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Biomedical subjects

K Larsson

Publications and source records attributed to K Larsson.

At least 37 records · Page 2Linked to original sources

Determinants of undiagnosed asthma.

BACKGROUND: The conformity between asthma diagnosed in a clinical setting and asthma from an epidemiological point of view has not been much studied. METHODS: History, symptoms, and clinical findings in persons with and without a previous physician diagnosed asthma were studied among persons classified as having asthma according to an epidemiological definition. RESULTS: Smoking was more prevalent in persons not diagnosed as having asthma prior to the study (n = 96), than in those with a previous asthma diagnosis (n = 119), (60% vs. 41%, P = 0.006). Positive skin prick test (SPT) was less common (39.6% vs. 58.0%, P = 0.009), lung function expressed as FEV1.0 in percentage of predicted was better (92.1 vs. 85.4, P = 0.018), reversibility to a bronchodilator was smaller (mean reversibility 4.0% vs. 6.2% of predicted, P = 0.003) and symptoms were less frequently reported (P < 0.001) by those who had not a physician diagnosed asthma prior to the study. CONCLUSION: The asthma diagnosis is often overlooked by the medical profession in patients with mild disease. Furthermore, smoking seems to worsen asthma exacerbations in patients with mild disease.

Adult↗

Human herpesvirus 6 infection and cytomegalovirus-specific lymphoproliferative responses in allogeneic stem cell transplant recipients.

The aim of this study was to investigate the effects of HHV-6 DNAemia on the CMV specific lymphoproliferative response after allogeneic stem cell transplantation. Twenty-one allogeneic stem cell transplantation (allo-SCT) patients were included in the study. The patients were either CMV seropositive and/or had CMV seropositive donors. We studied the effects of HHV-6 infection, documented by PCR, on CMV-specific lymphocyte proliferation response and on CMV infection documented by PCR. HHV-6 DNAemia correlated with the absence of CMV-specific lymphocyte proliferation responses after allo-SCT. Three of nine patients with persistent HHV-6 DNA had a CMV-specific lymphocyte proliferative response compared to 11 of 12 patients without persistent HHV-6 DNAemia (P = 0.02). Patients with higher HHV-6 DNA levels (>100 copies) were more likely than those with lower copy numbers not to develop a CMV-specific immune response (six of nine vs one of eight; P < 0.05). Patients who were repeatedly HHV-6 positive in three or more consecutive blood samples were also more likely to need repeated courses of preemptive antiviral therapy against CMV during the first 6 months after transplantation (P < 0.001). Our data indicate the possibility that HHV-6 can suppress the development of CMV-specific immune responses and thereby could predispose to development of late CMV disease.

Adult↗

Comparison of four allergen-sampling methods in conventional and allergy prevention classrooms.

BACKGROUND: Several allergen-sampling methods are used to assess level of personal or indirect exposure to cat in homes, schools and other public buildings and working environments. OBJECTIVE: To compare four different allergen-sampling methods (dust collectors, Petri dishes, person-carried pumps and intranasal samplers) by simultaneous sampling in classrooms and to compare the cat allergen levels between conventional classrooms and allergy prevention classrooms. Another aim was to relate the results to self-reported frequency of allergy and asthma symptoms among the children, to their perception of the school environment. METHODS: Among all compulsory schools (n = 257) in the Stockholm suburban area, 35 classrooms (five with implemented allergy prevention measures, seven with additional cleaning and 23 with normal cleaning routines) were chosen for allergen-sampling. Dust collectors (two models), Petri dishes, person-carried pumps and intranasal samplers were used simultaneously. All children (n = 829) received a self-administered questionnaire which included questions about home and school environment, allergic disease, asthma symptoms and pet contact. RESULTS: The correlation between sampling methods was generally poor.Furthermore, there was no significant difference in allergen levels between allergy prevention and allergen avoidance classes compared to conventional classes. Median levels were generally, but not significantly, lower in classes with few cat owners, compared to classes with many cat owners. Children in allergy prevention classes were more satisfied with the indoor air quality and cleaning than children attending classes with fewer or no allergy prevention measures (P < 0.0001). Nine per cent of all children reported allergic symptoms while at school. CONCLUSION: The lack of correlation between sampling methods used simultaneously demonstrates the difficulty in assessing allergen levels in schools and similar environments. The implemented intervention measures (allergy prevention/allergen avoidance) did not influence cat allergen levels at school.

Air Pollution, Indoor↗

Prevalence and risk factors for asthma and chronic bronchitis in the capitals Helsinki, Stockholm, and Tallinn.

The aim of this part of the FinEsS-studies was to assess whether differences existed in prevalence of asthma, chronic bronchitis, and respiratory symptoms between three Baltic capitals, and to examine risk factor profiles for respiratory conditions. In 1996, a postal survey was performed in these cities with a response rate of 72% in Stockholm, 76% in Helsinki, and 68% in Tallinn. The prevalence of physician-diagnosed asthma was 76% in Stockholm, 6.2% in Helsinki, and 2.3% in Tallinn, while respiratory symptoms were most common in Tallinn. The prevalence of physician-diagnosed chronic bronchitis was 10.6% in Tallinn, 3.4% in Helsinki, and 3.0% in Stockholm. Risk factor analyses revealed a significantly increased risk for those living in Tallinn compared to that of Stockholm for wheezing conditions, OR 1.56-1.69, longstanding cough, OR 1.92 (1.74-2.13), attacks of shortness of breath during the previous 12 months, OR 1.35 (1.20-1.52), and chronic productive cough, OR 1.49 (1.28-1.74). Subjects having symptoms common in asthma were more likely to have physician-diagnosed asthma in Stockholm and Helsinki than in Tallinn, while subjects having bronchitis symptoms had more often physician-diagnosed chronic bronchitis in Tallinn. Prevalence of respiratory symptoms was higher in Tallinn than in Stockholm and Helsinki, while physician-diagnosed asthma was more common in Stockholm and Helsinki. The prevalence of physician-diagnosed chronic bronchitis was three times as high in Tallinn as in Helsinki or Stockholm. Our results also suggest large differences in diagnostic practices between the three countries, while the differences between the capitals in true prevalence of disease may be small.

Adult↗

High prevalence of obesity in asthmatic patients on sick leave.

Obesity and asthma are common chronic diseases in the industrialised world. The aim of the present study was to investigate a possible relationship between asthma and obesity among persons on sick leave due to respiratory disorder. The diagnosis of asthma (n = 237) was made in a three-stage model (questionnaire, telephone interview and clinical examination) in persons on sick leave due to any respiratory disorder. Persons on sick leave due to non-specific spinal pain, (n = 1231) and a general population sample (n = 5092) were used as references. Obesity (body mass index > 30 kg/m2) was found in 20.7% of the asthmatic patients on sick leave compared with 13.7% in the non-specific pain patients on sick leave and in 6.5% of the controls (P < 0.001). It is not clear whether the increased prevalence of obesity among asthmatics reflects a true increase in asthma in obese persons or whether asthma-like symptoms occur because of obesity. Weight reduction schemes and weight maintenance programmes should be important components in treatment and rehabilitation plans for persons with asthma.

Absenteeism↗

Effect of deep inhalations after a bronchial methacholine provocation in asthmatic and non-asthmatic subjects.

Deep inhalations cause a transient relaxation of the peripheral airways smooth muscles in non-asthmatic subjects. It has been claimed that the airway response to deep inhalations may be different in asthmatic subjects in whom deep inhalations should rather cause bronchoconstriction. The aim of the present study was to find out whether deep inhalations discriminate between asthmatic and non-asthmatic subjects with pre-constricted airways, using a methacholine provocation test protocol with deep inhalations following the last dose of methacholine. In 164 adults, a methacholine provocation was performed. Directly after the FEV1 measurement at the highest metacholine concentration, the subjects took one deep breath and another three deep inhalations 20 s later. One minute after the inhalation of the highest concentration FEV1 was measured twice. Thirty-three asthmatics PD20FEV1 = 0.24 mg (0.13-0.39) (median, 25-75th 75th percentiles) and 131 non-asthmatics PD20FEV1 = 2.05 mg (0.72-10.1) participated. The mean maximal decrease in FEV1 after the provocation test was 36% in the asthmatics and 27% in the non-asthmatics. Corresponding values after the deep inhalations were 18% in the asthmatics and 12% in the non-asthmatics. In conclusion, deep inhalations attenuate the methacholine-induced bronchoconstriction in both asthmatic and non-asthmatic subjects. Thus, the effect of deep inhalations did not discriminate between asthmatic and non-asthmatic subjects.

Adult↗

Health-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease.

BACKGROUND: The chronicity of inflammatory bowel disease (IBD) and effects of medical and surgical treatments probably affect the daily lives of patients and may thus impair their health-related quality of life and psychological well-being. METHODS: Health-related quality of life and psychological distress were investigated in a population-based Swedish sample of patients with IBD. A total of 492 patients, 331 with ulcerative colitis (UC) and 161 with Crohn disease (CD), filled out the Short Form-36 (SF-36), the Inflammatory Bowel Disease Questionnaire (IBDQ) and the Hospital Anxiety and Depression (HAD) scale. RESULTS: Patients with UC reported higher (superior) levels in all dimensions of health-related and disease-specific quality of life than did patients with CD. CONCLUSIONS: Having an ileostomy does not seem to affect patients' quality of life, while having ileoanal anastomosis appears to reduce patients' quality of life in several of the dimensions assessed. CD patients reported more anxiety and depression than did patients with UC. The higher psychological distress in the CD group could be explained by more severe symptoms of the disease. Having ileoanal anastomosis may lead to more anxiety and depression, while having an ileostomy does not.

Activities of Daily Living↗

Lymphocyte activation after exposure to swine dust: a role of humoral mediators and phagocytic cells.

Exposure to swine dust causes intense airway inflammation with multifold increase in inflammatory cells and secretion of pro-inflammatory cytokines. This in vitro study focuses on the swine-dust activation of lymphocytes in whole blood, in phagocyte-depleted whole blood and in peripheral blood mononuclear cells (PBMC), in order to investigate whether phagocytic cells and/or soluble mediators are involved in the activation of T-cells following exposure to organic dust from a swine confinement house. T-cell activation was analysed by flow cytometry with double staining for CD3 and the activation marker CD69. Swine dust (50 microg) incubated (24 h) with heparinized whole blood was shown to activate 27.6% of the T-cells, while swine dust incubated with whole blood depleted from phagocytic cells or PBMC only activated 4.5%, and 4.8% of the T-cells, respectively. Plasma separated from whole blood preincubated with swine dust for 24 h stimulated as much as 32.4% of PBMC T-cells and contained high levels of interleukin (IL)-12 (14 pg x mL) and interferon (IFN)-gamma (2284 pg x mL(-1)), while plasma from PBMC incubated with swine dust contained low levels of IL-12 (2 pg x mL(-1)) and IFN-gamma (196 pg x mL(-1)). This study demonstrates that activation of T-cells by organic dust from a swine confinement building seems to require phagocytic cells, most likely acting through the release of soluble mediators. Also, conditioned plasma from swine-dust exposed whole blood, which was capable of activating T-cells, contained high concentrations of interleukin-12 and interferon-y.

Adult↗

Exhaled nitric oxide and bronchial responsiveness in healthy subjects exposed to organic dust.

Inhalation of organic dust from swine houses causes an intense inflammatory reaction in the respiratory tract, and increased bronchial responsiveness to methacholine in healthy subjects. The aims of the present study were to investigate whether exhaled nitric oxide (NO) is a marker of the inflammation caused by exposure to organic dust (swine dust), whether there is a relationship between an increase in exhaled NO and bronchial responsiveness, and also whether wearing a half-mask influences the airway reaction (assessed by exhaled NO) and the increased bronchial responsiveness. Thirty-three healthy nonatopic, nonsmoking subjects were exposed during 3 h of light work in a swine confinement building. Eleven of the subjects were wearing a half-mask and 22 were unprotected. Lung function, bronchial responsiveness and exhaled NO were measured before and after exposure. The provocative concentration causing a 20% fall in forced expiratory volume in one second fell by 2.7 (2.1-4.1) (median (25th-75th percentiles)) doubling concentration steps in subjects without a half-mask and by 1.5 (0.9-2.9) doubling concentration steps in subject wearing a mask. Exhaled NO increased from 7.5 (5.7-13.7) parts per billion (ppb) before to 13.4 (10.5-17.5) ppb after exposure in the unprotected group and was unaltered (8.3 (6.1-14.1) to 8.6 (6.6-14.6) ppb) in the group wearing a half-mask. There was no correlation between NO increase and provocative dose causing a 20% fall in the forced expiratory volume in one second decrease. In conclusion, bronchial responsiveness and exhaled nitric oxide increased after exposure to a swine confinement facility. Half-mask abolished the increase in exhaled nitric oxide levels, but influenced the increase in bronchial responsiveness to a minor extent. These results indicate that these two outcome measures reflect different aspects of airway inflammation induced by exposure to a farming environment.

Adult↗

Free, soluble interleukin-17 protein during severe inflammation in human airways.

Studies in rodents indicate that the cytokine, interleukin (IL)-17, links the activation of T-lymphocytes to neutrophilic inflammation. The aim of the current study was to determine whether free, soluble IL-17 protein can be released during severe inflammation in human airways. Fifteen healthy subjects were exposed to a swine confinement in order to induce severe inflammation characterized by high neutrophil numbers in the airways. Bronchoalveolar lavage (BAL) fluid was harvested 2 weeks prior to and 24 h after this exposure and the concentration of IL-17 protein was measured using an enzyme-linked immunosorbent assay. Total and cell differential counts were also performed in BAL fluid. Prior to exposure to the swine confinement, the concentration of IL-17 in BAL fluid was low (<7.8 pg x mL(-1)) in 14 out of 15 subjects. However, exposure to the swine confinement caused an increase in IL-17 in 13 out of 15 subjects (median IL-17 concentration of 26.9 pg x mL(-1)). This exposure also caused a 51-fold increase in the concentration of neutrophils in BAL fluid. To conclude, free, soluble interleukin-17 protein can be released during severe inflammation characterized by high neutrophil numbers in human airways. The significance of interleukin-17 in inflammatory airway diseases therefore deserves further evaluation.

Adult↗

Effects of formoterol and ipratropium bromide in COPD: a 3-month placebo-controlled study.

The aim of this study was to compare the effects of formoterol, ipratropium bromide and a placebo on walking distance, lung function, symptoms and quality of life (QoL) in chronic obstructive pulmonary disease (COPD) patients. A total of 183 patients (mean age 64 yrs, 86 female) with moderate-to-severe nonreversible COPD participated in this randomised, double-blind, parallel-group study. After a 2-week placebo run-in, patients were randomised to formoterol Turbuhaler 18 microg b.i.d. (delivered dose), ipratropium bromide 80 microg t.i.d. via a pressurised metered dose inhaler, or placebo for 12 weeks. Inhaled short-acting beta2-agonists were allowed as relief medication and inhaled glucocorticosteroids were allowed at a constant dose. The primary variable was walking distance in the shuttle walking test (SWT). Baseline mean SWT distance was 325 m, mean forced expiratory volume in one second (FEV1) was 40% predicted. Clinically significant improvements in SWT (>30 m) were seen in 41, 38 and 30% of formoterol, ipratropium and placebo patients, respectively (not significant). Mean increases from run-in were 19, 17 and 5 m in the formoterol, ipratropium and placebo groups, respectively. Both active treatments significantly improved FEV1, forced vital capacity, peak expiratory flow and daytime dyspnoea score compared with placebo. Formoterol reduced relief medication use compared with placebo. Neither active treatment improved QoL. Formoterol and ipratropium improved airway function and symptoms, without significant improvements in the shuttle walking test.

Adrenergic beta-Agonists↗

Organic dust-induced interleukin-12 production activates T- and natural killer cells.

Exposure in swine confinement buildings causes intense airway inflammation and lymphocyte activation, as assessed by bronchoalveolar lavage. To further clarify the T-cell activation, the present in vitro study focused on intracellular cytokine production following exposure to organic dust from swine houses. Whole blood from healthy donors was incubated with swine dust, phytohaemagglutinin (positive control) or Roswell Park Memorial Institute 1640 medium (negative control), and the production of intracellular interferon (IFN)-gamma, tumour necrosis factor (TNF)-alpha, interleukin (IL)4 and IL-12 was analysed by flow cytometry. Cells were double stained for specific cell surface markers on T-cells (CD3+, CD4+, CD8+), natural killer (NK) cells (CD56+ CD16+) and monocytes (defined as CD14+ cells). Following 1 h of incubation of whole blood with swine dust, CD14+ cells produced high levels of TNF-alpha and IL-12, whereas CD3+, CD4+ and CD8+ T-cells and CD56+ CD16+ NK cells required a longer incubation time (22 h) to produce IFN-gamma and TNF-alpha. When antibodies that block the IL-12 receptor were added to whole blood incubated with swine dust, NK cell production of IFN-gamma was attenuated and CD69 expression on CD3+ cells decreased. In conclusion, this study indicates that swine dust can, at least in part, stimulate phagocytic cells to activate natural killer cells and T-lymphocytes through the production of interleukin-12.

Adult↗

Underdiagnosis of chronic obstructive pulmonary disease in Northern Sweden.

OBJECTIVE: To assess underdiagnosis of chronic obstructive pulmonary disease. MATERIAL AND METHODS: Two cross-sectional studies of respiratory symptoms and diseases in two population samples of the same age living in the same areas in northern Sweden were performed 6 years apart. In 1986, 5698 (86%) out of 6610 subjects aged 35-36, 50-51 and 65-66 years responded to a postal questionnaire. In 1992 an identical study was performed, and 5617 subjects (87%) out of 6434 responded. Lung function measurements were performed in stratified samples. RESULTS: Of the subjects diagnosed with chronic bronchitis only 25% in 1986 and 23% in 1992 had been diagnosed prior to the study as having chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD). Chronic airflow limitation (CAL), used as a surrogate variable for COPD and defined as FEV1/VC <70% and FEV1 <80% of predicted value, was found in 171 subjects in 1986-1987 (12% of the examined subjects), and 166 subjects in 1993-1994 (11%). In 1986-1987, 26% of the subjects with CAL had been diagnosed as having chronic bronchitis or emphysema prior to the survey, while a diagnosis of either asthma, chronic bronchitis or emphysema, or use of asthma medicines, was found in 58%. The corresponding figures in 1993-1994 were 31% and 63%, respectively. The great majority of the subjects with CAL had recurrent wheeze, dyspnoea and chronic productive cough. CONCLUSION: Approximately 60% of the subjects with chronic airflow limitation had been diagnosed prior to the survey as having asthma, chronic bronchitis or emphysema, or were using asthma medicines. The results were similar in 1986-1987 and 1993-1994.

Adult↗

Crucial influence of solvent and chirality-the formation of helices and three-dimensional nets by hydrogen-bonded biimidazolate complexes.

Deprotonation and recrystallisation of racemic [Co(2,2'-biimidazole)3][NO3]3 by ammonia in water/dimethylformamide solutions gave crystals of [Co(Hbiim)3] x 0.8H2O x 0.5DMF (2: Hbiim = monoanion of 2,2'-biimidazole, DMF = dimethylformamide), a porous material that contains fourfold interpenetrating (10.3) three-dimensional nets formed by neutral, hydrogen-bonded [Co(Hbiim)3] units, with DMF molecules in the narrow channels. Recrystallisation of [delta-Co(2,2'-biimidazolate)3] gave helices instead of the expected (10,3)-a net. These results are discussed in the light of additional density functional theory and molecular mechanics calculations and the X-ray structure of [Co(H2biim)3][NO3]3.

Journal Article↗

Albumin, transferrin and alpha2-macroglobulin in bronchoalveolar lavage fluid following exposure to organic dust in healthy subjects.

OBJECTIVES: The purpose of the present study was to investigate leakage of plasma proteins in connection with the inflammatory airway reaction following exposure to dust in a pig house. Inhalation of swine-house dust causes intense inflammation with influx of inflammatory cells, predominantly neutrophils, into the airways. The aim of the study was to compare the concentration of three different proteins in bronchoalveolar lavage (BAL) fluid as markers for the inflammation. METHODS: In twenty healthy, non-allergic, non-smokers, not previously exposed to farm dust, BAL was performed approximately 2 weeks before and 24 h after 3 h of exposure to swine dust in a swine-confinement building. Differential cell count and protein concentration were assessed in BAL fluid. Albumin (66.5 kDa) and alpha2-macroglobulin (720 kDa) were quantified by the use of enzyme-linked immunosorbent assay (ELISA) techniques, and transferrin (80 kDa) by zone immunoelectrophoresis assay. The coefficient of variation for repeated protein measurements was <9%. RESULTS: alpha2-Macroglobulin concentration increased six-fold, from 68.0 (36.1-99.9) microg/l, mean (95% CI) before exposure to 411.2 (254.0-568.4) microg/l after exposure (P < 0.001). Transferrin and albumin increased from 19.7 (16.2-23.1) mg/l and 1.8 (1.4-2.2) mg/l, 2.6 and 1.9 times, respectively (P < 0.001). There was significant correlation between the exposure-induced increased protein levels in BAL fluid, although alpha2-macroglobulin was a better discriminator of pre- and post-exposure concentrations than were albumin and transferrin. There was a significant correlation between the exposure-induced BAL-fluid neutrophilia and the increase in alpha2-macroglobulin and transferrin, but not for albumin. This correlation was found only when pre- and post- differences, but not ratios, of plasma proteins were compared. CONCLUSIONS: The levels of plasma proteins increased in BAL fluid following exposure to swine-house dust. alpha2-Macroglobulin was a better marker of this plasma leakage than were albumin and transferrin.

Adult↗

Addition of hydrophilic and lipophilic compounds of biological relevance to the monoolein/water system. I. Phase behavior.

The solubilization of hydrophilic and lipophilic molecules, with biological relevance, in the monoolein/water (MO/W) system has been investigated for phase behavior. Small angle X-ray scattering (SAXS), nuclear magnetic resonance (NMR) and optical microscopy (OM) have been used to characterize the microstructure of the liquid crystalline phases. Partial phase diagrams of the MO/W system in the presence of sodium decanoate, 1-adamantanamine hydrochloride, decanoic and dodecanoic acids, acetyl salicilic acid and retinol have been determined. The stability of the various phases has been followed for at least eight months. The polarity and the molecular structure of the additive determine whether it is located at the polar interface or in the apolar region of the lipid layer. Therefore, the additive affects the interfacial curvature of the lipid layer differently, which in turn will trigger transition to disparate phases. A cubic-to-reverse hexagonal phase transition has been observed with time for most of the ternary systems, with the exception of 1-adamantanamine hydrochloride and retinol. The release of free glycerol and oleic acid due to MO hydrolysis has been clearly demonstrated by 13C NMR. This would account for the changes in phase behavior observed with time. The released oleic acid, located in the MO acyl chain region, favors the inverse interfacial curvature. The average lipid dimensions in the cubic and in the reverse hexagonal phases have been calculated from SAXS data.

Carbon Isotopes↗

Sodium polyacrylate potentiates the anti-adhesion effect of a cellulose-derived polymer.

Available methods for postoperative adhesion prevention are insufficient. A previous study demonstrated that LM-200, a bioadhesive cellulose derivative was effective in reducing adhesions. Increasing the viscosity of a polymer solution enhances the tissue separating properties. Theoretically, a combination of sodium polyacrylate (PA) and LM-200 would give more viscous solutions than LM-200 alone, and thus be more efficacious. Therefore the efficacy of various combinations of LM-200 and PA was investigated. A lesion was created in the peritoneum of mice. The solutions to be tested, or saline, were given intraperitoneally. One week post-operatively, adhesion formation was quantified and expressed as a percentage of the original lesion covered with adhesions. PA (0.01 and 0.03 wt%) given separately did not differ in adhesion reducing effect from LM-200 (p = 0.3710 and 0.3481) but PA (0.1 wt%) resulted in significantly less adhesion formation (p = 0.0004). The effect of LM-200 increased significantly when adding PA (0.01 wt%) (p = 0.0007) or PA (0.03 wt%) (p < 0.0001). When adding PA (0.1 wt%) the effect was even more pronounced (p < 0.0001). The combination of a bioadhesive cellulose derivative and the polymer PA, was effective in reducing postoperative adhesion formation and a dose-dependent increase in efficacy was obtained compared to using the two components separately.

Abdomen↗

Sodium cromoglycate attenuates pulmonary inflammation without influencing bronchial responsiveness in healthy subjects exposed to organic dust.

BACKGROUND: Inhalation of organic dust from a pig house induces airway inflammation and increases bronchial responsiveness to methacholine in healthy subjects. OBJECTIVE: To study whether sodium cromoglycate influences the airway inflammatory reaction and the increase in airway responsiveness induced by inhalation of organic dust. METHODS: Bronchoalveolar and nasal lavages, and bronchial methacholine challanges were performed and blood samples were drawn in 32 healthy subjects before and after exposure to dust in a pig farm. Sodium cromoglycate was inhaled (20 mg, twice a day) and administered intranasally (5.2 mg, twice a day) by 16 and a corresponding placebo was given to the other 16 healthy controls for two weeks prior to exposure. RESULTS: Exposure induced a significant increase in inflammatory cells and soluble components (pro-inflammatory cytokines, inflammatory mediators) in bronchoalveolar and nasal lavage fluid in both groups. The increase in neutrophils, interleukin (IL)-6 and tumour necrosis factor (TNF)-alpha as well as myeloperoxidase and soluble intracellular adhesion molecule (ICAM)-1 in bronchoalveolar lavage (BAL) fluid was significantly reduced by treatment with sodium cromoglycate. Although sodium cromoglycate inhalation largely influenced a variety of inflammatory indices in bronchoalveolar lavage fluid it had no effect on the increase in bronchial responsiveness to methacholine. CONCLUSION: Sodium cromoglycate alters the airway inflammatory response to inhaled organic dust without influencing the dust-induced increase in bronchial responsiveness to methacholine.

Adult↗