Beiträge zur Klinik der Tuberkulose und spezifischen Tuberkulose-Forschung

The inhibitory effects of reactive oxygen species (ROS) on the surface tension-lowering abilities of three surfactants were compared: natural lung surfactant (NLS), KL4 surfactant containing synthetic peptide resembling the hydrophobic/hydrophilic domains of SP-B in an aqueous dispersion of phospholipids, and Survanta® (SUR) containing SP-B and SP-C. The inhibitory concentrations of Fenton reactants (i.e. 0.65 mM FeCl2, 0.65 mM EDTA, 30 mM H2O2), deduced from dose-response plots of FeCl2 on minimum surface tension (MST) of SUR, were used to assess the Fenton effect on biophysical properties of various surfactants. Neither H2O2 (30 mM) nor FeCl2 with EDTA (both 0.65 mM) alone affected surfactant function, but when mixed together significantly increased (p < 0.01) the MST of SUR compared with KL4 (p < 0.05) in a FeCl2 concentration-dependent manner. This effect on NLS was not significant (p= 0.05) at similar phospholipid concentrations. Also, the range of increases in surface adsorption in mN/m at equilibrium surface tension (EST) was 27–40 for SUR, 36–44 for KL4, and 24–25 for NLS. We speculate that the presence of SP-A and the catalase content in NLS may have protective effects on inactivation of NLS by ROS. We conclude that the in vitro Fenton effect could be a valuable test system for comparing the inactivation range of surfactants by oxyradicals.

Although interleukin-10 (IL-10) is a potent inhibitor of allergic diseases, the association between promoter −1082/−819/−592 polymorphisms and asthma susceptibility remains inconclusive. We sought to determine if IL-10 promoter −1082/−819/−592 polymorphisms contribute to asthma susceptibility and are associated with phenotypes of atopic asthma. Systematic computerized searches were performed. Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated by using random-effect and fixed-effect models, based on between-study heterogeneity. Subgroup analyses were performed according to age, ethnicity, and atopy. Publication bias was detected by funnel plot using Egger’s test. A total of 4,716 asthmatic patients and 5,093 controls were included. The asthma susceptibility correlated significantly with IL-10 promoter gene −1082 polymorphism [OR (95 % CI) 1.26 (1.02, 1.55) for AA vs. AG + GG] and −592 polymorphism [OR (95 % CI) 1.12 (1.07, 1.34) for AC + AA vs. CC] (both P < 0.05), but not with −819 polymorphism (P > 0.05). Subgroup analyzes suggested that the AA versus AG + GG genotype of −1082A/G polymorphism and AC + AA versus CC genotype of −592A/C polymorphism contributed significantly to increased asthma susceptibility in adults [OR (95 % CI) 1.39 (1.03, 1.87) for −1082A/G and 1.53 (1.25, 1.87) for −592A/C polymorphism]. The Asian population [OR (95 % CI) 1.35 (1.1, 1.7) for −1082A/G and 1.4 (1.12, 1.64) for −592A/C polymorphism] and subjects with atopic asthma [OR (95 % CI) 1.49 (1.18, 1.88) for −1082A/G and 1.23 (1.01, 1.48) for −592A/C polymorphism] also had an increased susceptibility of asthma. No publication bias was detected. IL-10 promoter −1028A/G, −592A/C polymorphisms and their haplotypes, but not −819T/C polymorphism, correlate with asthma susceptibility.

34593 (51,2%) der Bewohner eines Landkreises im Alter von 1 bis 94 Jahren konnten durch den Tuberkulintest (85,8% intracutan und 14,2% percutan) erfaßt werden. Nach Eliminierung der BCG-Geimpften blieben noch 31 737 Testpersonen zur Auswertung übrig. Die Durchseuchung der Gesamtbevölkerung lag im Durchschnitt bei 43,2% (48,0% männlich, 38,6% weiblich). Zwischen dem 5. und 6. und dem 18. und 19. Lebensjahr kommt es zu einem starken Anstieg, und zwischen dem 67. und 68. Lebensjahr zu einem Abfall der Durchseuchung. Der Einfluß der Verkehrs- und Bevölkerungsdichte, der beruflichen Faktoren und der Rindertuberkulose auf die Durchseuchung der 73 Gemeinden des Landkreises wurde untersucht, wobei erwartungsgemäß in den stark besiedelten und verkehrsdichten Gemeinden eine höhere Durchseuchung der Bevölkerung festgestellt wurde. Die Angehörigen der technischen Berufe sind am stärksten infiziert, die des Gaststättenwesens und der privaten Dienstleistung am geringsten, wobei die Besetzung der ersteren Gruppe mit vorwiegend männlichen und der anderen Gruppe mit vorwiegend weiblichen Testpersonen, die im Durchschnitt geringer durchseucht sind, eine Rolle spielen dürfte. Die Rindertuberkulose hat nach unseren Ergebnissen zweifellos einen Einfluß auf die Durchseuchung des Landkreises ausgeübt. Schließlich wurde noch das Verhältnis der Morbidität zur Durchseuchung untersucht. Je mehr aktive, insbesondere ansteckende Tuberkulöse in den Gemeinden vorhanden waren, desto größer war die Anzahl der Infizierten. Neben der Mortalitäts- und Morbiditätsstatistik muß in Zukunft auch eine Infektionsstatistik der Gesamtbevölkerung geführt werden, um au einer wirksamen Bekämpfung und Ausrottung der Tuberkulose zu kommen. Es genügt nicht mehr, einzelne Bevölkerungsgruppen mit Schwerpunktuntersuchungen zu erfassen, sondern die Gesamtbevölkerung muß mit einer Art Kleinstraumsanierung allmählich infektionsfrei gemacht werden.

Limited bronchoalveolar lavage (BAL) as an extension of fiberoptic bronchoscopy has permitted the recovery of airway-alveolar space cells and soluble substances in the extracellular lining fluid that have been used diagnostically and as research specimens in patients with a variety of lung diseases and in normal subjects for the study of lung host defenses. During the past three decades, use of BAL specimens has stimulated immunologic and cellular research of pulmonary diseases, which has provided significant insight into local host immunity, inflammation, fibrogenesis, asthma mechanisms, and infections. From this research new methods of antifibrotic therapy of interstitial pulmonary fibrosis, for example, have followed. Moreover, BAL applications have greatly enhanced professional interest in the field of pulmonary medicine. This review attempts to analyze the history and impact of BAL, appraise its current status, and assess its future usefulness. Understanding the immunopathogenesis of many lung diseases is predicated on obtaining in situ specimens from affected lung tissue and airways. BAL provides a direct sample that can be compared with an endobronchial or transbronchial biopsy tissue specimen and with cellular and immunologic components in the vascular circulation. Thus, the recovery of BAL fluid and its components involved directly with a disease process or continguous with interstitial tissue permits a much more detailed assessment of new cellular mediators and cytokines participating in the pathologic process. Furthermore, subjecting BAL cells to microarrays of DNA to discern what genes are activated will be one step closer to identifying intracellular processes involved or deranged. Identification of causative factors may solve questions of causation, so that preventive strategies or definitive therapy can be used.

Dengue fever is an arboviral disease transmitted to humans through the bites of infected female Aedes mosquitoes. Dengue virus is a member of the Flaviviridae family, and human infection can be caused by any of the four antigenically distinct serotypes (DENV 1–4). The infection has become recognized as the most important and prevalent arboviral disease in humans, endemic in almost 100 countries worldwide. Nearly 3 billion people live in areas with transmission risk. Autochthonous transmission of the virus in previously disease-free areas, increased incidence in endemic areas, and epidemic resurgence in controlled regions could increase the risk of contracting more severe forms of the disease, such as dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). Symptomatic dengue virus infection can present with a wide range of clinical manifestations, from mild fever to life-threatening DSS. Thoracic complications may manifest as pleural effusion, pneumonitis, non-cardiogenic pulmonary edema, and hemorrhage/hemoptysis. No vaccine is currently available and no specific treatment for dengue fever exists, but prevention and prompt management of complications in patients with DHF can help reduce mortality. This review describes the main clinical, pathological, and imaging findings of thoracic involvement in DHF.

To identify plasma alterations in lipid species in patients with chronic obstructive pulmonary disease (COPD), as well as, relationships with smoking status, oxidative and inflammatory markers. Plasma was obtained from 100 patients with COPD and 120 healthy controls. Pulmonary function was assessed by plethysmography. Serum levels of IL-6 and TNF-α were determined by ELISA. Oxidative stress parameters were measured using standard methods. Lipids were extracted then analyzed by Matrix-Assisted Laser Desorption and Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF-TOF-MS). More than 40 lipid compounds were identified within plasma samples. Among these 19 lipid species including plasmalogens (PC O-), phosphatidylcholines (PC), and triglycerides (TG) were significantly altered in COPD. A decreased expression of PC O- (36:1, 36:2, 36:3, 36:4, 38:4, 38:5) species was found in patients with different severities compared to healthy controls. There was also a decrease in PC (34:3, 36:0, 36:4, 36:5, 40:6, 40:7) species in COPD patients. PC (34:3) levels were positively correlated with disease progression and pulmonary function decline (forced expiratory volume in 1 s (FEV1)) (r = 0.84, p < 0.001) and inversely correlated with thiobarbituric acid-reactive substances (TBARS) (r = − 0.77, p < 0.001). TG (50:0, 50:1, 52:1, 52:2, 52:3, 52:4, 54:4) species were altered in COPD patients and in those with advanced disease stages. Significant correlations between FEV1, TBARS, peroxynitrite, and TG (52:3) were found among COPD patients (r = − 0.69; r = 0.86; r = 0.77, p < 0.001, respectively). PC (34:3) and TG (52:3) could be potential lipid signatures of COPD that correlate with altered pulmonary function and oxidative status.