Biomedical subjects

P Maestrelli

Publications and source records attributed to P Maestrelli.

At least 91 records · Page 5Linked to original sources

PubMed1988

Pathogenesis of bronchial hyperresponsiveness.

In asthmatic subjects, the degree of bronchial hyperresponsiveness correlates with the severity of asthma and the amount of treatment required to control asthma. Both in normal and in asthmatic subjects, the degree of airway responsiveness may increase after viral infections, exposure to oxidant pollutants and allergens or sensitizing agents; however, airway hyperresponsiveness is quite stable in the absence of exposure to inflammatory stimuli, suggesting that there are at least two components in airway hyperresponsiveness: a transient component, caused by airway inflammation, and a long-lasting one, unrelated to exposure to acute inflammatory stimuli, which is hypothesized to be due to changes in the autonomic innervation or in the smooth muscle itself.

Animals↗

PubMed1988

A T-lymphocyte-derived factor that enhances IgG-dependent release of leukotriene B4 (LTB4) from human neutrophils.

We describe a human blood mononuclear cell (MNC)-derived leukotriene release enhancing factor (LREF) which significantly increased IgG-dependent leukotriene B4 (LTB4) generation by neutrophils. MNCs incubated with phytohaemagglutinin (PHA) or anti-CD3 monoclonal antibody and PHA-stimulated ER+ lymphocytes produced a 150-350% increase in LTB4 generation from IgG-stimulated neutrophils. With PHA, maximal activity was observed 48 hr after culture in serum-free medium. LREF was relatively stable when exposed to low pH (pH 2) or heat (56 degrees, 60 min). Following progressive purification by gel filtration (FPLC, Superose 12) and chromatofocusing (FPLC, Mono P) LREF was associated with proteins of molecular weight of 35-40 kD and a pI of 5.1-5.5. Partially purified LREF did not contain detectable amounts of interleukin 2 (IL-2) or interferon-gamma (IFN-gamma). Although high concentrations of recombinant granulocyte-macrophage colony stimulating factor (rGM-CSF) (greater than 2 ng/ml) and recombinant tumour necrosis factor (rTNF) (greater than 100 U/ml) gave a slight (60%) enhancement of LTB4 generation, this was considerably less than that of partially purified LREF (350%). Our results suggest that human lymphocyte-derived LREF may play a role in the amplification of inflammatory reactions involving sensitized lymphocytes, neutrophils and lipid mediators.

Humans↗

PubMed1988

Antigen-induced neutrophil chemotactic factor from cloned human T lymphocytes.

Here we report the presence of a low molecular weight (10,000 neutrophil chemotactic factor (NCF) in the supernatants of activated human T lymphocytes. Appreciable amounts of the 10,000 MW NCF were generated by peripheral blood mononuclear cells (PBMC) stimulated with anti-CD3 antibody, and comparable NCF was secreted by both long-term human T-helper (CD4+) cell lines reactive with house dust mite (Dermatophagoides farinae) and influenza A virus-immune T-cell clones. When the cloned T cells were stimulated with specific antigen in the presence of irradiated accessory cells (AC) or insolubilized anti-CD3 antibody the 10,000 MW NCF was readily identifiable in 24-hr culture supernatants. Cultures of AC and antigen alone produced negligible neutrophil chemotactic activity, as did control cultures using an irrelevant allergen (mixed grass pollen). These findings indicate that the 10,000 MW NCF may be T-lymphocyte derived and that formation and release are dependent upon stimulation via the antigen receptor.

Antigens↗

PubMed1988

Occupational asthma due to isocyanates.

162 subjects who had been exposed to isocyanates, who had developed symptoms during the exposure period, or in the evening or night and, therefore, had a history compatible with isocyanate-induced asthma, were studied with inhalation challenge testing to isocyanates (toluene diisocyanate and methylene diphenyl diisocyanate) and methacholine, because they were suspected of having occupational asthma. None of these subjects had symptomatic asthma before employment. The diagnosis of occupational asthma was delayed (duration of symptoms before diagnosis: 3.9 +/- 0.4 yrs). Isocyanate-asthma documented by a positive inhalation challenge to isocyanates was present in 57.4% of the subjects. A higher degree of airway responsiveness to methacholine was present in subjects with a positive isocyanate inhalation challenge compared to subjects with a negative challenge (Gmean and GESM: 0.407 (1.14) vs 0.942 (1.14) mg). The majority of the subjects complained of shortness of breath and cough. The low proportion of atopic subjects (21.5%) and of smokers (7.5%), and the high proportion of subjects with the late component in the asthmatic reaction (71%) appear to be common features in this disease.

Adult↗

PubMed1988

The identification and partial characterization of a human mononuclear cell-derived neutrophil chemotactic factor apparently distinct from IL-1, IL-2, GM-CSF, TNF and IFN-gamma.

We have identified a neutrophil chemotactic factor (NCF) in supernatants from human blood mononuclear cells (MNC) cultured in the presence of phytohaemagglutinin (PHA). Maximal activity was observed 48 hr after culture. Following gel filtration, NCF eluted as a single major peak, together with proteins, having a molecular size of approximately 10,000 MW. The material gave a single band on SDS-PAGE but was heterogeneous following chromatofocusing (pIs approximately 6.8-7.0, 5.5-6.0 and 5.0). The biological activity of the partially purified material was abolished by trypsin and chymotrypsin treatment. NCF was heat stable (70 degrees, 60 min) and promoted both directional migration (chemotaxis) of neutrophils and, to a lesser extent, stimulated random locomotion (chemokinesis). The factor was not associated with detectable amounts of IL-1, IL-2 or interferon-gamma (IFN-gamma). MNC-derived NCF had a molecular size lower than recombinant granulocyte-monocyte colony-stimulating factor (rGM-CSF) and recombinant tumour necrosis factor (rTNF), and was considerably more active in chemotaxis. Optimal chemotactic concentrations of partially purified MNC-derived NCF were of comparable potency to FMLP and LTB4 and had about 60% of the activity of optimal concentrations of C5a, C5a-des-Arg and platelet-activating factor (PAF). These experiments indicate that the human MNC-derived NCF is a potent chemo-attractant distinct from other cytokines previously reported to promote neutrophil locomotion.

Cell Movement↗

PubMed1987

Occupational asthma due to ebony wood (Diospyros crassiflora) dust.

A 47-year-old man developed a specific late asthmatic reaction after occupational-type exposure to ebony wood dust. Intradermal skin test to an aqueous extract of ebony wood did not give any immediate or late response. The challenge with ebony wood dust was therefore the only method of confirming the cause of asthma. The mechanism underlying this asthmatic reaction remains unknown.

Asthma↗

PubMed1985

Time course of the increase in airway responsiveness associated with late asthmatic reactions to toluene diisocyanate in sensitized subjects.

To understand better the mechanism of the increase in airway responsiveness associated with late asthmatic reactions, we determined the time course of toluene diisocyanate (TDI) effect on airway responsiveness in six sensitized subjects who exhibited a late asthmatic response after TDI exposure (0.018 +/- 0.005 ppm, 30 min) in the laboratory. Airway responsiveness was assessed before TDI exposure and then at 8 hr, 1 day, 1 wk, and 1 mo after TDI exposure. To assess responsiveness we determined the provocative dose of methacholine causing a decrease in FEV1 of 20% (PD20FEV1). The methacholine PD20 decreased from 0.50 mg geometric standard error of the mean (GSEM = 1.54) to 0.06 mg (GSEM = 1.55) (p less than 0.001) at 8 hr after exposure to TDI, was still decreased to 0.15 mg (GSEM = 1.93) (p less than 0.05) at 1 day, returned to 0.26 mg (GSEM = 1.91) (p greater than 0.05) at 1 wk, and returned to 0.43 mg (GSEM = 1.71) at 1 mo, indicating that full recovery occurred within 1 to 4 wk. These results demonstrate that TDI-induced late asthmatic response is associated with a reversible increase in airway responsiveness to methacholine and suggest that the TDI effect is linked to an acute inflammatory response in the airways.

Adolescent↗

PubMed1985

Prednisone inhibits late asthmatic reactions and the associated increase in airway responsiveness induced by toluene-diisocyanate in sensitized subjects.

To determine whether late asthmatic reactions and the associated increase in airway responsiveness induced by toluene diisocyanate (TDI) are linked to airway inflammation, we investigated whether they are inhibited by prednisone. Ten "sensitized" subjects were studied in 2 sets of experiments. In the first set, each subject was given no treatment and was studied before and for 8 h after exposure to TDI. In the second set, 2 to 4 wk later, each subject was studied before treatment and then during treatment with prednisone (50 mg once a day for 3 days, orally), both before and after exposure to TDI. To assess late asthmatic reactions to TDI, we measured FEV1 immediately before and after exposure, then hourly for 8 h. To assess changes in airway responsiveness, we measured the provocation dose (mg) of methacholine causing a 20% decrease in FEV1 (PD20FEV1) before and 8 h after exposure to TDI. When the subjects received no prednisone treatment, TDI caused late asthmatic reactions and increased airway responsiveness. By contrast, when the subjects received prednisone, TDI caused no late asthmatic reaction or increased airway responsiveness. Prednisone did not change baseline airway caliber or airway responsiveness. These results suggest that late asthmatic reactions and the associated increase in airway responsiveness induced by TDI in "sensitized" subjects may depend on the development of a steroid-responsive acute inflammatory reaction within the airways.

Adult↗

PubMed1983

Chronic peripheral neuropathy in workers with previous exposure to carbon disulphide.

Two groups of viscose rayon production workers were examined 10 years after discontinuation of exposure to CS2. Group A comprised 20 subjects exposed to high CS2 concentrations and group B 13 subjects with lower exposure. Clinical findings and the measurements of nerve conduction velocity of the slow fibres in the peripheral nerves were evaluated. Twelve subjects had both clinical and electromyographic evidence of neuropathy and 10 showed a diminution in motor conduction velocity. A relationship between the degrees of exposure to CS2 and prevalence of polyneuropathy was found. On re-examining 12 subjects with neuropathy who had been examined four years before no significant electromyographic improvement was observed. These findings are consistent with a permanent axonal neuropathy caused by carbon disulphide.

Age Factors↗

PubMed1977

[Prevalence of penumoconiosis in a steel-plant (author's transl)].

Chest X-rays of 483 steel workers employed in the same factory were examined by the authors and classified according to the ILO U/C 1971 classification for pneumoconiosis. The prevalence of pneumoconiosis was found to be 8.4%. The majority of the positive cases were detected among the furnace workers and then among presse and rolling-mill workers. Only one positive case was found among the workers of the other foremen. It is stated that the furnace is the main source of pollution and that the lack of protective systems spreads the risk also to the surrounding working sites. No significant differences were found as for the opacity features.

Adult↗

PubMedDate not supplied

Environmental exposure and occupational asthma.

Environmental exposure in relation to occupational asthma (OA) concerns the exposure of subjects in the work-place. There are qualitative and quantitative differences in occupational exposures which may influence the development and/or the course of OA. Although more than 300 different agents have been described causing OA, 5-6 groups of substances are sufficient to explain more than 80% of all cases of OA. In addition, a variant of occupational asthma without latency period may occur after an acute inhalation of massive concentrations of irritants, and exacerbations of a pre-existent asthma may be due to products or conditions in the work-place. Despite our increased knowledge of the etiology and pathophysiology of OA, its prevalence in the industrialised world has been relatively steady over the last decade. Therefore, the transfer of knowledge has not been sufficiently effective in the prevention of the disease. The results of studies on the exposure-response relationship for several high molecular weight chemicals (and fewer low molecular weight) indicate that sensitisation may be prevented in large part by reducing work-place concentrations of these agents. These data give support to the attempt to develop Threshold Limit Values (TLV) for sensitisers.

Asthma↗

PubMedDate not supplied

[Follow-up of latex-induced occupational asthma].

We studied 29 subjects with latex-induced occupational asthma in a follow-up of 5 +/- 3 years. Initial and follow-up visits included a questionnaire and measurement of lung volumes, bronchial responsiveness to methacholine (PD20FEV1), and latex-specific serum IgE levels. At follow-up, 17 subjects were no longer exposed to latex, whereas 12 subjects had reduced exposure. Asthma and rhinitis symptoms, use of steroids and bronchial hyperresponsiveness improved significantly at follow-up, whereas mean FEV1% and FVC% decreased (p < 0.05). Multiple regression analysis showed that the main determinant of FEV1 and PD20FEV1 at follow up were the values of these variables at diagnosis. Complete recovery of occupational asthma was observed in 7 subjects (24%), all in the non-exposed group. Latex-specific IgE did not exhibit significant changes. In conclusion latex-induced occupational asthma improves after a follow-up of 5 +/- 3 years, but a complete recovery occurs in a minority of subjects and is associated with cessation of exposure. Lung function measurements at follow up depend from their impairment at the time of diagnosis.

Adult↗

PubMedDate not supplied

[Occupational asthma: role of airway inflammation and remodelling in persistent respiratory symptoms and bronchial hyper-responsiveness].

BACKGROUND: Until the late 1970's occupational asthma (OA) was considered reversible once patients were removed from exposure. Unfortunately, respiratory symptoms and non-specific bronchial hyper-responsiveness (NSBH) persist in about two-thirds of patients for years after removal from the offending agent. OBJECTIVES AND METHODS: This review focuses on the role of airways inflammation and remodelling in persistent respiratory symptoms and NSBH after cessation of occupational exposure. RESULTS: Even though cessation of exposure does not always result in remission of OA, symptoms, airways calibre and NSBH do improve in many patients. Although improvements in FEV1 and NSBH tend to reach a plateau 1-2 years after workers leave exposure, reversing NSBH may take much longer and respiratory symptoms and NSBH can persist in subjects removed from exposurefor >10 yrs. Long-term treatment with inhaled corticosteroids (ICS) induces a small but significant improvement in respiratory symptoms and in quality of life and a decrease in NSBH. Prolonged exposure and respiratory symptoms, marked airway obstruction and NSBH, high total cell, eosinophil and neutrophil counts in bronchoalveolar lavage fluid, a strong reaction during specific inhalation challenge, and delayed treatment with ICS have been identified as prognostic factors of unfavourable outcome. If exposure persists, OA tends to deteriorate in many patients but regular long-term treatment with ICS and long-acting beta2-agonists seems to stabilize the outcome. Soon after the last exposure inflammatory cell infiltrates, including eosinophils, and increased thickness of sub-epithelial collagen have been observed. When time since removal from exposure was longer, persistence of respiratory symptoms and NSBH was associated with airway inflammation, remodelling and hypersensitivity to the offending agent. Thickness of sub-epithelial collagen and specific airway sensitivity were reduced after prolonged non-exposure to isocyanates, although NSBH and airway inflammation persisted. CONCLUSIONS: Pathologic features are similar in OA and non-occupational asthma. The main factors of favourable outcome are early removal from exposure and a mild airway obstruction and NSBH at diagnosis. Persistence of airway inflammation years after removal from exposure suggests this process may become independent of the offending agent. The role of remodelling on persistence of OA needs to be clarified further.

Asthma↗

PubMedDate not supplied

Prednisone, indomethacin and airway responsiveness in toluene diisocyanate sensitized subjects.

We investigated whether late asthmatic reactions and the associated increase in airway responsiveness induced by toluene diisocyanate (TDI) in sensitized subjects are inhibited by indomethacin and/or prednisone. Four sets of experiments were conducted in five subjects sensitized to TDI. To assess late asthmatic reactions to TDI, FEV1 was measured immediately before and after exposure to TDI and then hourly for 8 h. To assess change in airway responsiveness, the provocative dose (mg) of methacholine that caused a decrease in FEV1 of 20% (PD20FEV1) before treatment, and then before and after exposure to TDI was measured. In the first set of experiments, each subject was given no treatment and was studied before and 8 h after exposure to TDI; in the other two sets, each subject was studied before treatment, then during treatment with indomethacin (50 mg q.i.d. for 3 days, orally) or prednisone (50 mg once a day, for 3 days, orally), both before and 8 h after TDI exposure. In a fourth series of experiments, each subject was again given no treatment and studied before and 8 h after TDI. When the subjects were given no treatment or indomethacin, TDI caused late asthmatic reactions and increased airway responsiveness to inhaled methacholine. In contrast, when the subjects were given prednisone, TDI caused neither late asthmatic reactions nor increased airway responsiveness. Treatment with indomethacin and prednisone did not change baseline FEV1 and airway responsiveness. These results suggest that release of prostaglandins does not contribute to late asthmatic reactions and the associated increase in airway responsiveness induced by TDI. Inflammatory mediators inhibited by prednisone but not by indomethacin may be involved.

Adult↗

PubMedDate not supplied