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					Thematic Poster Session                                                                                                                      Hall C-17 - 12:50-14:40

                                                                    Monday, September 17th 2007

                                                                                       investigate whether gamma delta T cell counts are changed in patients with chronic
                                                                                       airway inflammation – COPD and asthma.
                                                                                       For this purpose, we have studied patients with COPD (n = 16) and asthma (n = 15),
        232. COPD, sarcoidosis, idiopathic                                             steroid-naive or without steroids for at least 1 month before the study, and
        pulmonary fibrosis, cystic fibrosis,                                             healthy subjects (n = 8). Gamma delta T cells were investigated in peripheral
                                                                                       blood (PB), bronchoalveolar lavage (BAL) and induced sputum (IS) by flow
       gastro-oesophageal reflux and cough                                              cytometry (FACSCanto, Becton Dickinson), using direct immunofluorescence with
                                                                                       monoclonal antibodies antiCD3-FITC, antiTCR-gd-PE and antiCD45-PerCP.
          variant asthma - pathogenesis                                                Results: IS gamma delta T cells were decreased in COPD patients compared to
                                                                                       asthmatics and healthy subjects (0.5±0.2 vs 1.63±1.0 and 2.2±0.8%, respectively,
             and differential diagnosis                                                p = 0.02) and in BAL (1.1±0.2 vs 5.4±1.3 and 3.8±1.4%, respectively, p < 0.001).
                                                                                       However, we did not obtain significant difference of PB gamma delta T cell counts
                                                                                       in all studied groups (3.74±1.4, 3.7±0.6, 3.8±1.0%, respectively). There was a
P2222                                                                                  significant correlation between IS and BAL gamma delta T cell counts (Rs=0.54,
Accumulation of dendritic cells in small airways of patients with chronic              p < 0.05).
obstructive pulmonary disease                                                          Conclusion: Finding of gamma delta T cells reduction in induced sputum and
G.R. Van Pottelberge1 , I.K. Demedts1 , G.F. Joos1 , G.G. Brusselle1 . 1 Department    BAL from COPD patients suggests that these cells may play a role in pathogenesis
of Respiratory Diseases, Ghent University Hospital, Ghent, Belgium                     of COPD; but it is not clear whether their reduction is a causal factor or
                                                                                       consequence of disease.
Introduction: Increased number of CD8 positive T cells and the presence of
lymphoid follicles in the lungs of patients with Chronic Obstructive Pulmonary
Disease (COPD) suggest that dendritic cells (DC) are involved in the pathogenesis
of COPD.                                                                               P2225
Objective: The aim of this study was to examine the number and distribution of         Inhalative vaccination with pneumococcal polysaccharide in patients with
DC in small airways of COPD patients using two markers: langerin and CD1a.             chronic obstructive pulmonary disease
Methods: Immunohistochemical staining for langerin and CD1a in small airways           P. Meyer1 , M. Menzel1 , B. Muellinger2 , N. Weber1 , K. H¨ ussinger1 , L. Ziegler-
(diameter < 2 millimeter) was performed on surgical resection specimens from           Heitbrock1 . 1 Clinical Cooperation Group “Inflammatory Lung Diseases”,
COPD patients GOLD stage I (n = 8), II (n = 12), III(n= 5), smokers without COPD       GSF-National Research Center for Environment and Health, Institute of
(n= 6) and never smokers (n = 9).                                                      Inhalation Biology and Asklepios Specialist Hospitals, Munich, Gauting,
Results: The mean number of langerin positive cells (+/−SEM) in epithelium was         Germany; 2 Research, INAMED GmbH, Munich, Gauting, Germany
significantly higher in COPD patients (20.6±3.6 x 10-3 /mm basement membrane)
compared to never smokers (8.1±2.5 x 10-3 /mm basement membrane) and                   In order to determine the feasibility of inhalative vaccination with polysaccharide
smokers without COPD (10.7±0.9 x10-3 /mm basement membrane) (p = 0.002                 antigen in patients with chronic obstructive pulmonary disease (COPD), we used
and p = 0.028, respectively). Number of langerin positive cells did not differ         controlled inhalation of a defined dose of Pneumovax® in a randomized 3-arm
between groups in the lamina propria. There was a significant higher number             study. The vaccine was either deposited in the alveoli (alveolar vaccination) or
of langerin positive cells in the adventitia of COPD patients (316.4±127.9 x           in the large airways (bronchial vaccination) and these were compared to standard
10−6 /mm2 ) compared to never smokers (62.9±33.3 x 10−6 /mm2 ) (p = 0.015). There      intra-muscular vaccination. Adverse effects were minor and never exceeded WHO
was no significant difference in CD1a positive cells in epithelium, lamina propria      grade 2. There was frequent cough, headache and shivering in the bronchial
and adventitia between the different patient groups.                                   vaccination group, frequent fatigue only in the alveolar vaccination group and no
Conclusion: A significant accumulation of langerin positive DC in small airways         frequent adverse effects in the intra-muscular vaccination group. Specific serum
of COPD patients was observed, suggesting a possible role for these cells in the       IgG antibody was measured before and at 4 and 12 weeks after vaccination.
pathogenesis of COPD.                                                                  At 12 weeks there was a greater than 2 fold rise in 7 out of 10 individuals in
                                                                                       every vaccination group. Mean antibody levels of responders at 12 weeks were
P2223                                                                                  278 mg/l for alveolar vaccination, 238 mg/l for bronchial vaccination and 737
Chemokine-receptor expression on allergen-specific T cells in allergic                  mg/l for standard intra-muscular vaccination. The data show that polysaccharide
asthma and allergic bronchopulmonary aspergillosis                                     vaccine can be safely administered by controlled inhalation in COPD patients and
G. Garcia1,2 , M. Humbert1,2 , F. Capel2 , D. Emilie2 , G. Veronique2 . 1 Service de   that it can induce a rapid serum antibody response.
                  e                                             e e
Pneumologie et R´ animation Respiratoire, Hopital Antoine B´ cl` re, Clamart,
France; 2 INSERM U764, IFR13, Clamart, France

Background: Allergic Bronchopulmonary Aspergillosis (ABPA) is a rare variant           P2226
of severe asthma resulting from hypersensitivity to Aspergillus Fumigatus (Asp f)      Can plasma arginase levels differantiate asthma and COPD?
present in the airways.                                                                Z. Bingol, T. Cagatay, L. Pur, B. Kiran, Z. Gulbaran, P. Cagatay, F. Erkan.
Aims of the study: We analyzed the expression of a panel of 6 chemokine                Pulmonary Department, Istanbul Medical Faculty, Istanbul, Turkey; Pulmonary
receptors (CCR3, CCR4, CCR8, CCR5, CXCR3 and CXCR4) on total blood                     Department, Istanbul Medical Faculty, Istanbul, Turkey; Pulmonary Department,
CD4+ T cells and Asp f-specific-T cells in ABPA patients. We asked whether the          Istanbul Medical Faculty, Istanbul, Turkey; Microbiology – Immunology
chemokine receptor pattern on T cells differs between ABPA patients, non-ABPA          Department, Istanbul Medical Faculty, Istanbul, Turkey; Pulmonary Department,
allergic asthmatics sensitised to Der p or Phl p and healthy controls.                 Istanbul Medical Faculty, Istanbul, Turkey; Biostatistic Department, Cerrahpasa
Methods: We used the fluorescent dye PKH26, a membrane bound marker,                    Medical Faculty, Istanbul, Turkey; Pulmonary Department, Istanbul Medical
to identify accumulated proliferating (cell-sorted PKH26low ) CD4+ T cells in          Faculty, Istanbul, Turkey
response to allergens (Asp f, Der p, Phl p) or recall antigens (PPD and TT).
Chemokine receptor expression was analyzed by flow cytometry on proliferating           Introduction: Recent studies suggest that a nitric oxide deficiency and elevated
CD3+CD4+ PKH26low cells.                                                               arginase activity induces hyperreactive airways and may play a role in the
Results: Stimulation of CD4+ T cells with the relevant allergen resulted in            pathogenesis of asthma. There are few studies evaluated levels of serum arginase
different patterns of chemokine receptor expression in ABPA and non-ABPA               in asthmatic and chronic obstructive pulmonary disease (COPD) patients.
allergic asthmatics. Upon Asp f exposure, proliferating CD4+ T cells from ABPA         Aim: In this study we aimed to measure serum arginase levels of patients with
patients down regulated the expression of CCR4 and CXCR3 while CCR4 and                asthma and COPD.
CXCR3 were upregulated in allergen-specific T cells from non-ABPA allergic              Methods and Results: Phycisian diagnosed 22 non – atopic, 20 atopic
asthmatics. Considering each group of patients, the pattern of chemokine receptors     asthmatics and 18 stable COPD patients enrolled in this study. The mean age
expressed on proliferating allergen-specific CD4+ T cells was similar to that           of the asthmatics was 47.74±11.4 years, COPD patients was 60.77±9.6 years.
expressed by recall antigen-specific T cells.                                           Fourty one patients (68.3%) were female. Nineteen healthy individuals enrolled
Conclusions: The down regulation of CCR4 and CXCR3 after allergen exposure             as normal control subjects for comparison. The mean age of control subjects
in Asp f-specific T cells seems to be a characteristic feature of ABPA patients         was 36 years, fourteen of whom (77.7%) were female. All asthmatics and COPD
and requires further evaluation.                                                       patients were stable and none of them were on systemic steroids at the enrollment.
                                                                                       All of the asthmatics were receiving inhaler corticosteroids, nearly 74% of them
P2224                                                                                  receiving inhaler long acting beta agonist and 44% of the COPD patients were
Gamma delta T cells in patients with COPD and asthma                                   receiving inhaler corticosteroids. None of them were active smoker. Mean serum
D. Urboniene1 , K. Stravinskaite1,2 , R. Sakalauskas1 , B. Sitkauskiene1,2 .           arginase level for non – atopic asthmatics was 56.58±31.25, atopic asthmatics;
  Department of Pulmonology and Immunology, Kaunas University of Medicine,             39.71±20.76, COPD patients; 54.61±44.23, normal controls; 19.22±14.12 (The
Kaunas, Lithuania; 2 Lab of Pulmonology, Institute for Biomedical Research,            Human Arginase I Liver-Type ELISA KIT was used) Serum arginase level was
Kaunas University of Medicine, Kaunas, Lithuania                                       increased significantly in patients with airway diseases versus normal control
                                                                                       subjects (p < 0.000, p = 0.012, p = 0.001, One-Way ANOVA)
Gamma delta T lymphocytes have been postulated to play an important role in            Discussion: Serum arginase levels did not differ asthma and COPD but signifi-
the regulation of immune responses associated with inflammation. We aimed to            cantly higher than the normal control subjects.

                             Abstract printing supported by Nonin Medical, Inc. Visit Nonin Medical, Inc. at stand B04:31
Thematic Poster Session                                                                                                                      Hall C-17 - 12:50-14:40

                                                                   Monday, September 17th 2007

P2227                                                                                  Conclusion: These findings demonstrate that T reg cells in peripheral blood
Analysis of pathogenic secretory immunity factors in saliva from patients              is significantly elevated in asthma patients comparing with those in COPD,
with chronic obstructive pulmonary disease                                             which shows that the percentage of T reg cells is a supportive parameter for
E. Altynbaeva1 , S.N. Teplova2 , G.L. Ignatova3 , A.R. Altynbaev1 , O.V. Danilova1 .   differentiating these two major lung diseases.
  Preventive Unit, Central Medical Sanitary Department No. 71, Ozyorsk,
Chelyabinsk Region, Russian Federation; 2 Department of Clinical Immunology            P2230
and Allergology, Chelyabinsk State Medical Academy, Chelyabinsk, Russian               Decreased TLR2 gene expression in alveolar macrophages from sarcoidosis
Federation; 3 Department of Therapy, Phthisiopulmology and Occupational                                 o
                                                                                       patients with L¨ fgren’s syndrome
Pathology, Urals State Medical Academy of Further Education, Chelyabinsk,              M. Wik´ n1 , F. Idali1 , J. Grunewald1 , A. Eklund1 , J. Wahlstr¨ m1 . 1 Dept. of
                                                                                               e                                                       o
Russian Federation                                                                     Medicine, Div. of Respiratory Medicine, Karolinska Institutet, Stockholm, Sweden
The study is focused on analysis of secretory immunity factors of antimicrobial
                                                                                       Background: Sarcoidosis is a granulomatous disease of unknown etiology, primar-
and phlogogenic action in saliva from workers of the large radiochemical facility
                                                                                       ily affecting the lungs. However, an infectious cause has been proposed, suggesting
with chronic obstructive disease. Out of 912 individuals (47%) of this contingent,
                                                                                       a role for the pattern-recognition receptors, such as toll-like receptors (TLRs), in
83 individuals were sampled, who worked at the radiochemical facility, smoked
                                                                                       the pathogenic process. Patients with L¨ fgren’s syndrome are characterized by
and had different degrees of COPD. All COPD patients had a long-term smoking
                                                                                       a good prognosis, while non-L¨ fgren’s syndrome patients often develop chronic
history of about 26 years; SI was over 200. Average age of the studied patients
                                                                                       disease with risk of fibrosis. We hypothesized that differences in innate immunity,
was 46.87±1.14 including 46.72±1.31 for males and 47.39±2.34 for females.
                                                                                       such as TLR expression, may be related to the disease course of sarcoidosis.
The control group included 26 healthy individuals of the same age and gender,
                                                                                       Methods: Using real-time PCR, the relative gene expression of TLR2 and
who worked at the same conditions, smokers, without signs of COPD. All patients
                                                                                       TLR4 was quantified in lung macrophages, sorted by flow cytometry, from total
were measured for proteins; mucin; total compliment activity and its components
                                                                                       bronchoalveolar lavage cells of sarcoidosis patients (n = 21) and healthy controls
(C1, C2, C3, C4, C5); amounts of C3a, C5a; levels of sIgA, IgG of the general and
                                                                                       (n = 11). The sarcoidosis group was further divided into patients with L¨ fgren’s
subclasses (G1, G2, G3, G4); lactoferrin; IL-8; and nitrogen oxide. The analysis
                                                                                       syndrome (n = 11) and non-L¨ fgren’s syndrome patients (n = 10).
of patients with COPD revealed significant differences from the control group
                                                                                       Results: The relative gene expression of TLR2 was significantly lower in
by factors in saliva. These differences, first of all, related to mucin, secretory
                                                                                       macrophages from sarcoidosis patients (0.34±0.51) (median±SD) compared to
immunoglobulin (sIgA), antimicrobial immunoglobulin (IgG2), IL-8 and finite
                                                                                       healthy controls (0.99±0.55), p = 0.032. L¨ fgren’s syndrome patients had a signif-
metabolites of nitrogen oxide, which reflected the inflammation persistence and
                                                                                       icantly lower TLR2 expression (0.21±0.39) than healthy controls, p = 0.0058, and
growing immune-dependent pro-inflammatory potential of saliva.
                                                                                       a tendency to lower expression than non-L¨ fgren’s syndrome patients, p = 0.062.
                                                                                       TLR4 gene expression did not differ between groups.
Nitric oxide in COPD patients saliva as marker of oxidative stress                     Conclusion: The lower alveolar macrophage TLR2 expression in patients with
                                                                                       L¨ fgren’s syndrome may be of functional relevance for the immune system
L. Stepanisheva1 , G. Ignatova1 , N. Gasyuk1 , E. Nikolaeva1 , N. Sadrutdinova1 .
1                                                                                      interaction with a postulated “sarcoidosis pathogen”, and could help explain the
  Therapy and Phthysiopulmonology Department, Ural State Medical Academy
                                                                                       distinct clinical presentation of sarcoidosis in these patients.
Postdiploma Education, Chelyabinsk, Russian Federation

The purpose of research: to define final metabolites of nitric oxide in saliva and       P2231
(NO2 , NO3 and NOx ) and whey in blood, to estimate their level, spontaneous and       Atopy can determine sarcoid outcome – an Irish cohort of newly diagnosed
induced with microbes lipopolysacharide, production blood monocytes in vitro           sarcoidosis
                                                                                       K.A. Khan, J. Kieran, V Twormey, A. O’Regan. Respiratory Medicine, Galway
and to reveal interrelation of these parameters. 78 men with I and II stage of
                                                                                       University Hospital, Galway, Ireland; Immunology and Allergy Medicine, Galway
COPD outside of an exacerbation and 30 persons of control group who are not
                                                                                       University Hospital, Galway, Ireland
having COPD are surveyed. Groups were comparable on a sex and age. Levels
of serum derivatives of nitric oxide (NOx , NO3 ) authentically raised at patients
with COPD in comparison with persons of control group are revealed. By means           Background: Lung fibrosis is uncommon in sarcoidosis but causes considerable
of the correlation analysis it is proved, that levels NOx , NO3 in monocyte culture    morbidity. Acute sarcoidosis is characterized by Th1-cytokine expression but
with stimulation and without it at patients with COPD directly correlated with the     several studies have shown Th2-cytokine expression in progressive disease. Atopy
maintenance of final metabolites of nitric oxide in whey of blood: NO2 (r = 0.98,       is characterized by Th2-cytokine expression. There is evidence that 70% of
r = 0.68, p < 0.05), with NOx (r = 0.60, r=0.94), with NO3 (r = 0.61, r=0.95). The     American sarcoid patients are atopic and that the presence of atopy correlates
correlation analysis has revealed also interrelation between immune parameters         with lung fibrosis. Unlike Ireland where less than 10% of patients have chronic
humoral and system immunity at patients with COPD. There is a direct strong            sarcoidosis, in USA almost 50% develop progressive disease.
communication between Ig G, Ig And, Ig M of blood and Ig G, sIg A in saliva            We hypothesized that an Irish cohort of sarcoid patient would have a lower
(r=0.95), between NO2 , NOx wheys and NO2 , NOx in saliva (r=0.96) and same            prevalence of atopy but that those with atopy may progress to chronic disease.
strong communication NO2 , Nox wheys with complement system (r=0.80), an               Methods: IRB approved prospective study of newly diagnosed biopsy proven
alpha-1-antitrypsine of a saliva (r=0.90). Thus, there is an interrelation between     sarcoidosis in Ireland. Patients were evaluated with a disease-specific question-
parameters system and humoral immunity and using immunogramm of saliva for             naire, pulmonary function testing, IgE, skin/RAST allergy testing and Radiological
definition NO at patients with COPD is possible.                                        staging of disease.
                                                                                       Results: 16 patients were enrolled. 10 were male, mean age was 38yrs, stage1
P2229                                                                                  8(50%), stage2 4(35%), stage3 3(19%) and 4 1(16%). Two (13%) had ex-
The role of regulatory T cells in differentiating asthma from COPD                     tra pulmonary involvement (cutaneous plaques. parotid enlargement).PFTs re-
L.P. Ozyigit1 , Z. Bingol1 , T. Cagatay1 , B. Kiran2 , P. Cagatay3 , Z. Gulbaran1 ,    vealed 13(81%) normal and 3(19%) had obstructive physiology with average
F. Erkan1 . 1 Respiratory Medicine, Istanbul University Istanbul Medical Faculty,      FEV1/FVC% 58.33. 3/16(20%) were atopic by skin testing or RAST. There was
Istanbul, Turkey; 2 Microbiology – Immunology Department, Istanbul University          high correlation between Skin and RAST testing. The 3(20%) atopic patients had
Istanbul Medical Faculty, Istanbul, Turkey; 3 Biostatistic Department, Istanbul        no significant characteristics of chronic disease.
University Cerrahpasa Medical Faculty, Istanbul, Turkey                                Conclusion: Atopy affected 20% of sarcoid patients in this study which mirrors
                                                                                       prevalence in the general population. This is in contrast to American cohort and
Background: Recent evidence puts forward the key role of T regulatory (T reg)          may reflect the generally favourable prognosis in Irish patients. Further studies
cells in balancing immune responses at asthma pathophysiology and the defective        are necessary to better define this association.
allergen-specific Treg cell activity in atopic and asthmatic subjects. However their
function remains unclear in patients with chronic obstructive pulmonary disease        P2232
(COPD).                                                                                IL8 as a marker of severity of disease progression in patients with idiopathic
Objective: The present study investigates the role of T reg cells in differentiating   pulmonary fibrosis (IPF)
the two major obstructive lung diseases; asthma and COPD in which the right                                                  .
                                                                                       A. Zacharova, T. Ses, L. Novikova, V Molodtsova. Scientific and Research
differential diagnosis results in better evaluation, and therapy.                      Institute of Pulmonology, Pavlov’s State Medical University, St-Petersburg,
Methods: The peripheral blood samples of 42 mild persistent asthma (25 atopic          Russian Federation
and 17 non-atopic), 19 mild COPD during their routine control and 23 healthy
controls were obtained and analyzed in terms of flow cytometry and then the             Aim: to investigate the activity of IL8 and it’s correlation with IPF severity and
percentage values of all markers were determined.                                      progression.
Results: Comparing the relative percentages of CD(4)(+)CD(25)(+) T reg cells of        The IPF severity and progression were estimated according to clinical data, X-ray
four groups, atopic with nonatopic asthmatic patients and COPD patients with           and spirographic criteria and pulmonary artery systolic pressure level.
control group, the difference was not significant. But there was a significant           Results: IL8 level in blood serum and lavage fluid was 318.0±1.8 ng/ml and
difference between asthmatic patients (even atopic or non-atopic) with COPD            400.8±2.4ng/ml resp. in cases with severe disease progression; 234.9±2.1 ng/ml
and asthmatic patients with control group (p < 0.001/p < 0.01). When the mean          and 292.2±1.7 ng/ml resp. in cases with moderate progression; 74.8±0.6 ng/ml
ages of these two lung diseases are considered, it is seen that COPD patients are      and 73.3±1.1 ng/ml resp. in cases with stabilization of the disease. These data
older. However, when this difference was eliminated by a covariant analysis, we        were significantly higher than those in control group (blood serum – 28.3±0.5
determined that age is a non-significant factor for the mean T reg value.               ng/ml, lavage fluid – 24.8±0.9 ng/ml). The level of IL8 in groups with severe

                            Abstract printing supported by Nonin Medical, Inc. Visit Nonin Medical, Inc. at stand B04:31
Thematic Poster Session                                                                                                                      Hall C-17 - 12:50-14:40

                                                                     Monday, September 17th 2007

and moderate progression of IPF was significantly higher than that in the group,          properties and AMP hyperreactivity. To investigate the accompanying asthma with
which demonstrated stabilization of the disease (p > 0.05).                              these methods in CF and nonCF-BE patients, we assessed AMP hyperreactivity,
Conclusions: there is a correlation between the severity of IPF and the level of         eosinophils, nitrite, Interleukin(IL)-8, IL-13, TNF alpha in sputum. The patient
IL8 in blood serum and lavage fluid. Measurement of IL8 level in IPF patients             group included 31 CF and 28 non-CF BE patients tested for bronchial hyper-
may be used as a marker of disease severity and help to evaluate the probability         activity with AMP and sputum nitrite, IL-8, IL-13, TNF alpha. The mean age
of its progression.                                                                      of patients with CF and non-CF BE were 14.1±4.6 and 12.8±3.4 respectively.
                                                                                         AMP hyperreactivity were identified in nine patients with CF and 2 patients
P2233                                                                                    with non-CF BE. The mean eosinophil percentage was significantly higher in
Unusual cause of dry cough and pleural effusions in a patient with                       the AMP-positive patient group compared with the AMP negative patient group
eosinophilia                                                                             (5.6±10.1 vs 0.5±0.8). Positive correlation was detected between sputum IL-13
M. Hubatsch2 , A. Greil1 , H. Marson1 , G. Jeannin1 , D. Caillaud1 . 1 Service de        and eosinophil percentage (r= 0,40, p = 0.002). In non-CF BE patients, there
Pneumologie, CHU Clermont Ferrand, Clermont Ferrand, France; 2 Pneumologie,              was positive correlation between sputum nitrite levels and eosinophil percentage
Cardiopulmonary Rehabilitation Clinic, Targu Mures, Romania                              (r = 0.47, p = 0.031). These findings suggest that IL-13, nitrite and eosinophils
                                                                                         in sputum and also AMP hyperreactivity can be used as diagnostic marker of
When the blood eosinophil count is persistently greater than 1500/mm3 for a              accompanying asthma in CF and non-CF BE patients.
period of 6 months and damage to major organs such as the heart, lungs, skin,
joints and nervous system (CNS) can be demonstrated in the absence of any clonal         P2236
abnormality or reactive cause, the term idiopathic hypereosinophilic syndrome            Immunopathologic reaction in children with bronchoobstructiv syndrome
(HES) is used.                                                                           associated with gastroesophageal reflux disease
We report the case of a 65 years old male with dry cough, dyspnoea, marked               O. Turcu, S. Sciuca, I. Adam. Pulmonology, University of Medicine, Chisinau,
weight loss, arthritis, fever, abdominal pain and eosinophilia. Chest CT showed          Moldova, Republic of; Pulmonology, University of Medicine, Chisinau, Moldova,
absence of pulmonary infiltrates, but bilateral pleural effusions and an ascites,         Republic of; Pulmonology, University of Medicine, Chisinau, Moldova, Republic
confirmed by ultrasonography. The BAL was negative for eosinophilia, but                  of
the pleural and abdominal effusions were rich in eosinophil 28% and 54%
respectively. The TEE revealed silent heart infarcts and systolic dysfunction.           Aim: To study the immunopathologic and reaginic reaction in children with
Secondary eosinophilia: parasitosis, aspergillosis, drugs, allergic conditions, con-     bronchoobstructive syndrome associated with gastroesophageal reflux disease
nective tissue disorders, pulmonary eosinophilia, eosinophilic gastroenteristis,         (GERD).
malignancy, endocrinopathies or primary eosinophilia have been ruled out. The            Methods and materials: The explorative Methods:esophagogastroduodenoscopy,
patient was prescribed prednisolone 1mg/kg/day. After 1 week of treatment the            determination of IgE level (immunoenzymatic method with standard test utiliza-
eosinophilia normalized, all clinical symptoms subsided and the pleural and              tion) and CIC (precipitation in poliethilenglicol method). The group of study
abdominal effusions have disappeared as well the renal and hepatic dysfunctions.         included 17 children (9 months-15 years) with cystic fibrosis(7), bronchial
HES is a rare disease, mostly seen in males. Multiple organs are usually affected,       asthma(7), recurrent wheezing(1) and aspiration pneumonia(1). All children pre-
we found the pleural effusions, hepatic and renal dysfunction, ascites, arthritis and    sented associated manifestations of GERD (regurgitations, heartburn and recurrent
cardiac ischemia (approx. in 40% of HES cases), but without CNS involvement.             vomiting) that were put in evidence by a validated questionnaire and specifically
As the multitude of possible differential diagnosis of pulmonary eosinophilia            clinical signs. Esophagitis of I degree with endoschopic manifestation of edema
in patients with persistent eosinophilia accompanied by organ damage or organ            and erythema in the lower third of the esophagus was present in 9 children
dysfunction the diagnosis of HES is one of exclusion.                                    with positive inflammatory modification; in one case the esophageal damage was
                                                                                         more severe with development of isolated erosions (esophagitis of II degree).
P2234                                                                                    The absence of visible changes of esophageal mucosa was revealed in 5 children
Churg-Strauss syndrome. Clinical study and follow-up of 10 patients                      (cystic fibrosis – 3, asthma – 2 children).
F.S. Oymak1 , N. Tutar1 , H. Buyukoglan1 , A. Ferahbas2 , E. Koseoglu3 , O. Canoz4 ,     Results: The blood examine presented a significant increased IgE values (p < 0.05)
M. Gulec5 , R. Demir1 , I. Gulmez1 . 1 Chest Diseases, Erciyes University Medical        294.53±58.85UI/ml in these children (age standards 56.8±4.83UI/ml) and the
Faculty, Kayseri, Turkey; 2 Dermatology, Erciyes University Medical Faculty,             CIC level (p < 0.05) 126.2±11.15Un (age standards 65.17±5.04Un). There was
Kayseri, Turkey; 3 Neurology, Erciyes University Medical Faculty, Kayseri,               no any correlation in comparative study of immunopathologic parameters and
Turkey; 4 Pathology, Erciyes University Medical Faculty, Kayseri, Turkey;                endoschopic characteristics of GERD.
5                                                                                        Conclusion: The bronhoobstructiv syndrome associated with GERD is related
  Radiology, Erciyes University Medical Faculty, Kayseri, Turkey
                                                                                         with hyperimmunoglobulinemia E and high CIC level, which causes a chronic
The aim of this study is to describe the clinical and radiological features, treatment   evolution of the diseases.
outcome of the patients with Churg-Strauss syndrome (CSS). We used retrospec-
tive analysis to review the radiographic and clinical findings of CSS. Clinical
                                                                                         Increased levels of IL-31 mRNA is in cough variant asthma
data were obtained from medical records. The study involved ten patients (7 men
                                                                                         K. Wu1 . 1 Department of Respiratory Diseases, Daping Hospital, Third Military
and 3 women) whose ages ranged from 21 to 54 years (median, 32) seen over 6
                                                                                         Medical University, Chongqing, China
years (2000–2006) in a University Hospital serving a population of 1.000.000. The
diagnosis of CSS is based on the classification criteria of the American Collage of
                                                                                         Background: IL-31 is a newly defined Th2 cytokine, and has been shown play
Rheumatology. Histologic samples were available in 6 patients. All patients had a
                                                                                         roles in atopic disease, such as dermatitis. Asthma is mediated by Th2 cells, but
history of asthma averaging 58 months (range, 4 months to 23 years) prior to the
                                                                                         the role of IL-31 in asthma have been poorly studied.
initial symptom of vasculitis and marked peripheral blood eosinophilia (mean peak
                                                                                         Objective: To study the relationship between IL-31 mRNA levels in sputum and
count, 7,980/mL; range, 1,500 to 18,000/mL; mean differential count, 41%; range,
                                                                                         lung function in CVA.
19 to 67%). Systemic vasculitis involving extrapulmonary organs occurred in all
patients, with specific organ involvement of peripheral nervous system (PNS) (8),
lungs (8), skin (5), joints (4), muscles (2), heart (2), bowel (2) and bone marrow
(1). Antineutrophil cytoplasmic antibodies with antimyeloperoxidase specificity
(MPO-ANCA) were detected in 3 patients (30%). Pleuropulmonary or cardiac
anomalies have been discovered in 9 cases. In 6 cases, corticosteroids resulted
in a favorable course, but cyclophosphamide was required in 4 patients. The
outcomes after long-term follow-up were generally good. Only one patient had
cardiomyopathy during the follow-up period. CSS is a rare disorder characterized
by hypereosinophilia and asthma. Vasculitis commonly affects the lungs and PNS.
Outcome is usually good with immunosuppressive agents.

Accompanying asthma in cystic fibrosis (CF) and non-CF bronchiectatic
patients: could we detect it with AMP bronchoprovocation and sputum
A.T. Aslan1 , N. Kiper1 , N. Gulcan1 , M. Ozturk2 , O. Keskin3 , D. Dogru1 ,
U. Ozcelik1 , E. Yalcin1 , S. Pekcan1 , N. Cobanoglu1 , O. Kalayci3 , P. Firat4 .
  Pediatric Pulmonology, Hacettepe University, Ankara, Turkey; 2 School of
Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey;
  Pediatric Allergy, Hacettepe University, Ankara, Turkey; 4 Pathology, Hacettepe
University, Ankara, Turkey

The determination of accompanying asthma in Cystic Fibrosis (CF) and non-CF
bronchiectatic (BE) patients still remains a debatable subject. The monitoring of
airway inflammation in bronchial asthma can be assessed by sputum inflammation

                             Abstract printing supported by Nonin Medical, Inc. Visit Nonin Medical, Inc. at stand B04:31
Thematic Poster Session                                                                                               Hall C-17 - 12:50-14:40

                                                                  Monday, September 17th 2007

Methods: CVA patients (n = 9) received ICS treatment. Before and at day 30,
60, 90, 180 of treatment, we obtained airway cells by sputum induction, and the
provocative concertration of methacholine causing a 20% fall in FEV1 (PC20-
FEV1) were tested, and healthy individuals (n =8) as control. IL-31 and IL-4,
IL-10 mRNA expression in lymphocytes of sputum was quantified by real-time
Results: The levels of IL-31 mRNA expression in sputum of CVA are higher
than controls, treatment with ICS, the decreased IL-31 and IL-3 expression
and increased IL-10 expression and PC20-FEV1. Levels of IL-31 significantly
correlated with IL-4 expression, negatively correlated with IL-10 expression and
Conclusion: As a Th2 cytokine, IL-31 may contribute the pathogenesis of asthma,
but the precise mechanisms is still to be defined.

Maximal airway response in patients with asthma and cough variant asthma
Y. Havlucu1 . 1 Chest Disease, Dortyol State Hospital, Hatay, Turkey

Bronchial hyperreactivity in asthma is characterized by an increase in sensitivity
and in maximal airway response to bronchoconstriction stimuli.
The aim of study was the compare the profiles of maximal airway response
between patients with asthma and patients with cough-variant ashma (CVA) to
a similar degree of airway hypersensitivity.
High-dose methacholine inhalation test was performed in 28 patients with asthma
and 28 patients with CVA.
There was no significant difference between groups according to gender, age,
pulmonary function parameters, and PC20 . 20 patients (71.4%) with CVA group
featured maximal response plateau (MRP) on dose-response curve to metha-
choline, whereas 8 patient (28.5%)with asthma had a MRP (p < 0.05). In those
subjets with a plateau there was no significant difference in its level between
patients with asthma and those with CVA (p > 0.05). When the percentage decline
in FEV1 at the end of the protocol was taken as the maximal response for the
subjects without plateau, the level of maximal airway response was significantly
lower in patients with asthma than patients with CVA (p < 0.05).
The difference in frequency of detection of MRP between the asthma group and
CVA group suggest that inflammatory change in asthma is more significant than

                            Abstract printing supported by Nonin Medical, Inc. Visit Nonin Medical, Inc. at stand B04:31

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