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Biomedical subjects

J Kidney

Publications and source records attributed to J Kidney.

4 recordsLinked to original sources
PubMed1995

Immunomodulation by theophylline in asthma. Demonstration by withdrawal of therapy.

Theophylline is the most widely used anti-asthma drug worldwide and is classified as a bronchodilator, although there is increasing evidence that it may have immunomodulatory effects. We have investigated the effects of theophylline withdrawal under placebo control in 27 asthmatic patients (25 to 70 yr) treated with long-term theophylline who were also treated with high dose inhaled corticosteroids. We measured asthma symptoms (diary card), lung function (spirometry and home records of peak expiratory flow), and peripheral leukocyte populations using dual color flow cytometry. In eight of these patients, we examined fiberoptic bronchial biopsies by immunocytochemistry. We also studied peripheral blood lymphocytes in eight asthmatic patients who have never received theophylline. Mean steady state plasma theophylline concentrations during theophylline therapy were 8.6 +/- 0.9 mg/L. Theophylline withdrawal was associated with a significant increase in asthma symptoms, particularly at night, and a fall in spirometry and morning peak flow. This was accompanied by a significant fall in peripheral blood monocytes (CD14+, activated CD4+ T-lymphocytes (CD4+/CD25+) and activated CD8+ T-cells (CD8+/HLA-DR+) in patients with a plasma theophylline > 5 mg/L. The lymphocyte populations in theophylline-naive patients were similar to those found after theophylline withdrawal. Bronchial biopsies showed a mirror image of the peripheral blood with an increase in CD4+ and CD8+ lymphocytes in the airway. Chronic treatment with theophylline, even at low plasma concentrations, controls asthma symptoms and has effects on T-lymphocyte populations in the peripheral blood which are the inverse of those observed in the airways.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjuvants, Immunologic↗
PubMed1991

Occupational asthma.

Occupational asthma is becoming an increasingly common problem worldwide. To date however, the impact of this disorder in Ireland has not been evaluated. In this present study we document 39 cases of occupational asthma presenting to St. Vincent's Hospital between 1978 and 1988 and evaluate the patient characteristics, the occupationals involved, the causative agents and clinical course and outcome. The characteristics of the occupational asthma group were striking when compared to traditional occupational lung diseases, such as the pneumoconioses. These features were (i) the relatively young age--30 patients (77%) developed their disease by the age of 35, (ii) the presence of a substantial group of women--31% of the study group, and (iii) the relatively rapid onset of asthma after taking up employment--56% had asthma within three years of exposure. In contrast the pneumoconioses affect older, preponderantly male workers who manifest clinically symptomatic disease after decades of exposure. Long standing traditional industries were well represented ranging from milling and the bakery trade to textiles and printing. However, there was an even larger contribution from the more modern, high technology sector particularily the chemical, electronic and plastic industries.

Adult↗