Blood eosinophil count and risk of postoperative pneumonia following coronary artery bypass graft surgery

AIM:To investigate the relationship between blood eosinophil count and risk of postoperative pneumonia in patients with coronary artery bypass graft (CABG) surgery. METHODS: The medical records of 613 patients who underwent CABG surgery from January 2008 to December 2017 in our hospital were collected and reviewed. The incidence of postoperative pneumonia and hospital mortality were compared in the patients with low or high blood eosinophil count. The risk factors for postoperative pneumonia following CABG surgery were analyzed by multiple logistic regression. RESULTS: The patients enrolled in the study were 582, in which 220 patients had preoperative blood eosinophil counts of less than 2% (low blood eosinophil count) and 362 patients had eosinophil counts of 2% or more (high blood eosinophil count). The incidence of postoperative pneumonia in the patients with low blood eosinophil count was 14.1% (31/220), significantly higher than that (6.4%, 23/362) in the patients with high blood eosinophil count (P=0.002). However, the hospital mortality of the patients with high or low blood eosinophil count had no difference. Low blood eosinophil count (OR=3.521, 95% CI:1.213~10.223, P=0.021), nasogastric tube (OR=6.490, 95% CI:2.757~15.280, P<0.001) and mechanical ventilation ≥ 24 h (OR=3.496, 95% CI:1.156~10.178, P=0.035) were identified as independent risk factors for postoperative pneumonia following CABG surgery. CONCLUSION: Low blood eosinophil count is associated with increased risk of postoperative pneumonia following CABG surgery.     

Effect of dexamethasone or theophylline on platelet-activating factor-induced eosinophils

AIM: To elucidate the effects of platelet-activating factor (PAF) on eosinophil activation and the action of dexamethasone or theophylline during this process. METHODS: Eosinophils (EOS) from the peripheral blood of normal subjects were isolated. The hypodense eosinopil (HE) and normodense eosinophil (NE) were studied with electron microscopy. The effects of PAF on eosinophil activation and the action of dexamethasone or theophylline during the above process were measured. RESULTS: Hypodense eosinophil had significantly smaller individual granules than normodense eosinophil had. PAF induced eosinophil peroxidase release, and generated. Eosinophils incubated with 10^-8 mmol/L PAF and 10^-5 mmol/L dexamethasone released (101.17±10.32) mg/L eosinophil peroxidase (P<0.05). Eosinophils incubated with 10^-9 mol/L PAF and 10^-5 mmol/L dexamethasone caused a decrease in eosinophil peroxidase (110.85±4.16) mg/L and induced the generation of hypodense eosinophil (17.87%±2.16%). Eosinophils incubated with 10^-8 mmol/L PAF and 10 mg/L theophylline released (100.53±9.65) mg/L eosinophil peroxidase (P<0.05). Eosinophils incubated with 10^-9 mol/L PAF and 10 mg/L theophylline caused a similar decrease in eosinophil peroxidase (106.94±10.11) mg/L and induced the generation of hypodense eosinophil (14.08%±2.42%). CONCLUSIONS: Eosinophil degranulation is one of the reasons by which hypodense eosinopils develop. PAF induced eosinophil degranulation, so generated hypodense eosinopils. Dexamethasone and theophylline inhibited above effects.     

Contact Dermatitis in Dogs and Cats: Pathogenesis,Histopathology, Experimental Induction and Case Reports*

Résumé— Une revue de la physiopathologie et de Thistopathologie des dermites de contact par allergie et irritation est présentée. Le rôle des lymphocytes, des cellules de Langerhans, des basophiles et des éosinophiles est discuté. Des résultates précédents non-publiés de dermites de contact expérimentales chez le chien sont présentées. Les résumés des cas cliniques de dermites de contact spontannées chez le chien et le chat présentées lors du 9e congrès de l'AAVD sont inclus. Les cas cliniques sont comparés aux cas expérimentaux et aux aspects histopathologiques décrits chez 1'homme. Des lésions avec un infiltrat riche en éosinophiles ont été retrouvées dans trois cas; une discussion sur la possibilité d'existence d'IgE à la surface des cellules de Langerhans entrainant à la fois une réponse de type I et de type IV chez ces patients est développée. [Walder, E. J., Conroy, J. D. Contact dermatitis in dogs and cats: pathogenesis, histopathology, experimental induction and case reports (Dermite de contact chez le chien et le chat: pathogénie, histopathologie, induction expérimentale et cas cliniques). Resumen— Se revisa la fisiopatología e histopatología de la dermatitis por contacto alérgica y por irritación en la especie humana y en los animales. Se discute el papel de los linfocitos, las células de Langerhans, los basófilos y los eosinófilos. Se presentan datos sobre la dermatitis por contacto alérgica y por irritación en el perro no descritos hasta la fecha. Se incluyen los resumenes de los casos clinicos presentados en las das jornadas de la Academia Americana de Dermatología Veterinaria. Se comparan los casos clinicos con los hallazgos expérimentales en el perro y con las caracteristícas histopatológicas recientemente descritas en la especie humana. En tres casos se descubrieron vesiculo-pústulas con abundantes eosinófilos; se especula con la posibilidad de que células de Langerhens cargadas con IgE induzcan reacciones mixtas de hipersensibilidad de tipo I y IV (“atopia por contacto”). [Walder, E. J., Conroy, J. D. Contact dermatitis in dogs and cats: pathogenesis, histopathology, experimental induction and case reports (Dermatitis por contacto en el perro y en el gato: patogénesis, histopatología, reproducción experimental y casos clínicos). Zusammenfassung— Es erfolgt eine übersicht über Pathophysiologie und Histopothologie der irritativen und allergischen Kontakdermatitis das Mensch und Tier. Es werden die Rollen der Lymphozyton, Langerhans Zellen, basne und eosinophilen Granulozyten diskutiert. Es werden unveröffentlichte Daten über experimentelle irritative und allergische Kontaktdermatitis bei Hunden vorgestellt. Die Zusammenfassungen von Fallstudien spontaner Kontaktdermatitis bei Hund und Katze, veröffentlicht beim 9. Jahrestreffen der American Academy of Veterinary Dermatology werden miteingeschlossen. Die Fallstudien werden mit den experimentellen Ergebnissen beim Hund und mit den klassischen und kürzlich beschriebenen histopatholo-gischen Bildern beim Menschen verglichen. In drei Fällen wurden vesikulopustulöse Veränderungen, reich an ensinophilen Granulozyten, festgestellt; es werden Mutmaßungen über die Möglichkeit von IgE-tregenden Langerhans-Zellen angstellt, die überlappende Typ I- und Typ IV-Reaktionen (“Kontaktatopie”) bei diesen Patienten induzieren. [Contact dermatitis in dogs and cats: pathognesis, histopathology, experimental induction, and case reports (Kontaktdermatitis bei Hund und Katze: Pathogenese, Histopathologie, experimentelle Induktion und Fallstudien). Abstract— The pathophysiology and histopathology of irritant and allergic contact dermatitis in man and animals are reviewed. The roles of lymphocytes, Langerhans cells, basophils and eosinophils are discussed. Previously unreported data on experimental irritant and allergic contact dermatitis in dogs are presented. The abstracts of case reports of spontaneous contact dermatitis in dogs and cats presented at the Ninth Annual American Academy of Veterinary Dermatology Meeting are included. The case reports are compared to the experimental findings in dogs and to classical and recently-described histopathologic features in humans. Eosinophil-rich, vesiculopustular lesions were found in three cases; speculation is made regarding the possibility of lgE-bearing Langerhans cells inducing overlap Type I and Type IV hypersensitivity reactions (“contact atopy”) in these patients.     

Putative Diethylcarbamazine-induced Urticaria with Eosinophilic Dermatitis in a Dog

Résumé— Une urtricaire due à la diethylcarbamazine associée à une dermite prurigineuse a été suspectée chez un chien mâle castré croisé Retriever. L'animal présentait des lésions d'urticaire multiples qui avaient tendance à fusionner au niveau des paupières, des lèvres, les conques auriculaires et du prépuce. Les biopsies cutanées ont révélé un infiltrat périvasculaire et périannexiel intense riche en polynucléaires éosinophiles. Parfois les polynuclaires éosinophiles étaient “dégranulés” ou présentaient des formes “en flamme”. La suppression de l'administration de diethylcarbamazine a été suivie d'une disparission rapide de toutes les lésions cutanées. L'hypothèse d'une réaction immune à la diethylcarbamazine est proposée. [Vitale, C. B., Ihrke, P. J., Gross, T. L. Putative diethylcarbamazine-induced uticaria with eosinophilic dermatitis in a dog. (Probable urticaire et dermite éosinophilique induites par la diethylcarbamazine chez un chien). Resumen— Se describe el caso de un perro macho castrado, cruzado de retriever que presentaba una dermatitis pruritica con urticaria supuestamente inducida por dietilcarbamacina. El perro mostraba multiples habones, principalmente alrededor de los ojos, la boca, los pabellones auriculares y el prepucio. El estudio histológico mostró un infiltrado perivascular y perianexal, con predominancia de eosinófilos. Ocasionalmente los eosinófilos degranulaban formando “figuras en llama”. La retirada de la terapia con dietilcarbamacina fue seguida por una mejoria rápida y espectacular de todas las lesiones cutáneas. Se postula una reacción adversa a la dietilcarbamacina mediada por factores inmunológicos. [Vitale, C. B., Ihrke, P. J. and Gross, T. L. Putative diethylcarbamazine-induced urticaria with eosinophilic dermatitis in a dog (Urticaria con dermatitis eosinofilica supuestamente inducida por dietilcarbamacina en un perro). Zusammenfassung— Es wird über eine vermutlich Diethylcarbamazin-verursachte Urtikaria mit Juckreiz bei einem männlich-kastrierten Retrievermischling berichtet. Der Hund wies generalisiert multifokale Striemen auf, die dazu tendierten um Augen, Mund, Ohrmuscheln und Präputium zusammenzulaufen. Die Hautbiopsie zeigte ein starkes perivaskuläres und periadenxales Infiltrat mit vorwiegend eosinophilen Granulozyten. Gelegentlich degranulierten die Eosinophilen zu “Flammenform”. Das Absetzen von Diethylcarbamazin führte zu einer dramatischen und raschen Abheilung aller Hautveranderungen. Es wird eine immunologischvermittelte Arzneimittelreaktion auf Diethylcarbamazin vermutet. [Putative diethylcarbamazine-induced utricaria with eosinophilic dermatitis in dogs (Vermutlich Diethylcarbamazin-verursachte Urtikaria mit eosinophiler Dermatitis beim Hund). Abstract— A suspected diethylcarbamazine-induced urticarial dermatitis with associated pruritus is reported in a castrated male mixed breed retriever. The dog had generalized multifocal wheals that tended to cluster around the eyes, mouth, pinnae, and prepuce. Skin biopsy revealed an intense perivascular and periadnexal infiltrate with eosinophils predominating. On occasion, eosinophils degranulated to form “flame figures”. Withdrawal of diethylcarbamazine resulted in dramatic and rapid resolution of all skin lesions. An immunologically mediated adverse drug reaction to diethylcarbamazine is proposed.     

The Polymorphonuclear and Mast Cell Responses in Ovine Skin Infected with Orf Virus

Abstract— Histological examination and quantification of some of the cell types during the first 120h of orf virus infection of scarified skin indicated that the main polymorphonuclear cell involved during early viral replication is the neutrophil, although the accumulation of this cell type also occurred in response to the initial trauma. Orf virus infection had no appreciable influence on the relatively low eosinophil population in the dermis but induced a basophil response which followed the appearance of viral antigen in the epidermis and was greatest at the periphery of the lesion. The number of cutaneous mast cells was not significantly affected by scarification and infection. Résumé— L'examen histologique et la numération de certains types de cellules pendant les 120 heures suivant la scarification de la peau avec du virus de l'ecthyma contagieux, ont montré que le polynucléaire le plus impliqué pendant le début de la réplication virale était le polynucléaire neutrophile, prenant en compte que l'accumulation de ce type de cellule intervient aussi en réponse au traumatisme initial. L'infection par le virus de l'ecthyma contagieux n'a pas eu d'influence appréciable sur la population relativement faible des éosinophiles dans le derme mais, a induit, à la suite de l'apparition de l'antigène viral dans l'épiderme, une résponse des basophiles, surtout observée à la périphérie de la lésion. Le nombre des mastocytes cutanés n'a pas été sensiblement modifié par la scarification ni par l'infection. Zusammenfassung— Durch histologische Untersuchung und Quantifizierung verschiedener Zelltypen während der ersten 120 Stunden einer ORF-Infektion von skarifizierter Haut konnte der neutrophile Granulozyt als hauptsächliche polymorphkernige Zelle der frühen viralen Replikationsphase bestimmt werden. Allerdings kommt es auch zu einer Vermehrung dieser Zellen als Reaktion auf das initiale Trauma. Die ORF-Virusinfektion hatte keinen bemerkens-werten Einfluß auf die relativ geringe Eosinophilenpopulation in der Dermis, induzierte jedoch eine basophile Reaktion nach dem Erscheinen des virus-Antigens in der Epidermis vor allem im peripheren Bereich der Läsion. Die Zahl der Hautmastzellen änderte sich durch die Skarifizierung und Infektion nicht statistisch signifikant. Resumen El examen histológico y la cuantificación de las células presentes en la piel durante las 120 h. siguientes a la infectión por virus del ectima contagiosos en pieles escarificadas indicó que la principal célula polimorfonuclear que participa en la replicatión viral temprana es el neutrófilo, aunque el acúmulo de este tipo celular también se presenta como respuesta al trauma inicial. La infectión con el virus del ectima no tuvo una influencia apreciable sobre la población relativamente baja de eosinófilos de la dermis, pero indujo una respuesta de basófilos a continuación de la aparición de la presencia de antígeno viral en la epidermis y que fue de mayor intensidad en la periferia de la lesión. El número de mastocitos no se vió influenciado significativamente por la escarificación e infectión.     

Effect of Toll-like receptor 4 signal transduction on airway inflammation in infant asthmatic rat

AIM: To study the change and regulatory mechanism of Toll-like receptor 4 (TLR4) on eosinophil (EOS) apoptosis. METHODS: Twenty-seven SD rats were randomly divided into control group (A), asthma group (B) and dexamethasone group (D). Asthmatic model rats were sensitized and repeatedly exposed to aerosolized ovalbumin. Pulmonary tissues were observed under light microscope (LM). The inflammatory cells in BALF were counted. The levels of IL-10 in serum were measured by ELISA. Expressions of TLR4 mRNA were tested by hybridization. The apoptotic EOS was detected by TUNEL.RESULTS: (1) LM showed that inflammatory cells infiltrated around the bronchus, airway mucous plug in group B, obviously lightened in group D. (2) Inflammatory cells count in BALF: the total cellular score, EOS absolute count and EOS% in group B were significantly increased (P<0.01). Compared to group B, a significant decrease in group D was observed (P<0.01). (3) The level of IL-10 in group B was significantly higher than that in group A and in group D (P<0.01). (4) No significant difference (P>0.05) of TLR4 mRNA expression was observed between group A and group B. However, that in group D were significantly increased (P< 0.01). (5) Percentages of apoptotic EOS in group B were significantly lower than those in group A (P<0.01), those in group D were significantly increased (P<0.01). A significant correlation between TLR4 mRNA and apoptotic EOS (r=0.612, P<0.01) was observed. CONCLUSION: Dexamethasone can increase IL-10 secretion, induce EOS apoptosis, which may correlate with TLR4 signal transduction.     

Environmental Exposures and Airway Inflammation in Young Thoroughbred Horses

Background

Inflammatory airway disease (IAD) in horses is a widespread, performance‐limiting syndrome believed to develop in response to inhaled irritants in the barn environment.

Objectives

To evaluate changes in bronchoalveolar lavage fluid (BALF) cytology and exposure to particulates, endotoxin, and ammonia during horses'' first month in training.

Animals

Forty‐nine client‐owned 12‐ to 36‐month‐old Thoroughbred horses entering race training.

Methods

In this prospective cohort study, a convenience sample of horses was assigned to be fed hay from a net (n = 16), whereas the remaining horses were fed hay from the ground (n = 33). BALF was collected at enrollment and after 14 and 28 days in training. Respirable particulate, inhalable particulate, respirable endotoxin, and ammonia concentrations were measured at the breathing zone of each horse weekly.

Results

Median respirable particulates were significantly higher when horses were fed from hay nets than when fed hay from the ground (hay net 0.28 mg/m³, no hay net 0.055 mg/m³, P < .001). Likewise, inhalable particulate (hay net 8.3 mg/m³, no hay net 3.3 mg/m³, P = .0064) and respirable endotoxin (hay net 173.4 EU/m³, no hay net 59.2 EU/m³, P = .018) exposures were significantly higher when horses were fed from hay nets. Feeding hay from a net resulted in significantly higher BALF eosinophil proportions over time (P < .001). BALF eosinophils were significantly related to respirable particulate exposure (14 days in training r _s = 0.37, P = .012, 28 days in training, r _s = 0.38, P = .017).

Conclusions and Clinical Importance

Pulmonary eosinophilic inflammation develops in response to respirable particulate exposure in young Thoroughbreds, indicating a potential hypersensitivity to inhaled particulate allergens.     

Immune dysregulation in flea allergy dermatitis--a model for the immunopathogenesis of allergic dermatitis

BACKGROUND: Flea allergy dermatitis (FAD) is a common skin disease in dogs and can be induced experimentally. It often coexists with other allergic conditions. So far no studies have investigated the quantitative production of cytokine mRNA in skin biopsies and peripheral blood mononuclear cells (PBMC) in flea allergic dogs. OBJECTIVE: The aim of our study was to improve the understanding of the immunopathogenesis of allergic dermatitis as a response to fleabites. MATERIAL AND METHODS: Allergic and non-allergic dogs were exposed to fleas. Before and after 4 days of flea exposure mRNA was isolated from biopsies and PBMC. Production of chymase, tryptase, IL-4, IL-5, IL-13, TNF-alpha and IFN-gamma mRNA was measured by real-time RT-PCR. The inflammatory infiltrate in the skin was scored semi-quantitatively. The number of eosinophils, mast cells (MC) and IgE+ cells/mm2 was evaluated to complete the picture. RESULTS: FAD was associated with a higher number of MC before flea exposure and with a significant increase of eosinophils after flea exposure as compared to non-allergic dogs. The number of IgE+ cells was higher in allergic dogs before and after flea exposure. In allergic dogs mRNA for most cytokines and proteases tested was higher before flea exposure than after flea exposure. After exposure to fleas an increased mRNA production was only observed in non-allergic dogs. In vitro stimulation with flea antigen resulted in a decreased expression of most cytokines in allergic dogs before flea exposure. In contrast, in PBMC, only increased levels of IL-4 and IL-5 mRNA were observed in allergic dogs before flea exposure. However, after flea exposure and additional stimulation with flea antigen the production of mRNA for all cytokines tested was significantly increased in allergic dogs. CONCLUSION: We demonstrated that the response in biopsies and PBMC is different and that FAD is associated with a TH2 response.     

Effects of eosinophils deletion on sPLA2-X in bronchial asthma model mice

AIM To investigate the association between soluble phospholipase A2-X（sPLA2-X） and eosinophils in bronchial asthma, and to provide new insight and strategies for the treatment of bronchial asthma. METHODS Female Babl/c mice （n=48） of SPF grade and 6~8 weeks old were divided into 4 groups （with 12 in each group： healthy control group,asthma control group, eosinophil deletion group, and asthma /eosinophil deletion isotype control group）. The mouse model of bronchial asthma was constructed. The mice in healthy control group were intraperitoneally injected with saline on days 0, 7, and 14. The mice in other groups were intraperitoneally injected with 50 μg OVA and 2 mg aluminum hydroxide gel（soluble in 200 μL saline.On the 21st d and 26 th d, eosinophil deletion antibody （anti-CCR3） and isotype control were intraperitoneally injected and intranasally respectively, and then the lungs function test was conducted within 48 h after the end of nebulization.Half of the mice in each group were subjected to whole lung lavage, the remaining half were used for lung tissue section with HE staining, the whole blood was used to measure serum IgE, the supernatant of broncho alveolar lavage fluid （BALF） was used to measure cytokines, and total number of cells in the bronchoalveolar lavage fluid was analyzed for cell classification and flow cytometry. RESULTS （1）Compared with asthma control group,the airway and alveolar inflammatory responses in asthma/eosinophil deletion group was significantly alleviated.（2） Compared with asthma control group, anti-CCR3 successfully deleted eosinophils, and the percentage of eosinophils in bronchoalveolar lavage fluid in asthma/eosinophil deletion group was significantly reduced （P<0.05）.（3） The airway hyperresponsiveness in asthma/eosinophil deletion group was significantly decreased as compared with asthma control group（P<0.05）.（4） The levels of sPLA2-X in the serum and BALF was significantly reduced in asthma/eosinophil deletion group as compared with asthma control group（P<0.05）.（5）Compared with asthma control group,the levels of IL-4, IL-5, and IL-13 in the BALF of the mice in asthma/eosinophil deletion group were significantly reduced, and the serum level of IgE was also decreased （P<0.05）. CONCLUSION Eosinophils in bronchial asthma are importantly associated with sPLA2-X.