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Lee SB, Kim YH, Hyun MC, Kim YH, Kim HS, Lee YH. T-Helper Cytokine Profiles in Patients with Kawasaki Disease. Korean Circ J 2015; 45:516-21. [PMID: 26617655 PMCID: PMC4661368 DOI: 10.4070/kcj.2015.45.6.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/11/2015] [Accepted: 06/02/2015] [Indexed: 01/15/2023] Open
Abstract
Background and Objectives Kawasaki disease is an acute systemic vasculitis of which pathogenesis suspected is caused by immune dysregulation. The goal of this study is to evaluate the activation pattern of T helper cell type 1 (Th1) and T helper cell type 2 (Th2) in patients with Kawasaki disease. Subjects and Methods Prospective study of 60 patients (male 36, female 24) with diagnosis of Kawasaki disease were enrolled. One hundred and eighty blood samples from these patients were collected according to the different clinical stages {before initial intravenous immunoglobulin (IVIG), 5 days after initial IVIG, 2 months after initial IVIG}. The plasma level of Th1 cytokines; interferon-gamma (IFN-γ) & interleukin (IL)-2 and Th2 cytokines; IL-4 & IL-10 were measured by enzyme-liked immunosorbent assay. Results In all patients, the plasma level of Th1 cytokines (IFN-γ, IL-2) and Th2 cytokines (IL-4 and IL-10) were markedly elevated during the acute stage of Kawasaki disease. Since then, the plasma level of all these cytokines decreased significantly along with the process of clinical stages. Regardless of the existence of coronary artery lesion or no response to initial IVIG treatment, there were no significant differences between them. Conclusion These data suggest that both Th1 and Th2 cells may be activated simultaneously during the acute stage of Kawasaki disease. Further studies are therefore required to establish the difference of activation pattern of T helper cells between Kawasaki disease and other inflammatory diseases.
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Affiliation(s)
- Sang Bum Lee
- Department of Pediatrics, Kyungbook National University School of Medicine, Daegu, Korea
| | - Young Hyun Kim
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Myung Chul Hyun
- Department of Pediatrics, Kyungbook National University School of Medicine, Daegu, Korea
| | - Yeo Hyang Kim
- Department of Pediatrics, Kyungbook National University School of Medicine, Daegu, Korea
| | - Hee Sun Kim
- Department of Microbiology, Yeungnam University College of Medicine, Daegu, Korea
| | - Young Hwan Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
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Gong P, Li Y, Tan YP, Li H. Pretreatment With Inactivated Bacillus Calmette-Guerin Increases CD4+CD25+ Regulatory T Cell Function and Decreases Functional and Structural Effects of Asthma Induction in a Rat Asthma Model. Artif Organs 2015; 40:360-7. [PMID: 26495900 DOI: 10.1111/aor.12566] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Bacillus Calmette-Guerin (BCG) has been shown to have therapeutic effects on asthma through CD4+CD25+ regulatory T cells (Tregs). We sought to assess pretreatment with inactivated BCG on CD4+CD25+ Tregs and its functional and structural effects in rat asthma model. The rat asthma model was established using ovalbumin (OVA) sensitization and challenge. Ten rats were pretreated with BCG prior to OVA and received continued BCG injections during OVA challenge (BCG+OVA group), 10 rats were treated with OVA alone (OVA group), and 10 rats were treated with saline (control group). After 9 weeks, histamine dihydrochloride effect on airway resistance was measured. Number of CD4+CD25+ Tregs was measured by flow cytometry, expression of Foxp3 and CTLA-4 mRNA was measured, and serum TGF-β levels were determined. Differential cell count in bronchoalveolar lavage fluid (BALF) was determined, and lung tissue was processed and stained with hematoxylin and eosin, Masson's trichrome, and alcine blue and periodic acid Schiff's reaction to evaluate inflammatory cell infiltration, collagen deposition, and presence of goblet cells, respectively. BCG treatment led to an increase in CD4+CD25+ Tregs, as well as an increase in Foxp3 and CTLA-4 expression and serum TGF-β levels. In addition, we observed a decrease in histamine dihydrochloride-induced airway resistance, a decrease in inflammatory leukocytes in BALF, and a decrease in airway remodeling indicators in BCG+OVA-treated rats compared with OVA-treated rats. Intradermally injected inactivated BCG has the potential to improve airway inflammation, airway resistance, and airway remodeling through a mechanism that may involve CD4+CD25+ Tregs.
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Affiliation(s)
- Ping Gong
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Yun Li
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Yu-Pin Tan
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Hong Li
- Department of Pediatrics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
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Platts-Mills TAE. The allergy epidemics: 1870-2010. J Allergy Clin Immunol 2015; 136:3-13. [PMID: 26145982 DOI: 10.1016/j.jaci.2015.03.048] [Citation(s) in RCA: 307] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 03/24/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
Abstract
Before the first description of hay fever in 1870, there was very little awareness of allergic disease, which is actually similar to the situation in prehygiene villages in Africa today. The best explanation for the appearance and subsequent increase in hay fever at that time is the combination of hygiene and increased pollen secondary to changes in agriculture. However, it is important to remember that the major changes in hygiene in Northern Europe and the United States were complete by 1920. Asthma in children did not start to increase until 1960, but by 1990, it had clearly increased to epidemic numbers in all countries where children had adopted an indoor lifestyle. There are many features of the move indoors that could have played a role; these include increased sensitization to indoor allergens, diet, and decreased physical activity, as well as the effects of prolonged periods of shallow breathing. Since 1990, there has been a remarkable increase in food allergy, which has now reached epidemic numbers. Peanut has played a major role in the food epidemic, and there is increasing evidence that sensitization to peanut can occur through the skin. This suggests the possibility that changes in lifestyle in the last 20 years could have influenced the permeability of the skin. Overall, the important conclusion is that sequential changes in lifestyle have led to increases in different forms of allergic disease. Equally, it is clear that the consequences of hygiene, indoor entertainment, and changes in diet or physical activity have never been predicted.
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Affiliation(s)
- Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Va.
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Hsiao YT, Cheng WC, Liao WC, Lin CL, Shen TC, Chen WC, Chen CH, Kao CH. Type 1 Diabetes and Increased Risk of Subsequent Asthma: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2015; 94:e1466. [PMID: 26356702 PMCID: PMC4616625 DOI: 10.1097/md.0000000000001466] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The association between type 1 diabetes mellitus (T1DM) and asthma remains controversial and has led to new interest in these 2 disorders. The purpose of this study was to examine the associations among young people with T1DM and asthma and offer a clinical demonstration of the balance between Th1 and Th2 responses.We conducted a retrospective cohort study by using data from the National Health Insurance (NHI) system of Taiwan. The cohort consisted of 3545 T1DM cases and 14,180 controls established during the 1998 to 2011 period. Of the 3545 T1DM patients, 55.1% were girls and 26.5% were in the age group <8 years.The overall incidence of asthma was 47% higher in the T1DM cohort than in the control cohort (6.49 vs 4.42 per 1000 person-y), with an adjusted hazard ratio (HR) of 1.34 (95% confidence interval [CI] = 1.11-1.62). Moreover, T1DM patients who visited the emergency room (ER) more than twice for diabetes had a higher adjusted HR of 17.4 (95% CI = 12.9-23.6) of developing asthma. The adjusted HR of asthma was 38.6 (95% CI = 28.5-52.2) in T1DM patients who had been hospitalized more than twice for diabetes.We observed a significantly higher incidence of asthma in young patients with T1DM than in the general population. Among young people of T1DM with more ER visits or frequent hospitalization because of diabetes mellitus were associated with risk of asthma, may indicate that poor glycemic control significantly contributes to asthma risk.
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Affiliation(s)
- Yung-Tsung Hsiao
- From the Department of Chest Medicine, Buddhist Tzu Chi General Hospital, Guanshan Branch, Taitung, Taiwan (Y-TH); Division of Pulmonary and Critical Care Medicine, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan (Y-TH); Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan (W-CC, W-CL, T-CS, W-CC, C-HC); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (W-CL, T-CS, C-HC,C-HK); Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (C-LL); College of Medicine, China Medical University, Taichung, Taiwan (C-LL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
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Shim JU, Lee SE, Hwang W, Lee C, Park JW, Sohn JH, Nam JH, Kim Y, Rhee JH, Im SH, Koh YI. Flagellin suppresses experimental asthma by generating regulatory dendritic cells and T cells. J Allergy Clin Immunol 2015; 137:426-35. [PMID: 26303344 DOI: 10.1016/j.jaci.2015.07.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 07/03/2015] [Accepted: 07/15/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although the hygiene hypothesis suggests that microbial infections could subvert asthma and thus a microbial product might serve as a therapeutic adjuvant for asthma, the relationship between bacterial components and asthma is complex. Recently, low levels of flagellin, the Toll-like receptor (TLR) 5 ligand, have been reported to promote asthma. OBJECTIVE We show that a therapeutic dose of flagellin suppresses asthma and that the effect occurs through generating regulatory dendritic cells (rDCs) and regulatory T (Treg) cells. METHODS Ovalbumin (OVA)-induced wild-type and TLR5 knockout asthmatic mice were treated intranasally with a mixture of OVA and 10 μg of a flagellin B (FlaB; of Vibrio vulnificus). OVA/FlaB-treated rDCs were adoptively transferred to mice with OVA-induced asthma. Anti-CD25 mAb was used to deplete Treg cells. A mixture of house dust mite (HDM) and FlaB was used to treat mice with HDM-induced asthma. Blood CD14(+) monocyte-derived dendritic cells from HDM-sensitive asthmatic patients were treated with FlaB and incubated with autologous CD4(+) T cells. RESULTS An OVA/FlaB mixture ameliorated OVA-induced asthma by inhibiting TH1/TH2/TH17 responses in a TLR5-dependent manner through generating rDCs and Treg cells. The adoptive transfer of OVA/FlaB-treated dendritic cells inhibited OVA-induced asthma, whereas the depletion of CD25(+) cells eliminated the inhibitory effect. A similar effect of FlaB was observed in mice with HDM-induced asthma. In patients with HDM-sensitive asthma, FlaB-treated rDCs inhibited HDM-stimulated TH1/TH2 responses while enhancing Treg cells in an IL-10-dependent manner. CONCLUSION These findings collectively suggest that flagellin could be used as a tolerogenic adjuvant to treat allergic asthma.
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Affiliation(s)
- Jae-Uoong Shim
- Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Shee Eun Lee
- Department of Pharmacology and Dental Therapeutics, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - Won Hwang
- School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju, Korea; Academy of Immunology and Microbiology (AIM), Institute for Basic Science (IBS), Pohang, Korea
| | - Changhon Lee
- Academy of Immunology and Microbiology (AIM), Institute for Basic Science (IBS), Pohang, Korea; Division of Integrative Biosciences and Biotechnology (IBB), Pohang University of Science and Technology, Pohang, Korea
| | - Jung-Won Park
- Division of Allergy and Immunology, Department of Internal Medicine and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jung-Ho Sohn
- Division of Allergy and Immunology, Department of Internal Medicine and Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Nam
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Kim
- Department of Pathology, Chonnam National University Medical School, Gwangju, Korea
| | - Joon Haeng Rhee
- Clinical Vaccine R&D Center, National Research Laboratory of Molecular Microbial Pathogenesis, Research Institute for Vibrio Infections, Department of Microbiology, Chonnam National University Medical School, Gwangju, Korea.
| | - Sin-Hyeog Im
- Academy of Immunology and Microbiology (AIM), Institute for Basic Science (IBS), Pohang, Korea; Division of Integrative Biosciences and Biotechnology (IBB), Pohang University of Science and Technology, Pohang, Korea.
| | - Young-Il Koh
- Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
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Dixon DL. The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic Wheezing Illness. CHILDREN (BASEL, SWITZERLAND) 2015; 2:289-304. [PMID: 27417364 PMCID: PMC4928768 DOI: 10.3390/children2030289] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/21/2015] [Accepted: 06/29/2015] [Indexed: 12/26/2022]
Abstract
Infants who are breastfed are at an immunological advantage when compared with formula fed infants, evidenced by decreased incidence of infections and diminished propensity for long term conditions, including chronic wheeze and/or asthma. Exclusive breastfeeding reduces the duration of hospital admission, risk of respiratory failure and requirement for supplemental oxygen in infants hospitalised with bronchiolitis suggesting a potentially protective mechanism. This review examines the evidence and potential pathways for protection by immunomodulatory factors in human milk against the most common viral cause of bronchiolitis, respiratory syncytial virus (RSV), and subsequent recurrent wheeze in infants. Further investigations into the interplay between respiratory virus infections such as RSV and how they affect, and are affected by, human milk immunomodulators is necessary if we are to gain a true understanding of how breastfeeding protects many infants but not all against infections, and how this relates to long-term protection against conditions such as chronic wheezing illness or asthma.
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Affiliation(s)
- Dani-Louise Dixon
- Intensive and Critical Care Unit, Flinders Medical Centre, Adelaide 5042, Australia.
- Department of Critical Care Medicine, Flinders University, Adelaide 5001, Australia .
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Gillissen A, Paparoupa M. Inflammation and infections in asthma. THE CLINICAL RESPIRATORY JOURNAL 2015; 9:257-69. [PMID: 24725460 PMCID: PMC7162380 DOI: 10.1111/crj.12135] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 04/26/2014] [Accepted: 04/04/2014] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Asthma is driven by an inflammatory response against normally harmless environmental inorganic and organic compounds in the respiratory tract. Immune responses to airborne pathogens such as viruses and bacteria may reduce the allergic responses but are also known to trigger asthma attacks and eventually lead to severe disease condition. OBJECTIVE To investigate the role of respiratory pathogens concerning the induction or protection against acute or chronic asthma manifestations. METHODS We included 131 articles for the final review according to their relevance with the subject. RESULTS There is apparently contradictory interaction of respiratory germs in the airways of asthmatics which may be protective on one angle but deleterious on the other. CONCLUSION The relationship between inflammation and remodeling and the pathogenic role of viral and bacterial infection in the airways of asthmatic patients is still highly debatable and incompletely understood.
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Affiliation(s)
- Adrian Gillissen
- Department of Pulmonary MedicineGeneral Hospital KasselKasselGermany
| | - Maria Paparoupa
- Department of Pulmonary MedicineGeneral Hospital KasselKasselGermany
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Fenoy IM, Sánchez VR, Soto AS, Picchio MS, Martin V, Goldman A. Toxoplasma gondii infection modulate systemic allergic immune response in BALB/c mice. Exp Parasitol 2015; 154:47-50. [DOI: 10.1016/j.exppara.2015.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/19/2015] [Accepted: 04/08/2015] [Indexed: 11/29/2022]
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Kearney SC, Dziekiewicz M, Feleszko W. Immunoregulatory and immunostimulatory responses of bacterial lysates in respiratory infections and asthma. Ann Allergy Asthma Immunol 2015; 114:364-9. [DOI: 10.1016/j.anai.2015.02.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/30/2015] [Accepted: 02/09/2015] [Indexed: 01/22/2023]
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Abstract
The immune system in early life goes through rapid and radical changes. Early life is also the period with the highest risk of infections. The foetal immune system is programmed to coexist with foreign antigenic influences in utero, and postnatally to rapidly develop a functional system capable of distinguishing helpful microbes from harmful pathogens. Both host genetics and environmental influences shape this dramatic transition and direct the trajectory of the developing immune system into early childhood and beyond. Given the malleability of the immune system in early life, interventions aimed at modulating this trajectory thus have the potential to translate into considerable reductions in infectious disease burden with immediate as well as long-lasting benefit. However, an improved understanding of the underlying molecular drivers of early life immunity is prerequisite to optimise such interventions and transform the window of early life vulnerability into one of opportunity.
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Fonseca DM, Wowk PF, Paula MO, Gembre AF, Baruffi MD, Fermino ML, Turato WM, Campos LW, Silva CL, Ramos SG, Horn C, Marchal G, Arruda LK, Russo M, Bonato VLD. Requirement of MyD88 and Fas pathways for the efficacy of allergen-free immunotherapy. Allergy 2015; 70:275-84. [PMID: 25477068 DOI: 10.1111/all.12555] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND We have shown that mycobacterial antigens and CpG oligodeoxynucleotides downmodulate airway allergic inflammation by mechanisms dependent on T-cell activation. Here, we investigated the participation of the innate response, particularly the role of MyD88 adaptor, and Fas molecules in the effectiveness of DNA-HSP65 or CpG/culture filtrated proteins (CFP) immunotherapy. METHODS Mice sensitized and challenged with Der p 1 allergen were treated with DNA-HSP65, CpG/CFP, or with adoptively transferred cells from immunized mice. The treatment efficacy was assessed by evaluating eosinophil recruitment, antibody, and cytokine production. RESULTS In addition to downregulating the Th2 response, DNA-HSP65 and CpG/CFP promoted IL-10 and IFN-γ production. Adoptive transfer of cells from mice immunized with DNA-HSP65 or CpG/CFP to allergic recipients downmodulated the allergic response. Notably, transfer of cells from DNA-HSP65- or CpG/CFP-immunized MyD88(-/-) mice failed to reduce allergy. Additionally, for effective reduction of allergy by cells from CpG/CFP-immunized mice, Fas molecules were required. Although DNA-HSP65 or CpG/CFP immunization stimulated antigen-specific production of IFN-γ and IL-10, the effect of DNA-HSP65 was associated with IL-10 while CpG/CFP was associated with IFN-γ. Moreover, after stimulation with mycobacterial antigens plus Der p 1 allergen, cells from mite-allergic patients with asthma exhibited similar patterns of cytokine production as those found in the lung of treated mice. CONCLUSIONS This study provides new insights on the mechanisms of allergen-free immunotherapy by showing that both DNA-HSP65 and CpG/CFP downregulated house dust mite-induced allergic airway inflammation via distinct pathways that involve not only induction of mycobacterial-specific adaptive responses but also signaling via MyD88 and Fas molecules.
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Affiliation(s)
- D. M. Fonseca
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - P. F. Wowk
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
- Carlos Chagas Institute; Oswaldo Cruz Foundation; Curitiba Brazil
| | - M. O. Paula
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - A. F. Gembre
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - M. D. Baruffi
- Department of Clinical Analyses, Toxicology and Food Sciences; Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - M. L. Fermino
- Department of Clinical Analyses, Toxicology and Food Sciences; Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - W. M. Turato
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - L. W. Campos
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - C. L. Silva
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - S. G. Ramos
- Department of Pathology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - C. Horn
- Laboratory of Immunology and Immunogenetics; Evandro Chagas Clinical Research Institute; Oswaldo Cruz Foundation; Rio de Janeiro Brazil
| | - G. Marchal
- Immunotherapix Bio Top; Institute Pasteur; Paris France
| | - L. K. Arruda
- Department of Medicine; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
| | - M. Russo
- Department of Immunology; Institute of Biomedical Sciences; University of São Paulo; São Paulo Brazil
| | - V. L. D. Bonato
- Department of Biochemistry and Immunology; Ribeirão Preto Medical School; University of São Paulo; Ribeirão Preto Brazil
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Lagranderie M, Guyonvarc'h PM. The interplay between bacillus Calmette-Guérin and Treg cells and its role to prevent or cure inflammatory diseases. Expert Rev Clin Immunol 2015; 10:741-5. [PMID: 24837545 DOI: 10.1586/1744666x.2014.909286] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Clinical evidence indicates that Bacillus Calmette-Guérin (BCG) vaccination exerts anti-inflammatory effects in diseases such as asthma, multiple sclerosis or Type 1 diabetes. Although the exact mechanisms for this activity remain debated, the capacity of mycobacteria to induce regulatory T cells (Tregs) in vivo has been widely reported. However, adverse events associated with live BCG prevent its repeated use, especially in immunocompromised individuals. This article reviews the preclinical data showing a potent, systemic and long-term anti-inflammatory effect in animal models of allergic asthma, inflammatory bowel disease and atherosclerosis with a preparation of BCG inactivated by Extended Freeze-Drying (EFD BCG). It also presents the characteristics of EFD BCG-induced Tregs which play a crucial role in the immunomodulation of various inflammatory diseases. Finally, it compares EFD BCG with other approaches based on the therapeutic use of Tregs in humans.
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He S, Mao X, Sun H, Shirakawa T, Zhang H, Wang X. Potential therapeutic targets in the process of nucleic acid recognition: opportunities and challenges. Trends Pharmacol Sci 2015; 36:51-64. [DOI: 10.1016/j.tips.2014.10.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 10/18/2014] [Accepted: 10/28/2014] [Indexed: 02/07/2023]
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Park SS, Heo EY, Kim DK, Chung HS, Lee CH. The Association of BCG Vaccination with Atopy and Asthma in Adults. Int J Med Sci 2015; 12:668-73. [PMID: 26283887 PMCID: PMC4532975 DOI: 10.7150/ijms.12233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 07/18/2015] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION There are few studies investigating the association between BCG vaccination and atopy or asthma in adults. OBJECTIVE We investigated the association between BCG scar and the occurrence of atopy and asthma in Korean adults. METHODS We carried out a retrospective study of Korean adults who underwent skin prick testing, and, in some cases, spirometry and bronchial provocation tests in a secondary care hospital from April 2010 to February 2011. Atopy status was classified according to allergen/histamine (A/H) ratio of wheal (A/H ratio ≥ 1, atopy; 0 < A/H ratio < 1, intermediate; A/H ratio = 0, non-atopy). A patient with asthma was defined as one who has symptoms compatible with asthma and showed either a positive provocation testing or bronchodilator reversibility. RESULTS Among 200 participants, neither the presence (intermediate vs. non-atopy: adjusted odds ratio (aOR) 0.83; 95% CI 0.26, 2.60; p = 0.75, atopy vs. non-atopy: aOR 0.89; 95% CI 0.33, 2.37; p = 0.81, respectively). nor the size of BCG scar was significantly associated with atopy status. However, among those patients who underwent either bronchodilator response testing or bronchial provocation testing, the presence of BCG scar (aOR 0.33; CI 0.14, 0.77; p = 0.01) and the size of BCG scar were inversely associated with asthma. (p = 0.01) CONCLUSIONS: We found a significant association between BCG scar and asthmatic status in Korean adults, although there was no significant association between either the presence or size of BCG scar and atopy.
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Affiliation(s)
- Sung Soo Park
- 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical center, Seoul, Republic of Korea
| | - Eun Young Heo
- 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical center, Seoul, Republic of Korea
| | - Deog Kyeom Kim
- 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical center, Seoul, Republic of Korea
| | - Hee Soon Chung
- 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical center, Seoul, Republic of Korea
| | - Chang-Hoon Lee
- 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical center, Seoul, Republic of Korea ; 2. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Bisgaard H, Bønnelykke K, Stokholm J. Immune-mediated diseases and microbial exposure in early life. Clin Exp Allergy 2014; 44:475-81. [PMID: 24533884 DOI: 10.1111/cea.12291] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The non-communicable disease pandemic includes immune-mediated diseases such as asthma and allergy, which are likely originating in early life where the immature immune system is prone to alterations caused by the exposome. The timing of exposure seems critical for the developing immune system, and certain exposures may have detrimental effects in the earliest life, but no or even beneficial effects later. The human microbiome and infections are candidates as intermediary in the interaction between the host and the environment. The evidence seems inconsistent as infections as well as particular colonization patterns in neonates drive both short-term and long-term asthma symptoms, while, on the other hand, the composition of the microbiome in early life may protect against asthma and allergy in later life. This apparent contradiction may be explained by a deeper disease heterogeneity than we are currently able to discriminate, and in particular, the indiscriminate lumping together of different diseases into one atopic disease category. Also, the microbiome needs a differentiated understanding, considering balance between microbial groups, diversity and microbial genetic capability. Furthermore, the effects of the microbial exposure may only affect individuals with certain susceptibility genes. Few of the observations have been replicated, and publication bias is likely. Therefore, we are still far from understanding, or having proved, causal effects of the human microbiome. Still, the microbiome-gene interaction is a fascinating paradigm that fosters exiting research and promises a breakthrough in the understanding of the mechanisms driving asthma, allergy and eczema, and potentially also other immune-mediated non-communicable diseases.
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Affiliation(s)
- H Bisgaard
- Copenhagen Prospective Studies on Asthma in Childhood, Health Sciences, University of Copenhagen, Gentofte, Copenhagen, Denmark; The Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark
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66
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Plötz SG, Wiesender M, Todorova A, Ring J. What is new in atopic dermatitis/eczema? Expert Opin Emerg Drugs 2014; 19:441-58. [DOI: 10.1517/14728214.2014.953927] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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67
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Abstract
This thesis explores the contribution of twin studies, particularly those studies originating from the Danish Twin Registry, to the understanding of the aetiology of asthma. First, it is explored how twin studies have established the contribution of genetic and environmental factors to the variation in the susceptibility to asthma, and to the variation in several aspects of the clinical expression of the disease such as its age at onset, its symptomatology, its intermediate phenotypes, and its relationship with other atopic diseases. Next, it is explored how twin studies have corroborated theories explaining asthma's recent increase in prevalence, and last, how these fit with the explanations of the epidemiological trends in other common chronic diseases of modernity.
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68
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Juhn YJ. Risks for infection in patients with asthma (or other atopic conditions): is asthma more than a chronic airway disease? J Allergy Clin Immunol 2014; 134:247-57; quiz 258-9. [PMID: 25087224 PMCID: PMC4122981 DOI: 10.1016/j.jaci.2014.04.024] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/22/2014] [Accepted: 04/22/2014] [Indexed: 12/16/2022]
Abstract
Most of the research effort regarding asthma has been devoted to its causes, therapy, and prognosis. There is also evidence that the presence of asthma can influence patients' susceptibility to infections, yet research in this aspect of asthma has been limited. There is additional debate in this field, with current literature tending to view the increased risk of infection among atopic patients as caused by opportunistic infections secondary to airway inflammation, especially in patients with severe atopic diseases. However, other evidence suggests that such risk and its underlying immune dysfunction might be a phenotypic or clinical feature of atopic conditions. This review argues (1) that improved understanding of the effects of asthma or other atopic conditions on the risk of microbial infections will bring important and new perspectives to clinical practice, research, and public health concerning atopic conditions and (2) that research efforts into the causes and effects of asthma must be juxtaposed because they are likely to guide each other.
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MESH Headings
- Asthma/complications
- Asthma/immunology
- Asthma/pathology
- Bacterial Infections/complications
- Bacterial Infections/immunology
- Bacterial Infections/pathology
- Chronic Disease
- Dermatitis, Atopic/complications
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/pathology
- Disease Susceptibility
- Humans
- Immunity, Innate
- Mycoses/complications
- Mycoses/immunology
- Mycoses/pathology
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/immunology
- Rhinitis, Allergic, Perennial/pathology
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/pathology
- Risk Factors
- Virus Diseases/complications
- Virus Diseases/immunology
- Virus Diseases/pathology
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Affiliation(s)
- Young J Juhn
- Department of Pediatric and Adolescent Medicine/Internal Medicine/Health Sciences Research, Mayo Clinic, Rochester, Minn.
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69
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Induction of IL-12 production in human peripheral monocytes by Trypanosoma cruzi Is mediated by glycosylphosphatidylinositol-anchored mucin-like glycoproteins and potentiated by IFN- γ and CD40-CD40L interactions. Mediators Inflamm 2014; 2014:345659. [PMID: 25120285 PMCID: PMC4120781 DOI: 10.1155/2014/345659] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 06/16/2014] [Indexed: 12/04/2022] Open
Abstract
Chagas disease, caused by the protozoan parasite Trypanosoma cruzi (T. cruzi), is characterized by immunopathology driven by IFN-γ secreting Th1-like T cells. T. cruzi has a thick coat of mucin-like glycoproteins covering its surface, which plays an important role in parasite invasion and host immunomodulation. It has been extensively described that T. cruzi or its products—like GPI anchors isolated from GPI-anchored mucins from the trypomastigote life cycle stage (tGPI-mucins)—are potent inducers of proinflammatory responses (i.e., cytokines and NO production) by IFN-γ primed murine macrophages. However, little is known about whether T. cruzi or GPI-mucins exert a similar action in human cells. We therefore decided to further investigate the in vitro cytokine production profile from human mononuclear cells from uninfected donors exposed to T. cruzi as well as tGPI-mucins. We observed that both living T. cruzi trypomastigotes and tGPI-mucins are potent inducers of IL-12 by human peripheral blood monocytes and this effect depends on CD40-CD40L interaction and IFN-γ. Our findings suggest that the polarized T1-type cytokine profile seen in T. cruzi infected patients might be a long-term effect of IL-12 production induced by lifelong exposure to T. cruzi tGPI-mucins.
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70
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Takeda S, Hidaka M, Yoshida H, Takeshita M, Kikuchi Y, Tsend-Ayush C, Dashnyam B, Kawahara S, Muguruma M, Watanabe W, Kurokawa M. Antiallergic activity of probiotics from Mongolian dairy products on type I allergy in mice and mode of antiallergic action. J Funct Foods 2014. [DOI: 10.1016/j.jff.2014.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Juhn YJ, Wi CI. What does tympanostomy tube placement in children teach us about the association between atopic conditions and otitis media? Curr Allergy Asthma Rep 2014; 14:447. [PMID: 24816652 PMCID: PMC4075145 DOI: 10.1007/s11882-014-0447-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Otitis media is the most common infection second only to viral upper respiratory infection in the outpatient setting. Tympanostomy tube insertion (TTI) is the most common ambulatory surgical procedure in the USA. While many risk factors for otitis media have been identified, atopic conditions have been underrecognized as risk factors for recurrent and persistent otitis media. Given that asthma and other atopic conditions are the most common chronic conditions during childhood, it is worth examining the association between atopic conditions and risk of otitis media, which can provide insight into how atopic conditions influence the risk of microbial infections. This paper focuses its discussion on otitis media; however, it is important that the association between atopic conditions and risk of otitis media be interpreted in the context of the association of atopic conditions with increased risks of various microbial infections.
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Affiliation(s)
- Young J Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA,
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72
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Sussan TE, Ingole V, Kim JH, McCormick S, Negherbon J, Fallica J, Akulian J, Yarmus L, Feller-Kopman D, Wills-Karp M, Horton MR, Breysse PN, Agrawal A, Juvekar S, Salvi S, Biswal S. Source of biomass cooking fuel determines pulmonary response to household air pollution. Am J Respir Cell Mol Biol 2014; 50:538-48. [PMID: 24102120 DOI: 10.1165/rcmb.2013-0201oc] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Approximately 3 billion people-half the worldwide population-are exposed to extremely high concentrations of household air pollution due to the burning of biomass fuels on inefficient cookstoves, accounting for 4 million annual deaths globally. Yet, our understanding of the pulmonary responses to household air pollution exposure and the underlying molecular and cellular events is limited. The two most prevalent biomass fuels in India are wood and cow dung, and typical 24-hour mean particulate matter (PM) concentrations in homes that use these fuels are 300 to 5,000 μg/m(3). We dissected the mechanisms of pulmonary responses in mice after acute or subchronic exposure to wood or cow dung PM collected from rural Indian homes during biomass cooking. Acute exposures resulted in robust proinflammatory cytokine production, neutrophilic inflammation, airway resistance, and hyperresponsiveness, all of which were significantly higher in mice exposed to PM from cow dung. On the contrary, subchronic exposures induced eosinophilic inflammation, PM-specific antibody responses, and alveolar destruction that was highest in wood PM-exposed mice. To understand the molecular pathways that trigger biomass PM-induced inflammation, we exposed Toll-like receptor (TLR)2-, TLR3-, TLR4-, TLR5-, and IL-1R-deficient mice to PM and found that IL-1R, TLR4, and TLR2 are the predominant receptors that elicit inflammatory responses via MyD88 in mice exposed to wood or cow dung PM. In conclusion, this study demonstrates that subchronic exposure to PM collected from households burning biomass fuel elicits a persistent pulmonary inflammation largely through activation of TLR and IL-1R pathways, which could increase the risk for chronic respiratory diseases.
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Affiliation(s)
- Thomas E Sussan
- 1 Center for Global Clean Air, Department of Environmental Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
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73
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Choi IS. Immunomodulating approach to asthma using mycobacteria. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2014; 6:187-8. [PMID: 24843791 PMCID: PMC4021234 DOI: 10.4168/aair.2014.6.3.187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 03/19/2014] [Indexed: 01/22/2023]
Affiliation(s)
- Inseon S Choi
- Department of Allergy, Chonnam National University Medical School, Gwangju, Korea
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74
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Allergic diseases: the price of civilisational progress. Postepy Dermatol Alergol 2014; 31:77-83. [PMID: 25097472 PMCID: PMC4112251 DOI: 10.5114/pdia.2014.40936] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 09/26/2013] [Accepted: 09/28/2013] [Indexed: 12/22/2022] Open
Abstract
Atopic disorders are a major global health problem. The prevalence of asthma, allergic rhinitis and atopic dermatitis has been increasing over the last four decades, both in the industrialized and developing countries. It seems to be related to changes in the social structure, increasing industrialization, pollution and dietary changes. Many hypotheses link the allergy epidemic to stringent hygiene, dominance of a westernized lifestyle and an accelerated pace of life. Dietary antioxidants, lipids, sodium, vitamin D seem also to be implicated. We endeavour to review the most relevant theories with a special emphasis on the hygiene, antioxidative, lipid and air pollution hypotheses. It is however important to note that none of them explains all the aspects of unprecedented rise in the prevalence of allergic disorders. A complex interplay between host's immune response, invading pathogens, diversity of environmental factors and genetic background seems to be of a particular importance. Current allergy epidemic is multifactorial and basic and epidemiologic studies are warranted to further our understanding of this phenomenon.
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75
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Patel AR, Zietlow J, Jacobson RM, Poland GA, Juhn YJ. Asthma and the immune response to MMR vaccine viruses in Somali immigrant children: a cross-sectional retrospective cohort study. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2014; 22:278-83. [PMID: 23636585 PMCID: PMC3914143 DOI: 10.4104/pcrj.2013.00039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: According to the ‘hygiene hypothesis’, an increase in microbial exposure in childhood leads to a T-helper cell 1 (Th1) predominant immune response and protection against asthma and atopic conditions. Aims: To assess the prevalence of asthma and other atopic conditions in Somali immigrants and to determine the humoral immune response to the measles, mumps, and rubella (MMR) vaccine viruses in Somali immigrants with asthma. Methods: A retrospective cohort study was conducted in Olmsted County, Minnesota. Study subjects were Somali immigrants who were born and lived in Africa during childhood and immigrated to the USA. The subjects had participated in a previous MMR vaccine study. Asthma was ascertained using predetermined asthma criteria after a thorough medical record review. An atopic condition was determined from physician-diagnosed ICD codes. Virus-specific IgG levels in response to the MMR vaccine viruses were determined using an enzyme immunoassay. Results: Of the 62 eligible subjects, 33 (53%) were female and 29 (47%) were male; 10 (16%) had asthma and 22 (35%) had other atopic conditions. There was no difference in the rubella (p=0.150) and measles (p=0.715) virus-specific IgG levels between the subjects with and without asthma. Mumps virus-specific IgG antibody levels were lower in those with asthma than in those without asthma (mean±SE 2.08±0.28 vs. 3.06±0.14, p=0.005). Conclusions: Our study results may not support the hygiene hypothesis. In addition, the previously reported abnormal T-cell development in Caucasian children with atopy can be considered even in Somali immigrants.
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Affiliation(s)
- Apurvi R Patel
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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76
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Wu Q, Chu HW. Role of infections in the induction and development of asthma: genetic and inflammatory drivers. Expert Rev Clin Immunol 2014; 5:97-109. [PMID: 19885377 DOI: 10.1586/1744666x.5.1.97] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Genetic and environmental factors interact to initiate and even maintain the course of asthma. As one of the highly risky environmental factors, infections in predisposed individuals can promote asthma development and exacerbations and/or prolong symptoms. This review will describe our current understanding of the genetic markers of innate immunity in the induction and development of asthma, the diverse roles of infections in modulating allergic inflammation, host susceptibility to infections and subsequent acute exacerbations in an allergic setting, and the therapeutic or preventive implications of existing knowledge. Current challenges and future directions in basic and clinical research of asthma are also discussed.
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Affiliation(s)
- Qun Wu
- Postdoctoral Research Fellow, Department of Medicine, National Jewish Health, 1400 Jackson Street, Room A635, Denver, CO 80206, USA, Tel.: +1 303 398 1589, ,
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77
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Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy 2014; 69:3-16. [PMID: 24417229 DOI: 10.1111/all.12270] [Citation(s) in RCA: 303] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 12/31/2022]
Abstract
There is a growing desire to explain the worldwide rise in the prevalence of atopic dermatitis (AD). Trend data on the burden of AD suggest that the picture in the developing world may soon resemble that of wealthier nations, where AD affects over 20% of children. This, combined with significant variations in prevalence within countries, emphasizes the importance of environmental factors. Many hypotheses have been explored, from the modulation of immune priming by hygiene, gut microbiota diversity, and exposure to endotoxins through farm animals to the effects of pollution, climate, and diet. The discovery of the filaggrin skin barrier gene and its importance in AD development and severity has brought the focus on gene-environment interactions and the identification of environmental factors that impact on skin barrier function. This article reviews our current understanding of the epidemiology of AD, with an emphasis on the findings reported in the international literature over the last 5 years.
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Affiliation(s)
- C. Flohr
- Departments of Paediatric Dermatology & Children's Allergies; St John's Institute of Dermatology; Guy's and St Thomas’ Hospitals NHS Foundation Trust and King's College; London UK
| | - J. Mann
- Department of Dermatology; Medway NHS Foundation Trust; Medway Maritime Hospital; Gillingham Kent UK
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78
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Ovchinnikova OA, Berge N, Kang C, Urien C, Ketelhuth DFJ, Pottier J, Drouet L, Hansson GK, Marchal G, Bäck M, Schwartz-Cornil I, Lagranderie M. Mycobacterium bovis BCG killed by extended freeze-drying induces an immunoregulatory profile and protects against atherosclerosis. J Intern Med 2014; 275:49-58. [PMID: 23962000 DOI: 10.1111/joim.12127] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Atherosclerosis is an inflammatory disease of the arterial wall that leads to myocardial infarction and stroke. Regulatory T cells (Tregs) and IL-10 exert significant anti-atherogenic effects in experimental models of atherosclerosis by modulating vascular inflammation. We have previously shown that Mycobacterium bovis BCG killed by extended freeze-drying (EFD BCG) decreases lung and colon inflammation by recruiting IL-10-producing Tregs. Therefore, the aim of this study was to investigate the effect of EFD BCG on the development of atherosclerosis. DESIGN We used two strains of atherosclerosis-prone mice: Ldlr(-/-) (four or six EFD BCG injections) and Apoe(-/-) (six injections). RESULTS In both models, EFD BCG significantly reduced the size of atherosclerotic lesions, increased IL-10 production and reduced the serum levels of pro-inflammatory cytokines (IL-6, IL-13, KC and tumour necrosis factor-α). Shortly after treatment with EFD BCG, the number of plasmacytoid dendritic cells (pDCs) and Foxp3(+) Tregs in the draining lymph nodes increased. EFD BCG also led to accumulation of Tregs, but not of pDCs in the spleen, and reduced activity of NF-κB and increased activity of PPAR-γ in both the spleen and vascular tissue of treated mice. CONCLUSION EFD BCG has atheroprotective effects through IL-10 production and Treg expansion. These findings support a novel approach to the prevention and treatment of atherosclerosis.
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Affiliation(s)
- O A Ovchinnikova
- Department of Medicine, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden; Almazov Federal Heart, Blood and Endocrinology Centre, St. Petersburg, Russia
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79
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Singh M, Das RR, Kumar L, Kumar R. Bacille Calmette-Guérin vaccination is associated with lower prevalence of allergic diseases in Indian children. Am J Rhinol Allergy 2013; 27:e107-12. [PMID: 23883802 DOI: 10.2500/ajra.2013.27.3940] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Immunization with bacille Calmette-Guérin (BCG) has been shown to augment T helper (Th) 1 biased response and hence gives protection against developing allergies. However, results across the studies have been inconclusive and there is no Indian study verifying this association. We explored the link between BCG vaccination and prevalence of allergic diseases among school children of Chandigarh, North India. METHODS In a large cross-sectional study, children aged 7-14 years, with and without documentation and/or scar consistent with BCG vaccination, were examined over a period of 2 years and 5 months with the help of a questionnaire-based survey followed by skin-prick test (SPT). RESULTS A total of 10,028 children were included. The mean age was 11.04 ± 2.8 years and M/F ratio was 1.1:1. Among them, 77.7% had documentation of BCG vaccination, 17% had a BCG-like scar but no documentation and 5.3% had no scar/documentation. SPT was performed on 1614 (16%) children. In the BCG group (vaccination and/or scar) 16.7% were atopic (positive SPT) compared with 21.3% in no BCG (no vaccination/scar). The prevalence of allergic diseases among BCG(+) subjects was 10.1%. Among these, asthma was the commonest one (6.1%), followed by rhinitis (3.5%) and eczema (0.5%). There was significant negative correlation between BCG positivity, atopy (p = 0.037), and allergic diseases as a whole (p = 0.028), but on independent analysis the negative correlation was strongest with allergic rhinitis (p = 0.011). CONCLUSION BCG vaccination is associated with lower prevalence of allergic disorders in Indian children.
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Affiliation(s)
- Meenu Singh
- Department of Pediatrics, Post-Graduate Institute of Medical Education and Research, Chandigarh, India.
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80
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Yatagai Y, Sakamoto T, Masuko H, Kaneko Y, Yamada H, Iijima H, Naito T, Noguchi E, Hirota T, Tamari M, Imoto Y, Tokunaga T, Fujieda S, Konno S, Nishimura M, Hizawa N. Genome-wide association study for levels of total serum IgE identifies HLA-C in a Japanese population. PLoS One 2013; 8:e80941. [PMID: 24324648 PMCID: PMC3851760 DOI: 10.1371/journal.pone.0080941] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 10/07/2013] [Indexed: 12/11/2022] Open
Abstract
Most of the previously reported loci for total immunoglobulin E (IgE) levels are related to Th2 cell-dependent pathways. We undertook a genome-wide association study (GWAS) to identify genetic loci responsible for IgE regulation. A total of 479,940 single nucleotide polymorphisms (SNPs) were tested for association with total serum IgE levels in 1180 Japanese adults. Fine-mapping with SNP imputation demonstrated 6 candidate regions: the PYHIN1/IFI16, MHC classes I and II, LEMD2, GRAMD1B, and chr13∶60576338 regions. Replication of these candidate loci in each region was assessed in 2 independent Japanese cohorts (n = 1110 and 1364, respectively). SNP rs3130941 in the HLA-C region was consistently associated with total IgE levels in 3 independent populations, and the meta-analysis yielded genome-wide significance (P = 1.07×10−10). Using our GWAS results, we also assessed the reproducibility of previously reported gene associations with total IgE levels. Nine of 32 candidate genes identified by a literature search were associated with total IgE levels after correction for multiple testing. Our findings demonstrate that SNPs in the HLA-C region are strongly associated with total serum IgE levels in the Japanese population and that some of the previously reported genetic associations are replicated across ethnic groups.
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Affiliation(s)
- Yohei Yatagai
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Hironori Masuko
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hideyasu Yamada
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | | | - Emiko Noguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tomomitsu Hirota
- Laboratory for Respiratory Diseases, Center for Genomic Medicine, the Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan
| | - Mayumi Tamari
- Laboratory for Respiratory Diseases, Center for Genomic Medicine, the Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan
| | - Yoshimasa Imoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Fukui, Fukui, Japan
| | - Takahiro Tokunaga
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Fukui, Fukui, Japan
| | - Shigeharu Fujieda
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Fukui, Fukui, Japan
| | - Satoshi Konno
- First Department of Medicine, School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Masaharu Nishimura
- First Department of Medicine, School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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81
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Brown EM, Arrieta MC, Finlay BB. A fresh look at the hygiene hypothesis: how intestinal microbial exposure drives immune effector responses in atopic disease. Semin Immunol 2013; 25:378-87. [PMID: 24209708 DOI: 10.1016/j.smim.2013.09.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
There currently is no consensus on which immunological mechanisms can best explain the rise in atopic disease post industrialization. The hygiene hypothesis lays groundwork for our understanding of how altered microbial exposures can drive atopy; yet since its introduction increasing evidence suggests the exposure of our immune system to the intestinal microbiota plays a key role in development of atopic disease. As societal change shifts our microbial exposure, concordant shifts in the tolerant and effector functions of our immune systems give rise to more hypersensitive responses to external antigens. This is contrasted with the greater immune tolerant capabilities of individuals still living in regions with lifestyles more representative of our evolutionary history. Recent findings, buoyed by technological advances in the field, suggest a direct role for the intestinal microbiota-immune system interplay in the development of atopic disease mechanisms. Overall, harnessing current mechanistic studies for translational research into microbiota composition and function in relation to atopy have potential for the design of therapeutics that could moderate these diseases.
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Affiliation(s)
- Eric M Brown
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada; Michael Smith Laboratories, University of British Columbia, Vancouver, BC, Canada
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82
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Ming M, Li C, Luo Z, Lv S. Effect of inhaled inactivated Mycobacterium phlei in children with moderate asthma. Immunotherapy 2013; 5:191-7. [PMID: 23413910 DOI: 10.2217/imt.12.156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Bacillus Calmette-Guérin and other mycobacterial vaccines are important therapeutic methods in a series of chronic inflammatory disorders characterized by Th1/Th2 imbalance in which Th2 type cells and cytokines often increase. However, few studies have investigated whether it can reduce or prevent the symptoms and attacks in children with asthma. This study evaluated the effect of inactivated Mycobacterium phlei inhaled by an atomizing device placed on asthmatic children. In this randomized, single-center, Seretide-controlled study, children aged 4-12 years with newly diagnosed, moderate, persistent asthma were treated with either inhaled inactivated M. phlei or inhaled Seretide patch. The efficacy of inhaled inactivated M. phlei was related with the alleviation of asthma symptoms, improvement of lung function and reduction of bronchial hyper-responsiveness and total serum IgE, which was similar with Seretide. These findings may have important clinical value in confirming inhaled inactivated M. phlei as a new therapeutic method in moderately asthmatic children.
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Affiliation(s)
- Moyu Ming
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
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83
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Abstract
PURPOSE OF REVIEW It has been hypothesized that increased cleanliness, reduced family size, and subsequent decreased microbial exposure could explain the increases in global asthma prevalence. This review considers the recent evidence for and against the 'hygiene hypothesis'. RECENT FINDINGS Recent evidence does not provide unequivocal support for the hygiene hypothesis: the hygiene hypothesis specifically relates to atopic asthma, but some of the protective effects (e.g. farm exposures) appear to apply to both atopic and nonatopic asthma; asthma prevalence has begun to decline in some western countries, but there is little evidence that they have become less clean; Latin American countries with high infection rates have high asthma prevalence and the hygiene hypothesis relates to early-life exposures, but exposures throughout life may be important. SUMMARY There is a considerable body of evidence which warrants scepticism about the hygiene hypothesis. However, these anomalies contradict the 'narrow' version of it in which microbial pressure early in life protects against atopic asthma by suppressing T-helper 2 immune responses. It is possible that a more general version of the hygiene hypothesis is still valid, but the aetiologic mechanisms involved are currently unclear.
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Maternal exposure to combustion generated PM inhibits pulmonary Th1 maturation and concomitantly enhances postnatal asthma development in offspring. Part Fibre Toxicol 2013; 10:29. [PMID: 23856009 PMCID: PMC3717277 DOI: 10.1186/1743-8977-10-29] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 07/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Epidemiological studies suggest that maternal exposure to environmental hazards, such as particulate matter, is associated with increased incidence of asthma in childhood. We hypothesized that maternal exposure to combustion derived ultrafine particles containing persistent free radicals (MCP230) disrupts the development of the infant immune system and results in aberrant immune responses to allergens and enhances asthma severity. METHODS Pregnant C57/BL6 mice received MCP230 or saline by oropharyngeal aspiration on gestational days 10 and 17. Three days after the second administration, blood was collected from MCP230 or saline treated dams and 8-isoprostanes in the serum were measured to assess maternal oxidative stress. Pulmonary T cell populations were assayed in the infant mice at six days, three and six weeks of postnatal age. When the infant mice matured to adults (i.e. six weeks of age), an asthma model was established with ovalbumin (OVA). Airway inflammation, mucus production and airway hyperresponsiveness were then examined. RESULTS Maternal exposure to MCP230 induced systemic oxidative stress. The development of pulmonary T helper (Th1/Th2/Th17) and T regulatory (Treg) cells were inhibited in the infant offspring from MCP230-exposed dams. As the offspring matured, the development of Th2 and Treg cells recovered and eventually became equivalent to that of offspring from non-exposed dams. However, Th1 and Th17 cells remained attenuated through 6 weeks of age. Following OVA sensitization and challenge, mice from MCP230-exposed dams exhibited greater airway hyperresponsiveness, eosinophilia and pulmonary Th2 responses compared to offspring from non-exposed dams. CONCLUSIONS Our data suggest that maternal exposure to MCP230 enhances postnatal asthma development in mice, which might be related to the inhibition of pulmonary Th1 maturation and systemic oxidative stress in the dams.
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Dosanjh A, Eridon J, Koziol J. Neonatal, atopic and infectious disease outcomes among children born to mothers with latent tuberculosis infection. J Asthma Allergy 2013; 6:61-6. [PMID: 23671394 PMCID: PMC3650890 DOI: 10.2147/jaa.s42458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Exposure to microbes may result in maternal immune responses that can affect fetal immune development. Several lines of evidence have shown that mycobacterial antigens can change the onset of atopic disease. We hypothesized that infants born to mothers with a positive tuberculosis (TB) test and a negative chest radiograph, may exhibit differential development of atopic disease during early childhood. The study was designed as a case control study. Birth records for infants born to untreated mothers with a positive TB skin test (TST), as defined by ≥10 mm induration were reviewed (n = 145 cases) and compared to a randomly selected unmatched control cohort of 46 women with a negative TST who delivered during the same time period at Scripps Hospital in San Diego, CA, USA. Childhood outcome parameters reviewed were: (1) the onset of physician diagnosed asthma; (2) lower respiratory tract infection (LRTI) with wheezing, latent tuberculosis infection/wheezing diagnosed on physical examination; (3) nonsurgical hospitalization; (4) atopic disease (eye/skin/nasal-sinus disease); (5) infections: ear, LRTI, sinus. LRTI was defined as an infection of the lower airways, eg, pneumonia. Outcomes at the end of years 1, 2, and 3–5 years combined were analyzed. Fisher exact test, Chi-square analysis or Poisson regression analysis were used as appropriate and a P-value of <0.05 was defined as significant. The cases and controls had similar birth weights, gestational ages, maternal ages: 3.34 versus 3.35 kg; 38.3 versus 39.2 weeks, 27.4 versus 26 years (P = non-significant). The childhood outcome parameters of the new onset of asthma was significantly higher than controls by age 2 years, but not at other ages studied, based on available clinic follow up data (P = 0.02). There was a difference in the risk for lung infection at age 2 and 3–5 years (P < 0.0001). There were no differences in the other outcome parameters studied (P = ns). There were no cases of infants with a positive TST, maternal Bacille Calmette-Guerin vaccination or active maternal TB, based on our study findings. There was a higher occurrence of asthma and lung infections at age 2 years among controls (P = 0.02). Our study defines for the first time a possible influence of maternal latent TB infection on fetal and childhood illness.
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Affiliation(s)
- Amrita Dosanjh
- Department of Pediatrics, Scripps Hospital, San Diego, CA, USA
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86
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Pang W, Wang H, Shi L, Sun Y, Wang X, Wang M, Li J, Wang H, Shi G. Immunomodulatory effects of Escherichia coli ATCC 25922 on allergic airway inflammation in a mouse model. PLoS One 2013; 8:e59174. [PMID: 23536867 PMCID: PMC3607577 DOI: 10.1371/journal.pone.0059174] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/12/2013] [Indexed: 11/18/2022] Open
Abstract
Background Hygiene hypothesis demonstrates that the lack of microbial exposure would promote the development of allergic airway disease (AAD). Therefore, the gut microbiota, including Escherichia coli (E. coli), would probably offer a potential strategy for AAD. Objective To investigate whether E. coli infection is able to suppress the induction of AAD and to elucidate the underlying mechanisms. Methods Nonpathogenic E. coli ATCC 25922 was infected by gavage before AAD phase in three patterns: 108 or 106 CFU in neonates or 108 CFU in adults. Then mice were sensitized and challenged with ovalbumin (OVA) to induce allergic inflammation in both the upper and lower airways. Hallmarks of AAD, in terms of eosinophil infiltration and goblet cell metaplasia in subepithelial mucosa, Th2 skewing of the immune response, and levels of T regulate cells (Tregs), were examined by histological analysis, ELISA, and flow cytometry, respectively. Results E. coli, especially neonatally infected with an optimal dose, attenuated allergic responses, including a decrease in nasal rubbing and sneezing, a reduction in eosinophil inflammation and goblet cell metaplasia in subepithelial mucosa, decreased serum levels of OVA-specific IgE, and reduced Th2 (IL-4) cytokines. In contrast, this effect came with an increase of Th1 (IFN-r and IL-2) cytokines, and an enhancement of IL-10-secreting Tregs in paratracheal lymph nodes (PTLN). Conclusion E. coli suppresses allergic responses in mice, probably via a shift from Th1 to Th2 and/or induction of Tregs. Moreover, this infection is age- and dose-dependent, which may open up novel possibilities for new therapeutic interventions.
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Affiliation(s)
- Wenhui Pang
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Hefeng Wang
- Qilu Hospital, Shandong University, Jinan, China
| | - Lei Shi
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Yueqi Sun
- Otorhinolaryngology Hospital, The first affiliated hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoting Wang
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Mingming Wang
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Jianfeng Li
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Haibo Wang
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
| | - Guanggang Shi
- Institute of Eye and Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Provincial Hospital affiliated to Shandong University, Jinan, China
- * E-mail:
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Clinical efficacy and laboratory improvement of bacillus calmette-guerin vaccination on adult atopic asthma: a cohort study. World Allergy Organ J 2013; 1:63-9. [PMID: 23283393 PMCID: PMC3650947 DOI: 10.1097/wox.0b013e31816c8b85] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Recent studies have shown that Bacillus Calmette-Guerin (BCG) vaccination is inversely related to asthma, a Th2 cell-associated with allergic disease, which BCG in humans induces Th1-cell immune responses and prevents airway remodeling. Objective To investigate whether thrice BCG vaccinations are clinically effective and could induce laboratory improvement compared with placebo on phase 1 (12 weeks) and single BCG vaccination on phase 2 of the study, then finding out whether the effect might last until 9 months after thrice vaccination and 9 months after single vaccination on adult atopic extrinsic asthma. Methods According to the Global Initiative for Asthma criteria, 40 mild to moderate persistent atopic asthma patients were randomly assigned in a double-blind fashion into groups that received intra-dermal injection of 0.1 mL of BCG (n = 20) or 0.1 mL of placebo (n = 20) on the first day. On the first phase, subjects on BCG vaccinations were given intradermal injections 3 times on the deltoid region every 4 weeks. On the second phase, at the 12th week, the placebo group was given BCG vaccination once, and this group became the single BCG group. The symptom score (SS) and drug score (DS), lung function, eosinophil blood count (EBC), total serum immunoglobulin E, interferon-γ (IFN-γ), interleukin 4, and transforming growth factor-β1 (TGF-β1) were examined on the first phase (before the treatment and at the 12th week) and on the second phase (on the sixth and ninth months after the third vaccination for thrice BCG group or after single BCG for control group) to monitor the efficacy. Results There were some improvements of asthma SS (P < 0.05) and DS (P < 0.05), forced expiratory volume in 1 second (P < 0.05), peak expiratory flow rate (P < 0.05), EBC (P > 0.05), IFN-γ (P < 0.05), and TGF-β1 (P < 0.05) on thrice BCG group compared with prevaccination and with placebo on the first phase and second phase of the study compared with single BCG (formerly placebo). Conclusions Based on the previous findings, we could confirm that thrice BCG vaccinations proved to be better than the placebo group and single vaccination. The efficacy of thrice BCG vaccinations on asthma was detected by the improvement of SS, DS, forced expiratory volume in 1 second, peak expiratory flow rate, EBC, IFN-γ, and TGF-β1 until 9 months from the last vaccination without any side effects.
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Al-Daghri NM, Alokail MS, Abd-Alrahman SH, Draz HM, Yakout SM, Clerici M. Polycyclic aromatic hydrocarbon exposure and pediatric asthma in children: a case-control study. Environ Health 2013; 12:1. [PMID: 23286340 PMCID: PMC3621697 DOI: 10.1186/1476-069x-12-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 12/11/2012] [Indexed: 05/18/2023]
Abstract
BACKGROUND Bronchial asthma is one of the most prevalent diseases in Arab children. Environmental pollution has been suggested to be considered causative of asthma, nasal symptoms and bronchitis in both children and adult. The objectives of this study were to evaluate the association between serum polycyclic aromatic hydrocarbons (PAHs) levels, asthma and allergic outcomes among Saudi children aged up to 15 yrs. We hypothesized that increased serum PAHs are associated with allergy, asthma, or respiratory symptoms. METHODS A total of 195 Saudi children (98 asthma pediatric patients and 97 healthy controls) were randomly selected from the Riyadh Cohort Study for inclusion. The diagnosis of Asthma was based on established pediatric diagnosis and medications taken. RESULTS Asthma related markers showed highly significant differences between children with and without asthma. Thus IgE, resistin and IL-4 were significantly increased (p 0.004, 0.001 and 0.003, respectively) in children with asthma compared with non-asthma control subjects. GMCSF, IFN-γ, IL-5, IL-8 and IL-10, on the other hand, were significantly decreased in children with asthma (p 0.003, 0.03, 0.001, 0.004 and 0.03, respectively). Strong associations between serum PAHs levels and biomarkers of childhood asthma were detected in Arabic children. Data confirmed the role of naphthalene, 4H-cyclobenta[def]phenanthrene, 1,2-benzanthracene, chrysene and benzo(e)acephenanthrylene in childhood asthma; levels of these PAHs were correlated with asthma related biomarkers including IgE, resistin, GMCSF and IFN-γ as well as IL-4, IL-5, IL-8 and IL-10 cytokines. CONCLUSIONS This data highlight the pivotal role of specific PAHs in childhood asthma.
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Affiliation(s)
- Nasser M Al-Daghri
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Majed S Alokail
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Sherif H Abd-Alrahman
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
- Pesticides Residues and Environmental Pollution Dept., Central Agricultural Pesticide Laboratory, Agricultural Research Center, Giza 12618, Egypt
| | - Hossam M Draz
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
- Biochemistry Department, National Research Centre, Dokki, Cairo 12311, Egypt
| | - Sobhy M Yakout
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mario Clerici
- Department of Biomedical Sciences and Technology, Milano University Medical School, Segrate-Milano 20090, Italy and Fondazioe Don C Gnocchi, Milan, Italy
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89
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Frew AJ. Immunotherapy of allergic disease. Clin Immunol 2013. [DOI: 10.1016/b978-0-7234-3691-1.00104-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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90
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Herrant M, Loucoubar C, Bassène H, Gonçalves B, Boufkhed S, Diene Sarr F, Fontanet A, Tall A, Baril L, Mercereau-Puijalon O, Mécheri S, Sakuntabhai A, Paul R. Asthma and atopic dermatitis are associated with increased risk of clinical Plasmodium falciparum malaria. BMJ Open 2013; 3:bmjopen-2013-002835. [PMID: 23883878 PMCID: PMC3731724 DOI: 10.1136/bmjopen-2013-002835] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To assess the impact of atopy and allergy on the risk of clinical malaria. DESIGN A clinical and immunological allergy cross-sectional survey in a birth cohort of 175 children from 1 month to 14 years of age followed for up to 15 years in a longitudinal open cohort study of malaria in Senegal. Malaria incidence data were available for 143 of these children (aged 4 months to 14 years of age) for up to 15 years. Mixed-model regression analysis was used to determine the impact of allergy status on malaria incidence, adjusting for age, gender, sickle-cell trait and force of infection. MAIN OUTCOME MEASURES Asthma, allergic rhinoconjunctivitis and atopic dermatitis status, the number of clinical Plasmodium falciparum malaria episodes since birth and associated parasite density. RESULTS 12% of the children were classified as asthmatic and 10% as having atopic dermatitis. These groups had respectively a twofold (OR 2.12 95%; CI 1.46 to 3.08; p=8×10(-5)) and threefold (OR 3.15; 1.56 to 6.33; p=1.3×10(-3)) increase in the risk of clinical P falciparum malaria once older than the age of peak incidence of clinical malaria (3-4 years of age). They also presented with higher P falciparum parasite densities (asthma: mean 105.3 parasites/μL±SE 41.0 vs 51.3±9.7; p=6.2×10(-3). Atopic dermatitis: 135.4±70.7 vs 52.3±11.0; p=0.014). There was no effect of allergy on the number of non-malaria clinical presentations. Individuals with allergic rhinoconjunctivitis did not have an increased risk of clinical malaria nor any difference in parasite densities. CONCLUSIONS These results demonstrate that asthma and atopic dermatitis delay the development of clinical immunity to P falciparum. Despite the encouraging decrease in malaria incidence rates in Africa, a significant concern is the extent to which the increase in allergy will exacerbate the burden of malaria. Given the demonstrated antiparasitic effect of antihistamines, administration to atopic children will likely reduce the burden of clinical malaria in these children, increase the efficacy of first-line treatment antimalarials and alleviate the non-infectious consequences of atopy.
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Affiliation(s)
- Magali Herrant
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Cheikh Loucoubar
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
- INSERM, U946, Genetic Variation and Human Diseases Unit,Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Paris, France
| | - Hubert Bassène
- Institut de Recherche pour le Développement (IRD), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS-IRD 198 UMR 6236, Dakar, Sénégal
| | - Bronner Gonçalves
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Sabah Boufkhed
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Fatoumata Diene Sarr
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Arnaud Fontanet
- Institut Pasteur, Unité d'Epidémiologie des Maladies Emergentes, Paris, France
- Conservatoire National des Arts et Métiers, Paris, France
| | - Adama Tall
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | - Laurence Baril
- Institut Pasteur de Dakar, Unité d'Epidémiologie des Maladies Infectieuses, Dakar, Senegal
| | | | - Salaheddine Mécheri
- Institut Pasteur, Unité de Biologie des Interactions Hôte Parasite, Paris, France
- Centre National de la Recherche Scientifique, Unité de Recherche Associée 2581, Paris, France
| | - Anavaj Sakuntabhai
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
- Complex Systems Group, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Richard Paul
- Institut Pasteur, Unité de la Génétique Fonctionnelle des Maladies Infectieuses, CNRS URA3012, Paris, France
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Sun K, Xie C, Xu D, Yang X, Tang J, Ji X. Lactobacillus isolates from healthy volunteers exert immunomodulatory effects on activated peripheral blood mononuclear cells. J Biomed Res 2012; 27:116-26. [PMID: 23554802 PMCID: PMC3602869 DOI: 10.7555/jbr.27.20120074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 09/01/2012] [Accepted: 10/31/2012] [Indexed: 11/29/2022] Open
Abstract
As probiotics in the gut, Lactobacilli are believed to play important roles in the development and maintenance of both the mucosal and systemic immune system of the host. This study was aimed to investigate the immuno-modulatory function of candiate lactobacilli on T cells. Lactobacilli were isolated from healthy human feces and the microbiological characteristics were identified by API 50 CHL and randomly amplified polymorphic DNA (RAPD) assays. Anti-CD3 antibody activated peripheral blood mononuclear cells (PBMCs) were treated by viable, heat-killed lactobacilli and genomic DNA of lactobacilli, and cytokine profiles were tested by ELISA. Isolated lactobacilli C44 and C48 were identified as L. acidophilus and L. paracacei, which have properties of acid and bile tolerance and inhibitor effects on pathogens. Viable and heat-killed C44 and C48 induced low levels of proinflammatory cytokines (TNF-α, IL-6 and IL-8) and high levels of IFN-γ and IL-12p70 in PBMCs. In anti-CD3 antibody activated PBMCs, viable and heat-killed C44 increased Th2 cytokine levels (IL-5, IL-6 and IL-10), and simultaneously enhanced Th1 responses by inducing IFN-γ and IL-12p70 production. Different from that of lactabacillus strains, their genomic DNA induced low levels of IL-12p70, IFN-γ and proinflammatory cytokines in PBMCs with or without anti-CD3 antibody activation. These results provided in vitro evidence that the genomic DNA of strains of C44 and C48, especially C44, induced weaker inflammation, and may be potentially applied for treating allergic diseases.
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Affiliation(s)
- Keyi Sun
- Department of Microbiology and Immunology, Nanjing Medical University, Nanjing, Jiangsu 210029, China
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92
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Weant TE, Turner AN, Murphy-Weiss M, Murray DM, Wang SH. Can social history variables predict prison inmates' risk for latent tuberculosis infection? Tuberc Res Treat 2012; 2012:132406. [PMID: 23320160 PMCID: PMC3540758 DOI: 10.1155/2012/132406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 11/06/2012] [Indexed: 12/04/2022] Open
Abstract
Improved screening and treatment of latent tuberculosis infection (LTBI) in correctional facilities may improve TB control. The Ohio Department of Rehabilitation and Correction (ODRC) consists of 32 prisons. Inmates are screened upon entry to ODRC and yearly thereafter. The objective of the study was to determine if social history factors such as tobacco, alcohol, and drug use are significant predictors of LTBI and treatment outcomes. We reviewed the medical charts of inmates and randomly selected age-matched controls at one ODRC facility for 2009. We used a conditional logistic regression to assess associations between selected social history variables and LTBI diagnosis. Eighty-nine inmates with a history of LTBI and 88 controls were identified. No social history variable was a significant predictor of LTBI. Medical comorbidities such as asthma, rheumatoid arthritis, and hepatitis C were significantly higher in inmates with LTBI. 84% of inmates diagnosed with LTBI had either completed or were on treatment. Annual TB screening may not be cost-effective in all inmate populations. Identification of factors to help target screening populations at risk for TB is critical. Social history variables did not predict LTBI in our inmate population. Additional studies are needed to identify inmates for the targeted TB testing.
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Affiliation(s)
- Tyler E. Weant
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Abigail Norris Turner
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | | | - David M. Murray
- Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20892, USA
| | - Shu-Hua Wang
- Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
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93
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Luo Y, Pang Z, Zhu Q, Cai X, Yin Y, Wang M, Zhu J, Chen J, Zeng K, Zhang C, Zhang J. Locally instilled tumor necrosis factor-α antisense oligonucleotide inhibits allergic inflammation via the induction of Tregs. J Gene Med 2012; 14:374-83. [PMID: 22576979 DOI: 10.1002/jgm.2631] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Anti-tumor necrosis factor (TNF)-α therapeutics has the potential to alleviate allergic inflammation. However, in previous studies, the systemic administration of anti-TNF-α agents was frequently accompanied by many adverse effects, such as infection, immunogenicity and malignancy. Efforts are made in the present study to evaluate whether or not local administration of TNF-α antisense oligonucleotide would inhibit allergic airway inflammation and influence systemic immune responses in an ovalbumin-induced asthmatic murine model. METHODS The treatment effects of TNF-α antisense oligonucleotide on mice, as well as the alternative proportion of regulatory T cells and T(H) 2 cells, were examined and compared with untreated mice. RESULTS Local administration of TNF-α antisense oligonucleotide resulted in significantly inhibited TNF-α expression, remarkably decreased inflammatory cell infiltration and dramatically reduced mucus hypersecretion. These treatment effects were associated with induced CD4(+) CD25(+) Foxp3(+) regulatory T cells, reduced T(H) 2 cells and generally decreased T(H) 2-type cytokines expression in bronchoalveolar lavage fluid. Systemic immunosuppression was not triggered by local antisense oligonucleotide administration because the proportion of CD4(+) CD25(+) Foxp3(+) regulatory T cells in the blood, thymus or spleen was not affected. Attenuated 4-1BBL expression was likely involved in the alternative proportion of T cells. CONCLUSIONS These findings demonstrate that local administration of TNF-α antisense oligonucleotide contributes to anti-inflammatory action via the enhancement of regulatory T cells-mediated immune tolerance, which is not accompanied by systemic immunosuppression associated with systemically-induced regulatory T cells.
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Affiliation(s)
- Yi Luo
- State Key Laboratory of Pharmaceutical Biotechnology, School of Life Sciences, Nanjing University, Nanjing, People's Republic of China
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94
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van Aalderen WM. Childhood asthma: diagnosis and treatment. SCIENTIFICA 2012; 2012:674204. [PMID: 24278725 PMCID: PMC3820621 DOI: 10.6064/2012/674204] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 09/18/2012] [Indexed: 05/31/2023]
Abstract
Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.
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Affiliation(s)
- Wim M. van Aalderen
- Department of Pediatric Respiratory Disease and Allergy, Emma Children's Hospital AMC, Meibergdreef 7, 1105 AZ Amsterdam, The Netherlands
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95
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Yang IV, Schwartz DA. Epigenetic mechanisms and the development of asthma. J Allergy Clin Immunol 2012; 130:1243-55. [PMID: 23026498 PMCID: PMC3518374 DOI: 10.1016/j.jaci.2012.07.052] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 07/26/2012] [Accepted: 07/27/2012] [Indexed: 12/19/2022]
Abstract
Asthma is heritable, influenced by the environment, and modified by in utero exposures and aging; all of these features are also common to epigenetic regulation. Furthermore, the transcription factors that are involved in the development of mature T cells that are critical to the T(H)2 immune phenotype in asthmatic patients are regulated by epigenetic mechanisms. Epigenetic marks (DNA methylation, modifications of histone tails, and noncoding RNAs) work in concert with other components of the cellular regulatory machinery to control the spatial and temporal levels of expressed genes. Technology to measure epigenetic marks on a genomic scale and comprehensive approaches to data analysis have recently emerged and continue to improve. Alterations in epigenetic marks have been associated with exposures relevant to asthma, particularly air pollution and tobacco smoke, as well as asthma phenotypes, in a few population-based studies. On the other hand, animal studies have begun to decipher the role of epigenetic regulation of gene expression associated with the development of allergic airway disease. Epigenetic mechanisms represent a promising line of inquiry that might, in part, explain the inheritance and immunobiology of asthma.
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Affiliation(s)
- Ivana V Yang
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA.
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96
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de Andrade CR, da Cunha SS, Alvim CG, Fontes MJF, Bedran R, Binato HA, Camargos P. Does BCG revaccination protect against the development of asthma? Respir Med 2012; 107:317-9. [PMID: 23137882 DOI: 10.1016/j.rmed.2012.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 10/10/2012] [Accepted: 10/17/2012] [Indexed: 11/19/2022]
Abstract
Single BCG vaccination has been considered as a protective factor against asthma. However the effect of a second dose of BCG on the prevalence rate of asthma and asthma-allergic rhinitis-eczema comorbidity has not been studied exclusively among adolescents. In this ISAAC protocol-based cross sectional study we assessed the association between one single versus two doses of BCG among 2213 individuals aged 13-14 years old. We found no association between BCG revaccination and asthma, associated (OR = 0.68, 95% CI, 0.37-1.25) or not to allergic rhinitis and/or atopic eczema (OR = 1.07, 95% CI, 0.84-1.36).
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MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/prevention & control
- BCG Vaccine
- Brazil/epidemiology
- Cross-Sectional Studies
- Dermatitis, Atopic/epidemiology
- Dermatitis, Atopic/prevention & control
- Humans
- Immunization, Secondary
- Prevalence
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/prevention & control
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/prevention & control
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97
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Kondrashova A, Seiskari T, Ilonen J, Knip M, Hyöty H. The 'Hygiene hypothesis' and the sharp gradient in the incidence of autoimmune and allergic diseases between Russian Karelia and Finland. APMIS 2012; 121:478-93. [PMID: 23127244 DOI: 10.1111/apm.12023] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 10/04/2012] [Indexed: 12/13/2022]
Abstract
Autoimmune and allergic diseases have become a major health problem in the Western world during past decades. The hygiene hypothesis suggests that decreased microbial exposure in childhood leads to increasing prevalence of these diseases. This review summarizes epidemiological evidence and current immunological knowledge concerning the hygiene hypothesis. Recent results from Russian Karelia and Finland imply that environmental factors have greatly contributed to the increasing prevalence of immune-mediated disorders. Infections, or lack of them, may indeed be strongly involved in the development of both autoimmune and allergic diseases.
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98
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Karasawa K, Otani H. The effect of matured date palm tree (Phoenix dactyliferaL.) fruit extract on mite-induced allergic symptoms in NC/Nga mice. FOOD AGR IMMUNOL 2012. [DOI: 10.1080/09540105.2012.733353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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99
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Early environments and the ecology of inflammation. Proc Natl Acad Sci U S A 2012; 109 Suppl 2:17281-8. [PMID: 23045646 DOI: 10.1073/pnas.1202244109] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Recent research has implicated inflammatory processes in the pathophysiology of a wide range of chronic degenerative diseases, although inflammation has long been recognized as a critical line of defense against infectious disease. However, current scientific understandings of the links between chronic low-grade inflammation and diseases of aging are based primarily on research in high-income nations with low levels of infectious disease and high levels of overweight/obesity. From a comparative and historical point of view, this epidemiological situation is relatively unique, and it may not capture the full range of ecological variation necessary to understand the processes that shape the development of inflammatory phenotypes. The human immune system is characterized by substantial developmental plasticity, and a comparative, developmental, ecological framework is proposed to cast light on the complex associations among early environments, regulation of inflammation, and disease. Recent studies in the Philippines and lowland Ecuador reveal low levels of chronic inflammation, despite higher burdens of infectious disease, and point to nutritional and microbial exposures in infancy as important determinants of inflammation in adulthood. By shaping the regulation of inflammation, early environments moderate responses to inflammatory stimuli later in life, with implications for the association between inflammation and chronic diseases. Attention to the eco-logics of inflammation may point to promising directions for future research, enriching our understanding of this important physiological system and informing approaches to the prevention and treatment of disease.
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100
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Zhang J, Guo S, Li C, Jiang X. Therapeutic effects of inhaled inactivated Mycobacterium phlei in adult patients with moderate persistent asthma. Immunotherapy 2012; 4:383-7. [PMID: 22512632 DOI: 10.2217/imt.12.25] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BCG and other mycobacterial infections suppress airway hyper-responsiveness and inflammation in asthma models; however, its efficacy in human populations remains controversial. We use inactivated Mycobacterium phlei by way of atomizing inhalation to investigate whether it would protect against asthma in adult patients. Patients with newly diagnosed, uncontrolled, moderate persistent bronchial asthma were randomly divided into two groups. The patients in group A were treated with a solution of inhaled inactivated-M. phlei. Group B were treated with salmeterol xinafoate and fluticasone propionate powder. The Spirometry and Bronchial Provocation Test and Asthma Control Test were carried out; the peak expiratory flow and forced expiratory volume in 1 s-PD20 of the patients in the two groups increased significantly. However, overall, there was no significant difference between the two groups. Asthma Control Test scores of the patients in the two groups were significantly increased. We concluded that inhaled inactivated M. phlei, to a certain extent, improves asthma symptoms, reduces the need for rescue medication and reduces acute exacerbation of asthma. It plays the same role as inhaled Seretide treatment in reducing airway hyper-responsiveness.
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Affiliation(s)
- Jinghong Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
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