There is increasing evidence that an exaggerated accumulation of activated neutrophils is linked to the clinical course of obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease. The present review article focuses on the evidence that the T cell cytokine interleukin (IL)-17 plays a role in orchestrating the accumulation and subsequent activation of neutrophils in the airways and lungs. The mechanistic roles of neutrophils and IL-17 in obstructive airway disease are discussed. It is concluded that targeting IL-17 may consitute a potential strategy for developing novel pharmacotherapeutic interventions against obstructive airway disease.

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Background: Hypersensitivity to the group 1 grass pollen allergens is a significant causative factor in the onset of symptoms for hay fever sufferers. To better understand the IgE reactivity of the group 1 allergen from rye grass pollen, we sought to disrupt potential conformational IgE epitopes on recombinant (r) Lol p 1 by the specific replacement of the seven cysteine residues in the protein sequence.
Methods: Site-directed mutagenesis on the Lol p 1 coding sequence was used to replace all seven cysteine residues with serine residues. rLol p 1 and the seven cysteine variants generated by this method were tested for comparative human IgE reactivity via western blot immunoscreening and densitometry.
Results: Alteration of the cysteine residues at amino acid positions 72, 77, 83 and 139 of rLol p 1 was found to reduce the human IgE binding potential of the molecule. However, the most consistent reduction in human IgE reactivity was demonstrated by replacement of C⁷⁷; human IgE antibodies showed an average 62.7% reduction in reactivity to this molecule.
Conclusions: The present investigation has shown that at least one of the cysteine residues within the Lol p 1 protein contributes to the IgE binding properties of this allergen.

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Background: Colonization of atopic dermatitis lesions with Staphylococcus aureus is a frequent phenomenon and may exacerbate inflammation of the skin. The aim of the present study was to determine the effect of S. aureus on T cell-mediated immune responses in contact hypersensitivity caused by a hapten or a protein with large molecule.
Methods: Staphylococcus aureus or phosphate-buffered saline was inoculated on experimental contact dermatitis induced by 2,4,6-trinitro-1-chlorobenzene (TNCB) or house dust mite antigen. At various times after inoculation, the experimental lesions were examined histologically and immunohistochemically. Furthermore, the kinetics of cytokine patterns (interferon (IFN)-γ, interleukin (IL)-2, IL-4 and IL-5) in each lesion were analyzed by reverse transcription-polymerase chain reaction.
Results: In TNCB-challenged lesions inoculated with S. aureus, the levels of IL-2 mRNA decreased; in contrast, mRNA levels of IL-4 and IL-5 were upregulated. In mite antigen-challenged lesions, IL-4 and IL-5 mRNA expression was detected throughout the period of the investigation, even without S. aureus inoculation. Interferon-γ mRNA expression in mite dermatitis without S. aureus inoculation was observed only in the later period and IL-2 mRNA expression in mite dermatitis with S. aureus was suppressed and observed much later than in the control group.
Conclusions: Infestation of S. aureus on skin lesions in experimental contact hypersensitivity induces a shift in the immune reaction from a Th1- to a Th2-dominant response.

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Background: The majority of Swedish birch pollen (BP)-allergic patients report hypersensitivity to some fruits, nuts and vegetables. Some BP-allergic patients complain 'I can't tolerate any fruit'. The main aim of the present study was to answer the question, 'can BP-allergic patients tolerate some of the exotic fruit, not at present common in Sweden?'
Methods: Consecutive patients (n = 397) visiting the participating Allergy Clinics, who had a BP allergy and reported a food hypersensitivity, were asked to fill out questionnaires regarding 66 different fruits and vegetables. Subjects had three alternatives as an answer to each of the food questions: (i) 'I tolerate it'; (ii) 'I get symptoms from it'; or (iii) 'I have not tried this food'. Skin prick tests were performed with pollen allergens.
Results: Most patients had experienced reactions to several foods; only 31 patients (8%) reported hypersensitivity to one food only. Some of the fruit had been tried by only a few patients. In addition to earlier well-known BP-related foods, more than 40% of patients who had knowingly eaten Japanese pear and pomegranate said that they had experienced symptoms after eating the fruit. Most patients tolerated pineapple, melon, grapes and citrus fruits, as well as zucchini, lychee, rambutan, mangosteen, ugli, melon pear and cherimoya.
Conclusions: Although an allergy to fruit is common among BP-allergic patients, there are several widely available fruits that most patients tolerate; for instance, pineapple, melon, grapes and citrus fruit. Furthermore, there are many exotic fruits that most patients have not yet tried.

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Background: In allergic rhinitis, antigen-antibody reactions occur in the nasal mucosa through antigen exposure. A strong reaction occurs following exposure to a large amount of antigen, whereas no reaction occurs in the absence of antigens. In seasonal allergic rhinitis, nasal hypersensitivity increases during the pollen-dispersing season, which is known as the 'priming effect'. The purpose of the present study was to clarify whether repeated nasal challenges bring about increased nasal hypersensitivity in patients with perennial allergic rhinitis.
Methods: Fourteen patients with perennial allergic rhinitis to house dust mites were enrolled in the present study. Repeated challenge tests were performed once daily for 8 consecutive days with a fixed amount of antigen.
Results: Sneezing and nasal secretion were slightly enhanced by repeated challenges only on the 2nd and 3rd days, whereas nasal resistance remained unchanged. Increased sneezing and nasal secretion was marked in a group of subjects who were not sneezing at the first challenge, whereas changes in nasal reaction following repeated challenge were less obvious in subjects who were sneezing at the first challenge.
Conclusions: In contrast with pollinosis, nasal provocation reactions were not clearly enhanced by repeated provocation. To further understand nasal reactions induced by antigen challenge, studies should be performed under specified conditions (i.e. in an experimental room) with a prescribed quantity of antigens administered, as well as within a study environment.

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Background: This is the first report about the pharmacokinetics (PK) of pranlukast in children. The aim of the present study was to assess the PK parameters of pranlukast in children and to compare them with those in adults.
Methods: Six healthy adult male volunteers and 22 children with bronchial asthma at 3-14 years of age were enrolled in the study. Both 225 and 112.5 mg pranlukast hydrate dry syrup was administered orally to adults, whereas 3.5 mg/kg pranlukast hydrate dry syrup was given to children. Blood samples were obtained at approximately 20 time points per adult (n = 121) and at two or three time points per child (n = 54). Population PK analysis was performed using _NONMEM (Globomax, Hanover, MD, USA). The concentration-time-course of pranlukast was described by using a one-compartment model with first-order absorption. The robustness of the final model was evaluated using 200 bootstrap samples.
Results: Apparent clearance (CL/F) was 1.81 and 1.14 L/h per kg in children and adults, respectively. According to subgrouping of children, no significant difference was observed in CL/F between infants (3-6 years of age) and schoolchildren (7-14 years of age). The interindividual variability of CL/F accounted for 48.7%. The additive and proportional residual variability was 7.33 ng/mL and 73.8%, respectively. All fixed effect parameters fell within 10% of the bootstrapped mean.
Conclusions: Compared with adults, children showed a higher CL/F and more rapid elimination after ingestion of pranlukast hydrate dry syrup. However, no significant variation was seen in CL/F between infants and schoolchildren.

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Eosinophilic myocarditis is characterized by an acute inflammatory infiltration of eosinophils in the myocardium. Diagnosis is confirmed by a heart muscle biopsy. Immunopathological studies suggest that several toxic proteins, such as eosinophilic cationic protein (ECP) derived from the degranulation of eosinophils, may play an important role in the pathogenesis of this cardiac disorder. Serum levels of ECP, which are related to the inflammatory activity of the disease are used to monitor and determine the effects of treatment in adult patients. Herein, we present the case of a 12-year-old, previously healthy, junior high school girl with eosinophilic myocarditis. The diagnosis was confirmed by a myocardial biopsy and the patient was treated successfully with prednisolone. On admission, her peripheral blood eosinophil count (3342 /µL) and serum ECP level (124 µg/L) were extremely high, but both decreased significantly during corticosteroid therapy. In the present case, corticosteroid treatment was successful and early diagnosis by endomyocardial biopsy is recommended. Furthermore, serum ECP is useful to monitor the efficacy of treatment in pediatric patients.

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