BACKGROUND AND OBJECTIVES: It is well recognized that respiratory infection modulates allergic airway inflammation. However, there is apparent controversy about the role for exposure site of bacterial components such as lipopolysaccharide (LPS) in allergic inflammation. This study investigated allergic airway inflammation after the administration of the same amount of LPS in the ovalbumin (OVA) induced murine allergy model. MATERIALS AND METHOD: Six-week-old BALB/c mice were sensitized with OVA at day 0 and 7 of the start of experiment via intraperitoneal route and challenged with OVA or OVA and LPS at day 14, 15, 16, 21, 22 and 23 with or without anesthesia via intranasal route. After the last challenge, parameters for airway hyperresponsiveness were measured, followed by evaluation of airway histology, serum OVA specific antibodies, inflammatory cells and cytokines of bronchoalveolar lavage fluid (BALF) and nasal cavity lavage fluid (NALF). RESULTS: Airway hyperresponsiveness significantly increased not only in the groups of asthma (ASM) and asthma with LPS (ASM+LPS) but also in the allergic rhinitis with LPS (AR+LPS) group. In the lung, infiltration of inflammatory cells including eosinophils and lymphocytes were prominent only in the groups of ASM and ASM+LPS. When compared with the control, in the nasal cavity, the infiltration of inflammatory cells was prominent in all of the groups, whereas in BALF, IL-5 and IL-13 were significantly increased in the groups of ASM+LPS and ASM, and OVA specific IgE and IgG2a were significantly increased in all of the groups. CONCLUSION: These results support the concept that the systemic mechanism linking allergic rhinitis to asthma depends on the location and extent of airway allergen exposure.
Anesthesia ; Animals ; Antibodies ; Asthma ; Bronchoalveolar Lavage Fluid ; Cytokines ; Eosinophils ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulin G ; Inflammation ; Interleukin-13 ; Interleukin-5 ; Lung ; Lymphocytes ; Mice ; Nasal Cavity ; Ovalbumin ; Ovum ; Rhinitis ; Rhinitis, Allergic, Perennial ; Therapeutic Irrigation

BACKGROUND AND OBJECTIVES: Although the mechanism of ozone-induced airway inflammation and hyperresponsiveness is largely unknown, NO and peroxynitrite has been suggested to be associated with it. Ebselen, a seleno-organic compound, is known to inhibit the production of superoxide, iNOS-related NO, and their combined product, peroxynitrite. The purpose of this study is to investigate whether ebselen suppress ozone-induced nasal inflammation and whether ebselen inhibit the production of NO and peroxynitrite in nasal mucosa. SUBJECTS AND METHOD: Thirty-six BALB/c mice were divided into three groups: control group, ozone exposure group, and ozone+ebselen treated group. In the ozone exposure group, mice were exposed to 1 ppm ozone for 8 hours a day for 3 consecutive days. In the ebselen treated group, the ebselen (32.5 mg/kg) solution was injected intraperitoneally 1 hour before and 3 hours after the ozone exposure. At 18 hours of the last ozone exposure, Evans blue was infused via tail vein in 6 animals of each group. Mice were sacrificed five minutes later and nasal mucosa was obtained to measure the amount of extravasated Evans blue dye. From the remaining 6 animals in each group, nasal lavage fluid (NLF) was obtained to measure the concentration of albumin and the number of neutrophils. After lavage fluid was obtained, nasal mucosa was taken for immunohistochemical staining against iNOS and nitrotyrosine usng the ABC method. RESULTS: Extravasation of Evans blue was significantly increased in the ozone exposure group, but it was significantly decreased in the ebselen treated group. Albumin concentration in NLF showed a tendency to increase in the ozone exposure group and a tendency to decrease in the ebselen treated group when compared with the ozone exposure group. The number of neutrophils was significantly increased in the ozone exposure group and was decreased more in the ebselen treated group than in the ozone exposure group. Immunoreactivity to iNOS and nitrotyrosine was strongly expressed in nasal mucosa of the ozone exposure group. However, it was nearly abolished by the treatment with ebselen. CONCLUSIONS: These results may suggest that ebselen can be applied as a useful therapeutic agent for airway diseases by modulating the oxidant-related inflammatory process.
Animals ; Evans Blue ; Inflammation* ; Mice* ; Nasal Lavage Fluid ; Nasal Mucosa ; Neutrophils ; Nitric Oxide ; Ozone ; Peroxynitrous Acid ; Superoxides ; Therapeutic Irrigation ; Veins

BACKGROUND AND OBJECTIVES: Although different methods of collecting nasal fluid exist and can influence the result of the study, there have not been any studies made yet to compare the different methods. The authors aimed to evaluate the usefulness of these methods by comparing the albumin concentration of nasal fluid after nasal provocation in patients with allergic rhinitis. SUBJECTS AND METHOD: In 22 patients with allergic rhinitis, we measured the change of nasal obstruction and rhinorrhea after nasal provocation using Visual Analogue Scale (VAS). In Group A (n=10), the nasal lavage and direct suction method were used and in Group B (n=12), nasal lavage and filter paper method were used. Nasal fluids were obtained before, 20 min after and 8 hours after provocation. The concentration of albumin was calculated using rate nephelometry. RESULTS: Patients' nasal symptoms were aggravated in early allergic reaction but subsided in late reaction. There was meaningful increase of albumin concentration with the use of direct suction and filter paper methods. In contrast, there was no significant increase of concentration with the use of lavage method. CONCLUSION: The filter paper method is superior in the quantitative analysis of mediators in nasal fluid after nasal provocation in allergic patients. The lavage method, however, is considered inappropriate because of its dilution effect.
Humans ; Hypersensitivity ; Nasal Lavage ; Nasal Lavage Fluid ; Nasal Obstruction ; Nasal Provocation Tests ; Nephelometry and Turbidimetry ; Rhinitis ; Rhinitis, Allergic, Perennial ; Suction ; Therapeutic Irrigation

BACKGROUND: For unknown reasons, the serum ferritin concentrations are higher in patients with acute lung injury. A pretreatment with aspirin reduces the acute lung injury in rats subjected severe hemorrhage, and increases the rate of ferritin synthesis in vitro. This study investigated the effect of aspirin on the serum ferritin changes in rats subjected to severe hemorrhage. METHODS: Hemorrhagic shock was induced by withdrawing blood (20 ml/kg of B.W.) through the femoral artery for 5 min. The rats were pretreated with aspirin (10 mg/kg, i.v.) 30 min before hemorrhage. RESULTS: The protein content and leukocyte count in the bronchoalveolar lavage fluid, lung tissue myeloperoxidase activities were significantly higher after hemorrhage. The aspirin pretreatment prevented these changes. The serum and lavage fluid ferritin concentrations were elevated higher after hemorrhage. These were also attenuated by the aspirin pretreatment. CONCLUSION: The changes in the serum and lung lavage ferritin level might be closely related to the severity of hemorrhage?induced acute lung injury. Therefore, the serum and lavage ferritin concentrations can be a useful biomarker for patients with precipitating conditions.
Acute Lung Injury* ; Animals ; Aspirin* ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Femoral Artery ; Ferritins ; Hemorrhage* ; Humans ; Leukocyte Count ; Lung ; Peroxidase ; Rats* ; Shock, Hemorrhagic ; Therapeutic Irrigation

BACKGROUND: For unknown reasons, the serum ferritin concentrations are higher in patients with acute lung injury. A pretreatment with aspirin reduces the acute lung injury in rats subjected severe hemorrhage, and increases the rate of ferritin synthesis in vitro. This study investigated the effect of aspirin on the serum ferritin changes in rats subjected to severe hemorrhage. METHODS: Hemorrhagic shock was induced by withdrawing blood (20 ml/kg of B.W.) through the femoral artery for 5 min. The rats were pretreated with aspirin (10 mg/kg, i.v.) 30 min before hemorrhage. RESULTS: The protein content and leukocyte count in the bronchoalveolar lavage fluid, lung tissue myeloperoxidase activities were significantly higher after hemorrhage. The aspirin pretreatment prevented these changes. The serum and lavage fluid ferritin concentrations were elevated higher after hemorrhage. These were also attenuated by the aspirin pretreatment. CONCLUSION: The changes in the serum and lung lavage ferritin level might be closely related to the severity of hemorrhage?induced acute lung injury. Therefore, the serum and lavage ferritin concentrations can be a useful biomarker for patients with precipitating conditions.
Acute Lung Injury* ; Animals ; Aspirin* ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Femoral Artery ; Ferritins ; Hemorrhage* ; Humans ; Leukocyte Count ; Lung ; Peroxidase ; Rats* ; Shock, Hemorrhagic ; Therapeutic Irrigation

Background: This study aimed to investigate the release and response of IL-18 to steroid treatment in the allergic rhinitis (AR) mouse model. MATERIALS AND METHODS: BALB/c mice were sensitized systematically using an intraperitoneal ovalbumin (OVA) injection and locally by OVA inhalation. The steroid treatment group had an intraperitoneal dexamethasone injection. Symptom scores, eosinophil counts in nasal septal mucosa, and IL-18 concentrations in nasal and lung lavage fluid were analyzed. RESULTS: The symptom scores and eosinophil counts of the negative control and steroid treatment groups were significantly lower than those of the positive control group (p<.01). Meanwhile IL-18 concentrations of nasal lavage fluid of the three groups were not significantly different (56.68+/-9.57, 63.39+/-8.93, and 64.47+/-6.83 pg/mL, repectively). IL-18 concentration of lung lavage fluid was significantly different between the positive control and steroid treatment groups (430.75+/-154.54 and 69.94+/-14.26pg/mL respectively, p=.028). CONCLUSION: In this study, IL-18 concentration increased not in the nasal lavage fluid but in the lung lavage fluid in AR mouse model. The increased IL-18 concentration decreased after the steroid therapy. This result suggests that the role of IL-18 in the pathogenesis of AR may be different from that of asthma.
Animals ; Asthma ; Bronchoalveolar Lavage Fluid ; Dexamethasone ; Eosinophils ; Inhalation ; Interleukin-18* ; Mice* ; Mucous Membrane* ; Nasal Lavage Fluid ; Ovalbumin ; Ovum ; Rhinitis*

Acute eosinophilic pneumonia(AEP) was first described in 1989 and represents a clinical entity distinct from chronic eosinophilic pneumonia. AEP is characterized by acute respiratory insufficiency, hypoxemia, fever, diffuse radiographic infiltrates, and eosinophilia in bronchoalveolar lavage fluid or lung biopsies in the absence of infection, atopy, or asthma. Rapid response to corticosteroids is characteristic. We experienced a 47-year-old metal driller presenting typical clinical and radiological characteristics of AEP. We confirmed eosinophilic pneumonia with brochoalveolar lavage analysis and transbronchial lung biopsy. We report a case of AEP diagnosed by clinical, radiographic, and histologic findings with a brief review of the literature.
Adrenal Cortex Hormones ; Anoxia ; Asthma ; Biopsy ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils* ; Fever ; Humans ; Lung ; Middle Aged ; Pulmonary Eosinophilia* ; Respiratory Insufficiency ; Therapeutic Irrigation

OBJECTIVETo evaluate the effectiveness of the flexible bronchoscopy in the diagnosis and treatment of refractory pneumonia among children.

METHODSSixty children with refractory pneumonia were randomly divided into two groups: lavage and control (n=30 each). The control group received conventional medical treatment. The lavage group was given flexible bronchoscopy besides conventional medical treatment. The therapeutic effects were compared between the two groups. The results of bacterial culture and detection of antibodies against Mycoplasma pneumoniae in bronchoalveolar lavage fluid (BALF) were observed.

RESULTSThe coincidence of bacterial culture results between BALF and sputum samples was 63.3%, and there were no significant differences in the positive bacterial culture results between them. The coincidence of PCR test for antibodies against Mycoplasma pneumoniae between BALF and serum samples was 73.3%. The results of Fisher's exact test showed the positive rate of Mycoplasma pneumoniae antibodies of BALF was higher than that of serum (P<0.05). The effective rate in the lavage group was significantly higher than that in the control group (97% vs 73%; P<0.01).

CONCLUSIONSThe flexible bronchoscopy is useful for the diagnosis and treatment of refractory pneumonia in children.

Bacteria ; isolation & purification ; Bronchoalveolar Lavage Fluid ; microbiology ; Bronchoscopy ; methods ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pneumonia ; diagnosis ; therapy ; Polymerase Chain Reaction ; Therapeutic Irrigation

BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.
Adult ; Humans ; Nasal Cavity ; Nasal Lavage ; Nose ; Rhinitis ; Rhinitis, Vasomotor ; Sodium Chloride ; Therapeutic Irrigation

BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.
Adult ; Humans ; Nasal Cavity ; Nasal Lavage ; Nose ; Rhinitis ; Rhinitis, Vasomotor ; Sodium Chloride ; Therapeutic Irrigation