Serum and secretory immunoglobulins in allergic diseases

A total of 158 patients with pollinosis, bronchial asthma, urticaria and Quincke's edema were examined. The immunoglobulin and C3 levels in sera and the immunoglobulin and albumin levels in saliva were determined by the method of single radial immunodiffusion with the corresponding monospecific antisera. In all the groups of patients subjected to examination the presence of polyclonal hypergammaglobulinemia was detected, which was manifested by a rise in the levels of IgG, IgA and especially IgM; the level of IgD was low. A decrease in the level of C3 was detected in pollinosis patients in the absence of the exacerbation of the disease. No circulating immune complexes were detected. An essential increase in the level of IgG in saliva was revealed, which was due to the local synthesis of this immunoglobulin. In winter the level of salivary IgA in pollinosis patients was found to be essentially below normal, but at the period of exacerbation it increased twofold, probably in response to local stimulation with antigen-allergen. Patients with bronchial asthma and pollinosis were found to have a high level of free secretory component (SC); in pollinosis the level of free SC sharply increased during the stage of exacerbation, which was due to the increase of its synthesis and secretion by the epithelial cells of the mucous membranes. The importance of these data for the pathogenesis of allergic diseases are discussed.     

Diagnostic significance of immunoglobulins in infectious allergic bronchial asthma

In 100 patients with infectious allergic bronchial asthma the levels of IgM. IgG and IgA were determined by Mancini's method and the levels of IgE, tissue and microbial antibodies by the Prausnitz - Küstner test before and after combined treatment carried out under conditions of the microclimate of the salt mines in the village of Solotvino. The data on the content of immunoglobulins in the blood serum allowed the authors to establish 3 types of immediate hypersensitivity. THe decreased content of IgM in the blood serum indirectly revealed the role of immune complexes in the pathogenesis of infectious allergic bronchial asthma. The high content of IgE suggested that atopy could take some part in the infectious process.     

The effect of sodium nucleinate on allergic and immunological reactions

Experiments on immunized rabbits and guinea pigs indicated that sodium nucleinate (SN) was capable of weakening or entirely eliminating anaphylactic and skin reactions of delayed type hypersensitivity to repeated administration of staphyloanatoxin, APDT vaccine. The findings on patients with the infectious form of bronchial asthma and chronic rheumatism showed that sodium nucleinate attenuated reactions to the subcutaneous administration of staphylococcal and streptococcal allergens. The treatment of patients suffering from infectious-allergic bronchial asthma and rheumatism with SN resulted in the recovery of deficient T cells, T-suppressors, normalization of immunoglobulin concentrations. In children with acute glomerulonephritis sodium nucleinate normalized decreased T-suppressor cells and increased IgG and circulating immune complexes (CIC), resulting in a pronounced remission of disease. The mechanism of desensitization and elimination of CIC by SN has not been explored, however, the parameters of SN-induced immunomodulation are known rather completely. It is suggested that SN brings about accumulation in the cell of cyclic AMP which diminished membrane permeability, activates monoaminooxidase resulting in the degradation of histamine and other biogenic amines, enhances the synthesis of endogenous corticosteroids with their desensitizing properties. All these effects contribute to the elimination of delayed type hypersensitivity. The role of SN in the inhibition of delayed type hypersensitivity remains obscure.     

Effect of inhalation therapy with beclomethasone dipropionate on unspecific bronchial hyperreactivity in patients with asthma]

An effect of beclomethasone dipropionate (Beclocort-Polfa) was investigated in the group of 24 patients with atopic and non-atopic bronchial asthma who have shown unspecific bronchial hyperreactivity to histamine during the periods of remission. The drug was administered in the form of aerosol in a daily dose of 1.0 mg for 4 weeks. Provocative histamine dose was established with Bronchoscreen device (Jaeger) thrice:prior to the treatment, after 1 week of placebo therapy, and after 1 month of beclomethasone administration. Statistically significant increase in histamine dose for provocation of bronchospasm (p < 0.01) being nearly twice higher than the baseline value has been noted in patients treated with beclomethasone dipropionate aerosol. It advocates such a treatment in unspecific bronchial hyperreactivity independently of the type of the bronchial asthma.     

Dependence of the migration activity of blood granulocytes from healthy donors and from bronchial asthma patients on the presence of cellular mediators

The migration activity of granulocytes in human blood has been shown to depend both on the locomotor properties of these cells and on the presence of cell mediators secreted by blood mononuclears and by granulocytes themselves. Granulocytes in the blood of patients with the atopic form of bronchial asthma differ from granulocytes in healthy donors by sharply decreased spontaneous migration activity. Granulocytes and mononuclears in the blood of patients with the atopic form of bronchial asthma differ from the corresponding cells of donor blood in the activity of cell mediators secreted by them and influencing the migration of granulocytes in the donors.     

Immunological mechanisms of specific hyposensitization in allergic diseases of an infectious nature.. I. Hyposensitization with autovaccine]

Immunological processes in 17 patients with infectious allergic bronchial asthma accompanied by chronic respiratory tract infection were studied in dynamics resulting from the hyposensitization of the patients with autovaccine. Specific sensitization was shown to produce stable clinical remission. The therapeutic effect of this method was ensured by a simultaneous hange in non-specific cellular and humoral immunity. A stable therapeutic effect was observed gainst the background of activated immunological processes and weakened sensitization.     

CARD15 and TLR4 genes polymorphisms in atopic bronchial asthma

In order to investigate whether single nucleotide polymorphisms G(+2722)C and 3020insC in CARD15 gene and Asp299Gly in TLR4 gene contribute to atopic bronchial asthma we performed a comparative analysis of alleles and genotypes frequencies of these polymorphisms in Russian patients from Moscow. DNA samples from 283 patients with atopic bronchial asthma and 227 healthy donors were genotyped. There were associations neither of G(+2722)C and 3020insC in CARD15 gene and Asp299Gly in TLR4 gene with asthma nor of markers of CARD15 gene with asthma severity. Haplotype frequency analysis of CARD15 gene polymorphisms did not reveal significant difference between groups. However, a strong association was found between Asp299Gly and asthma severity. Allele Asp of this marker showed association with mild atopic bronchial asthma and allele Gl--with moderate/severe asthma = 0.47, 95% CI [0.24-0.93] i OR = 2.12, 95% CI [1.08-4.18] respectively).     

Role of cockroaches Blatella germanica in the development of atopic bronchial asthma

The results of the development of manufacturing technology for the preparation of allergen from the bodies of cockroaches and the physico-chemical characteristics of this allergen are presented. The complex allergological examination of patients with atopic bronchial asthma revealed that 69.3% of such patients were sensitized to house dust, and in 68.4% of them IgE antibodies to cockroach allergens were detected. Patients with atopic bronchial asthma, not sensitized to house dust, were found to have sensitization to Blatella germanica in 12.2% of cases.     

T cells of atopic asthmatics preferentially infiltrate into human bronchial xenografts in SCID mice

T cells play an important role in the pathogenesis of bronchial asthma. However, it is not completely known how circulating lymphocytes infiltrate into the airways of asthmatic patients. Because SCID mice are unable to reject xenogenic transplants, many xenotransplant models using various human tissues have been developed. Therefore, to examine the interaction between bronchi and T lymphocytes of asthma, it may be possible to use the human bronchial xenograft and PBMC xenograft in SCID mice. We transplanted human bronchi into the subcutaneum of SCID mice and i.p. injected PBMCs that were obtained from patients with atopic asthma, atopic dermatitis and rheumatoid arthritis, and normal subjects (asthmatic, dermatitis, rheumatic, and normal huPBMC-SCID mice). There was no difference in the percentage of CD3-, CD4-, CD8-, CD25-, CD45RO-, CD103-, and cutaneous lymphocyte Ag-positive cells in PBMCs among the patients with asthma, dermatitis, rheumatoid arthritis, and normal subjects, and CD3-positive cells in peripheral blood of asthmatic, dermatitis, rheumatic, and normal huPBMC-SCID mice. The number of CD3-, CD4-, and CD8-positive cells in the xenografts of asthmatic huPBMC-SCID mice was higher than those of dermatitis, rheumatic, and normal huPBMC-SCID mice. IL-4 mRNA and IL-5 mRNA were significantly higher in the xenografts of asthmatic huPBMC-SCID mice than those in the xenografts of normal huPBMC-SCID mice, but there were no significant differences in the expressions of IL-2 mRNA or IFN-gamma mRNA between them. These findings suggest that T cells, especially Th2-type T cells, of asthmatics preferentially infiltrate into the human bronchi.     

Bronchial asthma and endorphins

The paper deals with the investigation of endorphin content in the blood of patients with asthma. The increase in alpha- and beta-endorphin concentration was shown to depend on the severity of clinical manifestations of infectious-allergic and atopic forms of bronchial asthma. This regularity was not observed for gamma-endorphin. The infectious-allergic form of asthma was characterized by drastic reduction in the content of all three endorphin types upon treatment with dexamethasone. The possible role of endorphin reactions in the pathogenesis of asthma is discussed.     

Usefulness of Multitest CMI for the measurement of cell-mediated immunity in patients with bronchial asthma

Cell-mediated immunity has been measured in vivo in 30 patients with allergic-infectious bronchial asthma with the use of Multitest CMI (Merieux). A decrease in the immunological reactivity has been showed in the asthmatic patients. It was expressed by means of the arithmetic mean value of the positive reactions, and was particularly significant in patients who require long-term corticotherapy. The obtained results suggest that Multitest CMI is a new, valuable device in the diagnosis and monitoring the treatment in asthmatic patients.     

Circulating immunologic complexes in blood sera of bronchial asthma patients treated with attenuated vaccine

The study included 20 patients (8 males and 12 females) with non-atopic bronchial asthma treated with attenuated vaccines. Circulating immune complexes were assayed with two methods prior to and after the treatment of each patient. No increase in serum circulating immune complexes was produced after the treatment. Clinical improvement was noted in 75% of treated patients. Circulating immune complexes were detected in the blood serum of three patients treated without an effect.     

Evaluation of selected personality features in patients with various clinical forms of bronchial asthma]

Psychological factors are of importance in the onset and clinical course of the bronchial asthma. Marked emotional disorders are seen in patients with atypical asthma. This study aimed at evaluating selected personality features in patients with various clinical forms of the bronchial asthma. Statistical analysis included 91 asthmatic patients and 30 healthy individuals being a control group. Selected personality features were evaluated with three psychological tests: Eysenck Personality Inventory, Minnesota Multiphasic Personality Inventory, and Cattel's Self cognition Chart. The obtained results have shown that the index of psychopathologies is higher in patients with non-atopic bronchial asthma than in patients with atopic asthma. Therefore, psychotherapy of asthmatic patients, especially with non-atopic form of the disease, should emphasize disturbances of experienced feelings in such patients.     

Elevation of serum soluble E-selectin and VCAM-1 in severe asthma

OBJECTIVE: To investigate the significance of circulating adhesion molecules associated with leucocyte-endothelial cell interactions in asthma, serum levels of soluble E (sE)-selectin, soluble P (sP)-selectin, soluble L (sL)-selectin, and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in mild, moderate and severe asthma. METHOD: Serum levels of sE-selectin, sP-selectin, sL-selectin, and sVCAM-1 were measured in 32 women with asthma and 30 healthy donors using an enzyme-linked immunosorbent assay method. Twenty patients were suffering from severe asthma, and 12 from mild/moderate asthma. RESULTS: Serum sE-selectin and sVCAM-1 levels from patients with asthma were significantly higher than those observed in healthy donors (p < 0.01). The levels of sP-selectin were the same as those of controls. The level of sE-selectin exhibited an important increase in the severe asthmatic patients compared with mild/moderate asthma (p < 0.01). The sVCAM-1 level was increased in severe asthma when compared with healthy controls. There was no correlation between the levels of soluble selectins and the age of the patients. A significant correlation was found between sE-selectin and sVCAM-1 levels. CONCLUSION: These data indicate that circulating soluble forms of the selectins may have different kinetics during the clinical course of asthma, suggesting that they may reflect different inflammatory pathways in severe asthma. Both sVCAM-1 and sE-selectin may be useful immunological markers for monitoring disease activity in asthma.     

Clinical and immunological effect produced by vaccination with "Pneumo 23" of children with atopic bronchial asthma

A total of 45 children aged 4-16 years with atopic bronchial asthma of different severity level-resulted from a past case of outhospital pneumonia, received vaccine "Pneumo 23" ("Aventis Pasteur", France). The vaccine was found to be well tolerated, no cases of the exacerbation of the atopic process were registered. A reliable Increased level of specific antibodies to the mixture of polysaccharides, contained in the vaccine "Pneumo 23", was found to occur. The tendency towards decreased level of serum IgE was established.     

Increased serum IL-17A and Th2 cytokine levels in patients with severe uncontrolled asthma

Abstract

Asthma is a syndrome of chronic bronchial inflammation and airway remodelling. Initially, asthma has been categorized into atopic and nonatopic types, based on antigen-specific IgE levels. Moreover, recently, asthma has been classified into different endotypes based on its pathophysiology, leading to the selection of the most optimal and effective therapies. Although T helper cell type 2 (Th2) cytokines were proven to play critical roles in atopic asthma, IL-17A has been reported to be involved in severe refractory asthma.

Patients and methods

In this study, we measured the levels of 24 cytokines/chemokines in the sera of healthy controls (HCs) (n = 34) and patients with asthma (n = 77), that were compared among patient groups with different disease activities and characteristics.

Results

The serum levels of nine cytokines were significantly higher in patients with asthma than in HCs, and the levels of IL-17A and SCF were significantly different between uncontrolled and well-controlled patient groups (p = 0.003). The IL-17A levels were significantly correlated with those of IL-4, IL-25, IL-10, and IFN-γ in patients with uncontrolled asthma, and the patients with the highest levels of all the above cytokines were refractory to high-dose of inhaled corticosteroid therapy and have a history of acute exacerbation within 1 year, requiring systemic steroid therapy.

Discussion

This study examines the profiles of upregulation and downregulation of various cytokines and chemokines in relation to asthmatic control status. IL-17A was significantly upregulated in patients with the uncontrolled and refractory status. Therefore, IL-17A may play important roles in asthmatic exacerbation, and its high level, in combination with upregulated Th2 and other cytokines, may indicate the refractory endotype of asthma.

     

Clinico-immunologic aspects of using mildronate in patients with bronchopulmonary diseases

The immunity status of 35 patients with chronic bronchitis and infectious and allergic bronchial asthma was studied. Defects in the humoral immunity were revealed. To correct the immunity status, all the patients were treated with mildronate. The immunomodulatory effect of mildronate was found in all the groups of the patients. Mildronate was shown to increase the activity of a secondary immune response and the bronchial potency in the persons with infectious and allergic asthma.     

Neutrophil chemotaxis in patients with infectious-allergic bronchial asthma

Patients with infectious allergic bronchial asthma have been shown to have a defect in the chemotaxis of neutrophils. This defect is more pronounced in corticosteroid-dependent patients.     

Variants of endothelin-1 and its receptors in atopic asthma.

Endothelin-1 (ET-1) is a 21 amino acid peptide released from several types of bronchial cells. It operates through two types of receptors, type A(ET-RA) and type B(ET-RB) and has various activities in the pathophysiology of atopic asthma. These genes are localised on different chromosomes where genome-wide searches have identified linkage for atopic asthma, thus supporting the candidacy of ET-1 and its receptors for atopic asthma. A genetic association study was performed with variants of these three genes in both British (n = 300) and Japanese populations (n = 200). No significant association was found between variants of EDN1 and EDNRB genes, and atopic asthma in either population. However, variants of EDNRA gene showed a marginal association with atopy [odds = 0.39(95% CI: 0.17-0.89), p = 0.022, Pc = 0.066], especially with antigen specific IgE levels [odds = 0.31 (95% CI: 0.20-0.77), p = 0.006, Pc = 0.018] in the British population. These findings suggest that EDNRA is a major candidate locus for atopy on chromosome 4.