Zeynep Arikan Ayyildiz

Mesenchymal stem cells ameliorate the histopathological changes in a murine model of chronic asthma.

Asthma therapies are effective in reducing inflammation but airway remodeling is poorly responsive to these agents. New therapeutic options that have fewer side effects and reverse chronic changes in the lungs are essential. Mesenchymal stem cells (MSCs) are promising for the development of novel therapies in regenerative medicine. This study aimed to examine the efficacy of MSCs on lung histopathology in a murine model of chronic asthma. BALB/c mice were divided into four groups: Group 1 (control group, n=6), Group 2 (ovalbumin induced asthma only, n=10), Group 3 (ovalbumin induced asthma + MSCs, n=10), and Group 4 (MSCs only, n=10). Histological findings (basement membrane, epithelium, subepithelial smooth muscle thickness, numbers of goblet and mast cells) of the airways and MSC migration were evaluated by light, electron, and confocal microscopes. In Group 3, all early histopathological changes except epithelial thickness and all of the chronic changes were significantly ameliorated when compared with Group 2. Evaluation with confocal microscopy showed that no noteworthy amount of MSCs were present in the lung tissues of Group 4 while significant amount of MSCs was detected in Group 3. Serum NO levels in Group 3, were significantly lower than Group 2. The results of this study revealed that MSCs migrated to lung tissue and ameliorated bronchial asthma in murine model. Further studies are needed to evaluate the efficacy of MSCs for the treatment of asthma.

Effects of Curcumin on Lung Histopathology and Fungal Burden in a Mouse Model of Chronic Asthma and Oropharyngeal Candidiasis

BACKGROUND AND AIMS Oropharyngeal candidiasis (OPC) is one of the most common local side effects of current therapy in chronic asthma. New therapeutic options with fewer side effects and reverse chronic changes are needed. Curcumin, as a promising antiinflammatory and antifungal agent, could be a candidate of alternative therapy in asthma. This study aimed to determine the efficacy of orally administrated curcumin on lung histopathology, serum nitric oxide levels and fungal burden in a murine model of asthma and OPC. METHODS Thirty five BALB/c mice were divided into five groups: I, II, III, IV (placebo) and V (control). All groups except the control were sensitized and challenged with ovalbumin. OPC model was established after the model of chronic asthma. Lung histology, serum nitric oxide levels and fungal burden were evaluated after 5 days of treatment with curcumin, dexamethasone, curcumin-dexamethasone combination and placebo. Evaluation of lung histology included subepithelial smooth muscle and epithelial thickness and number of goblet and mast cells by using light microscopy. RESULTS All histological parameters improved in curcumin group similar to dexamethasone group. Curcumin and dexamethasone-curcumin combination were also as effective as dexamethasone on decreasing nitric oxide levels. Oral fungal burden was significantly lower in curcumin-treated group than dexamethasone. CONCLUSIONS In our study we demonstrated that curcumin administration alleviates the pathological changes in asthma and decreases the fungal burden. Curcumin may have a potential effect on treating chronic asthma and decreasing the frequency of the OPC.

Resveratrol ameliorates 2,4-dinitrofluorobenzene-induced atopic dermatitis-like lesions through effects on the epithelium

Background. Resveratrol is a natural polyphenol that exhibits anti-inflammatory effects. The aim of this study was to investigate the effects of resveratrol treatment on epithelium-derived cytokines and epithelial apoptosis in a murine model of atopic dermatitis-like lesions. Material and Methods. Atopic dermatitis-like lesions were induced in BALB/c mice by repeated application of 2,4-dinitrofluorobenzene to shaved dorsal skin. Twenty-one BALB/c mice were divided into three groups: group I (control), group II (vehicle control), and group III (resveratrol). Systemic resveratrol (30 mg/kg/day) was administered repeatedly during the 6th week of the experiment. After the mice had been sacrificed, skin tissues were examined histologically for epithelial thickness. Epithelial apoptosis (caspase-3) and epithelium-derived cytokines [interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP)] were evaluated immunohistochemically. Results. Epithelial thickness and the numbers of IL-25, IL-33, TSLP and caspase-3-positive cells were significantly higher in group II compared to group I mice. There was significant improvement in epithelial thickness in group III compared with group II mice (p < 0.05). The numbers of IL-25, IL-33, and TSLP-positive cells in the epithelium were lower in group III than in group II mice (p < 0.05). The number of caspase-3-positive cells, as an indicator of apoptosis, in the epithelium was significantly lower in group III than in group II mice (p < 0.05). Conclusion. Treatment with resveratrol was effective at ameliorating histological changes and inflammation by acting on epithelium-derived cytokines and epithelial apoptosis.

Chlamydia pneumoniae infection presenting with angioedema in an adolescent.

Chlamydia pneumoniae is a rare causative infectious agent for acute urticaria or angioedema; however it has not been associated with chronic urticaria. We report a case with angioedema as an initial presentation that led to diagnosis of Chlamydia pneumoniae infection. A 13-year-old boy was admitted to a medical centre with a complaint of non-pitting swelling around the right eyelid and upper lip concurrently with asthma exacerbation. Although he had taken systemic antihistamine and corticosteroid for angioedema, his symptoms had continued in the following days. He had no tongue swelling or laryngeal edema on his otolaryngeal examination. Laboratory tests, including complete blood count, biochemical analyses, thyroid hormones, stool and urine analysis and cultures, complement (C3, C4) and total immunoglobulin (Ig) E levels, were normal. Serological tests were found compatible with acute chlamydial infection with positive antiChlamydia pneumonia IgM and anti-Chlamydia pneumonia IgG titer of 1/512. According to the diagnosis of acute Chlamydia pneumonia infection, oral clarithromycin treatment was adjusted. After the second dose of the treatment, the marked edema around his eyes and lips started to regress in the fourth day of hospitalization. Pulmonary symptoms were controlled with salbutamol inhalation in addition to clarithromycin. After 4 weeks, antichlamydia IgG showed a rise in a titer up to 1/2048. His skin prick tests for aeroallergens, mite, animal dander and latex were negative. He had no symptoms in his follow-up period. Angioedema is an acute self-limited non-pitting edema that involves the face, lips, tongue and larynx. The major causes of angioedema are foods, infections, insect bites, environmental allergens, physical stimuli and drugs for children, respectively. Investigations to clarify the cause of the urticaria/angioedema should be based on clinical history and physical examination. Extensive routine work-up is not endorsed for mild cases that are responding to conventional treatment. When the resolution of symptoms cannot be achieved by proper treatment, the infectious causes and related serological tests might be considered. Histamine, one of the main cytokines, plays a role in the pathogenesis of angioedema, and is synthesized by histidine decarboxylase (HDC) from L-histidine. According to the results of an experimental study, infection with Chlamydia pneumonia causes increased HDC activity and the enzyme activity is directly correlated with interleukin (IL)-3, IL-4 and interferon (IFN)gamma levels in the bronchial epithelial cells. The results of this study might explain the association between local histamine and other pro-inflammatory cytokine production in angioedema and Chlamydia infection. Specific diagnosis of Chlamydia pneumonia infection is based on isolation of the organism in culture but such a method is rarely performed because of technical difficulties. Polymerase chain reaction (PCR) testing is the most promising method, but this assay is not commercially available. The microimmunofluorescence (MIF) technique is the only currently acceptable method in which acute infection is defined by a fourfold increase in IgG titer or an IgM titer of 16 or greater. Thus, the diagnosis is accomplished by elevated titers of IgM for Chlamydia pneumonia in the symptomatic period for our patient. The fourfold increase in IgG titer after 4 weeks supported acute Chlamydia pneumoniae infection. Elimination of suspected agent or trigger is the principle management approach for urticaria and/or angioedema. Treatment with intravenous corticosteroids, antihistamines or subcutaneous epinephrine should lead to rapid resolution of symptoms and prevent potential airway intubation and need of care in the intensive care unit. In the published reports, Chlamydia pneumoniae has been described as an infectious cause for chronic urticaria. We suggest that it might be a causative agent for acute urticaria or angioedema. Children who do not respond to conventional urticarial treatment might have an infectious cause and a serological test might be helpful to identify the underlying cause of such cases.

Expectoration of a foreign body at the late period: A case report.

Foreign body (FB) aspiration is a relatively common problem in children, particularly during the first 3 years of life. It is an emergency condition and the removal of the FB by bronchoscopy is the primary treatment. Children with undiagnosed retained foreign bodies may present with respiratory symptoms including recurrent or persistent wheezing, with or without respiratory failure. Spontaneous expectoration of a FB is a rare occurrence. Herein, we present a case that was diagnosed with FB aspiration during investigation for persistent wheezing and who expectorated part of a sunflower seed 2 months after aspiration.

The Effects of Suplatast Tosilate Treatment and Prophylaxis on Lung Histopathology in a Mouse Model of Chronic Asthma

Introduction Suplatast tosilate is a medication that inhibits TH2-type cytokines. We aimed to investigate the effects of suplatast tosilate treatment and prophylaxis on lung histopathology and cytokine levels in a mouse model of chronic asthma. Materials and Methods Forty-two BALB/c mice were divided into 6 groups: group I (control), group II (vehicle control), group III (dexamethasone), group IV (prophylaxis with suplatast tosilate), group V (treatment with suplatast tosilate), and group VI (prophylaxis and treatment with suplatast tosilate). All of the groups, except for the control and vehicle control groups, were sensitized and challenged with ovalbumin. The mice in the study groups, except those in the group receiving suplatast tosilate for prophylaxis only, were treated with study drugs. After the mice were killed, IL-4, IL-5, and interferon-γ levels were quantified in the lung tissue, which were examined histologically by light and electron microscopy. Results There were significant improvements in all histopathological parameters in the group treated with suplatast tosilate compared with the vehicle control group. Similar improvements were observed when the group receiving prophylaxis and treatment with suplatast tosilate was compared with the vehicle control as well. There were no significant differences between the group receiving only prophylaxis with suplatast tosilate and the vehicle control group. Cytokine levels were significantly higher in the vehicle control group when compared with the control group. Although all of the groups had lower cytokine levels than those of the vehicle control group, the differences were not statistically significant. Conclusions Treatment with suplatast tosilate was effective in improving all histopathological parameters in a mouse model of chronic asthma. It was observed that the use of prophylactic suplatast tosilate was ineffective and had no additional effects when administered together with treatment.

P58 - The role of osteopontin and vitamin D in school-age asthmatic children for predicting asthma exacerbation

Results OPN levels (ng/ml) were significantly higher in asthmatics in exacerbation period when compared to nonexacerbation period, and controls [30,61±3,21 vs. 28,7 ±3,71 vs. 27,62±3,91, respectively; p<.001]. There was no significant difference among OPN levels between asthmatics and controls, (p=.094). 25(OH)D levels (ng/ml) were significantly lower in asthmatics in exacerbation period when compared to non-exacerbation period, and controls [30,15±5,11 vs. 32,23±5,80 vs. 34,16±5,86, respectively; p<.001]. There was no significant difference among 25(OH)D levels between asthmatics and controls, (p=.051).There was a correlation for both OPN and 25 (OH)D levels among asthmatics in exacerbation period and non-exacerbation period, respectively (r=0,40, p<,001 and r=0,62, p<.001). But, no correlation between OPN and 25(OH)D levels among asthmatics in exacerbation and non-exacerbation periods (r=-0,78, p=,481; r=0,10, p=,448, respectively).

Sunflower seed allergy in a child reveloping after sensitization to sunflower pollen or dust

Sunflower seed is one of the most commonly consumed snacks in our country. Sunflower seeds are not only eaten as snacks but also are used as ingredients of breads, mueslies and bars in recent years. Sunflower seed allergy is seen rarely in children and may be presented as angioedema or anaphylaxis. Respiratory allergies have been reported previously in adults owning birds fed on sunflower seeds. We present a case with sunflower seed allergy who had been already sensitized with sunflower pollen or dust and developed sunflower seed allergy afterwards.

Anaphylaxis in an infant to raw potato

Potato was believed to have a lower allergenic potential and it was the one of the first preferred food for weaning period in infancy. To date, the allergenic reactions are mostly reported in adults including oral allergy syndrome, contact dermatitis, exacerbations of asthma, and rarely anaphylaxis.