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Biomedical subjects

M Halonen

Publications and source records attributed to M Halonen.

At least 55 records · Page 3Linked to original sources

Recurrent cough in childhood and its relation to asthma.

Risk factors for recurrent cough (RC) in childhood, and its relation to asthma were investigated as part of the prospective, longitudinal Tucson Children's Respiratory Study. RC, defined as > or = 2 episodes of cough without a cold in the past year, was assessed by questionnaire in 987 children at age 6. Children having RC without wheeze (n = 154) did not differ from children with neither symptom (n = 610) in serum IgE levels, skin test response, size-corrected forced expiratory flow, or percentage of decline following cold air challenge. In contrast, children with both RC and wheeze (n = 116) had significantly more respiratory illness, more atopy, lower flow at end-tidal expiration (V'maxFRC), and greater declines in lung function following cold air challenge than children with neither symptom. Current parental smoking was a risk for RC without wheeze, whereas male gender, maternal allergy, wheezing lower respiratory tract illness (LRI) in early life, and high IgE were significant risks for RC with wheeze, compared with children having neither symptom. RC early in life resolved in the majority of children, between ages 2-3 yr and age 6, and between age 6 and age 11. High IgE and positive skin prick test were associated with persistence of RC to age 6 among children who wheezed, and markers of allergy were associated with persistence of RC between 6 and 11 yr. These findings suggest that recurrent cough in the absence of wheeze differs in important respects from classic asthma, and using the same label to refer to these distinct syndromes may obscure their diverse pathophysiologies.

Asthma↗

Segregation analysis of physician-diagnosed asthma in Hispanic and non-Hispanic white families. A recessive component?

The inheritance of asthma, evident from its high family concordance, is not well understood. To investigate whether asthma may be inherited through a major gene with two alleles, segregation analyses were conducted in 3,369 individuals from 906 nuclear families enrolled, without selection, in a longitudinal study of respiratory health in Tucson, Arizona. Physician-diagnosed asthma and its age of onset were ascertained for each family member when children were at a mean age of 7 yr. Age of asthma diagnosis was allowed for in analyses, and the impact of the covariate total serum IgE level on age of onset was examined. Segregation analyses were conducted with and without residual family effects, with and without the covariate IgE. The hypothesis of a single two-allele locus for asthma was rejected. However, depending on the method of assessment of the residual familial effects, either a polygenic/multifactorial mode of inheritance alone, or an oligogenic model with some evidence of a recessive component present in the population with the high frequency of 0.67, were compatible with the data. Results were unchanged with the addition of the covariate IgE.

Adult↗

Asthma and wheezing in the first six years of life. The Group Health Medical Associates.

BACKGROUND: Many young children wheeze during viral respiratory infections, but the pathogenesis of these episodes and their relation to the development of asthma later in life are not well understood. METHODS: In a prospective study, we investigated the factors affecting wheezing before the age of three years and their relation to wheezing at six years of age. Of 1246 newborns in the Tucson, Arizona, area enrolled between May 1980 and October 1984, follow-up data at both three and six years of age was available for 826. For these children, assessments in infancy included measurement of cord-serum IgE levels (measured in 750 children), pulmonary-function testing before any lower respiratory illness had occurred (125), measurement of serum IgE levels at nine months of age (672), and questionnaires completed by the children's parents when the children were one year old (800). Assessments at six years of age included measurement of serum IgE levels (in 460), pulmonary-function testing (526), and skin allergy testing (629). RESULTS: At the age of six years, 425 children (51.5 percent) had never wheezed, 164 (19.9 percent) had had at least one lower respiratory illness with wheezing during the first three years of life but had no wheezing at six years of age, 124 (15.0 percent) had no wheezing before the age of three years but had wheezing at the age of six years, and 113 (13.7 percent) had wheezing both before three years of age and at six years of age. The children who had wheezing before three years of age but not at the age of six had diminished airway function (length-adjusted maximal expiratory flow at functional residual capacity [Vmax FRC]) both before the age of one year and at the age of six years, were more likely than the other children to have mothers who smoked but not mothers with asthma, and did not have elevated serum IgE levels or skin-test reactivity. Children who started wheezing in early life and continued to wheeze at the age of six were more likely than the children who never wheezed to have mothers with a history of asthma (P < 0.001), to have elevated serum IgE levels (P < 0.01), to have normal lung function in the first year of life, and to have elevated serum IgE levels (P < 0.001) and diminished values for VmaxFRC (P < 0.01) at six years of age. CONCLUSIONS: The majority of infants with wheezing have transient conditions associated with diminished airway function at birth and do not have increased risks of asthma or allergies later in life. In a substantial minority of infants, however, wheezing episodes are probably related to a predisposition to asthma.

Algorithms↗

Association of interleukin-2 and interferon-gamma production by blood mononuclear cells in infancy with parental allergy skin tests and with subsequent development of atopy.

The mechanisms regulating the onset of atopic sensitization in human beings are not yet fully clarified. We assessed the capacity of mitogen-stimulated umbilical and peripheral blood mononuclear cells to produce interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) at birth and at 9 months of age in 159 infants. Mononuclear cell production of both IFN-gamma and IL-2 at 9 months, but not at birth, was found to be inversely related to parental immediate skin test reactivity to seven local aeroallergens. Skin test reactivity at the age of 6 years was also inversely related to IFN-gamma and IL-2 production at 9 months of age. However, no relationship was evident between total serum IgE levels at 6 years and production of these cytokines at 9 months. The proportions of circulating lymphocytes and CD4+ or CD8+ cells were also unrelated to skin test reactivity at the age of 6 years. These data suggest that mechanisms regulating skin test reactivity to inhaled allergens may involve deficient IFN-gamma production, deficient IL-2 production, or both during or preceding the time of initial sensitization and that additional mechanisms are involved in regulating total serum IgE level.

Adult↗

Association of non-wheezing lower respiratory tract illnesses in early life with persistently diminished serum IgE levels. Group Health Medical Associates.

BACKGROUND: The role of lower respiratory tract illnesses (LRIs) in the development of allergies is not well understood. The relation of wheezing and non-wheezing LRIs to serum IgE levels and atopy was studied in 888 children. METHODS: Total serum IgE levels were measured at birth, nine months and six years of age; and interferon gamma production by blood mononuclear cells was measured at birth and nine months. Atopy was determined by skin prick tests at age six. Wheezing and non-wheezing LRIs up to age three were diagnosed by a physician. RESULTS: Cord serum IgE levels were similar between all LRI groups and the no LRI group. Children who had wheezing LRIs until the age of three had IgE levels at nine months and at six years within normal ranges for age. In contrast, children who had a non-wheezing LRI before the nine month IgE sample had lower IgE levels at nine months and six years (geometric mean 1.8 IU/ml and 9.9 IU/ml, respectively) compared with children who had no LRIs (3.9 IU/ml and 38.3 IU/ml, respectively). Children who had non-wheezing LRIs after the nine month IgE sample had normal nine month IgE levels (3.2 IU/ml) but decreased IgE levels at six years of age (15.7 IU/ml). Children with more than one non-wheezing LRI before the age of three were less likely to be atopic than those with no LRI (odds radio 0.2). Interferon gamma production was higher in the non-wheezing LRI group at nine months than in the no LRI or wheezing LRI groups. CONCLUSIONS: Non-wheezing LRIs are associated with subsequent depression of IgE levels and reduced skin test reactivity.

Child, Preschool↗

Longitudinal evaluation of the association between pulmonary function and total serum IgE.

The role of immunoglobulin E (IgE) in the development and course of impaired ventilatory function and chronic obstructive pulmonary disease (COPD) required further study. This role has been examined in the longitudinal Tucson Epidemiological Study of Airways Obstructive Disease, which started in 1972. The association between IgE and longitudinal changes in pulmonary function measures was examined in subjects in the community population sample in Tucson who had an initial age of 35 or more. There were a total of 1,533 such subjects with lung function tests over the 20 yr period who also had IgE determinations. A significant inverse association was found between total serum IgE and FEV1/FVC that was independent of smoking and asthma status. The finding was statistically separate from the relation with age in all but elderly current smokers (age > 55). The magnitude of this effect in nonasthmatic subjects was relatively small. For asthmatic subjects, however, the inverse association was larger in both current and never smokers. Subjects excluded from the current analysis either did not have an IgE measurement and/or had no pulmonary function values after 35 yr of age. These findings suggest that higher IgE levels may indicate the presence of a disease process that may involve inflammation and/or other mechanisms related to IgE production, which impair lung function over time. However, in this study we were not able to account for possible parental or inheritance contributions to increases in total IgE, which have been shown to be important.

Adult↗

Regulation of airway muscarinic cholinergic receptor subtypes by chronic anticholinergic treatment.

Anticholinergic agents are commonly used as bronchodilators for patients with airway obstructive diseases. The effects of chronic anticholinergic therapy on airway function and bronchial responsiveness are not known, but data from clinical studies suggest the possibility of adverse effects. We demonstrated in rabbits that, after atropine treatment for 4 weeks, the efficacy (maximum contraction) of in vitro methacholine-induced contraction of mainstem bronchi was increased [control (untreated), 1.0 +/- 0.1 g; atropine-treated, 1.6 g +/- 0.2 g; p = 0.04]. However, there was no significant change in the potency (EC50) of methacholine-induced contraction. Chronic atropine treatment increased the maximum density (Bmax) of muscarinic receptors in the airways, as determined by radioligand binding studies with tritiated quinuclidinyl benzilate. Individual muscarinic receptor subtypes were measured using antibodies selective for the m1-m5 subtypes. Of the subtypes detected in rabbit tracheal smooth muscle (m2, m3, and m4), only the m2 and m3 muscarinic receptor subtypes were significantly up-regulated compared with control, after chronic atropine treatment. Because cholinergic agent-mediated contraction of smooth muscle has been shown to be mediated by m3 muscarinic receptors, the atropine-induced increase in the methacholine response in airway smooth muscle appears to be the result of the up-regulation of m3 muscarinic cholinergic receptors. Such a mechanism may explain the clinical observations that chronic anticholinergic therapy for asthmatic patients is associated with an increase in bronchial responsiveness and that continuous versus "on demand" anticholinergic bronchodilator therapy may cause an accelerated decline in ventilatory function.

Animals↗

Relationships between total serum IgE, atopy, and smoking: a twenty-year follow-up analysis.

BACKGROUND: A number of cross-sectional studies have demonstrated that higher levels of IgE are found in subjects who currently smoke cigarettes and/or who are atopic and that IgE levels decline with age. OBJECTIVE: This report examines the interactions among atopic status, smoking, and IgE with longitudinal data and methods. METHODS: Subjects were participants in the Tucson Epidemiological Study of Airways Obstructive Disease and were 6 years of age and older. Total serum IgE measures and allergen skin test results were obtained during three surveys spanning a period of up to 20 years. RESULTS: The results showed no significant gender differences between nonatopic nonsmoking subjects, who were considered the reference group. Nonatopic current smokers had IgE levels similar to those of the reference subjects initially, but IgE levels did not decline with age at the same rate as in the reference subjects, causing significant differences at older ages. There was a significant relationship between number of cigarettes smoked and IgE level. CONCLUSIONS: Atopy and smoking are both associated with elevated total serum IgE levels. Although the exact mechanism for elevated IgE levels in smokers is not known, the significant dose relationship is suggestive of a causal association.

Age Factors↗

Epidemiology of physician-diagnosed allergic rhinitis in childhood.

OBJECTIVE: To investigate the natural history of and risk factors for allergic rhinitis in the first 6 years of life. METHODS: Parents of 747 healthy children followed from birth completed a questionnaire when the child was 6 years old. Data were obtained regarding physician-diagnosed allergic rhinitis (PDAR), associated symptoms, and age at onset. Risk-factor data were taken from earlier questionnaires, and data regarding immunoglobulin E (IgE) and skin-test reactivity were obtained at age 6. RESULTS: By the age of 6, 42% of children had PDAR. Children whose rhinitis began in the first year of life had more respiratory symptoms at age 6 and were more likely to have a diagnosis of asthma. Early introduction of foods or formula, heavy maternal cigarette smoking in the first year of life, and higher IgE, as well as parental allergic disorders, were associated with early development of rhinitis. Risk factors for PDAR that remained significant in a multivariate model included maternal history of physician-diagnosed allergy (odds ratio: 2.2, 95% confidence interval: 1.35-3.54), asthma in the child (4.06, 2.06-7.99), and IgE greater than 100 IU/mL at age 6 (1.93, 1.18-3.17). The odds for atopic as opposed to nonatopic PDAR were significantly higher only among those with high IgE and those who had dogs. CONCLUSION: Allergic rhinitis developing in the first years of life is an early manifestation of an atopic predisposition, which may be triggered by early environmental mental exposures.

Age of Onset↗

Evidence for Mendelian inheritance of serum IgE levels in Hispanic and non-Hispanic white families.

Considerable evidence is available suggesting a significant genetic component in the pathogenesis of asthma, but the mechanism of inheritance is not well understood. The main objective of this study was to assess if total serum IgE level, a known intermediate phenotype for asthma, is under the control of a major autosomal gene. We studied nuclear families participating in the Tucson Children's Respiratory Study in Tucson and originally selected because they belonged to a health maintenance organization. One hundred twenty-five Hispanic and 673 non-Hispanic White nuclear families were eligible; 50 Hispanic families (with 191 subjects) and 241 non-Hispanic White families (with 886 subjects) were included. Prevalence of asthma, hay fever, and parental smoking was similar among eligible families who were included and those who were not. Segregation analyses using regressive models for continuous traits showed that the best fit to the data was given by a model of Mendelian codominant inheritance of a major autosomal gene associated with higher serum IgE level. Log-likelihood for this model was not significantly different from that of the best-fitting ("unrestricted") model (P = .3) and was significantly better than log-likelihood for a dominant model (P < .0001) and a recessive model (P < .0001). An environmental model showed significant departure (P < .0001) from the unrestricted model. Tests for genetic heterogeneity showed no significant difference between the two ethnic groups. The data strongly suggest that total serum IgE levels are controlled by a major autosomal codominant gene.

Arizona↗

Chronic exposure to a beta 2-adrenoceptor agonist increases the airway response to methacholine.

Scheduled chronic administration of beta 2-adrenoceptor agonist bronchodilators in patients with asthma recently has been reported to be associated with a worsening of symptoms and an increase in bronchial responsiveness. We wanted to determine whether a 28-day in vivo exposure to albuterol (beta 2-adrenoceptor agonist) altered the response of rabbit airways to the cholinergic agonist methacholine. We found, using in vitro tissue bath techniques, that in mainstem bronchi from rabbits given a 28-day exposure to albuterol, maximum contraction to methacholine was increased in the albuterol-treated group (control group = 1.10 +/- 0.11 g vs. treated group = 1.50 +/- 0.13 g, P < 0.05). The potency (EC75) was also increased in the albuterol-treated group. The potency for the control group was 5.6 microM (95% confidence limit: 2.3-13 microM) and was 1.7 microM (95% confidence limit: 1.1-2.8 microM, P < 0.05) for the albuterol-treated group. In a subgroup of animals, maximum contraction to KCl, a receptor-independent contractile stimulus, was not significantly different between the groups (control group = 0.79 +/- 0.23 g vs. treated group = 0.82 +/- 0.20 g). The potency (EC50) for KCl-induced contractions was also not significantly different between the groups: control = 12 mM (95% confidence limit: 3.3-44 mM) vs. treated 19 mM (95% confidence limit: 18-20 mM). These data demonstrate that chronic in vivo exposure to a beta 2-adrenoceptor agonist can alter the in vitro tissue bath response of airway smooth muscle to methacholine.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗

The effects of combined histamine and platelet-activating factor antagonism on systemic anaphylaxis induced by immunoglobulin E in the rabbit.

Of the mediators released during IgE-induced allergic reactions, it is not known which have the greatest physiologic import in systemic anaphylactic responses. This study describes the effects of histamine and platelet-activating factor (PAF) antagonism (combined) on IgE-induced systemic anaphylaxis in the rabbit. Pretreatment with 30 mumol/kg chlorpheniramine and 30 mumol/kg cimetidine with (Ch/Ci/WEB group) or without (Ch/Ci group) 2.2 mumol/kg of the PAF antagonist WEB 2086 inhibited the anaphylactic alterations in right ventricular pressure, total pulmonary resistance, and decrease in dynamic compliance but not systemic hypotension. Lethality was inhibited only in the Ch/Ci/WEB group. Because previous studies had shown WEB 2086 alone could inhibit the increase in pulmonary resistance, specificity studies were done to determine if WEB 2086 affected histamine activity or release. Responses to intravenously administered histamine (0.54 mumol/kg) were unaffected by WEB 2086 (13.1 mumol/kg). Also, WEB 2086 did not inhibit in vitro antigen-induced basophil degranulation. Thus, the decrease in dynamic compliance and pulmonary hypertension in IgE anaphylaxis appear to be mediated primarily by histamine and the increase in pulmonary resistance by histamine and/or PAF, whereas lethality appears to involve PAF. Some alterations, most notably systemic hypotension, likely involve other allergic mediators.

Airway Resistance↗

Cloning of a human platelet-activating factor receptor gene: evidence for an intron in the 5'-untranslated region.

A clone encoding a gene for a human platelet-activating factor (PAF) receptor has been isolated from a human genomic library. A 6-kb Hind III fragment was subcloned and was found to contain a full coding sequence identical with that previously reported for cDNA clones encoding PAF receptors from leukocyte cDNA libraries. Sequencing of the 6-kb Hind III fragment upstream from the start codon revealed that the 5'-untranslated region deviated from reported cDNA sequences beginning at base -39, suggesting the presence of an intron in this region. Consensus sequences for a splice junction appear appropriately located at the predicted 3' end of the purported intron. Restriction map analysis of the region revealed that the size of the intron in the 5'-untranslated region was at least 16 kb. These data indicate that a gene for a human PAF receptor is present in the genome without introns in the coding sequence and that splicing of mRNA encoding PAF receptors appears to occur in the 5'-untranslated region.

Amino Acid Sequence↗

Antigen enhances neuronally induced contraction of intrapulmonary bronchi from IgE-producing rabbits.

The effect of in vitro antigen exposure on contraction induced by electrical field stimulation (EFS) was examined in bronchial rings isolated from rabbits producing specific IgE antibodies. After exposure to antigen, tissues showed an enhanced isometric contractile response to EFS especially at low frequencies, leading to a significant change in the mean slope factor (p less than 0.05) derived from modeling the log frequency response curve using a 4-parameter logistic function. Also, the mean log EF20 +/- SEM decreased from 1.03 +/- 0.05 to 0.88 +/- 0.07 Hz (p less than 0.02). This antigen-induced effect was blocked by pretreatment with 3 microM chlorpheniramine and not observed in unsensitized tissues. Antigen challenge of tissues passively sensitized with IgE (but not IgG) antibodies led to a similar EFS-enhancing effect, significantly reducing the mean slope factor (p less than 0.025). Substituting EFS with exogenous acetylcholine resulted in no antigen-induced enhancement of contraction. The data suggest that antigen-IgE interaction leads to local histamine release sufficient to enhance the function of excitatory airway neurons.

Animals↗

Lymphocyte subpopulation number and function in infancy.

Normal values for percentages of lymphocyte subpopulations and functional responses to mitogen stimulation in infancy are not well established. In the present study, lymphocyte subpopulations were examined in umbilical cord blood samples and in peripheral blood samples drawn before 7 and 24 months of age (mean age 10.4 months) from a healthy population of infants born in Tucson, Arizona. Results indicate significant increases occurred from birth to later infancy in the percentages of total T cells (CD3), T-cell subsets (CD4, CD8) and B cells (CD20). The CD4/CD8 ratio and the functional responses to ConA and PWM mitogens significantly decreased from birth to later infancy. PHA responsiveness did not show a significant change. Results from cross-sectional analyses (n = 271) were supported in a smaller longitudinal subset (n = 37). There were no detectable ethnic- or gender-related differences in cord blood or samples obtained in later infancy. The normal values established in this study will be useful in studies of immune-system maturation and in the clinical evaluation of newborns, infants, and toddlers suspected of either acquired or congenital immune-deficiency states.

Cell Count↗

The predictive relationship between serum IgE levels at birth and subsequent incidences of lower respiratory illnesses and eczema in infants.

Cord serum IgE levels are predictive of subsequent atopic diseases early in life. Lower respiratory illnesses (LRI) have often been included with atopic diseases in infancy but have not been examined as a separate entity for a relation to cord IgE levels. Among 767 healthy newborns in Tucson, Arizona studied longitudinally, cord serum IgE levels were directly related to the subsequent incidence of eczema. In contrast, the incidence of LRI not only failed to show a direct relationship to IgE levels but actually decreased with increasing cord IgE levels from 34.8% in the lowest cord IgE group to 22.2% in the highest IgE group (greater than 1.0 IU/ml IgE; p for trend chi-square less than 0.03). Limiting LRI to those with wheeze did not alter the inverse relationship with IgE levels. The inverse LRI-IgE relationship was strong for non-RSV LRI, whereas RSV LRI had neither a direct nor an inverse relationship. These inverse LRI-IgE relationships were significant for LRI occurring in infants before but not after 6 months of age. Maternal (but not paternal) allergic history was associated with higher cord IgE levels and with an increased incidence of LRI, the latter effect being independent of IgE. This study suggests that most LRI in the first year of life are not early manifestations of an allergic predisposition.

Arizona↗

A minority of muscarinic receptors mediate rabbit tracheal smooth muscle contraction.

To enhance our understanding of cholinergic mechanisms and muscarinic receptors in bronchoconstriction, we have characterized the muscarinic receptor subtypes in rabbit tracheal smooth muscle using radioligand binding and functional assays. The Kd for [3H]quinuclidinyl benzilate ([3H](-)QNB) binding determined from saturation isotherms was 12.6 x/divided by 1.1 pM (geometric mean x/divided by SEM), and the Bmax was 269 +/- 7 fmol/mg protein (arithmetic mean +/- SEM). Competitive inhibition studies with the muscarinic antagonists pirenzepine (PZ), 11[[2-[(diethylamino)-methyl]1-piperidinyl]acetyl]-5,11-dihydro-6H- pyrido[2,3-b][1,4]benzodiazepine-6-one (AF-DX116), 4-diphenylacetoxy-N-methylpiperidine methobromide (4-DAMP), and hexahydrosiladifenidol (HHSiD) demonstrated heterogeneity of muscarinic receptor subtypes in rabbit tracheal smooth muscle. PZ bound with low affinity to a single receptor site, indicative of an absence of M1 receptors. AF-DX116 (M2 selective) bound with high affinity to approximately 83% of muscarinic binding sites, and 4-DAMP and HHSiD (M3 antagonists) bound with high affinity to approximately 24 and 28% of muscarinic binding sites, respectively. Additionally, direct binding studies with [3H]4-DAMP demonstrated high-affinity binding with 23% of muscarinic binding sites. Thus, the majority of muscarinic receptors in rabbit tracheal smooth muscle bound with high affinity to an M2-selective antagonist, and the remaining receptor sites bound with high affinity to M3 antagonists. The inhibitory effects of atropine, PZ, AF-DX116, and 4-DAMP on methacholine-induced contraction of rabbit tracheal rings were compared. 4-DAMP was a potent inhibitor of methacholine-induced contraction, but PZ and AF-DX116 demonstrated low potency.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗