Lack of an exaggerated inflammatory response on virus infection in cystic fibrosis.

Respiratory virus infections play an important role in cystic fibrosis (CF) exacerbations, but underlying pathophysiological mechanisms are poorly understood. We aimed to assess whether an exaggerated inflammatory response of the airway epithelium on virus infection could explain the increased susceptibility of CF patients towards respiratory viruses. We used primary bronchial and nasal epithelial cells obtained from 24 healthy control subjects and 18 CF patients. IL-6, IL-8/CXCL8, IP-10/CXCL10, MCP-1/CCL2, RANTES/CCL5 and GRO-α/CXCL1 levels in supernatants and mRNA expression in cell lysates were measured before and after infection with rhinoviruses (RV-16 and RV-1B) and RSV. Cytotoxicity was assessed by lactate dehydrogenate assay and flow cytometry. All viruses induced strong cytokine release in both control and CF cells. The inflammatory response on virus infection was heterogeneous and depended on cell type and virus used, but was not increased in CF compared with control cells. On the contrary, there was a marked trend towards lower cytokine production associated with increased cell death in CF cells. An exaggerated inflammatory response to virus infection in bronchial epithelial cells does not explain the increased respiratory morbidity after virus infection in CF patients.

Embryonic chicken trachea as a new in vitro model for the investigation of mucociliary particle clearance in the airways.

Mucociliary clearance (MC) is an important defense mechanism of the respiratory system to eliminate inhaled and possibly noxious particles from the lung. Although the principal mechanics of MC seem to be relatively clear there are still open questions regarding the long-term clearance of particles. Therefore, we have developed a new set-up based on embryonic chicken trachea (ECT) to investigate mucociliary particle clearance in more detail. ECT was placed in an incubation chamber after carbon particles were applied and tracked using optical microscopy. The aim of the study was to validate this model by investigating the impact of temperature, humidity and drugs on particle transport rates. Particles were transported reproducibly along the trachea and clearance velocity (2.39 +/- 0.25) mm/min was found to be in accordance to data reported in literature. Variation in temperature resulted in significantly reduced MC: (0.40 +/- 0.12) mm/min (20 degrees C); (0.42 +/- 0.10) mm/min (45 degrees C). Decreasing humidity (99-60%) had no significant effect on MC, whereas reduction to 20% humidity showed a significant influence on particle clearance. The use of different cilio- and muco-active drugs (propranolol, terbutalin, N-acetylcysteine) resulted in altered MC according to the pharmacological effect of the substances: a concentration dependent decrease of MC was found for Propranolol. From our results we conclude that this model can be employed to investigate MC of particles in more detail. Hence, the model may help to understand and identify decisive physico-chemical parameters for MC and to answer open questions regarding the long-term clearance phenomenon.

Follow-up of discrepancies in X-ray and electrocardiogram interpretations, and positive laboratory results.

This article describes the 1-year follow-up program implemented at Baystate Medical Center Emergency Department during 1999. Our previous system used staff who worked clinically, which led to prolonged delays in follow-up. Before initiating the program, 57% [95% confidence interval (CI): 55-59%] of all follow-up cases were done within 3 days. After program implementation, 69% (95% CI: 67-72%) of all follow-up cases were completed in the same time frame. We reduced our "delayed" follow-up cases from 20% (95% CI: 18-22%) to 4% (95% CI: 3-5%) of all cases. Critical to the new system is the assignment of nurse-physician pairing to do follow-up when they are not doing direct patient care.

Defective aeroallergen surveillance by airway mucosal dendritic cells as a determinant of risk for persistent airways hyper-responsiveness in experimental asthma.

A hallmark of atopic asthma is development of chronic airways hyper-responsiveness (AHR) that persists in the face of ongoing exposure to perennial aeroallergens. We investigated underlying mechanisms in sensitized rats focusing on a strain expressing the high-allergen-responder phenotype characteristic of human atopic asthmatics, and find that their high susceptibility to aeroallergen-induced persistent AHR is associated with deficiencies in the immunoregulatory and mucosal trafficking properties of inducible T-regulatory cells (iTregs). Counterintuitively, AHR susceptibility was inversely related to aeroallergen exposure level, high exposures conferring protection. We demonstrate that underlying this AHR-susceptible phenotype is reduced capacity of airway mucosal dendritic cells (AMDCs) for allergen sampling in vivo; this defect is microenvironmentally acquired, as allergen uptake by these cells in vitro is normal. Moreover, intranasal transfer of in vitro aeroallergen-loaded AMDC from naïve animals into AHR-susceptible animals during prolonged aerosol challenge markedly boosts subsequent accumulation of iTregs in the airway mucosa and rapidly resolves their chronic AHR, suggesting that compromised antigen surveillance by AMDC resulting in defective functional programming of iTreg may be causally related to AHR susceptibility.

Recent advances into understanding some aspects of the structure and function of mammalian and avian lungs.

Recent findings are reported about certain aspects of the structure and function of the mammalian and avian lungs that include (a) the architecture of the air capillaries (ACs) and the blood capillaries (BCs); (b) the pulmonary blood capillary circulatory dynamics; (c) the adaptive molecular, cellular, biochemical, compositional, and developmental characteristics of the surfactant system; (d) the mechanisms of the translocation of fine and ultrafine particles across the airway epithelial barrier; and (e) the particle-cell interactions in the pulmonary airways. In the lung of the Muscovy duck Cairina moschata, at least, the ACs are rotund structures that are interconnected by narrow cylindrical sections, while the BCs comprise segments that are almost as long as they are wide. In contrast to the mammalian pulmonary BCs, which are highly compliant, those of birds practically behave like rigid tubes. Diving pressure has been a very powerful directional selection force that has influenced phenotypic changes in surfactant composition and function in lungs of marine mammals. After nanosized particulates are deposited on the respiratory tract of healthy human subjects, some reach organs such as the brain with potentially serious health implications. Finally, in the mammalian lung, dendritic cells of the pulmonary airways are powerful agents in engulfing deposited particles, and in birds, macrophages and erythrocytes are ardent phagocytizing cellular agents. The morphology of the lung that allows it to perform different functions-including gas exchange, ventilation of the lung by being compliant, defense, and secretion of important pharmacological factors-is reflected in its "compromise design."

Caffeic acid-containing medium for identification of Cryptococcus neoformans.

A new growth medium containing caffeic acid and ferric citrate is described. The pigment produced on this medium is specific for the identification of Cryptococcus neoformans and differentiates it from other cryptococci. The medium is more easily compounded and requires less time for pigment formation than the conventional Guizotia extract media. The medium is stable in the dry form as well as in the prepared form.

Trichophyton rubrum infections according to age, anatomical distribution and sex.

Trichophyton rubrum caused 72.9% of the cases of dermatophytosis observed in a sample of caucasoids from Philadelphia. Tinea pedis was found in 84% of the female and male patients with dermatophytosis. Tinea manuum occurred with equal frequency in both sexes whereas tinea unguium was more prevalent in females. Tinea cruris occurred almost exclusively in males. Infections of two or more anatomical sites were observed more frequently in males. The data are compared with those reported by Rosman (1966) from a similar study done in Copenhagen.

Systemic amyloidosis in mice inoculated with lyophilized Candida cells.

Injection of lyophilized Candida albicans or C. parapsilosis cells induced amyloidosis in outbred CFW mice. The disease process was irreversible, and a significant number of animals died of systemic amyloidosis within 400 days after the last treatment. The techniques described may represent a model system for the study of systemic amyloidosis.

Immunological studies on dermatophytes. I. Serological reactivities of neutral polysaccharides with rabbit antiserum to Microsporum quinckeanum.

Antiserum produced in the rabbit to autoclaved mycelial suspensions of Microsporum quinckeanum reacted with three neutral polysaccharides isolated from each of five species of dermatophytes, M. quinckeanum, Trichophyton granulosum, T. interdigitale, T. rubrum, and T. schönleinii. The serological reactivities of these polysaccharides, grouped as galactomannans I, galactomannans II, and glucans, were compared by qualitative precipitation analyses in gel and quantitative complement-fixation analyses. Significant differences were found among the glucans and galactomannans II but not among the galactomannans I of these species.

Pigment production of Cryptococcus neoformans grown with extracts of Guizotia abyssinica.

Brown pigment(s) formed in Cryptococcus neoformans when grown on media containing extracts of the seeds of Guizotia abyssinica cannot be extracted by common organic solvents or by 6 n HCl or 2 n NaOH. A similar pigmentation was observed in C. neoformans when grown on a medium containing caffeic acid isolated from the hydrolyzed methanol extract of G. abyssinica seeds. Its methyl ester and the diacetate thereof, as well as the following structurally related compounds, 3-hydroxytyramine, 3,4-dihydroxybenzoic acid, 3,4-dihydroxyphenylethanolamine, and 4-hydroxy-3,5-dimethoxycinnamic acid, brought about similar pigmentation. However, 2,4-, 2,5-, 2,6-, and 3,5-dihydroxybenzoic acids, tyrosine, phenylalanine, cinnamic acid, 4-hydroxycinnamic acid, and 4-hydroxy-3-methoxycinnamic acid did not cause coloration in C. neoformans.

Antibodies with affinity for epithelial tissue in chronic dermatophytosis.

Antibodies to dermatophytes which also had affinity for intercellular material of epithelial tissue, were detected in sera from 80% of patients with chronic dermatophytosis using an indirect fluorescent antibody test. The class of immunoglobulins reactive with both the dermatophyte and the epithelial tissue was identified as IgM. IgM antibodies with affinity for arthrospores of Trichophyton mentagrophytes and intercellular substance of epithelial tissue could be removed from sera with mycelium of Trichophyton rubrum.

Immunological studies on dermatophytes. IV. Chemical structures and serological reactivities of polysaccharides from Microsporum praecox, Trichophyton ferrugineum, Trichophyton sabouraudii, and Trichophyton tonsurans.

The chemical structures and serological specificities of polysaccharides isolated from four species of dermatophytes, Microsporum praecox, Trichophyton ferrugineum, T. sabouraudii, and T. tonsurans, were investigated. Each of these species yielded a mixture of crude polysaccharides which could be separated into three water-soluble, neutral polysaccharides free of nitrogen. These were grouped as galactomannan I, galactomannan II, and glucan. The galactomannans I were quite similar in chemical structure. When measured by complement fixation, their serological cross-reactivities were similar with rabbit antisera to each of these species except T. sabouraudii. The differences in their relative reactivities with this antiserum could be correlated with differences in structure and specificity of this antiserum for galactofuranose end groups. The galactomannans II differed both in chemical structure and in their serological reactivities with antisera to each of these species. The galactomannan II from T. ferrugineum differed most in chemical structure and was the least reactive serologically. The glucans also differed in both structure and serological reactivities.