The measurement of total serum IgE levels in rats.

A direct solid phase radioimmunoassay for the measurement of total serum IgE in the rat has been developed. The assay is very sensitive with a lower limit of detection of 5 ng/ml. The intra and interassay reproducibility proves to be very acceptable and the specificity is demonstrated by looking at the interferen-e by other immunoglobulins. Preliminary results on total serum IgE levels are given.

Effect of nedocromil sodium on bronchoconstriction induced by adenosine and tachykinins.

Purines and neuropeptides may act as neurotransmitters of the local axon reflex in the airways. Nedocromil sodium has been shown to inhibit adenosine- and neurokinin A-induced bronchoconstriction both in the rat and in man. In this study we used the rat model for further investigation of the mechanism of action of nedocromil sodium in the adenosine- and neurokinin A-challenge. The animals were challenged intravenously, and immediately after maximal bronchoconstriction a bronchoalveolar lavage was performed and histamine was assayed in the supernatant of the lavage fluid. Nedocromil sodium significantly inhibited the adenosine- and the neurokinin A-induced increase in histamine concentration in the lavage fluid. Nedocromil sodium had no influence on the airway responsiveness to serotonin or carbachol. We therefore concluded that the inhibitory effect of nedocromil sodium on adenosine- and neurokinin A-induced bronchoconstriction can be explained by its activity on airway mast cells.

Effect of nedocromil sodium on the bronchoconstrictor effect of neurokinin A in asthmatics.

In a double-blind, crossover study we have investigated the effect of nedocromil sodium on neurokinin A (NKA)-induced bronchoconstriction in asthmatics. 12 patients with mild asthma inhaled either nedocromil sodium 4mg or placebo, on 2 separate days, as 2 puffs from a metered-dose aerosol 30 minutes before challenge with NKA. On the placebo treatment day, NKA produced a concentration-dependent decrease in basal specific airway conductance (sGaw) and forced expiratory volume in 1 second (FEV1). The inhalation of nedocromil sodium 4mg inhibited the decrease in both sGaw and FEV1. The maximal percentage decrease in sGaw on the nedocromil sodium day was 27.0 +/- 5.2 (vs placebo, 53.3 +/- 5.4; p less than 0.05) and the maximal percentage decrease in FEV1 5.5 +/- 1.4 (vs placebo, 12.4 +/- 2.3; p less than 0.05). We conclude that nedocromil sodium protects against NKA-induced bronchoconstriction in asthmatics.

Fibrotic stage of allergic bronchopulmonary candidiasis.

Since its first description in 1952, ABPA has been recognized with increasing frequency. More recently fungi other than Aspergillus fumigatus, in particular Candida albicans, have been implicated in a similar disease process. The following case report illustrates the possibility of finding a fibrotic stage 5 ABPM caused by C albicans.

Bronchoalveolar lavage in acute hypersensitivity pneumonitis caused by sulfasalazine.

Sulfasalazine has been reported to induce pulmonary eosinophilia and hypersensitivity with symptoms of dyspnea and fever. We present the results of bronchoalveolar lavage in a patient with acute sulfasalazine-induced hypersensitivity pneumonitis. The lavage specimen showed a significant influx of eosinophils.

Scintigraphic, spirometric, and roentgenologic effects of radiotherapy on normal lung tissue. Short-term observations in 14 consecutive patients with breast cancer.

The effects of radiotherapy on lung function, ventilation/perfusion scans, and chest radiography were studied prospectively in 15 patients who underwent either modified radical mastectomy or tumorectomy, followed by radiotherapy for breast cancer. In all patients, pulmonary function studies, chest x-ray films, and lung scintigraphic studies were performed prior to and at the end of radiotherapy as well as three months later. No consistent or significant alteration in either parameter was detected. No patient developed clinical symptoms suggestive of radiation-induced lung changes, although in one of them, major radiologic features were found that were consistent with radiation pneumonitis; those changes disappeared completely in the course of the subsequent months. It is concluded that the tangential beam technique for postoperative irradiation as used in these patients is largely safe as regards pulmonary function, perfusion, and ventilation.

Adamantinoma of the tibia with pulmonary metastases and hypercalcemia.

Adamantinomas of long bones are rare primary malignant bone tumors. A case of a woman who died of pulmonary metastases of an adamantinoma of the tibia is presented. A unique feature of this case is the association with hypercalcemia. The association of hypercalcemia, hypophosphatemia, decreased parathyroid hormone levels and increased urinary cAMP excretion suggests a humorally mediated hypercalcemia. Histologic and ultrastructural analysis of the pulmonary metastases demonstrated that the tumor was composed of a heterogeneous cell population with mesenchymal and epithelial differentiation.

Epsilon amino caproic acid myopathy: additional features.

In a patient with a proximal myopathy due to Epsilon Amino Caproic Acid (EACA) bedrest led to marked improvement even before withdrawal of the drug. A biopsy showed a selective necrosis of type I fibers. Plasma level of EACA was low and plasma level of lysine was normal. A 99mTechnetium-MDP showed marked uptake in the affected muscles, whereas a 67Gallium scan was negative.

The effect of ketotifen on bronchial beta-adrenergic tachyphylaxis in normal human volunteers.

The effect of ketotifen on bronchial beta-adrenergic tachyphylaxis was studied in healthy volunteers. In a 2-week pilot study, 19 volunteers inhaled 300 micrograms of salbutamol, four times a day. Ten subjects became tachyphylactic to inhaled salbutamol, assessed by a dose-response curve, before and after the 2 weeks of treatment from a metered-dose inhaler. These 10 subjects were then involved in a double-blind, crossover study comparing the effect of ketotifen, 1 mg in the evening during 1 week, and 1 mg, twice daily, during 3 weeks, and placebo on the bronchial beta-adrenergic tachyphylaxis induced by the concomitant administration during the last 2 weeks of each treatment period of 300 micrograms of salbutamol, four times a day, from a metered-dose inhaler. The end of the pilot study preceded the double-blind study by at least 1 month. However, the salbutamol dose-response curve at the beginning of the double-blind study was still significantly decreased, compared to the dose-response curve before the pilot study. During placebo treatment, a further decrease in bronchial beta-adrenergic sensitivity was observed. Treatment with ketotifen prevented the induction of further beta-adrenergic tachyphylaxis. Each 2 weeks of treatment with inhaled salbutamol increased significantly the baseline specific airway conductance; therefore, based on the present data, it is impossible to determine whether ketotifen also restores the sensitivity of an already desensitized beta-adrenergic system in the airways.

The bronchial effects of adenosine in the rat.

The in vivo intravenous administration of adenosine caused bronchoconstriction in the rat. There were significant differences between inbred rat strains with regard to bronchial reactivity to adenosine. Inosine caused bronchoconstriction in the rat but was a less potent bronchoconstrictor than adenosine and there was no correlation between the bronchial reactivity to inosine and the reactivity to adenosine. Theophylline, DSCG and nedocromil were potent inhibitors of the adenosine-induced bronchoconstriction. Bilateral vagotomy and the ganglion blocker hexamethonium had no effect on the adenosine-induced bronchoconstriction. High doses of atropine had a small inhibitory effect. The bronchial adenosine receptor has the characteristics of the A2 type.

Changes in lymphocyte subpopulations in patients treated with cefodizime for acute lower respiratory tract infections.

The influence of cefodizime (CDZ) on CD4 and CD8 lymphocytes was investigated in patients with lower respiratory tract infection and underlying respiratory diseases. Ten men and one woman were treated with CDZ 1 g i.m. b.i.d. for ten days. The infecting organisms were Haemophilus influenzae (5), Streptococcus pneumoniae (2) and Escherichia coli (1). No adverse events were reported. Nine patients were clinically cured; two required further antibiotic therapy. Leucocyte counts decreased significantly during treatment. Lymphocyte counts and CD4 cells both increased significantly in absolute and relative numbers, while there was a much smaller increase in CD8 cells. This resulted in a significant increase in the CD4/CD8 ratio. These effects of CDZ might be of benefit for immunocompromised patients with bacterial infections.

Plasma levels of carcinoembryonic antigen in bronchial carcinoma and chronic bronchitis.

The plasma levels of carcinoembryonic antigen were increased in 80% of 49 patients with bronchial carcinoma and in 68% of 25 patients with an acute exacerbation of chronic bronchitis. There was no statistically significant difference between the two groups. A single determination of the plasma carcinoembryonic antigen level has no prognostic value in patients with bronchial carcinoma.

Delayed hypersensitivity in patients with bronchial carcinoma.

Delayed hypersensitivity skin test reactions have been carried out in patients with bronchial carcinoma. Dinitrochlorobenzene, used as a parameter of newly induced cell-mediated immunity, was clearly suppressed, and this suppression was associated with a poor prognosis. Tuberculin reactivity, used as a parameter of the memory function of the cell-mediated immune system, was not altered, and bears no relation to prognosis.

Total serum IgE levels in normals and patients with chronic non-specific lung diseases.

Total serum IgE was measured, using a sensitive sandwich method, in a healthy control population, in healthy persons with a familial history of chronic non-specific lung disease and in patients with chronic non-specific lung disease (CNSLD). In the control population a median total serum IgE of 39 I.U./ml was found. Total serum IgE levels were significantly lower in women that in men. Healthy persons with a familial history of CNSLD had significantly increased total IgE levels compared with the control population. The IgE level was even higher in the group of patients with CNSLD. The presence of specific IgE antibodies and/or an early onset of the symptoms of CNSLD was accompanied by higher total serum IgE levels compared with the IgE values in the other CNSLD patients. But the total IgE levels were increased in all subgroups of CNSLD patients. A significant decrease of the IgE level with age was observed in CNSLD patients.

An animal model for adenosine-induced bronchoconstriction.

The inhalation of adenosine is known to cause bronchoconstriction in asthmatic patients. A thorough study of the possible role of this purine nucleoside in the pathogenesis of asthma has been hampered by the lack of a suitable animal model. We have studied the bronchial effects of adenosine in an in vivo rat model. The intravenous injection of 0.1 to 10 micromoles/kg body weight of adenosine causes in BDE-rats an increase in lung resistance and decrease in dynamic compliance. Study of the potency of various adenosine analogs suggests that the bronchial adenosine receptor belongs to the A2-type. The bronchoconstriction caused by adenosine is inhibited by atropine, methysergide, sodium cromoglycate, nedocromil sodium, and ketotifen. Xanthines in doses of 5 and 15 mg/kg body weight have no significant effect on the adenosine-induced bronchoconstriction. These results suggest that adenosine causes bronchoconstriction by stimulating postsynaptic vagal nerve endings and mast cells.