Neutrophil extracellular trap production and CCL4L2 expression influence corticosteroid response in asthma

The association between neutrophil extracellular traps (NETs) and response to inhaled corticosteroids (ICS) in asthma is unclear. To better understand this relationship, we analyzed the blood transcriptomes from children with controlled and uncontrolled asthma in the Taiwanese Consortium of Childhood Asthma Study using weighted gene coexpression network analysis and pathway enrichment methods. We identified 298 uncontrolled asthma-specific differentially expressed genes and one gene module associated with neutrophil-mediated immunity, highlighting a potential role for neutrophils in uncontrolled asthma. We also found that NET abundance was associated with nonresponse to ICS in patients. In a neutrophilic airway inflammation murine model, steroid treatment could not suppress neutrophilic inflammation and airway hyperreactivity. However, NET disruption with deoxyribonuclease I (DNase I) efficiently inhibited airway hyperreactivity and inflammation. Using neutrophil-specific transcriptomic profiles, we found that CCL4L2 was associated with ICS nonresponse in asthma, which was validated in human and murine lung tissue. CCL4L2 expression was also negatively correlated with pulmonary function change after ICS treatment. In summary, steroids fail to suppress neutrophilic airway inflammation, highlighting the potential need to use alternative therapies such as leukotriene receptor antagonists or DNase I that target the neutrophil-associated phenotype. Furthermore, these results highlight CCL4L2 as a potential therapeutic target for individuals with asthma refractory to ICS.

PD-L1 Enhanced by cis-Urocanic Acid on Langerhans Cells Inhibits Vγ4+ γδT17 Cells in Psoriatic Skin Inflammation

Psoriasis is an IL-23/IL-17-mediated inflammatory autoimmune dermatosis and ultraviolet B (UVB) may contribute to immunosuppression and ameliorate associated symptoms. One of the pathophysiology underlying UVB therapy is through the production of cis-urocanic acid (cis-UCA) from keratinocytes. However, the detailed mechanism is yet to be fully understood. In the current study, we found filaggrin expression and serum cis-UCA levels were significantly lower in psoriasis patients than in healthy controls. We also noted that cis-UCA application inhibited psoriasiform inflammation through the reduction of Vγ4⁺ γδT17 cells in murine skin and draining lymph nodes. Meanwhile, CCR6 was down-regulated on γδT17 cells, which would suppress the inflammatory reaction at a distal skin site. We revealed that 5-HT_2A receptor (HTR2A), the known cis-UCA receptor, was highly expressed on Langerhans cells (LCs) in the skin. cis-UCA also inhibited IL-23 expression and induced PD-L1 on LCs, leading to the attenuated proliferation and migration of γδT cells. Compared to the isotype control, α-PD-L1 treatment in vivo could reverse the anti-psoriatic effects of cis-UCA. PD-L1 expression on LCs was sustained through cis-UCA-induced MAPK/ERK pathway. These findings uncover the cis-UCA-induced PD-L1-mediated immunosuppression on LCs, which facilitates the resolution of inflammatory dermatoses.

Separation of Gagua Rise from Great Benham Rise in the West Philippine Basin during the Middle Eocene

The West Philippine Basin (WPB) has started opening at ~ 58 Ma and ceased spreading at ~ 33 Ma, developing a fast spreading (~ 44 mm/yr half-spreading rate) magmatic episode between 58 and 41 Ma and the second amagmatic episode between 41 and 33 Ma. The occurrence of the first stage of spreading is closely related to the Oki-Daito mantle plume and related Benham Rise (BR) and Urdaneta Plateau (UP) activity. To the east of the Luzon–Okinawa Fracture Zone (LOFZ), BR was the most active volcanism from 48 to 41 Ma. The geomagnetic ages on both sides of the LOFZ have been determined; however, their causal relationship and evolution in the WPB remain unclear. In this study, we performed integrated analyses of multichannel seismic data and swath bathymetry data for the area to the west of the LOFZ. To the west of the LOFZ, the Gagua Rise (GR), is identified by a high residual free-air gravity anomaly, volcanic seamount chains and an overlapping spreading center. The GR is located at magnetic isochrons C20/C22 (50 to 44 Ma) and shows a thick oceanic crust of at least 12.7 km. We first propose an oceanic plateau named Great Benham Rise (GBR) which includes GR, UP and BR. We infer that the GR was a portion of the GBR since ~ 49 Ma and was separated from the GBR at ~ 41 Ma by the right-lateral LOFZ motion. Later, the relict GBR magmatism only continued in the area to the east of the LOFZ. Overall, the GBR dominates the spreading history of the WPB.

CEACAM3 decreases asthma exacerbations and modulates respiratory syncytial virus latent infection in children

BACKGROUND

Respiratory syncytial virus (RSV) is associated with childhood asthma. Nevertheless, not all children exposed to RSV develop asthma symptoms, possibly because genes modulate the effects of RSV on asthma exacerbations.

OBJECTIVE

The purpose of this study was to identify genes that modulate the effect of RSV latent infection on asthma exacerbations.

METHODS

We performed a meta-analysis to investigate differentially expressed genes (DEGs) of RSV infection from Gene Expression Omnibus datasets. Expression quantitative trait loci (eQTL) methods were applied to select single nucleotide polymorphisms (SNPs) that were associated with DEGs. Gene-based analysis was used to identify SNPs that were significantly associated with asthma exacerbations in the Taiwanese Consortium of Childhood Asthma Study (TCCAS), and validation was attempted in an independent cohort, the Childhood Asthma Management Program (CAMP). Gene-RSV interaction analyses were performed to investigate the association between the interaction of SNPs and RSV latent infection on asthma exacerbations.

RESULTS

A total of 352 significant DEGs were found by meta-analysis of RSV-related genes. We used 38 123 SNPs related to DEGs to investigate the genetic main effects on asthma exacerbations. We found that eight RSV-related genes (GADD45A, GYPB, MS4A3, NFE2, RNASE3, EPB41L3, CEACAM6 and CEACAM3) were significantly associated with asthma exacerbations in TCCAS and also validated in CAMP. In TCCAS, rs7251960 (CEACAM3) significantly modulated the effect of RSV latent infection on asthma exacerbations (false-discovery rate <0.05). The rs7251960 variant was associated with CEACAM3 mRNA expression in lung tissue (p for trend=1.2×10^-7). CEACAM3 mRNA was reduced in nasal mucosa from subjects with asthma exacerbations in two independent datasets.

CONCLUSIONS

rs7251960 is an eQTL for CEACAM3, and CEACAM3 mRNA expression is reduced in subjects experiencing asthma exacerbations. CEACAM3 may be a modulator of RSV latent infection on asthma exacerbations.

Consumption of betel quid contributes to sensorineural hearing impairment through arecoline-induced oxidative stress

Betel quid is one of the most widely used psychoactive substances, and is consumed by approximately 10% of the world’s population. In addition to its carcinogenicity, betel quid has also been reported to affect many organs, including the brain, heart, lungs, gastrointestinal tract, and reproductive organs. As betel quid contains several neurotoxic ingredients, we hypothesize that it also possesses ototoxicity and may lead to sensorineural hearing impairment (SNHI). In this study, we investigated the contribution of betel quid consumption to SNHI in a large clinical cohort, and validated the pathogenetic mechanisms in ex vivo tissue explants. We enrolled a total of 2364 volunteers, and determined their audiologic results based on Z-scores converted from their original frequency-specific hearing thresholds. Using generalized linear regression, we identified a positive correlation between betel quid consumption and the Z-scores across different frequencies. Subsequently, we explored the toxicity of arecoline, the main neuroactive component of betel quid, on tissue explants from murine cochleae. Arecoline reduced cell activity in the explant cultures and induced apoptosis in the hair cells, probably through the effects of oxidative stress. These findings have expanded the potential hazards of betel quid to common neurological disorders, and provide insights into preventive strategies against SNHI caused by neurotoxic substances.

A simple prediction tool for inhaled corticosteroid response in asthmatic children

Background

Inhaled corticosteroids are recommended as the first-line controller medication for childhood asthma owing to their multiple clinical benefits. However, heterogeneity in the response towards these drugs remains a significant clinical problem.

Methods

Children aged 5 to 18 years with mild to moderate persistent asthma were recruited into the Taiwanese Consortium of Childhood Asthma Study. Their responses to inhaled corticosteroids were assessed based on their improvements in the asthma control test and peak expiratory flow. The predictors of responsiveness were demographic and clinical features that were available in primary care settings. We have developed a prediction model using logistic regression and have simplified it to formulate a practical tool. We assessed its predictive performance using the area under the receiver operating characteristic curve.

Results

Of the 73 asthmatic children with baseline and follow-up outcome measurements for inhaled corticosteroids treatment, 24 (33%) were defined as non-responders. The tool we have developed consisted of three predictors yielding a total score between 0 and 5, which are comprised of the following parameters: the age at physician-diagnosis of asthma, sex, and exhaled nitric oxide. Sensitivity and specificity of the tool for prediction of inhaled corticosteroids non-responsiveness, for a score of 3, were 0.75 and 0.69, respectively. The areas under the receiver operating characteristic curve for the prediction tool was 0.763.

Conclusions

Our prediction tool represents a simple and low-cost method for predicting the response of inhaled corticosteroids treatment in asthmatic children.

Associations of serum perfluoroalkyl acid levels with T-helper cell-specific cytokines in children: By gender and asthma status

Perfluoroalkyl acids (PFAAs) are a group of common chemicals that ubiquitously exist in wildlife and humans. Experimental data suggest that they may alter T-lymphocyte functioning in situ by preferentially enhancing the development of T-helper 2 (TH2)- and inhibiting TH1-lymphocyte development and might increase allergic inflammation, but few human studies have been conducted. To evaluate the association between serum PFAAs concentrations and T-lymphocyte-related immunological markers of asthma in children, and further to assess whether gender modified this association, 231 asthmatic children and 225 non-asthmatic control children from Northern Taiwan were recruited into the Genetic and Biomarker study for Childhood Asthma. Serum concentrations of ten PFAAs and levels of TH1 [interferon (IFN)-γ, interleukin (IL)-2] and TH2 (IL-4 and IL-5) cytokines were measured. The results showed that asthmatics had significantly higher serum PFAAs concentrations compared with the healthy controls. When stratified by gender, a greater number of significant associations between PFAAs and asthma outcomes were found in males than in females. Among males, adjusted odds ratios for asthma among those with the highest versus lowest quartile of PFAAs exposure ranged from 2.59 (95% CI: 1.14, 5.87) for the perfluorobutanesulfonate (PFBS) to 4.38 (95% CI: 2.02, 9.50) for perfluorooctanesulfonate (PFOS); and serum PFAAs were associated positively with TH2 cytokines and inversely with TH1 cytokines among male asthmatics. Among females, no significant associations between PFAAs and TH2 cytokines could be detected. In conclusion, increased serum PFAAs levels may promote TH cell dysregulation and alter the availability of key TH1 and TH2 cytokines, ultimately contributing to the development of asthma that may differentially impact males to a greater degree than females. These results have potential relevance in asthma prevention.

Smoking-related microRNAs and mRNAs in human peripheral blood mononuclear cells

Teenager smoking is of great importance in public health. Functional roles of microRNAs have been documented in smoke-induced gene expression changes, but comprehensive mechanisms of microRNA-mRNA regulation and benefits remained poorly understood. We conducted the Teenager Smoking Reduction Trial (TSRT) to investigate the causal association between active smoking reduction and whole-genome microRNA and mRNA expression changes in human peripheral blood mononuclear cells (PBMC). A total of 12 teenagers with a substantial reduction in smoke quantity and a decrease in urine cotinine/creatinine ratio were enrolled in genomic analyses. In Gene Set Enrichment Analysis (GSEA) and Ingenuity Pathway Analysis (IPA), differentially expressed genes altered by smoke reduction were mainly associated with glucocorticoid receptor signaling pathway. The integrative analysis of microRNA and mRNA found eleven differentially expressed microRNAs negatively correlated with predicted target genes. CD83 molecule regulated by miR-4498 in human PBMC, was critical for the canonical pathway of communication between innate and adaptive immune cells. Our data demonstrated that microRNAs could regulate immune responses in human PBMC after habitual smokers quit smoking and support the potential translational value of microRNAs in regulating disease-relevant gene expression caused by tobacco smoke.

Interactions between traffic air pollution and glutathione S-transferase genes on childhood asthma

AIM: To evaluate the role of glutathione S-transferase P1 (GSTP1) genetic polymorphisms potentially modifying the association between NO₂ and asthma/wheeze in Taiwanese children.

METHODS: We investigated 3714 schoolchildren in Taiwan Children Health Study from 14 communities. Children’s information was measured from questionnaire by parents. The traffic air pollutant was available from Environmental Protection Administration monitoring stations.

RESULTS: A two-stage hierarchical model and a multiple logistic regression model were fitted to estimate the effects of NO₂ exposures and GSTs polymorphisms on the prevalence of asthma and wheeze. Among children with GSTP1 Ile/Val or Val/Val genotypes, those residing in high-NO₂ communities had significantly increased risks of asthma (OR = 1.76, 95%CI: 1.15-2.70), late-onset asthma (OR = 2.59, 95%CI: 1.24-5.41), active asthma (OR = 1.93, 95%CI: 1.05-3.57), asthma under medication (OR = 2.95, 95%CI: 1.37-6.32) and wheeze (OR = 1.54, 95%CI: 1.09-2.18) when compared with children in low-NO₂ communities. Significant interactions were noted between ambient NO₂ and GSTP1 on asthma, late-onset asthma, asthma under medication and wheeze (P for interaction < 0.05). However, we did not find any association with polymorphisms in GSTM1 and GSTT1.

CONCLUSION: Children under high traffic air pollution exposure are more susceptible to asthma, especially among those with GSTP1 Val allele.

Evaluation of salivary function by sialoscintigraphy in locally advanced nasopharyngeal cancer patients after intensity modulated radiotherapy

PURPOSE

This study aimed to evaluate the salivary gland function changes by sialoscintigraphy in locally advanced nasopharyngeal cancer (NPC) after intensity modulated radiotherapy (IMRT).

MATERIALS AND METHODS

Salivary function was assessed by sialoscintigraphy. Quantitative sialoscintigraphy was performed in 24 NPC patients prior to and after IMRT. Results were categorized in four groups according to the duration of treatment. The sialoscintigraphy parameters were examined.

RESULTS

Sialoscintigraphy showed a significant difference in the secretion of each interval groups. The parameters of scintigraphy, except maximum accumulation (MA) of submandibular glands, decreased first after radiotherapy, and then recovered. However, the MA of submandibular glands was continuously downhill after radiation.

CONCLUSIONS

The sialoscintigraphy parameters of each gland changed with the different radiation dose and follow-up intervals. The salivary function was influenced after radiotherapy in locally advanced NPC, especially, in the submandibular gland. Strategies to improve the salivary function should be assessed.

Contribution of adiponectin and its type 1 receptor to age-related hearing impairment

Age-related hearing impairment (ARHI) is a complex neurodegenerative disorder caused by a combination of environmental and genetic factors. We have reported previously that obesity increases the risk for ARHI, and that plasma levels of adiponectin are associated with ARHI. In the present study, we further explored the role of adiponectin in the pathophysiology of ARHI by investigating the genotypes of ADIPOQ and ADIPOR1, the genes of adiponectin and its type 1 receptor, respectively. A total of 1682 volunteers were enrolled, and their audiological phenotypes were determined according to the z scores converted from their original frequency-specific hearing thresholds. A total of 9 tag-single nucleotide polymorphisms (tagSNPs) in ADIPOQ and 4 tagSNPs in ADIPOR1 were genotyped, and the genotypes were correlated to the audiological phenotypes under the assumption of various inheritance models. Significant associations were identified between certain ADIPOQ tagSNPs and z scores under dominant, codominant, or additive models, whereas no association was identified between ADIPOR1 tagSNPs and z scores. The associations between ADIPOQ tagSNPs and z scores appear to exist only in subjects with specific ADIPOR1 genotypes, indicating an interaction between adiponectin and AdipoR1. Measurement of plasma adiponectin in 736 subjects revealed that ADIPOQ genotypes might exert their effects on hearing levels via modulation of plasma adiponectin levels. Subsequently, we confirmed the expression of AdipoR1 in the inner ear of mice, and demonstrated antiapoptotic effects of adiponectin in cochlear explant cultures. These results provide insights into the physiological function and potential clinical implications of adiponectin against ARHI.

Association of time-location patterns with urinary cotinine among asthmatic children under household environmental tobacco smoke exposure

INTRODUCTION

Environmental tobacco smoke (ETS) is a hazardous component of indoor air, and may increase the risk of respiratory diseases, atherosclerosis and otitis media in children. In this study, we explored the relationship between time inside the house, ETS exposure and urinary cotinine level, and also determined the association of time inside the house on asthma phenotypes when children exposed to ETS.

METHODS

A total of 222 asthmatic children and 205 non-asthmatic controls were recruited in the Genetic and Biomarker study for Childhood Asthma (GBCA). Structured questionnaires and time-location pattern questionnaires were administered by face-to-face interview. Urinary cotinine was measured by liquid chromatography tandem mass spectrometry (LC/MS/MS). The level of household ETS exposure was assessed using the cotinine/creatinine ratio (CCR).

RESULTS

In general, urinary cotinine and CCR were higher in subjects exposed to household ETS than those who never had ETS at home. A significant positive relationship was found between average time inside the house and urinary CCR in asthmatic children with current ETS at home (β=0.278, p=0.02). After adjustment for age and gender, average time inside the house was positively related to severe wheeze in asthmatic children with household ETS within 1 month (OR: 1.26, 95%: 1.02-1.64).

CONCLUSIONS

Our study suggests that the major source of ETS exposure for children is due to longer period of exposures among children living with adult smokers at home. Home-smoking restrictions that effectively prevent children from being exposed to ETS would be worthwhile.

Charge separation in donor-acceptor spiro compounds at metal and metal oxide surfaces investigated by surface photovoltage

Molecules with donor (diphenylamine) and acceptor moieties (dicyano or cyanoacrylic acid moieties) were linked by fluorene or spirobisfluorene cores and the chain length has been changed by introducing a thiophene group between fluorene and diphenylamine. Four different kinds of fluorene and spirobisfluorene compounds were adsorbed from highly diluted solutions at ultra-thin nanoporous TiO2 (np-TiO2), Au and ITO surfaces. Charge separation has been investigated by surface photovoltage spectroscopy in the fixed capacitor and Kelvin probe arrangements in vacuum. Striking differences between the interaction of linking (dicyano or cyanoacrylic moieties) and different substrates were observed. Intra-molecular charge separation and electron injection have been distinguished and the directed adsorption of spiro compounds was deduced.

Genetic variability in copper-transporting P-type adenosine triphosphatase (ATP7B) is associated with Alzheimer's disease in a Chinese population

Previous experiments demonstrated that transgenic mice carrying both amyloid precursor protein and mutant ATP7B transgenes reduce amyloid plaques and diminish plasma Abeta levels. These experiments showed that a structural change of ATP7B may affect Alzheimer’s disease (AD) susceptibility. In this study three missense SNPs in ATP7B gene (rs1801243, rs1801244, and rs1801249) were chosen to test whether they were associated with AD. We tested this hypothesis using a case control design. The experimental data showed that there was a significant deviation from Hardy-Weinberg equilibrium (HWE) for SNP rs1801249 (c.3419 T greater than C, Val1140Ala) in the case group (p = 0.014) but not in the control group and that there was an association between SNP rs1801249 and AD under a recessive model (p = 0.003). The data also showed that the genotype frequency distribution of the ATP7B c.1366 G greater than C polymorphism (rs1801244, Val456Leu) differed significantly between the AD patients and the normal subjects (p = 0.012). In addition, the frequency of the TGC haplotype of SNPs rs1801243, rs1801244, and rs1801249 was significantly higher in the AD patients compared with the normal subjects (p = 8.49×10-7). These observations suggested that genetic variations in the copper transporter gene ATP7B might contribute to AD pathogenesis in the Taiwanese population.

Serum polyfluoroalkyl concentrations, asthma outcomes, and immunological markers in a case-control study of Taiwanese children

BACKGROUND

Perfluorinated compounds (PFCs) are ubiquitous pollutants. Experimental data suggest that they may be associated with adverse health outcomes, including asthma. However, there is little supporting epidemiological evidence.

METHODS

A total of 231 asthmatic children and 225 nonasthmatic controls, all from northern Taiwan, were recruited in the Genetic and Biomarkers study for Childhood Asthma. Structure questionnaires were administered by face-to-face interview. Serum concentrations of 11 PFCs and levels of immunological markers were also measured. Associations of PFC quartiles with concentrations of immunological markers and asthma outcomes were estimated using multivariable regression models.

RESULTS

Nine PFCs were detectable in most children (≥ 84.4%), of which perfluorooctane sulfonate (PFOS) was the most abundant (median serum concentrations of 33.9 ng/mL in asthmatics and 28.9 ng/mL in controls). Adjusted odds ratios for asthma among those with the highest versus lowest quartile of PFC exposure ranged from 1.81 (95% CI: 1.02, 3.23) for the perfluorododecanoic acid (PFDoA) to 4.05 (95% CI: 2.21, 7.42) for perfluorooctanic acid (PFOA). PFOS, PFOA, and subsets of the other PFCs were positively associated with serum IgE concentrations, absolute eosinophil counts (AEC), eosinophilic cationic protein (ECP) concentrations, and asthma severity scores among asthmatics.

CONCLUSIONS

This study suggests an association between PFC exposure and juvenile asthma. Because of widespread exposure to these chemicals, these findings may be of potential public health concern.

Interleukin-13 genetic variants, household carpet use and childhood asthma

Interleukin (IL)-13 genetic polymorphisms have shown adverse effects on respiratory health. However, few studies have explored the interactive effects between IL-13 haplotypes and environmental exposures on childhood asthma. The aims of our study are to evaluate the effects of IL-13 genetic variants on asthma phenotypes, and explore the potential interaction between IL-13 and household environmental exposures among Taiwanese children. We investigated 3,577 children in the Taiwan Children Health Study from 14 Taiwanese communities. Data regarding children's exposure and disease status were obtained from parents using a structured questionnaire. Four SNPs were tagged accounting for 100% of the variations in IL-13. Multiple logistic regression models with false-discovery rate (FDR) adjustments were fitted to estimate the effects of IL-13 variants on asthma phenotypes. SNP rs1800925, SNP rs20541 and SNP rs848 were significantly associated with increased risks on childhood wheeze with FDR of 0.03, 0.04 and 0.04, respectively. Children carrying two copies of h1011 haplotype showed increased susceptibility to wheeze. Compared to those without carpet use and h1011 haplotype, children carrying h1011 haplotype and using carpet at home had significantly synergistic risks of wheeze (OR, 2.5; 95% CI, 1.4–4.4; p for interaction, 0.01) and late-onset asthma (OR, 4.7; 95% CI, 2.0–10.9; p for interaction, 0.02). In conclusions, IL-13 genetic variants showed significant adverse effects on asthma phenotypes among children. The results also suggested that asthma pathogenesis might be mediated by household carpet use.

Fine particle, ozone exposure, and asthma/wheezing: effect modification by glutathione S-transferase P1 polymorphisms

Background

There are limited studies on the role of interaction between exposure to ambient air pollution and glutathione-S-transferase (GST) P1 on the risk of asthma/wheezing among children, which provided suggestive, but inconclusive results.

Methods

To assess the joint effect of air pollutants and GSTP1 on asthma/wheezing, we conducted a nationwide cross-sectional study of 3,825 children in Taiwan Children Health Study. The studied determinants were three GSTP1 Ile105Val (rs 1695) genotypes (Ile-Ile; Ile-Val and Val-Val) and expoure to ambient air pollutants. We used routine air-pollution monitoring data for ozone (O₃) and particles with an aerodynamic diameter of 2.5 µm or less (PM_2.5). The effect estimates were presented as odds ratios (ORs) per interquartile changes for PM_2.5 and O₃.

Findings

In a two-stage hierarchical model adjusting for confounding, the risk of asthma was negatively associated with PM_2.5 (adjusted odds ratio (OR) 0.60; 95% confidence interval (CI) 0.45, 0.82) and O₃ (OR 0.74; 95% CI 0.60, 0.90) among Ile105 homozygotes, but positively associated with PM_2.5 (OR 1.52; 95% CI 1.01, 2.27) and O₃ (OR 1.19; 95% CI 0.91, 1.57) among those with at least one val105 allele (interaction p value = 0.001 and 0.03, respectively). A similar tendency of effect modification between PM_2.5 and O₃ and GSTP1 on wheezing was found.

Conclusion

Children who carried Ile105 variant allele and exposed to PM_2.5 and O₃ may be less likely to occurrence of asthma/wheezing.

Home dampness, beta-2 adrenergic receptor genetic polymorphisms, and asthma phenotypes in children

BACKGROUND

Dampness in the home is a strong risk factor for respiratory symptoms and constitutes a significant public health issue in subtropical areas. However, little is known about the effects of dampness and genetic polymorphisms on asthma.

METHODS

In 2007, 6078 schoolchildren were evaluated using a standard questionnaire with regard to information about respiratory symptoms and environmental exposure. Multiple logistic regression analyses were performed to assess the effects of home dampness and beta-2-adrenergic receptor (ADRB2) gene polymorphisms on the prevalence of asthma and selected indicators of severity of asthma.

RESULTS

The frequency of mildewy odor, the number of walls with water stamp, and the duration of water damage were all associated with being awakened at night due to wheezing. However, no other clear-cut associations were found for any of the other indicators of asthma. Children exposed to mildewy odor with ADRB2 Arg/Arg genotype were associated with being awakened at night due to wheezing (OR=1.95, 95% CI, 1.14-3.36), compared to those without exposure and with the ADRB2 Gly allele. ADRB2 Arg16Gly showed a significant interactive effect with home dampness on being awakened at night due to wheezing and current wheezing, but no significant effect on active asthma and medication use. Frequency and degree of home dampness were also associated with the prevalence of asthma and selected indicators of severity of asthma, in an exposure-response manner among children with ADRB2 Arg/Arg genotype.

CONCLUSIONS

Home dampness prevention is one of the important steps of asthma control, especially in children carrying ADRB2 Arg/Arg genotypes.

Association analysis of dopaminergic gene variants (Comt, Drd4 And Dat1) with Alzheimer s disease

Defects in dopaminergic transmission play important roles in the disturbance of synaptic plasticity and even in advanced cognitive behavior. However, the relationship between genes involved in the regulation of dopamine levels and predisposition for Alzheimer s disease (AD) remains unclear. The potential association of dopamine-modulating gene polymorphisms with AD was evaluated. We performed a case-control study with 120 patients and 86 healthy controls. Two catechol-O-methyltransferase (COMT) single-nucleotide polymorphisms (SNPs) (rs2020917 and rs4646312), two dopamine D4 receptor (DRD4) SNPs (rs3758653 and rs916455), and four dopamine transporter (DAT1) SNPs (rs2937639, rs6347, rs12516948 and rs11133762) were investigated. The T allele at the DRD4 SNP (rs3758653) was found to be significantly associated with AD. Our results also showed that haplotype frequencies, observed from the analyzed SNPs, were distributed significantly differently in AD patients vs control subjects. Moreover, a strong association was observed between the A allele at rs6347 of DAT1 and moderate stage of dementia. These observations suggest that genetic variations in the dopamine-modulating genes, COMT, DRD4 and DAT1, may contribute to AD pathogenesis in the Taiwanese population.

Remodeling of rabbit abdominal aorta and Cx43 gap junctions after stent placement: effect of balloon injury plus cholesterol-enriched diet

AIM

To examine the effect of stenting and cholesterol-enriched diet (CED) on vascular remodeling, including the expression of connexin43 (Cx43) gap junctions in smooth muscle cells (SMC).

METHODS

Rabbits abdominal aortae were either implanted stent made of 316 stainless steel (group 1) or denuded followed by stent placement 28 days later (groups 2 and 3). Animals were given normal chow except those of group 3, which were fed CED after the denudation. Eight weeks later, the development of neointima and the expression of connexin43 (Cx43) were examined. In parallel, human aortic SMC were grown on 316 stainless steel or treated with C-reactive protein (CRP) followed by analysis of Cx43.

RESULTS

The results showed that, serum CRP levels became transiently elevated after denudation and stent implantation. For the stented aortic segments, the dimensions of neointima were group 3 > group 2 > group 1 (P<0.05). In groups 1 and 2, Cx43 gap junctions are less in amount in neointima of the stented segment, compared to the unstented upstream neointima or medial layer (all P<0.01). In culture experiments, Cx43 in SMC grown on stent material was up-regulated in growth medium but down-regulated in differentiation medium, and CRP did not affect Cx43 expression.

CONCLUSION

Vascular remodeling post stent implantation varied according to the presence of balloon injury, CED, or both. Cx43 expression in SMC is altered after exposure to stent and the regulation depended on the milieu.

Early-life indoor environmental exposures increase the risk of childhood asthma

We aim to explore the relationships between exposure to dampness, pets, and environmental tobacco smoke (ETS) early in life and asthma in Taiwanese children, and to discuss their links to early- and late-onset asthma. We conducted a 1:2 matched case-control study from the Taiwan Children Health Study, which was a nationwide study that recruited 12-to-14 year-old school children in 14 communities. The 579 mothers of the participants were interviewed by telephone about their children's environmental exposures before they were 5 years old, including the in-utero period. Childhood asthma was associated with exposure to early life environmental factors, such as cockroaches (OR=2.16; 95% CI, 1.15-4.07), visible mould (OR=1.75; 95% CI, 1.15-2.67), mildewy odors (OR=5.04; 95% CI, 2.42-10.50), carpet (OR=2.36; 95% CI, 1.38-4.05), pets (OR=2.11; 95% CI, 1.20-3.72), and more than one hour of ETS per day (OR=1.93; 95% CI, 1.16-3.23). The ORs for mildewy odors, feather pillows, and ETS during early childhood were greater among children with late-onset asthma. Cockroaches, carpet, pets, and in-utero exposures to ETS affected the timing of early-onset asthma. Exposure to these factors led to dose-responsiveness in the risk of asthma. And the earlier exposures may trigger the earlier onset. Interventions in avoiding these environmental exposures are necessary for early-prevention of childhood asthma.

Matrix metalloproteinase-12 leads to elastin degradation in BALB/c mice with eosinophilic meningitis caused by Angiostrongylus cantonensis

The rat lugworm Angiostrongylus cantonensis can cause eosinophilic meningitis. The purpose of this study was to determine whether matrix metalloproteinase (MMP)-12 and its substrate elastin participate in this inflammatory response. We showed that the MMP-12/tissue inhibitor of metalloproteinase-1 ratio was significantly increased in the CSF of A. cantonensis-infected mice from day 10 p.i., and reached high levels on days 20 and 25 p.i. MMP-12 production was correlated with elastin degradation, eosinophil count, blood-CSF barrier permeability and pathological changes in the subarachnoid space. Also, MMP-12 might contribute to elastin degradation in the meningeal vessel of the subarachnoid space. Simultaneous administration of albendazole and doxycycline significantly reduced the levels of MMP-12, elastin and Evans blue in mice with meningitis. These results imply that MMP-12 contributes to the elastin degradation that occurs in angiostrongyliasis meningitis, and doxycycline can reverse related inflammatory events by inhibition of MMP-12.

Genetic polymorphisms of the DNA repair gene MPG may be associated with susceptibility to rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease and can lead to deformities and severe disabilities, due to irreversible damage of tendons, joints, and bones. A previous study indicated that a DNA repair system was involved in the development of RA. In this study, we investigated the association of four N-methylpurine-DNA glycosylase (MPG) gene polymorphisms (rs3176364, rs710079, rs2858056, and rs2541632) with susceptibility to RA in 384 Taiwanese individuals (192 RA patients and 192 control subjects). Our data show a statistically significant difference in genotype frequency distributions at rs710079 and rs2858056 SNPs between RA patients and control groups (P = 0.040 and 0.029, respectively). Our data also indicated that individuals with the GG genotype at rs2858056 SNP may have a higher risk of developing RA. In addition, compared with the haplotype frequencies between case and control groups, individuals with the GCGC haplotype appeared to be at a greater risk of RA progression (P = 0.003, OR = 1.75; 95&percnt; CI = 1.20-1.55). Our results suggest that rs710079 and rs2858056 polymorphisms and the GCGC haplotype in the MPG gene are associated with the risk of RA progression, and thus may be used as molecular markers of RA if they are confirmed by further research.

Tumour necrosis factor G-308A polymorphism modifies the effect of home dampness on childhood asthma

OBJECTIVES

Environmental exposure at home, such as dampness, has been shown to have adverse effects on respiratory health. However, few studies explored the association between home dampness and genetic polymorphisms on childhood asthma. The aim of the study is to evaluate the effects of home dampness and tumour necrosis factor-α gene (TNF-α) on asthma in Taiwanese children.

METHODS

The authors investigated 3810 schoolchildren in Taiwan Children Health Study from 14 communities. Children's exposure and disease status were measured from a parental questionnaire. Multiple logistic regression models were fitted to estimate the effects of home dampness exposure and TNF-α genotypes on the prevalence of asthma and wheeze.

RESULTS

Mildewy odour at home was significantly associated with increased prevalence of lifetime wheeze (OR=1.36, 95% CI 1.05 to 1.77, p for trend=0.04). The effects of water stamp on the wall at home were associated with lifetime asthma and lifetime wheeze. Children with water stamp on the wall at home and TNF-308 A allele had increased risks on lifetime asthma, active asthma and lifetime wheeze. TNF-α showed significant interactive effects with mildewy odour on lifetime asthma (p for interaction=0.01), and with water stamp on the wall at home on lifetime wheeze (p for interaction=0.04). Under stratification by TNF-308 genotypes, we found that the frequency of water stamp on the wall was associated with increased risks of all asthma subcategories and lifetime wheeze among TNF-308 GA or AA genotypes (p for trend<0.05).

CONCLUSIONS

Home dampness is a risk factor for asthma and wheeze among children, especially for those with the TNF-308 A allele.

Microsomal epoxide hydroxylase genotypes/diplotypes, traffic air pollution, and childhood asthma

BACKGROUND

Epidemiologic studies indicate that exposure to air pollution caused by traffic may have an association with an increased risk of childhood asthma. Some studies report an association between the polymorphisms of the microsomal epoxide hydroxylase (EPHX1) gene and enzyme activity. We investigated the associations of EPHX1 Tyr113His and His139Arg polymorphisms with asthma and wheezing outcomes, and focused on the functional genetic change in different ambient nitrogen dioxide (NO₂) levels on glutathione S-transferase p1 (GSTP1) and glutathione S-transferase m1 (GSTM1) genotypes.

METHODS

A total of 3,741 children were enrolled in the Taiwan Children Health Study from 14 communities. We examined the associations of EPHX1 Tyr113His and His139Arg genotypes and diplotypes with asthma and wheezing outcomes under different ambient NO₂ exposures.

RESULTS

Children with the EPHX1 Arg/His or Arg/Arg genotypes at codon 139 were significantly associated with increased risks of lifetime asthma (adjusted OR [aOR] = 1.3; 95% CI, 1.1-1.7; and aOR = 1.5; 95% CI, 1.1-2.1, respectively). The EPHX1 diplotypes showed significant associations with lifetime asthma (global P value = .01) and early-onset asthma (global P value = .01). The risk of EPHX1 139Arg allele and 113Tyr-139Arg diplotype were of greater magnitude in higher compared with lower NO₂ communities. The increase of the effect from the EPHX1 139Arg allele with higher NO₂ exposure was most marked in the GSTP1 Val allele and GSTM1 present genotype.

CONCLUSIONS

Children with high EPHX1 activity may have increase risk of asthma and wheezing outcomes, and can be mediated through airway oxidative stress generation.

Faceted ice growth in hydrophilic and hydrophobic channels

This study is motivated by the cryo-preservation for tissues, which is related to the solidification of blood in a confined space. The morphological behavior of growing ice facet in 1.3 mm hydrophilic and hydrophobic channels is the focus of this study. Both DI water and KCl solution were solidified without seeds in the channels and the growing front facet was discussed in regards to contact angle, in-situ morphology, conductivity difference between two phases and solute segregation. For DI water, the formation of facets was observed during ice growth in both hydrophilic and hydrophobic channels and could be classified into two modes according to the local curvature of the interface. The facet was formed at different positions of the interface in hydrophilic and hydrophobic channels. Solutal segregation effect was taken into consideration to partially govern the interface morphology and the facet formation during solidification of the KCl solution. In addition, the growth rates of the ice growth with a facet were also compared and discussed.

The involvement of insulin receptor genotypes in pre- and co-obese acanthosis Nigricans children and adolescent

Acanthosis nigricans (AN) is most commonly related to obesity as a manifestation of cutaneous insulin resistance in children and adolescents, while the interaction and time course between AN and obesity and detailed mechanism for the pre- and co-obese appearance of AN (PCOAN) in child are unclear. In this study, the involvement of insulin receptor in child PCOAN was investigated via studying the association of polymorphisms of INSR gene with PCOAN. In total, 99 children with PCOAN and 100 healthy controls recruited were genotyped and analyzed by PCR-RFLP method. Significantly different distributions were found in the frequency of the INSR His1085His genotypes, but not in other INSR genotypes, between the two groups. Our results provide not only the evidence that the T allele of INSR His1085His is correlated with the appearance of PCOAN but revealed that the insulin receptor pathway may play an important role in this PCOAN.

A nationwide seven-year trend of hip fractures in the elderly population of Taiwan

To investigate the recent longitudinal trend of hip fractures (including cervical and trochanteric fractures) in Taiwan's elderly population (> or =65 years), a nationwide descriptive epidemiological study was conducted using the database of the Bureau of National Health Insurance from 1996 through 2002. Frequencies and incidences of hip fracture by gender, fracture site, and age group were estimated, and the 7-year incidence trend was further evaluated. The results showed that a total of 75,482 hip fractures occurred during the study period with an incidence rate of 57.54 per 10,000 per year. Overall incidence significantly increased by 30% (p<0.0001), from 49.56 to 64.37 per 10,000 per year during the 7-year study period. The increase in rates was greater in males (36%) than in females (22%). The average female-to-male ratio was 1.76, lower than those in many countries. In females, the annual incidence of cervical fracture was higher than that of trochanteric fractures throughout the 7 years, while the incidence of trochanteric fractures was higher than cervical fractures each year in males (p<0.0001). The average annual incidence of patients older than 85 years was 9.9 times higher than that of aged 65 to 69 years in females and 7.9 times in males. Development and implementation of public health strategies for hip fractures should more focus on these subgroups in Taiwan's rapidly aging society.

Analysis of ERCC2/XPD functional polymorphisms in systemic lupus erythematosus

Sunlight/ultraviolet (UV) irradiation has been recognized as an important risk factor for developing systemic lupus erythematosus (SLE). However, the interpretation of genetic variations involved in UV-light sensitivity is largely unknown. Recent studies indicated that two genetic variations of ERCC2/XPD gene (rs1799793 in exon 10 and rs13181 in exon 23) have been found to exert negative influences on nucleotide excision repair system. To analyse the possible contribution of the ERCC2/XPD functional single nucleotide polymorphisms in genetic susceptibility to SLE, the rs13181 and rs1799793 SNPs in ERCC2/XPD were genotyped by polymerase chain reaction followed by restriction fragment length polymorphism analysis. Association was studied by case-control analyses using samples from 172 SLE patients and 160 healthy controls. Haplotype analysis was performed to detect the association with genetic predisposition to SLE and the clinical features. Although these two functional genetic variations are linked to several immune dysfunction-induced diseases, no statistically significant differences in allele or genotype frequencies were observed between SLE patients and controls. Haplotype analysis showed that none of ERCC2/XPD haplotypes was associated with the incidence of SLE disease, nor the preference of clinical features. In conclusion, the ERCC2/XPD functional polymorphisms analysed in this study showed no association in genetic susceptibility to SLE.

Morphology and mechanical behavior of TTCP-derived calcium phosphate cement subcutaneously implanted in rats

A pre-hardened, TTCP-derived CPC was immersed in Hanks' solution as well as subcutaneously implanted into abdomen of rats. The implant-soft tissue interfacial morphology was examined and properties of the CPC were evaluated and compared under in vitro and in vivo conditions. The results indicate that the surface of immersed samples appeared rougher and more porous than that of implanted samples and was covered with a layer of fine apatite crystals. The CPC samples implanted for 4 weeks or longer were surrounded by a layer of fibrous tissue, which was further surrounded by a soft tissue capsule comprising numerous fat cells. The soft tissue capsule had a non-uniform distribution in thickness, which increased most significantly between 4 weeks and 12 weeks after implantation. None of polymorphic cells, osteoblast cells or bone cells adjacent to the implant were observed. The majority of original TTCP powder was transformed into apatite after 1 day of either immersion in Hanks' solution or implantation. The average porosity values of samples immersed in Hanks' solution for 4 weeks or longer were significantly larger than those immersed for 1 day or 1 week. The porosity values of samples implanted for different times were not significantly different. The DTS values of Hanks' solution-immersed samples largely decreased after a few weeks of immersion. The implanted samples maintained their strengths throughout the study.

Intrapericardial isolation of the inferior vena cava through a transdiaphragmatic pericardial window for tumor resection without sternotomy or thoracotomy

AIMS

The prognosis for patients with advanced tumors invading the inferior vena cava (IVC) is dismal and surgical treatments for these tumors are challenging. A surgical approach that avoids sternotomy and thoracotomy for tumors invading the IVC even to the level of the hepatocaval junction would be extremely helpful.

METHODS

The intrapericardial IVC was isolated via a transdiaphragmatic pericardial window using a transabdominal approach. Hepatectomy was then applied via an anterior approach until the IVC was seen. Total hepatic vascular exclusion was achieved by clamping the portal triad, intrapericardial IVC and infrahepatic IVC. We removed the primary tumor, the liver portion involved and the tumor thrombi, with segmental resection of the IVC. Vascular continuity was reestablished using a 20-mm-diameter polytetrafluoroethylene graft.

RESULTS

Four patients with tumors invading the IVC were treated with this method. All underwent gross en-bloc tumor resections and all survived.

CONCLUSION

This method for the resection of IVC tumors could avoid emboli dislodging from the tumor thrombi, prevent the complications of sternotomy, cardiopulmonary bypass and shorten operative times.

Amino acid concentrations in cerebrospinal fluid in children with acute lymphoblastic leukemia undergoing chemotherapy

Cerebrospinal fluid (CSF) amino acid concentrations were measured in 45 children with acute lymphoblastic leukemia (ALL). Central nervous system (CNS) disease was absent in 34 and present in 11 (Groups L and M, respectively) at diagnosis. Thirty-two otherwise healthy children with febrile convulsions were studied for comparison. Results from this study show that glutamine levels at Day 0 were significantly higher in patients than in controls. Patients in Group M had elevated glutamine levels compared to Group L. In comparison, at Day 14, concentrations of glutamine and asparagine decreased, while glutamic acid amounts increased significantly in Group L. Glutamine levels fell at Day 42 in Group M, which may have resulted from more intensive treatment. From this study we hypothesise that higher baseline glutamine levels are indicative of a greater risk for CNS leukemia. Large-scale prospective trials are required to confirm increased baseline CSF glutamine levels in ALL patients, to identify glutamine as a marker for CNS disease and to clarify underlying mechanisms regulating glutamine in ALL.

Increase in laminin expression in allergic airway remodelling and decrease by dexamethasone

Lung expression of the extracellular matrix protein, laminin, and its receptor, laminin-1 receptor, were examined in a mouse model of asthma with airway remodelling. Ovalbumin (OVA) was administered to BALB/c mice, intraperitoneally on days 0 and 14, and intranasally periodically between days 14 and 75. The mice developed airway eosinophil and mononuclear inflammatory cell infiltration and fibrosis. On day 76, a marked increase in total laminin was seen in the airways of OVA-treated mice compared to controls by Western blot analysis. The increased laminin expression was detected immunocytochemically in the thickened subepithelial basement membrane and around airways and blood vessels. The OVA-treated mice showed increased expression of the alpha1, beta1, and gamma1 chains of the laminin-1 isoform in monocytes, macrophages and eosinophils infiltrating the airways. Laminin-1 receptor expression was increased in inflammatory and endothelial cells in the lungs of OVA-treated mice compared to controls. Treatment of OVA-sensitised/challenged mice with dexamethasone reduced airway expression of laminin and laminin-1 receptor in OVA-treated mice but not airway hyperresponsiveness to methacholine. Laminin deposition may be an important component of the airway remodelling observed in chronic allergic lung inflammation and is a process modulated by corticosteroids.

Usefulness of 99mTc ethyl cysteinate dimer brain SPECT to detect abnormal regional cerebral blood flow in patients with acute carbon monoxide poisoning

99mTc ethyl cysteinate dimer (99mTc-ECD) brain single photon emission computed tomography (SPECT) was used to detect abnormal regional cerebral blood flow (rCBF) in patients with acute carbon monoxide (CO) poisoning. Ten patients with acute CO poisoning and no past histories of psychoneurological disorders were enrolled in this study. After oxygen treatment, all of the 10 patients were investigated using 99mTc-ECD brain SPECT and brain computed tomography (CT) scan. Brain CT scan findings were normal in all of the 10 patients. 99mTc-ECD brain SPECT showed the hypoperfusion lesions of the basal ganglia and brain cortex in five and seven patients, respectively. Only three of the 10 patients had normal 99mTc-ECD brain SPECT findings. This study suggests that, in comparison with brain CT scan, 99mTc-ECD brain SPECT is a better tool for the early detection of hypoperfusion brain lesions in acute CO poisoning in patients with normal brain CT findings.

Interleukin-1 receptor antagonist gene polymorphism in Taiwanese patients with gout

OBJECTIVE

The purpose of this study was to examine whether interleukin-1 receptor antagonist (IL-1Ra) gene polymorphism is a marker of susceptibility to or of the clinical characteristics of gout in Taiwanese patients.

METHODS

196 Taiwanese patients with gout and 103 unrelated normal healthy control subjects living in central Taiwan were studied. Polymorphism of the gene for IL-1Ra was typed from genomic DNA. Allelic frequencies and carriage rates were compared between gout patients and control subjects. The relationship between IL-1Ra genotypes and the clinical characteristics of gout was also evaluated.

RESULTS

No significant differences were observed in genetic and allelic frequencies of the IL-1Ra gene polymorphism between patients with gout and healthy control subjects. Furthermore, we did not detect any association of IL-1Ra genotype with the clinical and laboratory profiles in patients with gout.

CONCLUSION

The results from the present study suggest that the interleukin-1 receptor antagonist gene polymorphism is not a genetic marker of susceptibility to gout for Taiwanese. Furthermore, our study also suggests that the IL-1Ra gene polymorphism is unrelated to the clinical characteristics of gout.

Two novel mutations of the glycine receptor gene in a Taiwanese hyperekplexia family

The authors report a Taiwanese family with autosomal recessive hyperekplexia. Two novel mutations, W96C (from the paternal allele) and R344X (from the maternal allele), which are located in exon 4 and exon 7 of the GLRA1 gene, were identified in this family. A series of electrophysiologic investigations were conducted in one of the probands, and the results suggest that the "startle center" is located subcortically.

Comparison of quantitative 99mTc-HMPAO and 67Ga citrate lung scans in patients with active diffuse infiltrative lung disease

Diffuse infiltrative lung disease (ILD) is a heterogeneous group of disorders that predominantly affect the lung parenchyma and spare the airway. To objectively assess the degree of pulmonary vascular endothelium damage in active ILD, lung/liver uptake ratios (L/L ratios) on 99mTc hexamethylpropylene amine oxime (99mTc-HMPAO) lung scans were determined in 21 patients with active ILD. Meanwhile, the 67Ga citrate uptake index (GUI) on 67Ga lung scans was measured in order to evaluate the severity of lung inflammation in active ILD. The results show there were statistically significant differences between normal controls and patients with active ILD, as shown in the L/L ratio and GUI. However, when the patients were divided into two groups: (1) eight patients with normal chest X-ray findings, and (2) 13 patients with abnormal X-ray findings, there was no significant difference between groups 1 and 2 for the results of L/L ratio and GUI. In addition, no correlation between the degree of damage to the pulmonary vascular endothelium and the severity of lung inflammation was found. In conclusion, L/L ratios on 99mTc-HMPAO lung scans and GUI on 67Ga lung scans are different to the findings of chest X-rays and have the potential to objectively detect the degree of damage to the pulmonary vascular endothelium and the severity of lung inflammation in active IDL. However, the relationship between L/L ratio and GUI in active ILD is not significant.

Association between urokinase gene 3'-UTR T/C polymorphism and Chinese patients with rheumatoid arthritis in Taiwan

OBJECTIVES

The purpose of this study was to investigate whether the urokinase gene 3'-UTR C/T polymorphism is a marker of susceptibility to or severity of rheumatoid arthritis (RA) in Chinese patients.

METHODS

A total of 145 RA patients and 134 healthy control subjects were enrolled in this study. We identified the C/T polymorphism of the urokinase gene, which is mapped on the 3'-untranslated region (3'-UTR) on chromosome 10 by polymerase chain reaction (PCR).

RESULTS

There were significant differences in the distribution of the urokinase gene 3'-UTR C/T polymorphism frequency between RA patients and subjects in the control group. However, we did not detect an, association between the urokinase gene 3'-UTR C/T polymorphism and rheumatoid factor (RF), extraarticular involvement or bone erosion in RA patients.

CONCLUSION

The urokinase gene 3'-UTR "T" allele was associated with RA in Chinese patients in Taiwan.

Simultaneously evaluating the effects of one-week fluticasone propionate inhalation therapy on lung ventilation and permeability in children with asthma

This study evaluated the effects of fluticasone propionate inhalation therapy on lung ventilation and alveolar permeability by quantitative Tc-99m DTPA radioaerosol inhalation lung scintigraphy in 15 children with asthma. Lung ventilation was evaluated as the distribution percentage (D%) of Tc-99m DTPA radioaerosols in the central, intermediate and peripheral regions of the right lung. Alveolar permeability was measured by the rate of Tc-99m DTPA radioaerosol clearance curve from the peripheral alveoli of the right lung and represented as slope. The D% and slopes were calculated before and after one-week inhalation therapy (100 microg fluticasone propionate two times daily for one-week) to evaluate the effects of inhalation therapy on lung ventilation and alveolar permeability. The preliminary results revealed statistically significantly improved lung ventilation but no significant change of alveolar permeability in the right lung after one-week fluticasone propionate inhalation therapy in children with asthma. We suggest that the widely available and noninvasive Tc-99m DTPA radioaerosol inhalation lung scintigraphy can simultaneously evaluate lung ventilation and alveolar permeability in one study and should contribute to any disorder involving both alveoli and airways.

Combined therapy with deferiprone and desferrioxamine successfully regresses severe heart failure in patients with beta-thalassemia major

Cardiac complications caused by iron deposition are major causes of death in patients with beta-thalassemia major. Deferiprone (L1) was found to have greater efficacy at depleting myocardial iron than desferrioxamine (DFX). Furthermore, combined therapy with L1 and DFX produced an additive or synergistic iron chelating effect. We report the successful treatment of severe heart failure in two patients with beta-thalassemia major with the combined therapy. Magnetic resonance images showed a marked recovery of signal intensity in the heart, indicating a significant reduction of iron load in the heart. No significant adverse effects were noted. Therefore, combined therapy with L1 and DFX should be considered in patients with beta-thalassemia major and cardiac complications.