N-acetyl-beta-hexosaminidase activity in asthma.

BACKGROUND: N-acetyl-beta-hexosaminidase (beta-hex) is a lysosomal hydrolase, which is selectively secreted into the extracellular space by inflammatory cells. The aim of our study was to assess the activity of beta-hex in the plasma of asthmatic patients, and to establish whether it correlates with asthma severity and airway inflammation. METHODS: The study was conducted in a group of 46 asthmatic patients and 13 healthy volunteers. All study participants underwent analysis of exhaled nitric oxide and flow-volume spirometry. beta-hex activity, peripheral blood eosinophils, total serum IgE and eosinophil cationic protein were analyzed in blood samples from all asthmatic patients and healthy volunteers. RESULTS: beta-hex activity was significantly higher in patients with severe or moderate asthma compared with healthy volunteers and was positively correlated with exhaled nitric oxide levels and serum eosinophil cationic protein in these groups of patients. There was no correlation between beta-hex activity and forced expiratory volume in 1 s, blood eosinophil count or total serum IgE in these groups of asthmatics. CONCLUSIONS: Our results suggest that beta-hex could take part in airway inflammation and remodeling in asthma. Our study is the first report in which the elevated activity of beta-hex in subjects with asthma has been observed. However, more studies are needed to establish the precise role of this enzyme in asthma in humans.

The role of endothelium-derived mediators in exercise-induced bronchoconstriction.

BACKGROUND: Exercise-induced bronchoconstriction (EIB) is a highly prevalent condition whose pathogenesis and effect on airways remain unclear. The aim of the study was to evaluate the changes in endothelial-derived mediators following intensive exercise in asthmatic patients. METHODS: The study was conducted in a group of 25 asthmatic patients (15 with EIB, 10 without EIB) and 8 healthy volunteers. Changes induced by intensive exercise in the plasma concentrations of endothelin-1 (ET-1), thrombomodulin and soluble E-selectin were determined. Moreover, the possible correlations of these measurements with the results of baseline lung function, bronchial hyperreactivity (BHR), exhaled nitric oxide (F(ENO)), baseline eosinophil cationic protein, peripheral blood eosinophilia and total IgE were investigated. RESULTS: In the group of asthmatics with EIB, statistically significantly higher baseline concentrations of ET-1 and soluble E-selectin compared with asthmatics with negative exercise test results were revealed. In this group of patients, ET-1, thrombomodulin and soluble E-selectin concentrations significantly increased after exercise. Baseline concentrations of ET-1 as well as an increase in soluble E-selectin concentrations 60 min after exercise showed a statistically significant correlation with baseline eosinophil cationic protein, F(ENO) and BHR. The increase in plasma concentrations of ET-1 15 min after exercise and soluble E-selectin 60 min after exercise showed a statistically significant correlation with the increase in F(ENO) and BHR to histamine 24 h after exercise. CONCLUSIONS: We suggest that during EIB changes in the function of pulmonary endothelium occur and these changes may influence inflammation of the airway and remodeling in asthmatic patients.

Effect of ciclesonide and fluticasone on exhaled nitric oxide in patients with mild allergic asthma.

Ciclesonide is a novel, lung-activated, inhaled corticosteroid with once-daily efficacy and potent anti-inflammatory activity. The aim of the study was to compare the effect of ciclesonide and fluticasone propionate on exhaled nitric oxide (FENO), pulmonary function, and other parameters used in clinical evaluation of patients with mild allergic asthma. The study indicates that ciclesonide (in a daily dose of either 80 or 160 microg) induces both a faster and stronger decrease of FENO in comparison with fluticasone (100 microg twice daily). In both groups of patients treated with ciclesonide, the highest decrease in FENO levels was observed after 2 weeks of treatment. In the group of patients treated with fluticasone, this maximum effect was not observed till 8 weeks. An improvement in spirometric indices was observed in all groups studied. Statistical differences between the groups were not found; however, there was a trend toward higher increase in the group receiving 160 microg of ciclesonide. In all groups studied we observed clinical improvement (asthmatic symptoms and consumption of rescue medication were reduced), but there were no significant differences between these groups. Our results indicate that ciclesonide, compared with fluticasone, has stronger anti-inflammatory activity in patients with mild allergic asthma.

[Syndrom Corrao--cough variant asthma]. / Zespól Corrao--kaszlowa postac astmy.

Asthma is one of the most common aetiologies of chronic cough. In a subgroup of asthmatics, cough may be the predominant or sole symptom. This condition is referred to as cough variant asthma (CVA). The diagnosis of CVA often presents a challenge since physical examination and spirometric tests may be normal. Up to 50% of patients with CVA have associated eosinophilic bronchitis, with the degree of eosinophilia being similar to that of other asthmatics. Demonstration of bronchial hyperresponsiveness by methacholine inhalation challenge, elevated level of exhaled nitric oxide and sputum eosinophilia support the presence of CVA, but the diagnosis is confirmed only upon resolution of the cough with specific antiinflammatory treatment.

[Exhaled breath condensate in the assessment of airway inflammation]. / Kondensat powietrza wydychanego w diagnostyce przewleklych chorób zapalnych ukladu oddechowego.

Exhaled breath condensate (EBC) is a novel, non-invasive method for obtaining samples from the lung. Use of exhaled condensate as a source of biomarkers is based on the hypothesis that aerosol particles of exhaled breath reflect the composition of airway lining fluid. The technique is simple to perform, effort-independent, rapid, may be repeated frequently, and can be easily perform even in young children, adults, or patients with severe disease. EBC contains large number of various mediators including isoprostanes, cysteinyl-leukotrienes, adenosine, hydrogen peroxide, peptides, cytokines. Concentrations of these biomarkers are influenced by inflammation, oxidative stress and modulated by therapeutic interventions. EBC can be used to assess airway inflammation and oxidative stress in the respiratory tract, in differential diagnosis of airway disease and in the treatment monitoring.

[The role of measurement of exhaled nitric oxide in asthma patients]. / Stezenie wydychanego tlenku azotu w nieinwazyjnej diagnostyce chorych na astme.

The aim of the study was to evaluate exhaled nitric oxide levels (F(ENO)) in asthmatics and to establish the possible correlation of these measurements with clinical symptoms, disease severity, anti-inflammatory treatment and spirometric indices. The measurement of exhaled NO was performed using NO analyser model 280i, Sievers Instruments, Inc., USA. This measurement was based on the gas phase chemiluminescence reaction between NO and ozone. The investigations were performed on the group of 85 asthmatic patients (34 with chronic mild asthma, 31 with chronic moderate asthma, 20 with chronic severe asthma). F(ENO) level in healthy, non-smoking volunteers (46 persons--control group) was mean 12.9 +/- 4.6 ppB and it was statistically significant lower than in all groups of asthmatics. The highest F(ENO) levels were observed in patients with severe asthma (74 +/- 72 ppB). Statistically significant lower levels of ENO were obtained in patients with moderate (42 +/- 31 ppB) and mild asthma (49 +/- 43 ppB). In all groups of asthmatic patients higher levels of F(ENO) were observed in subjects with allergic asthma. In patients with mild and moderate asthma ENO levels were negatively correlated with the used dosage of inhaled steroids. Similar dependences were not noticed in patients with severe asthma. The measurement of exhaled nitric oxide levels provides a rapid, reproducible, non-invasive and reliable test, which is very useful in diagnosis and treatment monitoring in asthmatic patients.