Dietary (1→3), (1→4)-β-d-glucans from oat activate nuclear factor-κB in intestinal leukocytes and enterocytes from mice

The impact of β-glucan on the therapeutic outcome of experimental Trichinella spiralis infection

Trichinellosis is a cosmopolitan zoonosis that is caused mainly by Trichinella spiralis infection. The human disease ranges from mild to severe and fatality may occur. The treatment of trichinellosis still presents a challenge for physicians. Anti-inflammatory drugs are usually added to antiparasitic agents to alleviate untoward immuno-inflammatory responses and possible tissue damage but they are not without adverse effects. Thus, there is a need for the discovery of safe and effective compounds with anti-inflammatory properties. This study aimed to evaluate the activity of β-glucan during enteral and muscular phases of experimental T. spiralis infection as well as its therapeutic potential as an adjuvant to albendazole in treating trichinellosis. For this aim, mice were infected with T. spiralis and divided into the following groups: early and late β-glucan treatment, albendazole treatment, and combined treatment groups. Infected mice were subjected to assessment of parasite burden, immunological markers, and histopathological changes in the small intestines and muscles. Immunohistochemical evaluation of NF-κB expression in small intestinal and muscle tissues was carried out in order to investigate the mechanism of action of β-glucan. Interestingly, β-glucan potentiated the efficacy of albendazole as noted by the significant reduction of counts of muscle larvae. The inflammatory responses in the small intestine and skeletal muscles were mitigated with some characteristic qualitative changes. β-glucan also increased the expression of NF-κB in tissues which may account for some of its effects. In conclusion, β-glucan showed a multifaceted beneficial impact on the therapeutic outcome of Trichinella infection and can be regarded as a promising adjuvant in the treatment of trichinellosis.

Chemical composition and antioxidant activity of some Syrian wild mushroom (Agaricus spp) strains

This research aims to study the chemical content (moisture, ash, fat, protein, fiber and carbohydrate), phenolic compounds, and antioxidant activity of the fruit bodies resulting from the cultivation of six edible Syrian wild mushroom strains of the Agaricus genus. These strains were collected from the western countryside of Homs governorate in Syria (Agaricus bispours BR5, Agaricus bispours B.R.9, Agaricus sinodeliciosus BR17, Agaricus qilianensis BR22, Agaricus sinodeliciosus BR42 and Agaricus qilianensis BR47) and were compared to the commercially cultivated Agaricus bisporus strain Sylvan A15 as a control. The results showed that wild strains had a good chemical composition. The BR47 had the highest protein content among the studied strains (29.52%), which was close to the content of the control (28.55%). All strains recorded higher carbohydrate content compared to the control (p < 0.01), and BR42 had the highest content (72.24%). The fat content in the studied strains ranged from 1.68 to 5.34%, and they were all less than the control (7.29%). BR9 was marked by a high phenol content (1.93 mg.g-1 of dry weight), while the control had higher antioxidant activity (82.41%). A strong correlation was noted between antioxidant activity, protein, fat and ash. Some studied strains showed nutritional value and distinctive biological properties, indicating they can be used for food and pharmaceutical purposes.

A Review of Health-Beneficial Properties of Oats

Oat is among the food crops and ancient grains cultivated and consumed worldwide. It is gaining in popularity owing to its nutritional composition and multifunctional benefits of select bioactive compounds. Beta-glucan is an important component of dietary fiber found in oat grains. It is the major active compound in oats with proven cholesterol-lowering and antidiabetic effects. Oats also provide substantial levels of other bioactive compounds such as phenolic acids, tocols, sterols, avenacosides, and avenanthramides. The consumption of oats has been determined to be beneficial for human health by promoting immunomodulation and improving gut microbiota. In addition, oat consumption assists in preventing diseases such as atherosclerosis, dermatitis, and some forms of cancer. While much has been published in relation to oat nutrients and oat fibers and their impact on major diseases, the oat industries and consumers may benefit from greater knowledge and understanding of clinical effects, range of occurrence, distribution, therapeutic doses and food functional attributes of other oat bioactives such as avenanthramides and saponins as well as other anti-inflammatory agents found in the cereal. This review focuses on the various studies relevant to the contribution of the consumption of oats and oat-based products in preventing human diseases and promoting human health.

Ingestion of High β-Glucan Barley Flour Enhances the Intestinal Immune System of Diet-Induced Obese Mice by Prebiotic Effects

The prebiotic effect of high β-glucan barley (HGB) flour on the innate immune system of high-fat model mice was investigated. C57BL/6J male mice were fed a high-fat diet supplemented with HGB flour for 90 days. Secretory immunoglobulin A (sIgA) in the cecum and serum were analyzed by enzyme-linked immunosorbent assays (ELISA). Real-time PCR was used to determine mRNA expression levels of pro- and anti-inflammatory cytokines such as interleukin (IL)-10 and IL-6 in the ileum as well as the composition of the microbiota in the cecum. Concentrations of short-chain fatty acids (SCFAs) and organic acids were analyzed by GC/MS. Concentrations of sIgA in the cecum and serum were increased in the HGB group compared to the control. Gene expression levels of IL-10 and polymeric immunoglobulin receptor (pIgR) significantly increased in the HGB group. HGB intake increased the bacterial count of microbiota, such as Bifidobacterium and Lactobacillus. Concentrations of propionate and lactate in the cecum were increased in the HGB group, and a positive correlation was found between these organic acids and the IL-10 expression level. Our findings showed that HGB flour enhanced immune function such as IgA secretion and IL-10 expression, even when the immune system was deteriorated by a high-fat diet. Moreover, we found that HGB flour modulated the gut microbiota, which increased the concentration of SCFAs, thereby stimulating the immune system.

Evaluation of an O2-Substituted (1-3)-β-D-Glucan, Produced by Pediococcus parvulus 2.6, in ex vivo Models of Crohn's Disease

1,3-β-glucans are extracellular polysaccharides synthesized by microorganisms and plants, with therapeutic potential. Among them, the O2-substituted-(1–3)-β-D-glucan, synthesized by some lactic acid bacteria (LAB), has a prebiotic effect on probiotic strains, an immunomodulatory effect on monocyte-derived macrophages, and potentiates the ability of the producer strain to adhere to Caco-2 cells differentiated to enterocytes. In this work, the O2-substituted-(1–3)-β-D-glucan polymers produced by GTF glycoyltransferase in the natural host Pediococcus parvulus 2.6 and in the recombinant strain Lactococcus lactis NZ9000[pNGTF] were tested. Their immunomodulatory activity was investigated in an ex vivo model using human biopsies from patients affected by Crohn’s disease (CD). Both polymers had an anti-inflammatory effect including, a reduction of Interleukine 8 both at the level of its gene expression and its secreted levels. The overall data indicate that the O2-substituted-(1–3)-β-D-glucan have a potential role in ameliorating inflammation via the gut immune system cell modulation.

Yarrowia lipolytica N6-glucan protects goat leukocytes against Escherichia coli by enhancing phagocytosis and immune signaling pathway genes

Immunostimulant and protective effects of Yarrowia lipolytica glucans against important pathogens, such as Escherichia coli, have not been investigated in goats and other ruminants. This study aimed to characterize Y. lipolytica N6-glucan (Yl-glucan) and its possible role in immunological signaling pathway activation and immunoprotection against E. coli in goat leukocytes. Characterization analyses showed that Y. lipolytica content had a mix of β and α-D-glucans, molecular weight of 3301.53 kDa and low solubility after the heat treatment. The stimulation of goat leukocytes with Yl-glucan induced protection against E. coli challenge. Remarkably, Yl-glucan and E. coli interaction increased gene expression of dectin-1 and TLR-2 receptors, signaling pathway Syk/NFκB, and cytokines, such as TNF-α and IL-10. As a consequence of signaling activation, phagocytosis, and nitric oxide production enhanced killing of pathogens. Altogether, Y. lipolytica-glucan demonstrated to possess an immunoprotective potential against E. coli through innate immune response modulation in goat leukocytes.

Dietary Oat Bran Reduces Systemic Inflammation in Mice Subjected to Pelvic Irradiation

Patients undergoing radiotherapy to treat pelvic-organ cancer are commonly advised to follow a restricted fiber diet. However, reducing dietary fiber may promote gastrointestinal inflammation, eventually leading to deteriorated intestinal health. The goal of this study was to evaluate the influence of dietary fiber on radiation-induced inflammation. C57BL/6J male mice were fed a High-oat bran diet (15% fiber) or a No-fiber diet (0% fiber) and were either irradiated (32 Gy delivered in four fractions) to the colorectal region or only sedated (controls). The dietary intervention started at 2 weeks before irradiation and lasted for 1, 6, and 18 weeks after irradiation, at which time points mice were sacrificed and their serum samples were assayed for 23 cytokines and chemokines. Our analyses show that irradiation increased the serum cytokine levels at all the time points analyzed. The No-fiber irradiated mice had significantly higher levels of pro-inflammatory cytokines than the High-oat irradiated mice at all time points. The results indicate that a fiber-rich oat bran diet reduces the intensity of radiation-induced inflammation, both at an early and late stage. Based on the results, it seems that the advice to follow a low-fiber diet during radiotherapy may increase the risk of decreased intestinal health in cancer survivors.

Sparassis crispa Intake Improves the Reduced Lipopolysaccharide-Induced TNF-α Production That Occurs upon Exhaustive Exercise in Mice

Our previous study showed that lipopolysaccharide (LPS)-induced tumor necrosis factor (TNF)-α production is inhibited by acute exhaustive exercise in mice, leading to transient immunodepression after exercise. Sparassis crispa (SC), an edible mushroom, has immunopotentiative properties. This study aimed to clarify the effects of SC intake on reduced LPS-induced TNF-α production upon exhaustive exercise in mice. Male C3H/HeN mice were randomly divided into three groups: normal chow intake + resting sedentary, normal chow intake + acute exhaustive treadmill running exercise, and SC intake (chow containing 5% SC powder for 8 weeks) + the exhaustive exercise groups. Each group was injected with LPS immediately after the exhaustive exercise or rest. Plasma and tissue TNF-α levels were significantly decreased by exhaustive exercise. However, this reduction of the TNF-α level was partially attenuated in the plasma and small intestine by SC intake. Although levels of TLR4 and MyD88 protein expression were significantly decreased in tissues by exhaustive exercise, the reduction of TLR4 and MyD88 levels in the small intestine was partially attenuated by SC intake. These results suggest that SC intake attenuates exhaustive exercise-induced reduction of TNF-α production via the retention of TLR4 and MyD88 expression in the small intestine.

The Case for a More Holistic Approach to Dry Eye Disease: Is It Time to Move beyond Antibiotics?

Dry eye disease (DED) is one of the most frequent presentations to optometrists with over 16 million US adults (6.8% of adult population) diagnosed as having this disorder. The majority of associated marketed products offer relief from symptomatology but do not address aetiology. DED harbours many distinguishing features of a chronic inflammatory disorder. The recent explosion in human microbiome research has sparked interest in the ocular microbiome and its role in the preservation and extension of ocular surface health and in the contribution of the gut microbiome to chronic systemic inflammation and associated "Western life-style" diseases. With a significant lack of success for many patients using currently available DED treatments, in this era of the microbiome, we are interested in exploring potential novel therapies that aim to reconstitute healthy bacterial communities both locally and distally (in the gut) as a treatment for DED. Although this direction of investigation is in its infancy, burgeoning interest makes such a review timely. This paper considers a number of studies into the use functional foods and associated products to ameliorate dry eye.

Potential of Mushroom Compounds as Immunomodulators in Cancer Immunotherapy: A Review

Since time immemorial, plants and their compounds have been used in the treatment and management of various ailments. Currently, most of conventional drugs used for treatment of diseases are either directly or indirectly obtained from plant sources. The fungal group of plants is of significance, which not only provides food directly to man but also has been source of important drugs. For instance, commonly used antibiotics are derived from fungi. Fungi have also been utilized in the food industry, baking, and alcohol production. Apart from the economic importance of the microfungi, macrofungi have been utilized directly as food, which is usually got from their fruiting bodies, commonly known as mushrooms. Due to their richness in proteins, minerals, and other nutrients, mushrooms have also been associated with boosting the immune system. This makes mushrooms an important food source, especially for vegetarians and immunosuppressed individuals including the HIV/AIDS persons. In complementary and alternative medicines (CAMs), mushrooms are increasingly being accepted for treatment of various diseases. Mushrooms have been shown to have the ability to stimulate the immune system, modulate humoral and cellular immunity, and potentiate antimutagenic and antitumorigenic activity, as well as rejuvenating the immune system weakened by radiotherapy and chemotherapy in cancer treatment. This potential of mushrooms, therefore, qualifies them as candidates for immunomodulation and immunotherapy in cancer and other diseases' treatment. However, a critical review on mushroom's immune modulating potential in cancer has not been sufficiently addressed. This review puts forward insights into the immune activities of mushroom associated with anticancer activities.

Enzymatically synthesized megalo-type isomaltosaccharides enhance the barrier function of the tight junction in the intestinal epithelium

Megalo-type isomaltosaccharides are an enzymatically synthesized foodstuff produced by transglucosylation from maltodextrin, and they contain a mid-chain length polymer of D-glucose with α-1,6-glycoside linkages. The injection of a solution of megalo-type isomaltosaccharides (1-4%(w/v), average DP = 12.6), but not oligo-type isomaltosaccharides (average DP = 3.3), into the intestinal lumen dose-dependently reduced the transport rates of tight junction permeable markers in a ligated loop of the anesthetized rat jejunum. Application of the megalosaccharide also suppressed the transport of tight junction markers and enhanced transepithelial electrical resistance (TEER) in Caco-2 cell monolayers. Cholesterol sequestration by methyl-β-cyclodextrin in the Caco-2 monolayers abolished the effect of megalosaccharide. Treatment with anti-caveolin-1 and a caveolae inhibitor, but not clathrin-dependent endocytosis and macropinocytosis inhibitors, suppressed the increase in TEER. These results indicate that isomaltosaccharides promote the barrier function of tight junctions in the intestinal epithelium in a chain-length dependent manner and that caveolae play a role in the effect.

Characterization of Oat (Avena nuda L.) β-Glucan Cryogelation Process by Low-Field NMR

Low-field nuclear magnetic resonance (LF-NMR) is a useful method in studying the water distribution and mobility in heterogeneous systems. This technique was used to characterize water in an oat β-glucan aqueous system during cryogelation by repeated freeze-thaw treatments. The results indicated that microphase separation occurred during cryogelation, and three water components were determined in the cryostructure. The spin-spin relaxation time was analyzed on the basis of chemical exchange and diffusion exchange theory. The location of each water component was identified in the porous microstructure of the cryogel. The pore size measured from the SEM image is in accordance with that estimated from relaxation time. The formation of cryogel is confirmed by rheological method. The results suggested that the cryogelation process of the polysaccharide could be monitored by LF-NMR through the evolution of spin-spin relaxation characteristics.

Biological activities of derivatized D-glucans: a review

D-Glucans have triggered increasing interest in commercial applications in the chemical and pharmaceutical sectors because of their technological properties and biological activities. The glucans are foremost among the polysaccharide groups produced by microorganisms with demonstrated activity in stimulating the immune system, and have potential in treating human disease conditions. Chemical alterations in the structure of D-glucans through derivatization (sulfonylation, carboxymethylation, phosphorylation, acetylation) contributes to their increased solubility that, in turn, can alter their biological activities such as antioxidation and anticoagulation. This review surveys and cites the latest advances on the biological and technological potential of D-glucans following chemical modifications through sulfonylation, carboxymethylation, phosphorylation or acetylation, and discusses the findings of their activities. Several studies suggest that chemically modified d-glucans have potentiated biological activity as anticoagulants, antitumors, antioxidants, and antivirals. This review shows that in-depth future studies on chemically modified glucans with amplified biological effects will be relevant in the biotechnological field because of their potential to prevent and treat numerous human disease conditions and their clinical complications.

Barley β-glucans-containing food enhances probiotic performances of beneficial bacteria

Currently, the majority of prebiotics in the market are derived from non-digestible oligosaccharides. Very few studies have focused on non-digestible long chain complex polysaccharides in relation to their potential as novel prebiotics. Cereals β-glucans have been investigated for immune-modulating properties and beneficial effects on obesity, cardiovascular diseases, diabetes, and cholesterol levels. Moreover, β-glucans have been reported to be highly fermentable by the intestinal microbiota in the caecum and colon, and can enhance both growth rate and lactic acid production of microbes isolated from the human intestine. In this work, we report the effects of food matrices containing barley β-glucans on growth and probiotic features of four Lactobacillus strains. Such matrices were able to improve the growth rate of the tested bacteria both in unstressed conditions and, importantly, after exposure to in vitro simulation of the digestive tract. Moreover, the effect of β-glucans-containing food on bacterial adhesion to enterocyte-like cells was analyzed and a positive influence on probiotic-enterocyte interaction was observed.

The immunologically active oligosaccharides isolated from wheatgrass modulate monocytes via Toll-like receptor-2 signaling

Wheatgrass is one of the most widely used health foods, but its functional components and mechanisms remain unexplored. Herein, wheatgrass-derived oligosaccharides (WG-PS3) were isolated and found to induce CD69 and Th1 cytokine expression in human peripheral blood mononuclear cells. In particular, WG-PS3 directly activated the purified monocytes by inducing the expression of CD69, CD80, CD86, IL-12, and TNF-α but affected NK and T cells only in the presence of monocytes. After further purification and structural analysis, maltoheptaose was identified from WG-PS3 as an immunomodulator. Maltoheptaose activated monocytes via Toll-like receptor 2 (TLR-2) signaling, as discovered by pretreatment of blocking antibodies against Toll-like receptors (TLRs) and also determined by click chemistry. This study is the first to reveal the immunostimulatory component of wheatgrass with well defined molecular structures and mechanisms.

Gut microbiota, host health, and polysaccharides

The intestinal microbiota is a complicated ecosystem that influences many aspects of host physiology (i.e. diet, disease development, drug metabolism, and regulation of the immune system). It also exhibits spatial patterning and temporal dynamics. In this review, the effects of internal and external (environmental) factors on intestinal microbiota are discussed. We describe the roles of the gut microbiota in maintaining intestinal and immune system homeostasis and the relationship between gut microbiota and diseases. In particular, the contributions of polysaccharides, as the most abundant diet components in intestinal microbiota and host health are presented. Finally, perspectives for research avenues relating to gut microbiota are also discussed.

β-Glucans are involved in immune-modulation of THP-1 macrophages

SCOPE

We aimed to examine different immunological aspects of β-glucans derived from different food sources (oat, barley and shiitake) on phorbol myristate acetate (PMA)-differentiated THP-1 macrophages. Commercially purified barley β-glucan (commercial BG) and lentinan were included to compare β-glucans from the same origin but different degree of purity and processing.

METHODS AND RESULTS

Chemical composition and molecular weight distribution of β-glucan samples were determined. Inflammation-related gene expression kinetics (IL-1β, IL-8, nuclear factor kappa B [NF-κB] and IL-10) after 3, 6 and 24 h of stimulation with 100 μg/mL β-glucan were investigated. All tested β-glucans mildly upregulated the observed inflammation-related genes with differential gene expression patterns. Similar gene expression kinetics, but different fold induction values, was found for the crude β-glucan extracts and their corresponding commercial forms. Pre-incubation of THP-1 macrophages with β-glucans prior to lipopolysaccharide (LPS) exposure decreased the induction of inflammation-related genes compared to LPS treatment. No production of nitric oxide (NO) and hydrogen peroxide (H₂O₂) was detected in β-glucan stimulated THP-1 macrophages. Phagocytic activity was not different after stimulation by β-glucan samples.

CONCLUSION

Based on these in vitro analyses, it can be concluded that the analysed β-glucans have varying levels of immunomodulating properties, which are likely related to structure, molecular weight and compositional characteristic of β-glucan.

Cereal β-glucan quantification with calcofluor-application to cell culture supernatants

The specific binding of the fluorescent dye calcofluor to cereal β-glucan results in increased fluorescence intensity of the formed complex and is in use for the quantification of β-glucan above a critical molecular weight (MW) by flow injection analysis. In this study, this method was applied in a fast and easy batch mode. In order to emphasize the spectral information of the emission spectra of the calcofluor/β-glucan complexes, derivative signals were calculated. A linear relationship was found between the amplitude of the second derivative signals and the β-glucan concentration between 0.1 and 0.4 μg/mL. The low detection limit of this new method (0.045 μg/mL) enabled its use to study the transport of cereal β-glucans over differentiated Caco-2 cell monolayers. Additionally, the method was applied to quantify β-glucan in arabinoxylan samples, which correlated well with data by an enzyme based method.

Discharge of solubilized and Dectin-1-reactive β-glucan from macrophage cells phagocytizing insoluble β-glucan particles: involvement of reactive oxygen species (ROS)-driven degradation

Phagocytes engulf pathogenic microbes, kill them and degrade their cellular macromolecules by hydrolytic enzymes in phagolysosomes. However, such enzymes are unable to degrade some microbial polysaccharides, and fate of such indigestible polysaccharides in phagocytes remains uncertain. Using the extracellular domain of Dectin-1 as β-glucan-specific probes, we succeeded in detection of soluble and Dectin-1-reactive β-glucan discharged from mouse RAW 264.7 and human THP-1 macrophage cell lines as well as mouse peritoneal macrophages, which had phagocytized insoluble β-glucan particles. The RAW 264.7 cell culture-supernatant containing the discharged β-glucan stimulated naïve RAW 264.7 cells, resulting in the induction of cytokine expression. Such discharge of Dectin-1-reactive β-glucan from macrophage cells was inhibited by either NADPH oxidase inhibitors (apocynin and diphenylene iodonium) or radical scavengers (N-acetyl cysteine and MCI-186). Moreover, reactive oxygen species (ROS) produced by a Cu(2+)/ascorbic acid system solubilized insoluble β-glucan particles in vitro, and a part of the solubilized β-glucan was Dectin-1 reactive and biologically active in macrophage activation. The soluble and biologically active β-glucan was degraded further during prolonged exposure to ROS. These results suggest that degraded but Dectin-1-reactive β-glucan is discharged from macrophage cells phagocytizing insoluble β-glucan particles and stimulates not only themselves again but also the other naïve phagocytes, leading to the effective elimination of infecting microbes and the ultimate breakdown and inactivation of metabolically resistant β-glucan.

In vivo effects of dietary (1→3), (1→4)-β-D-glucans from oat on mucosal immune responses in man and mice

OBJECTIVE

Antimicrobial peptides and tight junction proteins are crucial to maintain mucosal immunity. It is known that oat β-glucan may affect intestinal immunity. Therefore, the aim of the present study was to evaluate the effect of oat β-glucan on the presence of antimicrobial peptides and tight junction protein.

MATERIAL AND METHODS

We analyzed antimicrobial peptide levels in fecal water prepared from 24 h ileostomic bag contents obtained from ileostomic patients consuming oat β-glucan enriched or control diets in a cross-over design. In addition, intestinal sections of mice, which received oat β-glucan via oral gavages for 3.5 days, were analyzed for lysozyme and zonula occludens-1 expression.

RESULTS

We observed a trend toward lower lysozyme (-23%; p = 0.076) and bactericidal/permeability-increasing protein (-17%; p = 0.098) levels in oat β-glucan enriched fecal water as compared with placebo. Additionally, mice receiving oat β-glucan showed a lower lysozyme expression in stained distal small intestinal sections (p = 0.011). Staining of zonula occludens-1 was decreased in β-glucan treated mice indicating disruption of the tight junction integrity.

CONCLUSIONS

In conclusion, the consumption of oat β-glucan seems to decrease the levels of antimicrobial peptides in fecal water from human ileostomy patients and its expression in distal small intestine sections in mice. The decreased intestinal integrity in mice could be explained by the drop in antimicrobial peptides.

Polysaccharides isolated from Açaí fruit induce innate immune responses

The Açaí (Acai) fruit is a popular nutritional supplement that purportedly enhances immune system function. These anecdotal claims are supported by limited studies describing immune responses to the Acai polyphenol fraction. Previously, we characterized γδ T cell responses to both polyphenol and polysaccharide fractions from several plant-derived nutritional supplements. Similar polyphenol and polysaccharide fractions are found in Acai fruit. Thus, we hypothesized that one or both of these fractions could activate γδ T cells. Contrary to previous reports, we did not identify agonist activity in the polyphenol fraction; however, the Acai polysaccharide fraction induced robust γδ T cell stimulatory activity in human, mouse, and bovine PBMC cultures. To characterize the immune response to Acai polysaccharides, we fractionated the crude polysaccharide preparation and tested these fractions for activity in human PBMC cultures. The largest Acai polysaccharides were the most active in vitro as indicated by activation of myeloid and γδ T cells. When delivered in vivo, Acai polysaccharide induced myeloid cell recruitment and IL-12 production. These results define innate immune responses induced by the polysaccharide component of Acai and have implications for the treatment of asthma and infectious disease.