Inhaled corticosteroids reduce neutrophilic bronchial inflammation in patients with chronic obstructive pulmonary disease

BACKGROUND

Airways inflammation is a feature of chronic obstructive pulmonary disease (COPD), but the role of corticosteroids in the management of clinically stable patients has yet to be established. A randomised controlled study was carried out to investigate the effect of high dose inhaled beclomethasone dipropionate (BDP) administered for two months to patients with stable, smoking related COPD. Sputum induction was used to evaluate bronchial inflammation response.

METHODS

34 patients (20 men and 14 women) were examined on three separate occasions. At the initial clinical assessment (visit 0), spirometry and blood gas analysis were performed. On visit 1 (within one week of visit 0) sputum induction was performed and each patient was randomised to receive either BDP 500 micrograms three times daily (treated group) or nothing (control group). After two months (visit 2), all patients underwent repeat clinical assessment, spirometry, and sputum induction.

RESULTS

There were no differences in sputum cell counts between the groups at baseline. After two months of treatment, induced sputum samples from patients in the treated group showed a reduction in both neutrophils (-27%) and total cells (-42%) with respect to baseline, while the control group did not (neutrophils +9%, total cells +7%). Macrophages increased in the treated group but not in the control group. The mean final value of sputum neutrophils was 52% in the treated group and 73.3% in the control group (95% confidence interval (CI) -27.2 to -15.4). The mean final value of sputum macrophages was 35.8% in treated group and 19.3% in control group (95% CI 10.3 to 22.8). The differences between the treated and control groups for neutrophils (-21.3%), macrophages (+16.5%), and total cells (-65%) were significant. Spirometry and blood gas data did not change from baseline in either patient group.

CONCLUSIONS

A two month course of treatment with high dose inhaled BDP reduces significantly neutrophil cell counts in patients with clinically stable, smoking related COPD. Further studies on the effectiveness of inhaled steroids in COPD are needed to confirm the clinical importance of this observation.

Alpha-1-antitrypsin deficiency and nephropathy

Glomerulonephritis occurring in association with alpha(1)-antitrypsin deficiency has been sporadically reported in the literature but it is assumed to be a rare and poorly investigated disease. The complete pathologic pattern of glomerular lesions has not yet been established. The aim of our work was to investigate the correlation between the extent of antiprotease deficiency and the expression of nephropathy evaluated in two groups of patients (47 heterozygotic subjects with the PiMZ phenotype and 12 homozygotic subjects with the PiZZ phenotype) by a noninvasive approach with urinalyses and proteinuria measurement. No statistical differences between proteinuria in the two groups were observed suggesting that nephropathy is not a direct and single expression of the protein deficiency.

Cisplatin, mitomycin-C, 5-fluorouracil and leucovorin combination chemotherapy (l-FCM) in locally advanced unresectable or metastatic gastric carcinoma: a phase-II study

Despite relevant progress, the impact of chemotherapy on advanced gastric cancer patients' survival is still unsatisfactory. Thus, the key objective of our efforts should be palliation of the symptoms and the maintenance of an adequate quality of life. In this phase-II study, we evaluated toxicity and efficacy of the combination of cisplatin, fluorofolates and mitomycin C. Thirty-one advanced gastric cancer patients received cisplatin (15 mg/m2) and 5-fluorouracil (350 mg/m2), both for 5 consecutive days every 4 weeks; 5-fluorouracil infusion was preceded by a rapid i.v. injection of 100 mg/m2 leucovorin, while mitomycin-C (10 mg/m2) was administered on day 1 of odd cycles. Cycles were repeated every 4 weeks until disease progression. We recorded 16 objective responses (51.6%, 95% confidence interval: 42.63-60.57); furthermore, such a response rate was coupled with a moderate degree of toxicity and an extremely good tolerance. In particular, alopecia, a frequent and distressing side-effect in patients, especially women, in our series occurred only in two patients. This treatment appears to be an active and tolerable therapeutic option for patients with advanced gastric carcinoma.

Immunological markers anti-saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) in inflammatory bowel disease: a helpful diagnostic tool

AIM

Nowadays the diagnosis of inflammatory bowel disease (IBD) and the differentiation between Crohn disease (CD) and ulcerative colitis (UC) is still based on morphological changes identified at endoscopy, radiology, and histopathology. In 5-15% of cases this differentiation is not possible (diagnosed with indeterminate colitis).

METHODS

We evaluated if recently developed commercial kits for the determination of anti-Saccharomyces Cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) are useful in differentiating cases of UC from CD diseases with a consequent reduced number of undefined colitis and improved clinical management. Sera from 56 consecutive patients with a clinical diagnoses of IBD were evaluated in a blinded fashion for the presence of ASCA IgA and IgG and ANCA IgG with 2 different diagnostic methods: indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA).

RESULTS

In our cases we observed good agreement between histopathological examination and laboratory results and the combined use of ASCA and ANCA yielded a correct diagnosis in 93% of patients with CD and in 97% of the UC patients.

CONCLUSIONS

We confirm the value of the test for the diagnosis of CD and UC and the differentiation from other forms of colitis.

Antioxidant capacity and athletic condition of endurance horses undergoing nutraceutical supplementation

Endurance is an equestrian discipline that primarily relies on aerobic metabolism. Intense aerobic exercise produces reactive oxygen species due to an imbalance between oxidant and antioxidant substances, known as oxidative stress, which may reduce athletic performance. This study evaluated the effects of a feed supplement containing natural antioxidants and omega-3 fatty acids on the blood antioxidant activity and the athletic condition of endurance horses undergoing an exercise test. Twelve Arabian endurance horses were randomly assigned to treatment or control groups. At T0, blood lactate, whole blood and red blood cells (RBC) antioxidant capacity were assessed. The horses performed an exercise test with heart rate monitoring. After 30 min, blood lactate, antioxidant capacity and serum creatine kinase (CK) were measured. The treatment group received the dietary supplement for 21 days, while controls maintained their diet. Then, the protocol was repeated (T1). Variables were compared within and between groups through two-way ANOVA and post-hoc tests. Significant time*group effects were observed for serum CK (p = 0.026), RBC antioxidant capacity at rest (p = 0.034) and post-exercise (p = 0.019). At T1, in treatment group, CK was lower than controls (p = 0.006), while RBC antioxidant capacity increased at rest (p = 0.037) and after exercise (p = 0.006) compared to T0. The dietary supplement showed efficacy in enhancing RBC antioxidant capacity, and it could be beneficial for horses engaged in intense aerobic exercise.

Characterisation of Dry-Salted Violino and Bresaola from Grass-Fed Bergamasca Sheep

This study focuses on characterising two seasoned products, violino and bresaola, derived from grass-fed Bergamasca sheep monitored with a GPS system. The evaluation includes both nutritional and sensory aspects. Results reveal that both products boast a high protein content (approximately 40%) and a beneficial fatty acid profile, endorsing a healthy n-6/n-3 ratio (2.2), along with rumenic acid (92-184 mg/100 g) and branched-chain fatty acids (BCFAs) (237-621 mg/100 g). The sensory evaluation highlights distinctive ovine characteristics in aroma and flavour. Violino and bresaola from grass-fed Bergamasca sheep showcase positive attributes for human consumption. The study emphasises the potential for added value to seasoned products from Bergamasca sheep through a traceable, sustainable, and health-conscious supply chain.

[Antibodies anti granulocytic antigens in IBD: from microscopic morphology to antigenic specificity]

OBJECTIVE

ANCA (p-ANCA and x-ANCA) have been documented to occur in many inflammatory disorders. The specific ANCA antigens and the clinical correlation of a positive ANCA test in these disorders are still for the most part obscure. The aim of the present study was to investigate the prevalence of and the target antigens for ANCA in patients with IBD.

METHODS

104 patients (67 age between 3-18 years, mean age 8+/-3 and 37 age between 25-70 years, mean age 48+/-15) clinically and hystopathologically diagnosed as: 67 ulcerative colitis, 16 Crohn' disease, 21 other colitis (7 indeterminate colitis) were enrolled in our study. ANCA were determined by ELISA and IIF methods.

RESULTS

We observed a good performance in terms of sensibility and specificity of ANCA, and a good correlation between the two methods used; as regard ELISA determination the antigen frequently found in our cases was lactoferrin (60%).

CONCLUSIONS

Is still unclear the role of these "minor antigens" in the diagnosis and pathogenesis of IBD, but is clear that only morphologic evaluation is no more sufficient.

Study of release of eosinophil cationic proteins (ECP and EPX) in the hypereosinophilic syndrome (HES) and other hypereosinophilic conditions

BACKGROUND

Up to date, the etiology and the pathogenesis of HES are still unknown and particularly it is unclear why eosinophils in HES are more aggressive towards tissues than in other eosinophilic conditions.

METHODS

We assessed the cationic proteins ECP and EPX serum concentrations, their in vitro release from polymorphonuclear cell culture, and the monoclonal antibodies EG1 and EG2 in 3 patients with HES, 6 patients with other hypereosinophilic conditions and 20 healthy control subjects.

RESULTS

Serum ECP and EPX concentrations were higher in eosinophilic patients than in healthy subjects. Hypereosinophilic patients had more EG2+ cells than healthy subjects, but EG2+ rate failed to differentiate HES from other hypereosinophilic conditions (p = 0.074). Moreover, the release in vitro of ECP and EPX was significantly higher in HES patients (p < 0.05).

CONCLUSIONS

Our preliminary results seem to suggest the importance of functional data, such as ECP and EPX release, in differentiating HES from other hypereosinophilic diseases. Particularly, ECP and EPX release in vitro is higher in cell cultures from HES patients than from patients with other hypereosinophilic conditions.

The Effect of Vitamins on the Immune Systems of Pigs

In modern pig farming, there are many environmental, physiological or social stresses that weaken the immune response and increase susceptibility to disease. Nutritional management has a significant impact on the efficiency of the immune system in pigs. Among the various nutrients, vitamins have been shown to have specific effects on immune system activity. However, the needs of modern genetic types are not met by the dietary recommendations for vitamins in pig diets. The present study therefore summarises the data on dietary integration with supranutritional doses of vitamins in gestating and lactating sows and post-weaning piglets in terms of the immune response. The present data highlight that high doses of dietary vitamins are an effective way to improve the immune system, antioxidant status and gut health. Further studies are needed to deepen the understanding of the role of dietary supplementation with vitamins in pigs on immune system and gut functionality.

Verbascoside-Rich Plant Extracts in Animal Nutrition

In recent years, the search for dietary intervention with natural products able to sustain animal health and decrease environmental impact, has raised the number of studies pertaining to the use of plants' secondary metabolites. In fact, in livestock, there is a clear relationship between the animals' antioxidant status and the onset of some diseases that negatively affect animal welfare, health, and productive performance. An interesting compound that belongs to the secondary metabolites family of plants, named phenylpropanoids, is verbascoside. The genus Verbascum, which includes more than 233 plant species, is the genus in which this compound was first identified, but it has also been found in other plant extracts. Verbascoside exhibits several properties such as antioxidant, anti-inflammatory, chemopreventive, and neuroprotective properties, that have been evaluated mainly in in vitro studies for human health. The present work reviews the literature on the dietary integration of plant extracts containing verbascoside in livestock. The effects of dietary plant extracts containing verbascoside on the productive performance, antioxidant status, blood parameters, and meat quality in several animal species were evaluated. The present data point out that dietary plant extracts containing verbascoside appear to be a favorable dietary intervention to enhance health, antioxidant status, and product quality in livestock.