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Biomedical subjects

M Topilsky

Publications and source records attributed to M Topilsky.

At least 73 records · Page 4Linked to original sources
PubMed1989

Suppressive activity of alveolar macrophages and blood monocytes from interstitial lung diseases: role of released soluble factors.

Two groups of patients suffering from interstitial lung diseases (ILD) namely sarcoidosis (SA) and idiopathic pulmonary fibrosis (IPF) were investigated for alveolar macrophages (AM), secretion of prostaglandin E2 (PGE2) and interleukin 1 (IL-1), together with superoxide anion (O2-) production. Peripheral blood monocytes (PBMO) of the same patients were examined concomitantly for suppressive activity. Consistent with previous results, AM obtained by bronchoalveolar lavage (BAL) from ILD patients markedly suppressed the effects of PHA stimulation of autologous peripheral blood lymphocytes (APL): 61.8 +/- 9.7% suppressive activity compared to 15.5 +/- 15.4% in the control group (CO) P less than 0.001. The AM suppressive activity was correlated with an increase in PGE2 secretion: 3.861 +/- 2.194 ng/10(5) cells/ml in the IPF group, but not in the sarcoid group: 0.217 +/- 0.116 ng/10(5) cells/ml (P less than 0.001 between them). On the other hand, IL-1 secretion by AM was greatly increased in sarcoid patients (308 +/- 196 U/ml) but was within the normal limits in IPF (27.3 +/- 28.8 U/ml, P less than 0.01 between them). Therefore, an inverse correlation was found between degree of PGE2 secretion and IL-1 release by AM in ILD. O2-production by AM was markedly increased in all ILD patients but this mechanism is apparently not involved in suppressive activity. PBMO originating from ILD patients were less suppressive than the corresponding AM.

Adult↗
PubMed1989

Nedocromil sodium and placebo in the treatment of bronchial asthma. A multicenter, double-blind, parallel-group comparison.

The efficacy of nedocromil sodium (4 mg twice daily by inhalation) in treating bronchial asthma was assessed by double-blind, placebo-controlled group comparison in 69 adults from three centers. The patients (34 active, 35 placebo) had a history of bronchial asthma with at least 15 percent reversibility. Inhaled corticosteroids, used by 22 and 24 subjects in the active and placebo groups respectively, were discontinued before the study, in which a two-week baseline was followed by six weeks of treatment. Two-weekly clinic assessments of lung function, symptoms and final opinions of treatment were significantly (p less than 0.05 p less than 0.001) in favor of nedocromil sodium. Daily diary cards showed a similar trend with significant drug effects seen after the third week. Blood and urine samples showed no abnormalities and the majority of patient withdrawals (five from nedocromil sodium and six from placebo treatment) were due to worsening asthma. Overall, we found nedocromil sodium to be well tolerated and effective in the management of bronchial asthma.

Administration, Inhalation↗
PubMed1989

The combined effect of nifedipine and sodium cromoglycate on the airway response to inhaled hypertonic saline in patients with bronchial asthma.

The combined effect of oral nifedipine and aerosolized sodium cromoglycate on the airway response to inhaled sodium chloride at increasing concentrations was randomly studied in 10 patients with bronchial asthma. Nifedipine (20 mg) protected the airways in 6 of the 10 patients, and sodium cromoglycate (20 mg) in all the 10 patients. Following both drugs, the airway response to hypertonic saline was further reduced when compared to each drug on its own. It is concluded that the combination of nifedipine with sodium cromoglycate might be of benefit in the treatment of difficult asthmatic patients.

Administration, Inhalation↗
PubMed1989

Comparison between refractoriness after distilled water-induced asthma and exercise-induced asthma.

Inhalation of distilled water (DW) frequently induces bronchoconstriction in asthmatic patients. We compared the degree of refractoriness to repeated inhalation of DW to that of repeated exercise challenge in 14 asthmatics. Refractoriness was seen following inhalation of DW. The maximum drop in FEV1 (% of predicted) following the first challenge was 31 +/- 13% and the maximal drop following the second challenge was 18 +/- 9% (P less than .01). The pattern of the airway response seen during 45 minutes following repeated inhalation of DW and exercise was similar. Cross refractoriness was also seen when inhalation of DW followed exercise challenge. It was concluded that both stimuli probably share a common mechanism of action on the airway.

Adolescent↗
PubMed1988

The effect of food and exercise on the skin response to compound 48/80 in patients with food-associated exercise-induced urticaria-angioedema.

Food-associated, exercise-induced urticaria-angioedema is increasingly being recognized. We studied five atopic individuals in whom ingestion of food was followed by exercise-induced urticaria-angioedema. The combined effect of food and exercise on skin wheal response to compound 48/80 and histamine was studied. Symptoms could be reproduced in only four of the patients who performed strenuous exercise after ingestion of food to which they were skin sensitive. When symptoms appeared, that is, after a combination of food and exercise challenge, there was a marked increase in the wheal response to compound 48/80 (greater than 200%) and not to histamine. Food or exercise challenge alone did not induce any significant change in the skin reactivity to compound 48/80 or to histamine. It was concluded that mast cell releasability could be increased when the patient was subjected to combined factors.

Adolescent↗
PubMed1988

Correlation between PGE2 production and suppressor activity of alveolar macrophages from patients with interstitial lung diseases.

The suppressive activity of alveolar macrophages (AM) obtained from bronchoalveolar lavage (BAL), on PHA stimulation of autologous peripheral blood lymphocytes (APL) was evaluated. The effect on lymphocyte stimulation was evaluated by coculturing the AM and APL cells at a ratio of 1:1. PGE2 released by AM during the culture period was measured by a radioimmune assay. The patients included in the study were 11 cases with interstitial lung disease (ILD), 8 cases of lung cancer (CA), and 5 controls (CO). Addition of AM of patients from the CA group resulted in slight suppression of lymphocyte stimulation in 4 cases, slight enhancement in 3 cases and no effect in one case. AM from the CO group induced slight suppression in 4 out of 5 cases. AM from all 11 ILD cases exerted a significant high suppressive activity (65.6% +/- 18.2 - P less than 0.001 by comparison with the CO and CA groups). In ILD cases, a dichotomous pattern was found in regard to relation between high suppressive activity of AM and release of PGE2: in idiopathic pulmonary fibrosis (IPF) patients, high suppressive activity of AM (70.4% +/- 15.4) correlated well with elevated secretion of PGE2: 3.58 +/- 0.26 ng/ml/10(5) cells (P less than 0.02 compared to CO). AM from sarcoidosis patients suppressed PHA stimulation by 61.6% +/- 19.3 but secreted only 0.357 +/- 0.26 ng/ml/10(5) cells of PGE2 (P less than 0.02 compared with the idiopathic pulmonary fibrosis group). Therefore, it seems that other factors, in addition to PGE2, might be involved in the suppressive activity of AM from interstitial lung diseases.

Aged↗
PubMed1988

IgE values in the allergic and healthy Israeli population.

This study was designed to establish IgE values in different allergic diseases in an Israeli population and healthy controls. The geometric mean IgE in the control group was 41 IU/mL (range = 15 to 111 IU/mL) and in the atopic group 142 IU/mL (range = 36 to 556 IU/mL). The highest values were found in patients with asthma plus allergic rhinitis plus atopic dermatitis and asthma plus atopic dermatitis. The lowest values were from patients with urticaria. There was a gradual increase in IgE levels from 4 to 10 years and then a gradual decrease. IgE was significantly higher in males, particularly in the 21 to 40-year age group and above 60 years. There was no difference in IgE levels in the various ethnic groups. There was a correlation between IgE levels and the number of positive skin tests. Peripheral eosinophilia was found in one-third of the patients with low IgE and in 2/3 of the patients with IgE above 500 IU/mL. An IgE of 120 IU/mL or more was found in 56% of patients with asthma in addition to other atopic diseases. Only 10% of normal controls had an IgE value of 120 IU/mL or more. These results are similar to those reported from European and North American countries.

Adolescent↗
PubMed1986

Hypersensitivity pneumonitis induced by nalidixic acid.

Interstitial pneumonitis developed in a patient one week after therapy with nalidixic acid was initiated. The causal association between the drug and the lung disease is based on the temporal relationship, an increased eosinophil count in both peripheral blood and fluid obtained by bronchoalveolar lavage, a positive migration inhibitory factor test with nalidixic acid, and exclusion of other causes. This is, to the best of our knowledge, the first report of a pulmonary hypersensitivity reaction to nalidixic acid.

Aged↗
PubMed1986

Bronchoalveolar lavage--a sensitive tool for early diagnosis of pulmonary involvement in rheumatoid arthritis.

Bronchoalveolar lavage (BAL) was performed to assess the nature of pulmonary involvement in 12 asymptomatic nonsmoking patients with rheumatoid arthritis (RA). All 12 patients had normal lung function tests, including diffuse capacity for carbon monoxide and normal blood gases. Four patients (33%) had mild basilar interstitial changes on chest radiographs. In these 4 patients an elevated lymphocytic count in BAL fluid (30.7 +/- 8.3%) was found, as compared to the 8 patients with normal chest roentgenograms (7.2 +/- 1.9%; p less than 0.001). We suggest that BAL may be used as a sensitive tool for early diagnosis of pulmonary involvement in patients with RA.

Adult↗
PubMed1986

Bronchial inhalation challenge with ultrasonically nebulized saline; comparison to exercise-induced asthma.

The airway response to ultrasonically nebulized sodium chloride of increasing concentration (0.9%, 2.5%, 5%, 10%, and 20%) was assessed in twenty asthmatic patients and five healthy subjects. Their response was compared to a standard exercise provocation test. Each concentration was inhaled for five minutes and the airway response was assessed by the measurement of the maximal expiratory flow volume curves. While only 65% of the patients developed significant bronchoconstriction to exercise, 90% had such response to inhaled sodium chloride of 20% or less. None of the healthy subjects showed any significant airway response. It is concluded that the inhalation of hypertonic sodium chloride is a sensitive method for the evaluation of airway hyperreactivity and can be used instead of the exercise provocation test in asthmatic patients.

Adolescent↗