ORCID Profile
0000-0002-5428-8578
Current Organisation
University of Manchester
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Publisher: Elsevier BV
Date: 10-2012
Abstract: Microaspiration is often considered a potential cause of cough. The aim of this study was to investigate the relationship between microaspiration, the degree and type of gastroesophageal reflux, and the frequency of coughing in patients with chronic cough. One hundred patients with chronic cough (mean [± SD] age, 55.8 years [± 11.0 years] 65 women) and 32 healthy volunteers (median age, 43.5 years [interquartile range (IQR), 30-50.8 years] 16 women) were recruited. Patients with chronic cough performed 24-h objective cough frequency with simultaneous esophageal impedance H monitoring and measurement of pepsin concentrations in sputum and BAL. Twelve healthy volunteers underwent bronchoscopy/BAL, and 20 underwent impedance H monitoring. Patients with chronic cough had significantly more reflux episodes than healthy volunteers (median, 63.5 reflux episodes [IQR, 52.5-80.0] vs 59.0 [IQR, 41.8-66.0] P = .03), although the absolute difference was small, and there was no difference in numbers of events extending into the proximal esophagus (median, 17.2% [IQR, 8.0%-26.0%] vs 20.3% [IQR, 5.1%-32.1%] P = .36). BAL pepsin levels were also similar in chronic cough to control subjects (median, 18.2 ng/mL [range, 0-56.4 ng/mL] vs 9.25 ng/mL [range, 0-46.9 ng/mL] P = .27). Sputum but not BAL pepsin weakly correlated with the number of proximally occurring reflux events (r = 0.33, P = .045) but was inversely related to cough frequency (r = −0.52, P = .04). Sputum pepsin was, therefore, best predicted by combining the opposing influences of cough and proximal reflux (r = 0.50, P = .004). Proximal gastroesophageal reflux and microaspiration into the airways have limited roles in provoking chronic cough. Indeed, coughing appears to be protective, reducing pepsin concentration in the larger airways of patients with chronic cough.
Publisher: BMJ
Date: 23-07-2015
Publisher: Oxford University Press (OUP)
Date: 24-02-2005
DOI: 10.1111/J.1365-2249.2005.02743.X
Abstract: The increasing prevalence of atopic diseases over the last few decades is thought to be due to reduced exposure to environmental microbes that normally down-regulate allergic responses (hygiene hypothesis). We have shown previously that administration of the environmental microbe Mycobacterium vaccae ameliorates atopic dermatitis in school-age children at 3 months post-treatment. The present study tested the hypothesis that M. vaccae suppresses Th2-type cytokine activity and increases transforming growth factor (TGF)-β1 immunomodulatory activity in these children. Interleukin (IL)-4, IL-5, TGF-β1 and interferon (IFN)-γ activity were assessed in resting and stimulated peripheral blood mononuclear cells (PBMC) isolated from 12 of the children who received M. vaccae in our original clinical trial. A cDNA expression array was used to examine a broader range of cytokine pathway transcripts. There were no significant changes in either Th2-type or TGF-β1 activity. A 5- to 10-fold increase in Th1-type activity was found at 1 month post-M. vaccae administration (P & 0·05), but it had returned to baseline by 3 months. The results do not support the hypothesis that M. vaccae reduces Th2-type or increases TGF-β1 activity of PBMC isolated from children with atopic dermatitis. The transient surge in IFN-γ at 1 month is unlikely to explain any improvement in eczema score at 3 months.
Publisher: BMJ
Date: 11-05-2002
Publisher: Springer Science and Business Media LLC
Date: 04-01-2018
Publisher: American Society for Microbiology
Date: 07-2004
DOI: 10.1128/CDLI.11.4.686-690.2004
Abstract: The gut microbiota may be important in the postnatal development of the immune system and hence may influence the prevalence of atopic diseases. Bifidobacteria are the most numerous bacteria in the guts of infants, and the presence or absence of certain species could be important in determining the geographic incidence of atopic diseases. We compared the fecal populations of bifidobacteria from children aged 25 to 35 days in Ghana (which has a low prevalence of atopy), New Zealand, and the United Kingdom (high-prevalence countries). Natal origin influenced the detection of bifidobacterial species in that fecal s les from Ghana almost all contained Bifidobacterium infantis whereas those of the other children did not. Choosing species on the basis of our bacteriological results, we tested bifidobacterial preparations for their effects on cell surface markers and cytokine production by dendritic cells harvested from cord blood. Species-specific effects on the expression of the dendritic-cell activation marker CD83 and the production of interleukin-10 (IL-10) were observed. Whereas CD83 expression was increased and IL-10 production was induced by Bifidobacterium bifidum , Bifidobacterium longum , and Bifidobacterium pseudocatenulatum , B. infantis failed to produce these effects. We concluded that B. infantis does not trigger the activation of dendritic cells to the degree necessary to initiate an immune response but that B. bifidum , B. longum , and B. pseudocatenulatum induce a Th2-driven immune response. A hypothesis is presented to link our observations to the prevalence of atopic diseases in different countries.
Publisher: Elsevier BV
Date: 2021
Publisher: Wiley
Date: 30-05-2002
DOI: 10.1046/J.1365-2222.2002.01403.X
Abstract: Assessment of personal exposure to dust mite allergen has relied on proxy measures. Only recently has a means to directly measure inhaled allergen particle number become available (the intra-nasal air s ler). To quantify inspired dust mite group 1 and group 2 allergen-bearing particles in bed in undisturbed conditions prior to sleep by nasal air s ling and to investigate the relationship between inhaled particles and reservoir allergen levels. Twelve volunteers wore nasal s lers in bed for 6 evenings, nose-breathing in undisturbed conditions. Allergen-bearing particles ('halos') were detected by immunostaining for Der p 1, Der p 2, or Der p 1 and Der p 2 together, and counted by light microscopy. Count data were square root transformed for analysis of variance. Mattress dust s les were assayed for Der p 1 and Der p 2 concentrations. Square root detransformed mean particle counts per 30-min s le were: Der p 1, 4.22 Der p 2, 5.9 Der p 1 + Der p 2, 4.87 and for all s les, 5.01, with no difference between the groups. With replicate s les, halo number correlated significantly with mattress allergen concentrations (Der p 1 r = 0.80, P < 0.01 Der p 2 r = 0.68, P < 0.02). Nasal air s ling can be used to quantify nocturnal Der p exposure in undisturbed conditions in an area with moderate exposure to mite allergen and can provide a direct measure of inhaled mite allergen. The choice of either Der p 1 or Der p 2 is appropriate for this purpose.
Location: Australia
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Ashley Woodcock.