[Role of theophylline in treatment of chronic obstructive pulmonary disease].
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Biomedical subjects
Publications and source records attributed to M Kraus-Filarska.
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The migration of neutrophils is an important part of the allergic inflammatory response. The aim of our study was to investigate the effect of glucocorticosteroids (GCS) on the stimulated and unstimulated migration of neutrophils. The study comprised 103 asthmatics including 44 subjects under GCS therapy (20 GCS resistant and 24 GCS sensitive) as well as 96 healthy control individuals. Unstimulated (random) motility as well as chemotactic response towards fMLP (10-8 mol/l) were determined after Boyden method. Neutrophil motility was determined by the distance of the leading front in filter. In both resistant and sensitive asthmatics under GCS therapy we observed significantly increased unstimulated motility as compared to normal controls (p < 0.001). However, this effect was not demonstrated in the GCS untreated group. Neutrophil chemotaxis towards fMLP was increased in GCS untreated group as compared to healthy controls (p < 0.05). In GCS sensitive subjects the chemotatic activity was decreased. In GCS resistant asthmatics it was moderately increased. We conclude that increased unstimulated neutrophil motility might be one of the immunosuppressive mechanisms of GCS by preventing the cell accumulation at the sites of inflammation.
Eosinophil cationic protein (ECP) was measured in blood serum of 15 atopic asthmatics during early (EAR) and late (LAR) asthmatic reaction triggered by specific allergen provocation. Nonspecific bronchial hyperreactivity was evaluated in histamine provocation test before and 48 hours after the allergen challenge. We observed dual asthmatic reaction (DAR) in 8 and an isolated EAR in 7 patients. The ECP serum level and nonspecific bronchial hyperreactivity were significantly higher (p < 0.05) in the DAR group when compared to EAR responders. An inverse correlation between PC20 for histamine and ECP level was shown before and after the allergen challenge in all examined subjects (R = -0.5472, p < 0.05).
In this study we have measured spontaneous and allergen induced basophil histamine release before and 24 hours after specific allergen bronchoprovocation challenge. Non-specific bronchial hyperreactivity was estimated twice: before and after allergen challenge. 15 atopic asthmatic entered the study. 8 of them developed only early asthmatic reaction and 7 demonstrated dual asthmatic reaction. In dual responders group higher values of spontaneous basophil histamine release before and increase of allergen induced basophil histamine release after specific allergen bronchoprovocation challenge were observed. There was an inverse correlation between values of allergen induced basophil histamine release and values of PC20 for histamine.
Allergic asthmatic patients were challenged with specific allergen resulting in early and dual asthmatic reaction. FMLP induced granulocyte chemiluminescence was measured before and in 10 min, 60 min, 4 hours and 24 hours after allergen challenge. We have observed significant decrease of granulocyte chemiluminescence in both groups. In patient with early asthmatic reaction decrease of luminescence was observed during first hour only. In patients with dual asthmatic reaction decrease of luminescence was observed during 24 hours after allergen challenge.
The chemotactic response of peripheral blood lymphocytes from nonatopic asthmatics and healthy subjects in the gradients of various bacterial strains obtained from the airways of the asthmatic patients was investigated. The dominant autologous strains were found to be effective chemoattractants for lymphocytes form the asthmatics. However, none of the bacterial strains investigated in this study induced increased motility of lymphocytes from healthy subjects. These findings might explain the mechanisms of the accumulation of lymphocytes in the airways of nonatopic asthmatics.
Clinical study on efficiency of the nedocromil sodium (Tilade, Fisons) was performed in 20 patients with atopic and nonatopic bronchial asthma. The drug was administrated in dose of 8 mg per day for 2 months which allowed to renounce regular using of Beclocort forte after 7 days of the treatment. In both types of bronchial asthma the positive effect of nedocromil sodium was confirmed, causing increase of pulmonary ventilation and decrease of bronchial hyperactivity. Especially profitably effect was noticed in atopic bronchial asthma in which statistically important increase of peak expiratory flow (PEF) was obtained and decrease of bronchial hyperreactivity by PC20 for histamine was observed (p < 0.05). Mentioned above spirometric parameters did not differ in statistically important pattern in patients with nonatopic bronchial asthma, when Beclocort forte group with Tilade group compared. Neither important differences in general number of cells nor percentage composition of cell smears were observed in bronchoalveolar lavage fluid.
The chemotactic response of peripheral blood MNC from healthy subjects and non-atopic asthmatics against the respective pathogen isolated and cultured from sputum of individual patients was investigated. We found that the wide range of concentrations of autologous bacteria induced chemotaxis of MNC from asthmatics but showed no influence on MNC from healthy subjects. This finding might explain the mechanism of lymphocyte accumulation in the lungs of non-atopic asthmatics.
In 15 patients with non-atopic bronchial asthma bronchial aspirates were carried out. Bacterial strains were isolated from the aspirates and used to produce material for provocation tests andautologous vaccines. Bronchoprovocation was carried out twice--before and after treatment with autovaccines. A decrease in bronchial reactivity was seen after treatment with autologous vaccines. The improvement in spirometric indices was accompanied by clinical improvement in 11 out of the 15 treated cases (73.3%).
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In 40 patients with infectious bronchial asthma and in 40 patients with atopic form of the disease, the behavior of T and B lymphocyte populations was studied by the E and EAC rosette tests. The control group consisted of 20 students unaffected by allergic diseases. A significant decrease in the percentage of E rosette forming T lymphocytes was found in the group of patients with atopic bronchial asthma, as compared with the control and infectious bronchial asthma groups (p less than 0.001). The proportions of EAC forming B lymphocytes showed no significant differences in all groups under examination.
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