Effects of becotide and becodisk glucocorticoid drugs on bronchial reactivity in patients with bronchial asthma

Efficacy of inhalation corticosteroids becotide and becodisk was compared in 24 patients with bronchial asthma. Becodisk has the advantage of not containing freon which irritates upper airways and bronchial mucosa. Clinical, allergological, bronchial resistance, provocative carbacholine tests, external respiration tests, peakflowmetry demonstrated that becodisk reduced the number of asthma attacks, lowered the need in inhalation sympathomimetics, improved external respiration function, decreased bronchial sensitivity to carbacholine. Determination of specific and nonspecific bronchial reactivity is thought essential in comparing efficacy of asthma chemotherapy. Becodisk significantly reduces bronchial reactivity to nonspecific mediator substances, is simple in use and well tolerated. It is recommended for basic therapy in various bronchial asthma forms managed with local corticosteroids.     

Patterns in children''s fruit and vegetable consumption by meal and day of the week

Seasonal bronchial asthma causally connected with the exposure to pollen allergens is a chronic, eosinophilic mucosal inflammation of airway. This inflammation is the basis for the development of nonspecific bronchial hyperreactivity which is the most typical but mutable feature of asthma. Bronchial hyperreactivity often determines asthma intensity and the need of asthma treatment. The nonspecific bronchial hyperreactivity over two consecutive years was evaluated in 11 patients (2 women and 9 men) with seasonal bronchial asthma, sensitized to grass, remaining under the conditions of natural allergen exposure and out of this period. Bronchial reactivity to histamine was measured by Cockcroft's at all method. So called histamine threshold (PC20H) in mg/ml was assessed. The values of ventilatory parameters (FVC, FEV1) and asthma symptom scores were also measured. It was showed that nonspecific bronchial hyperreactivity significantly increased in subjects with seasonal bronchial asthma during natural pollen exposure. PC20H in two studies performed during this period decreased 3 and 6 times when compared to preseasonal values. The majority part of patients (80%) has the increased bronchial reactivity to histamine also beyond the of grass season when clinical symptoms of asthma and rhinitis are not observed. This postseasonal hyperreactivity could be the effect of the chronic inflammation process persisted from the period of natural allergen exposure. Continuous subthreshold, which means asymptomatic exposure to perennial allergens to which most of patients are sensitized, could be another reason of this hyperreastivity. The possibility of exposure to the activity of seasonal allergens the whole year in persons with asthma can not omitted, as the presence of pollens in the sample of the house dust in patient's flat is observed during the yield of pollen season. Nonspecific bronchial hyperreactivity in individual patients is fluctuated, which probably is not dependent on the intensity of natural allergen exposure.     

Epithelial dependence of the bronchodilatory effect of sevoflurane and desflurane in rat distal bronchi

The bronchial epithelium releases substances that enhance bronchodilation in response to certain bronchodilators. We examined the hypothesis that the bronchodilatory effect of desflurane and sevoflurane depends on the epithelium in rat distal bronchial segments. Wistar rat subsegmental bronchial segments (diameter approximately 100 microm) were dissected. After preconstriction with 5-hydroxytryptamine, each segment was exposed to increasing concentrations of desflurane 0%-12% or sevoflurane 0%-4.8% under four conditions: after epithelial rubbing, after pretreatment with the nitric oxide (NO) synthase inhibitor N(G)-nitro-L-arginine (L-NNA), after pretreatment with the cyclooxygenase inhibitor indomethacin, or with no preintervention (control). Changes in bronchial diameter were monitored using an in vitro video detection system. Both desflurane and sevoflurane produced concentration-dependent bronchodilation (P < 0.001 for either anesthetic; 54% +/- 8% [mean +/- SD] dilation for 12% desflurane and 48% +/- 14% dilation for 4.8% sevoflurane). For both anesthetics, bronchodilation was significantly attenuated by epithelial rubbing (15% +/- 4% dilation for 12% desflurane and 13% +/- 10% dilation for 4.8% sevoflurane; P < 0.001 each), by pretreatment with indomethacin (12% +/- 3% dilation for 12% desflurane and 9% +/- 5% dilation for 4.8% sevoflurane; P < 0.001 each), and by L-NNA (24% +/- 8% dilation for 12% desflurane, P < 0.001; and 17% +/- 10% dilation for 4.8% sevoflurane, P < 0.01). Desflurane- and sevoflurane-mediated bronchodilation depends at least partially on the epithelium, and may involve both a prostanoid and NO in rat distal bronchi. IMPLICATIONS: Bronchodilation by the volatile anesthetics desflurane and sevoflurane is at least partially epithelium-dependent and may be attenuated in diseases affecting the epithelium, such as asthma.     

Nedocromil sodium in treatment of bronchial asthma

Clinical study on efficiency of the nedocromil sodium (Tilade, Fisons) was performed in 20 patients with atopic and nonatopic bronchial asthma. The drug was administrated in dose of 8 mg per day for 2 months which allowed to renounce regular using of Beclocort forte after 7 days of the treatment. In both types of bronchial asthma the positive effect of nedocromil sodium was confirmed, causing increase of pulmonary ventilation and decrease of bronchial hyperactivity. Especially profitably effect was noticed in atopic bronchial asthma in which statistically important increase of peak expiratory flow (PEF) was obtained and decrease of bronchial hyperreactivity by PC20 for histamine was observed (p < 0.05). Mentioned above spirometric parameters did not differ in statistically important pattern in patients with nonatopic bronchial asthma, when Beclocort forte group with Tilade group compared. Neither important differences in general number of cells nor percentage composition of cell smears were observed in bronchoalveolar lavage fluid.     

The effect of kavinton on bronchial tonus in bronchial asthma patients

Intravenous cavinton given in a dose of 10 mg for 3 days was studied for its effects on bronchial tone in 40 patients with bronchial asthma. Respiratory parameters were pneumotaxometrically determined and cerebral circulatory parameters were rheographically measured prior to and following the drug injection. The findings have demonstrated that cavinton significantly decreased bronchial tone improved cerebral circulation, particularly in patients with bronchial asthma and chronic cerebral circulatory disorders.     

The inhibition of yohimbine injected intrathecally on electroacupuncture-induced analgesia and release of beta-endorphin from rat brain

No study has investigated the effects of ethanol on bronchial responsiveness in patients with alcohol-induced asthma, although acetaldehyde, which is a metabolite of ethanol and is thought to be a main factor in alcohol-induced asthma, causes both bronchoconstriction and bronchial hyperresponsiveness. The purpose of this study was to investigate the direct action of ethanol on the airway in patients with alcohol-induced asthma. First, we investigated the bronchial response to inhalation of ascending doses (5, 10, and 20%) of ethanol in nine patients with alcohol-induced asthma. Then, the bronchial responsiveness to methacholine was measured in 14 patients who were pretreated with saline or 20% ethanol in a double-blind, randomized, placebo-controlled, crossover fashion. Ascending doses of inhaled ethanol caused no significant changes in FEV1. The methacholine concentrations producing a 20% fall in FEV1 (PC20-MCh) after 20% ethanol (0.769 mg/ml, GSEM 1.514) were significantly (P = 0.0357) higher than those after saline (0.493 mg/ml, GSEM 1.368). This indicates that ethanol has a reducing effect on nonspecific bronchial responsiveness in patients with alcohol-induced asthma; this paper is the first report on the effects of ethanol on bronchial responsiveness.     

Allergic bronchopulmonary aspergillosis in a patient with no symptoms of asthma until after bronchial lavage

An asymptomatic 56-year-old man was admitted to our hospital because of an abnormal shadow on a chest X-ray film. Allergic bronchopulmonary aspergillosis was diagnosed on the basis of five findings: eosinophilia, immediate skin reactivity to Aspergillus antigen, the presence of precipitating antibodies against Aspergillus antigen, a high concentration of IgE in serum, and central bronchiectasis. He had no symptoms of asthma at the time of diagnosis, but did a few days after he underwent bronchial lavage. We speculate that the asthma attack was related to the bronchial Lavage as follows: First, drainage of mucus plugs by bronchial lavage may have exposed the bronchial epithelium, which had already been sensitized, to aspergillus antigens. Second, the scattered antigen may have dose-dependently stimulated the bronchi. Third, the infection may have increased bronchial responsiveness to the antigen. Symptoms of bronchial asthma are not necessary for the diagnosis of allergic bronchopulmonary aspergillosis.     

Rigidity of dental local anaesthetic injection needles

OBJECTIVE: To study mechanism of bronchial hyperresponsiveness (BHR) and the relationship between asymptomatic BHR and asthma. METHODS: Bronchial biopsies were taken through fiberoptic bronchoscope from 17 cases of asymptomatic BHR, 12 cases of chronic asthma with remission and 10 normal control subjects. Bronchial mucosas were investigated by light microscopy and transmission electron microscope. Analysed by morphometric technique for the granules in both eosinophils (EOS) and mast cells (MC). RESULTS: Airway allergic inflammation (AAI) existed in 9 cases (53%) with asymptomatic BHR. It was similar in bronchial mucosal pathologic changes to chronic asthma with remission. Inflammation existed in the other 8 cases (47%), but unlike AAI, there were no infiltration of EOS and MC in bronchial mucosa. CONCLUSIONS: The pathological changes of asthma in bronchial mucosa were existed in a part of patients with asymptomatic BHR.     

Evidence for an increased intracellular free calcium concentration in platelets of bronchial asthma patients

The pathogenesis of bronchial asthma is not yet fully understood. Recently much attention has been given to the hypothesis that intracellular free calcium ([Ca2+]i) metabolism is abnormal in various diseases. In this study we investigated whether [Ca2+]i exists abnormally in subjects with bronchial asthma. The [Ca2+]i in 32 treated or untreated subjects with bronchial asthma were compared with 63 normal subjects. Resting levels of [Ca2+]i were estimated by loading the fluorescent indicator Fura-2 in washed platelets. The [Ca2+]i level in the control subjects was 129.7 +/- 18.0 nM (mean +/- SD). However, in that of the bronchial asthma patients was 152.7 +/- 44.1 nM, significantly higher than that of the control subjects (p < 0.05). It is well recognized that an increase of [Ca2+]i in vascular smooth muscle involves contraction. The findings suggest that the same phenomenon is quite possible in the tracheal smooth muscle and that it plays an important role in the pathogenesis of bronchial asthma.     

Clinical value of evaluating "markers" of cellular inflammation in monitoring bronchial asthma

In the base of bronchial asthma is a chronic inflammatory process which takes place in bronchial mucous membrane. The main cells of allergic reaction are: mastocytes., basophils, eosinophiles and others. There are many factors released from them in various periods of allergic inflammation. Evaluation of a concentration of these factors may be very usefull in diagnostic and treatment of bronchial asthma.     

Pulmonary mechanics of bronchial asthma (author's transl)

Airway resistance was measured in 10 patients with bronchial asthma before and 5--30 minutes after gradual effort of 60 and 95 watt by means of bodyplethysmography. The resistance values showed three typical alterations: 1. no reaction; 2. decrease of resistance at 60 watt and increase at 95 watt; 3. increase at both degrees of exercise. In another group of patients with asthma the resistance was determined by means of the eosophagus-balloon method before, during and after exercise. The trend of resistance alteration was not identical during and after exercise. This behaviour of bronchial obstruction shows that unspecific factors affect the pulmonary mechanics because of the changed bronchial reactivity. The behaviour of a single patient with bronchial asthma is not predictable.     

The prevalence of iron-deficiency anemia in young women in the Republic of Tajikistan

AIM: Study of efficiency of inhalation glucocorticosteroid Aldecine. MATERIALS AND METHODS: A 4-week trial of 30 patients with bronchial asthma. Treatment results were evaluated by clinical symptoms, demand of inhalation sympathomimetics, external respiration, viscosity and elasticity of bronchial secretion, concentrations of hydrocortisone and thyroid hormones. RESULTS: Aldecine produced a good clinical effect, improved external respiration, allowed to reduce doses of inhalation beta-adrenomimetics. No deterioration of either bronchial secretion rheology or inhibition of adrenal and thyroid function was seen. Candidiasis was clinically negligible. CONCLUSION: Aldecine proved highly effective and tolerable in patients with bronchial asthma.     

Expression of interleukin (IL)-4 and IL-5 proteins in asthma induced by toluene diisocyanate (TDI)

BACKGROUND: TDI-induced asthma exhibits clinical, functional and morphological similarities with allergen-induced asthma, suggesting that an immunological mechanism is involved in the sensitization to TDI. In vitro studies using the technique of cloning lymphocytes demonstrated that a great proportion of T-cell clones derived from bronchial mucosa of subjects with TDI-induced asthma produced IL-5 and interferon-gamma, but not IL-4, upon in vitro stimulation. OBJECTIVES: To investigate in vivo the role of IL-4 and IL-5 on the inflammatory response of the bronchial mucosa to TDI in sensitized subjects, we performed a quantitative analysis of bronchial biopsies. METHODS: We obtained bronchial biopsies from six subjects with TDI asthma 48 h after an asthmatic reaction induced by TDI challenge (challenged group), in six subjects with TDI asthma 1-4 weeks after the last exposure to TDI (chronic group), and in six non-asthmatic controls. The number of eosinophils, mast cells, T-lymphocytes, and IL-4 and IL-5 protein positive cells was determined by immunohistochemistry in the area 100 microm beneath the epithelial basement membrane. RESULTS: The characteristic increase of submucosal eosinophils, but not of mast cells and T-lymphocytes, was observed in the subjects with TDI-induced asthma when compared with controls. No differences were detected between the two groups of asthmatics. In the subjects with TDI-induced asthma, cell immunoreactivity for IL-5 was increased when compared with normal controls. There was no difference in the expression of IL-5 protein between challenged and chronic asthmatics. In contrast, the expression of IL-4 protein was increased only in the asthmatic subjects tested after recent exposure to TDI. CONCLUSIONS: We demonstrated that TDI asthma 48 h after specific bronchial challenge was associated with increased numbers of cells expressing IL-4 and IL-5, whereas chronic TDI asthma was associated with increased expression of IL-5, but not of IL-4. The results suggest that subjects who developed TDI asthma exhibit increased production of IL-5 even in the absence of a recent trigger by the exogenous sensitizer and that production of TH2-like cytokines in TDI-induced asthma may not always be co-ordinately regulated in vivo.     

Computer system failure: planning disaster recovery

Selective denervation of the lung (SDL) has been conducted in 389 patients with bronchial asthma. This operation stimulates function of Tg-suppressors, enhances the activity of blocked adrenergic structures and glucocorticoid supply, attenuates adrenal and extraadrenal insufficiency. SDL is thought pathogenetically validated in bronchial asthma with deficient suppression, generalized adrenodeficiency, combined glucocorticoid insufficiency.     

The relationship between bronchial histamine reactivity and atopic status

It has been proposed that increased production of IgE, a feature of atopy, is a cause of the non-specific bronchial hyper-reactivity that is characterisitc of asthma. This hypothesis was examined by selecting groups of subjects with asthma or rhinitis and a group of healthy control subjects and studying the relationship between their bronchial histamine reactivity and their atopic status. In none of the groups tested was there a significant association between the degree of bronchial histamine reactivity and either the serum level of total IgE or the number of extracts of aeroallergens giving positive prick test reactions.     

Prolonged peribulbar anaesthesia with indwelling catheter: a preliminary report of 217 cases

Epidemiological aspects of attacks of bronchial asthma related to drugs are prospectively studied in inpatients of three teaching hospitals in the Comprehensive Hospital Drug Monitoring (CHDM)-programme. Results are based on 34,840 individual patients (among 48,005 consecutive admissions) in the years 1974-1993. Between 1974 and 1993, every patient admitted to any of the three medical clinics in the CHDM programme was monitored for any suspicion of an adverse drug reaction (ADR); every drug exposure period during hospital stay was registered. Nineteen patients (0.05% of the 34,840 individual patients) had at least one attack of bronchial obstruction during hospitalisation, considered as probable or definite ADR. The frequency related to exposure periods in response to penicillins is 0.014%, to non-steroidal anti-inflammatories (NSAIDs) 0.0145, to acetyl salicylic acid (ASA) 0.018%, to paracetamol 0.008% and to beta-adrenoceptor blockers 0.26%. Of the 12 patients reacting to a drug with an allergic or idiosyncrasy/intolerance type of bronchial obstruction, 7 had a history of bronchial asthma (extrinsic or intrinsic), and 3 had the diagnosis chronic obstructive pulmonary disease (COPD). A history of bronchial asthma or COPD is confirmed to be a risk factor for this particular ADR. Of the seven patients with a bronchial obstruction to beta-adrenoceptor blockers, five were diagnosed with COPD, while two had neither COPD nor bronchial asthma. The relative risk for this pharmacological reaction in COPD patients was 96 (95% confidence interval 45-208) compared with non-COPD patients in the group of 3244 exposed to beta-adrenoceptor blockers.     

Increase in non-specific bronchial hyperresponsiveness without specific response to isocyanate in isocyanate-induced asthma: a pilot study

Increased non-specific bronchial hyperresponsiveness (BHR) has been reported after positive reaction to isocyanates in patients with isocyanate-sensitive asthma. The increased responsiveness may, however, also precede the asthma attack. We therefore compared non-specific BHR to a cholinergic agent before and after exposure to toluene-diisocyanate (TDI) that induced no asthma symptoms in 11 workers with isocyanate-related asthma. Patients were exposed for 3 consecutive days to progressively increasing doses of TDI (5, 10, and 20 ppb min-1 for 20 min) in an exposure chamber with continuous TDI monitoring. No immediate nor late asthmatic bronchial reaction was observed in any patient after any dose of TDI during or after challenge. A significant increase in non-specific BHR was noted 24 h after the last dose of TDI challenge, however. This increase was at least one doubling dose for seven of 11 patients. In conclusion, our study shows that, in patients with isocyanate-induced asthma, exposure to TDI induces a slight but significant increase in non-specific BHR in the absence of any immediate or late bronchial response to isocyanate. This result, which requires further confirmation, may justify a proposal to measure non-specific BHR, even after a negative specific inhalation test to TDI, as an additional diagnostic element for TDI-induced occupational asthma, to help lower the percentage of the undetected occupational asthma cases.     

The influence of salmon calcitonin on the soluble form of VCAM-1 (CD 106) and E-selectin (CD 62E) in serum of patients with atopic bronchial asthma

The aim of the study was to evaluate the effect of salmon calcitonin (CT) on serum level of soluble form of VCAM-1 (sVCAM-1 = soluble vascular cell adhesion molecule-1) and E-selectin (sE-selectin = soluble E-selectin) in patients with atopic bronchial asthma. Twenty-four individuals divided into 4 groups (6 persons each) were investigated. The first group consisted of patients with chronic moderate bronchial asthma, the second and third groups consisted of patients with mild bronchial asthma and the fourth group K consisted of healthy individuals. The patients of the first and second group were treated with CT at a dose of 100 i.v./days s.c. for three days. The patients of the third group were given placebo (phychological saline) in similar way as CT. The indices were measured before the treatment with CT or placebo and on the 4th day of the treatment. It was found that CT treatment decreased sVCAM-1 in serum only in the patients of the first group (p < 0.05) but had no effect upon sE-selectin level. The obtained results suggest that CT interfered into mechanisms of inflammation involving adhesion molecules in patients with bronchial asthma.     

The effect of the Russian inhalant glucocorticosteroid budesonide on bronchial inflammation and hyperreactivity during the long-term treatment of bronchial asthma patients

11 patients with severe bronchial asthma entered a randomized trial of glucocorticosteroid budesonide of Russian produce. Of them 6 patients received inhalations of budesonide (800 micrograms/day for 6 months), 5 control patients did not receive the drug. As shown by investigations of external respiration and bronchoalveolar lavage with estimation of cytogram, metacholine provocative tests, fiber bronchoscopy, budesonide inhalations relieved clinical symptoms of asthma, bronchial hyperreactivity and inflammation.