| 1. |
- Esberg, Anders, et al.
(author)
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Oral Microbiota Profile in Patients with Anti-Neutrophil Cytoplasmic Antibody–Associated Vasculitis
- 2022
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In: Microorganisms. - : MDPI. - 2076-2607. ; 10:8
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Journal article (peer-reviewed)abstract
- Microbiota has been associated with autoimmune diseases, with nasal Staphylococcus aureus being implicated in the pathogenesis of anti-neutrophil cytoplasmic antibody–associated vasculitis (AAV). Little is known about the role of oral microbiota in AAV. In this study, levels of IgG antibodies to 53 oral bacterial species/subspecies were screened using immunoblotting in plasma/serum in pre-symptomatic AAV-individuals (n = 85), matched controls, and established AAV-patients (n = 78). Saliva microbiota from acute-AAV and controls was sequenced from 16s rDNA amplicons. Information on dental status was extracted from a national register. IgG levels against oral bacteria were lower in established AAV versus pre-AAV and controls. Specifically, pre-AAV samples had, compared to controls, a higher abundance of periodontitis-associated species paralleling more signs of periodontitis in established AAV-patients than controls. Saliva microbiota in acute-AAV showed higher within-sample diversity but fewer detectable amplicon-sequence variants and taxa in their core microbiota than controls. Acute-AAV was not associated with increased abundance of periodontal bacteria but species in, e.g., Arthrospira, Staphylococcus, Lactobacillus, and Scardovia. In conclusion, the IgG profiles against oral bacteria differed between pre-AAV, established AAV, and controls, and microbiota profiles between acute AAV and controls. The IgG shift from a pre-symptomatic stage to established disease cooccurred with treatment of immunosuppression and/or antibiotics.
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| 2. |
- Gustafsson, Anna, et al.
(author)
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Antisecretory factor in breastmilk is associated with reduced incidence of sepsis in preterm infants
- 2023
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In: Pediatric Research. - 0031-3998 .- 1530-0447. ; 95:3, s. 762-69
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Journal article (peer-reviewed)abstract
- Background: Antisecretory Factor (AF) is a protein present in breastmilk that regulates inflammatory processes. We aimed to investigate the level of AF in mothers’ own milk (MOM) in relation to sepsis and other neonatal morbidities in preterm infants. Methods: Samples of breastmilk and infant plasma were collected at 1, 4, and 12 weeks after birth from 38 mothers and their 49 infants born before 30 weeks gestation. AF-compleasome in MOM was determined by a sandwich enzyme-linked immunosorbent assay (ELISA) and inflammatory markers in infant plasma by a panel of 92 inflammatory proteins. Neonatal treatments and outcomes were recorded. Results: The level of AF in MOM week 1 was lower for infants with later sepsis compared to no sepsis (p = 0.005). Corrected for nutritional intake of MOM, higher levels of AF decreased the risk for sepsis, OR 0.24. AF in MOM week 1 was negatively correlated to inflammatory proteins in infant plasma week 4, markedly IL-8, which was also associated with infant sepsis. Overall, higher AF levels in MOM was associated with fewer major morbidities of prematurity. Conclusion: Mother’s milk containing high levels of antisecretory factor is associated with reduced risk for sepsis and inflammation in preterm infants. Impact: High level of antisecretory factor (AF) in mothers’ own milk is associated with less risk for later sepsis in preterm infants.Receiving mothers’ milk with low AF levels during the first week after birth is correlated with more inflammatory proteins in infant’s plasma 2–4 weeks later.Human breastmilk has anti-inflammatory properties, and antisecretory factor in mothers’ own milk is a component of potential importance for infants born preterm.The findings suggest that food supplementation with AF to mothers of preterm infants to increase AF-levels in breastmilk may be a means to decrease the risk of inflammatory morbidities of prematurity.
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| 3. |
- Gustafsson, Anna, et al.
(author)
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Changes in Antisecretory Factor in Human Milk During the Postpartum and Length of Gestation.
- 2022
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In: Journal of human lactation : official journal of International Lactation Consultant Association. - : SAGE Publications. - 1552-5732. ; 38:1, s. 131-140
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Journal article (peer-reviewed)abstract
- Preterm infants are more susceptible to inflammatory complications than term infants. Human milk contains numerous bioactive components protecting the newborn infant. Antisecretory factor, a protein regulating secretory and inflammatory processes by complex binding with complement factors, is present in human milk.To describe antisecretory factor (1) in mother's own milk in term and preterm infants; and (2) in donor milk before and after Holder pasteurization.The study was prospective, longitudinal, explorative, and descriptive. Antisecretory factor-compleasome was determined using sandwich enzyme-linked immunosorbent assay in longitudinal human milk samples over 12 weeks from mothers (N = 87) of term (n = 41) and of preterm (n = 46) infants and 20 anonymized donor human milk samples before and after Holder pasteurization.Antisecretory factor-compleasome was overall higher in colostrum versus mature milk (p < .001) and no difference was found in term or preterm colostrum (p = .82). In mature milk, compleasome was higher and more variable in the preterm group (p = .01). After Holder pasteurization, compleasome levels increased (p < .001).Antisecretory factor followed the pattern of other immunological factors with high levels in colostrum. After preterm birth, levels of antisecretory factor were higher and more variable in mature milk. Holder pasteurization did not degrade antisecretory factor, indicating preserved anti-inflammatory properties in donor human milk.
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| 4. |
- Hidemark, Ove, et al.
(author)
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Nygotiska kyrkor i Skåne : utveckling i form, material och konstruktion 1840-1910
- 1991
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Book (pop. science, debate, etc.)abstract
- Denna bok har sin utgångspunkt i 1981/82 års studier i skånskt 1800-talsbyggande där Arkitekturskolans restaureringslinje valde att ägna sitt intresse åt det relativt obeaktade bestånd av nygotiska kyrkor som Skåne erbjuder. Studiernas syfte har varit attförsöka fånga kyrkornas specifika såväl estetiska som tekniska karaktäristiska och beskriva den utveckling som de representerar.
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| 5. |
- Johansson, Ewa-Lena, et al.
(author)
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Doftöverkänslighet : sensorisk hyperreaktivitet i luftvägarna
- 2016
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Book (pop. science, debate, etc.)abstract
- Kemisk överkänslighet innebär att man får hälsobesvär av vissa dofter och kemikalier. Utlösande faktorer kan till exempel vara parfym, blomdoft, rök eller rengöringsprodukter. De drabbade reagerar betydligt kraftigare än vad som är normalt redan vid låga doser som inte anses skadliga eller toxiska.Det finns en särskild grupp av personer som får luftvägsbesvär av dofter och kemikalier. I dagligt tal kallar vi det doftöverkänslighet. Inom vården används begreppet sensorisk hyperreaktivitet, SHR, för detta tillstånd. Ungefär sex procent av befolkningen uppfyller kriterierna för diagnos.I den här kunskapssammanställningen belyses epidemiologi, trolig patofysiologi, utredning och behandlingsmöjligheter av SHR ur olika aspekter. Den är främst ämnad för dig som i din yrkesroll kommer i kontakt med patienter med SHR, men rekommenderas till alla med särskilt intresse för området.
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| 6. |
- Johansson, Ewa-Lena, et al.
(author)
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Down-regulation of cough sensitivity after eucapnic dry air provocation in chronic idiopathic cough.
- 2009
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In: Pulmonary pharmacology & therapeutics. - : Elsevier BV. - 1522-9629 .- 1094-5539. ; 22:6, s. 543-7
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Journal article (peer-reviewed)abstract
- Down-regulation of cough sensitivity in humans is rarely discussed in terms other than pharmacological treatment of cough or hypersensitive cough reflex. Chronic cough and increased cough sensitivity could be due to a number of airway and other diseases. When such conditions are excluded, there still remains a group of patients with no evident medical explanation for persistent coughing; such patients are often described as having "chronic idiopathic cough". The aim of this study was to use a standardized eucapnic dry air provocation among patients with chronic idiopathic cough in order to study physiological parameters and measure their possible influence on capsaicin cough sensitivity. Fourteen female patients with chronic idiopathic cough and ten healthy controls underwent a capsaicin inhalation provocation on two occasions. In all patients, irritating environmental factors were known to induce cough and airway symptoms. One of the two capsaicin provocations was preceded by a eucapnic dry air provocation. Number of coughs, spirometry, respiratory rate, pulse rate, end-tidal CO(2), and oxygen saturation by pulse oximetry (PSaO(2)) were registered and compared. The patients showed increased capsaicin sensitivity compared with the control subjects. This sensitivity was decreased when the capsaicin test was preceded by a eucapnic dry air provocation. Before the dry air provocation and after the capsaicin provocations, end-tidal CO(2) was decreased among the patients in comparison with the controls. After dry air provocation, spirometry values remained unchanged. The results suggest that in patients with chronic idiopathic cough, physiological down-regulation of the cough sensitivity is possible with a eucapnic dry air provocation.
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| 7. |
- Johansson, Ewa-Lena, et al.
(author)
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Physical Therapy Treatment of Impaired Chest Mobility in Patients with Airway Sensory Hyperreactivity
- 2017
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In: Physiotherapy Research International. - : Wiley. - 1358-2267. ; 22:2
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Journal article (peer-reviewed)abstract
- Background and Purpose. In sensory hyperreactivity (SHR), patients have symptoms from the airways and the chest induced by environmental irritants like scenting products and cigarette smoke. They are characterized by increased cough reaction to inhaled capsaicin compared with healthy controls. Lung function tests are normal, and asthma medications have no or little effect. In a recent published article, patients with SHR were found to have impaired chest mobility and increased pain sensitivity. The purpose of this study was to evaluate if a physiotherapeutic intervention can increase chest mobility in SHR, influence these patients' symptoms and reduce capsaicin cough sensitivity. Methods. Forty-one SHR patients were initially randomized in to groups, one for training and one for symptom registration in this controlled training study. It consisted of a daily training programme containing simple movements to increase the flexibility of the chest, a breathing exercise and a relaxation session as well as symptom registration. Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors. Pain sensitivity was assessed using pressure algometry and a standardized capsaicin inhalation threshold provocation-evaluated cough sensitivity. Results. Twenty seven patients were left for analyses after 12 weeks and 26 patients after 24 weeks. Chest mobility and upper thoracic respiratory movements improved (p<0.01), feeling of chest pressure and the capsaicin cough sensitivity decreased (p<0.01). The patients also showed of significantly lowered pain pressure thresholds measured with algometry, compared with healthy controls (p<0.001). Conclusion. Improvement of chest mobility after physiotherapeutic intervention indicates that these patients may have acquired a dysfunctional breathing pattern. The regular use of a training programme and structural breathing instructions can be used to improve chest mobility, chest symptoms and capsaicin cough sensitivity in patients with SHR and signs of dysfunctional breathing. Copyright (C) 2016 John Wiley & Sons, Ltd.
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| 8. |
- Johansson, Ewa-Lena, et al.
(author)
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Respiratory movement and pain thresholds in airway environmental sensitivity, asthma and COPD
- 2012
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In: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 106:7, s. 1006-1013
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Journal article (peer-reviewed)abstract
- Introduction: Patients with "sensory hyperreactivity" (SHR) have airway environmental sensitivity, chronic cough and dyspnoea. Cough, chest discomfort and sense of difficulties getting air are some of the symptoms these patients seek medical attendance for. The patients have increased cough sensitivity to inhaled capsaicin, mediated by ion channel receptors on sensory nerves also known to react to pain stimuli. Whether a link exists between capsaicin airway sensitivity and pain sensitivity has not yet been evaluated. The aim was to investigate chest mobility, respiratory movement and pain sensitivity in SHR patients compared with patients with asthma, chronic obstructive pulmonary disease (COPD) and alleged healthy control subjects. Methods: Thirty-five patients diagnosed with SHR, 19 with COPD, 32 with asthma and 28 control subjects were included. Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors. Pain sensitivity was assessed using a pressure algometer. Results: Groups differed significantly in lung function, respiratory rate and pain sensitivity but also in chest expansion and abdominal breathing movement. In comparison with the control and asthma groups but not the COPD patients, SHR patients had an increased respiratory rate and reduced abdominal movement during deep breathing. All patient groups showed lower pain thresholds than the controls. Conclusion: Patients with SHR have evident signs of dysfunctional breathing and appeared to be most similar to the COPD group except for lung function. Lower pain thresholds among the patients indicate a general up-regulation of the sensory nerve system. (C) 2012 Elsevier Ltd. All rights reserved.
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| 9. |
- Johansson, Ewa-Lena, et al.
(author)
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Small and large airway reactions to osmotic stimuli in asthma and chronic idiopathic cough
- 2018
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In: Pulmonary Pharmacology & Therapeutics. - : Elsevier BV. - 1094-5539. ; 49, s. 112-118
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Journal article (peer-reviewed)abstract
- Background: Chronic cough is a common symptom and related to several pulmonary, airway and heart diseases. When all likely medical explanations for the coughing are excluded, there remains a large group of patients with chronic coughing, which is mostly a cough reflex easily triggered by environmental irritants and noxious stimuli. The main aim of this study was to improve the diagnostic ability to differentiate chronic idiopathic cough (CIC) from asthma. Methods: Twenty-three patients with CIC, 16 patients with mild asthma and 21 control participants were included. The study consisted of three randomised bronchial provocations with osmotic stimuli: mannitol, eucapnic dry air and hypertonic saline. At each provocation lung function was assessed by spirometry and impulse oscillometry (IOS). Results: In a comparison of the groups, while the FEV1 measurements did not differ, the CIC group had increased airway resistance and reactance after provocation with hypertonic saline compared to the control subjects. After mannitol provocation the patients with asthma had significantly increased airway resistance compared to the controls and from eucapnic dry air provocations these patients had a significant reduction in spirometry values and increased airway resistance compared to both the patients with CIC and the controls. Conclusion: The asthma group reacted in a predictable way with impaired lung function from osmotic provocations, whereas the patients with CIC demonstrated peripheral airway changes from hypertonic saline, also known to be a noxious stimulus. The IOS method uncovers differences between patients with CIC and control participants that contribute to our ability to provide a correct diagnosis.
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| 10. |
- Johansson, Ewa-Lena, et al.
(author)
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Small and large airways' reactions to inhaled capsaicin in patients with chronic idiopathic cough, or asthma and in healthy control subjects
- 2019
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In: Experimental Lung Research. - : Informa UK Limited. - 0190-2148 .- 1521-0499. ; 45:3-4
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Journal article (peer-reviewed)abstract
- Aims: Cough is a common medical problem, and when it persists for more than 8 weeks it is arbitrarily defined as chronic. While spirometry assesses the large airways, impulse oscillometry system (IOS) measures peripheral airway function. The present study investigated whether provocation with inhaled capsaicin affects the large and small airways in patients with chronic idiopathic cough (CIC) or asthma and in healthy controls. Materials and methods: Twenty-one patients with CIC, 18 patients with asthma, and 22 healthy controls were subjected to a provocation with capsaicin, and lung function was assessed by IOS and spirometry. Results: At baseline, before the capsaicin provocation, the CIC group had significantly increased airway resistance compared to the controls. After capsaicin provocation, the CIC group exhibited a significant increase in total airway resistance. The asthma group showed a small but significant reduction in spirometry, increased airway resistance, and reactance after capsaicin provocation. Capsaicin inhalation affected neither the spirometry nor the IOS of the healthy controls. Conclusions: The present study demonstrates that inhaled capsaicin induces changes in lung function, both in patients with CIC and in patients with asthma, when IOS, which measures changes also in the peripheral airways, is used. IOS appears to be a more sensitive tool than spirometry for the detection of airway impairment in airway provocation studies. In patients with CIC, higher peripheral resistance at baseline may have clinical significance.
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