Journal of physiology and pharmacology : an official journal of the Polish Physiological Society
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J. Physiol. Pharmacol. · Dec 2008
Case ReportsTherapeutic approach to a child with acute respiratory distress syndrome: a report of two cases.
The course of a respiratory disorder in a child may end up in respiratory failure. There are also acute non-respiratory diseases which have a great influence on the respiratory functions and often lead to the acute lung injury and sometimes to the acute respiratory distress syndrome (ARDS). A feature of respiratory function deterioration is changed in the surfactant system. ⋯ Despite many recently published studies explaining the principle of this disorder, the mortality of ARDS is still very high (30-50%). There are several studies documenting successful administration of exogenous surfactant as part of a complex combined therapy of patients with ARDS, which leads to decreased mortality, improved oxygenation, and decreased need for aggressive artificial pulmonary ventilation. The authors of this article present their own experience with administration of exogenous surfactant in therapy of children with ARDS.
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J. Physiol. Pharmacol. · Dec 2008
Comparative StudyComparison of cellular and biochemical markers of airway inflammation in patients with mild-to-moderate asthma and chronic obstructive pulmonary disease: an induced sputum and bronchoalveolar lavage fluid study.
Although the clinical pictures of asthma and chronic obstructive pulmonary disease (COPD) may be similar, the pathogenesis differs in many aspects. The aim of the present study was to compare the cellular and biochemical features of airway inflammation in patients with asthma and COPD. The study was conducted in 22 patients with asthma (M/F 12/10, mean age 36 +/-14 years) and 17 patients with COPD (M/F 10/7, mean age 57 +/-11 years). ⋯ The BALF concentration of MPO was significantly higher in patients with COPD compared with asthma patients. We conclude that the comparison of cellular composition and the concentration of inflammatory mediators in IS does not differentiate between asthma and COPD. The evaluation of BALF reveals more differences in the cellular and biochemical features of airways inflammation in patients with asthma and COPD than that of IS.
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J. Physiol. Pharmacol. · Dec 2008
Concentration of matrix metalloproteinase-9 in serum of patients with chronic obstructive pulmonary disease and a degree of airway obstruction and disease progression.
Chronic obstructive pulmonary disease (COPD) is chronic inflammation leading to irreversible airway obstruction. Previous studies showed increased metalloproteinases (MMP) level, especially MMP-9, as a sign of local inflammation. Up-to-date, only a few studies estimated the MMP-9 serum concentration in COPD with respect to correlation with systemic inflammation. ⋯ In the COPD group, the MMP-9 levels were negatively correlated with FEV1 (P=0.01) and FEV1/FVC (P=0.0002). In conclusion, the results suggest that MMP-9 plays an important role in systemic inflammation in COPD. Higher MMP-9 serum concentration is connected with higher airway obstruction and disease progression.
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J. Physiol. Pharmacol. · Dec 2008
Significance of pulmonary vagal afferents for respiratory muscle activity in the cat.
The influence of vagal stretch receptor afferents on respiratory motor-output and respiratory changes in esophageal pressure (DeltaP(es)) was studied in anaesthetized cats. Tracheal occlusions and lung inflations were performed during hyperoxic normocapnia, during electrical stimulation of one carotid sinus nerve (CSN) or the intracranial medullary chemosensitivity (MCS), during hypercapnia or the combination of CSN and hypercapnia. Tracheal occlusions during inspiration led to increased and prolonged inspiratory muscle (IM) activity. ⋯ The sensitivity of the lung reflexes is enhanced with increasing respiratory drive. The HB-inspiration inhibitory reflex limits the depth of lung inflation, whereas the HB-expiration facilitatory reflex promotes an effective lung deflation. Both reflex mechanisms, the inspiratory and expiratory one, are present in eupnoeic breathing, but play an important role during increased chemoreflex drive and obstruction of expiration, e.g., with increased external airway resistance.
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J. Physiol. Pharmacol. · Dec 2008
ReviewSystemic treatment by inhalation of macromolecules--principles, problems, and examples.
Aerosol inhalation is an established route of medical administration for the treatment of pulmonary diseases. In contrast, aerosol inhalation for treatment of systemic diseases is a novel therapeutic approach. Clinical use of the latter therapy for many years has been limited by the lack of accuracy, efficiency, and reproducibility of the administered doses. ⋯ Studies demonstrated that only a small number of morphological factors influence alveolar drug deposition (e.g., exogen allergic alveolitis, active sarcoidosis, active smoking). In consequence, an increasing number of studies investigated the systemic effect of inhaled high molecular weight substances (e.g., insulin, heparin, interleukin-2) and demonstrated that controlled aerosol therapy may serve as a non-invasive alternative for drug application by means of a syringe. Our review briefly summarizes the mechanisms for pulmonary absorption of macromolecules and gives an overview on prior research in the field of inhalant treatment of systemic diseases.