Małgorzata Bocheńska-Marciniak

The effect of recombinant interleukin-8 on eosinophils and neutrophils migration in vivo and in vitro

Background:  Interleukin‐8 (IL‐8) is a chemokine that causes chemotaxis of neutrophils, eosinophils and lymphocytes in vitro; however, its role as a chemoattractant in allergic inflammation is unclear. The objective of this study was to investigate the effect of nasal instillation of IL‐8 on the influx of inflammatory cells.

Ranitidine (150 mg daily) inhibits wheal, flare, and itching reactions in skin-prick tests.

H(1)-receptor antagonists are known to suppress reactions in skin-prick tests (SPTs); however, the effect of H(2)-receptor antagonists, which are widely used in our everyday practice, remains unclear. The aim of this study was to determine the influence of ranitidine on wheal, flare, and itching sensation in SPTs. Twenty-one atopic patients (5 women and 16 men) with an average age of 28.04 years (SD, +/-8.24) were tested with histamine, codeine, negative control solution, and standard allergen extracts. Ranitidine (150 mg daily), loratadine (10 mg daily), or placebo were given to the volunteers for 5 days in a double-blind manner with 14 days of washout period. SPTs were applied to the volar surface of a forearm. There was no difference in wheal, flare, and itching between SPTs performed after placebo and washout period. The analysis revealed a statistically significant suppression of wheal and flare by ranitidine and loratadine (p = 0.013 and <0.00001, respectively, for wheals after allergens solutions tests, Wilcoxon rank-sum test). We found a significant suppression of itching induced by ranitidine (reduction of 26.85%; p = 0.005) and loratadine (29.6%; p = 0.005) as compared with placebo (p = 0.068 versus washout). Our data show a suppressive effect of ranitidine on the wheal, flare, and itching sensation in SPT. Because the sensitivity and specificity of skin testing requires withholding medication that could change the skin reactivity, it seems important to take into account the possible influence of H(2)-receptor antagonists on allergy diagnosis and therapy.

Perennial is more effective than preseasonal subcutaneous immunotherapy in the treatment of seasonal allergic rhinoconjunctivitis.

Background Two different regimens of subcutaneous immunotherapy (IT), perennial or preseasonal, may be used in the treatment of seasonal allergy. The aim of this study was to compare the efficacy and safety of perennial IT (PIT) and preseasonal IT (PSIT) in patients suffering from seasonal rhinoconjunctivitis. Methods The study was planned as a randomized, double-blind, comparative study on the efficacy and safety of PIT and PSIT. The study group comprised 120 patients allergic to grass and rye pollen. After the observational season they were randomized to receive PIT or PSIT for 3 years. The effect of IT was assessed based on symptom severity and medication use recorded in diaries. Results Ninety-nine patients completed the study. No difference was seen between the groups regarding combined symptom medication score (SMS) in the first season of IT. During the second season, the difference between PIT and PSIT regarding combined SMS was 27.9% (p = 0.063) and reached 42.7% (p = 0.012) in favor of PIT in the third season. Both treatments had a similar safety profile. Conclusion PIT was more effective than PSIT in the treatment of rhinoconjunctivitis in patients allergic to grass and rye pollens. Clinicaltrials.gov registration number NCT01555736.

Adhesion molecules and their ligands in nasal polyps of aspirin-hypersensitive patients

BACKGROUND Chronic inflammation with tissue eosinophilia plays a key role in the pathogenesis of asthma and nasal polyps in patients with aspirin hypersensitivity. OBJECTIVE To evaluate the expression of vascular cell adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule I (ICAM-1) and their ligands (the integrins lymphocyte function-associated antigen 1 and very late-activation antigen 4 [VLA-4]) in nasal polyps of patients with aspirin hypersensitivity compared with aspirin-tolerant individuals. METHODS Immunohistochemical studies were performed using a peroxidase method and monoclonal antibodies on 6-microm-thick cryostat sections cut from frozen polyps collected during elective surgery from 21 aspirin-sensitive and 23 aspirin-tolerant patients. RESULTS The mean +/- SD values of the semiquantitatively evaluated immunoexpression of ICAM-1, VCAM-1, and VLA-4 were significantly increased in patients with aspirin hypersensitivity compared with aspirin-tolerant patients (1.7 +/- 0.8 vs 0.9 +/- 0.8, P < .003; 1.8 +/- 0.8 vs 0.8 +/- 0.8, P < .001; and 2.2 +/- 0.7 vs 1.3 +/- 0.7, P < .001, respectively), whereas the mean +/- SD values of the expression of lymphocyte function-associated antigen 1 did not differ significantly (2.4 +/- 0.5 vs 2.2 +/- 0.9; P = .57). We found a correlation between the immunoexpression of VCAM-1 and its ligand VLA-4 in all studied tissue samples (r = 0.4; P < .02). CONCLUSIONS In nasal polyps of aspirin-hypersensitive patients, up-regulation of the adhesion molecules ICAM-1 and VCAM-1 and the integrin VLA-4 may play an important role in the development of chronic eosinophilic inflammation.

Inhaled Corticosteroids in Asthma: Promoting or Protecting Against Atherosclerosis?

Background Bronchial asthma is an inflammatory disease of the respiratory system. However, it may also induce systemic effects. Although reports suggest patients with asthma are at increased risk of cardiovascular events, the association between asthma and atherosclerosis is unclear. The aim of the present study was to compare the progression of atherosclerosis between patients with asthma treated with inhaled corticosteroids and healthy controls. Material/Methods In 102 adult patients with asthma, markers of arterial stiffness (pulse wave velocity and augmentation index) were evaluated by applanation tonometry. Structural atherosclerotic changes (intima-media complex thickness and presence of atherosclerotic plaque) were assessed sonographically. Lipid profile and fasting glucose level were measured. Clinical data concerning the course of asthma, its severity, and management strategy were obtained. A group of 102 healthy, age-matched controls were examined according to the same protocol. Results The majority of patients presented well-controlled asthma of moderate severity. When adjusted for weight, age, and systolic blood pressure, no significant differences were observed in pulse wave velocity, in augmentation index, or in intima-media complex thickness between groups. In controls, atherosclerotic plaque occurred significantly more often than in patients with asthma (p=0.0226). Moreover, in patients with asthma, the intima-media complex thickness of the right common carotid artery was significantly correlated with forced expiratory volume in 1 second (R2=−0.2951, p=0.0083). There was no significant difference in any of the atherosclerosis markers between different types and doses of administered inhaled corticosteroids. Conclusions Patients with bronchial asthma presented a decreased risk of atherosclerosis in comparison to healthy controls.

287 Nasal Nitric Oxide Levels after Lysine Aspirin Nasal Challenge in Subjects with Aspirin Induced Asthma.

Background Changes in nasal nitric oxide (nNO) levels after nasal lysine aspirin (lys-ASA) challenge have not been determined. Methods Fourteen patients with aspirin induced asthma (AIA) with or without nasal polyps with aspirin were included to the study. Hypersensitivity had to be confirmed by positive result of oral aspirin challenge Ten healthy subjects served as the control group. 12 mg of lys-ASA were applied unilaterally. Nasal symptoms were assessed using visual analogue scale (VAS) and nNO and peak nasal inspiratory flow (PNIF) measurements were performed before and 1, 2, 4 and 24 hours after the challenge. The result of the challenge was considered as positive when at least 20% fall of PNIF as well as 20% increase of total VAS score were observed. Results Ten patients (71.4%) had clinically positive result of the challenge. We observed significant fall in nNO levels in AIA patients after 1 and 2 hours after the challenge (653. 1 ± 420. 2 at baseline versus 490. 3 ± 456. 0; P = 0.0029 and 439. 9 ± 556. 4 ppb; P = 0.0076; respectively). The decrease in nNO level was more pronounced in patients with clinically positive result of the challenge (510. 1 ± 212. 5 at baseline versus 283. 3 ± 173. 4; P = 0.005; 159, 6 ± 166,1; P = 0.005 and 331. 0 ± 312.0 ppb; P = 0.037 after 1, 2 and 3 hours, respectively). In 4 subjects with clinically negative result of the challenge we noticed a trend towards higher nNO concentrations after lys-ASA challenge (1010. 8 ± 625. 2 at baseline vs 1341. 3 ± 670. 5 ppb after 4 hours). No significant changes in nNO levels after the challenge were observed in healthy controls. Conclusions NO levels decrease after lys-ASA nasal challenge in subjects with AIA and clinically positive nasal provocation. An unexpected trend towards increase in nNO levels was observed in subjects with AIA and clinically negative provocation Potential usefulness of nNO measurement in aspirin nasal provocation needs further evaluation.