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1.
Cell Host Microbe ; 29(4): 543-545, 2021 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-33857416

RESUMO

In many parts of the world, women are co-infected with intestinal helminths and sexually transmitted pathogens. In this issue of Cell Host & Microbe, Chetty et al. demonstrate that intestinal helminth infection increases epithelial damage and pathology associated with herpes virus infection.


Assuntos
Coinfecção , Helmintíase , Helmintos , Viroses , Animais , Eosinófilos , Feminino , Helmintíase/complicações , Herpesvirus Humano 2 , Humanos , Saúde da Mulher
2.
J Zoo Wildl Med ; 52(1): 348-356, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33827198

RESUMO

Ecophysiology and conservation studies often require the prior establishment of baseline physiologic metrics. For instance, expected reference intervals for health metrics are valuable tools for veterinarians and conservationists who monitor the health status of endangered populations and species. This study establishes reference intervals for hematologic metrics in free-ranging Olrog's gull (Larus atlanticus) during the nonbreeding season. Fifty-six gulls (immature and adults) were captured and studied in Mar del Plata and neighboring coastal areas (Buenos Aires, Argentina) during the winter of 2018 (n = 22) and 2019 (n = 34). Hematocrit, red blood cells (erythrocytes), hemoglobin, mean cell volume, mean cell hemoglobin (MCH), MCH concentration, white blood cells (WBC; leukocytes), heterophils, lymphocytes, eosinophils, monocytes, and basophils were analyzed. Additionally, the variability of hematologic metrics according to body weight, sex, age, and calendar year was examined. Hematologic metrics were in line with those reported in other seabird species. Males had greater body weight and MCH than females. The heterophil to lymphocyte ratio and lymphocyte levels were higher in adults than in immatures. Hematocrit, WBC, heterophils, and basophils also varied significantly between calendar years. The results highlight the importance of appropriate metrics and reference intervals for monitoring the health status of this threatened species, and it is recommended to implement such comparative assessments among populations.


Assuntos
Charadriiformes/sangue , Estações do Ano , Envelhecimento , Animais , Argentina , Ascomicetos , Basófilos , Eosinófilos , Contagem de Eritrócitos , Índices de Eritrócitos , Feminino , Hematócrito , Hemoglobinas , Contagem de Leucócitos , Linfócitos , Masculino , Monócitos
3.
Artigo em Chinês | MEDLINE | ID: mdl-33794605

RESUMO

Objective:To investigate the roles of nasal nitric oxide(nNO) in diagnosis and endotypes of CRSwNP. Methods:Eighty-two CRSwNP patients and thirty healthy volunteers were recruited for this study. The patients were classified into eosinophilic CRSwNP (Eos CRSwNP) and non-eosinophilic CRSwNP (non-Eos CRSwNP) endotypes by tissue eosinophil percentage. nNO levels were measured with an electrochemical sensor-based device. nNO levels and clinical factors were compared among the groups. Receiver-operating characteristic (ROC) curve and logistic regression analyses were performed to evaluate the predictive ability of the nNO for diagnosis and endotypes of CRSwNP. Results:Eos CRSwNP patients(143.9±106.2) ×10-9 had lower nNO levels than non-Eos CRSwNP[(228.3±109.2) ×10-9, P=0.000 9) and healthy subjects(366.5±88.0) ×10-9, P<0.000 1). Patients with atopy exhibited significantly higher levers of nNO compared with patients without atopy(P<0.05). For Eos CRSwNP diagnosis, nNO had the highest predictive value(AUC: 0.939; sensitivity: 76.74%; specificity: 96.67%; cut-off value: 231×10-9, P<0.001). Furthermore, nNO levels were associated with CRSwNP endotypes(odds ratio: 1.010; 95% confidence interval: 1.003%, 1.016%; P=0.002). When the nNO concentration was 158 ×10-9, we could discriminate Eos CRSwNP from non-Eos CRSwNP(AUC=0.710, sensitivity: 76.92%; specificity, 60.47%, P=0.001). After it was combinated by nNO, periphera blood eosinophil count(PEAC) and VAS score, the AUC was increased to 0.894(95%CI=0.807 to 0.951, P<0.000 1, sensitivity: 76.74%, specificity: 89.74%). Conclusion:nNO may has potential for non-invasive diagnosis and endotype of CRSwNP. nNO combined with PEAC and VAS score may be an ideal diagnostic tool for endotyps of Eos CRSwNP. However, the atopic status of the patients influenced the levels of nNO.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Doença Crônica , Eosinófilos/patologia , Humanos , Pólipos Nasais/diagnóstico , Pólipos Nasais/patologia , Óxido Nítrico , Rinite/diagnóstico , Rinite/patologia , Sinusite/diagnóstico , Sinusite/patologia
4.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 35(4): 306-311;315, 2021 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-33794626

RESUMO

Objective:This study aimed to explore the biomarkers in nasal secretion that can assist in the diagnosis of allergic rhinitis(AR) and can be used to evaluate the therapeutic effect of AR. Methods:Thirty-three patients with AR and 21 healthy controls were included. The nasal secretion of healthy controls and patients with AR(before and after treatment) were collected. The cytology, the concentrations of cytokines(IL-5, IL-6, IL-8, IL-33, IFN-γ) and inflammatory mediators(ECP, MPO) were detected. Then, we compared the differences of various biomarkers between healthy controls and AR patients(before and after treatment group). And analyzed the correlation between each biomarkers/biomarkers difference value/the percentage of biomarkers difference value and clinical symptom score/ score difference value / the percentage of score difference value. Results:Compared with normal controls, the levels of ECP, IL-5, IL-6, IL-8, IL-33 and IFN-γ in nasal secretion of AR patients were significantly higher than those of normal controls(P<0.05). There was no significant difference in MPO. After treatment, ECP decreased significantly(P<0.01), inflammatory cell grade and eosinophil percentage are also decreased(P<0.01). However, MPO, IL-5, IL-6, IL-8, IL-33 and IFN-γ did not change significantly. The difference value of ECP before and after treatment was correlated with the difference value of VAS score(r=0.348, P=0.047). The difference value of IL-5 was correlated with the difference value of VAS score and rhinorrhea, the correlation coefficients were 0.406(P=0.019) and 0.429(P=0.013), respectively. The difference value of eosinophil percentage in nasal secretion before and after treatment was correlated with nasal congestion, and the correlation coefficient was 0.383. The difference value of eosinophil percentage multiplied by inflammatory cell grade before and after treatment was correlated with VAS score(r=0.417, P=0.016) and nasal congestion difference value(r=0.519, P=0.002). The percentage of difference value of IFN-γ before and after treatment was correlated with the percentage of difference value of VAS score / rhinorrhea / sneeze / total nasal symptom score. Conclusion:ECP, IL-6, IL-8 and IL-33 in nasal secretion are expected to be objective biomarkers for auxiliary diagnosis of AR. And ECP, IL-5, IFN-γ, eosinophil percentage multiplied by grade is expected to be an objective index to judge the improvement of patients' symptoms after treatment.


Assuntos
Rinite Alérgica , Biomarcadores , Eosinófilos , Humanos , Inflamação , Mucosa Nasal , Nariz , Rinite Alérgica/diagnóstico
5.
Artigo em Chinês | MEDLINE | ID: mdl-33794635

RESUMO

Objective:To explore the predictive factors for asymptomatic airway hyperresponsiveness(AAHR) in patients with chronic rhinosinusitis with nasal polyps(CRSwNP). Methods:A total of 76 CRSwNP patients who were hospitalized in the Department of Otorhinolaryngology of Fenyang Hospital affiliated to Shanxi Medical University from May 2016 to October 2020 were retrospectively analyzed, including 40 patients in AAHR group and 36 patients in non-airway hyperresponsiveness(non-airway hyperresponsiveness, NAHR) group. The clinical symptoms, CT score of paranasal sinuses, eosinophil(EOS) count in peripheral blood and nasal polyp tissue were compared and analyzed. Logistic regression was used to analyze the risk factors of AAHR, and receiver operating characteristics curve was used to judge the predictive value of the parameters. Results:Compared with NAHR group, AAHR group had more symptoms of mouth breathing and postnasal drip, higher total score of CT in ethmoid sinus, sphenoid sinus, olfactory cleft, and more EOS count in peripheral blood and nasal polyp tissue. The differences were statistically significant. There was a positive correlation between EOS count in peripheral blood and in nasal polyp tissue(r=0.324, P<0.01). Postnasal drip, high posterior ethmoid sinus(PE) score and nasal polyp tissue EOS count were risk factors for AAHR. The predictive value of nasal polyp tissue EOS count was higher than that of PE score(AUC=0.786 and 0.685, respectively). When the PE score was ≥1.5, the sensitivity was 80.0% and the specificity was 55.6%. When the nasal polyp tissue EOS count was ≥5.67/HPF, the sensitivity was 82.5% and the specificity was 66.7%. Conclusion:The occurrence of AAHR in patients with CRSwNP was related to clinical symptoms, paranasal sinus CT score, peripheral and nasal polyp tissue EOS count. PE score and nasal polyp tissue EOS count can be used to predict AAHR, however nasal polyp tissue EOS has higher predictive value.


Assuntos
Pólipos Nasais , Seios Paranasais , Rinite , Sinusite , Doença Crônica , Eosinófilos , Humanos , Pólipos Nasais/complicações , Estudos Retrospectivos , Rinite/complicações , Sinusite/complicações
6.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(3): 218-224, 2021 Mar 12.
Artigo em Chinês | MEDLINE | ID: mdl-33721935

RESUMO

Objective: To analyze the distribution of blood eosinophils (EOS) in COPD patients in the community and outpatient clinics, and to study the clinical characteristics and influencing factors of COPD patients with high EOS counts. Methods: This study included 237 patients with stable COPD, of which the median age was 68 years and males accounted for 81.2%. There were 45 community patients from the China Pulmonary Health study conducted in 2012-2013 and another 192 outpatients who attended the Respiratory Department of Peking University Third Hospital from August 2013 to November 2014 or from September 2015 to May 2018. Taking 100 cells/µl as the cut-off value, it was divided into high EOS group (146 people, 61.6%) and low EOS group (91 people, 38.4%). We compared demographic characteristics, respiratory symptoms, acute exacerbation, lung function, inflammation, imaging and other indicators. Results: The median EOS count of community patients was 110.4 cells/µl, and that of outpatients was 110.0 cells/µl. There was no statistically significant difference in the distribution of blood EOS among community and outpatients. The median EOS count of the general population was 110.0 cells/µl, and the median percentage was 1.8%. EOS≥300 cells/µl accounted for 11.4%. In the high EOS group, the percentage of male gender was higher (85.6% vs 74.7%), the GOLD grade was more severe, and the percentage of neutrophils was lower (61.70% vs 64.70%) (P<0.05 for these three characteristics). After multivariate analysis, the high EOS group was closely related to older age (OR=1.035, 95%CI:1.004-1.067, P=0.029), heavier GOLD grade (P=0.015) and lower percentage of neutrophils (OR=0.956, 95%CI:0.923-0.991, P=0.015). Conclusion: The distribution of blood EOS of COPD patients between the community and the outpatient clinics is not significantly different. About 60% of COPD patients have blood EOS≥100 cells/µl, which is associated with advanced age, male, severe airflow limitation, and low neutrophils.


Assuntos
Eosinofilia , Doença Pulmonar Obstrutiva Crônica , Idoso , China/epidemiologia , Eosinófilos , Humanos , Contagem de Leucócitos , Masculino
7.
Am Fam Physician ; 103(7): 422-428, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33788511

RESUMO

Cerebrospinal fluid (CSF) analysis is a diagnostic tool for many conditions affecting the central nervous system. Urgent indications for lumbar puncture include suspected central nervous system infection or subarachnoid hemorrhage. CSF analysis is not necessarily diagnostic but can be useful in the evaluation of other neurologic conditions, such as spontaneous intracranial hypotension, idiopathic intracranial hypertension, multiple sclerosis, Guillain-Barré syndrome, and malignancy. Bacterial meningitis has a high mortality rate and characteristic effects on CSF white blood cell counts, CSF protein levels, and the CSF:serum glucose ratio. CSF culture can identify causative organisms and antibiotic sensitivities. Viral meningitis can present similarly to bacterial meningitis but usually has a low mortality rate. Adjunctive tests such as CSF lactate measurement, latex agglutination, and polymerase chain reaction testing can help differentiate between bacterial and viral causes of meningitis. Immunocompromised patients may have meningitis caused by tuberculosis, neurosyphilis, or fungal or parasitic infections. Subarachnoid hemorrhage has a high mortality rate, and rapid diagnosis is key to improve outcomes. Computed tomography of the head is nearly 100% sensitive for subarachnoid hemorrhage in the first six hours after symptom onset, but CSF analysis may be required if there is a delay in presentation or if imaging findings are equivocal. Xanthochromia and an elevated red blood cell count are characteristic CSF findings in patients with subarachnoid hemorrhage. Leptomeningeal carcinomatosis can mimic central nervous system infection. It has a poor prognosis, and large-volume CSF cytology is diagnostic.


Assuntos
Infecções do Sistema Nervoso Central/líquido cefalorraquidiano , Carcinomatose Meníngea/líquido cefalorraquidiano , Hemorragia Subaracnóidea/líquido cefalorraquidiano , Infecções Bacterianas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Bacterianas do Sistema Nervoso Central/diagnóstico , Infecções Fúngicas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/diagnóstico , Infecções Parasitárias do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Parasitárias do Sistema Nervoso Central/diagnóstico , Viroses do Sistema Nervoso Central/líquido cefalorraquidiano , Viroses do Sistema Nervoso Central/diagnóstico , Líquido Cefalorraquidiano/química , Líquido Cefalorraquidiano/citologia , Líquido Cefalorraquidiano/microbiologia , Proteínas do Líquido Cefalorraquidiano/líquido cefalorraquidiano , Técnicas de Cultura , Eosinófilos , Glucose/líquido cefalorraquidiano , Humanos , Leucócitos , Linfócitos , Carcinomatose Meníngea/diagnóstico , Meningite Criptocócica/líquido cefalorraquidiano , Meningite Criptocócica/diagnóstico , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/diagnóstico , Neutrófilos , Reação em Cadeia da Polimerase , Valores de Referência , Punção Espinal , Hemorragia Subaracnóidea/diagnóstico , Tuberculose do Sistema Nervoso Central/líquido cefalorraquidiano , Tuberculose do Sistema Nervoso Central/diagnóstico
8.
Virulence ; 12(1): 444-469, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33660566

RESUMO

Owing to the recent outbreak of Coronavirus Disease of 2019 (COVID-19), it is urgent to develop effective and safe drugs to treat the present pandemic and prevent other viral infections that might come in the future. Proteins from our own innate immune system can serve as ideal sources of novel drug candidates thanks to their safety and immune regulation versatility. Some host defense RNases equipped with antiviral activity have been reported over time. Here, we try to summarize the currently available information on human RNases that can target viral pathogens, with special focus on enveloped single-stranded RNA (ssRNA) viruses. Overall, host RNases can fight viruses by a combined multifaceted strategy, including the enzymatic target of the viral genome, recognition of virus unique patterns, immune modulation, control of stress granule formation, and induction of autophagy/apoptosis pathways. The review also includes a detailed description of representative enveloped ssRNA viruses and their strategies to interact with the host and evade immune recognition. For comparative purposes, we also provide an exhaustive revision of the currently approved or experimental antiviral drugs. Finally, we sum up the current perspectives of drug development to achieve successful eradication of viral infections.


Assuntos
/tratamento farmacológico , Endorribonucleases/metabolismo , RNA Viral/metabolismo , Ribonuclease Pancreático/metabolismo , Replicação Viral/fisiologia , Eosinófilos/metabolismo , Humanos , Padrões Moleculares Associados a Patógenos/metabolismo , /imunologia
9.
Artigo em Chinês | MEDLINE | ID: mdl-33730808

RESUMO

Objective: To investigate the histopathological and hematological changes in reoperation of recurrent chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: A total of 41 patients with CRSwNP who underwent two consecutive endoscopic sinus surgeries in Peking Union Medical College Hospital from February 1999 to April 2019 were included retrospectively, including 25 males and 16 females, aged (40.7±13.6) years at the former surgery and (47.0±13.2) years at the recurrent surgery. The peripheral blood cell count results were collected. Differential inflammatory cells in nasal polyp tissue sections were counted and characteristics of tissue remodeling were scored. Paired t test was used to compare the hematological and histological data of the two surgeries in the same cohort. Spearman's rank correlation coefficient was used to determine the correlation between tissue and peripheral blood eosinophil contents. Results: In histopathological tissue sections of nasal polyps, the mean tissue eosinophil, lymphocyte and total inflammatory cell counts per high power field significantly decreased (54.04±34.67 vs 76.97±65.59, 35.27±16.61 vs 50.01±26.94, 128.88±41.32 vs 176.38±80.59, t value was 2.413, 2.923, 3.445, respectively, all P<0.05), whereas the percentages of different inflammatory cell types remained unchanged when comparing the recurrent surgery with the former surgery. There was a significant reduction of basement membrane thickness and goblet cell hyperplasia score in the recurrent surgery (1.29±0.84 vs 2.00±0.84, 1.81±1.31 vs 2.44±1.10, t value was 5.367, 2.714, respectively, all P<0.05). Subgroup analysis suggested that changes in asthmatic cases, younger cases and cases without previous surgery were more remarkable than non-asthmatics, older cases and cases with previous surgery, respectively. There was no significant change in peripheral white blood cell counts and differential cell percentages, except a small increase of blood monocyte percentage. Correlation analysis showed that tissue eosinophil content correlated positively with blood eosinophil content at each surgery. Conclusions: In the recurrent surgery of CRSwNP, tissue eosinophil, lymphocyte and total inflammatory cell counts decrease significantly compare with that of the former surgery. The histological inflammatory load decreases with improvement of tissue remodeling, which could be attributed to the integrated treatment with surgery and medications.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Adulto , Doença Crônica , Eosinófilos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
Front Immunol ; 12: 650331, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33777047

RESUMO

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection represents a global health crisis. Immune cell activation via pattern recognition receptors has been implicated as a driver of the hyperinflammatory response seen in COVID-19. However, our understanding of the specific immune responses to SARS-CoV-2 remains limited. Mast cells (MCs) and eosinophils are innate immune cells that play pathogenic roles in many inflammatory responses. Here we report MC-derived proteases and eosinophil-associated mediators are elevated in COVID-19 patient sera and lung tissues. Stimulation of viral-sensing toll-like receptors in vitro and administration of synthetic viral RNA in vivo induced features of hyperinflammation, including cytokine elevation, immune cell airway infiltration, and MC-protease production-effects suppressed by an anti-Siglec-8 monoclonal antibody which selectively inhibits MCs and depletes eosinophils. Similarly, anti-Siglec-8 treatment reduced disease severity and airway inflammation in a respiratory viral infection model. These results suggest that MC and eosinophil activation are associated with COVID-19 inflammation and anti-Siglec-8 antibodies are a potential therapeutic approach for attenuating excessive inflammation during viral infections.


Assuntos
Antígenos CD/imunologia , Antígenos de Diferenciação de Linfócitos B/imunologia , Eosinófilos/imunologia , Lectinas/imunologia , Mastócitos/imunologia , Infecções por Vírus Respiratório Sincicial/imunologia , Vírus Sinciciais Respiratórios/imunologia , Receptores Toll-Like/imunologia , Animais , Anticorpos Monoclonais/farmacologia , Antígenos CD/genética , Antígenos CD/metabolismo , Antígenos de Diferenciação de Linfócitos B/genética , Antígenos de Diferenciação de Linfócitos B/metabolismo , /prevenção & controle , Estudos de Casos e Controles , Citocinas/metabolismo , Modelos Animais de Doenças , Eosinófilos/efeitos dos fármacos , Eosinófilos/metabolismo , Eosinófilos/virologia , Interações Hospedeiro-Patógeno , Humanos , Lectinas/antagonistas & inibidores , Lectinas/genética , Lectinas/metabolismo , Mastócitos/efeitos dos fármacos , Mastócitos/metabolismo , Mastócitos/virologia , Camundongos Transgênicos , Peptídeo Hidrolases/metabolismo , Infecções por Vírus Respiratório Sincicial/metabolismo , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Infecções por Vírus Respiratório Sincicial/virologia , Receptores Toll-Like/metabolismo
11.
Medicine (Baltimore) ; 100(10): e25164, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725918

RESUMO

RATIONALE: Herein, we report 3 hemodialysis patients with idiopathic hypereosinophilic syndrome who were successfully treated using corticosteroid therapy. PATIENT CONCERNS: Case 1 was a 63-year-old man who was undergoing hemodialysis because of bilateral nephrectomy and developed hypereosinophilia with digestive symptoms, myocardial injury, and intradialytic hypotension. Case 2 was an 83-year-old man who was undergoing hemodialysis because of nephrosclerosis and developed hypereosinophilia with pruritus, myocardial injury, and intradialytic hypotension. Case 3 was a 59-year-old man who was undergoing hemodialysis because of diabetic nephropathy and developed hypereosinophilia with pruritus, myocardial injury, and intradialytic hypotension. DIAGNOSES: All 3 patients presented with hypereosinophilia (eosinophil count ≥1500 /µL for more than 1 month) and multiple-organ involvement (intradialytic hypotension, cardiac injury, digestive symptoms, and allergic dermatitis). A specific cause for the hypereosinophilia was not identified by systemic computed tomography, electrocardiography, echocardiography, bone marrow examination, or blood tests. Furthermore, Case 2 and 3 had not recently started taking any new drugs and drug-induced lymphocyte stimulation tests were negative in Case 1. Therefore, they were diagnosed with idiopathic hypereosinophilic syndrome. INTERVENTIONS: All 3 patients received corticosteroid therapy with prednisolone at a dose of 40 mg/d, 30 mg/d, and 60 mg/d in Case 1, 2, and 3, respectively. OUTCOMES: Their digestive symptoms, pruritus, intradialytic hypotension, and serum troponin I concentrations were immediately improved alongside reductions in their eosinophil counts. LESSONS: There have been few case reports of idiopathic hypereosinophilic syndrome in patients undergoing hemodialysis. We believe that recording of the clinical findings and treatments of such patients is mandatory to establish the optimal management of idiopathic hypereosinophilic syndrome.


Assuntos
Glucocorticoides/administração & dosagem , Síndrome Hipereosinofílica/tratamento farmacológico , Diálise Renal/efeitos adversos , Insuficiência Renal/terapia , Administração Oral , Idoso de 80 Anos ou mais , Nefropatias Diabéticas/complicações , Nefropatias Diabéticas/terapia , Diagnóstico Diferencial , Relação Dose-Resposta a Droga , Eosinófilos , Humanos , Síndrome Hipereosinofílica/sangue , Síndrome Hipereosinofílica/diagnóstico , Síndrome Hipereosinofílica/etiologia , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Nefrectomia/efeitos adversos , Nefroesclerose/complicações , Nefroesclerose/terapia , Prednisolona/administração & dosagem , Insuficiência Renal/etiologia , Resultado do Tratamento
12.
BMC Pulm Med ; 21(1): 74, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653314

RESUMO

BACKGROUND: Blood eosinophil count may predict treatment response in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbations (AE). However, the ability and thresholds of blood eosinophil counts in stable status to predict eosinophilic AECOPD have not been completely investigated. METHODS: This was a retrospective multicenter study performed January 2010 to December 2014. COPD subjects hospitalized with exacerbations, were included. Blood samples were obtained at the time of AE and stable disease at outpatient clinic before or after admission. We identified a blood eosinophil count cut-off point at stable COPD, either taken as a percentage or as absolute value, for identification of eosinophilic exacerbation. RESULTS: There was significant positive correlation of eosinophil counts between stable COPD and AECOPD. The best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation based on blood eosinophil count ≥ 2% was 300 cells/µL (area under the ROC curve [AUC] 0.614, P = 0.001, 39% sensitivity, 83.8% specificity). When the eosinophilic COPD exacerbation was based on blood eosinophil count ≥ 300 cells/µL, the best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation was also 300 cells/uL (AUC 0.634, P = 0.046, 45.8% sensitivity, 80.9% specificity). CONCLUSIONS: We demonstrated association between blood eosinophil counts at stable COPD and those with AECOPD. The thresholds of blood counts at stable COPD to predict eosinophilic exacerbations was 300 cells/µL. Further and prospective studies in other populations should validate our results.


Assuntos
Eosinofilia/sangue , Eosinófilos , Doença Pulmonar Obstrutiva Crônica/sangue , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Eosinofilia/complicações , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Mortalidade , Prognóstico , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/terapia , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos
13.
Ann Hematol ; 100(3): 675-689, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33523290

RESUMO

2019 coronavirus disease (COVID-19) presents as a newly recognized pneumonia that has brought about a global pandemic and is increasingly considered as a systemic illness. We investigated the clinical and laboratory features of recovered COVID-19 patients without pre-existing hematologic diseases at Wuhan No. 1 Hospital. Fifty-nine male and 68 female Chinese patients were included with the median age at 64 years in the present study. Eosinopenia (37.80%), monocytosis (51.97%), lymphocytopenia (25.20%), and anemia (51.97%) were the most common hematologic findings in our cohort, particularly in severe or critically ill COVID-19. The levels of changes in leukocytes, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets, hemoglobin levels, mean corpuscular volume (MCV), and mean cell hemoglobin concentration (MCHC) are overall associated with lung involvement, oxygen demand, and disease activity. However, changes of eosinophils (end hospitalization-baseline) (coefficients = 10.32; 95% CI = 1.03-19.60, P = 0.03) and basophils (Max - Min) (coefficients = 71.43; 95% CI = 8.55-134.31, P = 0.03) were independent predictors of delayed recovery in the hospital by the multivariate analysis in this recovered population. A variety of hematologic changes are associated with the severity and clinical outcome of recovered COVID-19 patients, which warrants further exploration of their underlying mechanisms.


Assuntos
Contagem de Células Sanguíneas , Convalescença , Adulto , Idoso , Basófilos , Proteína C-Reativa/análise , /epidemiologia , /terapia , China , Terapia Combinada , Comorbidade , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Eosinófilos , Feminino , Hemoglobinas/análise , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Interleucina-6/sangue , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Oxigenoterapia , Prognóstico , Resultado do Tratamento
14.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541953

RESUMO

A previously healthy 40-year-old man was referred to our emergency department with pruritic skin lesions and dyspnoea. Laboratory investigation revealed hypereosinophilia. Further diagnostic work-up confirmed the diagnosis of idiopathic hypereosinophilic syndrome (iHES), a rare myeloproliferative disease with a heterogeneous clinical presentation. We describe a unique case with cardiac, pulmonary, hepatic and cutaneous involvement at time of presentation. This case accentuates the importance of an extensive multidisciplinary diagnostic work-up, since iHES is a condition with potential rapid progressive multiorgan failure which requires prompt analysis and treatment. In addition, this case emphasises the importance of being aware of tunnel vision, especially during the COVID-19 pandemic, which might give rise to an increased risk of missing rare diagnoses. Our patient was treated with prednisolone, after which both his clinical condition and eosinophil concentrations markedly improved.


Assuntos
Síndrome Hipereosinofílica/diagnóstico , Síndrome Hipereosinofílica/patologia , Adulto , Anti-Inflamatórios/uso terapêutico , Biópsia/métodos , Diagnóstico Diferencial , Dispneia/complicações , Eosinófilos/patologia , Humanos , Síndrome Hipereosinofílica/complicações , Síndrome Hipereosinofílica/tratamento farmacológico , Masculino , Prednisolona/uso terapêutico , Dermatopatias/complicações , Dermatopatias/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
15.
Medicine (Baltimore) ; 100(3): e24328, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546064

RESUMO

ABSTRACT: To date, no effective biological markers have been identified for predicting the prognosis of esophageal cancer patients. Recent studies have shown that eosinophils are independent prognostic factors in some cancers. This study aimed to identify the prognostic impact of eosinophils in esophageal squamous cell carcinoma patients treated with concurrent chemoradiotherapy (CCRT).This study enrolled 136 patients who received CCRT for locally advanced unresectable esophageal squamous cell carcinoma (ESCC). We evaluated the survival time and clinical pathological characteristics of eosinophils. The Kaplan-Meier method was used to estimate survival data. The log-rank test was used for univariate analysis and the Cox proportional hazards regression model was used to conduct a multivariate analysis.Kaplan-Meier analysis revealed that high eosinophil infiltration correlated with better overall survival (OS) (P = .008) and better progression-free survival (PFS) (P = .015). The increase in absolute eosinophil count after CCRT also enhanced OS (P = .005) and PFS (P = .007). The PFS and OS in patients with high blood eosinophil count before CCRT (>2%) was better than those with low blood eosinophil count(<2%) (P = .006 and P = .001, respectively). Additionally, the multivariate analysis revealed that disease stage and high eosinophil infiltration, increased peripheral blood absolute eosinophil count after CCRT, and high peripheral blood eosinophil count before CCRT were independent prognostic indicators.High eosinophil count of tumor site, increased peripheral blood absolute eosinophil count after CCRT, and high peripheral blood eosinophil count before CCRT are favorable prognostic factors for patients with ESCC treated with CCRT.


Assuntos
Quimiorradioterapia/métodos , Eosinófilos/fisiologia , Carcinoma de Células Escamosas do Esôfago/sangue , Carcinoma de Células Escamosas do Esôfago/tratamento farmacológico , Prognóstico , Adulto , Idoso , Carcinoma de Células Escamosas do Esôfago/diagnóstico , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos
16.
Bratisl Lek Listy ; 122(3): 212-216, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33618531

RESUMO

AIM: This study has investigated the role of eosinophil cationic protein (ECP), released by eosinophils, in the coronary slow flow phenomenon. METHODS: This study included sixty patients with coronary slow flow (CSF) and sixty patients with normal coronary flow. The coronary flow rate was evaluated with TIMI frame count (TFC). ECP level, blood count and biochemical parameters were assessed. RESULTS: The ECP levels (18.9±7.5 vs 13.1±6.4 ng/ml, p<0.001) and eosinophil counts (0.25±0.14 vs 0.18±0.09 10³/mm³, p=0.001) were higher in the CSF group. Multivariable regression analysis showed that ECP level and eosinophil counts were independent predictors the presence of CSF (p=0.003 and p=0.006). There was a weak but important correlation among the ECP level, eosinophil count and mean TFC (p=0.001, p=0.003, respectively). The ROC analysis showed a cut off value of 14.05 ng/ml for ECP level to diagnose CSF with 73.3 % sensitivity and 66.7 % specificity, and area under the ROC curve was 0.745 (95% CI: 0.657-0.833, p<0.001). CONCLUSION: ECP levels were increased in CSF patients and this increasing correlated with coronary artery flow rates. The ECP level was independent predictor for the presence of SCF and it may be use as suitable diagnostic biomarker for CSF (Tab. 3, Fig. 3, Ref. 30).


Assuntos
Proteína Catiônica de Eosinófilo , Fenômeno de não Refluxo , Biomarcadores , Proteínas Sanguíneas , Eosinófilos , Humanos , Contagem de Leucócitos
17.
Nat Commun ; 12(1): 1084, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33597531

RESUMO

Children have mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) confirmed disease (COVID-19) compared to adults and the immunological mechanisms underlying this difference remain unclear. Here, we report acute and convalescent innate immune responses in 48 children and 70 adults infected with, or exposed to, SARS-CoV-2. We find clinically mild SARS-CoV-2 infection in children is characterised by reduced circulating subsets of monocytes (classical, intermediate, non-classical), dendritic cells and natural killer cells during the acute phase. In contrast, SARS-CoV-2-infected adults show reduced proportions of non-classical monocytes only. We also observe increased proportions of CD63+ activated neutrophils during the acute phase to SARS-CoV-2 in infected children. Children and adults exposed to SARS-CoV-2 but negative on PCR testing display increased proportions of low-density neutrophils that we observe up to 7 weeks post exposure. This study characterises the innate immune response during SARS-CoV-2 infection and household exposure in children.


Assuntos
Anticorpos Antivirais/imunologia , Imunidade Inata/imunologia , /imunologia , Adolescente , Adulto , /virologia , Criança , Pré-Escolar , Células Dendríticas/imunologia , Eosinófilos/imunologia , Humanos , Lactente , Células Matadoras Naturais/imunologia , Leucócitos Mononucleares/imunologia , Pessoa de Meia-Idade , Neutrófilos/imunologia , /fisiologia , Adulto Jovem
18.
Zhonghua Yi Xue Za Zhi ; 101(6): 383-387, 2021 Feb 09.
Artigo em Chinês | MEDLINE | ID: mdl-33611887

RESUMO

In the treatment of stable chronic obstructive pulmonary disease (COPD), international guidelines have updated the recommendations for inhaled corticosteroids (ICS) based on the accumulated clinical evidences, and the understanding has gone further from "controversy" to "affirmation" until the presence of the lastest guideline that indicates patients are divided into two phenotypes according to the clinical characteristics of dyspnea and acute exacerbation for adjustments in treatment strategy, and for patients with frequent acute exacerbations during the last one year, combined with their blood eosinophil counts, the individualized treatments including ICS are recommended.


Assuntos
Corticosteroides , Doença Pulmonar Obstrutiva Crônica , Administração por Inalação , Corticosteroides/uso terapêutico , Eosinófilos , Humanos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
19.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541947

RESUMO

A 54-year-old Chinese man presented with ascites for 2 weeks. He had a preceding 2-year history of intermittent dysphagia, lethargy and general malaise. Blood investigations revealed leucocytosis with eosinophilia of 26.5%, whereas paracentesis showed turbid fluid with high protein content (45 g/L) and a high white blood cell count of 5580/µL, predominantly eosinophils (90%). An incidental assay of vitamin D showed a very low level of 13.5 ng/mL. No other cause of ascites was found. Gastroscopy was normal except for duodenitis. However, biopsies from lower oesophagus confirmed the presence of eosinophilic infiltration. Following vitamin D replacement, the patient experienced marked improvement in symptoms of dysphagia within 2 weeks and no recurrence of ascites after 3 months. The reason for the patient's vitamin D deficiency remains unclear. The marked improvement in the patient's health indicates a causative role of vitamin D deficiency in causing eosinophilic esophagogastroenteritis and associated eosinophilic ascites.


Assuntos
Ascite/complicações , Hormônios e Agentes Reguladores de Cálcio/administração & dosagem , Colecalciferol/administração & dosagem , Enterite/diagnóstico , Eosinofilia/diagnóstico , Eosinófilos/patologia , Gastrite/diagnóstico , Deficiência de Vitamina D/complicações , Grupo com Ancestrais do Continente Asiático , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Paracentese , Tomografia Computadorizada por Raios X
20.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541998

RESUMO

Rosai-Dorfman disease is a rare benign histiocytic proliferative disease of unknown cause that, in exceptional cases, presents with lesions confined to the skin. Clinically variable types of lesions such as papules, nodules and plaques have been reported. We present a case of a 27-year-old woman with a 1-year history of erythematous papular and nodular lesions on the malar and right axillary regions, previously misdiagnosed as acne. She reported no fever, malaise or weight loss, while physical examination and laboratory workup were normal. Bacteriological and mycobacteriological cultures were negative. Histopathological findings showed dense infiltration of inflammatory cells involving the entire dermis, consisting of large macrophages with emperipolesis, S100 and CD68 positive, neutrophils, eosinophils, lymphocytes and plasma cells. The patient was treated with oral prednisolone without improvement. Dapsone was subsequently initiated with favourable clinical response. The present article aimed to emphasise the clinical and histological differential diagnosis and share the treatment experience.


Assuntos
Anti-Infecciosos/uso terapêutico , Dapsona/uso terapêutico , Glucocorticoides/uso terapêutico , Histiocitose Sinusal , Prednisolona/uso terapêutico , Doenças Raras , Pele/patologia , Adulto , Erros de Diagnóstico , Emperipolese , Eosinófilos/patologia , Feminino , Histiocitose Sinusal/diagnóstico , Histiocitose Sinusal/tratamento farmacológico , Humanos , Proteínas S100
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