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Reactive eosinophilic pleuritis. A sequela of pneumothorax in pulmonary eosinophilic granuloma.

Pneumothorax is a frequent complication of pulmonary eosinophilic granuloma (EG) and can be a presenting manifestation of this disorder. Histologically the differential diagnosis of EG in patients presenting with pneumothorax includes reactive eosinophilic pleuritis (REP), a nonspecific inflammatory reaction commonly observed in association with ruptured pleural blebs. The authors present a case in which both EG and REP were found in lung tissue from a patient with recurrent pneumothorax. Immunohistochemical stains for lysozyme and S-100 protein assisted in differentiating these two lesions. Histiocytic cells in areas of EG were S-100 positive and lysozyme negative, whereas mononuclear cells in areas of REP were S-100 negative and lysozyme positive. It is emphasized that the finding of REP and pleural blebs in lung tissue from patients presenting with pneumothorax does not exclude the diagnosis of EG.

Adult↗

From eosinophil chemotactic factor of anaphylaxis to leukotriene B4--chemistry, biology and functional significance of eosinophil chemotactic leukotrienes in dermatology.

The present paper examines evidence for the identity of low molecular weight eosinophil chemotactic factor (ECF) and of leukotriene B4 (LTB4) and its metabolites. Total congruity between the two entities is found regarding (1) cells of origin; (2) conditions for in vitro generation and pharmacological modulation; (3) physiochemical properties; (4) in vitro chemotaxis towards human monocytes, fibroblasts and guinea pig eosinophils; (5) in vivo activities in humans, and (6) occurrence of the factors in various dermatological diseases. Quantitative differences were observed only for in vitro neutrophil migration which may be due to neutrophil chemotactic mono-HETEs and possibly platelet activating factor in the ECF preparations. The name ECF should therefore be replaced by LTB4 and its metabolites, as has happened for SRS which is now called LTC4/D4.

Anaphylaxis↗

The promoter polymorphism in the eosinophil cationic protein gene and its influence on the serum eosinophil cationic protein level.

Asthma is characterized by reversible airway obstruction and airway inflammation. Serum levels of eosinophil cationic protein (ECP) might reflect eosinophilic airway inflammation and asthma activity. However, serum ECP levels are not elevated in some patients with asthma, even when they are symptomatic. In this study, we screened for polymorphisms in the ECP gene and analyzed association between these polymorphisms and asthma and serum ECP levels in 137 Japanese families identified through children with asthma. We identified three polymorphisms (-393C/T, -38C/A, and 124Arg/Thr) in human ECP. We did not find associations between these polymorphisms and asthma by the transmission disequilibrium test. However, we found that serum ECP levels in subjects with the -393T allele were significantly lower than those in subjects with the -393C allele. A reporter construct with the -393T allele showed significantly lower promoter activity than one with the -393C allele. Gel shift assay revealed that C/EBP proteins can bind the -393C/T polymorphic site. These data indicate that C/EBP proteins play an important role in the regulation of ECP and that a significant amount of the variance in baseline serum ECP levels may be explained by the -393C/T polymorphism. Although ECP polymorphisms are not likely to be involved in the development of asthma, measurement of ECP levels for the assessment of asthma activity may be improved when done in combination with genotyping of the -393C/T polymorphism.

Adolescent↗

The enigmatic eosinophil: investigation of the biological role of eosinophils in parasitic helminth infection.

In many helminth infected hosts the number of eosinophils increases dramatically, often without any concurrent increases in the number of other leukocytes, so that eosinophils become the dominant cell type. Many experimental investigations have shown that the eosinophilia is induced by interleukin-5 (IL-5) but its functional significance remains unclear. Mice genetically deficient in IL-5 (IL-5-/-) have been used to evaluate the functional consequences of the IL-5 dependent eosinophilia in helminth infected hosts. Host pathology and level of infection were determined in IL-5-/- and wild type mice infected with a range of species representative of each major group of helminths. The effects of IL-5 deficiency were very heterogeneous. Of the six species of helminth examined, IL-5 dependent immune responses had no detectable effect in infections with three species, namely the cestodes Mesocestoides corti and Hymenolepis diminuta and the trematode Fasciola hepatica. In contrast, IL-5 dependent immune responses were functionally important in mice infected with three species, notably all nematodes. Damage to the lungs caused by migrating larvae of Toxocara canis was reduced in IL-5-/- mice. Infections of the intestine by adult stages of either Strongyloides ratti or Heligmosomoides polygyrus were more severe in IL-5-/- mice. Adult intestinal nematodes were clearly deleteriously affected by IL- 5 dependent processes since in its presence there were fewer worms which had reduced fecundity and longevity. The implications of these results for the viability of using inhibitors of IL-5 as a therapy for asthma are considered.

Animals↗

Eosinophils and immune mechanisms. III. Production of the lymphokine eosinophil stimulation promoter by mouse T lymphocytes.

The lymphoid cell population responsible for production of eosinophil stimulation promoter (ESP), a lymphokine which increases migration of eosinophils, was investigated in murine Schistosoma mansoni infection. Con A challenge induced ESP production, whereas LPS did not. Prior treatment with anti-thetaC3H alloantiserum plus complement in vitro eliminated ESP production; in vivo treatment with rabbit anti-mouse thymocyte serum consistently reduced ESP production by splenic lymphoid cells, but affected lymph node cell ESP production only after exceptionally large doses. Thymocytes did not produce significant amounts of ESP; nor did lymphoid cells from congenitally athymic mice. Depletion of B lymphocytes and macrophages by nylon fiber adherence eliminated antigen-induced ESP production; this was partially restored by addition of non-immune, 72-hr peritoneal exudate cells. Con A-induced ESP production was not affected by nylon fiber treatment. These results demonstrate that ESP is produced by an ATS-sensitive, peripheralized T lymphocyte population, and suggest a macrophage requirement for antigen-induced production of this lymphokine.

Animals↗

[A case of eosinophilic myositis proven by immunohistochemistry using antibodies against eosinophilic granule protein].

A 50-year-old man had been well until three months earlier, when he felt general fatigue, and cutaneous rash with itching. Thereafter a general muscular weakness developed and the patient could not walk for a month. Four weeks before referral to our hospital, he had high fever and could not role over in the bed. On admission, the patient was able to walk. He had no skin rash. Neurologically, he showed mild weakness in proximal muscles. Hematologic examination showed mild eosinophilia and serum creatine kinase was mildly elevated. Needle electromyogram revealed a diffuse myogenic pattern in extremities. Eosinophilic myositis was diagnosed by a biopsy of the left calf muscle showing mild infiltration of eosinophilis which was identified using antibodies against eosinophilic granule protein.

Autoantibodies↗

Eosinophils and immune mechanisms. VI. The synergistic combination of granulocyte-macrophage colony-stimulating factor and IL-5 accounts for eosinophil-stimulation promoter activity in Schistosoma mansoni-infected mice.

Eosinophil stimulation promoter (ESP) is a lymphokine activity that stimulates eosinophil migration and is produced by mitogen or specific Ag stimulation of spleen cells from mice infected with Schistosoma mansoni. It is also produced by intact, schistosome egg-induced granulomas isolated from the livers of such mice without additional antigenic exposure. The production of ESP activity is decreased during chronic infection in a time course coordinate with granuloma modulation. Characterization of ESP was pursued to determine its relationship to other cytokines and to identify factors that may play a role in granuloma formation and modulation. Chromatographic separations, assays of recombinant cytokines, and cytokine-specific immunodepletions were used in the characterization. ESP+ supernatant fluids contain both granulocyte-macrophage CSF and IL-5. The removal of both granulocyte-macrophage CSF and IL-5 is required to eliminate ESP activity, and together they act synergistically to constitute ESP.

Animals↗

[Some modern views of the role of the eosinophils in allergic reactions and bronchial asthma and a new method of detecting eosinophils in the bronchial secretion].

A review of certain contemporary opinions of eosinophil function in allergic reactions and bronchial asthma is presented in this report. Phagocytosis and processing of the complexes antigenantibody, histamine inhibition and a histamine elimination elimination by a specific inhibitor, isolated from eosinophilis (EDI), stimulation of prostaglandines E release, which also inhibit histamine and have a bronchial dilataion effect. The new method is recommended for eosinophil detection in sputa based on the fluorescent principle as faster and more efficient.

Adult↗

[Monocellular quantitative study on the adhesive ability of eosinophils in the course of eosinophils activation].

OBJECTIVE: To observe the dynamic changes of eosinophils (EOS) adhesive ability in the course of eosinophils activation. METHODS: The adhesive ability EOS to vascular endothelial cell (EC) was measured by the use of a microminpulation technique. RESULTS: The critical separation stress (Sc) between rest EOS and EC was 0.61 +/- 0.07kPa. Treatment of EOS with platelet activaty factor (PAF) caused a significant increase in Sc. The Sc was 4.1 +/- 0.6kPa within 30 minutes of EOS exposure to PAF, and had no tendency to increase continuously by exposure time prolonged. CONCLUSIONS: The increase of EOS adhesive ability belongs to a kind of rapid response while EOS is activated. The increase could be an important basis of EOS adhesion to EC and EOS entry into bronchial mucosa.

Cell Adhesion↗

Blood eosinophils and eosinophil-derived proteins in allergic asthma.

The concentrations of the eosinophil (EOS)-derived proteins, major basic protein (MBP), EOS-derived neurotoxin (EDN), EOS peroxidase (EPO), and EOS cationic protein (ECP), and EOS counts were measured in the peripheral blood of 12 atopic subjects with asthma and 23 normal control subjects. The same measurements were performed in seven subjects with asthma with previously documented dual (early plus late) asthmatic responses after inhalation challenges with methacholine and allergen. EOSs (p less than 0.001), MBP (p less than 0.01), EDN (p less than 0.01), and ECP (p greater than 0.03) were elevated in the subjects with asthma compared with control subjects, whereas EPO (p less than 0.01) concentrations were reduced. There were no significant differences between baseline measurements of FEV1, EOSs, MBP, EDN, EPO, or ECP on the methacholine- and allergen-challenge days. When the changes in these variables after allergen challenge were compared with the corresponding changes after methacholine challenge, there were no significant differences at 0 to 60 minutes or at 3 hours, whereas EDN (p less than 0.025), EPO (p less than 0.05), and ECP (p less than 0.025) were relatively increased at 6 to 12 hours and accompanied the late falls in FEV1 (p less than 0.001). EOSs (p less than 0.025) were elevated at 24 hours when there was a small relative increase in MBP (p less than 0.05). EOSs appear to be "activated" in subjects with allergic asthma, and further activation may occur during late asthmatic responses.

Adult↗

[Clinical study of eosinophilic cystitis (2). Clinical observation on 5 cases of eosinophilic cystitis].

Clinical observations were performed on 5 cases of eosinophilic cystitis that had been diagnosed by our criteria. In all 5 cases some kind of allergic diseases was found. General urinalysis did not show any definite tendency, but eosinophils in urine were found in 4 cases. Cystoscopy revealed only chronic inflammation and submucosal hemorrhage in 4 cases, and the other case showed ulcerative changes. A positive to immediate skin reaction was seen in 2 of the 4 cases. IgE RAST was positive for mite, house dust and mugwort in 1 of these 2 cases. In this case immediate allergic reaction was suspected as part of the cause of the cystitis.

Adult↗

[Eosinophilic gastroenteritis simulating ascites (eosinophilic ascites). Presentation of a case and review of the literature].

Eosinophilic gastroenteritis is an uncommon disorder of unknown etiology characterized by recurrent episodes of infiltration of the gastrointestinal wall with eosinophils and peripheral eosinophilia. The Authors report a patient in which ascites with eosinophilia in the ascitic fluid was the cardinal feature of the disease. A low E.S.R. in the acute phase of illness was found. Steroids are indicated in patients presenting obstructive symptoms or malabsorption. In our case the treatment was not necessary because of the spontaneous remission of the symptoms.

Adult↗

[Eosinophilic esophagitis, a rare manifestation of eosinophilic gastroenteritis].

Eosinophilic gastroenteritis is a rare disease characterized by gastrointestinal symptoms, peripheral eosinophilia and massive infiltration of segments of the gastrointestinal tract by eosinophils. A case of this disease in a 25-year-old patient with symptoms of slight dysphagia and isolated esophageal involvement is described. Improvement of the symptoms, but not of the histological abnormalities, was obtained by steroids combined with withdrawal of the food components probably responsible for the symptoms.

Adult↗

Eosinophilic gastroenteritis with hepatic eosinophilic granulomas. Report of a case with 30-year follow-up.

A patient with eosinophilic gastroenteritis of 30 years' duration is presented. During the course of the illness, anemia, hepatosplenomegaly, diarrhea and hepatic giant cell granulomas with surrounding eosinophilia were noted. The differential diagnosis of the granulomatous lesion is discussed. The patient's initially serious but subsequently benign illness illustrates the diverse manifestations of eosinophilic gastroenteritis. The need for a cautious therapeutic approach to the disorders of eosinophilia and organ infiltration is emphasized.

Adult↗

Circulating fibrosis markers, eosinophil cationic protein and eosinophil protein X in patients with Wuchereria bancrofti infection: association with clinical status.

We measured the concentrations of several circulating fibrosis markers (type I collagen I, type III procollagen, hyaluronan) and eosinophil granule proteins (ECP and EPX) in lymphatic filariosis patients to investigate their relationship with clinical, parasitological and immunological data. This study was conducted in Polynesian patients with various stages of the disease (acute lymphangitis, chyluria, hydrocoele, elephantiasis), a closely related microbial lymphangitis and endemic controls. We observed modifications of the different markers in this pathology. Serum type I collagen and PIIINP were decreased. Serum hyaluronan, linked to perilymphatic granulomatous inflammation, was significantly increased in acute lymphangitis and elephantiasis patients. Serum ECP was also increased, at the limit of significance in our sample, in elephantiasis patients. These two last markers, already validated in another helminth disease, schistosomiasis, have potential interest in terms of follow-up of morbidity in these parasitic diseases.

Adult↗

Percentage of eosinophils with surface CD44 and levels of eosinophil cationic protein in the peripheral blood in children with bronchial asthma and their changes after montelukast therapy.

Bronchial asthma (BA) is chronic inflammation of the respiratory tract with a role played by a variety of cells, particularly mast cells, eosinophils (Eo), and T lymphocytes. The serum levels of Eo cationic protein (S-ECP) reflect the severity of bronchial inflammation and the level of bronchial hyperreactivity in asthma patients. One of the most important adhesion molecules is CD44. We examined S-ECP, the percentage of Eo with surface CD44 expression (EoCD44), and Eo count in the peripheral blood of newly diagnosed pediatric atopic patients with intermittent and persistent mild BA according to the Global Iniative for Asthma 2002, in a proportion of patients 3 months after initiation of montelukast therapy. Ninety-seven children with BA had their medical history taken, and S-ECP, with the percentage of EoCD44 determined by direct fluorescence from whole blood using flow cytometry with a Coulter EPICS XL cytometer, and Eo count, total serum immunoglobulin E levels (S-IgE) were determined. Therapy with montelukast (5 mg daily) was started in 23 children. Three months after the first collection, a second S-ECP level and EoCD44 count determinations were made. An inverse correlation between S-ECP and EoCD44 (-0.602; p < 0.0001) was found in the 97 children with BA. In the 23 children receiving montelukast we documented inverse correlation of fluctuation on S-ECP and EoCD44 after 3 months. These results were not significant. An inverse correlation between S-ECP and percent of EoCD44 was established in the 97 children with asthma before therapy initiation. The lower percentage of EoCD44 in peripheral blood in asthmatic children is due to Eo inflammation activity and attests to massive Eo invasion into the airways. Determination of the percentage proportion of EoCD44 is another potential indirect marker of the multiple features of Eo inflammation.

Acetates↗