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Bleakley AS, Kho S, Binks MJ, Pizzutto S, Chang AB, Beissbarth J, Minigo G, Marsh RL. Extracellular traps are evident in Romanowsky-stained smears of bronchoalveolar lavage from children with non-cystic fibrosis bronchiectasis. Respirology 2023; 28:1126-1135. [PMID: 37648649 PMCID: PMC10947271 DOI: 10.1111/resp.14587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The importance of extracellular traps (ETs) in chronic respiratory conditions is increasingly recognized but their role in paediatric bronchiectasis is poorly understood. The specialized techniques currently required to study ETs preclude routine clinical use. A simple and cost-effective ETs detection method is needed to support diagnostic applications. We aimed to determine whether ETs could be detected using light microscopy-based assessment of Romanowsky-stained bronchoalveolar lavage (BAL) slides from children with bronchiectasis, and whether the ETs cellular origin could be determined. METHODS Archived Romanowsky-stained BAL slides from a cross-sectional study of children with bronchiectasis were examined for ETs using light microscopy. The cellular origin of individual ETs was determined based on morphology and physical contact with surrounding cell(s). RESULTS ETs were observed in 78.7% (70/89) of BAL slides with neutrophil (NETs), macrophage (METs), eosinophil (EETs) and lymphocyte (LETs) ETs observed in 32.6%, 51.7%, 4.5% and 9%, respectively. ETs of indeterminate cellular origin were present in 59.6% of slides. Identifiable and indeterminate ETs were co-detected in 43.8% of slides. CONCLUSION BAL from children with bronchiectasis commonly contains multiple ET types that are detectable using Romanowsky-stained slides. While specialist techniques remain necessary to determining the cellular origin of all ETs, screening of Romanowsky-stained slides presents a cost-effective method that is well-suited to diagnostic settings. Our findings support further research to determine whether ETs can be used to define respiratory endotypes and to understand whether ETs-specific therapies may be required to resolve airway inflammation among children with bronchiectasis.
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Affiliation(s)
- Amy S. Bleakley
- Child and Maternal Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Steven Kho
- Global and Tropical Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Michael J. Binks
- Child and Maternal Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Susan Pizzutto
- Research Institute for the Environment and Livelihoods, Faculty of Science and TechnologyCharles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Anne B. Chang
- Child and Maternal Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
- Department of Respiratory and Sleep MedicineQueensland Children's Hospital and Australian Centre for Health Services Innovation, Queensland University of TechnologyBrisbaneQueenslandAustralia
| | - Jemima Beissbarth
- Child and Maternal Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Gabriela Minigo
- Global and Tropical Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
- School of Medicine, Faculty of HealthCharles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Robyn L. Marsh
- Child and Maternal Health DivisionMenzies School of Health Research, Charles Darwin UniversityDarwinNorthern TerritoryAustralia
- School of Health SciencesUniversity of TasmaniaLauncestonTasmaniaAustralia
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Hare KM, Smith-Vaughan HC, Chang AB, Pizzutto S, Petsky HL, McCallum GB, Leach AJ. Propensity of pneumococcal carriage serotypes to infect the lower airways of children with chronic endobronchial infections. Vaccine 2017; 35:747-756. [PMID: 28062125 DOI: 10.1016/j.vaccine.2016.12.059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 12/05/2016] [Accepted: 12/22/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Chronic endobronchial infections in children are responsible for a high disease burden. Streptococcus pneumoniae is frequently isolated; however, few publications have described serotypes associated with non-invasive lower airway infection. METHODS Paired nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids were collected from children undergoing bronchoscopy for chronic cough. NP swabs were also collected from asymptomatic children in otitis media surveillance studies (controls). Specimens were processed and lower airway infection defined (⩾104 colony forming units/mL BAL) as previously described. Serotype-specific odds ratios (ORs) were calculated (as described for invasive pneumococcal disease) to indicate propensity for infection. RESULTS From 2007-2015, paired specimens were processed from 435 children with protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) or bronchiectasis. S. pneumoniae lower airway infection was detected in 95 children: 27% with PBB and 20% with CSLD/bronchiectasis. Most (91%) children were vaccinated with ⩾2 doses of 7-valent, 10-valent or 13-valent pneumococcal conjugate vaccine. Paired NP and BAL serotype distributions were very similar; prevalent serotypes (>10 isolates) were 19A (9%), 19F, 6C, 35B, 15B, 16F, 15A, 15C, 23A, 23F and 11A. For 21 serotypes found in both NP and BAL specimens, ORs for infection were low; range 0.46 (serotype 23B) to 2.15 (serotype 6A). In the 2008-2013 surveillance studies, NP swabs were collected from 1565 asymptomatic children; 74% were pneumococcal carriers. For 21 of 22 serotypes found in both control NP swabs and BAL specimens, ORs for infection were similarly low; range 0.33 (serotype 23B) to 3.29 (serotype 22F); none was significantly different from 1. The exception was serotype 7B with OR 8.84 (95% CI 1.46, 38.1). CONCLUSIONS Most NP carriage serotypes have a similar propensity to cause lower airway infection in children with suppurative lung diseases. Further development of pneumococcal vaccines is needed to prevent non-invasive disease caused by commonly carried serotypes.
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Affiliation(s)
- Kim M Hare
- Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia.
| | - Heidi C Smith-Vaughan
- Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia; Queensland Children's Health Service and Queensland University of Technology, Graham Street, South Brisbane, QLD 4101, Australia
| | - Susan Pizzutto
- Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
| | - Helen L Petsky
- Queensland Children's Health Service and Queensland University of Technology, Graham Street, South Brisbane, QLD 4101, Australia
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
| | - Amanda J Leach
- Child Health Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia
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Hodge S, Upham JW, Pizzutto S, Petsky HL, Yerkovich S, Baines KJ, Gibson P, Simpson JL, Buntain H, Chen ACH, Hodge G, Chang AB. Is Alveolar Macrophage Phagocytic Dysfunction in Children With Protracted Bacterial Bronchitis a Forerunner to Bronchiectasis? Chest 2016; 149:508-515. [PMID: 26867834 DOI: 10.1016/j.chest.2015.10.066] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/11/2015] [Accepted: 10/15/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Children with recurrent protracted bacterial bronchitis (PBB) and bronchiectasis share common features, and PBB is likely a forerunner to bronchiectasis. Both diseases are associated with neutrophilic inflammation and frequent isolation of potentially pathogenic microorganisms, including nontypeable Haemophilus influenzae (NTHi), from the lower airway. Defective alveolar macrophage phagocytosis of apoptotic bronchial epithelial cells (efferocytosis), as found in other chronic lung diseases, may also contribute to tissue damage and neutrophil persistence. Thus, in children with bronchiectasis or PBB and in control subjects, we quantified the phagocytosis of airway apoptotic cells and NTHi by alveolar macrophages and related the phagocytic capacity to clinical and airway inflammation. METHODS Children with bronchiectasis (n = 55) or PBB (n = 13) and control subjects (n = 13) were recruited. Alveolar macrophage phagocytosis, efferocytosis, and expression of phagocytic scavenger receptors were assessed by flow cytometry. Bronchoalveolar lavage fluid interleukin (IL) 1β was measured by enzyme-linked immunosorbent assay. RESULTS For children with PBB or bronchiectasis, macrophage phagocytic capacity was significantly lower than for control subjects (P = .003 and P < .001 for efferocytosis and P = .041 and P = .004 for phagocytosis of NTHi; PBB and bronchiectasis, respectively); median phagocytosis of NTHi for the groups was as follows: bronchiectasis, 13.7% (interquartile range [IQR], 11%-16%); PBB, 16% (IQR, 11%-16%); control subjects, 19.0% (IQR, 13%-21%); and median efferocytosis for the groups was as follows: bronchiectasis, 14.1% (IQR, 10%-16%); PBB, 16.2% (IQR, 14%-17%); control subjects, 18.1% (IQR, 16%-21%). Mannose receptor expression was significantly reduced in the bronchiectasis group (P = .019), and IL-1β increased in both bronchiectasis and PBB groups vs control subjects. CONCLUSIONS A reduced alveolar macrophage phagocytic host response to apoptotic cells or NTHi may contribute to neutrophilic inflammation and NTHi colonization in both PBB and bronchiectasis. Whether this mechanism also contributes to the progression of PBB to bronchiectasis remains unknown.
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Affiliation(s)
- Sandra Hodge
- Chronic Inflammatory Lung Disease Research Laboratory, Lung Research Unit, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, and The School of Medicine, The University of Adelaide, Adelaide, SA, Australia.
| | - John W Upham
- Princess Alexandra Hospital, Brisbane, QLD, Australia; The School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Susan Pizzutto
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Helen L Petsky
- Queensland University of Technology, South Brisbane, QLD, Australia
| | - Stephanie Yerkovich
- The School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Katherine J Baines
- Respiratory and Sleep Medicine, School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle, Callaghan, NSW, Australia
| | - Peter Gibson
- Respiratory and Sleep Medicine, School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle, Callaghan, NSW, Australia
| | - Jodie L Simpson
- Respiratory and Sleep Medicine, School of Medicine and Public Health, Centre for Asthma and Respiratory Disease, The University of Newcastle, Callaghan, NSW, Australia
| | - Helen Buntain
- Queensland Children's Health Service, Brisbane, QLD, and Queensland Children's Medical Research Institute, Brisbane, QLD, Australia
| | - Alice C H Chen
- The School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Greg Hodge
- Chronic Inflammatory Lung Disease Research Laboratory, Lung Research Unit, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, and The School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia; Queensland Children's Health Service, Brisbane, QLD, and Queensland Children's Medical Research Institute, Brisbane, QLD, Australia
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Walton SF, Dougall A, Pizzutto S, Holt D, Taplin D, Arlian LG, Morgan M, Currie BJ, Kemp DJ. Genetic epidemiology of Sarcoptes scabiei (Acari: Sarcoptidae) in northern Australia. Int J Parasitol 2004; 34:839-49. [PMID: 15157767 DOI: 10.1016/j.ijpara.2004.04.002] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2004] [Revised: 03/31/2004] [Accepted: 04/01/2004] [Indexed: 11/20/2022]
Abstract
Utilising three hypervariable microsatellite markers we have previously shown that scabies mites on people are genetically distinct from those on dogs in sympatric populations in northern Australia. This had important ramifications on the formulation of public health control policies. In contrast phylogenetic analyses using mitochondrial markers on scabies mites infecting multiple animal hosts elsewhere in the world could not differentiate any genetic variation between mite haplotype and host species. Here we further analyse the intra-specific relationship of Sarcoptes scabiei var. hominis with S. scabiei var. canis by using both mitochondrial DNA and an expanded nuclear microsatellite marker system. Phylogenetic studies using sequences from the mitochondrial genes coding for 16S rRNA and Cytochrome Oxidase subunit I demonstrated significant relationships between S. scabiei MtDNA haplotypes, host species and geographical location. Multi-locus genotyping using 15 microsatellite markers substantiated previous data that gene flow between scabies mite populations on human and dog hosts is extremely rare in northern Australia. These data clearly support our previous contention that control programs for human scabies in endemic areas with sympatric S. scabiei var. hominis and var. canis populations must focus on human-to-human transmission. The genetic division of dog and human derived scabies mites also has important implications in vaccine and diagnostic test development as well as the emergence and monitoring of drug resistance in S. scabiei in northern Australia.
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Affiliation(s)
- S F Walton
- Queensland Institute of Medical Research, Brisbane, Qld, Australia.
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Abstract
OBJECTIVE To compare the acaricidal activity of Melaleuca alternifolia (tea tree) oil (TTO) and some of its individual active components on the itch mite Sarcoptes scabiei var hominis. DESIGN In vitro acaricide sensitivity assessment. SETTING The Menzies School of Health Research laboratory, located near the Infectious Diseases Ward of the Royal Darwin Hospital, Australia, where patients are admitted and treated for crusted scabies. PARTICIPANTS Scabies mites (S scabiei var hominis) were collected from a 20-year-old Aboriginal woman admitted to the Royal Darwin Hospital with crusted scabies. Interventions Within 3 hours of collection, scabies mites were placed in continuous direct contact with the TTO products and control acaricides and were observed at regular intervals. MAIN OUTCOME MEASURES Percentage of mites dead at regular observation intervals between 5 minutes and 24 hours during continuous exposure to the TTO products and acaricides. RESULTS The 5% TTO and active component terpinen-4-ol were highly effective in reducing mite survival times. Statistically significant differences in mite survival curves were observed for 5% TTO, 2.1% terpinen-4-ol, 5% permethrin, and ivermectin (100 microg/g of Emulsifying Ointment British Pharmacopoeia 88). In vivo effectiveness was also observed. CONCLUSIONS Documentation of resistance against antiectoparasitic compounds is increasing. Reported S scabiei treatment failures with lindane, crotamiton, and benzyl benzoate, as well as likely emerging resistance to 5% permethrin and oral ivermectin, are of concern and advocate for the identification and development of novel acaricidal drugs. Tea tree oil is a membrane-active biocide extracted from the tree M alternifolia. It is a principal antimicrobial in a wide range of pharmaceuticals sold in Australia, with the main active component being oxygenated terpenoids. The results suggest that TTO has a potential role as a new topical acaricide and confirm terpinen-4-ol as the primary active component.
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Affiliation(s)
- Shelley F Walton
- Menzies School of Health Research, and Northern Territory Clinical School, Flinders University, Darwin, Australia.
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