[Efficacy of omalizumab in the treatment of eosinophilic granulomatous polyangiitis with asthma as the first symptom]

Objective: To investigate the efficacy, and safety of omalizumab in the treatment of eosinophilic granulomatous with polyangiitis (EGPA) with asthma as the first symptom. Method: The clinical characteristics of 22 EGPA patients with asthma as the first symptom treated with omalizumab in the First Affiliated Hospital of Guangzhou Medical University from March 2018 to December 2020 were retrospectively analyzed. The asthma control test (ACT) score, the frequency of asthma exacerbation (AE), the Birmingham Vasculitis Activity Score (BVAS), the variation rate of peak expiratory flow (PEF), the percentage of PEF to predicted value of PEF (PEFpred%), the percentage of forced expiratory volume in first second (FEV₁) to predicted value of FEV₁ (FEV₁pred%), the dosage of oral corticosteroid (OCS) and other clinical data [M(Q₁, Q₃)] were collected before and after treatment, to observe the efficacy and adverse reactions of omalizumab. Results: There were 22 subjects recruited in this study. The median age was 42 (22-70) years. Eleven of the patients were males. After treated with omalizumab for 4 months, there were 68.2%(15/21) of patients who responded to the treatment. In the response group (n=15), the patients' ACT score increased from 19.0 (16.5, 21.0) to 23.0 (21.5, 24.0) (P=0.001). The frequency of AE decreased from 0.7 (0.3, 1.0) to 0 (0, 0.7) per four mouths (P<0.001). The BVAS decreased from 4.0 (2.0, 6.0) to 2.0 (2.0, 4.0) (P=0.007). The variation rate of PEF decreased from 18.8% (14.0%, 27.7%) to 9.2% (6.8%, 11.9%) (P=0.007). The PEFpred% increased from 80.8% (73.5%, 90.7%) to 100.5% (79.4%, 114.0%) (P=0.005). The maintenance dosage of OCS reduced from 15.0 (10.0, 20.0) mg/d to 8.8 (5.0, 10.0) mg/d (P=0.005). The level of baseline eosinophil in peripheral blood of patients in non-response group was higher than that in response group [11.4% (9.2%, 22.6%) vs 3.4% (1.1%, 6.5%), P<0.05]. A total of 190 injections were performed in 22 patients, and only 4 patients (2.1%) had adverse reactions after a single injection of omalizumab, such as dizziness, swelling of injection site and pruritus. The adverse reactions were tolerable. Conclusions: Omalizumab has certain curative effect on EGPA, can reduce asthmatic symptoms and OCS maintenance dosage, and has a good safety profile. The rate of response to the treatment is higher in patients with mild eosinophilic inflammation.

Nucellar callus of 'Femminello' lemon, selected for tolerance toPhoma tracheiphila toxin, shows enhanced release of chitinase and glucanase into the culture medium

Phoma tracheiphila is the causative agent of the disease mal secco. Citrus cultivars differ substantially in respect to their sensitivity to the pathogenP. tracheiphila and its toxin. Some cultivars (e.g., 'Femminello' lemon) are inherently sensitive while others (e.g., 'Tarocco' orange) are tolerant. Cell lines derived from nucellar tissue of 'Femminello', 'Tarocco' and a cell line selected for tolerance to the fungal toxin ('Femminello-S') were used to study host-pathogen interaction. Our results showed that calli or conditioned media of 'Tarocco' and 'Femminello-S' inhibited the size of co-cultivated fungal colonies when compared to 'Femminello'. In addition, conditioned medium of 'Tarocco' as well as 'FemminelloS', but not 'Femminello', promoted bursting of hyphal tips. A ten-fold increase in chitinase and glucanase enzymatic activity, as evaluated by radiometric assay and laminarin hydrolysis respectively, was detected in 'Femminello-S' extracellular extracts as compared to 'Femminello'. An increase in chitinase was also shown by immunoblot analysis. Our findings suggest a positive correlation between the presence of chitinase and glucanase in the conditioned media of the cultured cells and the tolerance of those cells toP. tracheiphila toxin.

Diagnosis of tertian malaria by enzyme-linked immunosorbent assay

A method of ELISA diagnosis of tertian malaria based on detecting Plasmodium vivax antigen in red blood cells (RBC) was developed, using 0.16 ml of packed, washed, and sonicated RBC. 68 blood samples from tertian malaria cases were examined; 67 (98.5%) were positive. 104 normal persons were all negative by this test. The lowest parasite number detected was 3 parasites/10(5) RBC on a thin film, or 1-2 parasites per thick film of usual size.