Local fungus-specific Immunoglobulin E production in chronic rhinosinusitis with nasal polyps

BACKGROUND

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease, and its pathogenesis remains controversial. This study aimed to examine the involvement of fungi in CRSwNP pathogenesis.

METHODS

We enrolled 29 controls and 111 CRSwNP patients. We analyzed fungi in the nasal secretions, serum fungus-specific immunoglobulin E (IgE) levels, and nasal polyp (NP) IgE levels. Moreover, we evaluated the correlation between patients' IgE levels and computed tomography (CT) scores.

RESULTS

There was no difference in fungal detection rate between CRSwNP patients with and without asthma. Specific IgEs against various antigens were highly detectable in NPs of CRSwNP patients. In CRSwNP patients, fungus-specific IgE levels in NPs were correlated with CT scores. Serum fungus-specific IgEs became undetectable after operation in more than half of the CRSwNP patients without asthma but not in those with asthma. Other serum airborne antigen-specific IgEs did not become undetectable after operation.

CONCLUSIONS

Fungus-specific IgEs were highly detectable in NPs of CRSwNP patients, and NPs comprised a major region of specific IgE production. Fungi may therefore play an important role in CRSwNP pathogenesis by inducing Th2 immune responses, including IgE synthesis.

Drain outlets in patient rooms as sources for invasive fusariosis: an analysis of patients with haematological disorders

BACKGROUND

Invasive fusariosis (IF) is a frequently fatal disease as there are few antifungals to treat it, making the prevention of IF crucial. However, fusarium infections have not been as thoroughly studied as other common pathogenic fungi such as Aspergillus or Candida.

AIM

To investigate the epidemiology of IF in patients with haematological diseases in Japan and to elucidate the infectious route of fusarium infection.

METHODS

We retrospectively analysed 29 IF cases in patients with haematological diseases from 2009 to 2019 in Japan. To discover the infectious source of IF, we performed an indoor environment survey targeted at indoor air and drain outlets in medical institutions and residences using culture-based and metagenomic methods. Finally, we performed aerosol- and droplet-mediated dispersion studies.

FINDINGS

The epidemiological study showed that the primary pathogen of IF was Fusarium solani species complex (FSSC), and the most common species was Fusarium petroliphilum. Most patients were likely to develop IF during hospitalization. A fusarium culture was positive in 26 of 72 drain samples. Few fusarium were detected from air samples; by contrast, 29 of 108 isolates from the drain outlets were identified as fusarium. Furthermore, similar results were obtained in the metagenomic analysis. Interestingly, species belonging to FSSC were isolated from indoor drain outlets, which was similar to those of the IF patients. In the droplet-mediated dispersion study, eight to 17 colonies of fusarium were isolated.

CONCLUSION

Our study indicates that causative Fusarium spp. could inhabit drain outlets in hospitals or residences, and droplet-mediated fusarium dispersion is a potential cause of IF.

Controlled trial of the effects of milk basic protein (MBP) supplementation on bone metabolism in healthy adult women

Milk has more beneficial effects on bone health compared to other food sources. Recent in vitro and in vivo studies showed that milk whey protein, especially its basic protein fraction, contains several components capable of both promoting bone formation and inhibiting bone resorption. However, the effects of milk basic protein (MBP) on bone metabolism of humans are not known. The object of this study was to examine the effects of MBP on bone metabolism of healthy adult women. Thirty-three normal healthy women were randomly assigned to treatment with either placebo or MBP (40 mg per day) for six months. The bone mineral density (BMD) of the left calcaneus of each subject was measured at the beginning of the study and after six months of treatment, by dual-energy x-ray absorptiometry. Serum and urine indices of bone metabolism were measured at the base line, three-month intervals, and the end of the study. Daily intake of nutrients was monitored by a three-day food record made at three and six months. The mean (+/- SD) rate of left calcaneus BMD gain of women in the MBP group (3.42 +/- 2.05%) was significantly higher than that of women in the placebo group (2.01 +/- 1.75%, P = 0.042). As compared with the placebo group, urinary cross-linked N-teleopeptides of type-I collagen/creatinine and deoxypyridinoline/creatinine were significantly decreased in the MBP group (p < 0.05), while no significant differences between the two groups were observed in serum osteocalcin and bone-specific alkaline phosphatase concentrations. A daily MBP supplementation of 40 mg in healthy adult women can significantly increase their BMD independent of dietary intake of minerals and vitamins. This increase in BMD might be primarily mediated through inhibition of osteoclast-mediated bone resorption by the MBP supplementation.

Clonality of primary pulmonary lymphoproliferative disorders; using in situ hybridization and polymerase chain reaction for immunoglobulin

Primary pulmonary lymphoproliferative disorders (PLDs) are histologically divided into a neoplastic state of high and low grade malignant lymphoma (ML), and a reactive state of follicular bronchitis/bronchiolitis (FB) and lymphoid interstitial pneumonia (LIP). We reviewed 19 cases with PLDs, including 4 cases each of high and low grade B cell ML, 6 FB cases, and 5 cases of LIP. To clarify the clonality of the proliferating cells, we performed an immunohistochemical examination (IHC), in situ hybridization (ISH) for the immunoglobulin light chain and a polymerase chain reaction (PCR) analysis of the immunoglobulin heavy chain gene using DNA obtained from paraffin sections. In addition, a Southern blot analysis was also performed in 6 cases using fresh materials. In IHC, all ML were positive for L26 (CD20), while the monoclonality of the kappa light chain was observed in only one high grade case. However, using ISH we could detect the clonality in three of four high grade ML cases and in one of four low grade ML cases. In FB and LIP, no clonality of immunoglobulin by ISH was observed. In a PCR analysis for the immunoglobulin heavy chain gene, we could detect one or two prominent bands in all 8 cases of high and low grade ML. On the other hand, in all cases of FB and LIP, we could only detect either an oligoclonal or polyclonal population. In summary, the presence of monoclonality of ISH and/or PCR for the immunoglobulin heavy chain gene were limited in the neoplastic state, but not in the reactive state.

Effects of whey protein on calcium and bone metabolism in ovariectomized rats

We studied the effects of whey protein (WP) from cow's milk on calcium and bone metabolism in ovariectomized (OVX) rats. Six-week-old female Sprague-Dawley rats were ovariectomized and fed a low-calcium diet (0.03% Ca, 0.3% P) for 4 weeks. The OVX rats were divided into three groups and subjected to two experiments: Exp. 1, Cont group (20% casein, 0.3% Ca), WP (1%) group (19% casein, 1% whey protein, 0.3% Ca) and Low-Ca group (20% casein, 0.03% Ca); and Exp. 2, Cont group (20% casein, 0.3% Ca), WP (1%) group (19% casein, 1% whey protein, 0.3% Ca) and WP (2%) group (18% casein, 2% whey protein, 0.3% Ca). The rats were fed each experimental diet for 4 weeks. The final body weight, weight gain, food intake and food efficiency showed no significant difference between the Cont and WP (1%, 2%) groups in Exps. 1 and 2. There were no significant differences in the calcium balance, serum ALP or serum calcitonin levels between the Cont and WP groups in Exp. 1. But the breaking energies of the WP (1%, 2%) groups were higher than those of the Cont groups in Exps. 1 and 2. As for the amount of calcium, phosphorus and magnesium in the femur, there were no significant differences between the Cont and WP (1%, 2%) groups; however, the amounts of total amino acids in the femur of the WP (1%, 2%) groups were higher than those of the Cont groups in Exps. 1 and 2. The amounts of proline and hydroxyproline in the femur of the WP (1%, 2%) groups were also higher than those of the Cont groups in Exps. 1 and 2. These data indicate that the milk whey protein influence in OVX rats is an increase in bone proteins such as collagen and enhanced bone-breaking energy.

Combined effects of dietary protein and fat on lipid metabolism in rats

The combined effects of dietary protein (casein, whey protein, or soy protein) and fat (safflower oil, perilla seed oil, or their mixed oil; linoleic acid/alpha-linolenic acid = 5.0) on several lipid parameters were studied in rats. Serum cholesterol and triglyceride levels were lower in perilla seed oil groups irrespective of the protein sources. Liver triglyceride level, and fecal excretion of steroids were influenced mainly by protein sources, particularly isolated soy protein lowered liver triglyceride level, and increased the fecal steroid excretion. The fatty acid composition of liver phosphatidylcholine was influenced by dietary fat sources. The proportion of arachidonic acid was significantly lower in rats fed perilla seed oil than in those fed safflower oil or mixed oil, while the proportion of eicosapentaenoic acid was higher in rats fed perilla seed oil than in those fed safflower oil. Arachidonic acid/linoleic acid ratio was significantly lower in perilla seed oil groups, and tended to be higher in casein groups. Eicosapentaenoic acid/arachidonic acid ratio was influenced by both dietary protein and fat, and protein-fat interaction was observed. Eicosapentaenoic acid/arachidonic acid ratio was higher in perilla seed oil groups, and isolated soy protein in perilla seed oil groups lowered the ratio in comparison with other protein sources in perilla seed oil groups.

A simple method to assess osteoclast-mediated bone resorption using unfractionated bone cells

To determine osteoclastic bone resorption we established a simple assay system in which unfractionated cells obtained from femora of 13-day-old mice were cultured on a dentine slice and the number of osteoclasts and their induced pit area on the slices were measured. When the bone cells (1 x 10(5) cells/dentine slice) were cultured in the presence of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] or human parathyroid hormone (hPTH) for 4 days, at which time newly-formed osteoclasts were not detected, the pit area was dose-dependently increased, being a 4.3- or 4.1-fold respective increase over the control at a 10(-8) M concentration of hormones. Chick calcitonin (cCT) inhibited the osteoclastic bone resorption induced by either of these hormones. cCT alone also suppressed the bone resorption by the cells (3 x 10(5) cells/dentine slice). These findings indicate that 1,25(OH)2D3 or hPTH may mainly activate pre-existing osteoclasts, resulting in increased bone resorption, and that cCT may suppress this osteoclastic activity. When 1,25(OH)2D3 or hPTH was added to the cells pre-cultured in factor-free medium for 6 days, at which time pre-existing osteoclasts had almost degenerated, new osteoclasts were formed, resulting in an increase in pit formation. Thus this system is a useful method which could more sensitively evaluate the effects of hormones or factors on osteoclast formation and activation than other previous systems.

Effects of addition of arginine, cystine, and glycine to the bovine milk-simulated amino acid mixture on the level of plasma and liver cholesterol in rats

The effects of the addition of varying levels of arginine (Arg), cystine (Cys), and glycine (Gly) to the bovine milk-simulated amino acid mixture on the levels of plasma and liver cholesterol were investigated in rats. The diets containing a high amount of Cys lowered significantly the level of plasma cholesterol as the amount of Cys in diets increased. The serum high density lipoprotein (HDL)-cholesterol level and fecal excretion of acidic steroids were higher in rats fed the Cys diets than in those fed the Arg and Gly diets. No differences, however, was observed in the content of liver cholesterol. Liver triglyceride contents elevated significantly on feeding the Arg and Cys diets. Furthermore, liver phospholipid contents elevated significantly on feeding the Arg diet but lowered on feeding the Cys diet. Therefore, these results indicated that the feeding of a high amount of Cys lowers the plasma cholesterol levels as the result of the enhanced conversion of cholesterol to bile acids.