Bronchial hyperresponsiveness to methacholine in patients with primary Sjogren's syndrome

Article Abstract:

Sjogren's syndrome is one of the autoimmune inflammatory diseases, in which the body produces antibodies against its own tissues, and it chiefly affects exocrine glands such as sweat and mucus glands. The disease may occur alone, as primary Sjogren's syndrome, or as secondary Sjogren's syndrome in association with other autoimmune diseases. Primary Sjogren's syndrome may involve the lungs or other organs, and lung problems may be varied and include airway obstruction. Many patients with the disorder may have symptoms similar to those of bronchial hyperreactivity (BHR), whether related to poor glandular secretion of mucus or to actual lung involvement. Bronchial hyperreactivity, a hyperreactive constriction of the airway, may occur in affected people following exposure to smoke, cold, and exercise, as well as particular compounds such as histamine. Methacholine is a drug similar to the hormone which normally causes bronchial constriction and fluid secretion, and lung hyperresponsiveness to methacholine has been used as a test for BHR. The effect of methacholine in 21 patients (20 female) with primary Sjogren's syndrome, aged 22 to 78 years, was evaluated. Of 20 patients tested, 12 had BHR, one severely and five moderately. Of 21 healthy subjects also tested, only two had mild BHR. Nine of the 21 patients had dry coughs and a sensation of foreign bodies in the windpipe. Six had difficulty breathing on exertion, and two had asthma, while two had pleuritis (inflammation of the membrane between the lungs and rib cage) and five frequently had respiratory infections. Evaluation of lung function indicated that 16 patients had breathing problems which were varied in terms of severity. This study indicates that BHR correlates well with lung symptoms, and is more often found in patients with problems in the smaller airways, where oxygen is moved into the bloodstream. BHR may be related to mucus dryness. BHR testing may uncover patients with Sjogren's syndrome at risk for disease of small airways. The study suggests that Sjogren's syndrome should be suspected in patients with a chronic cough and other lung symptoms but whose lab tests are not compatible with a diagnosis of asthma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Causes of, Bronchial spasm

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Neutrophil function in patients with primary Sjogren's syndrome: relation to infection propensity

Article Abstract:

In autoimmune disorders the immune system does not recognize certain cells of the body as part of itself and inappropriately responds to them as foreign cells. Sjogren's syndrome is an autoimmune disorder that is characterized by chronic inflammation with infiltration of sweat, salivary, and similar glands by lymphocytes (immune cells important in fighting infection). Other organ systems, especially the lungs, may be also be involved. Recurrent infections of the upper and lower respiratory tract, ranging from colds to pneumonia, are a major cause of illness in patients with this disease. Changes in levels of granulocytes (white blood cells and immune cells containing granular packets) may underlie the increased tendency toward infection. To better understand this possibility, the functions of neutrophils (white blood cells that engulf and kill invading organisms) obtained from 23 patients with Sjogren's syndrome were evaluated and compared with neutrophils from 35 healthy control subjects. Neutrophil levels were similar in both groups. The most important neutrophil activities were similar in both groups, but other activities including adherence (the ability to attach to blood vessel walls) and opsonic activity (aids engulfment of bacteria) were reduced, especially in patients with greater propensities to bacterial infection. The report suggests that changes in neutrophils, especially decreased adherence, may be partly responsible for the greater frequency of bacterial infections in patients with Sjogren's syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Risk factors, Physiological aspects, Bacterial infections, Cell adhesion, Neutrophils

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The timing of glucocorticoid administration in rheumatoid arthritis

Article Abstract:

The timing of prednisolone treatment appears to affect disease activity in patients with rheumatoid arthritis. Effects on disease activity were analyzed in 26 patients with rheumatoid arthritis given low levels of prednisolone at either 2:00 AM or 7:30 AM. Markers of disease activity included joint pain, morning stiffness, erythrocyte sedimentation rates, and blood levels of interleukin-6, C reactive protein, and amyloid protein A. Both groups showed significant improvement in markers of disease activity but the effects were greater in the group taking prednisolone at 2:00 AM.

Drug therapy, Rheumatoid arthritis, Dosage and administration, Prednisone

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