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  • 1
    Electronic Resource
    Electronic Resource
    Vascular endothelial growth factor up-regulation and bronchial wall remodelling in asthma (2005)
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 35 (2005), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background There is increasing in vitro evidence to support a role for vascular endothelial growth factor (VEGF), a major regulator of angiogenesis, as a mediator of fibrosis associated with neovascularization.Objective We tested the hypothesis that VEGF is involved both in increased airway mucosal vascularity and in the subepithelial fibrosis of asthmatic patients.Methods Bronchial biopsies were performed in 24 asthmatic patients and eight healthy controls. Immunostaining, using computerized image analysis, was performed using monoclonal antibodies against VEGF+ cells, type IV collagen, to outline the basement membrane thickness, and tryptase and EG2, to identify mast cells and eosinophils, respectively.Results The counts of VEGF+ cells (P〈0.05), mast cells and EG2+ cells (both P〈0.01) were higher in asthmatics than in controls. The number of vessels, the vascular area in the lamina propria, and the basement membrane thickness were significantly higher in asthmatics than in healthy volunteers (P〈0.01). Moreover, in asthmatic patients, the number of VEGF+ cells was significantly related to the number of vessels (P〈0.01), to mast cells (P〈0.01) and to basement membrane thickness (P〈0.01). A colocalization study also revealed that mast cells were a relevant cellular source of VEGF. High doses of inhaled fluticasone propionate significantly reduced VEGF+ cells (P〈0.05), vessel number (P〈0.05), vascular area (P〈0.05) and basement membrane thickness (P〈0.05) in a subgroup of asthmatic patients.Conclusions This study shows that VEGF, in addition to being involved in the vascular component of airway remodelling, may play a role in the thickening of the basement membrane in asthma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.2005.02360.x
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  • 2
    Electronic Resource
    Electronic Resource
    Bronchial hyperresponsiveness in atopic dermatitis (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 44 (1989), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We investigated the prevalence of bronchial asthma, immediate skin reactivity and bronchial hyperresponsiveness in 40 patients with atopic dermatitis (AD). Eight patients reported to have asthma while 29 were found responders to methacholine test (PC20 Mch 〈 64 mg/ml) and 21 were skin reactors. The prevalence of skin positive reactions did not differ in responder and non-responder (PC20 Mch 〉 64 mg/ml) groups. Males were more likely both to have bronchial asthma and be responders to methacholine test than females. Moreover, responders had an earlier age of onset of AD than the non-responders. We suggest that bronchial responsiveness should be evaluated in children with AD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1989.tb04206.x
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  • 3
    Electronic Resource
    Electronic Resource
    Effects of low doses of inhaled fluticasone propionate on inflammation and remodelling in persistent-mild asthma (2005)
    Oxford, UK : Munksgaard International Publishers
    Allergy 60 (2005), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In asthma a dysregulation of eosinophil apoptosis and an imbalance of metalloproteinase-9 (MMP-9) and tissue inhibitor metalloproteinase-1 (TIMP-1) play an important role in airway inflammation and remodelling. We evaluated the effects of a low dose of inhaled fluticasone proprionate (FP) (100 μg bid by Diskus) for 4 weeks in 24 steroid naive patients with mild persistent asthma, symptomatic and with a sputum eosinophilia ≥3% on clinical outcomes and inflammatory markers such as the induced sputum eosinophils, the induced sputum apoptotic eosinophils, the levels of MMP-9 and TIMP-1 and their molar ratio in the induced sputum supernatants. After FP treatment forced expiratory volume (FEV1) and FEV1/forced vital capacity values, PEF (L/min), sputum apoptotic eosinophils, and MMP-9/TIMP-1 molar ratio in sputum supernatants of asthmatic subjects were significantly increased in comparison with baseline, while sputum eosinophils significantly decreased. Change (Δ) in FEV1 after treatment with FP negatively correlated with the Δ in sputum eosinophils, while the Δ in MMP-9 values positively correlated with Δ in TIMP-1 values. This study shows that the clinical improvement achieved by the use of low doses of FP in asthmatics is related, at least in part, to the resolution of eosinophilic inflammation and the downregulation of remodelling markers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.2005.00827.x
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  • 4
    Electronic Resource
    Electronic Resource
    A comparison of the clinical efficacy and safety of intranasal fluticasone propionate and antihistamines in the treatment of rhinitis (2000)
    Copenhagen : Munksgaard International Publishers
    Allergy 55 (2000), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Adequate management of allergic rhinitis is needed to avoid its considerable adverse social, clinical, and economic impact. Both topical intranasal steroids and oral or topical antihistamines are recognised as effective treatments for this condition. In comparative studies, however, intranasal steroids and, in particular, fluticasone propionate aqueous nasal spray (FPANS), have afforded consistently better symptomatic relief, and have a greater beneficial effect on quality of life. Furthermore, the addition of an antihistamine to FPANS therapy has generally produced little further benefit. Intranasal administration is associated with a low systemic absorption of fluticasone propionate and, following regular use of FPANS, placebo, or an oral antihistamine, no significant differences were seen between treatment groups in plasma or urinary cortisol. Overall, therefore, the data indicate that FPANS is superior to second-generation antihistamines in the management of allergic rhinitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1398-9995.2000.055suppl62012.x
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  • 5
    Electronic Resource
    Electronic Resource
    Intranasal and inhaled fluticasone propionate for pollen-induced rhinitis and asthma (2005)
    Oxford, UK : Munksgaard International Publishers
    Allergy 60 (2005), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Studies suggest that nasal treatment might influence lower airway symptoms and function in patients with comorbid rhinitis and asthma. We investigated the effect of intranasal, inhaled corticosteroid or the combination of both in patients with both pollen-induced rhinitis and asthma.Methods:  A total of 262 patients were randomized to 6 weeks’ treatment with intranasal fluticasone propionate (INFP) 200 μg o.d., inhaled fluticasone propionate (IHFP) 250 μg b.i.d., their combination, or intranasal or inhaled placebo, in a multicentre, double-blind, parallel-group study. Treatment was started 2 weeks prior to the pollen season and patients recorded their nasal and bronchial symptoms twice daily. Before and after 4 and 6 weeks’ treatment, the patients were assessed for lung function, methacholine responsiveness, and induced sputum cell counts.Results:  Intranasal fluticasone propionate significantly increased the percentages of patients reporting no nasal blockage, sneezing, or rhinorrhoea during the pollen season, compared with IHFP or intranasal or inhaled placebo. In contrast, only IHFP significantly improved morning peak-flow, forced expiratory volume in 1 second (FEV1) and methacholine PD20, and the seasonal increase in the sputum eosinophils and methacholine responsiveness.Conclusions:  In patients with pollen-induced rhinitis and asthma, the combination of intranasal and IHFP is needed to control the seasonal increase in nasal and asthmatic symptoms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.2005.00819.x
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  • 6
    Electronic Resource
    Electronic Resource
    A double-blind, placebo-controlled comparison of treatment with fluticasone propionate and levocabastine in patients with seasonal allergic rhinitis (1999)
    Copenhagen : Munksgaard International Publishers
    Allergy 54 (1999), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fluticasone propionate aqueous nasal spray (FPANS) is a topically active glucocorticoid which has been successfully used for the treatment of seasonal allergic rhinitis (SAR). Topical levocabastine is a highly selective H1 antagonist which has been proposed as an alternative treatment of SAR. The purpose of this study was to compare the clinical efficacy of two topical nasal treatments, FPANS and levocabastine, in the treatment of SAR. Additionally, the effect of treatments on nasal inflammation was examined during natural pollen exposure. A group of 288 adolescent and adult patients with at least a 2-year history of SAR to seasonal pollens participated in a multicenter, double-blind, double-dummy, and placebo-controlled study. Patients were treated with either FPANS 200 μg, once daily (n=97), or topical levocabastine, 200 μg, given twice daily (n=96), or matched placebo (n=95) for a period of 6 weeks, starting from the expected beginning of the pollen season. Clinically relevant pollens included Parietaria, olive, and grass. Assessment of efficacy was based on scores of daily nasal symptoms and on nasal cytology of nasal lavage. Nasal lavage was performed immediately before, during, and at the end of treatment in 39 patients. FPANS significantly increased the percentage of symptom-free days for nasal obstruction on waking and during the day, rhinorrhea, sneezing, and itching. FPANS provided a better control for night and day nasal obstruction (P〈0.02 and P〈0.01) and rhinorrhea (P〈0.01) than levocabastine. In addition, fewer patients treated with FPANS used rescue medication (P〈0.025). The percentage of eosinophils in nasal lavage was reduced only during treatment with FPANS. The results of this study indicate that FPANS 200 μg, once daily, provides a better clinical effect than levocabastine 200 μg, twice daily, in patients with SAR. Unlike levocabastine, FPANS significantly attenuates nasal eosinophilia during pollen exposure, a feature which may explain its therapeutic efficacy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1398-9995.1999.00200.x
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  • 7
    Electronic Resource
    Electronic Resource
    Allergy indices based on allergen dose-response curve in a randomly selected sample of schoolchildren (1987)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 42 (1987), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Skin-test sensitivity was computed in 61 schoolchildren drawn from a stratified random sample in order to generate two allergy indices based on a quantitative skin-test assay: Individual Allergy Index (IAI) and Population Allergy Index (PAI). The former to quantitate IgE-mediated skin test sensitivity of each subject, the latter to describe the degree of skin reactivity of our sample to a single allergen. Five allergen extracts were tested at 4-fold dilutions. Sensitivity endpoint data were used to generate IAI. Frequency distribution of IAI seemed to be bimodal as asymptomatic subjects gathered at the lower part while symptomatic children showed a peak in the middle. By means of criteria based on the relation between IAI and the prevalence of symptoms we were able to classify atopy in five classes from normal (all asymptomatic subjects) to severe atopy (all symptomatic subjects). Each positive reaction was plotted as a function of the allergen concentration eliciting the weal, and linear regression with confidence limits was calculated for grass and Dermatophagoides pteronyssinus only. PAI was represented by the slope, which depends on the reactivity of the sample, and the intercept, which involves the potency of the allergen as well. Grass and D. pteronyssinus showed the same slope while the intercepts differed. The slope increased if we considered symptomatic subjects only. We propose both these indices for clinical and epidemiological studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1987.tb02204.x
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