Change in inflammation in out-patient COPD patients from stable phase to a subsequent exacerbation

BACKGROUND: Inflammation increases during exacerbations of COPD, but only a few studies systematically assessed these changes. Better identification of these changes will increase our knowledge and potentially guide therapy, for instance by helping with quicker distinction of bacterially induced exacerbations from other causes. AIM: To identify which inflammatory parameters increase during COPD exacerbations compared to stable disease, and to compare bacterial and non-bacterial exacerbations. METHODS: In 45 COPD patients (37 male/8 female, 21 current smokers, mean age 65, FEV(1) 52% predicted, pack years 38) sputum was collected during a stable phase and subsequently during an exacerbation. RESULTS: Sputum total cell counts (9.0 versus 7.9 x 10(6)/mL), eosinophils (0.3 versus 0.2 x 10(6)/mL), neutrophils (6.1 versus 5.8 x 10(6)/mL), and lymphocytes (0.07 versus 0.02 x 10(6)/mL) increased significantly during an exacerbation compared to stable disease. A bacterial infection was demonstrated by culture in 8 sputum samples obtained during an exacerbation. These exacerbations had significantly increased sputum total cell and neutrophil counts, leukotriene-B4, myeloperoxidase, interleukin-8 and interleukin-6, and tumor necrosis factor-alpha (TNF-alpha) levels, and were also associated with more systemic inflammation compared to exacerbations without a bacterial infection. Sputum TNF-alpha level during an exacerbation had the best test characteristics to predict a bacterial infection. CONCLUSION: Sputum eosinophil, neutrophil, and lymphocyte counts increase during COPD exacerbations. The increase in systemic inflammation during exacerbations seems to be limited to exacerbations caused by bacterial infections of the lower airways. Sputum TNF-alpha is a candidate marker for predicting airway bacterial infection

Preeclampsia is Associated with lower Percentages of Regulatory T Cells in Maternal Blood

Objective: Immunological mechanisms are involved in the pathophysiology of preeclampsia. During pregnancy there is an increase in regulatory T (Treg) cells, which has an important role in regulating tolerance to the immunologically distinct fetus. We hypothesised that percentages of Treg cells are decreased in preeclamptic patients. Methods: Peripheral blood was obtained from 26 healthy pregnant controls and 18 preeclamptic patients. Treg cells were measured using flow-cytometry. Results: Women with pregnancies complicated by preeclampsia had significantly lower percentages of CD4(+)FOXP3(+) Treg cells. Conclusion: We conclude that a deficiency of regulatory T cells may play a role in the pathophysiology of preeclampsia

Asthma, airway hyperresponsiveness and exposure to indoor allergens

Allergic sensitization to indoor allergens is an important risk factor for the development of asthma and exposure to these allergens is an important cause of asthmatic symptoms in sensitized patients. Recommendations for reduction this exposure are important in the treatment of allergic patients. During the last decade, specific assays for assessment of allergen exposure have become available and it has therefore become possible to evaluate the effects of allergen avoidance measures. ... Zie: Summary

Basophil-activation tests in hymenoptera allergy

The measurement of basophil-activation markers may be useful in detecting IgIE-mediated sensitization but the relevance for application of the basophil-activation test in prediction of clinical reactivity in Hymenoptera allergy is very limited. For this reason, this test currently has no established role in the diagnosis and management of patients with insect sting allergy

Measurement of specific IgE and IgG antibodies against Aspergillus fumigatus antigen in patient sera by use of enzyme immunoassays:Influence of different procedures of antigen immobilization

IgG and IgE antibody titers against Aspergillus fumigatus were measured in patient sera by enzyme immunoassays by use of antigens or allergens immobilized to different carriers. Specific-IgG antibodies were measured by a double antibody-layer enzyme immunoassay; specific IgE was determined by Phadezym-RAST (Pharmacia Diagnostics). In both cases antigens and allergens were immobilized in two ways: first by covalent binding to CNBr-activated paper discs and second by spontaneous binding to polystyrene surface of microtiter plates. Much higher IgE-antibody titers were found with allergens immobilized to paper discs when these discs were compared with microtiter plates, which could be explained by a higher allergen-binding capacity of activated paper discs. On the contrary, higher IgG antibody titers were found with antigens bound to microtiter plates when these plates were compared with paper discs. It is concluded that IgG antibodies are directed against antigenic components that are preferentially bound to polystyrene surfaces