Victims exposed to sulfur mustard (HD) in World War I and Iran-Iraq war, and those suffered occupational or accidental exposure have endured discomfort in the respiratory system at early stages after ...exposure, and marked general physical deterioration at late stages due to pulmonary fibrosis, bronchiolitis obliterans or lung cancer. At molecule levels, significant changes of cytokines and chemokines in bronchoalveolar lavage and serum, and of selectins (in particular sE-selectin) and soluble Fas ligand in the serum have been reported in recent studies of patients exposed to HD in Iran-Iraq war, suggesting that these molecules may be associated with the pathophysiological development of pulmonary diseases. Experimental studies in rodents have revealed that reactive oxygen and nitrogen species, their product peroxynitrite (ONOO−), nitric oxide synthase, glutathione, poly (adenosine diphosphate-ribose) polymerase, activating protein-1 signaling pathway are promising drug targets for preventing HD-induced toxicity, whereas N-acetyl cysteine, tocopherols, melatonin, aprotinin and many other molecules have been proved to be effective in prevention of HD-induced damage to the respiratory system in different animal models. In this paper, we will systemically review clinical and pathophysiological changes of respiratory system in victims exposed to HD in the last century, update clinicians and researchers on the mechanism of HD-induced acute and chronic lung damages, and on the relevant drug targets for future development of antidotes for HD. Further research directions will also be proposed.
The objective of our work was to investigate the influence of Fasudil, a Rho inhibitor on the number and function of the late endothelial progenitor cells in peripheral blood of chronic obstructive ...pulmonary diseases (COPD) patients with pulmonary artery hypertension. Eighty COPD patients with pulmonary artery hypertension were selected and divided into two groups: the treatment group and the control group, which had 40 patients respectively. The control group received routine treatment, including oxygen uptake, anti-infection and phlegm dissolving. The treatment group received the Fasudil in addition to the routine treatment. The changes on the number and function of the late endothelial progenitor cells in peripheral blood of the patients before and after the treatment were compared between the two groups. The changes on the pulmonary artery pressure were also compared. The number of the late endothelial progenitor cells in peripheral blood of the treatment group increased and the function was enhanced. The pulmonary artery pressure was reduced. The difference before and after the treatment and with the control group was statistically significant (p<0.05). The changes on the number and function of the late endothelial progenitor cells in peripheral blood and the pulmonary artery pressure before and after the treatment of the control group were not statistically significant (p>0.05). The Rho-kinase inhibitor Fasudil increased the number and enhanced the function of the late endothelial progenitor cells in peripheral blood of COPD patients with pulmonary artery hypertension.
It is unclear how far the superior efficacy of omalizumab, established in randomized controlled clinical trials of patients with severe allergic asthma (SAA), translates into routine practice and ...when compared to matched controls.
New-onset omalizumab-treated (OT) patients with SAA (n = 53) were compared to a matched control group of usual-care (UC) patients (n = 53). Treatment and procedures were naturalistic. Subsequent to a baseline assessment, patients were followed up over at least 6 months with at least two follow-up assessments. Primary clinical outcomes were the number of asthma attacks, persistence of asthma symptoms and degree of control asthma control test (ACT), Global Initiative for Asthma. Secondary outcome criteria were quality of life (Euro-Qol 5D) and number of medications. For each outcome we compared within-group effects from baseline to 6-month follow-up as well as between-group effects.
OT patients showed significant improvements in number effect size (ES) = 0.03 and frequency (ES = 0.04) of asthma attacks as well as asthma control (ES = 0.09), whereas controls revealed no significant improvements in these measures. Further improvements in the OT group were found for 'perceived control always' (ACT, p = 0.006), no impairment (ACT, p = 0.02), reduction of sickness days (p = 0.002) and number of medications needed (p = 0.001).
Substantial beneficial effects of omalizumab, similar to those observed in controlled trials and after marketing studies, were confirmed, particularly with regard to the reduction of asthma attacks, persistence of symptoms, asthma control and reduction of concomitant asthma medications. This study provides a tougher test and generalizable evidence for the effectiveness of omalizumab in routine care.
Mast cells play a critical role in allergic and inflammatory diseases, including exercise-induced bronchoconstriction (EIB) in asthma. The mechanism underlying EIB is probably related to increased ...airway fluid osmolarity that activates mast cells to the release inflammatory mediators. These mediators then act on bronchial smooth muscle to cause bronchoconstriction. In parallel, protective substances such as prostaglandin E2 (PGE2) are probably also released and could explain the refractory period observed in patients with EIB.
This study aimed to evaluate the protective effect of PGE2 on osmotically activated mast cells, as a model of exercise-induced bronchoconstriction.
We used LAD2, HMC-1, CD34-positive, and human lung mast cell lines. Cells underwent a mannitol challenge, and the effects of PGE2 and prostanoid receptor (EP) antagonists for EP(1-4) were assayed on the activated mast cells. Beta-hexosaminidase release, protein phosphorylation, and calcium mobilization were assessed.
Mannitol both induced mast cell degranulation and activated phosphatidyl inositide 3-kinase and mitogen-activated protein kinase (MAPK) pathways, thereby causing de novo eicosanoid and cytokine synthesis. The addition of PGE2 significantly reduced mannitol-induced degranulation through EP(2) and EP(4) receptors, as measured by beta-hexosaminidase release, and consequently calcium influx. Extracellular-signal-regulated kinase 1/2, c-Jun N-terminal kinase, and p38 phosphorylation were diminished when compared with mannitol activation alone.
Our data show a protective role for the PGE2 receptors EP(2) and EP(4) following osmotic changes, through the reduction of human mast cell activity caused by calcium influx impairment and MAP kinase inhibition.
Given the importance of influenza infections in the Eastern Mediterranean Region (EMR), we conducted a comprehensive literature review to analyze the status of influenza research in the region from ...2012. Influenza research has gained more momentum recently with the emergence of H5N1 and new virus strains. Research covering epidemiological, veterinary, and basic science aspects is growing. More sequences were being generated per year, not only for diagnostic purposes but also for research. We included gray literature publications in our search and found several graduate student dissertations from Egypt, which were published on an online portal. However, the search revealed some weaknesses, mostly in the areas of study design and the lack of surveillance studies. Another weakness was the fact that the publications originated from very few countries, mainly Egypt and Iran. Although improving, influenza research in the EMR remains weak. We recommend encouraging countries in the EMR to conduct more influenza research using stronger methodologies.
The incidence of nontuberculous mycobacteria (NTM) pulmonary diseases in HIV-negative patients was studied prospectively from January 1, 2001 to December 31, 2003 by 32 sentinel sites distributed ...throughout France. In total, 262 patients who yielded NTM isolates from respiratory clinical specimens, met the bacteriological, radiological and clinical criteria established by the American Thoracic Society for NTM respiratory disease. Among the 262 NTM isolates, 234 were slow-growing mycobacteria (125 Mycobacterium avium-intracellulare complex (MAC), 66 M. xenopi, 34 M. kansasii) and 28 were rapidly growing mycobacteria (25 M. abscessus complex). In the Paris area, M. xenopi was the most frequently isolated species, followed by MAC. Most patients (>50%), except those with M. kansasii, had underlying predisposing factors such as pre-existing pulmonary disease or immune deficiency. Asthenia, weight loss, chronic cough and dyspnoea were the most common clinical symptoms. The classical radiological appearance of NTM infections was indistinguishable from that observed in patients with pulmonary tuberculosis. In summary, the incidence of nontuberculous mycobacteria pulmonary infections in HIV-negative patients was estimated at 0.74, 0.73 and 0.72 cases per 100,000 inhabitants in 2001, 2002 and 2003, respectively.
Objective: In this study, we aimed to determine the general demographic characteristics of smokers and to define the association of smoking with respiratory symptoms, level of education and ...income.Materials and Methods: This prospective study was conducted on 1019 people aged 40 and over. A questionnaire containing questions about respiratory symptoms, tobacco use and risk factors for chronic respiratory diseases was applied to all the participants. The study participants were grouped regarding their smoking status as current smokers, never smokers and former smokers. Age, gender, marital status, education level, monthly income per house person were recorded for all participants.Results: 1019 people with a mean age of 53.20 ±9.06 years (range: 40-90 years) were included in the study. Among females, 72/486 were active smoker; while in males 226/533 were active smoker (p:0.001). Mid- high school and university graduates were more commonly smoker or former-smoker. Participants with higher monthly income per house person (> 1000 TRY) were significantly more commonly active-smoker. Cough and sputum for longer than 3 months was determined in 66 (6.5%) people while the triad of cough and sputum for longer than 3 months and dyspnea was determined in 36 (3.5%) people. Among those participants the ratio of smokers was significantly higher. A significant proportion of participants (63.8%) with the symptoms predicting chronic pulmonary diseases, were not having diagnosis of any chronic respiratory disease before.Conclusion: We determined that; unlike the previous reports educated and higher monthly income people were more commonly smoker. We also found that chronic respiratory diseases is not sufficiently diagnosed. In screening for early diagnosis of chronic pulmonary diseases, we think that symptomatic interrogation is still important for selection of target population.
Amaç :Bu çalışmada sigara içenlerin genel demografik karakterlerini belirlemeyi ve sigara içme ile solunumsal belirtiler, eğitim ve gelir düzeyi arasındaki ilişkiyi tanımlamayı amaçladık.Gereç ve Yöntemler: 40 yaş ve üzeri 1019 kişinin dahil edildiği prospektif bir çalışma planlandı. Tüm katılımcılara solunumsal belirtiler, tütün kullanımı ve kronik solunum hastalığı ile ilişkili risk faktörlerini sorgulayan bir anket yapıldı. Çalışma katılımcıları sigara içme durumlarına göre halen içenler ,hiç içmeyenler ve sigarayı bırakmış olanlar şeklinde gruplandırıldı.Yaş, cinsiyet, evlilik durumu, eğitim seviyesi ve kişi başı aylık gelir düzeyi tüm katılımcılar için kaydedildi.Bulgular: Ortalama yaşı 53.20 ±9.06 (range: 40-90 yıl) olan 1019 kişi çalışmaya dahil edildi. Kadınlar arasında 72/486 erkekler arasında 226/533 kişi aktif sigara içicisiydi (p:0.001). Orta okul-lise ve üniversite mezunları daha fazla sıklıkla sigara içiyor veya sigarayı bırakmıştı. 3 aydan daha uzun süren öksürük ve balgam katılımcıların 66’sında (%6.5) tespit edilmişken, 3 aydan uzun süren öksürük, balgam, nefes darlığı bir triad olarak katılımcıların 36’sında (%3.5) tespit edildi. Bu hasta gurupları arasında sigara kullananların oranı belirgin olarak yüksekti. Kronik akciğer hastalığı düşündüren semptomları olan hastaların önemli bir kısmının (% 63.8) daha önce herhangi bir kronik solunum hastalığı tanısı yoktu.Sonuç: Önceki raporların aksine, eğitimli ve daha yüksek aylık gelirlilerde daha fazla sigara içildiğini tespit ettik. Ayrıca kronik solunumsal hastalıklarının yeterince teşhis edilemediğini bulduk. Kronik akciğer hastalıklarının erken teşhisi için yapılacak taramalarda hedef populasyonun seçimi için semptomatik sorgulamanın halen önemli olduğunu düşünüyoruz.
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