Antitumor and adjuvant effects of phagelysates of E.coli in mice with Ehrlich carcinoma

AIM

To augment anti-tumor host response and overcome the tumor-induced immunosuppression is of paramount importance especially when patient is subjected to radio-/chemotherapy and immune system suffers significantly. Various immunological methods have been employed as supplemental antitumor therapies. We were aimed to investigate the antitumor potential of phagelysates of gram-negative bacteria and their adjuvant effects for conventional chemotherapy in experiment.

METHODS

Bacterial phagelysates of E.coli and purified suspensions of corresponding Un bacteriophage were obtained by standard methods of phage research. Experiments were carried out on BL57C/6J mice bearing transplanted Ehrlich carcinoma. Different regimens of phagelysate administration (0,5 ml E. coli phagelysate, 3/8 times with 5 day intervals) and conventional chemotherapy (combination of Doxorubicin 60 mg/m2, Cyclophosphan 800 mg/m(2), Ftoruracil 600 mg/m(2), 3 times with 21 day intervals) were tested. Treatment efficacy was evaluated by tumor growth inhibition percent, index of malignant growth, lifespan and survival percent.

RESULTS

Experiments have shown that application of optimal doses of E. coli phagelysate can be well tolerated in mice. No stimulation or support of malignant growth was observed. E. coli phagelysate exhibited significant anticancer effect and adjuvant efficacy. Cancer development was delayed in 65% of inoculated animals in the test group. E. coli phagelysate inhibited tumor growth by 80-90% without apparent side effects. The mice survival was prolonged twice and more. On 65th-69th days of tumor growth in 13% animals complete regression of neoplasms was registered. Application of phagelysates in combination with chemotherapy significantly increased antitumor efficacy of conventional chemotherapeutic drugs.

CONCLUSION

Application of bacterial phagelysates can be considered as promising novel strategy in cancer therapeutics.

[Application of bacterial thermo-and phagelysates for suppression of malignant tumor growth in experimental studies: 1. Anticancer efficacy of thermo- and phagelysates of E.coli]

Immunotherapy is considered as one of the promising treatment strategies for patients with malignant tumors. In the presented work antitumor effects of E.coli thermo- and phagelysates on Ehrlich carcinoma growth in mice have been studied. The treatment efficacy was evaluated by estimation of dynamic changes in volume of cancer tissue and by the percentage of cancer growth inhibition. Semi-empirical mathematical model, describing cancer volume variations in relation to time, passed after Ehrlich carcinoma inoculation was elaborated. It was shown that at the early stage of cancer growth both tested bacterial preparations significantly inhibit cancer growth. Antitumor treatment effects were better expressed in animal studies using bacterial phagelysates in comparison to that of thermolysates. After cessation of administration of bacterial preparations a prolonged antitumor activity in animals treated with E. coli phagelysates was demonstrated.

Does OM-85 BV prophylaxis trigger autoimmunity in IgA deficient children?

BACKGROUND

IgA deficiency (IgAD) is the most common primary antibody deficiency. Although two-third of the cases are reported to be asymptomatic, some IgAD children may have frequent infections that urge the clinicians to search for prophylactic measures. OM-85 BV is one of these agents that is known to stimulate mucosa associated lymphoid tissue, and upregulate Th-1 response. This study was performed to determine a possible role of OM-85 BV in triggering autoimmunity in IgAD children within a four-year-follow up period.

METHODS

Sixty-three children (34 males (54%), 29 females (46%)) with sporadic IgAD and recurrent febrile infections were included. Patients were carefully screened for autoimmunity both on admission and in follow-up: Those with autoimmune features or under immunosuppressant treatment were excluded. Patients were randomly divided into two groups: Group I received bacterial lysate propylaxis (OM-85 BV) (n:37), and Group 2 received no prophylactic regimen (n:26). Development of clinical autoimmune findings or autoantibodies (anti-nuclear antibody (ANA), ANA profile (14 antigens), anti-cytoplasmic antibodies (ANCA), anti-cardiolipin antibodies IgG and IgM (aCL), rheumatoid factor (RF), direct Coombs test, anti-thyroglobulin (anti-T) and anti-thyroid microsomal antigen (anti-M)) were evaluated.

RESULTS

Mean age of the study group, age at the onset of infectious symptoms and at admission were 102.9±42.2, 27.1±24.9, and 55.2±25.1 months, respectively. Follow-up duration of the whole study group was 48.3±23.1 months. Number of infections was 6.2±2.7 per year in the whole study group. Sixteen patients (25.4%) of the whole study group showed ANA positivity in different patterns and titers. Frequency of ANA, ANCA and RF positivity was 24.3%, 5.4%, 2.7% in Group 1, and 26.9%, 11.5%, 3.8% in Group 2, respectively. Statistical comparisons revealed no significant difference between the two groups.

CONCLUSION

Significant clinical or laboratory markers for autoimmunity in follow-up were not observed between receivers or non-receivers of OM-85 BV. Frequency of ANA positivity was comparable to the previously reported values in IgAD children which was not affected by OM-85 BV usage. Possible effect of triggering autoimmunity with repeated cures of bacterial lysates needs to be further clarified. Side effects requiring the cessation of treatment were not recorded.

The immunostimulant OM-85 BV prevents wheezing attacks in preschool children

BACKGROUND

No reagents have been shown to be effective in preventing wheezing attacks provoked by acute respiratory tract illnesses (ARTIs) in preschool children. New therapeutic agents and preventive strategies are needed.

OBJECTIVES

We assessed the effect of OM-85 BV (Broncho-Vaxom; OM Pharma, Geneva, Switzerland) in preventing ARTI-provoked wheezing attacks in preschool children with recurrent wheezing.

METHODS

A randomized, double-blind, placebo-controlled, parallel-group study was carried out between August 2007 and September 2008. The study included 75 children with recurrent wheezing who were 1 to 6 years old. Participants were randomly assigned to groups given either OM-85 BV or a placebo (1 capsule per day for 10 days each month for 3 consecutive months) at the start of the trial. Participants were followed for 12 months, which included the administration period of the test article.

RESULTS

Subjects given OM-85 BV had a lower rate of wheezing attacks. The cumulative difference in wheezing attacks between the 2 groups was 2.18 wheezing attacks per patient in 12 months; there was a 37.9% reduction in the group given OM-85 BV compared with the group given placebo (P < .001). Stepwise multiple (linear) regression analysis showed that the main difference between the OM-85 BV and placebo groups was a reduction the number of ARTIs (R = -0.805, P < .001). The duration of each wheezing attack was 2 days shorter in the group given OM-85 BV than in the group given placebo (P = .001).

CONCLUSION

Administration of OM-85 BV significantly reduced the rate and duration of wheezing attacks in preschool children with ARTIs.

Blood components for topical use in tissue regeneration: evaluation of corneal lesions treated with platelet lysate and considerations on repair mechanisms

BACKGROUND

The fields of application of topically administered platelet derivatives are numerous and increasing. The use of this blood component is based on the fact that it contains growth factors and proteins of the clotting system. Studies carried out so far have been aimed at identifying these substances, assaying their content in the various types of platelet concentrate used, determining the in vivo and in vitro mechanisms of action, and trying to standardise the production methods. However, much still remains to be discovered, not only about the growth factors, but also about all those cytokines and biochemical mediators that are involved in the processes of tissue regeneration.

METHODS

We studied the use of platelet lysate, obtained from platelet-rich plasma which had been frozen, for the treatment of corneal ulcers caused by neurotrophic keratitis and of epithelial and stromal loss following physical or chemical trauma. The platelet lysate was administered in the form of eye drops to patients who had not responded to conventional therapy and who were at risk of corneal scarring.

RESULTS

The results were satisfactory in terms of both tissue regeneration and healing time. The clinical follow-up showed a clear reduction in the time of regeneration of the damaged epithelium and stabilisation of the repair process. The epithelial defects disappeared completely in all the treated eyes within 6 to 32 days, with the time depending on the type of lesion and the severity of the damage.

CONCLUSIONS

The cornea reacts to damage by releasing numerous substances, including cytokines, growth factors, proteases and neuropeptides in order to restore its anatomical integrity. A change in the balance between inhibitory and stimulating substances can lead to the development of complications. Fast, correct re-epithelialisation is fundamental for the formation of new, transparent tissue. The use of non-gelified platelet-rich plasma was found to be effective in all cases with loss of epithelium, such as post-herpetic corneal ulcers or ulcers occurring following trauma or exposure to caustic substances.

A prospective multi-center trial of Escherichia coli extract for the prophylactic treatment of patients with chronically recurrent cystitis

We have assessed the efficacy and safety of Escherichia coli extract (ECE; Uro-Vaxom) which contains active immunostimulating fractions, in the prophylactic treatment of chronically recurrent cystitis. Forty-two patients with more than 2 episodes of cystitis in the proceeding 6 months were treated for 3 months with one capsule daily of ECE and observed for a further 6 months. The primary efficacy criterion was the number of episodes of recurrent cystitis during the 6 months after treatment compared to those during the 6 months before treatment. At the end of the 9-month trial, 34 patients (all women) were eligible for statistical analysis. Their mean age was 56.4 yr (range, 34-75 yr), and they had experienced recurrent urinary tract infections for 7.2+/-5.2 yr. The number of recurrences was significantly lower during the 6-month follow-up period than during the 6 months preceding the trial (0.35 vs. 4.26, P<0.001). During the follow-up, 28 (82.4%) patients had no recurrences and 4 (11.8%) had 1 each. In patients who relapsed, ECE alleviated cystitis symptoms, including painful voiding, frequency and urgency. There were no serious adverse events related to the study drug. Our study demonstrates the efficacy and safety of ECE in the prophylactic treatment of chronically recurrent cystitis.

Natural products as aromatase inhibitors

With the clinical success of several synthetic aromatase inhibitors (AIs) in the treatment of postmenopausal estrogen receptor-positive breast cancer, researchers have also been investigating the potential of natural products as AIs. Natural products from terrestrial and marine organisms provide a chemically diverse array of compounds not always available through current synthetic chemistry techniques. Natural products that have been used traditionally for nutritional or medicinal purposes (e.g., botanical dietary supplements) may also afford AIs with reduced side effects. A thorough review of the literature regarding natural product extracts and secondary metabolites of plant, microbial, and marine origin that have been shown to exhibit aromatase inhibitory activity is presented herein.

Bacterial immunostimulants--mechanism of action and clinical application in respiratory diseases

Immunity towards bacteria might be achieved as a result of natural processes following infection, or as a consequence of medical intervention including vaccination, administration of immunoglobulins or therapy with immunostimulants derived from bacteria. Bacterial immunostimulants (ISs) containing bacterial lysate (OM-85 BV, LW 50020) or components of bacterial cells (ribosomal extracts) were shown to induce a non-specific response (i.e. intensification of phagocytosis) but also to orchestrate both cellular (B, T cell stimulation) and humoral responses (antibodies and proinflammatory cytokines production). Therefore, the duality of their immunomodulatory activity mimics or, to a certain extent, repeats the immune response evoked by the intrusion of a pathogen into the human body, which is initially non-specific, but subsequently becomes specific. However, their clinical efficacy in the prevention of respiratory tract infection (RTI) is still debated. This article reviews their mechanism of action, as well as the available clinical data, discussing the pros and cons of their use in the prevention of RITs in children and adults.

[Experience with bronchomunal used in the combined treatment of patients with bronchial asthma and chronic obstructive pulmonary disease]

The paper presents the results of treatment in 30 patients aged 16-59 years who have bronchial asthma and chronic obstructive pulmonary disease, by using a bacterial vaccine (bronchomunal) containing antigens of opportunistic bacteria: Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus viridans, Streptococcus piogenes, Moraxella catarrhalis. Immunotherapy with the vaccine had good and excellent effects in 73.33 of cases; the mean duration of acute respiratory viral infection decreased from 16 to 9 days after vaccination and a need for antibiotics. In the comparison group, a good effect was noted in 40% of the patients during one-year follow-up; the difference was statistically significant. The vaccine's tolerance was good; only 3 (9.9%) patients were observed to have vaccination-induced complications: exacerbations of chronic maxillary sinusitis and chronic bronchitis in 2 and 1 patients, respectively. The positive effect of bronchomunal was associated with the better values of cellular immunity, stabilized phagocytosis, and lower IgE levels.

Elastic plasma protein film blended with platelet releasate accelerates healing of diabetic mouse skin wounds

BACKGROUND AND OBJECTIVES

The growth factors derived from platelets and plasma proteins mediate the wound-healing process that is characterized by the sequential migration and differentiation of several cell populations that give rise to angiogenesis, collagen synthesis, wound contraction, and re-epithelialization. To evaluate the efficacy of the blood-derived factors in wound healing, we examined a novel wound dressing consisting of concentrated human plasma proteins and platelet releasate (CPPP).

MATERIALS AND METHODS

To generate CPPP, plasma proteins and platelets in the peripheral blood (n = 5) were concentrated with the cold ethanol precipitation method. The thrombin obtained from the same blood unit and calcium chloride (CaCl(2)) were mixed to a concentrate. The CPPP has enough strength to dress cutaneous wounds and contains large amounts of cytokines and fibronectin. We applied the CPPP to excisional skin wounds in genetically healing-impaired model mice (n= 5) and the wounds were evaluated 10 days after the operation.

RESULTS

The area of CPPP-treated wounds decreased significantly compared with that of the control wounds (65% vs. 94% of the original size, respectively, P= 0.032). The immunostained section revealed a striking effect of CPPP on vascularization compared with the control wounds (13.2 vs. 2.7 vessels per mm(2) as mean vascular density observed in the sections, respectively, P= 0.013).

CONCLUSIONS

Our results suggest that CPPP is a promising biologically active dressing for full-thickness skin wounds. CPPP can be an entirely autologous biological dressing, suggesting that it is free from the risk of transmission of pathogens through blood products.

Photodynamic therapy-generated tumor cell lysates with CpG-oligodeoxynucleotide enhance immunotherapy efficacy in human papillomavirus 16 (E6/E7) immortalized tumor cells

Immunotherapy with photodynamic therapy (PDT) offers great promise as a new alternative for cancer treatment; however, its use remains experimental. In this study, we examined the immunotherapeutic significance of human papillomavirus (HPV)-immortalized tumor cell lysates induced by PDT with CpG-oligodeoxynucleotide (ODN). PDT-cell lysates were generated by irradiating Radachlorin (5 microg/mL) preloaded TC-1 cells carrying HPV 16 E7. PDT-cell lysates plus ODN coinjection for protection against E7-expressing tumors as well as specific immune responses were evaluated with the following tests: heat shock protein 70 (HSP70) enzyme-linked immunosorbent assay, in vitro and in vivo tumor growth inhibition, interferon-gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) assay, cytotoxic T-lymphocyte assay, and fluorescence activated cell sorting (FACS) analysis. PDT-cell lysates plus ODN coinjection showed a significant suppression of tumor growth at both prophylactic and therapeutic levels, compared to PDT (or F/T)-cell lysates or ODN alone. In addition, we evaluated the level of the immune response with the coinjection. HSP70, an important regulator of inflammatory and immune response, was observed in abundance in the PDT-cell lysates. IFN-gamma production and cytotoxic T lymphocytes (CTL) responses were induced by PDT-cell lysates plus ODN injection. The coinjection resulted in PDT-cell lysate-specific antibodies (IgG1, IgG2a, IgG2b, and IgG3) and T-helper cell responses significantly higher than PDT-cell lysates alone. Moreover, IFN-gamma production and CTL responses were significantly induced in the PDT-cell lysate plus ODN immunized groups. These enhanced immune responses appeared to be mediated by CD8+ T cells only. These data suggest that PDT-cell lysates plus ODN injection may be an effective approach to induce CTL immune responses as a possible immunotherapeutic strategy for cancer therapy.

Cytoplasmic extracts from adipose tissue stromal cells alleviates secondary damage by modulating apoptosis and promotes functional recovery following spinal cord injury

Spinal cord injury (SCI) typically results from sustained trauma to the spinal cord, resulting in loss of neurologic function at the level of the injury. However, activation of various physiological mechanisms secondary to the initial trauma including edema, inflammation, excito-toxicity, excessive cytokine release and apoptosis may exacerbate the injury and/or retard natural repair mechanisms. Herein, we demonstrate that cytoplasmic extracts prepared from adipose tissue stromal cells (ATSCs) inhibits H(2)O(2)-mediated apoptosis of cultured spinal cord-derived neural progenitor cells (NPCs) resulting in increased cell survival. The ATSC extracts mediated this effect by decreasing caspase-3 and c-Jun-NH2-terminal kinase (SAPK/JNK) activity, inhibiting cytochrome c release from mitochondria and reducing Bax expression levels in cells. Direct injection of ATSC extracts mixed with Matrigel into the spinal cord immediately after SCI also resulted in reduced apoptotic cell death, astrogliosis and hypo-myelination but did not reduce the extent of microglia infiltration. Moreover, animals injected with the ATSC extract showed significant functional improvement of hind limbs as measured by the BBB (Basso, Beattie and Bresnahan) scale. Collectively, these studies show a prominent therapeutic effect of ATSC cytoplasmic extracts on SCI principally caused by an inhibition of apoptosis-mediated cell death, which spares white matter, oligodendrocytes and neurons at the site of injury. The ability of ATSC extracts to prevent secondary pathological events and improve neurologic function after SCI suggests that extracts prepared from autologous cells harvested from SCI patients may have clinical utility.

Influence of Hen Age on the Response of Turkey Poults to Cold Stress, Escherichia coli Challenge, and Treatment with a Yeast Extract Antibiotic Alternative

Two battery experiments were conducted to evaluate a commercial yeast extract feed supplement, Alphamune, in a cold stress-Escherichia coli challenge of 1-wk-old turkeys. Experiment 1 used 1-d-old male poults that were the progeny of 33-wk-old hens in their second week of lay. Experiment 2 used male poults of the same genetic line from 40-wk-old hens in their eighth week of lay. Poults were fed a standard unmedicated turkey starter diet or the same diet with either a low level (504 g/t) or a high level (1,008 g/t) of yeast extract. Challenged birds were exposed to intermittent cold stress during wk 1 to 3 and to a respiratory E. coli challenge at 1 wk of age. In both experiments, BW at wk 1 was increased by feeding yeast extract. In experiment 1, challenged, control-fed birds had decreased BW at wk 3 and feed conversion was protected by both levels of yeast extract supplementation. In experiment 2, challenge had no effect on control-fed birds; however, yeast extract decreased the BW of challenged birds. In experiment 1, total leukocyte numbers were decreased by challenge of control-fed birds only, and there was no effect of challenge on the heterophil/lymphocyte ratio. In experiment 2, total leukocyte numbers were decreased and the heterophil/lymphocyte ratio was increased in challenged, control-fed birds. Percentage mortality was not affected by challenge in experiment 1; however, in experiment 2, mortality was increased by challenge of control-fed birds and those fed the lower level of yeast extract. These results suggest that hen age should be considered when designing studies to evaluate antibiotic alternatives and in making decisions for incorporating such alternatives into production.

Clinical efficacy of OM-85 BV in COPD and chronic bronchitis: a systematic review

OM-85 BV is an immunomodulatory agent used for prevention of exacerbations in persons with chronic lung disease. We conducted a systematic review of OM-85 BV to evaluate its efficacy and safety. A systematic search for relevant articles was performed. Studies were included if they involved persons with chronic obstructive pulmonary disease or chronic bronchitis and were randomized to OM-85 BV or placebo. Investigators extracted data on study design, participant characteristics, and clinical outcomes. Thirteen trials involving 2066 individuals met inclusion criteria. Three trials enrolled an older, more homogenous population with chronic obstructive pulmonary disease. Utilizing quantitative pooled analysis in these studies, with one or more acute exacerbations as the endpoint, we found a non-statistically significant trend in favor of OM-85 BV [relative risk 0.83, 95% confidence interval 0.65-1.05]. Ten trials enrolled a heterogeneous population with chronic bronchitis. In these trials, exacerbation rates were less with OM-85 BV in 4 of 9 trials reporting this outcome. Varied results in the outcomes of hospitalization, symptom scores, and antibiotic or steroid use were found across studies. Withdrawals and adverse events were similar between OM-85 BV and placebo. While OM-85 BV is used to prevent exacerbations in persons with chronic lung disease, consistent evidence across multiple important outcomes does not exist to clearly demonstrate clinical benefit. Further randomized controlled trials enrolling large numbers of persons with well-defined COPD are necessary to confirm the effectiveness of this agent.

In vivo effect of an immunostimulating bacterial lysate on human B lymphocytes

The aim of the present study is to investigate in humans the mechanism by which the oral vaccine Polyvalent Mechanical Bacterial Lysate (PMBL) can rapidly mobilize specific immune response and evaluate the efficacy of its immunostimulating activity in preventing recurrent infections of the upper respiratory tract (URTIs) in a group of patients with a medical history of URTI recurrence. Patients received, by sublingual route, PBML, an immunostimulating lysate obtained by mechanical lysis of the most common bacteria responsible for upper respiratory tract infections. The treatment was administered for 10 consecutive days/month for 3 consecutive months. After the end of the treatment period the patients were followed up for an additional 3 months. The frequency of IgM memory B cells and the expression of the activation marker CD25 in peripheral blood lymphocytes were measured using the flow cytometric method before the start and at days 30 and 90 of the treatment cycle. To correlate clinical results to immunological parameters, the patients were monitored at different time-points during the treatment and at the end of follow-up period. The results showed that PMBL exerts a therapeutic and preventing effect in acute and recurrent infections of the upper respiratory tract and that this effect correlated with the activation and enhancement of both IgM memory B lymphocytes (CD24+/CD27+ cells) and IL2 receptor-expressing lymphocytes (CD25+ cells) involved either in humoral or cellular immunity.

In vivo anticancer activity of lysates from Trypanosoma cruzi of different genetic groups

Lyzed epimastigotes of Trypanosoma cruzi clones P209-1, Gamba1, Sp104-1, MASu, Y7/1, MN12, Cl-Brener, 86/2036, Y7/2-1 inhibit the growth of Ehrlich adenocarcinoma in mice. the tumor decreased 1.5-3 times after 12 daily injections of lysates from 15 million epimastigotes. The protective effect progressed after the injections were discontinued and depended on the dose and lysate producer clone. Trypanosoma lysates in the studied doses were nontoxic.

Silent reflux: ex juvantibus criteria for diagnosis and treatment of laryngeal disorders

CONCLUSIONS

Some primary laryngeal pathologies with specific clinical presentation may be related to silent laryngeal reflux. An ex adjuvantibus proton pump inhibitor (PPI) treatment may be helpful for showing evidence of such a hidden laryngeal disorder.

OBJECTIVE

To assess the validity of PPI as an ex adjuvantibus criterion for diagnosis and treatment of suspected reflux-associated laryngitis.

PATIENTS AND METHODS

Sixty patients with clinical suspicion of laryngo-pharyngeal reflux (LPR) were identified on the grounds of laryngeal symptoms (dysphonia, cough, globus sensation, increased throat clearing, bad taste, and laryngeal spasm), laryngeal features (arytenoid edema/erythema, partial or total vocal fold erythema, and posterior glottic edema) with or without gastro-esophageal reflux disorder (GERD). They were consequently subdivided in three groups: type I, with LPR symptoms and features without GERD; type II with LPR symptoms and features with GERD; and type III with LPR features only. Types I and III were randomly treated with omeprazole (group A) or with immunostimulating vaccine (group B) for 3 months. Pre- and post-treatment laryngeal features and symptoms in all groups were evaluated by laryngo-stroboscopy and analyzed for statistical correlation.

RESULTS

All omeprazole-treated patients showed improvement of laryngeal features and symptoms. With PPI treatment, a more significant improvement was noticed with respect to nonspecific immunostimulant therapy. Also, patients without LPR symptoms showed improvement of laryngeal features.

Double-blind study of OM-85 in patients with chronic bronchitis or mild chronic obstructive pulmonary disease

BACKGROUND

Interventions against acute exacerbations (AEs) of chronic obstructive pulmonary disease (COPD) are increasingly called for to reduce morbidity, mortality and costs. OM-85, a detoxified immunoactive bacterial extract, has been shown to prevent recurrent exacerbations of bronchitis and COPD.

OBJECTIVES

It was the aim of this study to demonstrate the protective effect of OM-85 against recurrent bronchitic exacerbations in patients with chronic bronchitis or mild COPD. The primary end point was the mean rate of AEs occurring within the study period.

METHODS

This double-blind multi-centre study enrolled adult outpatients>40 years old of both sexes with a history of chronic bronchitis or mild COPD at the time of an AE. The treatment consisted of one capsule of OM-85 or placebo per day for 30 days, followed by three 10-day courses for months 3, 4 and 5, with a 6-month study duration and monthly control visits.

RESULTS

One hundred and forty-two patients were treated with OM-85 and 131 received placebo. By the end of the treatment period, the mean number of AEs in the OM-85 group was 0.61 per patient versus 0.86 per patient in the placebo group (-29%; p=0.03). The difference between treatments was most notable in patients with a history of current or past smoking (-40%; p<0.01). No serious adverse events were attributed to the medication and no significant laboratory changes were reported.

CONCLUSIONS

OM-85 significantly reduced the frequency of AEs in patients with a history of chronic bronchitis and mild COPD and was well tolerated. This study confirms the findings of previous trials conducted in elderly patients with chronic bronchitis or COPD.

Transforming growth factor-beta and natural killer T-cells are involved in the protective effect of a bacterial extract on type 1 diabetes

The onset of type 1 diabetes in NOD mice is delayed by oral administration of a bacterial extract (OM-85) and can be completely prevented by its intraperitoneal administration. Optimal prevention is observed when starting treatment at 3 or 6 weeks of age, and some effect is still observed with treatment at 10 weeks of age. Using genetically deficient mice and cytokine-neutralizing monoclonal antibodies, we demonstrate here that the therapeutic effect does not involve T-helper type 2 cytokines (interleukin [IL]-4 and -10) but is tightly dependent on transforming growth factor (TGF)-beta. Natural killer T-cells also participate in the therapeutic effect because CD1d(-/-) NOD mice are partially resistant to the protective effect of OM-85. The question remains of the specificity of the protective effect of OM-85, which may include proinflammatory components. It will thus be important to further characterize the molecular components that afford protection from type 1 diabetes. Lipopolysaccharide is excluded, but other Toll-like receptor (TLR) agonists could be involved because OM-85 stimulated dendritic cells and induced TGF-beta production by splenocytes in a TLR-2-, TLR-4-, and MyD88-dependent fashion.

[A population-based case-control study of broncho-vaxom use during pregnancy]

OBJECTIVE

To study human teratogenic potential of oral broncho-vaxom treatments during pregnancy.

AIM

Pair analysis of cases with congenital abnormalities and matched population controls without congenital abnormalities.

PATIENTS AND METHOD

The large population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996.

PARTICIPANTS

Of 38.151 pregnant women who had babies without any defects (control group), and 22.865 pregnant women who had newborn infants or fetuses with congenital abnormalities (case group).

RESULTS

In the control group 58 (0,15%), while in the case group 22 (0,10%) pregnant women were treated with broncho-vaxom (OR with 95% CI: 0.6, 0.4-1.1). The case-control pair analysis concerning the use of broncho-vaxom during the second-third months of pregnancy did not show any human teratogenic potential in the different groups of congenital abnormalities. The mean gestational age was longer in control infants born to mother with broncho-vaxom treatment during pregnancy compared with the figure of control infants without this treatment (40 +/- 1.3 vs. 39.4 +/- 2.1, t = 2.28, p = 0.02).

CONCLUSION

Teratogenic risk for congenital abnormalities was not detectable in the children born to women treated with broncho-vaxom during pregnancy. The possible gestational age promoter effect of broncho-vaxom needs further studies.

[Effectiveness of Broncho-Vaxom in prevention of recurrent upper respiratory tract infection in children]

AIM OF THE STUDY

Evaluation of effectiveness of immunostimulating treatment with Broncho-Vaxom and his influence on concentration of proinflammatory cytokines in children with recurrent upper respiratory tract infection.

MATERIAL AND METHODS

The study comprised 32 children (the average age 8 years and 4 months) with recurrent upper respiratory tract infection received immunostimulating treatment with Broncho-Vaxom. 20 children (the average age 7 years and 8 months) with recurrent upper respiratory tract infection which did not receive treatment with Broncho-Vaxom consisted the control group. In all children clinical state and concentration of cytokines TNF-alpha and, IL-1beta, IL-6, IL-8 in serum was examined. Period of observation in both groups carried out 24 months. Follow-up was executed after 6 months.

RESULTS

In children treated with Broncho-Vaxom statistically significant (p<0.01) decrease in frequency of occurrence as well as shortening of duration of upper respiratory tract infection were observed. In children treated with Broncho-Vaxom statistically significant (p<0.01) decrease of serum concentration of TNF-alpha and in time of observation. The statistically significant changes were not observed in serum concentrations IL-1beta in time of observation. It was statistically significant (p<0.01) affirmed the rise of serum concentration of IL-6 in time of observation, the largest growth of concentration this cytokine stepped out in 1 year of treatment. The statistically significant (p<0.01) increase of concentration cytokine IL-8 in the first year of treatment as well as statistically significant (p<0.05) decrease of concentration this cytokine after end of treatment.

CONCLUSION

The treatment with Broncho-Vaxom shows the high effectiveness in prevention of recurrent upper respiratory tract infection in children as well as the influences of profitable changes in profile of serum cytokines which can impact on limitation the inflammation process in the upper respiratory tract.

[Influence of Broncho-Vaxom treatment on serum concentration of metalloproteinase-9 in patients with chronic obstructive pulmonary disease]

Immunomodulatory activity of bacterial extracts such as Broncho-Vaxom results in stimulation of different immune cells, increase of expression of proinflammatory cytokines and enhancement of resistance to infection. Lyophilized extracts from bacteria are particularly recommended for patients with chronic respiratory tract diseases, in whom infectious exacerbations irreversibly worsen lung damage. Despite the fact that treatment with bacterial lysates is considered safe, it is not clear if such immunomodulation does not negatively affect the proteinase--antiproteinase balance in patients with COPD.

AIM OF THE STUDY

Evaluation of influence of treatment with Broncho-Vaxom on the concentration of metalloproteinase-9 in serum of patients with chronic obstructive pulmonary disease.

MATERIAL AND METHODS

Forty one patients with moderate COPD were included in the study The patients were divided into two groups: smokers and nonsmokers. Each patient received Broncho-Vaxom for the first ten days each month for three consecutive months. The patients were examined twice: before treatment and in the third month of treatment. During each visit clinical symptoms of COPD were assessed, spirometric tests and blood tests were performed, the concentrations of immunoglobulins, C-reactive protein and metalloproteinase-9 in serum (MMP-9) were measured.

RESULTS

No significant differences were found between the groups in predicted value of FEV1%, concentrations of immunoglobulins and C-reactive protein in serum and the number of leukocytes in blood after treatment with Broncho-Vaxom. A significant decrease of intensity of COPD symptoms in both groups after immunostimulatory treatment was observed. There were no differences in metalloproteinase-9 concentration in serum between the smokers and nonsmokers. Administration of bacterial extract did not significantly influence MMP-9 concentration in serum of the patients.

RESULTS

Treatment with Broncho-Vaxom does not increase the concentration of metalloproteinase-9 in serum of patients with COPD, while it decreases the symptoms of stable COPD.

Extracts obtained from predegenerated nerves improve functional recovery after sciatic nerve transection

Gap injuries of peripheral nerves, resulting from trauma or neurosurgical procedures, presage badly, for the presence of the distal stump of the nerve seems to be indispensable for regeneration. The standard grafting method requires a lesion of a healthy nerve, and therefore various substitutional materials are under consideration. The aim of the present work was to examine the recovery of rat sciatic nerves after supplying 10-mm-long gaps with an autologous connective-tissue chambers filled with fibrin only or fibrin and various neuroactive substances (brain-derived neurotrophic factor (BDNF), extracts from predegenerated or non-predegenerated nerves). The nerves were allowed to regenerate for 16 weeks. Recovery was measured functionally using the sciatic functional index, and by comparing the weight ratios of calf muscles. The histologic features of regeneration were assessed by counting the number of acetylcholinesterase-positive nerve fibers present inside implanted chambers. We found that chambers filled with fibrin and predegenerated peripheral nerve extracts or BDNF supported functional nerve regeneration much more strongly than chambers filled with fibrin only or fibrin and non-predegenerated peripheral nerve extracts. We conclude that autologous connective-tissue chambers filled with fibrin and predegenerated peripheral nerve extracts or BDNF seem to be a promising tool in peripheral nerve gap injury treatment, with likely clinical implications.