Gut-lung crosstalk in pulmonary involvement with inflammatory bowel diseases

Pulmonary abnormalities,dysfunction or hyper-reactivity occurs in association with inflammatory bowel disease(IBD) more frequently than previously recognized.Emerging evidence suggests that subtle inflammation exists in the airways among IBD patients even in the absence of any bronchopulmonary symptoms,and with normal pulmonary functions. The pulmonary impairment is more pronounced in IBD patients with active disease than in those in remission. A growing number of case reports show that the IBD patients develop rapidly progressive respiratory symptoms after colectomy,with failure to isolate bacterial pathogens on repeated sputum culture,and often request oral corticosteroid therapy. All the above evidence indicates that the inflammatory changes in both the intestine and lung during IBD. Clinical or subclinical pulmonary inflammation accompanies the main inflammation of the bowel.Although there are clinical and epidemiological reports of chronic inflammation of the pulmonary and intestinal mucosa in IBD,the detailed mechanisms of pulmonaryintestinal crosstalk remain unknown. The lung has no anatomical connection with the main inflammatory site of the bowel. Why does the inflammatory process shift from the gastrointestinal tract to the airways? The clinical and subclinical pulmonary abnormalities,dysfunction,or hyper-reactivity among IBD patients need further evaluation. Here,we give an overview of the concordance between chronic inflammatory reactions in the airways and the gastrointestinal tract. A better understanding of the possible mechanism of the crosstalk among the distant organs will be beneficial in identifying therapeutic strategies for mucosal inflammatory diseases such as IBD and allergy.

Peripheral NK and B regulatory cell frequencies are altered with symptomatic exacerbation in generalized myasthenia gravis patients

Aim: Myasthenia gravis (MG) is an autoimmune disease, in which immunotherapy can improve symptoms for a period, but the majority of patients still experience symptomatic fluctuation or develop myasthenic crisis. This study aimed to explore the relationship between frequency of peripheral lymphocyte subsets and myasthenia gravis disease stage. Methods:The percentages of B regulatory (Breg) cells and natural killer (NK) cells in the peripheral blood samples obtained from 54 MG patients and 10 healthy controls were surveyed using flow cytometry. MG patients were subdivided into the ocular MG, generalized MG (GMG) in exacerbation stage and GMG in remission stage. Results: The percentage of Breg cells was significantly decreased in both the exacerbation stage (6.93 ± 1.18) and remission stage (6.56 ± 1.32) of GMG patients compared to healthy controls (15.97 ± 2.88). The percentage of NK cells were significantly increased in GMG patients in remission stage (20.69 ± 3.45) compared to healthy controls (11.33 ± 0.95). Frequency of NK cells in the patients in remission stage was significantly increased compared to patients in exacerbation (20.69 ± 3.45 vs. 12.32 ± 1.42). Conclusion: The Breg cells are involved in the pathogenesis of GMG, and NK cells are closely associated with the fluctuation of MG symptoms. NK cells could be a useful marker for MG activity and for monitoring effectiveness of immunotherapy.