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The effects of ethanol on blood flow in the coronary arteries, the major blood vessels supplying the heart, and the dimensions of the coronary arteries were examined in 29 patients with coronary artery disease and six normal subjects. Blood flow was measured in the coronary sinus, a large vein that drains coronary arteries, before and during a 15- to 30-minute infusion of dextrose, or sugar, into the hearts of 15 subjects and an infusion of 5 percent ethanol in dextrose solution in 20 subjects. In subjects receiving dextrose, heart rate, arterial pressure, and coronary sinus blood flow were unchanged. In subjects receiving ethanol, coronary sinus flow increased about 27 percent, and resistance in the coronary blood vessels to flow decreased 17 percent. In the ethanol group, there were also changes in the oxygen content in the coronary artery sinus and artery, but no changes in the coronary artery dimensions. The results show that ethanol increases coronary blood flow and decreases resistance without causing any changes in dimensions, suggesting that the effects of ethanol result from dilation of the small blood vessels called arterioles, which cause resistance to flow. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background: The immunologic response to immunotherapy with dog extract is not well characterized. Objective: The purpose of this study was to examine the immunologic response to 3 doses of dog extract expressed as their Can f 1 content. Methods: Cluster immunotherapy was administered to 28 patients with dog allergy who were randomly assigned to 1 of 4 treatment arms: placebo or acetone-precipitated extract containing 0.6 μg, 3.0 μg, or 15.0 μg Can f 1 per 0.5 mL maintenance dose. Studies included titrated skin prick tests, the late cutaneous response, titrated nasal challenge with dog extract, and serum allergen-specific IgE and IgG4. Dog allergen-stimulated lymphocyte proliferation was performed with measurement of secreted cytokines by ELISA and of intracellular cytokines by flow cytometry. Results: There was a significant dose-dependent response in suppression of titrated skin prick tests and suppression of the late cutaneous response. There was a significant increase from baseline in dog-specific IgG4 in both the high-dose and low-dose groups and a dose-dependent suppression of secreted TNF-α and increase in secreted TGF-β. There was a dose-dependent trend in suppression of secreted IL-4 with a significant decrease from baseline in the high-dose group. There were no significant changes in symptom scores; lymphocyte proliferation; secreted IFN-γ, IL-10, or IL-5; or intracellular cytokine production. Conclusion: The dose-response in immunologic parameters after immunotherapy with dog extract is similar to that previously demonstrated with cat extract. Clinical implications: The greatest and most consistent response is seen with a dose containing 15 μg Can f 1. [Copyright &y& Elsevier]

Background: Commercial and residential buildings can become contaminated with molds, which may trigger allergic disorders. Mold remediation efforts may require costly replacement of mold-contaminated building materials. Disinfectants that contain dilute sodium hypochlorite can kill mold and are practical to use. Whether they also inhibit mold allergy symptoms is unknown. Objective: We tested the hypothesis that sodium hypochlorite–containing spray products kill Aspergillus fumigatus and inhibit A fumigatus allergens. Methods: A fumigatus was grown on 3 common building construction materials, as well as in solution by conventional laboratory methods. Two sodium hypochlorite–containing household products (diluted bleach and Tilex) were sprayed on the mold-contaminated materials or added to mold in solution and compared with untreated controls. Surface mold and associated debris were mechanically removed from treated and untreated boards. Conidia in the extracted board materials were quantified by light microscopy, examined for morphologic changes by scanning electron microscopy, and cultured for viable mold. Extracts were tested for A fumigatus antigen by ELISA, and for A fumigatus allergen by skin prick testing using extracts prepared from both the boards and the cultured solutions. Results: Both sodium hypochlorite disinfectants killed A fumigatus in solution and on mold-contaminated building materials. Light microscopy and scanning electron microscopy demonstrated changes to the conidial surface. Both dilute bleach and Tilex inhibited A fumigatus recognition by ELISA. Skin testing supported the results of the ELISAs and demonstrated loss of skin test reactivity to the sodium hypochlorite–treated mold solutions in most of the subjects. Of the 4 individuals who had a positive skin test result to mold grown on oriented strand board building material, 3 no longer reacted to extracts from bleach-treated boards. Conclusion: Spray application of sodium hypochlorite–containing disinfectants onto mold-contaminated building material kills A fumigatus, modifies the surface characteristics of A fumigatus conidia, reduces recognition of A fumigatus mold by ELISA, and results in loss of skin test reactivity to the treated mold in individuals allergic to A fumigatus. [Copyright &y& Elsevier]

Background: To date, there have been no randomized, double-blind studies showing the effectiveness of sublingual immunotherapy with multiple allergens. Objective: The purpose of this study was to examine whether the efficacy of sublingual immunotherapy (SLIT) with standardized timothy extract was reduced by combination with other allergen extracts. Methods: A single-center, randomized, double-blind, placebo-controlled trial with SLIT was conducted. After an observational grass season, SLIT was administered for 10 months to 54 patients randomized to 1 of 3 treatment arms: placebo, timothy extract (19 μg Phl p 5 daily) as monotherapy, or the same dose of timothy extract plus 9 additional pollen extracts. Symptom and medication scores were collected and titrated nasal challenges, titrated skin prick tests, specific IgE, IgG4 and cytokines release by timothy-stimulated lymphocyte proliferation were performed. Results: Perhaps because of a very low grass pollen season in 2008, there were no significant differences in medication or symptom scores in either treatment group compared with placebo. Compared with placebo, in the timothy monotherapy group, thresholds for titrated nasal challenge and skin prick tests (P = .03 and P = .001, respectively), and serum-specific IgG4 levels (P = .005) significantly increased, and IFN- γ levels decreased (P = .02), whereas in the multiallergen group, there was significant improvement only in the titrated skin prick tests (P = .04) which was less than in the monotherapy group. There were no significant differences between the 2 active groups in any outcome measure, and both active groups experienced more adverse events than placebo. There were no systemic reactions. Conclusion: Improvement in multiple relevant outcomes strongly suggests that SLIT with timothy extract alone was effective; however, the results for symptom and medication scores were not significant. The differences between multiple allergen SLIT and placebo only in skin sensitivity to timothy suggest a reduction in SLIT efficacy in this group. However, further studies are required to confirm these observations. [Copyright &y& Elsevier]

Abstract: Respiratory Mycoplasma pneumoniae (Mp) infection is involved in several acute and chronic lung diseases including community-acquired pneumonia, asthma and chronic obstructive pulmonary disease. In the chronic disease process, recurrent respiratory bacterial infections could occur, which may result in varying degrees of symptoms and lung inflammation among patients. However, the lung immunologic differences of host responses to repeated bacterial (i.e., Mp) infections remain to be determined. In the present study, we examined cellular and humoral responses to multiple (up to 3) Mp infections in two genetically different strains of mice (BALB/c and C57BL/6). Mice were intranasally inoculated with one Mp infection, two or three Mp infections (4weeks apart), and sacrificed on days 3, 7 and 14 after the last Mp infection. Overall, compared to C57BL/6 mice, BALB/c mice demonstrated a significantly higher degree of lung tissue inflammatory cell infiltrate, BAL cellularity, and release of pro-inflammatory cytokines (TNF-α, keratinocyte-derived chemokine (KC, a mouse homolog of human chemokine Gro-alpha [CXCL1], and IFN-γ). In addition, BALB/c mice presented higher levels of serum Mp-specific IgG and IgM, but not IgA. Consistently with lung and serum data, Mp load in BAL and lung specimens was significantly higher in BALB/c mice than C57BL/6 mice. Moreover, repeated Mp infections in BALB/c, but not C57BL/6 mice, produced a greater inflammatory response than did a single Mp infection. Our results suggest that hosts with different genetic background may have different susceptibility to repeated respiratory Mp infections along with inflammatory responses. [Copyright &y& Elsevier]