Long-term treatment of asthma with beta2-agonists.
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Biomedical subjects
Publications and source records attributed to R Matusiewicz.
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The study aimed at assessing an effect of Cs A on spirometric indices in 30 patients with steroid-dependent bronchial asthma. All patients were treated with triamcinolone in a mean daily dose of 6-8 mg for at least 5 years. Half of patients were given in a double blind trial cyclosporin in a daily dose of 100 mg for 2 years. The remaining 15 patients were not given cyclosporin. All patients were also given corticosteroids, methylxanthines, and mucolytics. Statistically significant increase in FVC, FEV1, and PEFR was noted in patients treated with cyclosporin after 2 years while no change was seen in patients not given Cs. At the same time, a reduction of corticoids doses and diminished of post-steroid symptoms were noted in patients treated with cyclosporin.
The granulocyte migration inhibition tests both in vivo and in vitro from allergic skin infiltrations were carried out in 30 patients with atopic asthma and in 20 healthy people used as a control. It was found that the migration of leukocytes from allergic skin infiltrations was defective with the lowest ability to migrate. Neutrophils comprised about 80% cells found in the cutaneous allergic infiltrations.
A test to determine engulfing of neutral latex particles and Staphylococcus aureus by peripheral blood granulocytes was carried out in 28 healthy children who had at least one parent with infectious asthma and 13 children, in whom both parents had infectious asthma. A defect in engulfing neutral latex particles and Staphylococcus aureus by granulocytes was demonstrated in children who had both parents with infectious asthma.
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The study was carried out in 40 patients with atopic asthma, age 16-31 years (mean 26 years) and 30 healthy volunteers, age 19-25 years (mean 20 years). In vivo granulocyte migration tests were carried out simultaneously using two methods: Southam's and the authors' original (Matusiewicz, Brzezińska). The above mentioned tests were carried out twice: the first time in December/January, the second time February/March after subcutaneous administration of PAF. The authors have demonstrated that in patients with atopic asthma a defect in migration of tissue granulocytes is present. They have also shown that PAF does not effect significantly granulocyte migration in atopic patients.
After critical evaluation of the composition and technology of preparation of nonspecific bacterial vaccines (nsb) some of them were withdrawn from the production (Neoflaminum, Neurovaccinum) and replaced with a new one (Polyvaccinum submite). Part of them were modified (media) and modernised (Panodinum, vaccine according to Delbet). Panodine produced at the present is free from bovine bile, which according to the results of the studies is strongly haemolytic for human and animal red blood cells. Thus it was justified to withdraw this component from Neoflaminum and Panodinum preparations. Purity and degree of lysis of these preparations were evaluated on the basis of ratio between nucleic acid absorbance and protein absorbance A260/A280. This allowed to determine if nsb tested are partially lysed and if their production process is reproducible. Our pilot studies on five patients suffering from infectious asthma indicate that a restoration of phagocytic activity of granulocytes and an increase of leukocytes migration after subsequent Panodine injections take place.
In 274 outpatients with chronic spastic bronchitis long-term treatment with corticosteroids was used due to their clinical condition. In patients treated for 6 years with daily doses of 1-2 mg of prednisolone no corticosteroid-induced complications were observed. Transient ecchymoses occurred in patients treated for longer time periods with prednisolone 4 mg daily. In 12.5% of patients pityriasis versicolor developed, and muscle weakness was the complaint in 3.1% of cases. In patients treated with 6 mg daily of prednisolone petechiae were noted in 35% of cases, in 10% subcutaneous tissue atrophy, in 2.5% osteoporosis was observed, and menstruation disturbances were reported in 25% of the treated women. In patients receiving prednisolone 8 mg daily subcutaneous extravasations developed in 80% of cases, skin atrophy in 50%, myopathy in 25%, crural thrombophlebitis in 5%, cushingoid features in 7.5%. In patients receiving prednisolone 12 mg daily, besides the above complications, fractures occurred in 14.2% of cases, and psychotic symptoms in 7%.
The test of engulfing of neutral latex particles and Staphylococcus aureus by peripheral blood granulocytes was carried out in 37 healthy children who had at least one parent with asthma and in 14 children, both of whose parents had asthma. A defect of engulfing neutral latex particles and S. aureus by granulocytes was demonstrated in children who had both parents with asthma.
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In 42 patients with infectious bronchial asthma, aged 18-44 years (average 34) the levels of serum IgM, IgG, IgA and IgE were measured. Additionally, latex particles engulfment and nitroblue tetrazolium (NBT) tests according to the method of Park modified by the authors were performed. The control group consisted of 20 healthy people aged 22-45 years (average 39). It was found that in patients with infectious bronchial asthma, during the dyspnoeic attack a defect occurs in the engulfment of latex particles by peripheral blood granulocytes: The ability of granulocytes to engulf latex particles is inversely proportional to the IgG levels in sera of infectious asthma patients.
The test of leukocyte migration was carried out in vitro and in vivo in 162 patients suffering from chronic bronchitis with bronchospasm, who had been treated with corticosteroids for long time periods. Half of the patients were given TFX "Polfa" besides corticosteroids. TFX was found to have no effect on the leukocyte migration ability in vivo and in vitro. However, a significant improvement was observed in the clinical state of the patients taking TFX.
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Healthy children of atopically asthmatic parents received in vivo and in vitro granulocyte migration tests. Eleven children whose parents were both asthmatic showed statistically significant inhibition of granulocyte migration compared with controls.
Investigations were carried out on the ability of the granulocytes in the tissue pool and vascular pool of 50 healthy subjects to engulf latex particles and to reduce NBT in the test of Park as modified by the authors. In six subjects the investigation was carried out using bone marrow granulocytes. It was demonstrated that 0.2% of bone marrow granulocytes, 11% of vascular granulocytes and 93% of those in the tissue pool had the ability of NBT reduction. The ability to engulf neutral latex particles was exhibited by 6% of bone marrow granulocytes, 93% of those from the vascular pool, and 100% of those in the tissue pool.
Sixty-five patients with atopic asthma, 54 with infectious asthma, and 30 healthy controls were evaluated by in vitro granulocyte migration and by the in vivo skin window method of Southam. Quantitative IgM, IgG, IgA, IgE serum concentrations were measured. In vivo migration of granulocytes was decreased in patients with atopic asthma and elevated levels of IgE as well as in patients with infectious asthma and elevated levels of IgG. In vivo migration of granulocytes showed significant decreases in both asthmatic groups only during asthmatic attacks.
In 50 patients with atopic asthma aged 18-32 (average 25) the level of serum IgE was measured radioimmunologically and the peripheral leukocyte migration in agar plates was determined. The control group consisted of 20 healthy people aged 20-31 (average 26). An increased level of IgE was found in 39 atopic patients. Statistically significant inhibition of peripheral leukocyte migration was noted. In each patient the degree of inhibition of migration was reciprocal to the concentration of serum IgE.
The granulocytes obtained from patients with atopic diseases were investigated for their ability to engulf neutral latex particles and bacteria (S. aureus) in the presence of antigenically compatible sera of healthy subjects. Similar tests were done using the granulocytes of healthy subjects and sera of the patients with atopic diseases, and the granulocytes of these patients in autologous sera. Granulocytes of healthy subjects suspended in autologous sera served as a control. In all patients IgE globulins were determined in the serum. It was observed that only granulocytes from the patients with atopy showed a defect in engulfing latex particles and S. aureus. This defect was independent of the serum in which these granulocytes were suspended, and of the IgE level in the patient's serum.