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Echinacea extracts modulate the pattern of chemokine and cytokine secretion in rhinovirus-infected and uninfected epithelial cells.

Extracts of Echinacea purpurea are among the most widely used herbal medicines throughout Europe and North America for the prevention or treatment of common cold, coughs, bronchitis and other upper respiratory infections. Popular preparations include expressed juice from the aerial parts of the plant (which contain polysaccharides) and alcoholic tinctures from roots (containing caffeic acid derivatives and alkylamides). Since immune modulation has been reported for similar extracts, cytokine antibody arrays were used to investigate the changes in the pro-inflammatory cytokines and chemokines released from a cultured line of human bronchial epithelial cells exposed to Rhinovirus 14 and two different chemically characterized Echinacea extracts. Virus infection stimulated the release of at least 31 cytokine-related molecules, including several important chemokines known to attract inflammatory cells. Most of these effects were reversed by simultaneous exposure to either of the two Echinacea extracts, although the patterns of response were different for the two extracts. These results could explain the antiinflammatory properties of Echinacea extracts. Furthermore, a number of these cytokines were stimulated by the same Echinacea preparations in uninfected cells. These observations therefore provide support for the alleged beneficial uses of Echinacea extracts.

Cell Line, Transformed↗

Echinacea extracts modulate the production of multiple transcription factors in uninfected cells and rhinovirus-infected cells.

Extracts of Echinacea purpurea are widely used for the prevention and treatment of common colds, coughs, bronchitis and other upper respiratory infections, many of which are caused by rhinoviruses (RVs). Recent reports have indicated that rhinoviruses can stimulate the release of various pro-inflammatory cytokines and chemokines from cultured nasal and bronchial human epithelial cells, and several transcription factors (TFs) have been implicated in this process. The effects of Echinacea treatment and rhinovirus infection on the activation of a range of transcription factors were evaluated by means of a protein/DNA array analysis. The BEAS-2B cell line was used as the model, and nuclear extracts of uninfected cells and rhinovirus-14 infected cells were examined with and without treatment with one of two chemically different Echinacea extracts. It was found that both Echinacea extracts increased the nuclear content of more than 30 transcription factors, including the 12 pro-inflammatory factors examined, such as NFkB, AP-1, AP-2 and STATs 1-6. Virus infection resulted in a more dramatic increase in these same TFs. However, when RV-infected cells were treated with either of the two Echinacea extracts, TF levels were reduced to low levels, although the pattern of the reductions was different for the two extracts. These results indicate that rhinovirus infection of epithelial cells, and treatment with Echinacea extracts, led to profound effects on numerous transcription factors, which could explain the previously observed modulation of secreted cytokines and chemokines, as well as other signaling pathways. In addition, the results could help to explain the beneficial effects of Echinacea consumption.

Cell Line↗

Climatotherapy of psoriasis and hypertension in elderly patients at the Dead-Sea.

The responses of various age-groups of psoriatic patients to a four-week period of climatotherapy at the Dead-Sea was compared in three separate studies. In the first study, plaque clearance following climatotherapy was evaluated in a group of 688 psoriatics, as a function of age, sex and duration of the disease. Neither the age of the patient when treated, nor the duration of the disease, appeared to influence the degree of plaque clearance. However, when the age at onset of the disease was evaluated as the comparative parameter-a decrease in the rate of response with increasing patients' age was recorded. In the second study, the type and incidence of side effects after climatotherapy was studied in 502 patients aged over 65, and in more than 4,500 younger psoriatics. There was no difference in the type and frequency of side effects between the two age-groups. The most frequent side effects were: slight sun burn (8.2%), sun allergy (5.0%), common cold (3.4%), leg oedema (2.0%), diarrhea (1.4%) and herpes simplex (0.8%). In all cases the side-effects disappeared within a few days. In the third study, the reduction in the diastolic and systolic blood pressures in a group of 1,142 hypertensive psoriatics was evaluated as a function of time. It was demonstrated that while there was no significant age-dependent difference in lowering their diastolic blood pressure throughout the study, differences in lowering systolic measurements between the younger (< 40 y) and older (> 65 y) hypertensive patients were highly significant. On the basis of these studies we conclude that psoriatics aged 65 and over benefit from climatotherapy at the Dead-Sea no less than younger patients, and that, irrespective of age, high blood pressure is not a contraindication for this treatment in psoriatic patients at the Dead-Sea.

Adolescent↗

Role of substance P in cough.

The sensory neuropeptide, substance P (SP), is present in human airway nerves, beneath and within the epithelium where the condensed localization of neutral endopeptidase (NEP), the major enzyme degrading SP, is observed. To test the hypothesis whether SP stimulates the cough reflex and NEP modifies the cough reflex, we studied the cough response to various stimuli in awake guinea-pigs. Inhibition of NEP with phosphoramidon caused cough, which was inhibited by systemic capsaicin treatment and by aerosols of a specific NK1 receptor antagonist FK 888. Aerosols of FK 888 also inhibited cough induced by bronchoconstricting agents such as acetylcholine and histamine in non-sensitized animals and by ovalbumin antigen in animals sensitized to ovalbumin. The number of coughs induced by histamine aerosols was inhibited by systemic capsaicin treatment and enhanced by pretreatment with a NEP inhibitor phosphoramidon. Likewise, FK 888 inhibited the augmented cough response to aerosolized capsaicin in female guinea-pigs treated with a long-term medication of an angiotensin-converting enzyme inhibitor, cilazapril. In humans, aerosols of SP did not cause cough in normal subjects, whereas it did in patients with common colds. The SP fragment a major metabolite of SP produced by NEP, was less effective compared with SP in these patients, suggesting that damaged epithelium may facilitate the penetration of SP. These findings suggest that SP released from sensory nerves in response to stimuli may mediate cough and NEP may have a role in modulating SP-induced effects.

Angiotensin-Converting Enzyme Inhibitors↗

Cough provocation tests: their clinical value.

Cough provocation testing was originally developed for testing new anti-tussive agents and still remains a mandatory tool in their development. The methodology has been developed into single breath and multiple breath techniques. Neither has been fully validated; however, single breath techniques have been used in a number of patient series of more than 100 patients. These studies show that the cough reflex is more sensitive in patients with cough and becomes normal on recovery. Studies in the common cold and in angiotensin converting enzyme inhibitor-associated cough suggest that this may be cause and effect. These results point to a utility for cough provocation testing in epidemiology but not in routine clinical practice. The one exception in clinical practice is in the assessment of patient post stroke where it is a better method, than voluntary cough testing, for assessing damage to the cough reflex. Other than use in epidemiology it remains an invaluable tool in hypothesis testing.

Cough↗

Influence of experimental rhinitis on the gonadotropin response to intranasal administration of buserelin.

The influence of experimental rhinitis on the absorption of buserelin, measured as the serum luteinizing hormone (LH) response, has been investigated. A single dose of 200 micrograms buserelin was given to 24 healthy male volunteers after induction of experimental rhinitis with histamine and after use of a saline spray (placebo control). Except on one occasion, when the pump-spray apparently was incorrectly operated, serum LH concentration rose after buserelin. There was no difference in the LH response between histamine-induced rhinitis and saline controls. It was concluded that intranasal application of buserelin represents a reliable mode of application and that modification of the administration route or a change in the dosage schedule during naturally-occurring nasal inflammations, such as the common cold and allergic rhinitis, is unnecessary in patients undergoing chronic treatment with intranasal buserelin, e.g. for prostatic cancer, endometriosis, precocious puberty, and contraception.

Absorption↗

Causes of chromosome anomalies suggested by cytogenetic epidemiology of induced abortions.

Women who visited hospitals requesting induced abortions were asked about their obstetric and medical histories by attending physicians prior to the operation. The information was solely based on their reports at the interview. The period of coverage was nine weeks, comprising six weeks before and three weeks after the onset of the last menstruation. Both the occurrence of acute respiratory infectious diseases, which included the common cold, upper respiratory tract infection (U.R.T.I.), influenza, and pneumonia, and the use of analgesics and antipyretics were most frequently reported. Regardless of whether they had an acute respiratory illness, the women who took analgesics and antipyretics (including antihistamine, cough remedy, and nasal decongestant) had 13.8% (8/58) gross chromosome anomalies. The women without the treatment had 6.3% (71/1136) anomalies. The difference was statistically significant (P less than 0.05). Triploid formation was particularly related to drug consumption, thus there were 5.2% (3/58) in the treated group and 0.5% (6/1136) in the untreated group (P=0.0074). In contrast, trisomy was not considered to be related to drug consumption on account of 8.6% (5/58) and 4.1% (47/1136) in the corresponding groups (0.10 less than P less than 0.20). When the occurrence of trisomy was examined in connection with two variables, i.e., the presence of drug consumption and the age of mothers, association was not evident (X2 assoc. = 0.883, d.f. = 1 by Cochran's method). Besides these results, neither maternal X-irradiation nor irregularity of the menstrual period was found to be related to the frequency of chromosome anomalies in the progeny.

Abortion, Induced↗

Drug utilization by children in Tenerife Island.

Drug utilization was studied in children below 14 years of age in Tenerife, Canary Islands, who were seen as outpatients by 15 paediatricians and 10 general practitioners. Data on diagnosis, previous drug exposure and prescriptions were collected from a random sample of 1327 children. Nose and throat infections (40.1%), respiratory diseases (10.2%) and miscellaneous symptoms, namely common cold, influenza or nasal congestion (10.5%), were the most frequent reasons for visiting a physician. Antibiotics represented 28.5% of the prescriptions. The youngest group (0-2 years) received more drugs than the other two groups (2-6 and 6-14 years), and 8.4% of the children did not receive any drug. Only 358 (5.1%) of the 7,000 pharmaceutical specialities available were used, and the 10 most frequently prescribed drug products constituted more than 30% of all prescriptions. Combination drugs accounted for 42.4% of the prescribed items. Healthy children presenting only for check up were frequently treated with drugs.

Age Factors↗

Observations on the seasonal variation of the most common acute pediatric diseases in the Helsinki area (Finland).

Seasonal variations in the incidence of the most common acute diseases in childhood during the inter-epidemic year 1978 were investigated using a sample of 7,068 walk-in patients attending. Aurora Hospital, Helsinki. At least seven out of the ten most common diseases were of infectious origin. Generally, boys and the younger groups were affected most often. The clearest seasonal difference in both sexes was observed in patients with gastroenteritis and otitis media. Among boys, there was also a marked fluctuation in the incidence of asthmatic bronchitis and asthma, pneumonia, and laryngitis, whereas, among girls, marked variations were observed only in urinary tract infections and acute upper respiratory infections. Children between 1 and 3 years of age appeared to be most prone to the common cold syndrome all the year round.

Acute Disease↗

Mortality, morbidity and drug consumption in a rural area (Spain).

A descriptive study was made of the health indicators in 5 rural municipalities of the province of Castellón (Spain), with a total of 1428 inhabitants. This population is characterized by its aging, 36.9% of all individuals being older than 65 years. A retrospective evaluation was made of the annual mortality rates between 1940 and 1990, and of morbidity and medications consumption for the period between June 1991 and May 1992. An increase in general mortality was observed during the study period, though the rates also diminished in relation to age groups, sex and cause of death. In addition, 59.45% of the study population made use of health-care services in the course of one year, an average of 2.59 drugs being prescribed per inhabitant in that same period. Morbidity in decreasing order of importance was attributed to acute respiratory disease, osteomuscular disorders, hypertension, depression and gastric pathology. Medications for the common cold and coughing were the most frequently used drugs, along with pain-killers, cardioactive agents, psycholeptics and non-sterioidal anti-inflammatory drugs (NSAIDs). Aging causes the mortality variations recorded, despite the socio-sanitary improvements observed in the zone during the study period. Aging may also be related to the important use of healthcare services and of drugs noted in the study. The highest morbidity rates and drug consumption levels corresponded to chronic diseases that deteriorate patient quality of life without actually increasing mortality.

Adolescent↗

Detection of coronavirus-like particles in homosexual men with acquired immunodeficiency and related lymphadenopathy syndrome.

Coronavirus-like particles were identified by electronmicroscopy in the feces of homosexual men. The particles banded at a density of 1.21 g/ml after cesium chloride density gradient centrifugation. To determine whether the presence of this virus might be related to clinical symptoms, several patient groups were studied prospectively. In 8 of 16 (50%) homosexual males with acquired immunodeficiency syndrome (AIDS) or unexplained lymphadenopathy syndrome (LAS), coronavirus particles were found. In contrast, such particles were found in none of 18 heterosexual controls and in only 3 of 20 homosexual males without AIDS or LAS. Thus, coronavirus excretion correlated significantly (2 alpha less than 0.01) with the clinical diagnosis of AIDS or with syndromes belonging to the AIDS-related complex. In addition, such particles identified in the serum of one patient with LAS and diarrhea suggest invasion and systemic spread of the agent and underline that this virus behaves differently from "common cold" human coronaviruses.

Acquired Immunodeficiency Syndrome↗

Culture and gender diversity in commonsense beliefs about the causes of six illnesses.

One hundred seventy-eight subjects attributed a variety of causes to six illnesses/diseases: AIDS, the common cold, diabetes, hypertension, lung cancer, and headaches. Factor analysis of these causal attributions yielded four factors which were more complex than those in the existing literature. Each of the six illnesses was seen as caused by different factors. Ethnic and gender differences in causal attributions also were assessed. Although there were no differences between minorities and whites in the perceived causes of the six illnesses, a number of gender differences did emerge. Women were more likely than men to view illness as caused by Sin and Sex and as a form of punishment. Results are discussed in terms of their implications for ethnic and gender differences in health behavior, health service utilization, and somatic symptoms, and suggestions for future research are offered.

Adult↗

Pharmacy personnel and fever: a study on perception, self-care and information to customers.

To study the fever perception and self-care of pharmacy personnel as well as the information given to customers about the management of fever problems, a random sample of 152 Norwegian pharmacists and 150 pharmacy technicians were interviewed, in 1989, by a national opinion poll company. One-third thought that body temperatures between 39.0 degrees C and 40.5 degrees C could be life-threatening. Of all respondents 24% (33% of technicians, 16% of pharmacists) assumed body temperatures to be rising when sweating accompanied fever. In cases of common cold or influenza accompanied by fever 56% of the personnel would use antipyretics. 7% Of the staff (14% of technicians, 1% of pharmacists) believed penicillin to be effective against viral infections. Antipyretic drug preferences were consistent, but a wide range of perceptions was revealed, in particular with respect to start of antipyretic therapy and seeking medical care for children. Undergraduate and postgraduate education of pharmacy personnel should aim more at satisfying the demand for information of the general public and focus more on the symptomatic treatment of fever and minor illness in general. Pharmacists in charge have a special responsibility in counselling their assistants.

Anti-Inflammatory Agents, Non-Steroidal↗

Complementary and alternative medicine in developmental disabilities.

Developmental disabilities (DD) are defined as a diverse group of severe chronic conditions due to mental and/or physical impairments. Individuals with developmental disabilities have difficulty with major life activities including language, mobility, and learning. Developmental disabilities can begin anytime during development--from prenatal up to 22 years of age, and the disability usually lasts throughout a person's lifetime. Autism spectrum disorders, cerebral palsy, mental retardation, and attention deficit hyperactivity disorder are common conditions falling within the definition of developmental disabilities. Complementary and alternative medicine (CAM) is becoming increasingly utilized in the general population for treatment of everything from the common cold to complex and chronic medical conditions. This article reviews the prevalence of different types of CAM used for various developmental disabilities.

Child↗

The effect of linarin on LPS-induced cytokine production and nitric oxide inhibition in murine macrophages cell line RAW264.7.

The herb, Chrysanthemum zawadskii var, latilobum commomly known as Gu-Jul-Cho in Korea, used in traditional medicine to treat pneumonia, bronchitis, cough, common cold, pharyngitis, bladder-related disorders, gastroenteric disorders, and hypertension. Linarin is the main active compound and the biological mechanisms of its activity are unclear. It is believed that effects of this herb may be exerted through the pluripotent effectors of linarin due to its ability to treat a variety of afflictions. In this study, the effects of linarin on the mouse macrophages cell line, RAW 264.7, were investigated. It was found that linarin could activate macrophages by producing cytokines. Monocytes and tissue macrophages produce at least two groups of protein mediators of inflammation, interleukin 1 (IL-1) and the tumor necrosis factor (TNF). Recent studies have shown that TNF and IL-1 modulate the inflammatory function of endothelial cells, leukocytes, and fibroblasts. TNF-alpha production by macrophages treated with linarin occured in a dose dependent manner. However, IL-1 production was largely unaffected by this natural product. This study demonstrated the ability of linarin to activate macrophages both directly and indirectly. Linarin also affect both cytokine production and nitric oxide inhibition, in addition to the expression of some surface molecules. Nitric oxide (NO), derived from L-argin-ine, is produced by two forms(constitutive and inducible) of nitric oxide synthase (NOS). The NO produced in large amounts by inducible NOS is known to be responsible for the vasodilation and hypotension observed in septic shock. Linarin was found to inhibit NO production in the LPS-activated RAW 264.7 cells. Linarin may be a useful candidate as a new drug for treating endotoxemia and the inflammation accompanied by NO overproduction. The linarin-treated total lymphocytes exhibited cytotoxicity in a dose dependent manner between 20 microg/ml and 40 microg/ml. These results suggest that linarin may function through macrophage activation.

Animals↗

Acute intake of moderate amounts of red wine or alcohol has no effect on the immune system of healthy men.

BACKGROUND: A recent prospective cohort study revealed that moderate wine consumption but not consumption of other alcoholic beverages is associated with a decreased risk of common cold. In contrast, wine constituents such as ethanol and polyphenols are known to suppress immunity. AIM OF THE STUDY: We investigated whether acute intake of a moderate amount of alcohol modulates immune functions in healthy men and whether polyphenols in red wine with antioxidative and immunomodulatory potential induce changes in immune functions that differ from those induced by the consumption of the 12 % ethanol. METHODS: Six healthy males with moderate alcohol consumption patterns randomly consumed a single dose of 500 ml of red wine (12 % ethanol), a 12 % ethanol dilution, dealcoholized red wine, and red grape juice, respectively. The following immune functions were measured before beverage consumption and 1, 3, and 24 h later: phagocytic activity and intensity of neutrophils and monocytes, production of tumor necrosis factor-alpha, interleukin-2, and interleukin-4, lymphocyte proliferation, and lytic activity of natural killer cells. RESULTS: Acute consumption of a moderate amount of red wine and of a 12 % ethanol solution had no effect on immune functions in men. Acute consumption of polyphenol-rich beverages (dealcoholized red wine and red grape juice) also did not affect immunity. CONCLUSIONS: This study clearly shows that moderate consumption of alcohol at doses which inversely correlate with cardiovascular disease risk has no short-term effect on human immune cell functions. Acute intake of polyphenol-rich beverages such as red grape juice and dealcoholized red wine also does not affect immunity.

Alcohol Drinking↗

Acute hemorrhagic leukoencephalitis (Hurst's disease) linked to Epstein-Barr virus infection.

A 16-year-old girl presented signs of a common cold in combination with a hemolytic crisis. Within 3 days, she developed reduced consciousness and hemiparesis subsequently followed by coma. CT and MRI scans revealed evidence for raised intracranial pressure and an extensive inflammatory process extending from the brain stem up to the thalamus. The patient died within 3 weeks after onset of first symptoms of intracranial pressure despite maximum intensive care. Neuropathological examination revealed disseminated necrotic lesions and perivascular hemorrhages characteristic for acute hemorrhagic leukoencephalitis (Hurst's disease), mainly of the brain stem, diencephalon and cerebellum. Serological results, in situ hybridization and PCR analysis demonstrated an acute Epstein-Barr virus (EBV) infection of the central nervous system. To our knowledge, this is the first reported case of Hurst's disease linked to EBV.

Adolescent↗

Presacral epidermoid cyst: report of a case.

An asymptomatic tumor in the pelvis was incidentally found by ultrasonography in a 67-year-old woman while being examined after presenting with a common cold. Further examinations revealed a presacral cystic tumor, which measured 10 x 12cm in size. The cyst was thus removed in the normal manner for such cases. The pathological diagnosis was an epidermoid cyst. An analysis of 15 other cases previously reported in the literature indicated that large epidermoid cysts should normally be excised through an abdominal approach alone, provided that the tumor is benign.

Aged↗