By using a sandwich ELISA, soluble human IL-6 receptor (sIL-6 R) levels were measured in the sera of 20 healthy children and of 25 patients with systemic juvenile rheumatoid arthritis (JRA). In patients with systemic JRA, serum sIL-6 R levels (114.6±37.7 ng/ml) were significantly lower (P < 0.01) than those of healthy children (161.2±45.5 ng/ml). Serum sIL-6 R levels were negatively correlated (r = -0.610, P < 0.001) with serum IL-6 levels measured with the B9 cells. The serum IL-6/sIL-6 R complex was detected using an ELISA based on a monoclonal antibody to IL-6 for capture and on a monoclonal antibody to human sIL-6 R for detection. Healthy controls had little, if any, detectable serum IL-6/sIL-6 R complex (OD 0.024±0.027), while the majority of patients with systemic JRA presented measurable serum IL-6 /sIL-6 R complex (OD 0.492±0.546). IL-6 levels estimated in the circulating IL-6/sIL-6 R complexes were in the range of nanograms per milliliter and 20-fold higher than those measured by the B9 cells. Since serum C-reactive protein concentrations were much more correlated with serum levels of IL-6 / sIL-6 R complexes (r = 0.713, r2 = 0.51, P < 0.0001) than with the serum IL-6 levels measured with the B9 cells (r = 0.435, r2 = 0.19, P = 0.05), the large quantities of serum IL-6 present in

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The present document is a consensus statement reached by a panel of experts on noninvasive methods for assessment of airway inflammation in the investigation of occupational respiratory diseases, such as occupational rhinitis, occupational asthma, and nonasthmatic eosinophilic bronchitis. Both the upper and the lower airway inflammation have been reviewed and appraised reinforcing the concept of 'united airway disease' in the occupational settings. The most widely used noninvasive methods to assess bronchial inflammation are covered: induced sputum, fractional exhaled nitric oxide (FeNO) concentration, and exhaled breath condensate. Nasal inflammation may be assessed by noninvasive approaches such as nasal cytology and nasal lavage, which provide information on different aspects of inflammatory processes (cellular vs mediators). Key messages and suggestions on the use of noninvasive methods for assessment of airway inflammation in the investigation and diagnosis of occupational airway diseases are issued.

We found an imbalance in CXCR3/CCR4 expression on BAL CD4 lymphocytes and reduced CXCL10 BAL levels in patients with IPF, suggesting a pivotal role of these molecules in IPF.

Bronchoalveolar lavage (BAL), induced sputum and exhaled breath markers (exhaled nitric oxide and exhaled breath condensate) can each provide biological insights into the pathogenesis of respiratory disorders. Some of their biomarkers are also employed in the clinical management of patients with various respiratory diseases. In the clinical context, however, defining normal values and cut-off points is crucial. The aim of the present review is to investigate to what extent the issue of defining normal values in healthy adults has been pursued for the biomarkers with clinical value.The current authors reviewed data from literature that specifically addressed the issue of normal values from healthy adults for the four methodologies.Most studies have been performed for BAL (n59), sputum (n53) and nitric oxide (n53). There are no published studies for breath condensate, none of whose markers yet has clinical value. In healthy adult nonsmokers the cut-off points (mean+2SD) for biomarkers with clinical value were as follows. BAL: 16.7% lymphocytes, 2.3% neutrophils and 1.9% eosinophils; sputum: 7.7610 6 ?mL -1 total cell count and 2.2% eosinophils; nitric oxide: 20.2 ppb. The methodologies differ concerning the quantity and characteristics of available reference data. Studies focusing on obtaining reference values from healthy individuals are still required, more evidently for the new, noninvasive methodologies.

Stunted growth is a common complication of childhood diseases characterized by chronic inflammation or infections.We previously demonstrated that NSE/hIL-6 transgenic mice, overexpressing the inflammatory cytokine IL-6 since early phase of life, showed a marked growth defect associated with decreased IGF-I levels, suggesting that IL-6 is one of the factors involved in stunted growth complicating chronic inflammation in childhood. Here we show that NSE/hIL-6 mice have normal liver IGF-I production, decreased levels of IGF bind-

We read with interest the study reported by COLLIN et al. [1], who carried out a survey on organisation and priorities of national tuberculosis (TB) programmes in Europe. With an estimated annual incidence of 10 million cases, TB is considered one of the three global infectious disease priorities, together with HIV/AIDS and malaria. However, TB incidence has significantly declined in the general European population during the past two decades, with a relative increase in vulnerable groups [2, 3]. Traditional TB control is focused on the rapid diagnosis and effective treatment of infectious cases, in order to break the transmission chain, and to cure individual patients. As TB mainly affects low income countries, little research has been conducted to determine whether medical interventions should be considered complete when a patient is "successfully treated" [4], or if potential sequelae should be investigated and pulmonary rehabilitation (PR) performed. Although mainly focused on chronic obstructive pulmonary disease (COPD), the American Thoracic Society (ATS)/European Respiratory Society (ERS) rehabilitation guidelines discuss the potential usefulness of PR in other respiratory diseases. TB is not mentioned, although recent evidence shows that obstructive and/or restrictive functional sequelae could occur, potentially affecting quality of life (QoL) [5, 6]. To date, no guidance on indications and procedures for TB sequelae is available [5]. We retrospectively investigated if patients with sequelae detected after anti-TB treatment had any benefits from PR in a low TB incidence setting. Patients with a history of pulmonary TB and successful treatment, admitted between 2004 and 2017 in the PR reference centre of Tradate, Italy, were selected for the study. The institutional ethical committee approved the study (2215 CE, June 19, 2018). Only patients with clinical stability and able to perform >80% of the training sessions with a physiotherapist, as well as 6-min walking test (6MWT) before and after PR, were selected. The following information was collected: 1) Clinical data (i.e. anthropometric data, medical history, comorbidities and concomitant medications); 2) Lung function tests based on ATS guidelines at admission and pre-discharge [7], using a body plethysmograph (Masterlab Body; Jaeger, Würzburg, Germany) and ERS predicted values [8]; 3) Diffusing capacity of the lung for carbon monoxide according to the ATS/ERS guidelines [9] (MasterScreen PFT System; Jaeger, VIASYS Healthcare, Hoechberg, Germany); 4) Arterial blood gases from radial artery (ABL 820 Radiometer Medical, Brønshøj, Denmark) in patients breathing room air in the sitting position for at least 20 min; 5) Overnight oximetry monitoring (Nonin Handheld 8500; Nonin, Tilburg, the Netherlands); 6) 6MWT; 7) Symptoms (Borg dyspnoea and fatigue scores before and after the 6MWT). Patients underwent a comprehensive 3-week PR programme including: specialist nurse training (inhalation techniques and/or oxygen-therapy when prescribed); 18 aerobic-training ses...

Our results indicate that OA because of ammonium persulphate coexists with occupational rhinitis in half of the patients. Unexpectedly, rhinitis did not seem to have an impact on the natural history of asthma. The finding of nasal inflammation in subjects with OA-only without clinical manifestations of rhinitis supports the united airway disease concept in occupational respiratory allergy as a result of persulphates.