penh) was meaningfully reduced in the CRA-fed mice compared to the PBS fed mice (2.3 ± 0.4 vs 3.9 ± 0.6; p = 0.03). Directly measured airways resistance confirmed this trend when comparing the CRA-fed to the PBS-fed animals (2.97 ± 0.98 vs 4.95 ± 1.41). This effect was not due to reduced traditional inflammatory cell chemotactic factors, Th2 or other cytokines and chemokines. The mechanism of improved respiratory health in the tolerized mice was due to significantly reduced eosinophil numbers in the bronchoalveolar lavage fluid (43300 ± 11445 vs 158786 ± 38908; p = 0.007) and eosinophil specific peroxidase activity in the lung homogenate (0.59 ± 0.13 vs 1.19 ± 0.19; p = 0.017). The decreased eosinophilia was likely the result of increased IL-10 in the lung homogenate of the tolerized mice (6320 ± 354 ng/mL vs 5190 ± 404 ng/mL, p = 0.02).</p> <p>Conclusion</p> <p>Our results show that oral tolerization to CRA can improve the respiratory health of experimental mice in a CRA-induced model of asthma-like pulmonary inflammation by reducing pulmonary eosinophilia.</p

Burnout in nurses working in Portuguese palliative care teams: a mixed methods study

info:eu-repo/semantics/publishedVersio

Defence Mechanisms and Coping Strategies among Caregivers in Palliative Care Units

This article focuses on the relationship between defence mechanisms, coping strategies, palliative attitude, and the well-being of caregivers in palliative care units, who are confronted with death, suffering, and pain. They use many different defence mechanisms; however, studies linking their coping strategies and defence mechanisms are rare. This study uses a quantitative and qualitative design and is based on 18 caregivers (nurses) in 2 palliative care units in Belgium. Defence mechanisms are tested through a semi-structured interview, TAT, and DSQ-60. Coping strategies are evaluated through a semistructured interview, COPE, and WCQ. To maximize our global approach, coping strategies and defence mechanisms are associated with measures of wellbeing and palliative attitude. We determined that defence mechanisms and coping strategies should not be seen as obstacles to professional practices. Palliative caregivers are more likely to adopt “mature” and “mental inhibition and compromise formation” defence mechanisms, as well as “emotion-focused” and “problem-focused” coping strategies. Defence mechanisms are more unconscious and constitute appropriate answers in extreme emotional situations. Coping strategies allow for more conscious processes of adaptation to the environment of palliative care units. This study shows positive relationships between different defence mechanisms and coping strategies, palliative attitudes, and caregivers’ well-being. Institutions should improve the conditions for group exchange and for caregivers’ individual introspection so that caregivers develop adapted capacities to cope with anxiety