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Antibacterial antibody responses associated with the development of asthma in house dust mite-sensitised and non-sensitised children

Infants who develop house dust mite (HDM) allergy and HDM-sensitised children with severe persistent asthma have low antibody responses to the P6 antigen of Haemophilus influenzae.

 Objective

To measure the development of antibody to two ubiquitous bacteria of the respiratory mucosa in a prospective birth cohort at high risk of allergic disease and to assess which responses are associated with asthma and atopy.

 Methods

IgG1 and IgG4 antibody to H influenzae (P4 and P6) and Streptoccocus pneumoniae (PspA and PspC) surface antigens was measured in yearly blood samples of children aged 1–5 years. IgE to the P6 antigen was examined for the 5-year group. The children were stratified based on HDM sensitisation and asthma at 5 years of age.

 Results

HDM-sensitised children had lower IgG1 antibody titres to the bacterial antigens, and early responses (<3 years and before the development of HDM sensitisation and asthma) corrected for multiple antigens were significantly reduced for P4, P6 and PspC (p=0.008, p=0.004 and p=0.028, respectively). Similar associations with asthma were also found (p=0.008, p=0.004 and p=0.032 for P4, P6 and PspC, respectively). The IgG4 antibody titre and prevalence were similar in both HDM-sensitised and non-sensitised groups, but sensitised children had a slower downregulation of the IgG4 response. Children with asthma (27/145 at 5 years) had lower anti-P6 IgE responses (p<0.05).

 Conclusions

HDM-sensitised children have early defective antibody responses to bacteria that are associated with asthma. Surprisingly, antibacterial IgE was associated with a reduced risk for asthma.

Internet-based course on pulmonary pathophysiology.

A course of seven video lectures on pulmonary pathophysiology has been placed on the internet. This is a companion to the course on respiratory physiology available at http://meded.ucsd.edu/ifp/jwest/. That course dealt with normal respiratory physiology, and the new lectures are about the function of the diseased lung. The topics covered include pulmonary function tests, chronic obstructive pulmonary disease, asthma and localized airway obstruction, restrictive lung diseases, pulmonary vascular diseases, environmental or industrial lung diseases (with a short section on neoplastic and infectious diseases), and respiratory failure. Although it could be argued that PhD physiologists do not have a responsibility for teaching pathophysiology, collaborative teaching has become increasingly common in medical schools where, for example, a pulmonary block includes both normal respiratory physiology and some pulmonary pathophysiology.
It is hoped that these lectures will be useful to physiologists in that setting.

Stem Cells and Regenerative Medicine in Lung Biology and Diseases.

A number of novel approaches for repair and regeneration of injured lung have developed over the past several years. These include a better understanding of endogenous stem and progenitor cells in the lung that can function in reparative capacity as well as extensive exploration of the potential efficacy of administering exogenous stem or progenitor cells to function in lung repair. Recent advances in ex vivo lung engineering have also been increasingly applied to the lung. The current status of these approaches as well as initial clinical trials of cell therapies for lung diseases are reviewed below.

Breastfeeding and Lung Function at School-Age: Does Maternal Asthma Modify the Effect?

Conclusions: In this cohort, breastfeeding for over 4 months was associated with increased FEF(50) and, in children of asthmatic mothers, with increased FEV(1) and FVC. It seems that the effect is not mediated via avoidance of early infections or atopy, but rather through a direct effect on lung growth.

NHLBI Workshop: Improving Outcomes for Pulmonary Vascular Disease.

This report provides a summary of the objectives and recommendations to the NHLBI concentrating on clinical research efforts which are needed to better diagnose and treat PVD.

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