Probiotics: An adjuvant treatment strategy for chronic respiratory diseases.

Do inhaled corticosteroids reduce serum IgE levels? The answer is maybe but how relevant is the question?

Objective: Wheezing is a common symptom among children and is proposed to be associated with inflammatory cell infiltration, cytokines production, and with some risk factors such as gastro esophageal reflux (GER). The aim of the present study was to investigate endotheline-1 (ET-1) and leukotriene-E4 (LTE-4) levels, their response to steroid and ?2-agonist therapy, and to establish if these parameters can be used as a diagnostic tool for infantile asthma and assess their relation with GER during acute attack of wheezy infants (WI). Material and Methods: Thirty WI and 12 healthy infants were enrolled in the present study. Serum IgE, ET-1, urine LTE-4 levels, and eosinophil percentage were measured prior to and 5 days after the treatment (systemic or inhaled steroid therapy and inhaled ?2-agonist) in children with WI. In addition, esophageal pH was monitored for 24 hours. Results: Serum IgE, ET-1, and urine LTE-4 levels were significantly higher in the patients compared to the controls before and five days after the treatment (p= 0.009; p= 0.039, p= 0.032; p= 0.014, p= 0.017, respectively). The serum IgE and urine LTE-4 levels prior to and 5 days after the treatment were higher in the patients with GER when compared to the controls (p= 0.021, p= 0.016 and p= 0.039). Moreover, the systemic or inhaled steroid therapy did not influence the serum ET-1 and urine LT-E4 levels. We found that the serum IgE and ET-1 levels on 5^th day of the treatment and LTE-4 levels at the beginning and 5th day of the treatment were notably different in patients with higher likelihood for developing infantile asthma when compared to the controls. Finally, increased serum IgE levels were present in patients with good response to inhaled ?2-agonist with regard to those with poor response to inhaled ?2-agonist (p= 0.031). Conclusion: The present study indicated that IgE, ET-1 and LTE-4 levels were related to airway inflammation in WI while LTE-4 and IgE levels were associated with GER. LTE-4 and IgE levels could be novel parameters for determining the risk factor for developing asthma in child with WI. Inhaled ?2-agonist therapy seemed to be beneficial only in patients with high serum IgE levels.

Asthma and chronic obstructive pulmonary disease (COPD) are diseases of airway inflammation with clinical and physiological similarities, making their differentiation difficult. Airway inflammatory changes are associated with systemic changes. However, no serum marker is known for their differentiation. Therefore, serum interleukin (IL)-1β levels were determined. Out of a total of 1023 patients screened, we included in the study ten patients each with atopic asthma, non-atopic asthma and COPD and ten healthy subjects. Skin prick tests with 14 inhalant allergens were performed on each patient. Blood was collected in the symptomatic and asymptomatic phases of the diseases and serum IL-1β and IgE levels were determined. Our results showed that in the symptomatic phase in asthmatics, serum IL-1β levels were higher (P<0.05) than in patients with COPD. Serum IgE levels were higher (P<0.05) in atopic asthmatics than in non-atopic asthmatics and in COPD patients. We conclude that serum IL-1β level determination during the symptomatic phase of the diseases may help to differentiate asthmatics from patients with COPD. Serum IgE levels may differentiate atopic asthmatics from non-atopic asthmatics and COPD patients.

Chronic obstructive pulmonary disease (COPD) is an incurable disease related to the respiratory system. A 2017 report by the World Health Organization stated that it was the third most common cause of death in 2015. Macmoondong decoction is a prescription that has been used widely in Korea for the treatment of respiratory diseases, but there have been few investigations into the therapeutic mechanism. To investigate the anti-COPD effect of macmoondong decoction, the animals were divided into five treatment groups: control; COPD-induced control; Spiriva; 150 mg/kg macmoondong decoction; and 1500 mg/kg macmoondong decoction. Changes typically observed in COPD, such as the populations of WBC and neutrophils in BALF, the level of IgE in serum, morphological changes, the DNA levels, and the protein expression of cytokines and chemokines (TGF-β, CCL-2, CXCL1, and CXCL11) in the pulmonary system, were evaluated. Macmoondong decoction inhibited the populations of WBC and neutrophils in BALF and the level of IgE in serum. Dose-dependent prevention of the pulmonary morphological changes, such as emphysema and airway fibrosis, was observed. Macmoondong decoction suppressed the expression of DNA and proteins related to the occurrence of COPD, such as TGF-β, CCL-2, CXCL1, and CXCL11. In particular, the expression of TGF-β, CCL-2, and CXCL1 was significantly suppressed by 1500 mg/kg macmoondong decoction treatment compared with Spiriva treatment. Macmoondong decoction exerted an anti-COPD effect, and the mechanism of its action may be the suppression of TGF-β, CCL-2, CXCL1, and CXCL11 expression, which occurred in a dose-dependent manner. The mechanism of action of macmoondong decoction may be the dose-dependent suppression of TGF-β, CCL-2, CXCL1, and CXCL11, with TGF-β, CCL-2, and CXCL1 as the potential key factors involved in COPD suppression.

Efficacy and tolerability of antiasthma herbal medicine intervention in adult patients with moderate-severe allergic asthma

The relationship between serum IgE and surface levels of FcϵR on human leukocytes in various diseases: Correlation of expression with FcϵRI on basophils but not on monocytes or eosinophils

Predicting the impairment and accelerated decline of lung function - the role of immunoglobulin E.

From IgE to anti-IgE: where do we stand?

BackgroundElevated serum immunoglobulin (Ig) E is a diagnostic marker of immediate-type allergic reactions. We hypothesize that serum IgE does not necessarily reflect total body IgE because in vivo IgE can be bound to cell surface receptors such as FcεRI and FcεRII (CD23). The aim of this study was to analyze the relationships between levels of serum IgE, cell-bound IgE, and IgE-receptors on peripheral blood cells in a pediatric population.MethodologyWhole blood samples from 48 children (26 boys, 22 girls, mean age 10,3±5,4 years) were analyzed by flow cytometry for FcεRI, CD23, and cell-bound IgE on dendritic cells (CD11c+MHC class II+), monocytes (CD14+), basophils (CD123+MHC class II-) and neutrophils (myeloperoxidase+). Total serum IgE was measured by ELISA and converted into z-units to account for age-dependent normal ranges. Correlations were calculated using Spearman rank correlation test.Principal FindingsDendritic cells, monocytes, basophils, and neutrophils expressed the high affinity IgE-receptor FcεRI. Dendritic cells and monocytes also expressed the low affinity receptor CD23. The majority of IgE-receptor positive cells carried IgE on their surface. Expression of both IgE receptors was tightly correlated with cell-bound IgE. In general, cell-bound IgE on FcεRI+ cells correlated well with serum IgE. However, some patients carried high amounts of cell-bound IgE despite low total serum IgE levels.Conclusion/SignificanceIn pediatric patients, levels of age-adjusted serum IgE, cell-bound IgE, and FcεRI correlate. Even in the absence of elevated levels of serum IgE, cell-bound IgE can be detected on peripheral blood cells in a subgroup of patients.

Objective To analyze the clinical characteristics of patients with asthma-chronic obstructive pulmonary overlap syndrome (ACOS). Methods From January 2015 to December 2017, 40 patients with ACOS, 40 patients with asthma and 40 patients with chronic obstructive pulmonary disease(COPD) in Zhoushan Hospital were collected.The general information, laboratory test indicators, lung function test indicators and FEV1 mutation after bronchodilator test were compared among the three groups. Results There were statistically significant differences in age[(45.36±5.27) vs. (54.45±4.69) vs. (67.57±5.18), F=9.334, P=0.004], the proportion of smoking patients (92.50% vs. 75.00% vs. 60.00%, χ2=11.550, P=0.003), and the proportion of family history of asthma (7.50% vs. 20.00% vs. 30.00%, χ2=6.562, P=0.038) among the patients with ACOS, asthma and COPD.The percentage of eosinophils in peripheral blood [(8.46±0.94)% vs. (6.13±0.78)% vs. (3.75±0.45)%, F=11.626, P=0.001] and the serum IgE levels [(353.41±45.74)IU/mL vs. (252.65±30.45)IU/mL vs. (155.26±22.77)IU/mL, F=7.605, P=0.001] were decreased in turn, the differences were statistically significant.The FEV1/FVC% and FEV1% pred in the ACOS group were lower than those in the asthma group [(54.26±6.86)% vs. (72.43±8.52)%, t=10.506, P=0.001 and (50.35±6.22)% vs. (62.60±7.52)%, t=7.939, P=0.001], however, there were no significant differences compared with the COPD group[(54.26±6.86)% vs. (53.88±7.25)%, t=0.241, P=0.810 and (50.35±6.22)% vs. (50.56±6.46)%, t=0.148, P=0.883]. The proportion of small airway dysfunction in the ACOS group was higher than that in the asthma group (82.50% vs. 57.50%, χ2=5.952, P=0.015), however, there was no statistically significant difference compared with COPD group(82.50% vs. 85.00%, χ2=0.092, P=0.762). The RV/TLC% in the ACOS group was higher than that in the asthma group [(46.71±5.31)% vs. (32.46±4.52)%, t=12.924, P=0.001], however, there was no statistically significant difference compared with the COPD group [(46.71±5.31)% vs. (46.92±5.75)%, t=0.170, P=0.866]. The DLCO% in the ACOS group was lower than that in the asthma group [(64.37±4.66)% vs (82.62±4.53)%, t=17.760, P=0.001], but higher than that of the COPD group [(64.37±4.66)% vs. (51.25±4.35)%, t=13.017, P=0.001]. After bronchodilator test, the FEV1 mutation rate of the ACOS group was higher than that of the COPD group [(20.86±2.05)% vs. (6.52±0.55)%, t=42.730, P=0.001], but there was no statistically significant difference compared with the asthma group [(20.86±2.05)% vs. (21.13±2.14)%, t=0.576, P=0.566]. Conclusion Compared with asthma patients, the age of ACOS patients is older, the percentage of peripheral blood eosinophils and the level of serum IgE are lower, the pulmonary ventilation function is lower, the airway dysfunction is more significant, the residual volume is more significant, the lung diffuse function is lower, acidic granulocyte airway inflammation is mild.But compared with patients with COPD, the age of ACOS patients is younger, the percentage of peripheral blood eosinophils and serum IgE levels are higher, the lung diffuse function is higher, and acidic granulocyte airway inflammation is heavier. Key words: Asthma; Pulmonary disease, chronic obstructive; Oxyphil cells; Immunoglobulin E; Respiratory function tests

Environmental pollution is a serious public health problem closely related to various chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), bronchial asthma, and lung malignancies. Atmospheric particulate matter (PM) is an important component of environmental pollution, and its influence on COPD has been shown to be related to inflammation, oxidative stress, immune imbalance, abnormal cell death, and cell aging. A growing body of evidence has shown that an imbalance of the lung and intestinal microbiota, as well as changes in metabolites, is closely related to the occurrence and development of PM-induced COPD. PM exposure damages the respiratory system and alters the structure and activity of the gut microbiome. The metabolites produced by the gut microbiome, in turn, disrupt airway immunity and exacerbate respiratory inflammation. Therefore, the bidirectional influence of PM on the gut–lung axis has attracted widespread attention. This review explores the mechanisms by which PM causes oxidative stress damage to the lungs and intestines, as well as the characteristics of the resultant immune imbalance and changes in the microbiota and metabolite products. It also describes how PM disrupts barrier function through microecological imbalance and how it participates in the progression of COPD via the gut–lung axis. These mechanisms highlight the potential of targeting the microbial flora as a new approach for treating COPD caused by environmental pollution.

To compare and determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of nasal smear eosinophilia and serum IgE levels for the diagnosis of allergic rhinitis (AR). Analytical study. ENT and Pathology Departments, KEMU/Mayo Hospital, Lahore from January 2018 to December 2019. Methodology: Two hundred and twenty-one patients presenting with recurrent rhinitis were included in the study.They were divided into two groups: group 1 presented with history suggestive of allergy for more than four weeks and confirmed to be AR on skin prick tests; group 2 patients with negative skin prick tests taken as controls. Both groups were subjected to serum IgE levels and nasal smear for eosinophilia. Prick test was taken as gold standard, and p<0.05 was taken statistically significant. One hundred and twenty-one patients diagnosed as allergic rhinitis on skin prick tests in group 1 and 100 patients as controls in group 2 had negative skin prick tests. Ninety-one (75.2%) patients had AR on nasal smear eosinophilia in group 1 and 89 (73.6%) patients had AR on serum IgE levels in group 1. Sixty-eight patients (56.2%) were males and 53 (43.8%) were females in group 1. In group 2, 51 (51%) were males and 49 (49%) were females. Mean difference in nasal smear eosinophil count and serum IgE levels in AR and control group was statistically significant (p<0.001). Sensitivity, specificity, PPV and NPV of nasal smear eosinophilia was 77.8%,71.2%, 75.2%, and 74%; and of IgE level was 82.4%, 71.7%, 73.6%, and 81%, respectively. Serum IgE and nasal smear eosinophilia levels are helpful in diagnosing allergic rhinitis; however, serum IgE level has better sensitivity and higher NPV than smear eosinophilia. Specificity of both tests is comparable. Key Words: Allergic rhinitis, Nasal smear eosinophilia, Serum IgE level.

Anti-Interleukin 6 Receptor Monoclonal Antibody Therapy Reduced Serum Interleukin 4 and IgE Production in Castleman's Disease.

Understanding chronic respiratory diseases

Review question/objective The objective of this systematic review is to identify the best available research evidence related to the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy in people with chronic respiratory diseases, focusing on measures of adherence and health outcomes. The specific review questions to be addressed are: 1. What is the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy in terms of inhalation regimens and inhalation techniques in people with chronic respiratory diseases? 2. What is the effectiveness of educational and supportive interventions for improving adherence to inhalation therapy on health service utilization and patient outcomes including symptoms, pulmonary function, and quality of life? 3. What is the effectiveness of various designs, in terms of components, modes and intensities, of educational and supportive interventions for improving adherence to inhalation therapy? Inclusion criteria Types of participants This review will consider studies that include adults aged 18 or above, with a clinical diagnosis of chronic respiratory disease and prescribed self-administered inhalation therapy as a long term regular treatment, irrespective of the type of inhaler used. For the purposes of this review, "chronic respiratory diseases" is defined by WHO in 2007 as "the chronic diseases of the airways and other structures of the lung" (p.5). 1 Inhalation therapy is defined as "a treatment in which a substance is administered to the respiratory tract with inspired air". 6 This review will focus on inhalation of drugs. Those studies with prescribed administration of oxygen and water will be excluded. There is no universal standard for how long a treatment is undertaken to be defined as a "long term treatment". Acute episodic drug treatments, such as a course of antibiotics, will be excluded. Types of interventions of interest All educational interventions, with or without supportive programs, designed to improve the chronic respiratory disease sufferers inhalation technique and adherence to their prescribed inhalation therapy will be considered. Those studies that involve comparison of different types of inhalation medications, inhaler devices or inhalation methods to improve the adherence to inhalation therapy will be excluded. For the TRUNCATED AT 350 WORDS