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Infections of the respiratory tract are very common in young children. They may affect the quality of life and have a great economic impact. On the other hand, respiratory tract infections through MALT system play a positive role in the maturation and development of the immune system. The aim of the study was to examine quantitative and qualitative changes of T and B cells and granulocytes surface molecules in 24 children with recurrent (more than 8 episodes per year) infections of the respiratory tract and in 18 healthy children. The expression of CD2, CD3, CD4, CD8 on T cells; HLA-DR, CD19, CD5/CD20 on B cells, and CD11a/CD18, CD11b/CD18, CD62L, CD16 on granulocytes from peripheral blood was evaluated by a flow cytometry method. We observed a significant increase in the CD5+/CD20+ positive cells on B cells. We also observed a decreased expression of CD11c+/CD18+ cells, CD11a, and CD62L on granulocytes. The expression of other structures on lymphocytes and the CD11b/CD18+ on granulocytes remained unchanged. CD5+/CD20+ cells constitute a filogenetically old population responsible for the production of IgM of low specificity and affinity for specific antigens. The prevalence of this fetal phenotype population may be explained as a delayed maturation of the humoral immune system leading to increased susceptibility to infections. A lower percentage of CD11a may be related to the blockade of that molecule by rhinoviruses.
Increased susceptibility to infections can be a consequence of altered function of immune cells including neutrophils. The goal of the study was to evaluate the process of neutrophil activation via Ca2+-mediated signal. The study was performed on isolated peripheral blood neutrophils obtained from 41 children with recurrent infections (21 girls, 20 boys) 3-10 years old with more than five episodes of respiratory tract infection (RI) per year and from a control group of 30 healthy children age and sex matched, free from allergic, immune and hematological disorders. Neutrophils were activated by bacterial peptide fMLP, opsonized zymosan (OZ), and phorbol myristat acetate (PMA). The kinetics of the intracellular Ca2+ concentration i[Ca2+] was assessed by flow cytometry (Coulter Epics XL) with the use of Fluo3 and Fura Red fluorescent dyes. Data were collected in histograms displaying Fluo3 fluorescence vs. time and Fura Red fluorescence vs. time and the mean channels of fluorescence intensity were used for calculations. fMLP and OZ-induced Ca2+ mobilization lasted shorter in the RI group (P<0.05). The peak influx of free Ca2+ and i[Ca2+] in the resting state after stimulation with fMLP were lower in the patients (P<0.05). In the RI group stimulation with OZ was delayed compared with that in the control group (P<0.01). In response to PMA, i[Ca2+] decreased faster. The kinetic slopes of i[Ca2+] in both groups examined differed statistically at all points measured. A decrease in i[Ca2+] after PMA stimulation was greater (P<0.01) and lasted longer in the RI group. We conclude that increased sensitivity to infections in RI children may be related to the disturbance in neutrophil activation that is mediated by changes in i[Ca2+] with the subsequent production of free oxygen radicals. Such a disturbance may be inheritable or secondary to infection and antibiotic therapy.
Inhaled corticosteroids have a high level of topical anti-inflammatory activity. However, in patients with COPD these drugs have been reported to exert limited effects. A reduction in histone deacetylase (HDAC) activity is suggested to prevent the anti-inflammatory action of corticosteroids. Cigarette smoke is known to reduce HDAC expression. The aim of this study is to compare the outcome of corticosteroid therapy in both smoking and non-smoking COPD patients. Twenty-three smoking patients and 18 ex-smoking patients with COPD were treated with inhaled corticosteroids for a period of 2 months. Blood and induced sputum samples were collected before and after treatment. Values of FEV1 %-predicted did not change upon the therapy, but there was a trend to improve in the ex-smokers (63.1 64.8%-pred.), compared with a decrease in the smokers (63.3 61.6%-pred.). The levels of the pro-inflammatory cytokine IL-8 increased in the group of smokers from 379 ±78 to 526 ±118 ng/ml. Although not significant, a slight decrease from 382 ±70 to 342 ±62 ng/ml was observed in the group of ex-smokers. The neutrophil related elastase activity showed similar effects after steroid treatment, it went up from 36.4 ±12.0 to 113.5 ±9.7 nmol/l in smokers, and decreased from 346.2 ±72.1 to 131.1 ±6.5 nmol/l in ex-smokers with COPD. These results support the evidence that inhaled corticosteroids have no anti-inflammatory effects in COPD patients, but only when these patients are still smoking. Smoking cessation seems the best therapy for COPD patients.
Inhaled corticosteroids (ICS) are widely used for the treatment of COPD despite of controversial statements concerning their efficacy. The use of N-acetylcysteine (NAC), a mucolytic drug with antioxidant properties, is less clear, but it may counteract the oxidant-antioxidant imbalance in COPD. The aim of this study was to evaluate whether treatment of COPD patients with ICS or NAC is able to improve inflammatory indices and to enhance lung function. ICS treatment enhanced protective markers for oxidative stress such as glutathione peroxidase (GPx) (51.2 ±5.8 vs. 62.2 ±8.6 U/g Hb, P<0.02) and trolox-equivalent antioxidant capacity (TEAC) (1.44 ±0.05 vs. 1.52 ±0.06 mM, P<0.05). NAC decreased sputum eosinophil cationic protein (318 ±73 vs. 163 ±30 ng/ml, P<0.01) and sputum IL-8 (429 ±80 vs. 347 ±70 ng/ml, P<0.05). The increased antioxidant capacity prevented an up-regulation of adhesion molecules, since the levels of intracellular adhesion molecule 1 (ICAM-1) correlated negatively with GPx (P<0.0001) and TEAC (P<0.0001). On the other hand, expression of adhesion molecules was promoted by inflammation, reflected by a positive correlation between the levels of IL-8 and ICAM-1 (P<0.0001). The effects of treatment on lung function were only reflected in the FEV1 values. The absolute value of FEV1, both before and after salbutamol inhalation, increased from 1690 ±98 to 1764 ±110 ml, and 1818 ±106 to 1906 ±116 ml, respectively, after ICS (P<0.05) . Ten weeks after treatment, FEV1 values dropped to 1716 ±120 ml post-salbutamol (P<0.05). When followed by treatment with NAC, these values decreased even further to 1666 ±84 ml. These results suggest that ICS improved lung function in COPD patients with moderate airflow obstruction, beside a minor improvement in the oxidant-antioxidant imbalance leading to a lesser expression of ICAM-1. Treatment with NAC decreased some inflammatory parameters and had indirectly an inhibitory effect on the expression of adhesion molecules.
Due to the fastidious nature of B. henselae and the limited number of available isolates worldwide, there are few data on its in vitro susceptibility to antibiotics. We determined the minimal inhibitory concentrations (MIC) of ten antimicrobial agents against 11 feline isolates of B. henselae by Etest method. The lowest MICs were obtained for rifampicin = 0.002 mg/L. MICs of all isolates were < 0.016 mg/L for ampicilin, amoxicillin/clavulanic acid, tetracycline and ranged from 0.016 to 0.032 mg/L for azithromycin. The MICs for two tested fluoroquinolones: ciprofloxacin and levofloxacin ranged from 0.016 to 0.125 mg/L. The highest MICs were obtained for gentamicin ranging from 0.025 to 2.0 mg/L. Sulphonamide resistance genes sul 1, sul 2, sul 3 were not found in any of the tested isolates. Etest methodology seems to be a reliable method for determination of B. henselae susceptibility, however standardization is strongly desired.
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Induced sputum represents a useful and non-invasive tool to isolate different cells from the airways. Complete homogenization of sputum is important for dispersion of cells and is usually achieved by use of dithiothreitol (DTT). However, it is not known if DTT will influence the viability and functionality of cells obtained by induced sputum. In the present study, induced sputum was processed by DTT or by PBS treatment. The obtained neutrophils were compared with neutrophils obtained from peripheral blood and from bronchoalveolar lavage fluid (BAL). These isolated neutrophils were treated in a similar way as the sputum neutrophils with DTT or PBS. All isolated cells were used for chemiluminescence tests and for the measurement of elastase and myeloperoxidase release after stimulation with fMLP. The results showed that the maximum chemiluminescence response was always significantly lower after DTT treatment: blood, 16.68 ±1.89 vs. 2.62 ±0.43 mV, P<0.0001; sputum, 2.96 ±0.30 vs. 1.09 ±0.01 mV, P<0.01; BAL, 25.47 ±0.88 vs. 8.22±0.20 mV, P<0.0001. Both spontaneous and fMLP-induced release of elastase and myeloperoxidase (MPO) was in most cases enhanced after DTT-treatment (P-values range from 0.24 to <0.01). We conclude that the use of DTT to homogenize sputum for dispersion of cells is harmful to cell functions and these cells are hampered for the evaluation of their normal functional characteristics.
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