[Clinical study on the efficacy and tolerance in childhood of a new microgranule preparation of theophylline].
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Asthma↗
Biomedical subjects
A L Boner
Publications and source records attributed to A L Boner.
[Treatment of atopic dermatitis with sodium cromoglycate in children not selected for food allergy].
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Child↗
The Omenn's syndrome: histological, immunohistochemical and ultrastructural evidence for a partial T cell deficiency evolving in an abnormal proliferation of T lymphocytes and S-100 +/T-6 + Langerhans-like cells.
A 7 month old female infant was affected by a rapidly fatal familial disease highly reminiscent of Omenn's syndrome. She presented with widespread eczematous lesions, hepatosplenomegaly, superficial lymphadenopathy, peripheral blood lymphocytosis, eosinophilia and hyper-IgE. An axillary lymph node was involved by a marked proliferation of T-3 +/T-10-- lymphocytes admixed with S-100+/T-6+/Leu-3a+/Ia + reticular cells which lacked typical LC granules; cell suspension study revealed that 90%-96% of the lymph node cells were T-11+/T-3+ lymphocytes characterized by low expression of Leu-3a and T-8 antigens and by high expression of Ia antigens (52%). Peripheral blood T lymphocytes exhibited a similar distribution of surface phenotypes. The patient died of interstitial pneumonia and an autopsy was performed. The thymus was markedly atrophic and completely devoid of lymphocytes. The peri-arteriolar lymphoid sheets of the spleen were poorly developed and were mainly composed of T-8+ lymphocytes. The mediastinal nodes were rudimentary and were populated by T-3+/T-10+ lymphocytes with low expression of Leu-3a and T-8 antigens. Our results raise the possibility that Omenn's syndrome is a peculiar primary immunodeficiency in which, despite early thymic involution, some abnormal T lymphocytes still develop in the peripheral lymphoid organs. Antigenic triggering of these cells might result in prominent proliferations of T lymphocytes and Langerhans-like cells which lead to the clinical manifestation of the disease.
Antigens, Differentiation, T-Lymphocyte↗
Preliminary report on histamine release, circulating immune complexes, and complement activation in children with atopic dermatitis after oral challenge with milk and egg antigens.
The effects of dietary restriction and food challenge were evaluated in five children with atopic dermatitis, as a possible predictive marker for the dietary management of this clinically perplexing disease. Two of the five showed significant elevation of plasma histamine; an additional two demonstrated the presence of immune complexes and in the fifth no change was described. The results of these study lend further support to the causal relationship between food allergy and atopic dermatitis, and suggest that the use of these immunologic parameters may be useful in the clinical assessment and management of these patients.
Administration, Oral↗
Hypothalamic-pituitary-adrenal function in children with atopic dermatitis treated with clobetasone butyrate and its clinical evaluation.
Twenty-nine patients with symmetrical eczematous lesions were treated with 0.05% clobetasone butyrate cream. Clinical conditions and cortisol and ACTH concentrations were evaluated at the beginning and after 1 week in 12 children and after 2 weeks of treatment in 17 patients respectively. The lesions and symptoms improved steadily and no significant change in cortisol and ACTH plasma levels was observed throughout the study in all children. This steroid offers clinically effective topical antiinflammatory activity with a wide margin of safety.
Adolescent↗
Improvement of atopic dermatitis following natural measles virus infection. Four case reports.
Five children with atopic dermatitis were studied during natural measles virus infection. Four of the five patients showed temporary clearing of their skin lesions for 3 weeks following the infection. The reduction of cell-mediated immune responses caused by the measles virus may have played a role in the transient improvement of skin conditions in these children. Evidence for T cell involvement in the clinical entity of atopic dermatitis is discussed.
Dermatitis, Atopic↗
Inhibition of exercise-induced asthma by three forms of sodium cromoglycate.
Fifteen asthmatic children were tested in a double-blind fashion. The degree of prevention of exercise-induced asthma by three pharmacological forms of sodium cromoglycate (SCG with lactose powder, SCG in micropellets without lactose and SCG solution) was evaluated. FEV1 and FEF 25-75 were measured. Inhibition of the airway response to exercise was achieved by SCG without any statistical differences between the three active forms. Our data suggest that the new pelletised form of SCG without lactose is as active as the other preparations of the drug. The easy mode of administration allows a high compliance of the young asthmatic patients to chronic therapy.
Adolescent↗
Pulmonary function and bronchial hyperreactivity in asthmatic children with house dust mite allergy during prolonged stay in the Italian Alps (Misurina, 1756 m).
The effects of high altitude were evaluated in 14 children with allergic bronchial asthma over an 8-month period. Clinical improvement, as assessed by decreased bronchial lability, was demonstrated by pulmonary function studies. There was a decreased requirement for drugs and steroids were discontinued in our children. The results of this study suggest the use of this approach as a possible adjunct to the management of refractory cases of bronchial asthma.
Adolescent↗
Adrenocortical function during prolonged treatment with clobetasone butyrate in children with chronic atopic dermatitis and elevated IgE levels.
Twelve children with chronic atopic dermatitis and elevated IgE levels (age range: 2-13 years; mean age = 8.2 +/- 3.5 years) were selected for the study and treated with clobetasone butyrate (0.05% cream) thrice daily during the first week, then twice daily for three weeks. Adrenocortical function was evaluated at the beginning and the end of treatment period. The results show that there was no statistically significant change in adrenal function during the study period (tetracosactrin test). The results of the immunological studies, namely total IgE using the paper disc radioimmunoassay technique, specific IgE using the radioallergosorbent test and immunoglobulin levels are given.
Adolescent↗
A combination of cefuroxime and N-acetyl-cysteine for the treatment of maxillary sinusitis in children with respiratory allergy.
Twenty-four atopic children with allergic rhinitis, asthma and maxillary sinusitis were treated with a combination of cefuroxime 50-80 mg/kg/day and N-acetyl-cysteine 15-25 mg/kg/day administered intramuscularly for 10 days. The efficacy of the treatment was judged on the basis of radiological and clinical evolution. The treatment was effective in 95.8% of the children, and 37.5% of them were able to reduce their treatment for asthma. None of the patients suffered severe side effects. The data obtained confirm that appropriate treatment of the sinusitis frequently results in a significant improvement of the asthmatic condition.
Acetylcysteine↗
Evaluation of the effect of food on the absorption of sustained-release theophylline and comparison of two methods for serum theophylline analysis.
Fifteen healthy volunteers took part in a study to investigate the effect of food on the bioavailability of a slow-release formulation of theophylline. Serum theophylline levels were measured every two hours for ten hours after a single oral dose of 500 mg of theophylline. Serum levels were significantly higher after the dose was taken on an empty stomach; however, serum levels were significantly higher 10 hours later when the dose was taken after a standard meal. Despite these differences, eating had no overall effect on theophylline bioavailability. Two analytic methods for measuring serum levels of theophylline were compared, and it was found that fluorometry could measure lower levels and was therefore more precise than an enzyme immunoassay method, which is probably due to the complete automation and reduced interference of bilirubin and hemoglobin.
Adult↗
Bronchodilating activity of oral clenbuterol in asthmatic children after single administration of different dosages.
The dose-response activity of clenbuterol, a new long-acting beta 2-agonist, was evaluated in 12 children aged 5 to 11 years with moderate to severe asthma. The study was a double-blind cross-over comparison of three oral dose levels: 0.5, 1.0, and 1.5 micrograms/kg and placebo all in the form of syrup. Pulmonary function, heart rate, blood pressure, and tremor were evaluated at 30, 60, 90, and 120 min, then hourly for 8 hr, following the ingestion of the drug. The bronchodilating effect of clenbuterol, evaluated as percentage changes in expiratory flow rates was significantly different from placebo. The overall fall-off in the effect of 1.0 micrograms/kg and 1.5 micrograms/kg doses after 8 hr was small. The results of the 1.0 micrograms/kg dose often overlapped those of the 1.5 micrograms/kg dose, suggesting that a single 1.0 micrograms/kg dose of clenbuterol is most advisable in children, assuring the most favorable risk/benefit ratio. Even the highest dose of clenbuterol caused only a marginal increase in tremor, not statistically different from that induced by placebo.
Administration, Oral↗
Absolute and relative bioavailability of a slow release theophylline preparation in asthmatic children.
This study was carried out on 14 asthmatic children aged 7-13 years. They all received three preparations (aminophylline by intravenous infusion, lysine theophyllinate orally in solution and slow release theophylline orally as capsules) in a single dose of 100 mg active ingredient in a crossover design. Plasma theophylline concentrations, determined by a fluorescent polarization immunoassay, were evaluated both by compartmental and non-compartmental analysis. After administration of slow release theophylline, its maximum plasma concentration and the time needed to reach this were (+/- SD) 3.19 +/- 0.63 microgram/ml and 8.71 +/- 2.30 h, respectively, compared to 4.51 +/- 0.94 microgram/ml and 1.96 +/- 0.85 h, respectively, for the oral normal release solution. Mean absolute and relative percentage bioavailabilities for slow release theophylline in asthmatic children were (+/- SD) 92.7 +/- 23.2% and 83.14 +/- 14.69%, respectively. These are similar to the values found with other slow release formulations in paediatric patients.
Adolescent↗
Deficiency of INFgamma producing cells in adenoids of children exposed to passive smoke.
Exposure to passive smoke is a very common event associated with increased susceptibility to respiratory tract infections. Many related adverse effects result from the ability of cigarette smoke extracts to interfere with the immune system, but the mechanism is not yet completely understood. The aim of the present study is to evaluate the intracellular cytokine profile in adenoids and peripheral blood cells of children exposed to passive smoke. Children undergoing adenoidectomy exposed or not exposed to passive smoke were studied. The intracellular cytokine profile of lymphocyte subsets in adenoids and in peripheral blood were evaluated by flow cytometry analysis. Children exposed to tobacco smoke showed a significantly lower percentage of INF-gamma producing CD4+ and CD8+ cells in adenoids. Moreover a significant correlation was observed between the quantity of exposure and reduction in Th1 (CD4+INFgamma+ and CD8+INFgamma+) cells in adenoids. This reduction may be a contributing factor in the increasing susceptibility to respiratory tract infection in children exposed to tobacco smoke.
Adenoids↗
[Bronchial hyperreactivity. II. Diagnostic methods].
Bronchial hyperreactivity is studied for the evaluation of airways' response to stimuli that provoke bronchoconstriction in hyperreactive subjects. Exercise is often used, especially in children. This method in simple, sufficiently tolerated and reproducible. The inhalation of ultrasonically-nebulized distilled water is a simple, reproducible and rapid to perform in the majority of adult patients test; in childhood it is poorly inquired. Pharmacological tests (with histamine or methacholine) have a greater sensitivity and reproducibility. Aspecific bronchoprovocation with methacholine is a diagnostic method that allows the diagnosis of bronchial hyperreactivity in asymptomatic subjects with asthma, recurrent cough and recurrent bronchopneumonia.
Adrenergic beta-Antagonists↗
[Pulmonary fibrosis in children: diagnosis and therapy].
Pulmonary fibrosis is a chronic disorder characterized by inflammation, injury and fibrosis of the alveolar structures and consequent loss of functional alveolar-capillary units. It involves a number of unresolved terminologic, pathogenetic, diagnostic and therapeutic controversies. The key to understanding the disease is the recognition that inflammation is the first event. The staging of the patients, important for correct therapy decision, is made using methods that specifically evaluate the inflammation such as open lung biopsy, bronchoalveolar lavage, and Gallium 67 scanning. The most rational therapeutic approach is to suppress the inflammation and to prevent further injury and scarring. The drugs of choice for treatment are corticosteroids (prednisone particularly). It is suggested to use large doses during the initial portion of the therapeutic trial followed by a tapering of the dose. If the patient does not respond to corticosteroids other immunosuppressive agents can be considered, particularly cyclophosphamide. The frequency and duration of response to these regimens remains to be defined.
Adrenal Cortex Hormones↗
[Bronchial hyperreactivity. I. General concepts].
Bronchial hyperreactivity is a condition in which the airways show a much greater bronchoconstrictor response to provocative stimuli than normal. Non-specific bronchial hyperreactivity is a feature of asthmatic patients both allergic and non-allergic. It is proposed that bronchial hyperreactivity is due to the fact that the airways are narrower. In addition changes in the mass of muscle, and changes in the contractility of the muscle may contribute to bronchial hyperreactivity. Moreover bronchial hyperreactivity could be due to increased alpha-adrenergic or parasympathetic activity or to decreased beta-adrenergic or non adrenergic inhibitory activity. Bronchial hyperreactivity can be induced by factors such as infection, inflammation or exposure to allergens.
Airway Resistance↗
[Bronchial hyperreactivity. III. Clinical manifestations].
Bronchial hyperreactivity is a common report in several respiratory tract diseases such as bronchial asthma, chronic bronchitis and cystic fibrosis. Atopic patients and children who suffered lung diseases in early life (laryngotracheobronchitis, bronchiolitis, bronchopulmonary dysplasia) may have also persistent abnormalities in pulmonary function that frequently include bronchial hyperreactivity. A review of the actual literature, specially concerning with the clinical aspects of bronchial hyperreactivity in children and with the possible etiopathogenetic mechanism is presented.
Asthma↗