Biomedical subjects
D G Peroni
Publications and source records attributed to D G Peroni.
Effective allergen avoidance at high altitude reduces allergen-induced bronchial hyperresponsiveness.
We studied the effects of reduced allergen exposure on bronchial hypereactivity (BHR) in two groups of asthmatic children allergic to house dust mites (HDM) living at high altitude for 9 continuous mo. In the first group the serum levels of total and HDM-specific IgE showed significant decreases after 3 mo (p < 0.001 and p < 0.02, respectively) and after 9 mo (p < 0.001). Three months after returning home the total IgE levels had increased significantly (p < 0.001). The mean percentage fall in peak expiratory flow after exercise testing improved after 3 and 9 mo (p < 0.05), but it had deteriorated after 3 mo at home (p < 0.01). The methacholine PD20-FEV1 increased after 3 mo (p = 0.001) and further after 9 mo (p < 0.001), with a decrease after the 3-mo period at sea level (p = 0.01). In the second cohort there was a significant increase in HDM PD20-FEV1 after 6 and 9 mo (p < 0.001), with a slight decrease of magnitude of the allergen-induced late reaction. Histamine PD20-FEV1 significantly increased after 6 and 9 mo at high altitude, particularly in the challenges performed after the HDM bronchial provocation (p < 0.01). Our data demonstrate that allergen avoidance in asthmatic children not only decreases nonspecific BHR but also decreases allergen sensitivity, late allergen-induced bronchial reactions, and enhancement of BHR by allergen challenge.
Effects of nedocromil sodium on the binding of N-formyl-methionyl-leucyl-phenylalanine in human neutrophils.
In the present study the inhibition by nedocromil sodium of the specific receptor binding of FMLP was evaluated in human neutrophils (PMNs) using a FMLP-(3H) binding assay. The time course of the binding was markedly influenced by nedocromil sodium used at a concentration of 300 microM. No significant inhibition was obtained when the cells were treated with nedocromil sodium 3 microM or with sodium cromoglycate 300 microM. FMLP binding is essentially eliminated by the highest dose of nedocromil sodium. The biologic meaning of this effect in asthmatic patients should be further evaluated.
Inhibition of different dosages of oxatomide or placebo on skin prick test and nasal allergen provocation.
In this two-stage, double-blind study, we evaluated the effects of different dosages of oxatomide (1 and 2 mg/kg/day) on nasal provocation and skin reaction wheal induced by grass-pollen challenge. Children with a positive history of allergic rhinoconjunctivitis and positive responses to skin prick test and nasal provocation test to grass pollen were studied out of season. The results obtained with 1 mg/kg/day of oxatomide demonstrated no significant difference in wheal areas and nasal secretion induced by allergen challenge between treated and untreated patients. The administration of 2 mg/kg/day demonstrated a significant suppression in wheal reaction and nasal secretion induced by specific challenge.
Double-blind evaluation of effectiveness and safety of flunisolide aerosol for treatment of bronchial asthma in children.
A double-blind study was carried out in 20 asthmatic children in order to evaluate the therapeutic efficacy and safety of inhaled corticosteroid flunisolide. 0.5 mg of the drug was administered by a jet nebulizer twice daily for 2 months. Respiratory symptoms, pulmonary function values and methacholine PC20-FEV1 were evaluated, as also morning cortisol levels, plasma cortisol increase after ACTH test, and 24-h urinary cortisol excretion. The data obtained show the efficacy of the drug in reducing symptoms. No significant difference was observed in pulmonary function values and in bronchial reactivity results between the two groups. No effect of flunisolide was observed on hypothalamic-pituitary-adrenal function. This study confirms the efficacy and safety of flunisolide (0.5 mg b.i.d.) in the treatment of asthmatic children.
Theophylline inhibition of BCG-induced pulmonary inflammatory responses.
The present study was performed to evaluate the effect(s) of theophylline on BCG-induced pulmonary inflammatory responses in an experimental rat model system. Five groups of six animals each received the following: group 1: theophylline-treated, BCG-challenged, and sacrificed three days later; group 2: saline-treated, BCG-challenged, and sacrificed three days later; group 3: theophylline-treated, BCG-challenged, and sacrificed five days later; group 4: saline-treated, BCG-challenged, and sacrificed five days later; and group 5: no treatment and no BCG-challenge ("absolute controls"). Quantitative recovery of bronchoalveolar lavage (BAL) cells was performed and compared with histopathologic changes in lung specimens from each animal in all five groups. No significant differences in quantitative BAL cellular recovery were observed in theophylline-treated animals from saline-treated controls. There was a significant reduction in BAL cell number in saline-treated animals sacrificed five days after BCG-challenge (group 4) from that seen in saline-treated animals sacrificed three days after BCG-challenge (group 2). The most striking finding, however, was a marked diminution in granuloma formation induced by theophylline five days after BCG challenge (group 3). These findings suggest an antiinflammatory effect of theophylline.
Changes in bronchial reactivity in asthmatic children after treatment with beclomethasone alone or in association with salbutamol.
Airway inflammation is consistently present in patients with severe asthma. The combination of inhaled steroids and bronchodilators may be useful both for treating symptoms and improving the underlying inflammatory condition. We have compared the effect of beclomethasone dipropionate (BDP) combined with salbutamol (S), BDP alone, and placebo, on the severity of bronchial responsiveness in 30 children with allergic asthma during the period of specific allergen exposure. In children treated with BDP alone, PC20-FEV1 methacholine was 0.66 +/- 0.54 at the beginning and 1.91 +/- 2.11 at the end of the study period (p greater than 0.05). In children treated with BDP + S PC20, methacholine was 1.21 +/- 1.43 at the beginning and 4.22 +/- 3.88 at the end of the study (p less than 0.05). The group of children treated with placebo had a PC20-FEV1 methacholine of 0.79 +/- 0.61 at the beginning of the study and 0.80 +/- 0.46 at the end of the study. The results of the present study show that maintenance treatment with inhaled beclomethasone combined with salbutamol may lead to greater improvement in bronchial hyperreactivity than treatment with inhaled beclomethasone dipropionate alone.
Efficacy and duration of action of placebo responses in the prevention of exercise-induced asthma in children.
Exercise-induced bronchoconstriction, a common phenomenon in asthmatic children, may be prevented by the administration of appropriate drugs. In this study we evaluated the effect and duration of action of placebo (Freon gasses) administered to the patients as a protective drug. The maximum decrease in forced expiratory volume in 1 second (FEV1) after exercise testing was 40.3% +/- 3.10 at the initial screening session and, on different study days, 23.3% +/- 3.57, 28.8% +/- 3.86, and 33.7% +/- 3.71 30, 120, and 240 minutes, respectively, after the administration of Freon gasses. There was a linear trend indicating a reduction in protection with time. The placebo effect was marked 30-120 minutes after treatment (p less than 0.01) and completely disappeared after 4 hours. The placebo effect should always be considered in the evaluation of any new antiasthmatic drug.