Habib Mohammad Reazaul KARİM ,
Antonio M. ESQUİNAS ,
Sally ZİATABAR ,
Giuseppe INSALACO ,
Szymon SKOCZYNSKİ ,
Irena SARC ,
Luigi FERİNİ-STRAMBİ ,
Leyla PUR ÖZYİĞİT ,
Thierry HERNANDEZ-GİLSOUL ,
Subrata Kumar SİNGHA ,
Laura CİOBANU ,
Jos Luis Sandoval GUTİERREZ ,
Zbigniew SZKULMOWSKİ ,
Edoardo PİERVİNCENZİ ,
Margarida AGUİAR ,
Mohamad F. EL-KHATİB ,
Nadia CORCİONE ,
Aslıhan GÜRÜN KAYA ,
Aydın ÇİLEDAĞ ,
Akın KAYA ,
Gabriele VALLİ ,
Paola PİERUCCİ ,
Onofrio RESTA ,
Paschalis STEİROPOULOS ,
Francesca De MARCO ,
Vania CALDEİRA ,
Bushra A. MİNA
The use of continuous positive airway pressure (CPAP) in asthma has been a point of debate over the past several years. Various studies, including those on animals and humans have attempted to understand the role and pathophysiology of CPAP in patients with either well controlled or poorly controlled asthma. The aim of this manuscript is to review the currently available literature on the physiologic and clinical effects of CPAP in animal models of asthma and on humans with stable asthma.
|
Introduction: Ciprofloxacin (CPFX), a frequently prescribed quinolone, may induce cutaneous adverse drug reactions. Delayed type hypersensitivity reactions (DTHR) are often difficult to deal with, therefore, in vitro testing for DTHR is the long-anticipated method for their management. This study aimed to evaluate potential value of lymphocyte transformation test (LTT) and intracellular cytokine secretion of drug stimulated CD4+ T cells in patients with DTHR against ciprofloxacin. Material and Methods: Patients experienced DTHR with CPFX (n=8) and healthy subjects (n=10) were enrolled. CPFX skin prick, patch and intradermal tests were performed. LTT by flow cytometry aimed to determine CPFXspecific CD4+ T cell proliferation. Intracellular IL-4, IL-10, IL-2 & IFN-γ levels were analysed by flow cytometry in CPFX-specific CD4+ T cells. Cytokine contents of cell culture supernatants were evaluated by ELISA. Results: In patients with DTHR, 5 and 10 μg/mL CPFX induced significant CD4+ T cell proliferation (p=0.014 and p=0.05, respectively). IL-2 (p=0.02, p=0.001 and p=0.001, respectively) and IL-4 (p=0.001) secreting CD4+ T cell percentages were increased, while IFN-γ+ (p=0.001, p=0.011 and p=0.012, respectively) and IL-10+ (p=0.001, p=0.001 and p=0.002, respectively) CD4+ T cells were decreased. The cell culture supernatants revealed downregulated IL-10 (p<0.000, p=0.004, p=0.001 and p=0.0001, respectively) and upregulated IL-4 levels (p=0.003, p=0.013 and p=0.0001, respectively) in patients, regardless of CPFX stimulation. Intradermal test was positive in only one patient while all patch tests remained negative. Conclusion: Our findings suggest that the increase of IL-2 and IL-4-secreting CD4+ T cells together with the decrease of IL-10 and IFN-γ-secreting CD4+ T cells is related to DTHR seen in patients with delayed-type CPFX allergy. Intracellular cytokine measurement, together with LTT could ease the management of CPFX hypersensitivity when in vivo tests are non-available, remain inconclusive or negative.
|
Improved knowledge about the pathogenesis of asthma has facilitated the development of novel drugs and provided hope for patientswith severe asthma. After the short- and long-term success of omalizumab in severe allergic phenotype, researchers have targeted patients with severe eosinophilic asthma who comprise up to 45% of adult severe asthma. Interleukin (IL)-5 and IL-5 receptor subunit α playcrucial roles in the development, maturation, and operation of eosinophils. Currently, patients treated with anti-IL-5 biologicals depletingeosinophils experience the positive efficacy of these drugs, especially with regard to the reduction of exacerbation rate. The aim of thisreview was to shed light on severe eosinophilic asthma treatment with these new currently available agents selectively targeting IL-5 orits receptor, discussing their usage including pre-treatment concerns, such as selecting the target population and choosing the right agentamong them, and subsequent assessment of relevant effect and safety issues.
|
