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1.
Zhonghua Nei Ke Za Zhi ; 59(5): 372-374, 2020 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-32370466

RESUMO

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to The Sixth People's Hospital of Shanghai and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells (WBC) were analyzed. Patients in COVID-19 group showed relatively lower absolute WBC count 4.95(3.90,6.03)×10(9)/L, lymphocyte absolute count 1.20(0.98,1.50)×10(9)/L and eosinophil absolute count 0.01(0.01,0.01)×10(9)/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20(6.78,9.03)×10(9)/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10(9)/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10(9)/L(P=0.005). Lymphocytopenia occurred in 16.7% patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non-COVID-19 patients.


Assuntos
Infecções por Coronavirus/sangue , Leucócitos/citologia , Pneumonia Viral/sangue , Betacoronavirus , Estudos de Casos e Controles , China , Eosinófilos/citologia , Humanos , Contagem de Leucócitos , Leucopenia , Linfopenia , Pandemias
2.
Medicine (Baltimore) ; 99(14): e19625, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243388

RESUMO

Patients with both serous effusion and eosinophilia are rarely reported and geographically distributed; their early diagnosis is difficult.According to the ultimate diagnosis, patients (≤14 years) in West China Second hospital with serous effusion and eosinophilia were divided into two groups including a parasitic group and a non-parasitic group. Clinical data were collected and analyzed between the two groups. Subsequently, significant measurement indicators were evaluated by receiver operating characteristic (ROC) curve to explore the optimal cut-off points for the most appropriate sensitivity and specificity.A total of 884 patients were diagnosed with serous effusion and 61 of them displayed co-morbidity with eosinophilia during enrolled time. Among 61 patients, 34 patients had parasitic infection and 27 had non-parasitic diseases. There were statistical difference in effusion position, the levels of white blood cell count (WBC), eosinophil (EOS), EOS%, C-reactive protein (CRP) between parasitic group and non-parasitic group. ROC curve demonstrated that the areas under the curve of EOS count and EOS% were >80%, and the corresponding optimal cut-off values were 1.71 × 10/L and 25.6% for distinguishing between parasitic and non-parasitic infections in our patients.This study provided a quantified index for potentially quick and convenient indicators of pediatric patients presenting with both eosinophilia and effusion. Eosinophils were helpful to improve the initial diagnosis with awareness of parasitic diseases. For the cases with EOS > 1.71 × 10/L or EOS% > 25.6%, parasitic infection should be considered and serological tests are recommended in our region.


Assuntos
Doenças Parasitárias/diagnóstico , Derrame Pleural/diagnóstico , Eosinofilia Pulmonar/diagnóstico , Proteína C-Reativa/análise , Criança , Pré-Escolar , China , Diagnóstico Diferencial , Diagnóstico Precoce , Eosinófilos/metabolismo , Feminino , Humanos , Pacientes Internados , Contagem de Leucócitos , Masculino , Doenças Parasitárias/sangue , Doenças Parasitárias/complicações , Derrame Pleural/sangue , Derrame Pleural/parasitologia , Eosinofilia Pulmonar/sangue , Eosinofilia Pulmonar/parasitologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
3.
Am J Surg ; 219(4): 592-597, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32209240

RESUMO

BACKGROUND: The aim of this study was to determine whether acute histologic inflammatory activity at the rectal margin predicts postoperative complications in children with ulcerative colitis following ileal pouch-anal anastomoses (IPAA). METHODS: Patients who underwent IPAA following previous total abdominal colectomy for ulcerative colitis between 2006 and 2014 were included. Data collected included demographics, operative and postoperative data, histologic grading of the rectal margin at time of IPAA, and stooling outcomes at one, six and 12 months following ileostomy closure. RESULTS: Twenty-seven patients were included. Acute inflammation scores ranged between 2 and 13. Unadjusted and adjusted models showed no statistically significant relationship between inflammation and presence of any postoperative complications, number of daily stools, nighttime stooling, soiling, or stool-altering medication usage. CONCLUSION: Acute histologic inflammatory activity at the rectal margin is not associated with increased rates of postoperative complications following IPAA creation in children, nor with poorer continence outcomes following ileostomy closure.


Assuntos
Colite Ulcerativa/patologia , Colite Ulcerativa/cirurgia , Mucosa Intestinal/patologia , Reto/patologia , Adolescente , Estudos de Coortes , Bolsas Cólicas , Eosinófilos/patologia , Incontinência Fecal/etiologia , Feminino , Humanos , Fístula Intestinal/etiologia , Mucosa Intestinal/cirurgia , Obstrução Intestinal/etiologia , Leucócitos Mononucleares/patologia , Masculino , Neutrófilos/patologia , Complicações Pós-Operatórias , Pouchite/etiologia , Proctocolectomia Restauradora , Reto/cirurgia , Estudos Retrospectivos
4.
West Afr J Med ; 37(2): 124-130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32150630

RESUMO

BACKGROUND: Atopic dermatitis (AD) is a chronic, inflammatory, itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbations and remissions, except for severe cases where it may be continuous. In children younger than one, the face and extensor surfaces of the hands and legs are typically involved, and in some case the trunk as well. The aim of this study was to determine the prevalence, pattern, and sites of atopic dermatitis among children aged 6 months to 14 years, as well as document the full blood count picture with emphasis on the eosinophil count as a correlate in predicting atopic dermatitis. METHODS: This was a descriptive cross-sectional study of 490 eligible children recruited using the systematic random sampling technique. The data collected was analyzed using statistical package for social sciences, version 22 (SPSS 22 Chicago, Illinois, USA). RESULTS: The prevalence of AD from this study was 9.8% using the Hanifin and Rajka criteria, with the age group <5 years having the highest prevalence of 47.9% and it was more common in males than in females 64.6% and 35.4% respectively. The commonest site of affectation was the face and extensor surface (100.0%; 95.8% respectively). In terms of the severity of AD using the TIS score, majority were in the moderate category (81.3%). Mean Eosinophil count was 8.75% ±5.90. There was a statistical significant association between absence of AD and elevated absolute eosinophil count (P=0.015). CONCLUSION: The study highlights that the prevalence of atopic dermatitis among children 6 months to 14 years based on major Hanifin and Rajka Criteria is 9.8%. Individuals with AD are unlikely to have elevated absolute eosinophil count.


Assuntos
Dermatite Atópica/diagnóstico , Dermatite Atópica/epidemiologia , Pacientes Ambulatoriais/estatística & dados numéricos , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Estudos Transversais , Dermatite Atópica/sangue , Eosinófilos , Feminino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Prevalência , Índice de Gravidade de Doença , Distribuição por Sexo
6.
Lancet ; 395(10221): 371-383, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32007172

RESUMO

Asthma is a disease of reversible airflow obstruction characterised clinically by wheezing, shortness of breath, and coughing. Increases in airway type 2 cytokine activity, including interleukin-4 (IL-4), IL-5, and IL-13, are now established biological mechanisms in asthma. Inhaled corticosteroids have been the foundation for asthma treatment, in a large part because they decrease airway type 2 inflammation. However, inhaled or systemic corticosteroids are ineffective treatments in many patients with asthma and few treatment options exist for patients with steroid resistant asthma. Although mechanisms for corticosteroid refractory asthma are likely to be numerous, the development of a new class of biologic agents that target airway type 2 inflammation has provided a new model for treating some patients with corticosteroid refractory asthma. The objective of this Therapeutic paper is to summarise the new type 2 therapeutics, with an emphasis on the biological rationale and clinical efficacy of this new class of asthma therapeutics.


Assuntos
Antiasmáticos/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Asma/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Adulto , Biomarcadores/metabolismo , Ensaios Clínicos Fase III como Assunto , Citocinas/antagonistas & inibidores , Citocinas/fisiologia , Eosinófilos/fisiologia , Previsões , Humanos , Ácidos Indolacéticos/uso terapêutico , Interleucina-4/antagonistas & inibidores , Interleucina-5/antagonistas & inibidores , Omalizumab/uso terapêutico , Piridinas/uso terapêutico , Células Th2/fisiologia , Resultado do Tratamento
7.
BMC Infect Dis ; 20(1): 85, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000694

RESUMO

BACKGROUND: Little is known about the potential use of the eosinophil count as a predictive marker of bloodstream infection. In this study, we aimed to assess the reliability of eosinopenia as a predictive marker of bloodstream infection. METHODS: This retrospective cohort study was performed in the outpatient department and general internal medicine department of a tertiary university hospital in Japan. A total of 189 adult patients with at least 2 sets of blood cultures obtained during the period January 1-December 31, 2018, were included; those with the use of antibiotic therapy within 2 weeks prior to blood culture, steroid therapy, or a history of haematological cancer were excluded. The diagnostic accuracies of each univariate variable and the multivariable logistic regression models were assessed by calculating the areas under the receiver operating characteristic curves (AUROCs). The primary outcome was a positive blood culture indicating bloodstream infection. RESULTS: Severe eosinopenia (< 24.4 cells/mm3) alone yielded small but statistically significant overall predictive ability (AUROC: 0.648, 95% confidence interval (CI): 0.547-0.748, P < 0.05), and only moderate sensitivity (68, 95% CI: 46-85%) and specificity (62, 95% CI: 54-69%). The model comprising baseline variables (age, sex), the C-reactive protein level, and neutrophil count yielded an AUROC of 0.729, and further addition of eosinopenia yielded a slight improvement, with an AUROC of 0.758 (P < 0.05) and a statistically significant net reclassification improvement (NRI) (P = 0.003). However, the integrated discrimination index (IDI) (P = 0.284) remained non-significant. CONCLUSIONS: Severe eosinopenia can be considered an inexpensive marker of bloodstream infection, although of limited diagnostic accuracy, in a general internal medicine setting.


Assuntos
Agranulocitose , Bacteriemia/sangue , Bacteriemia/diagnóstico , Eosinófilos/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Biomarcadores/sangue , Confiabilidade dos Dados , Feminino , Hospitais Universitários , Humanos , Japão , Contagem de Leucócitos/métodos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neutrófilos/metabolismo , Estudos Retrospectivos , Sensibilidade e Especificidade
8.
Am J Gastroenterol ; 115(2): 224-233, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31913192

RESUMO

OBJECTIVES: Mast cells (MCs) are increased in eosinophilic esophagitis (EoE). Endoscopic abnormalities, symptoms, and epithelial changes can persist after treatment despite a reduction of esophageal eosinophilia. It is unknown whether this could be due to persistent MC infiltration. We aimed to determine whether patients with histologically inactive (HI) EoE (defined as <15 eosinophils per high-powered field) with persistent symptoms, endoscopic, or epithelial abnormalities after treatment have increased MCs. METHODS: Secondary analysis of prospective data from 93 children with EoE undergoing post-treatment endoscopy between 2011 and 2015. Thirty-five non-EoE controls were included. Immunohistochemistry for tryptase, an MC marker, was performed on mid and distal esophageal biopsies. Total and degranulated intraepithelial MCs per high-powered field (MC/hpf) were quantified. Symptoms and endoscopic findings were recorded at time of endoscopy. MC/hpf were compared between HI-EoE and control, and among HI-EoE based on endoscopic and histologic findings, and symptoms. Nine clinical remission (CR) patients were identified, with absence of endoscopic abnormalities and symptoms. RESULTS: MC/hpf were increased in HI-EoE compared with control (17 ± 11 vs 8 ± 6, P < 0.0). Patients with persistent endoscopic abnormalities had increased total (20 ± 12 vs 13 ± 10, P = 0.001) and degranulated (8 ± 6 vs 5 ± 4, P = 0.002) MC/hpf, with no difference in eosinophils. MC/hpf predicted furrowing (odds ratio = 1.06, P = 0.01) and rings (odds ratio = 1.05, P = 0.03) after controlling for treatment type, proton-pump inhibitor, eosinophils, and duration of therapy. Patients with persistent basal zone hyperplasia and dilated intercellular spaces had increased MC/hpf. Eosinophils were weakly correlated with MC/hpf in the mid (r = 0.30, P < 0.001) and distal (r = 0.29, P < 0.001) esophagus. Clinical remission patients had lower MC/hpf compared with patients with persistent symptoms and/or endoscopic abnormalities. DISCUSSION: MC density is increased in patients with endoscopic and epithelial abnormalities, as well as a few symptoms, despite resolution of esophageal eosinophilia after treatment. This association warrants further study to ascertain whether MCs play an eosinophil independent role in EoE.


Assuntos
Esofagite Eosinofílica/patologia , Eosinófilos/patologia , Mastócitos/patologia , Adolescente , Corticosteroides/uso terapêutico , Criança , Pré-Escolar , Dietoterapia/métodos , Edema/patologia , Esofagite Eosinofílica/fisiopatologia , Esofagite Eosinofílica/terapia , Esofagoscopia , Exsudatos e Transudatos , Feminino , Humanos , Masculino
9.
Nat Commun ; 11(1): 393, 2020 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-31959851

RESUMO

Asthma is one of the most common chronic diseases affecting both children and adults. We report a genome-wide association meta-analysis of 69,189 cases and 702,199 controls from Iceland and UK biobank. We find 88 asthma risk variants at 56 loci, 19 previously unreported, and evaluate their effect on other asthma and allergic phenotypes. Of special interest are two low frequency variants associated with protection against asthma; a missense variant in TNFRSF8 and 3' UTR variant in TGFBR1. Functional studies show that the TNFRSF8 variant reduces TNFRSF8 expression both on cell surface and in soluble form, acting as loss of function. eQTL analysis suggests that the TGFBR1 variant acts through gain of function and together with an intronic variant in a downstream gene, SMAD3, points to defective TGFßR1 signaling as one of the biological perturbations increasing asthma risk. Our results increase the number of asthma variants and implicate genes with known role in T cell regulation, inflammation and airway remodeling in asthma pathogenesis.


Assuntos
Remodelação das Vias Aéreas/genética , Asma/genética , Antígeno Ki-1/genética , Receptor do Fator de Crescimento Transformador beta Tipo I/genética , Linfócitos T/imunologia , Regiões 3' não Traduzidas/genética , Remodelação das Vias Aéreas/imunologia , Asma/imunologia , Eosinófilos , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Islândia , Antígeno Ki-1/imunologia , Antígeno Ki-1/metabolismo , Contagem de Leucócitos , MicroRNAs/metabolismo , Polimorfismo de Nucleotídeo Único/imunologia , Locos de Características Quantitativas/imunologia , Receptor do Fator de Crescimento Transformador beta Tipo I/imunologia , Receptor do Fator de Crescimento Transformador beta Tipo I/metabolismo , Reino Unido
10.
Ann Otol Rhinol Laryngol ; 129(5): 512-516, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31888343

RESUMO

BACKGROUND: Prior studies have demonstrated associations between serum eosinophilia and chronic rhinosinusitis (CRS) pathogenesis. However, the association of serum eosinophilia with histopathology profiling in CRS has not been fully delineated and may help better characterize CRS disease burden prior to surgery. METHODS: A structured histopathology report of 13 variables was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery (FESS). Complete blood count (CBC) with differential was drawn within 4 weeks prior to FESS. Serum eosinophilia was defined as >6.0% (>0.60 th/µL). Histopathology variables were compared among patients. RESULTS: A total of 177 CRS patients (37 with serum eosinophilia and 140 with normal serum eosinophilia) were analyzed. Compared to CRS patients with normal serum eosinophil counts, CRS patients with serum eosinophilia demonstrated increased polypoid disease (67.6% vs 35.0%, P < .001), eosinophil aggregates (45.9% vs 20.7%, P = .003), and eosinophils per high-power field (>5/HPF) (67.6% vs 40.7%, P = .003). CONCLUSION: CRS patients with serum eosinophilia demonstrated severe disease burden on histopathology with high levels of polypoid disease and tissue eosinophilia. However, a considerable number of patients without serum eosinophilia demonstrated eosinophilic disease on histopathology, indicating that preoperative serum eosinophilia alone could not be reliably used to predict eosinophilic CRS. LEVEL OF EVIDENCE: 4.


Assuntos
Eosinofilia/sangue , Eosinófilos/patologia , Rinite/complicações , Sinusite/complicações , Doença Crônica , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Período Pré-Operatório , Estudos Retrospectivos , Rinite/sangue , Rinite/diagnóstico , Índice de Gravidade de Doença , Sinusite/sangue , Sinusite/diagnóstico
11.
Int Arch Allergy Immunol ; 181(1): 11-23, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31786573

RESUMO

Eosinophils and their secretory mediators play an important role in the pathogenesis of infectious and inflammatory disorders. Although eosinophils are largely evolutionally conserved, their physiologic functions are not well understood. Given the availability of new eosinophil-targeted depletion therapies, there has been a renewed interest in understanding eosinophil biology as these strategies may result in secondary disorders when applied over long periods of time. Recent data suggest that eosinophils are not only involved in immunological effector functions but also carry out tissue protective and immunoregulatory functions that actively contribute to the maintenance of homeostasis. Prolonged eosinophil depletion may therefore result in the development of secondary disorders. Here, we review recent literature pointing to important roles for eosinophils in promoting immune defense, antibody production, activation of adipose tissue, and tissue remodeling and fibrosis. We also reflect on patient data from clinical trials that feature anti-eosinophil therapeutics.


Assuntos
Eosinófilos/imunologia , Síndrome Hipereosinofílica/imunologia , Inflamação/imunologia , Animais , Formação de Anticorpos , Humanos , Imunidade Celular , Imunomodulação , Interleucina-5 , Cicatrização
12.
Food Chem Toxicol ; 135: 110924, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31672514

RESUMO

BACKGROUND: Allergic conjunctivitis (AC) resulting from conjunctival reactive inflammation is a common ocular surface disease. Quercetin is known for its anti-allergic properties but its effects on conjunctivitis are less well understood. PURPOSE: In this study, we evaluated the anti-allergic effects of quercetin in animal models of conjunctivitis, and explored its molecular mechanism(s) of action in cultured human mast cells (MCs). KEY RESULTS: Quercetin inhibited the ovalbumin (OVA) induced expression of IgE, HA, IL-4, TNF-α and substance-P in the peripheral blood of AC mouse models. Quercetin also attenuated OVA induced MC degranulation, eosinophil number, substance P concentrations, and mRNA IL-4/TNF-α expression in the conjunctival tissue of AC models. In vitro analysis showed that quercetin reduced DNP-HSA/IgE induced calcium (Ca2+) influx, and suppressed degranulation and chemokine release in LAD2 cells (human primary mast cell). Quercetin also inhibited DNP-HSA/IgE induced Lyn/PLCγ/IP3R-Ca2+ activation, Lyn/ERK1/2 signaling, and Lyn/NF-κB activation in LAD2 cells, all of which promote inflammation. When added alone, quercetin had no effect on PLCγ1 phosphorylation or expression, but potently inhibited Lyn and phosphorylation-Lyn. Quercetin (200 µM) and Lyn inhibitors (Bafetinib, 10 µM) inhibit the activity of Lyn kinase, and quercetin can reduce the activation of Lyn kinase by Lyn agonist (Tolimidone, 10 µM). These data can be preliminarily determined that quercetin can inhibit allergic conjunctivitis as a Lyn kinase inhibitor. CONCLUSIONS AND IMPLICATIONS: This study illustrated the use of quercetin for the treatment of allergic conjunctivitis, which might act through its ability to inhibit Lyn/PLCγ/IP3R-Ca2+, Lyn/ERK1/2, and Lyn/NF-κB signaling. The inhibition of Lyn likely represents a major mechanism by which quercetin dampens the inflammatory response in AC disease models.


Assuntos
Antialérgicos/uso terapêutico , Conjuntivite Alérgica/tratamento farmacológico , Inibidores de Proteínas Quinases/uso terapêutico , Quercetina/uso terapêutico , Quinases da Família src/antagonistas & inibidores , Animais , Linhagem Celular , Quimiocinas/metabolismo , Conjuntivite Alérgica/induzido quimicamente , Conjuntivite Alérgica/metabolismo , Eosinófilos/efeitos dos fármacos , Eosinófilos/metabolismo , Humanos , Imunoglobulina E/metabolismo , Masculino , Mastócitos/efeitos dos fármacos , Mastócitos/metabolismo , Camundongos Endogâmicos C57BL , Ovalbumina , Transdução de Sinais/efeitos dos fármacos , Pele/patologia
13.
Postgrad Med ; 132(2): 126-131, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31852408

RESUMO

Chronic obstructive pulmonary disease (COPD) is one of the most common diseases worldwide. Although different guidelines regarding therapeutic algorithms exist, the most widely adopted approach is the one suggested by the Global Initiative in Chronic Obstructive Lung Disease in which patients are stratified according to their dyspnea severity and their exacerbation history during the previous year. This combined assessment of COPD, which takes into consideration all aforementioned characteristics of COPD patients as well as the number of blood eosinophils, results in a proposed therapeutic algorithm which is complex and hard to memorize. This complexity is probable one of the causes that most health care professionals are not adherent to the guidelines when treating COPD patients. Here, we propose a simplified therapeutic algorithm for the treatment of COPD patients taking into consideration the current evidence on the use of bronchodilators and inhaled corticosteroids.


Assuntos
Corticosteroides/uso terapêutico , Broncodilatadores/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Administração por Inalação , Corticosteroides/administração & dosagem , Agonistas de Receptores Adrenérgicos beta 2/farmacologia , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Broncodilatadores/administração & dosagem , Broncodilatadores/farmacologia , Protocolos Clínicos , Preparações de Ação Retardada , Combinação de Medicamentos , Quimioterapia Combinada , Eosinófilos/metabolismo , Humanos , Antagonistas Muscarínicos/farmacologia , Antagonistas Muscarínicos/uso terapêutico , Guias de Prática Clínica como Assunto , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Testes de Função Respiratória , Índice de Gravidade de Doença
14.
Am J Cardiol ; 125(2): 264-269, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31847958

RESUMO

Described herein are 3 adults in whom histologic study of the left ventricular myocardium excised ("LV core") to insert a left ventricular assist device (LVAD) disclosed severe acute myocarditis and the inflammatory cells included numerous eosinophils (eosinophilic myocarditis). Examination of the clinical records disclosed elevated absolute eosinophil counts at the time of insertion of the LVAD and the counts rapidly (<30 days) returned to normal after the operation. Because of the numerous medications that each patient was taking at the time of LVAD insertion, identification of a specific initiating medication as its cause was not possible. Of the 3 patients, 2 had idiopathic-dilated cardiomyopathy and 1 had ischemic cardiomyopathy and each had had heart failure for years. The eosinophilic myocarditis in these 3 patients appears to have been transient and superimposed on the earlier cardiomyopathy.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Eosinofilia/diagnóstico , Insuficiência Cardíaca/cirurgia , Ventrículos do Coração/patologia , Coração Auxiliar , Miocardite/diagnóstico , Miocárdio/patologia , Idoso , Biópsia , Eletrocardiografia , Eosinofilia/complicações , Eosinofilia/cirurgia , Eosinófilos/patologia , Feminino , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Ventrículos do Coração/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Miocardite/complicações , Miocardite/cirurgia , Índice de Gravidade de Doença
15.
Ann Allergy Asthma Immunol ; 124(1): 79-86, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31626906

RESUMO

BACKGROUND: Fixed airflow obstruction (FAO) is associated with severe eosinophilic asthma. Benralizumab is an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody for patients with severe, uncontrolled eosinophilic asthma. OBJECTIVE: We evaluated FAO influence on benralizumab treatment response. METHODS: We performed a post hoc analysis of pooled phase III SIROCCO (NCT01928771) and CALIMA (NCT01914757) data for patients with severe, uncontrolled asthma with baseline blood eosinophil counts of 300 or more cells/µL who received benralizumab 30 mg every 8 weeks or placebo. Demographics, baseline clinical characteristics, and treatment responses were evaluated by FAO status. FAO+ and FAO- were defined as ratios of postbronchodilator forced expiratory volume in 1 second (FEV1) to forced vital capacity of less than 70% and 70% or more, respectively, at baseline. RESULTS: FAO+ prevalence was 63% (935/1493). With benralizumab, similar annual asthma exacerbation rate (AER) reductions vs placebo were achieved for FAO+ and FAO- patients (rate ratio [95% confidence interval (CI)] = 0.56 [0.44-0.71] and 0.58 [0.41-0.83], respectively), whereas annual AER reductions associated with emergency department visits or hospitalizations were greater for FAO+ vs FAO- patients (rate ratio [95% CI] = 0.55 [0.33-0.91] and 0.70 [0.33-1.48], respectively). Prebronchodilator FEV1 (95% CI) increase from baseline to end of treatment was greater for FAO+ vs FAO- patients receiving benralizumab compared with placebo (0.159 L [0.082-0.236] vs 0.103 L [-0.008 to 0.215]). Other lung function measures, patient-reported outcomes, and symptom improvements were also numerically greater for FAO+ vs FAO- patients. CONCLUSION: Benralizumab improved asthma control across several measures for patients with severe, uncontrolled eosinophilic asthma and FAO. TRIAL REGISTRATION: SIROCCO trial: NCT01928771 (URL: https://clinicaltrials.gov/ct2/show/NCT01928771) CALIMA trial: NCT01914757 (URL: https://clinicaltrials.gov/ct2/show/NCT01914757).


Assuntos
Antiasmáticos/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Asma/tratamento farmacológico , Eosinofilia Pulmonar/tratamento farmacológico , Adulto , Asma/patologia , Método Duplo-Cego , Eosinófilos/citologia , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Subunidade alfa de Receptor de Interleucina-5/antagonistas & inibidores , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Placebos/administração & dosagem , Eosinofilia Pulmonar/patologia , Qualidade de Vida/psicologia , Capacidade Vital/efeitos dos fármacos
16.
Parasite Immunol ; 42(1): e12680, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31631347

RESUMO

Eosinophils are prominent effector cells in immune responses against gastrointestinal nematode infections in ruminants, but their in vivo role has been hard to establish in large animals. Interleukin-5 is a key cytokine in the induction and stimulation of anti-parasitic eosinophil responses. This study attempted to modulate the eosinophil response in sheep through vaccination with recombinant interleukin-5 (rIL-5) and determine the effect on subsequent Haemonchus contortus infection. Nematode-resistant Canaria Hair Breed (CHB) sheep vaccinated with rIL-5 in Quil-A adjuvant, had lower blood eosinophil counts and higher mean worm burdens than control sheep vaccinated with Quil-A adjuvant alone. In addition, adult worms in IL-5-vaccinated sheep were significantly longer with higher eggs in utero in female worms, supporting an active role of eosinophils against adult parasites in CHB sheep. These results confirm that eosinophils can play a direct role in effective control of H contortus infection in sheep and offer a new approach to study immune responses in ruminants.


Assuntos
Eosinófilos/imunologia , Hemoncose/veterinária , Haemonchus/imunologia , Doenças dos Ovinos/imunologia , Adjuvantes Imunológicos , Animais , Gastroenteropatias/parasitologia , Hemoncose/imunologia , Interleucina-5 , Masculino , Contagem de Ovos de Parasitas , Saponinas de Quilaia , Ovinos , Doenças dos Ovinos/parasitologia , Carneiro Doméstico , Vacinação
17.
Int J Cancer ; 146(6): 1730-1740, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31840816

RESUMO

Immune checkpoint blockade (ICB) has shown long-term survival benefits, but only in a small fraction of cancer patients. Recent studies suggest that improved vessel perfusion by ICB positively correlates with its therapeutic outcomes. However, the underlying mechanism of such a process remains unclear. Here, we show that anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) treatment-induced tumor vessel normalization was accompanied by an increased infiltration of eosinophils into breast tumors. Eosinophil accumulation was positively correlated with the responsiveness of a breast tumor to anti-CTLA4 therapy. Depletion of eosinophils subsequently negated vessel normalization, reduced antitumor immunity and attenuated tumor growth inhibition by anti-CTLA4 therapy. Moreover, intratumoral accumulation of eosinophils relied on T lymphocytes and interferon γ production. Together, these results suggest that eosinophils partially mediate the antitumor effects of CTLA4 blockade through vascular remodeling. Our findings uncover an unidentified role of eosinophils in anti-CTLA4 therapy, providing a potential new target to improve ICB therapy and to predict its efficacy.


Assuntos
Antineoplásicos Imunológicos/farmacologia , Antígeno CTLA-4/antagonistas & inibidores , Eosinófilos/efeitos dos fármacos , Eosinófilos/metabolismo , Neoplasias/etiologia , Neoplasias/metabolismo , Neovascularização Patológica/metabolismo , Antineoplásicos Imunológicos/uso terapêutico , Biomarcadores , Linhagem Celular Tumoral , Eosinófilos/imunologia , Feminino , Humanos , Imunidade , Imunomodulação/efeitos dos fármacos , Imunofenotipagem , Ativação Linfocitária/efeitos dos fármacos , Ativação Linfocitária/imunologia , Depleção Linfocítica , Linfócitos do Interstício Tumoral/efeitos dos fármacos , Linfócitos do Interstício Tumoral/imunologia , Linfócitos do Interstício Tumoral/metabolismo , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Neovascularização Patológica/tratamento farmacológico , Subpopulações de Linfócitos T/efeitos dos fármacos , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo
18.
Braz J Med Biol Res ; 53(1): e8659, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31859912

RESUMO

Eosinophils are abundant in the reproductive tract, contributing to the remodeling and successful implantation of the embryo. However, the mechanisms by which eosinophils migrate into the uterus and their relationship to edema are still not entirely clear, since there are a variety of chemotactic factors that can cause migration of these cells. Therefore, to evaluate the role of CCR3 in eosinophil migration, ovariectomized C57BL/6 mice were treated with CCR3 antagonist SB 328437 and 17ß-estradiol. The hypothesis that the CCR3 receptor plays an important role in eosinophil migration to the mouse uterus was confirmed, because we observed reduction in eosinophil peroxidase activity in these antagonist-treated uteruses. The antagonist also influenced uterine hypertrophy, inhibiting edema formation. Finally, histological analysis of the orcein-stained uteruses showed that the antagonist reduced eosinophil migration together with edema. These data showed that the CCR3 receptor is an important target for studies that seek to clarify the functions of these cells in uterine physiology.


Assuntos
Movimento Celular/efeitos dos fármacos , Eosinófilos/efeitos dos fármacos , Estradiol/administração & dosagem , Estrogênios/administração & dosagem , Receptores CCR3/antagonistas & inibidores , Útero/citologia , Animais , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Ovariectomia
19.
Environ Toxicol ; 35(1): 27-36, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31498972

RESUMO

In 2011, a link between humidifier disinfectants and patients with idiopathic pulmonary fibrosis was identified in Korea, and Kathon was suggested as one of the causative agents. In this study, Kathon induced apoptotic cell death along with membrane damage at 24 h post-exposure. Additionally, on day 14 after a single instillation with Kathon, the total number of pulmonary cells and the levels of TNF-α, IL-5, IL-13, MIP-1α, and MCP-1α clearly increased in the lung of mice. The proportion of natural killer cells and eosinophils were significantly elevated in the spleen and the bloodstream, respectively, and the level of immunoglobulin (Ig) A, but not IgG, IgM, and IgE, dose-dependently increased. Therefore, we suggest that inhaled Kathon may induce eosinophilia-mediated disease in the lung by disrupting homeostasis of pulmonary surfactants. Considering that eosinophilia is closely related to cancer and fibrosis, further studies are needed to understand the relationship between them.


Assuntos
Desinfetantes/toxicidade , Eosinofilia/induzido quimicamente , Pulmão/efeitos dos fármacos , Surfactantes Pulmonares/metabolismo , Tiazóis/toxicidade , Animais , Apoptose/efeitos dos fármacos , Linhagem Celular , Citocinas/imunologia , Eosinofilia/sangue , Eosinofilia/imunologia , Eosinófilos/citologia , Humanos , Imunoglobulina A/sangue , Exposição por Inalação/efeitos adversos , Pulmão/imunologia , Pulmão/metabolismo , Pulmão/patologia , Masculino , Camundongos , Camundongos Endogâmicos ICR
20.
Am J Otolaryngol ; 41(1): 102301, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31732306

RESUMO

PURPOSE: Allergic fungal rhinosinusitis (AFRS) forms a subset of chronic rhinosinusitis with nasal polyps (CRSwNP) that is mainly characterized by eosinophilic nasal polyps, allergic mucin detected in the sinuses at surgery, and specific features on computerized tomography. Which biological markers predict disease recurrence in AFRS is still not clear, and the role of blood inflammatory cells in predicting recurrent polyps after surgery has yet to be investigated. The aim of this study was to newly investigate the prognostic role (in terms of recurrence rate) of preoperative blood eosinophil and basophil levels in AFRS. MATERIALS AND METHODS: A consecutive series of 17 adult patients who underwent endoscopic sinus surgery for AFRS was retrospectively assessed. RESULTS: Sinonasal polyps recurred in 7 of 17 patients. Considering the whole cohort, a significant positive correlation emerged between blood eosinophil and basophil counts, but not between blood and tissue eosinophil counts. Statistical analysis found significantly higher blood eosinophil and basophil levels in AFRS patients who relapsed than in those who did not. CONCLUSIONS: Considering the current difficulty of identifying more effective, personalized approaches to postoperative disease management in AFRS, our preliminary data support the impression that blood eosinophil and basophil levels warrant testing in further prospective and larger (preferably multi-institutional) investigations as part of the preoperative work-up for patients with AFRS in order to administer dedicated postoperative medical treatments for patients at higher risk of relapse.


Assuntos
Basófilos , Eosinófilos , Micoses/sangue , Micoses/microbiologia , Rinite Alérgica/sangue , Rinite Alérgica/microbiologia , Sinusite/sangue , Sinusite/microbiologia , Adulto , Doença Crônica , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucinas/análise , Micoses/diagnóstico por imagem , Micoses/cirurgia , Pólipos Nasais/sangue , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/microbiologia , Pólipos Nasais/cirurgia , Prognóstico , Recidiva , Estudos Retrospectivos , Rinite Alérgica/diagnóstico por imagem , Rinite Alérgica/cirurgia , Sinusite/diagnóstico por imagem , Sinusite/cirurgia , Tomografia Computadorizada por Raios X
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