Potential of electric stimulation for the management of COVID-19.

The COVID-19 pandemic is the most devastating health emergency that humans have seen over the past century. The war against the disease has been handicapped by unavailability of effective therapeutic options. Till date, there is no clinically approved vaccine or drug for the treatment of COVID-19, and the ongoing search to find a novel therapy is progressing at pandemic pace. Herein, we propose a novel hypothesis based on sound research evidence that electric stimulation can be a potential adjuvant to the currently used symptomatic therapies and antiviral drugs. Based on preclinical evidence, we propose that electric stimulation can improve respiratory functions, inhibit SARS-CoV-2 growth, reduce pain, boost immunity and improve the penetration of antiviral drugs. We envisage that our hypothesis, if used clinically as an adjuvant, may significantly improve the therapeutic outcomes of the current treatment regimen being used around the globe for the management of COVID-19.

Work-related allergic respiratory disease and asthma in spice mill workers is associated with inhalant chili pepper and garlic exposures.

OBJECTIVE: The aim of the study was to determine the prevalence and risk factors for allergic respiratory disease in spice mill workers. METHODS: A cross-sectional study of 150 workers used European Community Respiratory Health Survey questionnaires, Phadiatop, serum specific IgE (garlic, chili pepper), spirometry and fractional exhaled nitric oxide (FeNO). Personal air samples (n=62) collected from eight-hour shifts were analysed for inhalable particulate mass. Novel immunological assays quantified airborne garlic and chili pepper allergen concentrations. RESULTS: Mean dust particulate mass (geometric mean (GM)=2.06 mg/m(3)), chili pepper (GM=0.44 µg/m(3)) and garlic allergen (GM=0.24 µg/m(3)) were highest in blending and were highly correlated. Workers' mean age was 33 years, 71% were men, 46% current smokers and 45% atopic. Spice-dust-related asthma-like symptoms (17%) were common, as was garlic sensitisation (19%), with 13% being monosensitised and 6% cosensitised to chili pepper. Airflow reversibility and FeNO>50 ppb was present in 4% and 8% of workers respectively. Spice-dust-related ocular-nasal (OR 2.40, CI 1.09 to 5.27) and asthma-like (OR 4.15, CI 1.09 to 15.72) symptoms were strongly associated with airborne garlic in the highly exposed (>0.235 µg/m(3)) workers. Workers monosensitised to garlic were more likely to be exposed to higher airborne chili pepper (>0.92 µg/m(3)) (OR 11.52, CI 1.17 to 113.11) than garlic allergens (OR 5.08, CI 1.17 to 22.08) in this mill. Probable asthma was also more strongly associated with chili pepper than with garlic sensitisation. CONCLUSIONS: Exposure to inhalable spice dust (GM >2.06 mg/m(3)) containing garlic (GM>0.24 µg/m³) and chili pepper (GM >0.44 µg/m(3)) allergens increase the risk of allergic respiratory disease and asthma.

Impact of chlorinated swimming pool attendance on the respiratory health of adolescents.

OBJECTIVE: The goal was to estimate the burden of allergic diseases associated with chlorinated pool exposure among adolescents. METHODS: We examined 847 students, 13 to 18 years of age, who had attended outdoor or indoor chlorinated pools at various rates. Of them, 114 had attended mainly a copper-silver pool and served as a reference group. We measured total and aeroallergen-specific immunoglobulin E (IgE) levels in serum and screened for exercise-induced bronchoconstriction. Outcomes were respiratory symptoms, hay fever, allergic rhinitis, and asthma that had been diagnosed at any time (ever asthma) or was being treated with medication and/or was associated with exercise-induced bronchoconstriction (current asthma). RESULTS: Among adolescents with atopy with serum IgE levels of>30 kIU/L or aeroallergen-specific IgE, the odds ratios (ORs) for asthma symptoms and for ever or current asthma increased with the lifetime number of hours spent in chlorinated pools, reaching values of 7.1 to 14.9 when chlorinated pool attendance exceeded 1000 hours. Adolescents with atopy with chlorinated pool attendance of >100 hours had greater risk of hay fever (OR: 3.3-6.6), and those with attendance of >1000 hours had greater risk of allergic rhinitis (OR: 2.2-3.5). Such associations were not found among adolescents without atopy or with copper-silver pool attendance. The population attributable risks for chlorinated pool-related ever-diagnosed asthma, hay fever, and allergic rhinitis were 63.4%, 62.1%, and 35.0%, respectively. CONCLUSION: Chlorinated pool exposure exerts an adjuvant effect on atopy that seems to contribute significantly to the burden of asthma and respiratory allergies among adolescents.

[Interest of allergology evaluation for the treatment of asthma and rhinosinusitis]. / Intérêt du bilan allergologique dans le traitement de l'asthme et la rhinosinusite chronique.

Clinical allergy is the consequence of an inflammatory immune-mediated hyperresponsiveness, induced by the contact with environmental substances, defined as allergens. The diagnosis of clinical allergy is based on the history of the symptoms appearing when the subject is exposed to the allergens, in association with the detection of allergen specific IgE antibodies. The detection of the specific IgE is mainly based on the skin tests and sometimes on the blood result (RAST). The detection of the causative allergen offers therapeutic options such as avoidance and desensitization (immunotherapy). The allergen desensitization is a validated treatment, considered effective in rhinitis and allergic asthma.

Acute effect of air pollution on respiratory complaints, exhaled NO and biomarkers in nasal lavages of allergic children during the pollen season.

During 2 months of the pollen season, the acute and putative adjuvant effect of traffic-related air pollution on respiratory health was investigated in children sensitised to grass pollen or house dust mite (HDM). Respiratory complaints were objectified via measurement of exhaled NO and inflammatory mediators in nasal lavage (NAL). During the study children, skin prick negative (n = 31) or positive to grass pollen (n = 22), HDM (n = 34) or grass pollen + HDM (n = 32), kept a daily diary on respiratory symptoms, and NAL and exhaled air was sampled twice a week. The level of air pollutants and pollen was monitored continuously. Like children sensitised to HDM, those sensitised to pollen reported respiratory complaints (shortness of breath, itchy eyes or blocked nose) more frequently than non-sensitised children during (but not before) the pollen season; the respiratory complaints of sensitised children were independent of the pollen level. In addition, exposure to increased levels of PM(10) induces 'shortness of breath' in pollen- and HDM-sensitised children, whereas ozone induces a blocked nose in HDM-sensitised children. Combined exposure to PM(10) + pollen and O(3) + pollen induces a blocked nose in both HDM-sensitised children and children sensitised to pollen + HDM. Significant positive associations were found between eNO and the levels of NO(2), CO, PM(2.5) and pollen in both sensitised and non-sensitised children. At the start of the pollen season, the NAL concentration of eosinophils and ECP in pollen-sensitised children was increased compared to winter, but their levels were not further affected by increased exposure to pollen or air pollution. In conclusion, during the pollen season, sensitised children continuously report a high prevalence of respiratory complaints which coincides with increased levels of upper and lower airway inflammatory markers. No additional pro-inflammatory effect of air pollution was observed, which indicates that air pollution does not facilitate allergen-induced inflammatory responses.

The toxic oil syndrome: 20 years on.

With hindsight, it is easy to criticise the standards of food regulation of two decades ago. Nevertheless, when the Spanish toxic oil syndrome (TOS) appeared in 1981, there were many who asked why aniline was permitted as an official adulterant for imported French rape seed oil, and why such adulterated oils were often illegally refined in Spain and marketed without difficulty. This review brings up to date a comprehensive survey of the ensuing research published in 1995 and concentrates on recent significant findings. These include the identification of the refinery that produced the toxic oil, and the detection of oil contaminants with possible aetiological significance. Possible chemical links have been found between oil contaminants and those detected in L-tryptophan implicated in the eosinophilia-myalgia syndrome (EMS). There is good evidence that the initial pathogenetic mechanism is immunological. On metabolic evidence, it is suggested that not one, but a group of, toxic agents was responsible for TOS.

Mercurialis annua pollen: a new source of allergic sensitization and respiratory disease.

Sensitization to Mercurialis annua pollen in 13 patients admitted for allergy study of asthma, rhinitis, or rhinoconjunctivitis is described. Twelve of these patients were also sensitized to other common aeroallergens. In five patients, a relationship was found between exposure to M. annua pollen and elicitation of symptoms. All patients were prick test and RAST positive to an extract of M. annua pollen. Nasal provocation test proved positive in 10 of 12 patients, and bronchial provocation test was positive in the only patient in whom it was performed. Two late responses were recorded. Immunoblotting of the 13 sera revealed two different groups of relevant allergens; one of isoelectric point 10.2, reacting with 12 of the 13 sera, and the other allergen of isoelectric point 5.0 to 5.5, reacting with 11 of the 13 sera. M. annua pollen is able to induce both sensitization and clinical disease in atopic patients. Since sensitization to this pollen accounts for 8.5% of total positive skin tested patients in the same period, we believe M. annua pollen should be considered as a relevant allergen and thus included in skin test batteries. Some patients labeled as having "intrinsic" asthma or rhinitis might be sensitized to this and other previously unknown allergens.

Immunological and respiratory changes in coffee workers.

Immunological status and respiratory function were studied in a group of 45 coffee workers. Skin tests with coffee allergens demonstrated the highest percentage of positive reactions to dust collected during emptying bags (40.0%), followed by dust of green (12%) and then roasted coffee (8.9%). Among 34 skin-tested control workers, 14.7% had positive skin reaction to dust collected during emptying bags, but none had positive skin reaction to green or roasted coffee. Serum levels of total IgE were increased in 24.4% of coffee workers and in 5.9% of control subjects. The prevalence of all chronic respiratory symptoms was significantly higher in coffee workers than in control subjects. Coffee workers with positive skin tests to coffee allergen had a significantly higher prevalence of chronic cough (63.6%) and chronic phlegm (72.7%) than those with negative skin tests (32.4% and 23.5% respectively). There was a significant mean decrease over the Monday work shift in the maximum expiratory flow rate at 50% of vital capacity (MEF50: -7.9%) and at 25% vital capacity (MEF25: -17.8%), suggesting an obstructive effect mostly in smaller airways. Coffee workers with positive skin tests to coffee allergens had larger acute reductions in flow rates than those with negative skin tests but the difference was not statistically significant.

Symposium: disease prevention in calves. Factors affecting susceptibility of calves to disease.

Enteric and respiratory disorders are the main hazards to successful calf rearing. The many interrelated factors in the etiology of these disorders are reviewed, and an attempt has been to classify the factors into those of a microbiological, immunological, nutritional, genetic, physical, or psychological nature. No one would dispute that enteric and respiratory disorders are the two main hazards to calf health, but many would argue about the relative importance of specific pathogens and other predisposing factors in the etiology of these disorders.