OBJECTIVEOver the past several decades, there has been a significant increase in allergy and asthma in the world, which correlates with alterations in microflora and widespread use of antibiotics. The authors have developed a mouse model of antibiotics-induced microbiota disruption. In that model, mice were challenged by intranasal exposure to Aspergillus fumigatus allergens to explore the relation of allergic airway response and intestinal microflora disruption.

METHODSSixty female BALB/c mice were divided at random into 6 groups with 10 mice in each. (1) First antibiotic therapy group: the mice were given oral cefoperazone for 7 days, on day 7, mice were inoculated with Candida albicans (10(9)/ml, 50 microl) orally. (2) First control group: the mice were treated as first antibiotic therapy group, but cefoperazone and Candida albicans were replaced by saline. The mice in groups (1) and (2) were sacrificed on day 8, and cecal contents were collected for quantitative analysis of the intestinal bacterial flora. (3) Antibiotic therapy and challenge group: the mice were treated as the first antibiotic therapy group, then challenged (day 9 and 16) by intranasal exposure to Aspergillus fumigatus allergen. (4) Second antibiotic therapy group: the mice were treated as the first antibiotic therapy group, then challenged (day 9 and 16) by intranasal exposure to saline. (5) Challenge group: the mice were treated as the first control group, then challenged (day 9 and 16) by intranasal exposure to Aspergillus fumigatus allergen. (6) Second control group: the mice were treated as the first control group, then challenged (day 9 and 16) by intranasal exposure to saline. The mice in (3) - (6) group were killed for analysis of allergic airway response on day 19.

RESULTSThe quantity of Enterobacteriaceae, Enterococcus, Bifidobacterium and Lactobacillus in first antibiotic therapy group was significantly lower than that in the first control group, the quantity of Candida albicans increased in the first antibiotic therapy group as compared with the first control group. Mice intestinal microflora were disrupted with weight reduction and increased moisture in feces. After challenging with Aspergillus fumigatus allergens via intranasal inhalation, the total cell count, eosinophils, lymphocytes and neutrophils increased in BALF, especially in bronchoalveolar lavage fluid (BALF) from the mice in antibiotic therapy and challenge groups. IL-4 level in BALF from antibiotic therapy and challenge group (45.35 +/- 2.36) pg/ml was higher than that in the second control group (35.32 +/- 2.53) pg/ml. The expression of GATA-3 mRNA in the mice lung tissue (0.569 +/- 0.023) was higher than that in the second control group (0.410 +/- 0.020), and the ratios of T-bet/GATA-3 (0.578 +/- 0.021) decreased as compared with that in the second control group (0.804 +/- 0.035). IFN-gamma level in BALF from any group was not significantly different. In the absence of antibiotics, mice exposed to Aspergillus fumigatus allergen did not develop an allergic response in the airways.

CONCLUSIONSThe allergic (Th2) immune response can be induced by airway challenge with Aspergillus fumigatus allergen in the mice in which the intestinal microflora disruption resulted from antibiotic therapy, this result suggests that the intestinal microflora disruption resulted from antibiotic therapy is a risk factor for allergy and asthma.

Animals ; Anti-Bacterial Agents ; adverse effects ; Antibiosis ; Aspergillus fumigatus ; chemistry ; growth & development ; Asthma ; drug therapy ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Cefoperazone ; therapeutic use ; Disease Models, Animal ; Eosinophils ; drug effects ; microbiology ; Female ; Hypersensitivity ; drug therapy ; microbiology ; Hypersensitivity, Immediate ; microbiology ; Intestines ; drug effects ; microbiology ; physiopathology ; Lung ; drug effects ; microbiology ; Mice ; Mice, Inbred BALB C ; Ovalbumin ; adverse effects ; immunology ; Respiratory System ; microbiology

Mycoplasma pneumoniae and Chlamydia pneumoniae have been suggested to take part in the acute exacerbation of bronchial asthma and chronic obstructive pulmonary disease (COPD). Several studies have questioned whether they may play pathogenic roles in connection with bronchial asthma and COPD. This study was designed to evaluate the seroprevalences of M. pneumoniae and C. pneumoniae in stable asthma and COPD patients, and to compare with control patients. The medical records of one hundred forty patients who underwent M. pneumoniae and C. pneumoniae serology were retrospectively reviewed. Seroprevalences of M. pneumoniae and C. pneumoniae in the asthma group (11.1% and 8.3%, respectively) were higher than in the control group (4.4% and 2.2%, respectively) without statistical significance. The seroprevalence of M. pneumoniae in the COPD group (16.9%) was significantly higher than in the control group, and the seroprevalence of C. pneumoniae in the COPD group (3.4%) was higher than in the control group without statistical significance. This study raises important questions about the relation of M. pneumoniae and C. pneumoniae infection with stable asthma or COPD.
Adult ; Aged ; Asthma/*microbiology ; Chlamydophila Infections/*epidemiology ; Chlamydophila pneumoniae/immunology ; Female ; Humans ; Male ; Middle Aged ; Pneumonia, Mycoplasma/*epidemiology ; Pulmonary Disease, Chronic Obstructive/*microbiology ; Seroepidemiologic Studies

OBJECTIVETo investigate whether recuperating lung decoction (RLD) can modulate the composition of gut microbiota in rats during asthma treatment.

METHODSFifteen Sprague-Dawley rats were divided randomly and equally into control group, model group, dexamethasone (DEX) group, RLD medium-dose group, and RLD high-dose group. The asthma model was established in all groups, except for the control group. The rats in the DEX and RLD groups were treated orally with DEX and RLD, respectively. The rats in the control and model groups were treated orally with 0.9% saline. The intestinal bacterial communities were compared among groups using 16S rRNA gene amplification and 454 pyrosequencing.

RESULTSThe microbial flora differed between the control and model groups, but the flora in the RLD groups was similar to that in the control group. No significant differences were observed between the RLD high-dose and medium-dose groups. RLD treatment resulted in an increase in the level beneficial bacteria in the gut, such as Lactobacillus and Bifidobacterium spp.

CONCLUSIONOral administration of RLD increased the number of intestinal lactic acid-producing bacteria, such as Lactobacillus and Bifidobacterium, in asthma model rats.

Animals ; Asthma ; drug therapy ; immunology ; microbiology ; Bacteria ; classification ; genetics ; isolation & purification ; Drugs, Chinese Herbal ; administration & dosage ; Gastrointestinal Microbiome ; drug effects ; Gastrointestinal Tract ; immunology ; microbiology ; Humans ; Male ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the effects of inhaled corticosteroids (ICS) on the distribution of throat flora in children with bronchial asthma.

METHODSSixty healthy children were included in the study as the control group and 160 children with asthma in acute period before ICS therapy were chosen as the experimental group. The experimental group were treated with ICS therapy. In this group, 89 children were followed up for 3 months, 68 for 6 months and 60 for 12 months. The ICS in the study was budesonide with the trade name as Pulmicort. Swab from the pharynx was used, then inoculated in agar plate. The bacteria were isolated, the distribution and variation of the microbial population in pharyngeal portion were evaluated. The data collected were analyzed using SPSS12.0 software.

RESULTSBacteria could be detected in all samples collected from children with asthma in acute, untreated period, which were mainly non-β-hemolytic streptococcus and gram negative cocci bacteria. Gram negative bacilli, streptococcus pneumoniae and mycetes were less. There were no significant differences (χ(2) value were 4.7441, 7.8582 and 1.5583 respectively, Fisher exact value were 0.0699, 0.6398, 0.2433, 0.8580, 0.6616, 0.6339, and 0.8479 respectively, P > 0.05) among children with asthma in acute period, children with asthma treated with ICS after 3, 6 and 12 months and control group. Three strains of mycetes were detected in the experimental group, and one strain in children with asthma treated with ICS for 6 months group.

CONCLUSIONSThere were no significant changes in the distribution of throat flora between the control group and the experimental group. The throat microbiology did not show significant change. Inhaled corticosteroids had no obvious effect in throat flora in children with asthma after being used for a short term and for 12 months, which suggested that inhaled corticosteroids was safe in bronchial asthma treatment. Dynamic monitoring of throat flora while the inhaled corticosteroids are used is of clinical significance.

Administration, Inhalation ; Adolescent ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; microbiology ; Bacteria ; isolation & purification ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Fungi ; isolation & purification ; Humans ; Male ; Pharynx ; microbiology

OBJECTIVETo investigate the proportion of incidence of children with non-specific chronic cough in Chongqing and analyze the characteristics of etiology during the follow-up.

METHODDiagnostic criteria were defined for children with non-specific chronic cough according to the Guidelines of diagnosis and therapy for children with chronic cough that were formulated by the Subspecialty Group, Society of Pediatrics, Chinese Medical Association and Chinese Journal of Pediatrics in 2008. Totally 266 patients in whom cough was the main or the only symptom,lasting > 4 weeks, presenting to Asthma Center of Children's Hospital, Chongqing Medical University between June 2008 and April 2009 were recruited into this study. Based on the Guidelines, diagnosis was made after taking history, physical examination and assistant examination. After etiological treatment, the patients were followed up during the second week, the fourth week and the twelfth week. Etiological diagnosis was confirmed if cough was resolved after specific therapy. If cough was not resolved,the diagnosis was rechecked and a new therapy was applied.

RESULTTotally 125 (47.0%) patients received final diagnoses of cough variant asthma (CVA), 58 (21.8%) was CVA and upper airway cough syndrome (UACS), 44 (16.5%) was diagnosed postinfection cough, 35 (13.2%) of UACS. In different age groups, the proportion of incidence of etiological agents is statistically distinct. In the ≤ 3 years old group, 35 patients (70.0%) were diagnosed CVA, 10 (20.0%) was postinfection cough; in 3 - 6 years group, 71 patients (50.7%) had CVA; the incidence of UACS was significantly higher in ≥ 6 years group.

CONCLUSIONIt is concluded that CVA, CVA and UACS, post infection cough, and simple UACS were identified as the three top reasons for children with chronic cough in Chongqing. Children with chronic cough of different age groups had different etiology of cough. The characteristic of each etiology need further study.

Adolescent ; Asthma ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Chronic Disease ; Cough ; epidemiology ; etiology ; microbiology ; Follow-Up Studies ; Humans ; Incidence ; Infant ; Infection ; epidemiology

OBJECTIVETo investigate the association of non-bacterial respiratory pathogens with asthmatic diseases in children, and the clinical significance of total serum IgE levels and peripheral eosinophil count in infection with non-bacterial respiratory pathogens.

METHODSIndirect immunofluorescence assay was used to detect IgM antibodies against nine types of non-bacterial respiratory pathogens in the sera of 490 children with asthmatic diseases between September 2010 and September 2011. Pathogens were analyzed and total serum IgE levels and peripheral eosinophil count were measured in IgM-positive cases.

RESULTSOf the 490 children with asthmatic diseases, 47.6% (233 cases) were positive with IgM antibodies against non-bacterial respiratory pathogens, the most common being Mycoplasma pneumoniae (MP) (25.3%), followed by adenovirus (ADV) (8.9%) and influenza B virus (Flu B) (8.8%). Thirty-six cases suffered from co-infection of two or more non-bacterial pathogens, mainly comprising MP and other pathogens (94%). There were significant differences in the total detection rate of IgM antibodies among all age groups (0-30 days: 50.0%; 1-6 months: 67.3%; 0.5-1 year: 33.1%; 1-3 years: 57.3%; 3-8.9 years: 61.7%). The positive rate of IgM antibodies against respiratory pathogens was highest in children with bronchial asthma, followed by children with asthmatic bronchitis, and it was lowest in children with bronchiolitis. IgM-positive children had significantly decreased blood eosinophils and significantly increased total serum IgE levels.

CONCLUSIONSThe main non-bacterial respiratory pathogens include MP, ADV and Flu B in children with asthmatic diseases, and co-infection of MP and other non-bacterial pathogens is common. Infants aged 1 to 6 months have a higher infection rate than other age groups. Monitoring the changes in total serum IgE levels and peripheral eosinophil count has great significance for the clinical diagnosis and treatment of asthmatic diseases in children.

Adenoviridae Infections ; diagnosis ; Age Factors ; Antibodies, Viral ; blood ; Asthma ; etiology ; microbiology ; virology ; Child ; Child, Preschool ; Eosinophils ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin E ; blood ; Immunoglobulin M ; blood ; Infant ; Infant, Newborn ; Male ; Pneumonia, Mycoplasma ; diagnosis

OBJECTIVETo assess the preventive effect of probiotics against pediatric allergic diseases.

METHODThe authors searched all randomized controlled trials on the preventive effect of probiotics on pediatric allergic diseases from 8 databases (Pubmed, Medline, Springer link, highwire, Cochrane, Vip, Wanfang Data and CNKI) up to September 2011. Two reviewers assessed the studies to see if they meet inclusion criteria, and extracted data. Meta-analysis for the result of homogenous studies was made with RevMan 4.2 and the co-effect was pooled by using fixed-effects model of relative risk (RR) ratios.

RESULTFifteen studies published between April 2001 and September 2011 including 3604 cases were included. All included studies were graded on randomization, allocation concealment, blinding, baseline and loss to follow-up. Meta-analysis based on included studies showed that prenatal and postnatal probiotic supplementation had preventive effect on pediatric atopic eczema by reducing the RR to 0.78 (95%CI: 0.70 - 0.88, P < 0.0001), and 3 studies in which probiotic was given only after birth, the RR was further reduced to 0.75 (95%CI: 0.66 - 0.86, P < 0.0001). Meta analysis for the effect of lactobacilus alone and combined with other bacteria showed that both decreased the RR ratios of 0.57 (95%CI: 0.44 - 0.73, P < 0.0001) and 0.79 (95%CI: 0.64 - 0.97, P = 0.02), respectively.

CONCLUSIONPresent evidences show that prenatal and postnatal probiotic supplementation will prevent pediatric atopic eczema, but not other allergic diseases such as sensitization, food allergy and asthma.

Asthma ; epidemiology ; prevention & control ; Child ; Child, Preschool ; Dermatitis, Atopic ; epidemiology ; prevention & control ; Female ; Humans ; Hypersensitivity ; epidemiology ; prevention & control ; Immunoglobulin E ; blood ; Infant ; Intestines ; microbiology ; Male ; Pregnancy ; Probiotics ; administration & dosage ; therapeutic use ; Randomized Controlled Trials as Topic ; Skin Tests