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PubMed2004

Induction of bone-marrow eosinophilia in mice submitted to surgery is dependent on stress-induced secretion of glucocorticoids.

1 We examined bone-marrow in mice receiving subcutaneous implants of heat-coagulated egg white, which are known to present chronic eosinophilic inflammation at the implant site. Egg white implants (EWIs) induced marked bone-marrow eosinophilia, and increased bone-marrow cell responses to granulocyte-macrophage colony-stimulating factor and interleukin-5 in culture. These effects were observed as early as 24 h and lasted for, at least, 30 days in implant recipients. 2 We found, however, that increased eosinophil production was also observed in control mice which underwent surgery but received no EWI (sham-implanted mice), up to 15 days post-surgery. As this suggests an important contribution of nonspecific stress mechanisms to eosinopoiesis, we further evaluated the role of stress hormones produced by the adrenal glands in the bone-marrow eosinophilia of sham-implanted mice. 3 Bone-marrow eosinophilia in mice undergoing surgery was dissociated from increases in other haemopoietic lineages. Surgery by itself increased circulating corticosterone levels by 24 h, and the increase was prevented by inhibition of adrenal glucocorticoid production by metyrapone. The effect of surgery on bone-marrow eosinophilia was prevented by pretreatment with both the glucocorticoid receptor antagonist, mifepristone, and metyrapone, and by surgical adrenalectomy. 4 By contrast, cathecolamine receptor antagonists (propranolol, prazosin and yohimbine) were ineffective, indicating that cathecolamine release from the adrenal glands was not responsible for the effects on bone-marrow. 5 These results highlight a critical role for stress-induced glucocorticoid hormones in selectively upregulating bone-marrow eosinopoiesis in mice submitted to surgery.

Adrenal Glands↗

PubMed2002

Tumour-associated tissue eosinophilia as a prognostic factor in oral squamous cell carcinomas.

AIMS: Tumour-associated tissue eosinophilia has been described in many sites, including head and neck. The mechanism of eosinophil recruitment and its role in tumours has not yet been defined, and its presence has been related to a favourable as well as unfavourable prognosis. The aim of this study was to evaluate the influence of tumour-associated tissue eosinophilia on the prognosis of 125 oral squamous cell carcinoma patients. METHODS AND RESULTS: The number of eosinophils was obtained by morphometric analysis and ranged from 0 to 392 per mm2. Tumour-associated tissue eosinophilia was classified according to intensity as mild, moderate, or intense and correlated statistically to the intensity of the mononuclear inflammatory infiltrate as well as to the location of the eosinophilic inflammatory infiltrate. The multivariate analysis demonstrated that intense tumour-associated tissue eosinophilia is an independent favourable prognostic factor for oral squamous cell carcinomas. CONCLUSION: These findings suggest an anti-tumoral role of eosinophils not as yet well understood that should be better investigated.

Adult↗

PubMed1999

Poverty and eosinophilia are risk factors for endomyocardial fibrosis (EMF) in Uganda.

OBJECTIVE: To determine the relative risks of socio-demographic, dietary, and environmental factors for endomyocardial fibrosis (EMF) in Uganda. METHOD: Unmatched case control study in Mulago Hospital, Kampala. Cases (n = 61) were sequential patients hospitalized with an echocardiographic diagnosis of EMF from June 1995 to March 1996. Controls (n = 120) were concurrent patients with other forms of heart disease (heart controls, n = 59) and subjects admitted for trauma or elective surgery (hospital controls, n = 61). All consenting subjects answered a structured questionnaire administered by trained interviewers. Complete blood counts, malaria films and stool examination for ova and parasites were performed. Questionnaires elicited information on home address, economic circumstances, variables concerned with environmental exposures and usual diet before becoming ill. RESULTS: After adjustment for age and sex, cases were significantly more likely than controls to have Rwanda/Burundi ethnic origins (P = 0.008). Compared with controls, cases had a lower level of education (P < 0.001 for heart controls and P = 0.07 for hospital controls), were more likely to be peasants (P < 0.001), and to come from Luwero or Mukono Districts (P = 0.003). After further adjustment for peasant occupation, cases were more likely than controls to walk barefoot (P = 0.015), consume cassava as their staple food (P < 0.001) and to lack fish or meat in dietary sauces (P = 0.02). Cases were more likely to exhibit absolute eosinophilia (P = 0.006). The effect of cassava diet was more marked in the younger age group, while the effect of eosinophilia was greater in adults. Socio-economic disadvantage is a risk for EMF. Absolute eosinophilia is a putative cause of EMF, a finding not explained by parasitism. CONCLUSION: Data indicate that relative poverty and environmental factors triggering eosinophilia appear to act in a geographically restricted region of Uganda in the aetiology of EMF.

Adolescent↗

PubMed1990

Association of the eosinophilia-myalgia syndrome with the ingestion of tryptophan.

We report on a series of three patients with an unusual syndrome of eosinophilia and myalgia associated with the oral ingestion of tryptophan that was recognized in New Mexico in October 1989. All three patients, who were women 37 to 44 years of age, had severe muscle pain, muscle weakness, mouth ulcers, and striking eosinophilia (more than 8 X 10(9) cells per liter). Other manifestations included fever, abdominal pain, dyspnea, skin rash, and elevated serum concentrations of aminotransferase and aldolase. The women had been taking tryptophan in doses of 1.2 to 2.4 g a day for three weeks to 2 1/2 years. The discontinuation of tryptophan and the initiation of glucocorticoid treatment resulted in improvement, but all three women were still symptomatic three to five months later. Tests for trichinosis and other parasites and for allergic and connective-tissues disorders were negative, and serum immunoglobulin concentrations and erythrocyte sedimentation rates were normal. A muscle biopsy in one patient and biopsies of the vagina, liver, and other abdominal organs in another revealed eosinophilic infiltration, as well as the extracellular deposition of eosinophil-granule major basic protein. All three patients had elevated serum and urinary levels of this protein and eosinophil-derived neurotoxin, indicative of eosinophil degranulation. The syndrome of eosinophilia and myalgia in association with the ingestion of tryptophan that was seen in these three patients is a newly recognized adverse effect of tryptophan ingestion. Our identification of this association in these patients led to the discovery of an epidemic of what is now called the eosinophilia-myalgia syndrome.

Adult↗

PubMed1990

Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan.

An association between the ingestion tryptophan and a syndrome characterized by scleroderma-like skin abnormalities, fasciitis, and eosinophilia has recently been recognized in the United States. We report the clinical and histopathological findings in nine patients and the results of biochemical analyses of tryptophan metabolism in seven patients with this syndrome. Edema of the extremities, frequently accompanied by pruritus, paresthesia, and myalgia, developed in the nine patients (six women and three men; age range, 30 to 66 years) 1 to 18 months after the start of therapy with tryptophan (1.5 to 3.0 g daily) for insomnia, depression, or obesity. Five patients were taking drugs (benzodiazepines) known to inhibit hypothalamic-pituitary-adrenal function, and one had adrenal insufficiency. All had blood eosinophilia in the acute phase of their illness (mean eosinophil count [+/- SD], 3.62 +/- 2.87 X 10(9) cells per liter). All had histopathological changes in the dermis and subcutaneous tissue typical of scleroderma, and seven patients had eosinophils. The fascia was inflamed and fibrotic, and adjacent skeletal muscle often showed perifascicular inflammation. Tryptophan was discontinued in all patients, and eight received prednisone. The cutaneous symptoms improved, but only two patients had complete resolution of their illness. The patients had plasma levels of tryptophan before and after an oral dose of tryptophan that were similar to those in normal subjects. Plasma levels of L-kynurenine and quinolinic acid, which are metabolites of tryptophan, were significantly higher in four patients with active disease than in three patients studied after eosinophilia had resolved or in five normal subjects (P less than 0.001)--findings consistent with the activation of the enzyme indoleamine-2,3-dioxygenase. This illness resembles eosinophilic fasciitis and probably represents one aspect of the recently reported eosinophilia-myalgia syndrome. The development of the syndrome may result from a confluence of several factors, including the ingestion of tryptophan, exposure to agents that activate indoleamine-2,3-dioxygenase, and possibly, impaired function of the hypothalamic-pituitary-adrenal axis.

Adult↗

PubMed1990

An investigation of the cause of the eosinophilia-myalgia syndrome associated with tryptophan use.

BACKGROUND: The eosinophilia-myalgia syndrome is a newly recognized illness that has been associated with the consumption of tryptophan products. It is not known whether the cause is related to the tryptophan itself or to chemical constituents introduced by the manufacturing process. METHODS: To describe the epidemiology of the eosinophilia-myalgia syndrome further and elucidate a possible association with the manufacturing process, we conducted surveillance for the syndrome in Minnesota, a community survey of tryptophan use in Minneapolis-St. Paul, and a case-control study to assess potential risk factors, including the use of tryptophan from different manufacturers. We performed high-performance liquid chromatography on tryptophan samples to identify other chemical constituents. RESULTS: The prevalence of tryptophan use increased from 1980 to 1989 and was highest among women. Among the subjects for whom the source of the tryptophan was known, 29 of 30 case patients (97 percent) and 21 of 35 controls (60 percent) had consumed tryptophan manufactured by a single company (odds ratio, 19.3; 95 percent confidence interval, 2.5 to 844.9; P less than 0.001). This company used a fermentation process involving Bacillus amyloliquefaciens to manufacture tryptophan. Analysis of the manufacturing conditions according to the retail lot demonstrated an association between lots used by case patients and the use of reduced quantities of powdered carbon in a purification step (odds ratio, 9.0; 95 percent confidence interval, 1.1 to 84.6; P = 0.014), as well as the use of a new strain of B. amyloliquefaciens (Strain V) (odds ratio, 6.0; 95 percent confidence interval, 0.8 to 51.8; P = 0.04). There was a significant correlation (r = 0.78, P less than 0.001) between the reduced amount of powdered carbon used during manufacturing and the use of the new bacterial strain. High-performance liquid chromatography of this company's tryptophan demonstrated one absorbance peak (peak E) that was present in 9 of the 12 retail lots (75 percent) used by patients and 3 of 11 lots (27 percent) used by controls (odds ratio, 8.0; 95 percent confidence interval, 0.9 to 76.6; P = 0.022). CONCLUSIONS: The outbreak of the eosinophilia-myalgia syndrome in 1989 resulted from the ingestion of a chemical constituent that was associated with specific tryptophan-manufacturing conditions at one company. The chemical constituent represented by peak E may contribute to the pathogenesis of the eosinophilia-myalgia syndrome, or it may be a surrogate for another chemical that induces the syndrome.

Adolescent↗

PubMed1999

Abnormal clones of T cells producing interleukin-5 in idiopathic eosinophilia.

BACKGROUND: The cause of persistent eosinophilia and the hypereosinophilic syndrome is unknown. Recent work suggests that in some patients with the hypereosinophilic syndrome, a clone of abnormal T cells produces large amounts of interleukin-5, a cytokine required for the growth and differentiation of eosinophils. We examined T-cell surface markers, rearranged T-cell-receptor genes, and in vitro production of cytokines by T cells from patients with idiopathic eosinophilia. METHODS: The expression of surface molecules on T cells was measured by flow cytometry. Cytokine expression was measured by enzyme-linked immunosorbent assay, flow cytometry, and immunohistochemical analysis. To identify dominant (clonal) rearrangements of the T-cell receptor within the lymphocyte population, Southern blot analysis (beta chain) and the polymerase chain reaction (gamma chain) were performed according to standard protocols. RESULTS: Among 60 patients with idiopathic eosinophilia, 16 had circulating T cells with an aberrant immunophenotype. In each of these patients, the abnormal immunophenotype was unique. Evidence of clonal rearrangements of the T-cell receptor was obtained in 8 of the 16 patients. In most instances, the abnormal T cells expressed large amounts of surface proteins associated with T-cell activation (the alpha chain of the interleukin-2 receptor and the HLA-DR antigen). Moreover, the aberrant T cells produced large amounts of interleukin-5 in vitro. CONCLUSIONS: Clonal populations of abnormal T cells producing interleukin-5 occur in some patients with idiopathic eosinophilia.

Adult↗

PubMed2002

IFN-gamma secretion by CD8T cells inhibits allergen-induced airway eosinophilia but not late airway responses.

BACKGROUND: CD8+T cells can suppress allergen-induced late airway responses (LARs) and airway inflammation. OBJECTIVE: To test the hypothesis that the suppression of LARs and airway eosinophilia by CD8+T cells is IFN-gamma mediated, we tested the effects of adoptively transferred CD8+T cells, in which IFN-gamma synthesis was inhibited by an antisense (AS) oligodeoxynucleotide (ODN), on the airway responses of a rat model of allergic asthma. METHODS: CD8+T cells were harvested from the cervical lymph nodes of ovalbumin (OVA)-sensitized Brown Norway rats for administration to other actively sensitized syngeneic rats. CD8+T cells (2 x 10(6)) were incubated for 6 hours with 2 micromol/L AS ODN or sense ODN and were injected intraperitoneally into recipients; inhibition of IFN-gamma expression in vitro by AS ODN was shown by means of flow cytometry. Two days later, rats were challenged with aerosolized OVA. RESULTS: OVA-induced LAR and bronchoalveolar lavage (BAL) fluid eosinophilia were suppressed by sense ODN-treated CD8+T cells. IFN-gamma expression in BAL cells was elevated in these animals. IFN-gamma expression in BAL cells was at control levels in recipients of AS ODN-treated CD8+ cells, confirming the success of the AS treatment in vivo. BAL eosinophilia was also largely restored in the AS ODN treatment group. In contrast, the CD8+T cell-induced suppression of the LAR was not significantly affected by AS ODN pretreatment. CONCLUSIONS: These results indicate that CD8+T cells inhibit airway eosinophilia through secretion of IFN-gamma but may suppress the LAR by means of other mechanisms.

Adoptive Transfer↗

PubMed2004

Reduction of allergic airway eosinophilia by dietary raffinose in Brown Norway rats.

Oral administration of raffinose, a naturally occurring indigestible oligosaccharide, has reportedly ameliorated atopic dermatitis in human subjects although the mechanism is unknown. The present study investigated the effect of dietary raffinose on allergen-induced airway eosinophilia in ovalbumin-sensitised Brown Norway rats as an atopic disease model. Brown Norway rats were immunised by subcutaneous injection with ovalbumin on day 0 and fed either a control diet or the diet supplemented with raffinose (50 g/kg diet). The rats were exposed to aerosolised ovalbumin on day 20, and broncho-alveolar lavage fluid was obtained on the next day. The number of eosinophils in the fluid was significantly lower in the rats fed the raffinose diet than in those fed the control diet. Dietary raffinose significantly reduced IL-4 and IL-5 mRNA levels in lung tissue and tended to lower ovalbumin-specific Ig E levels. Suppression of eosinophilia by dietary raffinose was still observed in caecectomised and neomycin-administered rats, suggesting little contribution by the colonic bacteria to the effect of raffinose. Intraperitoneal administration of raffinose also suppressed eosinophilia. Significant concentrations of raffinose were detected in portal venous and abdominal arterial plasma after the intragastric administration of raffinose. Overall, the findings suggest that dietary raffinose ameliorates allergic airway eosinophilia at least partly via post-absorptive mechanisms in Brown Norway rats.

Allergens↗

PubMed2004

Induced eosinophilia and proliferation in Angiostrongylus cantonensis-infected mouse brain are associated with the induction of JAK/STAT1, IAP/NF-kappaB and MEKK1/JNK signals.

Eosinophilic meningitis or meningoencephalitis caused by Angiostrongylus cantonensis is endemic to the Pacific area of Asia, especially Taiwan, Thailand, and Japan. Although eosinophilia is an important clinical manifestation of A. cantonensis infection, the role of eosinophils in the progress of the infection remains to be elucidated. In this experiment, we show that A. cantonensis-induced eosinophilia and inflammation might lead to the induction of IAP/NF-kappaB, JAK/STAT1 and MEKK1/JNK signals. The phosphorylation levels of JAK and JNK, STAT1, IAP, NF-kappaB and MEKK1 protein products were significantly increased after 12 days or 15 days of A. cantonensis infection. However, no significant differences in MAPKs such as Raf, MEK-1, ERK1/2 and p38 expression were found between control and infected mice. The activation potency of JAK/STAT1, IAP/NF-kappaB and MEKK1/JNK started increasing on day 3, with significant induction on day 12 or day 15 after A. cantonensis infection. Consistent results were noted in the pathological observations, including eosinophilia, leukocyte infiltration, granulomatous reactions, and time responses in the brain tissues of infected mice. These data suggest that the development of brain injury by eosinophilia of A. cantonensis infection is associated with activation of JAK/STAT1 signals by cytokines, and/or activation of MEKK1/JNK by oxidant stress, and/or activation of NF-kappaB by increasing IAP expression.

Angiostrongylus cantonensis↗

PubMedDate not supplied

Elevated serum IgE, eosinophilia, and lung function in rubber workers.

We previously reported an outbreak of acute respiratory illness associated with eosinophilia in a group of rubber workers who performed a thermoinjection process in which synthetic rubber was heated and then injected onto metal molds. This study was conducted to determine if persistent respiratory health effects were associated with this work area and to explore the possible allergic etiology of this syndrome. A survey was performed 1 mo after a major improvement in area ventilation and consisted of baseline, cross-shift, and cross-week spirometry; diffusing capacity; serum immunoglobulin E (IgE), total eosinophil count; and skin patch testing. Baseline lung function, cross-shift, and cross-week spirometry were not significantly worse in the exposed group as compared to the control group. However, either eosinophilia (greater than 450/mm3) or elevated serum IgE (greater than 470 ng/ml) were present in 44% of exposed workers vs. 11% of the control group (p = .003). Nine months later, neither eosinophilia nor elevated IgE were associated with employment in this work area. We conclude that employment in the thermoinjection process was associated with eosinophilia and elevated IgE, which suggests sensitization to one of the components of the rubber, although no effect on pulmonary function could be demonstrated.

Adult↗

PubMed1991

Eosinophilia-myalgia syndrome associated with L-tryptophan. A case report with pulmonary manifestations and review of the literature.

On October 1989, eosinophilia and incapacitating myalgia, together with arthralgia, dyspnea, cough and edema of the extremities, were shown to be associated with L-tryptophan ingestion. Since then, 1531 cases of eosinophilia-myalgia syndrome have been reported in United States and 22 in Belgium. We report here the unusual pulmonary presentation of this syndrome with a dramatic response of eosinophilia to corticotherapy. The cardio-pulmonary symptoms of eosinophilia-myalgia syndrome and its pathophysiology, which remains unclear, are discussed. The withdrawal of the substance and corticotherapy generally lead to complete recovery although several deaths have been reported.

Eosinophilia-Myalgia Syndrome↗

PubMed1998

Eliminating a region of respiratory syncytial virus attachment protein allows induction of protective immunity without vaccine-enhanced lung eosinophilia.

In a murine model of respiratory syncytial virus disease, prior sensitization to the attachment glycoprotein (G) leads to pulmonary eosinophilia and enhanced illness. Three different approaches were taken to dissect the region of G responsible for enhanced disease and protection against challenge. First, mutant viruses, containing frameshifts that altered the COOH terminus of the G protein, were used to challenge mice sensitized by scarification with recombinant vaccinia virus (rVV) expressing wild-type G. Second, cDNA expressing these mutated G proteins were expressed by rVV and used to vaccinate mice before challenge with wild-type respiratory syncytial virus (RSV). These studies identified residues 193-205 to be responsible for G-induced weight loss and lung eosinophilia and showed that this region was not was not necessary for induction of protective immunity. Third, mice were sensitized using an rVV that expressed only amino acids 124-203 of the G protein. Upon RSV challenge, mice sensitized with this rVV developed enhanced weight loss and eosinophilia. This is the first time that a region within RSV (amino acids 193-203) has been shown to be responsible for induction of lung eosinophilia and disease enhancement. Moreover, we now show that it is possible to induce protective immunity with an altered G protein without inducing a pathological response.

Animals↗

PubMed1980

Eosinophilia in systemic mastocytosis.

The diagnosis of systemic mastocytosis depends on the proper recognition of extensive mast cells infiltration in tissues. Accurate identification of the mast cells in tissues may be difficult when there is no clinical suspicion to initiate a special search for these cells. Four patients with atypical clinical features and eosinophilia in tissues and three with eosinophilia in blood had hematologic or histologic findings suggestive of myelofibrosis with myeloid metaplasia, and malignant lymphoma. It was the presence of blood and tissue eosinophilia in these patients that led to further investigation and recognition of the diagnosis of systemic mastocytosis. Methods for identification of the mast cells are examined. The combined use of Wright-Giemsa stain, toluidine blue, and aminocaproate esterase is preferred. The eosinophils are intimately related to the mast cells. In cases of eosinophilia of unknown etiology, systemic mastocytosis should be considered one of the possible etiologic factors.

Aged↗

PubMed1983

Humoral and cellular studies of eosinophils in reactive and myeloproliferative syndromes with marked eosinophilia.

In five patients with eosinophilia and myeloproliferative disorders, the IgE levels were normal, and immune complexes were not detected. In contrast, in six patients with reactive eosinophilia accompanying immunologic diseases, the IgE levels were elevated in five, and immune complexes were elevated in two. Five of six patients within the reactive group had positive rheumatoid factor titers by latex agglutination, while only one of five in the myeloproliferative group showed this finding. Purified eosinophils from patients with myeloproliferative diseases showed enhanced oxygen consumption responses during the ingestion of latex beads, relative to reactive eosinophils. The stimulated oxidative response of reactive eosinophils during phagocytosis of bacteria opsonized with antibody and complement was reduced, relative to myeloproliferative eosinophils. In vitro incubation of eosinophils with immune complexes reduced, by more than two-thirds, the increased oxidative responses of myeloproliferative eosinophils. Our findings suggest that eosinophilia seen in myeloproliferative diseases is an intrinsic part of the myeloproliferative process, which is not mediated or enhanced by allergic or immunologic reactions. The measurements reported here have potential value for differentiating reactive eosinophilic states from the eosinophilia accompanying myeloproliferative diseases.

Adult↗

PubMed1994

Disseminated coccidioidomycosis associated with extreme eosinophilia.

Primary coccidioidomycosis is frequently accompanied by eosinophilia in the range of 5%-10% of the peripheral white blood cell count. Dissemination of Coccidioides immitis to organs such as skin, bone, joints, and CNS usually is associated with risk factors such as sex (male), race (non-Caucasian), pregnancy, and immunosuppression. We report a case of coccidioidomycosis in an otherwise healthy African-American man with 72% eosinophilia who had dissemination to the skin, and we review cases in the literature of disseminated disease associated with eosinophilia. Marked eosinophilia may be an important early clue that dissemination of coccidioidomycosis has occurred.

Adult↗

PubMedDate not supplied

Tissue eosinophilia in human coccidioidomycosis.

Eosinophilia in peripheral blood and tissue of patients with coccidioidomyocsis was reviewed in an examination of the importance of this cellular response to Coccidioides immitis. Peripheral blood eosinophilia (greater than 5%) was found in each of two patients with primary infection but was markedly more pronounced (27%-53%) in three of five patients with disseminated coccidioidomycosis. Unusually large numbers of tissue eosinophils and organized microabscesses containing eosinophils were found in six patients with progressive or disseminated disease. These six patients all demonstrated cutaneous anergy to coccidioidin. Eosinophilic microabscesses were found surrounding rupturing spherules and free endospores. Phagocytosis of free endospores was not demonstrated by the technique used. The bone marrow of two patients with disseminated disease showed a marked increase in eosinophilic myeloid precursors; this result suggested the presence of an eosinophilopoietin. Although peripheral blood eosinophilia has been explained as a hypersensitivity response to C. immitis that represents a favorable prognosis, the data reported herein suggest that peripheral blood eosinophilia of greater than 20% and the presence of eosinophilic microabscesses correlate with progressive or disseminated infection and thus are indicative of a poor prognosis.

Adolescent↗

PubMed2005

Effect of vitamin E-bonded dialyzer on eosinophilia in haemodialysis patients.

BACKGROUND: Eosinophilia in haemodialysis patients probably results from allergy to haemodialysis-related materials, including dialyzer membranes. We examined the effects of vitamin E-bonded dialyzers on eosinophil counts in haemodialysis patients. METHODS: We enrolled seven patients who were on regular haemodialysis and had sustained eosinophilia. White blood cell, eosinophil, CD4- and CD8-positive lymphocyte counts, and serum interleukin-5 (IL-5) and IgE levels were determined before, 2 and 4 weeks after switching to vitamin E-bonded dialyzers. RESULTS: Eosinophil and CD4-positive lymphocyte counts and serum IL-5 were significantly (P = 0.003, 0.003 and 0.031, respectively) decreased after switching to vitamin E-bonded dialyzers. CD8-positive lymphocyte counts and serum IgE levels were unaltered. Crossover tests in two cases reproduced the higher eosinophilia within 4 weeks after returning to the original non-vitamin E-bonded dialyzer. CONCLUSION: Vitamin E-bonded dialyzers may ameliorate eosinophilia through a mechanism mediated by a decrease in IL-5 secretion by CD4-positive lymphocytes.

Analysis of Variance↗