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Background and Aims The aim of this study is to investigate the expression pattern of histone deacetylase 9 in peripheral blood of patients with allergic asthma and its regulatory effect on the balance of Th17/Treg cells involved in the pathogenesis of asthma. Methods flap-Ub promoter-GFP-WRE vector was used to construct the Jurkat-HA-FOXP3 cell line. After histone deacetylase inhibitor-trichostatin A (TSA) treatment, FOXP3 and RORγt expression were detected by real-time-polymerase chain reaction (RT-PCR). BALB/c mice were randomly assigned to control group, TSA treatment and the asthma group. Serum Immunoglobulin E (IgE) was detected with enzyme-linked immunosorbent assay (ELISA), airway inflammation in lung tissue evaluated by haematoxylin/eosin staining, bronchoalveolar lavage fluid (BALF) cell number and differential counted, interleukin (IL)-17A and TGF-β concentrations in BALF measured with ELISA, and expression of RORγt and FOXP3 messenger RNA (mRNA)measured by RT-PCR. Forty-seven patients with asthma were recruited and assigned to intermittent, mild and moderate–severe group. GATA3, IL-4, histone deacetylases (HDAC) 9 mRNA expression level were measured by RT-PCR. Results After TSA treatment, FOXP3 mRNA level was upregulated, while RORγt mRNA level was downregulated. FOXP3 protein level was also upregulated by TSA. In vivo, TSA treatment can inhibit IL-17 but promote transforming growth factor-beta production in the BALF of asthma mice, and inhibited the expression of Th17 cells and RORγt mRNA in lung; also can promote Foxp3 mRNA expression. GATA3, IL-4 mRNA expression levels were upregulated in patients with asthma than the healthy control. HDAC9 mRNA expression level was associated with the severity of disease. Conclusion The histone deacetylase inhibitor TSA can regulate the balance of Th17/Treg in asthma by regulating the activity of histone deacetylase.

Introduction HIV infections are prevalent; however, the clinical characteristics of these patients are atypical. Objectives In the present study, we analysed 79 patients who were newly diagnosed with HIV/acquired immunodeficiency syndrome (AIDS) at Ruijin Hospital between January 1998 and August 2011 to improve awareness of the physicians' diagnoses and to elucidate the risk factors for community-acquired pneumonia (CAP) and the progression to severe pneumonia or respiratory failure in AIDS patients. Methods The patients were divided into a CAP group (A) and a non-CAP group (B). Furthermore, group A was divided into a severe pneumonia group (A1) and a non-severe pneumonia group (A2). Results and Conclusion The serum albumin (25.60 ± 5.31 vs 34.00 ± 6.90; P

Background Allergen-specific immunotherapy (SIT) is the only available curative choice with a disease-modifying effect against respiratory allergies. The efficacy of SIT via the sublingual route was demonstrated by a number of clinical trials. This meta-analysis was performed to investigate the clinical efficacy and safety of sublingual-specific immunotherapy (SLIT) for allergic asthma. Methods PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for randomized, double-blind and placebo-controlled (DBPC) trials evaluating the efficacy and safety of SLIT on allergic asthma. Subgroup analyses were performed according to age, type of allergen and duration of SLIT treatment. Results Sixteen randomized DBPC trials comprising 794 patients in total met the inclusion criteria. The results suggest that SLIT significantly reduces both symptom [standardized mean difference (SMD), −0.74; P = 0.006] and medication scores (SMD, −0.78; P = 0.02) compared with placebo. SLIT offers a better clinical response in mite sensitive asthmatics but without confirmed proof from subgroup analyses. Prolonged duration of treatment for more than 12 months brings no additive effects. Improvement in the skin prick test was also observed following immunotherapy. There was no consistent effect on forced expiratory volume in 1 s, serum levels of antigen-specific immunoglobulin G4 and immunoglobulin E in the treated group. The risk of adverse effects was relative risk 2.23 (P = 0.01). Conclusions SLIT is safe and clinically effective in reducing symptoms and medication use for allergic asthma. Our subgroup analyses failed to identify a disproportionate benefit of SLIT in any specific group of asthmatics, but some possible trends did emerge.

Background Systemic corticosteroids (SCS) have been shown to improve the outcome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the optimal dose remains controversial. Objectives We performed a meta-analysis to evaluate whether high-dose SCS is better. Methods We searched PubMed, EMBASE, CPCI-S and CENTRAL databases, and references of reviews or meta-analyses to identify randomized controlled trials using SCS in AECOPD. We performed a routine meta-analysis to evaluate the effects of SCS on treatment failure rate and forced expiratory volume in 1 s (FEV1) improvement compared with placebo in AECOPD. Subgroup analysis was performed by dividing the studies into a high-dose group [initial dose ≥80 mg prednisone equivalent (PE)/day] and a low-dose group (initial dose 30–80 mg PE/day) in all patients and in only inpatients. Meta-regression was performed using initial dose as an independent factor. We classified the suspected adverse effects into several groups and combined them separately. Results Our search yielded 12 studies involving 1172 patients. SCS use was associated with a significant reduction in the treatment failure rate [risk ratio 0.58; 95% confidence interval (CI): 0.46–0.73] and improvement in ▵FEV1 (0.11 L; 95% CI: 0.08–0.14 L). The high-dose regimen did not show superiority to the low-dose regimen. No obvious correlation was found between the SCS effect and the initial dose. SCS led to an obvious increase in hyperglycemia risk. However, the high-dose group did not show obviously higher risk of adverse effects. Conclusion SCS can reduce treatment failure rate and improve lung function in AECOPD. The low-dose regimen (initial dose 30–80 mg/day PE) is proper for treating AECOPD.

Introduction Deficiency of Treg cells and hyperactivity of Th17 cells together are involved in the immunological pathogenesis of asthma. The adenosine A2A receptor (A2AR) plays a critical role in the increased Foxp3 expression of Treg cells and the decreased Th17 generation. Objective The study aimed to investigate A2AR expression in peripheral blood and its regulatory effect on balance of Treg/Th17 cells in asthma. Methods Thirty-one patients with chronic persistent asthma were recruited and divided into 18 intermittent to mild asthma patients, 13 moderate to severe asthma patients. A2AR, Foxp3, and ROR-γt mRNA expression levels in peripheral blood mononuclear cells (PBMCs) were measured by quantitative polymerase chain reaction (qPCR). TGF-β, IL-17, and IgE in plasma were detected with enzyme-linked immunosorbent assay (ELISA). Forty-two BALB/c mice were randomly, equally assigned to control group, ovalbumin (OVA) group and OVA + CGS (CGS21680, A2AR agonist) group. The infiltration of lung inflammation cells were evaluated by HE, A2AR, Foxp3, and ROR-γt mRNA in lung tissues measured by qPCR, TGF-β, IL-17, and IgE in plasma measured with ELISA, and IL-17 and TGF-β protein in lung tissues analyzed with immunohistochemical. Results Our results showed that expression A2AR mRNA in PBMCs was associated with asthma severity. Foxp3 mRNA, TGF-β, and FEV1%pred positively correlated with A2AR mRNA in asthma. ROR-γt mRNA and IL-17 negatively correlated with A2AR mRNA in asthma. CGS could promote Foxp3 mRNA expression, TGF-β, and improve lung function while inhibit ROR-γt mRNA expression, IL-17, and the infiltration of lung inflammation cells. Conclusion A2AR could regulate the balance of Treg/Th17 cells in asthma.

The aim of this study is to investigate the expression pattern of histone deacetylase 9 in peripheral blood of patients with allergic asthma and its regulatory effect on the balance of Th17/Treg cells involved in the pathogenesis of asthma.flap-Ub promoter-GFP-WRE vector was used to construct the Jurkat-HA-FOXP3 cell line. After histone deacetylase inhibitor-trichostatin A (TSA) treatment, FOXP3 and RORγt expression were detected by real-time-polymerase chain reaction (RT-PCR). BALB/c mice were randomly assigned to control group, TSA treatment and the asthma group. Serum Immunoglobulin E (IgE) was detected with enzyme-linked immunosorbent assay (ELISA), airway inflammation in lung tissue evaluated by haematoxylin/eosin staining, bronchoalveolar lavage fluid (BALF) cell number and differential counted, interleukin (IL)-17A and TGF-β concentrations in BALF measured with ELISA, and expression of RORγt and FOXP3 messenger RNA (mRNA)measured by RT-PCR. Forty-seven patients with asthma were recruited and assigned to intermittent, mild and moderate-severe group. GATA3, IL-4, histone deacetylases (HDAC) 9 mRNA expression level were measured by RT-PCR.After TSA treatment, FOXP3 mRNA level was upregulated, while RORγt mRNA level was downregulated. FOXP3 protein level was also upregulated by TSA. In vivo, TSA treatment can inhibit IL-17 but promote transforming growth factor-beta production in the BALF of asthma mice, and inhibited the expression of Th17 cells and RORγt mRNA in lung; also can promote Foxp3 mRNA expression. GATA3, IL-4 mRNA expression levels were upregulated in patients with asthma than the healthy control. HDAC9 mRNA expression level was associated with the severity of disease.The histone deacetylase inhibitor TSA can regulate the balance of Th17/Treg in asthma by regulating the activity of histone deacetylase.

Allergen-specific immunotherapy (SIT) is the only available curative choice with a disease-modifying effect against respiratory allergies. The efficacy of SIT via the sublingual route was demonstrated by a number of clinical trials. This meta-analysis was performed to investigate the clinical efficacy and safety of sublingual-specific immunotherapy (SLIT) for allergic asthma.PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for randomized, double-blind and placebo-controlled (DBPC) trials evaluating the efficacy and safety of SLIT on allergic asthma. Subgroup analyses were performed according to age, type of allergen and duration of SLIT treatment.Sixteen randomized DBPC trials comprising 794 patients in total met the inclusion criteria. The results suggest that SLIT significantly reduces both symptom [standardized mean difference (SMD), -0.74; P=0.006] and medication scores (SMD, -0.78; P=0.02) compared with placebo. SLIT offers a better clinical response in mite sensitive asthmatics but without confirmed proof from subgroup analyses. Prolonged duration of treatment for more than 12 months brings no additive effects. Improvement in the skin prick test was also observed following immunotherapy. There was no consistent effect on forced expiratory volume in 1 s, serum levels of antigen-specific immunoglobulin G4 and immunoglobulin E in the treated group. The risk of adverse effects was relative risk 2.23 (P=0.01).SLIT is safe and clinically effective in reducing symptoms and medication use for allergic asthma. Our subgroup analyses failed to identify a disproportionate benefit of SLIT in any specific group of asthmatics, but some possible trends did emerge.

HIV infections are prevalent; however, the clinical characteristics of these patients are atypical.In the present study, we analysed 79 patients who were newly diagnosed with HIV/acquired immunodeficiency syndrome (AIDS) at Ruijin Hospital between January 1998 and August 2011 to improve awareness of the physicians' diagnoses and to elucidate the risk factors for community-acquired pneumonia (CAP) and the progression to severe pneumonia or respiratory failure in AIDS patients.The patients were divided into a CAP group (A) and a non-CAP group (B). Furthermore, group A was divided into a severe pneumonia group (A1 ) and a non-severe pneumonia group (A2 ).The serum albumin (25.60 ± 5.31 vs 34.00 ± 6.90; P 0.05) and CD4 cell count (28.5 ± 30.5 vs 229.50 ± 229.45; P 0.05) of group A were much lower than those of group B. The serum albumin and CD4 cell count negatively correlated with the incidence of CAP. The CD4 cell count (24.15 ± 25.1 vs 47.85 ± 132.5; P 0.05) and partial pressure of oxygen (7.86 ± 1.43 vs 9.41 ± 2.15; P 0.05) of group A1 were significantly lower than those of group A2 . Low serum albumin levels and high blood urea nitrogen levels were the risk factors of hypoxaemia in group A. Early screening and diagnosis of AIDS, as well as nutritional support, would prevent AIDS patients from developing CAP or progressing to severe pneumonia or respiratory failure.

Systemic corticosteroids (SCS) have been shown to improve the outcome of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the optimal dose remains controversial.We performed a meta-analysis to evaluate whether high-dose SCS is better.We searched PubMed, EMBASE, CPCI-S and CENTRAL databases, and references of reviews or meta-analyses to identify randomized controlled trials using SCS in AECOPD. We performed a routine meta-analysis to evaluate the effects of SCS on treatment failure rate and forced expiratory volume in 1 s (FEV1) improvement compared with placebo in AECOPD. Subgroup analysis was performed by dividing the studies into a high-dose group [initial dose ≥80 mg prednisone equivalent (PE)/day] and a low-dose group (initial dose 30-80 mg PE/day) in all patients and in only inpatients. Meta-regression was performed using initial dose as an independent factor. We classified the suspected adverse effects into several groups and combined them separately.Our search yielded 12 studies involving 1172 patients. SCS use was associated with a significant reduction in the treatment failure rate [risk ratio 0.58; 95% confidence interval (CI): 0.46-0.73] and improvement in ▵FEV1 (0.11 L; 95% CI: 0.08-0.14 L). The high-dose regimen did not show superiority to the low-dose regimen. No obvious correlation was found between the SCS effect and the initial dose. SCS led to an obvious increase in hyperglycemia risk. However, the high-dose group did not show obviously higher risk of adverse effects.SCS can reduce treatment failure rate and improve lung function in AECOPD. The low-dose regimen (initial dose 30-80 mg/day PE) is proper for treating AECOPD.