Occupational asthma related to aescin inhalation.

BACKGROUND: More than 400 agents are recognized as causes of occupational asthma, a work-related disease that can be induced by an immunologic or a nonimmunologic mechanism. OBJECTIVE: To describe a 57-year-old man employed in the pharmaceutical industry who developed bronchial asthma while working with products such as Plantago ovata and aescin, an active ingredient with anti-inflammatory and venotonic properties. METHODS: Various tests were performed, including radiography, total serum IgE titer measurements, skin tests against common pneumoallergens and Plantago species, pulmonary function studies, a methacholine test, and specific inhalation challenge with P. ovata and aescin. RESULTS: The results of these tests, including specific inhalation challenge, confirmed the diagnosis of occupational asthma due to aescin exposure, whereas the results of specific challenge with P. ovata, a known cause of occupational asthma, were negative. CONCLUSIONS: Aescin may represent a new causative agent of occupational asthma in personnel working in the pharmaceutical industry. The mechanism by which aescin can produce asthma is unknown, but analysis of the characteristics of our patient suggests a non-IgE immunologic mechanism, although an irritative mechanism secondary to long-term low-level exposure to aescin, a possible irritant, cannot be ruled out.

Mucopolysaccharides from psyllium involved in wound healing.

Mucopolysaccharides derived from the husk of psyllium (Plantago ovata) have properties beneficial for wound cleansing and wound healing. Recent studies indicate that these mucopolysaccharides also limit scar formation. Our in vitro and in vivo studies aimed to investigate the mechanisms involved, e.g., fluid absorption, bacterial adherence and in vitro stimulatory effects on macrophages, which are pivotal in wound healing. The mucopolysaccharides contained in a sachet (Askina Cavity) or in a hydrocolloid mixture (Askina Hydro) were found to have a gradual and sustained absorbency over a period of 7 days, amounting to 4-6 times their weight in water. The swelling index was 9 mm after 312 h. Adherence of wound bacteria to the mucopolysaccharides started after 2 h and was more pronounced after 3 h. Semiquantitative measurements of bacterial adherence used centrifugation and subsequent optical density determinations of supernatant. These confirmed the strong adherence potential of psyllium particles. Lactic acid dehydrogenase staining of pretreated cultured human skin explants did not reveal toxicity of the mucopolysaccharides derived from psyllium husk. Langerhans' cell migration from the epidermis was negligible and interleukin-1 beta expression in the explants was not significant, supporting the very low allergenic potential of psyllium. The characteristics of mucopolysaccharide granulate derived from psyllium husk in Askina Cavity and Askina Hydro related to fluid absorption, bacterial adherence, biocompatibility, stimulation of macrophages, irritancy response and allergenicity showed an optimal profile, supporting the good clinical performance of wound healing products containing psyllium husk.

Experimental assessment of the allergenicity of a psyllium-containing laxative.

The allergenicity of psyllium was investigated using the Guinea Pig Maximation Test. Four of 12 animals gave positive skin reactions. Subsequent inhalation challenge of the same animals yielded respiratory hypersensitivity reactions in four of the animals. Two animals gave both skin and respiratory responses. The mosaic of respiratory and dermatologic symptoms demonstrated by animals resembled the pattern of findings reported in clinical studies. Results of SDS-acrylamide gel electrophoresis, immunoblot and protein determinations of aqueous psyllium extracts failed to indicate the presence of protein. Spectrophotometric studies suggested that the extract was a gum with a molecular weight greater than 14,000 daltons.

Effect of Metamucil on tumour formation by 1,2-dimethylhydrazine dihydrochloride in mice.

The effect of the plant cellulose metamucil on the tumorigenicity of 1,2-dimethylhydrazine dihydrochloride (1,2-DMH) was studied in random-bred Swiss mice. Three groups of mice, which were 5, 6 and 6 weeks old at the beginning of the experiment, were given the following treatments: (1) metamucil (20%, w/w) in powdered diet for their lifespan; (2) 1,2-DMH, ten weekly subcutaneous injections at 20 mg/kg body weight; (3) combination of treatments given to groups 1 and 2. The administration of metamucil enhanced the appearance of colon tumours induced by 1,2-DMH in males only. Metamucil had no statistically significant effect on the development of tumours elicited by 1,2-DMH at seven additional sites. It was expected that a high amount of dietary fibre would inhibit carcinogenesis in the large intestine. Instead, metamucil increased the incidence of colon tumours induced by 1,2-DMH, although only in males.