Higher Number Of Eosinophils Research Articles

Cord blood granulocyte levels are associated with severe bronchiolitis in the first year of life.

Bronchiolitis is a leading cause of infant hospitalisation in the first year of life, and it preferentially affects infants born to mothers with asthma. Here, we evaluate cord blood granulocytes in infants born to mothers with asthma participating in the Breathing for Life Trial (BLT), to investigate early life determinants of bronchiolitis hospitalisation within the first year of life. Cord blood from 89 participants was collected into EDTA tubes and processed within 6 h of birth. Cells were stained in whole cord blood for eosinophils (CD45+, CD193+, CD16-), and neutrophils (CD45+, CD193-, CD16+). Medical records were reviewed for bronchiolitis hospitalisation in the first 12 months of life. Statistical analyses were conducted using Stata IC16.1. Logistic regression adjusted for caesarean section, gestational age, maternal smoking during pregnancy, foetal heart deceleration during labour, and season of birth revealed an association between cord blood eosinophil levels and bronchiolitis hospitalisation in the first 12 months of life with an Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC) curve of 0.943 (aOR = 1.35, P = 0.011). Neutrophils were associated with the risk of bronchiolitis hospitalisation in a univariable logistic regression (OR = 0.93, P = 0.029); however, there was no statistical significance in the adjusted model. Higher eosinophil numbers in cord blood were associated with bronchiolitis hospitalisation in the first 12 months in a cohort of infants born to asthmatic mothers. This suggests that susceptibility to bronchiolitis in later life is influenced by the immune cell profile prior to viral infection.

Treating moderate-to-severe atopic dermatitis with benralizumab: results from the HILLIER study, a plain language summary.

What is this summary about? Atopic dermatitis (AD) is a chronic (long-lasting) skin disease that leads to dry, itchy, and swollen red spots, which can also be painful and flare up at any time. Some people with AD have a high number of eosinophils, a type of white blood cell, which are associated with worse disease. Medicated creams and lotions, prescribed by health care providers, are meant to reduce the symptoms of AD. For some people, these creams and lotions do not work. Benralizumab injection is a medication that reduces and removes eosinophils. A clinical trial called HILLER tested benralizumab to see if there was a difference in symptoms of AD after reducing or removing eosinophils. This article explains how benralizumab reduced eosinophils and the effect it had on AD symptoms in the HILLIER study. What were the main conclusions reported by the researchers? Benralizumab reduced blood eosinophil numbers. However, benralizumab showed no evidence of treatment benefit on signs, symptoms, or severity of AD, as measured by three skin assessments compared with placebo. Benralizumab was well tolerated and had a safety profile that was consistent with previous studies. The five most commonly reported side effects were COVID-19 infection, upper respiratory tract infection, headache, swelling of the lymph nodes, and pink eye (conjunctivitis) in patients who received either benralizumab or placebo What are the key takeaways? Benralizumab lowered the number of blood eosinophils without improving AD symptoms and was well tolerated.

Allarme rosso: il sanguinamento rettale

A 6-week-old, exclusively breastfed and well-appearing infant presented with blood in her stools. A diagnosis of food protein-induced allergic proctocolitis was promptly made by the presence of the high number of eosinophils in her blood and the prompt clinical response to the elimination of cow milk proteins from her mother's diet.

Allarme rosso: il sanguinamento rettale

A 6-week-old, exclusively breastfed and well-appearing infant presented with blood in her stools. A diagnosis of food protein-induced allergic proctocolitis was promptly made by the presence of the high number of eosinophils in her blood and the prompt clinical response to the elimination of cow milk proteins from her mother's diet.

Plain Language Summary of principles for improving the care of people with eosinophil-associated diseases.

Eosinophil-associated diseases (EADs) are a group of conditions in which eosinophils (a type of white blood cell) are thought to play a key role in the disease and how it develops. Some EADs are common, such as atopic dermatitis (also called eczema) and a subtype of asthma called eosinophilic asthma, while others are rare, such as hypereosinophilic syndrome (a condition in which a person has a very high number of eosinophils in both the blood and one or more organs). People with EADs face many problems related to their conditions. Symptoms such as severe abdominal pain, itch, or shortness of breath impact both the patient as well as their friends and family. Patients with EADs also experience delays to diagnosis and treatment as well as financial barriers. Healthcare professionals sometimes fail to recognize the complex set of symptoms that characterize an EAD, and this may cause delays in reaching a correct diagnosis. As a result, it may take longer for a patient to get the best care and the most effective treatments, which may contribute to poor health. The goal of this charter is to describe the key elements of good quality care, which all people with EADs deserve, as well as to present an action plan to improve health and overall well-being for people with EADs. Proposed use of this patient charter: The principles described in this charter (a written guide to achieve an outcome) show the core elements of quality care that people with EADs must receive. They also describe clear steps to reduce the burden on patients and their caregivers and to improve patient health outcomes. We urge healthcare professionals, hospitals, and policymakers around the world to adopt these principles quickly. By doing this, people with EADs will be more likely to receive an accurate and timely diagnosis and have access to quality care and treatment in the right setting.

Potential role for a Nematode Pan Allergen (NPA) in Tropical Pulmonary Eosinophilia (TPE)

Abstract Tropical Pulmonary Eosinophilia (TPE) is an asthma-like hyper-responsive syndrome characterized by accumulation of a high number of eosinophils in the lungs leading to severe respiratory morbidity in patients infected with lymphatic filariasis (LF), a helminth parasitic infection that affects 51 million people in 47 different countries worldwide. Subjects showing TPE also have circulating microfilariae (larval stages of LF) and a high titer of parasite-specific IgE in their blood. IgE and eosinophils are thought to play a major role in TPE pathology. However, specific antigens that are released from microfilariae responsible for generating the IgE antibodies in TPE are not known. Therefore, in this study, we screened a phage displayed cDNA expression library of Wuchereria bancrofti microfilaria with human monoclonal IgE antibodies generated from B cells isolated from TPE patients. The iterative screening identified WbNPA (Nematode Pan Allergen) and WbTCTP (Translationally Controlled Tumor Protein) as IgE antibody binding antigens. Subsequent analysis showed that rWbNPA and rWbTCTP can result in the release of histamine from mast cells in an IgE-dependent and independent manner. rWbNPA can induce accumulation of eosinophils in the peritoneal cavity of mice and can trigger the secretion of IL-2 and TNF-α from alveolar macrophages. These results suggest that WbNPA and WbTCTP have a potential role in the pathology of TPE in LF infections.

Antibody response and abomasal histopathology of lambs with haemonchosis during supplementation with medicinal plants and organic selenium

We evaluated the effects of dietary supplementation with medicinal plants (Herbmix) or organic selenium (Selplex) on the immune responses and histopathology of lambs infected with Haemonchus contortus. Twenty-seven lambs were infected and reinfected with approximately 11,000 third-stage larvae of H. contortus during the experiment (on days 0, 49 and 77). Lambs were divided into two supplemented experimental groups (Herbmix and Selplex) and unsupplemented group (Control). The abomasal worm counts at necropsy on day 119 were lower for Herbmix (4230) and Selplex group (3220) than to the Control (6613) which resulted in 51.3% and 36.0% of reduction, respectively. The mean length of adult female worms was in the order Control > Herbmix > Selplex (2.1, 2.08, and 2.01 cm, respectively). The specific IgG response against adults was significantly affected by time (P < 0.001). Serum-specific and total mucus levels of IgA in the Herbmix group were highest on day 15. Mean levels of serum IgM against adults were influenced by treatment (P = 0.048) and time (P < 0.001). The Herbmix group had strong local inflammation in the abomasal tissue, with the formation of lymphoid aggregates and the infiltration of immune cells, but the tissues of the Selplex group had higher numbers of eosinophils, globule leukocytes, and plasma cells. The lymph nodes of each animal had reactive follicular hyperplasia due to the infection. Dietary nutritional supplementation with a mixture of medicinal plants or organic selenium could improve local immune responses and thus enhance the resistance of animals to this parasitic infection.

What we have learned about lymphocytic variant hypereosinophilic syndrome: A systematic literature review

Lymphocytic variant is a rare subtype of hypereosinophilic syndrome (L-HES) secondary to overproduction of eosinophilopoietic cytokines by the underlying clonal T lymphocytes with abnormal immunophenotypes. Clinical profiles, treatment responses, and outcomes of L-HES are not well characterized given its rarity. We performed a systematic literature review to summarize cases identified in PubMed and Embase databases between January 1994 and July 2021. A total of 148 patients met the inclusion criteria with a median age at diagnosis of 46 years and 51.4% being male. Cutaneous manifestations (81.1%) predominated the clinical picture, while the characteristic cardiovascular involvement was seen in 11.5% of cases. The median eosinophil count at baseline was 5.3 × 109/L and 109 patients (73.6%) had underlying clonal T lymphocytes harboring the classic CD3−CD4+ immunophenotype, which was associated with higher numbers of eosinophils and organ involvement at baseline. Corticosteroids were the most common first-line agent (88.1%), but most patients required additional treatment, leading to clinical or hematologic response in two-thirds. The 10-year overall survival was 81.6% (95% confidence interval [CI] 68.1–89.8). Transformation into malignant T cell lymphoma was observed in 19 patients, specifically in those with cardiovascular involvement (odds ratio [OR] 4.723, 95% CI 1.304–17.108, p = 0.018) and imatinib use (OR 4.284, 95% CI 1.191–15.404, p = 0.026). Taken together, a heavier disease burden was shown in L-HES patients with classic CD3−CD4+ lymphocytes but they were manageable with corticosteroids and sparing agents. There is an increased risk of lymphoma transformation that could be associated with certain clinical surrogates.

Perspectives on the Efficacy of Benralizumab for Treatment of Eosinophilic Granulomatosis With Polyangiitis.

Two types of interleukin (IL)-5 antibody biologics, anti-IL-5 antibodies (mepolizumab) and anti-IL-5α receptor antibodies (benralizumab), are indicated for severe asthma. While high-dose mepolizumab is also indicated for EGPA, benralizumab is indicated only for severe asthma. Benralizumab is characterized by antibody-dependent cell-mediated cytotoxicity activity, giving them specific and rapid anti-IL-5α receptor binding abilities and the ability to target a high number of eosinophils in tissues as well as peripheral blood. Recently, reports on the efficacy of benralizumab as a treatment for EGPA have been published, along with reports on some cases that are difficult to treat with existing oral corticosteroids and mepolizumab. Therefore, we focus on the perspective of the efficacy and safety of benralizumab as a treatment for EGPA patients with steroid dependence in this review. A total of 41 patients with EGPA were treated with benralizumab. After the introduction of benralizumab, oral corticosteroids could be reduced to 10 mg/day or less in all cases and to less than 5 mg/day in 80% or more of the cases. Discontinuation of oral corticosteroids was achieved in more than 40% of patients with EGPA. Benralizumab was effective in patients with mepolizumab-refractory EGPA and intractable cardiac and neuropathy complications. Efficient elimination of eosinophils is expected to improve the remission rate of EGPA with benralizumab treatment. Although the total number of patients was small, benralizumab was safe and tolerable in a wide range of age groups, suggesting efficacy in severe cases with EGPA.

Клеточный профиль мокроты и активность миелопероксидазы у больных бронхиальной астмой с холодовой гиперреактивностью дыхательных путей

Th e aim of the research. To study the infl ammation pattern, myeloperoxidase activity and the content of the epithelium in the bronchi of patients with bronchial asthma (BA) with diff erent forms of airway hyperresponsiveness to physical stimuli. Material and methods. Th e degree of asthma control, pulmonary function, and cellular composition of induced sputum were studied in 142 BA patients with various forms of airway hyperresponsiveness to indirect provoking triggers. In cytological smears, the number of neutrophils, eosinophils, bronchial epithelial cells was counted. A cytochemical study of myeloperoxidase activity in sputum neutrophils was carried out. Results. It has been established that BA patients with combined airway hyperresponsiveness to various physical stimuli have lower asthma control, a higher number of eosinophils in sputum, a higher level of myeloperoxidase in neutrophils, and a lower percentage of intact bronchial epithelium compared to patients with isolated cold airway hyperresponsiveness. A close relationship was found between the level of eosinophils and the number of intact epitheliocytes (Rs=-0.52, p&lt;0.001). In patients with combined airway hyperresponsiveness, a relationship was found between the activity of myeloperoxidase in neutrophils and the severity of the bronchial response to isocapnic hyperventilation with cold air (R=-0.33; p&lt;0.05). Conclusion. Activation of the peroxidase function of neutrophils and stimulation of the eosinophil activity, which leads to destruction of the epithelium and a decrease in the content of normal epitheliocytes, are associated with a greater severity of airway hyperresponsiveness to cold and the addition of reactions to other stimuli

Efficacy of Albendazole Against Strongylus sp. and Hematology Changes on Equine in Yogyakarta Special Region

The infestation of Strongylus sp. in horses can cause losses to horse breeders, including anorexia, anemia, gastrointestinal diseases and can cause death and decrease the horse population in DIY. Albendazole was a Benzimidazole preparation that is often used to treat worms in ruminants. This study also aims to determine the effect of Albendazole on blood images before and after treatment. The material used in this study were 10 horses with male and female sex, over 3 years old, and infected with Strongylus sp. with an infestation rate of 200 EPG in faeces. Before treatment of drug was carried out, the faeces was examined with Mc Master method. After treatment with Albendazole, the worm eggs were examined three times at intervals of three days. Routine examination of worm eggs and blood was carried out at the Laboratory of the Department of Internal Medicine, Faculty of Veterinary Medicine, Universitas Gadjah Mada. The results showed that the EPG number decreased from the 0th, 3rd, 6th and 9th day of examinations. The average number of EPG on the 0th day was 990 eggs/gram, and the examination on the 9th day showed the number of eggs was 0 eggs/gram. The results of the hematology examination also showed no significant difference except for the high number of eosinophils on the 12th day after drug administration. The conclusion from this research is that Albendazole as a worm medicine can kill Srongylus sp. however, it does not affect the horse's hematology and health status.

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Evaluation of the influence and correction of pneumocystis infection on clinical and laboratory characteristics of chronic obstructive pulmonary disease

Introduction . Chronic obstructive pulmonary disease (COPD) is an actual problem of modern medicine due to the appearance of exacerbations and inevitable progression, but currently known clinical factors cannot fully explain the course of the disease. Aim . To assess the relationship between the presence of Pneumocystis (PC) infection and the clinical characteristics of COPD, as well as the effect of correcting the activity of PC on the course of COPD. Materials and methods . 90 patients with COPD of II, III, IV degrees of severity were examined. Against the background of standard therapy for COPD exacerbation and therapy with trimethoprim/sulfamethoxazole, laboratory and functional research methods were performed, the current of COPD was evaluated by validated questionnaires (CAT, mMRC), the titer of IgM and IgG antibodies to PC in the blood serum was determined, and the number of COPD exacerbations was tracked throughout the year. Results . Markers of active PC infection were detected in 62.2% of patients. PC infection with COPD exacerbation significantly increased the frequency of COPD exacerbations (2.68±0.08 vs. 2.45±0.15; р˂0.05). PC infection was statistically (р˂0.05) more common in individuals with grade II COPD. In the group with PC infection, a significantly higher number of eosinophils was observed than in the group without PC infection in COPD exacerbation of 360.46±15.39 vs. 277.82±13.63 cells/µL (р˂0.01) and remission of 398.87±19.49 vs. 324.21±26.68 cells/µL (р˂0.05). After treatment with trimethoprim /sulfamethoxazole, there was a disappearance of IgM to PC and a decrease in IgG titer, a significant decrease in the level of blood leukocytes (6.08±0.13 vs. 6.91±0.19×10 9 /L; p&lt;0.01), an improvement in the values of FEV 1 (63.59±1.30 vs. 61.06±1.29% pred.; р˂0.01) and FEV 1 /FVC 54.53±1.0 vs. 52.29±1.03%; р˂0.01). There was a significant decrease in COPD activity according to the CAT test, mMRC, and a decrease in the number of exacerbations during the year. Conclusion . Active PC infection in COPD is associated with a high number of eosinophils in the blood and an increased risk of frequent exacerbations of COPD during the year. Treatment of PC infection in COPD with a combination of trimethoprim/sulfamethoxazole leads to a significant improvement in clinical and laboratory parameters and a decrease in the frequency of exacerbations of the disease over the next year

P001 Pyostomatitis Vegetans in a Patient With Crohn's Disease: A Case Report on the Effectiveness of Ustekinumab

INTRODUCTION: Pyostomatitis vegetans (PV) is a rare inflammatory stomatitis that is seen in association with inflammatory bowel diseases (IBD). The treatment approach of PV depends on the presence of coexisting IBD. In the absence of IBD, topical steroids are often used, but in many cases, there is a need for systemic therapy. To date, there have been no published reports on the use of ustekinumab for PV. CASE: A 26-year-old female with long standing Crohn’s disease presented for further evaluation of recurrent lip and chin swelling as well as loose bowel movements and abdominal pain. She was diagnosed at the age of 8 with Crohn’s disease and was treated with mesalamine and azathioprine which maintained her in remission for 10 years. Overall, she remained well, but would experience mild gastrointestinal symptoms along with recurrent episodes of chin and lip swelling a couple of times a year. Upon presentation, she had severe swelling of her lips and chin with neck erythema. Additionally, the patient had lower abdominal pain, and loosening of her bowel movements. Endoscopic evaluation with biopsies was consistent with active Crohn's disease. After consulting with our dermatology colleagues, it was decided to give the patient a short course of steroids as she was in extreme distress from her PV. She was then started on ustekinumab monotherapy (initial dose 260 mg intravenously), especially given her history of mild psoriasis. Shortly after, her pustules crusted and then disappeared. The patient has been on ustekinumab 90 mg subcutaneously every 8 weeks for the past 7 months. Since then, her lip and chin swelling improved remarkably without recurrence. Additionally, her Crohn’s disease has been in remission based on symptoms and noninvasive inflammatory markers. DISCUSSION: PV is a rare inflammatory stomatitis that is often seen in association with IBD. PV oral lesions are benign. They consist of multiple small white and yellow pustules with an erythematous and edematous mucosal background. If they rupture, these pustules fuse and lead to a “snail-track” appearance. Those lesions can be painful or painless. On histology, intra and sub-epithelial micro abscesses with high number of eosinophils and neutrophils can be seen. The intestinal symptoms usually precede oral PV by several months or years. The clinical course of PV parallels the activity of IBD. As for treatment of PV, the approach depends on the presence of coexisting IBD. In patients with IBD, management of PV is often based on the therapy utilized to treat the underlying IBD. In the absence of IBD, topical steroids are efficacious, but in many cases, there will be a need for systemic therapy. Prior to this case, there have been no published reports on the use of ustekinumab for the treatment of PV. CONCLUSION: PV is a rare inflammatory stomatitis and it is often seen in association IBD. One treatment option that might be considered is ustekinumab, given its low immunogenicity and favorable safety profile.

3073 Eosinophilic Gastroenteritis and Eosinophilic Proctocolitis With a Large Rectal Sessile Serrated Adenoma: A Rare Association

INTRODUCTION: Eosinophilic Gastrointestinal Disorders (EGID) are a group of rare disorders characterized by eosinophilic infiltration of the gastrointestinal tract. Eosinophilic gastroenteritis (EGE), eosinophilic colitis (EC) and eosinophilic proctitis (EP) are different types of EGID. We report a case of rare association of EGID and a large sessile serrated adenoma in a middle-aged Hispanic female. CASE DESCRIPTION/METHODS: A 49-year-old Hispanic female presented with epigastric discomfort, nausea and hematochezia. The symptoms were insidious in onset and evolved over the span of 3 years. Upper GI Endoscopy showed mild diffuse erythematous mucosa in the antrum and body of the stomach. Colonoscopy showed a few superficial ulcers in the terminal ileum, two polyps in the transverse colon and a large laterally spreading polypoid lesion in the rectum with adjacent multiple small polypoid lesions (Figures 1 and 2). Histological assessment of the gastric biopsy specimen revealed chronic active gastritis, numerous H. pylori, in addition to very high number of eosinophils in the lamina propria. Biopsies of ileum, colon and the rectum also revealed very high number of eosinophils in the lamina propria. Stool for ova and parasite examinations were negative and no peripheral eosinophilia was noted. Patient did not have any food or environmental allergies. Other disorders that could contribute to eosinophil infiltration of the GI tract were ruled out. Hematochezia was likely due to eosinophilic proctitis and rectal polypoid lesion. Although exact eosinophilic count in the biopsy specimen of the stomach, small bowel and the colon was not reported, the clinical presentation and histology was likely consistent with EGID. Patient was treated for H. Pylori infection. Endoscopic submucosal dissection of the rectal polypoid lesion was performed (Figure 3). Pathology revealed sessile serrated adenoma. DISCUSSION: Eosinophilic gastrointestinal disorders are a group of rare gastrointestinal diseases with non-specific symptoms and clinical presentation. Diagnosis of EGE, EC and EP involves evaluating for presence of gastrointestinal symptoms, histopathology finding of eosinophilic infiltration of the GI tract and ruling out secondary causes of eosinophilia. Endoscopic examination may reveal patchy erythema, loss of vascularity and lymphonodular hyperplasia mostly localized to the rectum. The authors report this rare case of possible association of EGID and sessile serrated adenoma.

Eosinophils and Respiratory Viruses.

Eosinophils have been mainly associated with parasitic infection and pathologies such as asthma. Some patients with asthma present a high number of eosinophils in their airways. Since respiratory viruses are associated with asthma exacerbations, several studies have evaluated the role of eosinophils against respiratory viruses. Eosinophils contain and produce molecules with antiviral activity, including RNases and reactive nitrogen species. They can also participate in adaptive immunity, serving as antigen-presenting cells. Eosinophil antiviral response has been demonstrated against some respiratory viruses in vitro and in vivo, including respiratory syncytial virus and influenza. Given the implication of respiratory viruses in asthma, the eosinophil antiviral role might be an important factor to consider in this pathology.

Role of angiotensin II type 1 (AT1) and type 2 (AT2) receptors in airway reactivity and inflammation in an allergic mouse model of asthma

Objective: Angiotensin II (Ang II) exerts its effects through two G-protein coupled receptors: angiotensin II type 1 receptors (AT1) and type 2 receptors (AT2). Both these receptor subtypes are poorly understood in asthma. In this study, we investigated effects of AT1 receptor antagonist losartan, novel AT2 receptor agonist novokinin and AT2 receptor antagonist PD 123319 in a mouse model of asthma.Methods: Mice were divided into control (CON) and allergen sensitized (SEN) groups. SEN was sensitized with ovalbumin (OVA) on days 1 and 6 (30 μg; i.p.), followed by 5% OVA aerosol challenge (days 11–13). Treatments included (a) losartan (SEN + LOS; 20 mg/kg i.p., day 14), (b) novokinin (SEN + NOV; 0.3 mg/kg i.p., day 14), and (c) PD 123319 (SEN + PD; 5 mg/kg i.p., day 14). Experiments for airway responsiveness, bronchoalveolar lavage, and tracheal ring reactivity using isolated organ bath were performed.Results: Airway responsiveness to methacholine (MCh) (48 mg/mL) was significantly higher in SEN (563.71 ± 40% vs. 294.3 ± 123.84 in CON). This response was potentiated in SEN + PD group (757 ± 30%; p < .05 compared to SEN). SEN + LOS (247.61 ± 86.85%) and SEN + NOV (352 ± 11%) had significantly lower response compared to SEN. SEN + LOS (26.22 ± 0.29%) and SEN + NOV (46.20 ± 0.76%) treatment significantly (p < .001) attenuated total cell count and eosinophils compared to SEN group (69.38 ± 1.5%), while SEN + PD (73.04 ± 0.69%) had highest number of eosinophils. Tracheal response to MCh was significantly higher in SEN group compared to controls, and this response was significantly lowered with the losartan and novokinin treatments.Conclusions: These data suggest that AT1 and AT2 receptors have opposite effects in modulating airway hyperresponsiveness and inflammation in asthma.

ON THE OPTIMIZATION OF VERIFICATION OF BRONCHIAL ASTHMA IN CHILDREN WITH MANIFESTATIONS OF BRONCHOOBSTRUCTIVE SYNDROME

Bronchial asthma in children has different causes of development, and examination of markers to verify the disease in case of the first signs of bronchial obstruction is an important issue to find transitory or persisting asthma phenotypes. There were examined 156 children with signs of bronchial obstruction syndrome.They were divided into three clinical groups: the first (І) group included 36 children with acute obstructive bronchitis (average age 6,1 ± 0,6 years, 36 % of girls), the second (ІІ) group – 74 children with relapsing obstructive bronchitis (average age 5,60 ± 0,34 years, 38 % of girls), the third (ІІІ) group included 46 children suffering from bronchial asthma for two years (average age 11,6 ± 0,5 years, 33 % of girls).The family history of one of the parents and of both parents, aggravated by allergic diseases, was most often found in patients with bronchial asthma: in 34,8 % of children on maternal side (Р ˂ 0,05 with І, ІІ : ІІІ), in 17,4 % of cases on paternal side (Р ˃ 0,05) and in 4,3 % – on both sides (Р ˃ 0,05). Patients suffering from bronchial asthma in 78,3 % of cases demonstrated domestic, food or medical allergy, that was reliably higher than that of an appropriate number of children in І (33,3 %) and ІІ groups (37,2 %), Р ˂ 0,05. In case of complicated family anamnesis with allergic diseases and the level of nitrogen monoxide metabolites more than 40 µmol/l the diagnostic value of this test in detection of bronchial asthma is the following: sensitivity 87,5 %, specificity 89,5 %, predicted value of a negative result 97,1 % with realization odds ratio 59,5, relative risk 22,3. Relative blood eosinophilia (Р ˂ 0,05 with ІІІ : І, ІІ) and sputum eosinophilia (Р ˂ 0,05 with ІІІ : І, ІІ) in children suffering from bronchial asthma as compared to the patients with obstructive bronchitis were found. In patients with verified asthma compared with children with acute and recurrent obstructive bronchitis, a significantly higher number of eosinophils, alveolar macrophages and epithelial cells in sputum is observed, which is accompanied by a lower content of neutrophil granulocytes and lymphocytes.Thus, in children with bronchial obstruction, even at its first episode, to identify the risk of bronchial asthma, a family history should be carefully collected on the burden of allergic diseases, the history of the child on allergic manifestations, in the dynamics to determine the number of eosinophils in the peripheral blood and induced sputum, the level serum immunoglobulin E and the content of metabolites of nitric oxide in the condensate of exhaled air.

ON THE OPTIMIZATION OF VERIFICATION OF BRONCHIAL ASTHMA IN CHILDREN WITH MANIFESTATIONS OF BRONCHOOBSTRUCTIVE SYNDROME

Bronchial asthma in children has different causes of development, and examination of markers to verify the disease in case of the first signs of bronchial obstruction is an important issue to find transitory or persisting asthma phenotypes. There were examined 156 children with signs of bronchial obstruction syndrome.They were divided into three clinical groups: the first (І) group included 36 children with acute obstructive bronchitis (average age 6,1 ± 0,6 years, 36 % of girls), the second (ІІ) group – 74 children with relapsing obstructive bronchitis (average age 5,60 ± 0,34 years, 38 % of girls), the third (ІІІ) group included 46 children suffering from bronchial asthma for two years (average age 11,6 ± 0,5 years, 33 % of girls).The family history of one of the parents and of both parents, aggravated by allergic diseases, was most often found in patients with bronchial asthma: in 34,8 % of children on maternal side (Р ˂ 0,05 with І, ІІ : ІІІ), in 17,4 % of cases on paternal side (Р ˃ 0,05) and in 4,3 % – on both sides (Р ˃ 0,05). Patients suffering from bronchial asthma in 78,3 % of cases demonstrated domestic, food or medical allergy, that was reliably higher than that of an appropriate number of children in І (33,3 %) and ІІ groups (37,2 %), Р ˂ 0,05. In case of complicated family anamnesis with allergic diseases and the level of nitrogen monoxide metabolites more than 40 µmol/l the diagnostic value of this test in detection of bronchial asthma is the following: sensitivity 87,5 %, specificity 89,5 %, predicted value of a negative result 97,1 % with realization odds ratio 59,5, relative risk 22,3. Relative blood eosinophilia (Р ˂ 0,05 with ІІІ : І, ІІ) and sputum eosinophilia (Р ˂ 0,05 with ІІІ : І, ІІ) in children suffering from bronchial asthma as compared to the patients with obstructive bronchitis were found. In patients with verified asthma compared with children with acute and recurrent obstructive bronchitis, a significantly higher number of eosinophils, alveolar macrophages and epithelial cells in sputum is observed, which is accompanied by a lower content of neutrophil granulocytes and lymphocytes.Thus, in children with bronchial obstruction, even at its first episode, to identify the risk of bronchial asthma, a family history should be carefully collected on the burden of allergic diseases, the history of the child on allergic manifestations, in the dynamics to determine the number of eosinophils in the peripheral blood and induced sputum, the level serum immunoglobulin E and the content of metabolites of nitric oxide in the condensate of exhaled air.

Pathology and Distribution of Trombiculosis in Northern Chamois ( Rupicapra rupicapra rupicapra) in the Italian Alps.

Trombiculosis has been reported in some wild ruminant species. We investigated the occurrence of trombiculosis in the northern chamois ( Rupicapra rupicapra rupicapra) in the Western Italian Alps, and we describe the related histopathologic changes. Superficial scrapes and skin samples were taken from 191 chamois from the Lombardy and Piedmont regions during the hunting season in September-December 2015. Numbers of eosinophils, mast cells, cluster of differentiation (CD)3-, CD79α-, CD68-positive cells were determined on immunohistochemically stained skin sections using a semiautomatic analysis system. Forty (20.9, 40/191) chamois were positive for trombiculid larvae on skin scrapings. Of the positive animals, 15 were from Lombardy and 25 from Piedmont, with similar prevalences. Macroscopic lesions were light with involvement of body regions that had contact with the ground, especially head (pinnae and areas around eyes and mouth) and limbs, where stylostome was easily formed due to thin skin. Histologically, trombiculosis caused a focal moderate dermatitis with epidermal necrosis, thin crusts, and hyperkeratosis. Inflammatory infiltrates were suggestive of a granulomatous reaction centered on a stylostome, formed by mite saliva and necrotic host tissue debris. However, we detected some difference in cutaneous immune response with some chamois showing a prevalent T-cell response and others having an increased B-cell count associated with a higher number of eosinophils, mast cells and a lower number of T cells.