Biomedical subjects

Bor-Luen Chiang

Publications and source records attributed to Bor-Luen Chiang.

At least 91 records · Page 5Linked to original sources

PubMed2003

Clinical observation between chronic sustained cough with asthma and childhood inguinal hernia.

Inguinal hernias are common and cause problems for the health services. Several factors are thought to influence their development. Patients under 16 years old who had received hernioplasty at National Taiwan University Hospital were enrolled in a study to analyze the correlation between preceding recurrent cough with asthma and later hernia development. Patients aged 5 and 6 years old (when admitted for hernioplasty in 2000) were particularly focused. This entailed further analysis of their birth history, family atopic history, specific allergic diseases (allergic rhinitis, atopic dermatitis, asthma), hernia type (direct or indirect), the onset of chronic cough and asthma. One hundred and sixty three patients (2.66%) from a total hernioplasty population of 6130 were found to have had preceding asthma with recurrent cough before having the hernioplasty intervention. One hundred twenty-five patients were aged 5 to 6 years old, among whom 8 (6.4%) patients were found to have asthma, and 20 (16%) patients were noted to have recurrent sustained cough. All the hernia types were indirect and were received with high suture ligation. In conclusion, the incidence of asthma was not significantly higher in the group of individuals receiving hernioplasty. However, a higher incidence of recurrent sustained cough was noted, which could be a relatively important factor for the hernia development. Further reliable cough measurements would be needed to evaluate the severity of recurrent sustained cough as the potential risk for the hernia development.

Asthma↗

PubMed2003

Methimazole-induced lupus erythematosus: a case report.

A 15-year-old girl had a history of diffuse goiter and received methimazole treatment 2 months before admission to the hospital. She developed bilateral lower leg edema 5 days before admission and the laboratory examinations revealed leukopenia, anemia, proteinuria, and granular cast. Positive antinuclear antibodies and anti-double strand (anti-ds) DNA antibodies were noted, although complement levels were not reduced. Myeloperoxidase antineutrophil cytoplasmic antibody was positive. A renal biopsy disclosed that there was focal segmental glomerulosclerosis. Methimazole was discontinued, and she was treated with prednisolone and Plaquenil, after which the symptoms and laboratory tests became normal within 40 days. The prednisolone was discontinued after treatment for seven months. Currently, the anti-dsDNA, C3, C4, CBC, urinalysis, and thyroid function tests are within normal limits. With hydroxychloroquine and levothyroxine, she was free of symptoms after discontinuation of methimazole until now (about 21 months).

Adolescent↗

PubMed2003

The role of food allergens in childhood asthma.

Eighty-eight patients' sera with allergen-specific IgE levels elevated only to food allergens were collected between October 1997 and March 2002 at the National Taiwan University Hospital. Thirty-three of the patients fulfilled the diagnostic criteria of asthma and were included. Most (72.7%) patients had elevated serum allergen-specific IgE levels only to one food allergen. The most common food allergens were milk and egg white. The patients with elevated soy bean-specific IgE levels had significantly higher levels of serum food allergen-specific IgE than those with either elevated milk or egg white-specific IgE levels. This study investigated some food allergen responses of asthmatic patients whose serum allergen-specific IgE levels were elevated only to food allergens. The results suggested that the allergic asthmatic response in our patients was most likely related to food rather than aeroallergens or fungal allergens.

Age Factors↗

PubMed2002

Interleukin-12 inhibits eotaxin secretion of cultured primary lung cells and alleviates airway inflammation in vivo.

The mechanisms that cause the inflammation of airway and lung tissue in asthma have been studied extensively. It is noted that type 1T helper cell (Th1)-related cytokines could decrease the accumulation of eosinophils in lung tissue and relieve airway constriction. But the therapeutic mechanisms of Th1 cytokines remain unclear. In this study, interleukin-12 (IL-12) DNA plasmid as a therapeutic reagent was delivered intravenously. Bronchoalveolar lavage (BAL) fluids were collected from IL-12 treated and control mice, and analyzed for cell composition and eotaxin level. The results showed that IL-12 DNA plasmid could effectively inhibit eosinophilia and airway inflammation in vivo. The level of eotaxin in BAL fluid also decreased. To further investigate the effect of Th1-related cytokines such as IL-12 or interferon-gamma (IFN-gamma) on the eotaxin level produced by lung cells, primary lung cell culture was established. The results demonstrated that both IL-12 and IFN-gamma could suppress eotaxin secretion from IL-13 or IL-4 stimulated primary lung cell culture. Moreover, the inhibitory effect of IL-12 could not be reversed by the administration of anti-IFN-gamma antibody. All the evidences suggested that IL-12 could regulate airway inflammation by suppressing the eotaxin secretion of lung tissue through an IFN-gamma independent mechanism.

Animals↗

PubMed2002

HLA-Cw6 specificity and polymorphic residues are associated with susceptibility among Chinese psoriatics in Taiwan.

Previous serotyping in Chinese patients has failed to confirm an association between HLA-Cw6 and psoriasis. As serotyping has proved to be less valuable in the determination of HLA-C, genotyping of HLA-C in 68 Taiwanese psoriasis vulgaris (PSV) patients was performed using polymerase chain reaction/sequence-specific oligonucleotide probe hybridization (PCR-SSOPH) of HLA-Cw genes. Compared to 213 non-PSV control subjects, HLA-Cw6 was significantly associated with PSV (16.18% of PSV patients vs 5.16% of controls; odds ratio 3.53, Pc</=10(-4)). The amino acid residues on the heavy chain of the HLA-Cw antigens from exon one to exon five were also analyzed. Asp 9, Ser 24, Ala 73, Asp 90, Trp 97, Trp 156 and Asn 77/Lys 80 were found to be positively associated with PSV ( Pc</=0.0044, 0.0008, 0.0026, 0.0014, 0.039, 0.0020 and 0.0000, respectively).

Adolescent↗

PubMed2002

Molecular quality control machinery contributes to the leukocyte NADPH oxidase deficiency in chronic granulomatous disease.

Chronic granulomatous disease (CGD) is an inherited immunodeficiency disease caused by defects in leukocyte NADPH oxidase. Various inherited defects in one of the membrane-bound components of NADPH oxidase, gp91-phox, cause X-linked (X91) CGD. Analysis of three patients with X91 CGD revealed that different mechanisms of molecular quality control lead to the common phenotype of absence of mature membrane-bound NADPH oxidase complex in leukocytes. In the first patient, aberrant intron splicing created a premature stop codon. However, the mutant mRNA was degraded prematurely, which prevented the production of truncated protein. In the second patient, a frameshift mutation with the potential to generate a gp91-phox polypeptide, with an aberrant and elongated C-terminus, led to barely detectable levels of gp91-phox, even though the reported functional domains of the protein appeared unaffected. In the third patient, a point mutation created a single amino acid change in the predicted FAD-binding site of gp91-phox. Although gp91-phox was detectable with Western blotting, no cytochrome b(558) was expressed on the cell surface. These analyses showed that molecular quality control machinery plays an important role in the pathogenesis of CGD, not only in the X910 but also in the X91- form of this X-linked disease.

Cell Membrane↗

PubMed2002

Reduction of human-to-pig cellular response by alteration of porcine MHC with human HLA DPW0401 exogenes.

BACKGROUND: In pig-to-human discordant xenotransplantation, the xenograft can be rejected by a formidable human xenogenic T-cell response, even if the graft has gone through hyperacute rejection or delayed xenograft rejection (acute vascular rejection). We therefore examined, in this study, whether the human-to-pig cellular response could be attenuated through the generation of a transgenic pig for human HLA II. METHODS: With the technique of microinjection, we produced the HLA DPw0401 transgenic pig. The expression of the HLA DPw0401 gene on peripheral blood mononuclear cells (PBMCs) of the transgenic pig was examined by reverse transcriptase-polymerase chain reaction and flow cytometry. The antigenicity of the transgenic HLA DPw0401 molecule was tested by the HLA DPw0401-primed lymphocyte test reagent. The cellular response was analyzed by xenogenic mixed lymphocyte culture. RESULTS: The mRNA and protein of HLA DPw0401 were expressed in the PBMCs of the transgenic pig. The PBMCs of the HLA transgenic pig induced a stronger cellular reaction to HLA DPw0401-primed lymphocyte test reagents than the nontransgenic littermate pig (n=7, P<0.01). In direct xenogenic mixed lymphocyte culture with responders from HLA DPw0401(+) humans, the PBMCs from the HLA DPw0401 transgenic pig, as compared with those from the normal pig, induced a lower degree of xenogenic cellular response to human PBMCs (n=4, P=0.08). CONCLUSIONS: Our preliminary data demonstrated the possibility that the human HLA DPw0401 phenotype can be transferred onto porcine cells through the generation of HLA transgenic pigs and make the PBMCs of humans more tolerant to porcine cells.

Animals↗

PubMed2002

Co-delivery of GM-CSF gene enhances the immune responses of hepatitis C viral core protein-expressing DNA vaccine: role of dendritic cells.

Hepatitis C virus (HCV) infection has become a critical public health problem worldwide. In Taiwan, it has been estimated that more than 300,000 people, 2% of the general population, have HCV infection. It has been well documented that direct delivery of gene intramuscularly can generate both humoral and cellular immunity, which more closely simulates the conditions of infection. In this study, female Balb/c mice immunized with HCV core plasmid DNA with or without adjuvant GM-CSF cytokine gene could induce both cellular immune response and HCV core-specific antibody titers after injection. Furthermore, the mice immunized with HCV core plus GM-CSF genes showed higher antibody titer and cytotoxic T cell activity compared to those of mice immunized with HCV core gene only (P < 0.05). To explore the effect of GM-CSF gene, the mice were immunized with reporter gene and cytokine gene plasmid. Increased levels of reporter protein and infiltrating cells around muscle tissue were noted. Moreover, the protein could be detected in inguinal node 24 hr after injection, especially in mice immunized with HCV/core plasmid plus GM-CSF gene. It was also observed that reporter protein expressing CD11c(+) dendritic cells could be seen in the inguinal node. These data suggest that the GM-CSF gene did enhance HCV core specific immune response when co-immunized with HCV core DNA plasmid. Although more studies are needed, dendritic cells that appeared around the naked DNA injection area and that local lymph nodes might play a critical role in the immune response induced by naked DNA immunization.

Animals↗

PubMed2002

In vivo tolerance breakdown with dendritic cells pulsed with U1A protein in non-autoimmune mice: the induction of a high level of autoantibodies but not renal pathological changes.

One of the hallmarks of systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), is the immune response to nuclear autoantigens. Several studies have proposed that dendritic cells may acquire the nuclear autoantigens from the apoptotic cells to initiate the systemic autoimmune responses. To examine the immune response to a nuclear autoantigen induced by dendritic cells, bone marrow-derived dendritic cells (BMDCs) pulsed with U1 small nuclear ribonucleoprotein (snRNP)-A protein (U1A) were intravenously injected into non-autoimmune mice. The results showed that BMDCs pulsed with U1A proteins by intravenous injection into BALB/c (H-2d) and DBA-2xNZW F1 (H-2d/u) mice were capable of activating the autoreactive T cells and inducing a high titre of immunoglobulin G (IgG) anti-U1A antibodies. Both groups of mice with a high anti-U1A autoantibody titre also transiently developed IgG against double-stranded (ds) DNA. However, unlike NZBxNZW F1 (BWF1) (H-2d/u) mice, no obviously histopathological changes to the glomeruli were noted in the mice treated either with BMDCs or with U1A-pulsed BMDCs. Several months after immunization, all mice treated with U1A-pulsed BMDCs did develop IgG, but not the complement C3 deposit in the glomeruli. The cytokine profile produced by the U1A-specific T cells of primed DBA-2xNZW F1 mice was skewed toward the T helper type 1 phenotype compared with that of BWF1 mice. The model we describe here adds to the further understanding of the pathogenic mechanisms, such as self-antigen shifting, and the mechanisms that account for the different responses to self-antigens when in a normal or an autoimmune state.

Animals↗

PubMed2002

Effects of systematic nursing instruction of mothers on using medication and on health status of asthmatic children.

The purpose of this study was to investigate the effects of systematic nursing instruction for mothers of children with asthma on their knowledge of the medication, ability to use inhalation devices, self-efficacy of medication use, and on children's health status. A quasi-experimental study was conducted at the Pediatric Allergy Clinic of a major academically based medical center in Taipei, Taiwan. The sample consisted of 82 mothers and their children recruited by purposive sampling. The intervention group (n = 41) received systematic nursing instruction from the researchers and the control group (n = 41) received regular nursing care from staff nurses. The effects of systematic nursing instruction were evaluated two months later using four questionnaires: the mother's knowledge of medication, inhaling steps, self-efficacy of medication use, and child's health status. The results of this study showed that systematic nursing instruction of mothers of children with asthma significantly improved their knowledge of the medication, ability to use inhalation devices, and self-efficacy, as well as decreasing the number of episodes of respiratory disease of children over a two month period. To sum up, these findings demonstrate that systematic nursing instruction of mothers about asthma medication not only benefited mothers directly, but also improved children's health status indirectly.

Adult↗

PubMed2002

Correlation between serum lipid profiles and the ratio and count of the CD16+ monocyte subset in peripheral blood of apparently healthy adults.

BACKGROUND AND PURPOSE: Deposited vascular oxidized low-density lipoproteins (LDLs) are important triggers of the transformation of circulatory monocytes into macrophages. CD16+ monocytes have been reported to be the precursors of tissue macrophages. In this study, we sought to determine the relationship between serum LDL-cholesterol and the percentage and count of the CD16+ monocyte subset in the peripheral blood of healthy adults. METHODS: We studied the correlations between serum lipid profiles and both peripheral CD16+ and CD36+ monocyte subset ratios and counts in apparently healthy adults (50 men and 50 women). Monocyte surface antigens CD16 and CD36 on CD14+ monocytes were detected using fluorescent triple staining and flow-cytometry. Surface staining was performed by incubating 1 x 10(6) blood mononuclear cells with phycocrythrin-conjugated anti-CD14, fluorescein isothiocyanate-conjugated anti-CD36, and respective control isotopes (mouse IgGs). A total of 5,000 cells were counted and the frequency of surface antigens was determined by FACscan. RESULTS: A significant positive link between LDL-cholesterol and the CD16+ subset ratio was found by linear correlation analysis (p < 0.05) but not by multivariate regression analysis. Both linear correlation analysis and ANOVA revealed a significant inverse link between high-density lipoprotein (HDL)-cholesterol and the CD16+ subset ratio (both p < 0.01). By multivariate regression analysis, gender was the main significant determinant for the CD16+ subset ratio. When serum total cholesterol (TC) was excluded from the analysis to avoid the interference from collinearity between serum TC and LDL (r = 0.84), HDL-cholesterol became independently and inversely linked to the CD16+ subset ratio. There were independent inverse links between HDL-cholesterol and the counts of all monocytes, CD16+ monocytes, and CD36+ monocytes. CONCLUSIONS: Our results suggest that circulating HDL-cholesterol may be much more important than LDL-cholesterol in affecting the transformation of circulatory monocytes into macrophages. The inverse link between HDL-cholesterol and the number of macrophage precursors in peripheral blood might contribute partly to the well-known antiatherogenic effect of HDL-cholesterol.

CD36 Antigens↗

PubMed2002

Natural killer cell deficiency associated with Hodgkin's lymphoma: a case report.

Natural killer (NK) cells are large granular lymphocytes that play important roles in immunity against viral infection. NK cell deficiency is associated with recurrent episodes of severe herpes group virus reactivation. Few cases of NK cell deficiency have been reported. Here, we report the case of a Taiwanese girl who had suffered from severe atopic dermatitis since infancy, and recurrent episodes of herpes virus reactivation since the age of 3 years old. NK cell deficiency was diagnosed based on the finding of persistently low NK cell counts in peripheral blood. Hodgkin's lymphoma developed when she was 6 years old. The present case suggests that NK cell deficiency may be an important risk factor in the development of Hodgkin's lymphoma.

Child↗

PubMed2002

Sulfasalazine therapy for juvenile rheumatoid arthritis.

BACKGROUND AND PURPOSE: Sulfasalazine (SSZ) has recently been shown to be effective for the management of juvenile rheumatoid arthritis (JRA). This study investigated the efficacy and adverse effects of SSZ therapy in children with JRA. METHODS: Data from the medical records of 24 children with JRA who were treated with oral SSZ during the period from 1993 through 2000 were analyzed retrospectively. Disease onset was polyarticular in six children, oligoarticular in 11, and systemic in seven. All patients had received nonsteroidal anti-inflammatory drugs (NSAIDs) and 17 had received SSZ and azathioprine (AZA) concomitantly. The initial dose of SSZ averaged 21.6 mg.kg-1.d-1. The mean duration of treatment was 13.3 months (range, 3-66 mo). The mean duration of follow-up was 16.6 months (range, 3-66 mo) from the start of SSZ therapy. RESULTS: Twenty children (83%) showed clinical improvement and 18 children (75%) achieved clinical remission. Patients with systemic-onset JRA had lower response rates than did those with an oligoarticular onset (p < 0.05). SSZ was discontinued in seven patients following 7 months of clinical remission and 10 months of treatment. Relapse occurred in four patients (16.7%) following a mean of 17 months of clinical remission. All achieved remission again after restarting the regimen and increasing the SSZ dosage by one-third. Adverse effects related to SSZ were found in only three patients (12.5%): nausea and epigastralgia in two, skin rash in the other. CONCLUSIONS: SSZ in combination with other drugs (NSAIDs or disease-modifying antirheumatic drugs) is safe and appears to be an effective treatment for JRA, especially in patients with the oligoarticular- and polyarticular-onset disease.

Adolescent↗

PubMed2002

DiGeorge sequence with hypogammaglobulinemia: a case report.

The most common immunodeficiency in DiGeorge sequence patients is defects in T-cell production due to insufficient thymic tissue. However, because T-lymphocytes are important in regulating antibody responses, DiGeorge sequence is no longer regarded as a pure deficiency of cellular immunity but also a form of variable-combined immunodeficiency. Here we presented a 4-month-old male infant with characteristic facial dysmorphism, thymus dysplasia, tetralogy of Fallot, and documented deletion of chromosome 22q11.2 who had decrease B-lymphocyte numbers and hypogammaglobulinemia. The mitogen responses of T-lymphocytes function were normal with adequate number of CD4+ lymphocytes. This case report highlights the importance of evaluating not only the cellular but also the humoral immune function in patients with DiGeorge sequence.

Agammaglobulinemia↗

PubMed2002

Mycobacterium kansasii infection presenting as cellulitis in a patient with systemic lupus erythematosus.

The prevalence of mycobacterial infection has increased in recent years, especially in patients immunocompromised due to autoimmune disease, malignancy and AIDS. Mycobacterium kansasii infection most commonly presents as tuberculosis-like pulmonary disease. We report the case of a 38-year-old woman with systemic lupus erythematosus (SLE) who developed cellulitis over the left lower leg and had poor response to antibiotics. Two months before this admission, she had sustained a small wound over the right pretibial area and had noticed erythematous swelling after swimming at the beach. Pathologic examination of biopsied tissue showed acid-fast bacilli, and culture yielded M. kansasii. The cellulitis improved gradually during treatment with antimycobacterial agents for 1 year. This case emphasizes the possibility that cutaneous M. kansasii infection may occur in an immunocompromised patient and that exposure to contaminated water is a possible source. With early diagnosis, the response to an antimycobacterial multidrug regimen is usually satisfactory.

Adult↗

PubMed2002

Response to influenza vaccine in children with leukemia undergoing chemotherapy.

BACKGROUND AND PURPOSE: To assess the ability of children with acute lymphoblastic leukemia (ALL) to develop an antibody response after influenza vaccination. METHODS: A total of 65 children under 15 years old were studied, including 25 children with ALL undergoing chemotherapy, 30 with asthma in remission who were regularly followed at clinics, and 10 healthy children. The influenza vaccine contained antigens B/Yamanashi/166/98, A/New Caledonia/20/99 (H1N1), and A/Panama/2007/99 (H3N2). RESULTS: Children with ALL developed significant antibody titers to A/Panama /2007/ 99 antigen 4 weeks after the second immunization. Seroconversion rates after two doses of vaccine were 57.1 to 84.6% and seroresponse rates were between 24 and 60% in children with ALL. Compared to children with asthma in remission, who were regarded as immunocompetent individuals, the ALL children had less seroconversion and lower seroresponse rates to A/New Caledonia/20/99 (H1N1). The seroconversion and seroresponse rates to B/Yamanashi/166/98 and A/ Panama/2007/99(H3N2) antigens were comparable in asthmatic and leukemic children. On the other hand, the antibody response in children with ALL who received reinduction chemotherapy suggests that the therapy did not impair seroresponse rates. CONCLUSION: Our data suggest that the influenza vaccine is safe and effective in children with either ALL or asthma in Taiwan.

Antibodies, Viral↗

PubMed2002

Steroid refractory interstitial pneumonitis in a patient with juvenile dermatomyositis.

Interstitial pneumonitis is a severe complication of juvenile dermatomyositis. We report a 4-year-old girl with juvenile dermatomyositis. Coughing, shortness of breath, and general malaise developed during steroid treatment. The histology of her lung biopsy is compatible with interstitial pneumonitis. Aggressive treatment including intravenous methylprednisolone pulse therapy, intravenous immunoglobulin, and oral cyclosporin all failed. Creatinine phosphokinase level was within the normal range during the disease course. The clinical features are discussed and the importance of a differential diagnosis of interstitial pneumonitis in patients with juvenile dermatomyositis is emphasized.

Anti-Inflammatory Agents↗

PubMed2002

Neonatal lupus erythematosus with recurrent pancytopenia: a case report.

Neonatal lupus erythematosus is an immune-mediated disease associated with the transplacental passage of maternal autoantibodies, primarily anti-Ro (SS-A) and anti-La (SS-B). The major clinical manifestations are isolated congenital heart block and cutaneous lupus lesions. Other symptoms include hematologic and hepatic abnormalities. We report a male neonate, born to a mother with Sjögren's syndrome, who experienced cutaneous lupus lesions and 2 episodes of pancytopenia. Both anti-Ro and anti-La antibodies were positive in infant and mother.

Antibodies, Antinuclear↗