Biomedical subjects
Publications and source records attributed to S Kivity.
The statistical data for asthma mortality in Israel from 1960 to 1986 are presented. From the analysis of the data it is clear that the asthma mortality rates in Israel were among the lowest reported (for the general population as well as for the 5 to 34-year age group), although a trend toward increase was seen during 1982 to 1986.
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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.
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.
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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.
It has been shown that alveolar macrophages (AM) are able to modulate lymphocyte proliferation in vitro. The purpose of this study was to evaluate the effect of AM on the proliferation of autologous peripheral lymphocytes (APL) in patients with interstitial lung disease (ILD) compared to controls. Thirty patients were investigated: eight with idiopathic pulmonary fibrosis (IPF), nine with sarcoidosis(SA), seven with rheumatoid arthritis (RA) and six controls (CO). AM and APL were co-cultured at an increasing macrophage/lymphocyte ratio: 1%, 10%, 20% and 50%. A dose-dependent effect was observed and related to the number of AM added to APL, enhancing at low ratios and suppressing at high ratios. Suppression of proliferation by 50% AM differed in the four groups tested: 94.6% (92-98) in IPF, 73.0% (49-100) in SA, 43% (25-57) in RA, 32.4% (22-41) in the CO (P less than 0.01, P less than 0.05, and P0.05 respectively, compared to CO). Suppressive cell activity of AM from patients with ILD was higher than suppressive cell activity of the CO group. Suppression with 10% of AM in ILD group was 18% (2.2-62) compared with 2.58% (-13-17) in the CO group (P less than 0.05). 20% AM in ILD group showed 35% (3-76) suppression in comparison with 9.76% (-11-27) in the control group (P less than 0.01), 50% AM in ILD have a suppressive activity of 71% (25-100) in contrast to 32.4% (22-41) in control (P less than 0.01). In conclusion, AM from patients with interstitial lung diseases have a significantly stronger suppressive effect on the proliferation of autologous peripheral lymphocytes than controls. This is a new aspect of the study of activation of AM in these kinds of disorders.
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.
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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.
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Extrinsic asthmatic patients have been reported to have a deficiency of concanavalin A (Con A)-induced suppressor cell function. We tested whether in vitro colchicine and oral theophylline can correct this immunoregulatory abnormality. Asthmatic patients' mononuclear cells were incubated with Con A and/or colchicine and then suppression of proliferation was measured by coculture of these cells with healthy volunteers' mononuclear cells and phytohaemagglutinin. The Con A induced suppressor cell function of 29 theophylline treated patients (26 +/- 16%, mean +/- s.d.) was significantly (P less than 0.002) increased as compared to 21 untreated patients (12 +/- 10%) but significantly (P less than 0.01) decreased as compared to 45 healthy volunteers (39 +/- 17%). A pharmacological concentration (10(-8) M) of colchicine had no significant effect on Con A-induced suppressor cell function of 19 untreated patients (from 12 +/- 9% to 9 +/- 22%) but significantly (P less than 0.05) increased Con A-induced suppressor cell function of 20 theophylline treated patients (from 26 +/- 17% to 36 +/- 19%). Thus asthmatic patients have decreased Con A-induced suppressor cell function which is partially corrected by oral theophylline and almost completely corrected by oral theophylline plus in vitro colchicine. This synergistic effect raises the possibility that oral colchicine together with theophylline may be useful in treating patients with extrinsic asthma.
It is not known why the frequency of seizures sometimes increases in the perimenstrual period (catamenial epilepsy). We have examined the possibility that changes in anticonvulsant pharmacokinetics may be responsible. Seventeen women with seizures who were taking phenytoin (DPH) and whose seizures were more frequent perimenstrually were examined twice each, once on the first or second menstrual day and again after 2 weeks. Mean serum DPH levels were lower during the menses. In seven women with seizures unrelated to menses, the fall of DPH levels was much smaller. In catamenial epilepsy, the fall was due to increased DPH clearance. At the time of ovulation, hepatic DPH metabolism may be slowed by competition from steroid hormones.
We examined the effect of oral colchicine (1-2 mg/day) on four healthy volunteers' T cell subsets. Colchicine significantly (P less than 0.01) decreased the mean (+/- SD) percent of OKT3+ total T cells (from 70 +/- 16 to 47 +/- 13), OKT4+ helper/inducer T cells (from 44 +/- 9 to 24 +/- 6), and OKT8+ suppressor/cytotoxic T cells (from 27 +/- 7 to 17 +/- 7), but did not significantly affect the OKT4:OKT8 ratio (from 1.64 +/- 0.21 to 1.48 +/- 0.45) or concanavalin A-induced suppressor cell function (from 44 +/- 9% to 47 +/- 13%). Thus, colchicine non-selectively decreased the circulating helper/inducer and suppressor/cytotoxic T cells.