BioFact Environmental Health Research Center

Lerum, Sweden

BioFact Environmental Health Research Center

Lerum, Sweden
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Tercelj M.,University of Ljubljana | Salobir B.,University of Ljubljana | Zupancic M.,University of Ljubljana | Wraber B.,University of Ljubljana | Rylander R.,BioFact Environmental Health Research Center
Respirology | Year: 2014

Background and objective Previous studies have demonstrated increases of inflammatory mediators in sarcoidosis while epidemiological studies have also demonstrated an association with increased fungi exposure. This study measured the level of β-glucan in the lungs and of inflammatory mediators in serum, and correlated both with the extent of pulmonary granuloma infiltration. Methods This is a cross-sectional study of 98 patients with sarcoidosis and 26 controls. β-glucan, a cell wall constituent of fungi, was measured in bronchoalveolar lavage. Inflammatory mediator levels were determined in serum. The extent of granuloma infiltration was estimated on the chest X-ray. Exposure to fungi at home was determined by taking air samples in bedrooms and analysing for the presence of β-N-acetylhexosaminidase. Results Significantly, higher levels of β-glucan were found in broncho-alveolar lavage in subjects with sarcoidosis as compared with controls. There were significant positive relationships between the extent of granuloma infiltration and the levels of the different inflammatory mediators, except for interleukin-10. Domestic fungal exposure was higher among subjects with sarcoidosis. Conclusions This is the first time that a specific agent, previously suspected to be related to the risk of sarcoidosis, has been detected in the lung of subjects with sarcoidosis and related to the levels of inflammatory mediators and the degree of home exposure to fungi. The results suggest that exposure to fungi should be explored when investigating patients with sarcoidosis. This study demonstrated β-glucan - a fungal cell wall agent - in the lungs of sarcoidosis patients. It also confirmed a positive relationship between β-glucan and domestic fungi exposure. Lung granuloma infiltration correlated inflammatory cytokines except IL-10, an anti-granuloma cytokine. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Tercelj M.,University of Ljubljana | Salobir B.,University of Ljubljana | Zupancic M.,University of Ljubljana | Rylander R.,BioFact Environmental Health Research Center
Therapeutic Advances in Respiratory Disease | Year: 2011

Objectives: Fungi have been suspected of contributing to the pathogenesis of sarcoidosis. A previous intervention study demonstrated an improvement in the clinical condition in 15 out of 18 patients with a long-term history of sarcoidosis when antifungal medication was added to corticosteroids. The present study was performed to compare the effects of antifungal treatment with corticosteroid treatment in sarcoidosis.Methods: Patients with newly diagnosed sarcoidosis were recruited. Corticosteroids were given to 39 subjects, corticosteroid+antifungal to 31, and antifungal only to 22 subjects. The effects of the treatments were evaluated at 6 months. X-ray scores were measured before and after treatment together with pulmonary diffusion capacity and two markers of sarcoidosis activity, that is, angiotensin-converting enzyme in serum (sACE) and chitotriosidase (CTO).Results: X-ray scores as well as sACE and CTO decreased significantly in all groups. The X-ray score decreased slightly more among subjects in the groups that received antifungal medication compared with corticosteroids only (p<0.001).Conclusion: The results suggest that antifungal treatment is as efficient as corticosteroid treatment against the granulomatous and inflammatory manifestations of sarcoidosis. This is probably because this treatment is directed towards the causative agent. Additional studies are required to define the phenotype, where the antifungal treatment was not efficient (4/22) and to perform long-term follow up to determine the risk of recurrence. © The Author(s), 2011.

Tercelj M.,University of Ljubljana | Salobir B.,University of Ljubljana | Harlander M.,University of Ljubljana | Rylander R.,BioFact Environmental Health Research Center
Environmental Health: A Global Access Science Source | Year: 2011

Background: There is increasing evidence that exposure to moulds (fungi) may influence the development of sarcoidosis. To assess the influence of the environmental exposure, a study was undertaken to determine the exposure to fungi in homes of subjects with sarcoidosis. Methods. Subjects were patients with clinically established sarcoidosis recruited during the period September 2007 till June 2010. Of these 55 were newly diagnosed and currently under treatment for less than one year, 25 had been treated and had no recurrence and 27 had been treated but had recurrence of the disease. Controls were healthy subjects without any respiratory symptoms (n = 30). Samples of air (about 2.5 m3) were taken in the bedroom of the subjects using a portable pump and cellulose ester filters. The filters were analysed for the content of the enzyme N-acetylhexosaminidase (NAHA) as a marker of fungal cell biomass, using a specific substrate and a fluorescent technique and expressed as NAHA units (U)/m3. Results: Compared to controls, subjects undergoing treatment of the disease (newly diagnosed or with recurrence) had significantly higher activities of NAHA in their homes than controls (33.6 and 39.9 vs 10.0 U/m 3, p < 0.001 and <0.001). Among controls only 5 out of 30 subjects had levels of NAHA above the second quartile value (14 U/m 3). In homes of subjects with newly diagnosed disease with treatment less than one year, values above 14 NAHA U/m3 were found among 35 out of 55 and among those with recurrent disease among 18 out of 27. Conclusions: The higher activities of NAHA enzyme found in homes of subjects with active and recurrent sarcoidosis suggest that exposure to fungi is related to the risk of sarcoidosis. Further environmental studies to assess the importance of this exposure for subjects with sarcoidosis are warranted. The results suggest that remedial actions in homes with high levels of fungi may be justified. © 2011 Terelj et al; licensee BioMed Central Ltd.

Rylander R.,BioFact Environmental Health Research Center
Pregnancy Hypertension | Year: 2014

Magnesium is an important cation present in more than 300 enzymes in the body. This review evaluates the information on magnesium and pregnancy. In normal pregnancies Mg responsive genes are upregulated, suggesting Mg deficiency. Blood pressure increase is related to the urinary excretion of Mg. In pregnancies complicated by preeclampsia the Mg homeostasis is different from normal pregnancies. Supplementation with Mg has shown beneficial effects on high blood pressure and infant conditions in some studies. Although several studies show important relationships between Mg homeostasis and pregnancy, particularly those with pre-eclampsia, further studies are needed to assess the relationship and formulate requirements for intervention programmes. © 2014 International Society for the Study of Hypertension in Pregnancy Published by Elsevier B.V. All rights reserved.

Rylander R.,BioFact Environmental Health Research Center
Journal of Water and Health | Year: 2014

Studies in many countries have demonstrated a relationship between drinking water mineral content and the risk of death in cardiovascular disease (CVD). Particularly strong relationships have been found for magnesium and it has been suggested that magnesium be added to drinking water. The aim of this article is to evaluate the validity of this suggestion by reviewing information on possible causative agents. Major epidemiological studies on the drinking water content of calcium, magnesium, and hardness were analysed regarding exposure specificity, confounding factors, doseresponse relationships and biological plausibility. Intervention experiments were analysed. The risk of death in CVD was related to the content of Ca, Mg and HCO3-. The data demonstrate that Ca and Mg need to be considered together, and that HCO3- could play a role by intervening with the body acid load. There is no evidence to justify the addition of magnesium only to drinking water for preventive purposes. The data suggest that Ca and Mg could be administered together but no data are available regarding the relative proportions for an optimal effect. © IWA Publishing 2014.

Adhikari A.,University of Cincinnati | Reponen T.,University of Cincinnati | Rylander R.,BioFact Environmental Health Research Center
Indoor Air | Year: 2013

Fungal exposure may induce respiratory symptoms. The causative agents are compounds in the fungal cell wall. Fragments of microbes may be present in air samples but are not measurable using conventional spore counting or by the determination of viable organisms. This study assesses the proportion of fungal cell biomass and endotoxin in different particle size fractions in air samples from homes. Air samples were collected from 15 homes using a cyclone sampler, collecting particles in three aerodynamic size fractions: <1.0, 1.0-1.8, and >1.8 μm. N-Acetylhexosaminidase (NAHA) was determined as a marker of fungal cell biomass. Endotoxin was determined using the Limulus amebocyte lysate method. NAHA and endotoxin in the size range <1.0 μm comprised up to 63% (mean 22.7%) and 96.3% (mean 22.6%) of the total concentrations, respectively. There were significant relationships between the amounts of NAHA and endotoxin in the total amount and in the size fraction >1.8 μm but not in the smaller fractions. The results demonstrate significant amounts of fungal cell biomass and endotoxin in particles <1.0 μm. Homes with reported mold damage had a lower concentration of NAHA in particles <1.0 μm than homes without mold damage. To assess airborne exposure for diagnostic and preventive purposes, measurement techniques that include this fraction should be considered. © 2013 John Wiley & Sons A/S232 April 2013 10.1111/j.1600-0668.2012.00799.x Original Article Original Articles © 2012 John Wiley & Sons A/S.

Rylander R.,BioFact Environmental Health Research Center | Reeslev M.,Mycometer A S | Hulander T.,Fuktskadeteknik
Journal of Environmental Monitoring | Year: 2010

Mould in buildings constitutes a threat to health. Present methods to determine the moulds comprise counting of spores or determination of viable moulds which give imprecise measures of total mould cell biomass. Analysis of ergosterol and β-glucan as markers of mould cell biomass is expensive and cumbersome. To evaluate if airborne enzyme activity was related to mould in buildings air samples were taken using an impinger technique or cellulose filters in 386 rooms in 141 buildings. The samples were analysed for the activity of N-acetylhexosaminidase (NAHA) and expressed as enzyme units per m3 (EU per m3). The highest value found in a building was used for the classification of the building and was related to the results from the subsequent technical inspection. In buildings without mould damage, the NAHA activity was generally below 20 EU per m3. In buildings with mould damage, almost all the buildings had activities above 20 EU per m3 (specificity 85%). At 30 EU per m3 the specificity was 100%. Measurements of airborne enzyme activity have a high sensitivity and specificity to identify buildings with mould problems. The method can be used in the investigations of building related symptoms or for home exposure characteristics when investigating diseases such as asthma that can be related to mould exposure. © 2010 The Royal Society of Chemistry.

Nielsen T.F.,Hjorring Central Hospital | Rylander R.,BioFact Environmental Health Research Center
Archives of Gynecology and Obstetrics | Year: 2011

Objective: Pregnancy-induced hypertension and preeclampsia are serious clinical manifestations during late pregnancy and the cause for increased maternal and foetal morbidity and mortality. The pathogenesis is unknown but experience from treatment schemes suggests that minerals may be of importance. Mineral homeostasis is influenced by acid-base conditions. The aim of the study was to elucidate the relation between acid-base balance, urinary mineral excretion and blood pressure during pregnancy. Design: A prospective observational study of a general population. Materials and methods: The study was performed at the Midwife Health Center in Borås, Sweden, where practically all pregnant subjects in the catchment area are registered. First time pregnant subjects (n = 123) were voluntarily recruited without exclusion criteria. A 24 h urine sample was collected at pregnancy week 12 and analyzed for creatinine, calcium, magnesium, and urea as a proxy for acid conditions. Blood pressure was recorded every 2-3 weeks until delivery. Results: There was a relation between the excretion of urea and calcium and magnesium at week 12. A blood pressure increase was found after pregnancy week 30 but only among subjects who had a high excretion of calcium and magnesium at week 12. Conclusions: If an increase in blood pressure during the later part of pregnancy a risk indicator for preeclampsia, the results suggest that an excessive secretion of calcium leading to a functional deficit might be a risk indicator for gestational hypertension and preeclampsia. Intervention experiments are required to assess this hypothesis. © 2010 Springer-Verlag.

Rylander R.,BioFact Environmental Health Research Center
Journal of Pharmacy and Nutrition Sciences | Year: 2014

Background: Magnesium supplementation is of value in several different medical disorders. Several kinds of Mg-salts are commercially available. Purpose: This review evaluates their bioavailability criteria such as solubility, urinary excretion, and plasma levels of magnesium from studies of different Mg-salts. Conclusion: Although methodology differences were large, the results consistently demonstrate a better bioavailability for Mg-citrate.

Rylander R.,BioFact Environmental Health Research Center
Archives of Gynecology and Obstetrics | Year: 2015

Introduction: Women with pre-eclampsia (PE) have an increased risk of cardiovascular disease (CVD) later in life. This association might reflect an effect of pre-eclampsia on mechanisms inducing a higher risk of CVD or the presence of a group at risk. Materials and methods: The possibility that women with a magnesium deficiency might constitute a risk group was examined using published evidence form investigations on PE and CVD. Results: Available data strongly suggest that a magnesium deficiency is a major risk factor for both PE and for CVD disease later in life. Conclusions: Magnesium homeostasis studies in women with PE should be undertaken for validation purposes. The results suggest that women with PE should be given dietary counselling to decrease future risks of CVD. © 2015, Springer-Verlag Berlin Heidelberg.

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