Pulmonary pharmacology & therapeutics
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Pulm Pharmacol Ther · Dec 2014
Clinical TrialThrombomodulin for acute exacerbations of idiopathic pulmonary fibrosis: a proof of concept study.
The mortality of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is high. Anticoagulation therapy (recombinant human soluble thrombomodulin (rhTM)) is recognized as a potential new strategy for treating disseminated intravascular coagulation in Japan. This preliminary study was to evaluate whether the coagulation factors increase or decrease in AE-IPF-patients, and whether the additional administration of rhTM for AE-IPF-patients has any beneficial effects on inflammatory mediators and activated coagulation. ⋯ AE-IPF-patients were found to have significantly higher levels of coagulation. The rhTM administration in the surviving AE-IPF-patients led to significant differences in the oxygenation and intravascular coagulation disturbance.
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Pulm Pharmacol Ther · Oct 2014
Meta AnalysisProlonged treatment with macrolides in adult patients with non-cystic fibrosis bronchiectasis: meta-analysis of randomized controlled trials.
Infection, resulting in chronic airway inflammation, forms the basis of bronchiectasis pathogenesis. Macrolides possess antibacterial, anti-inflammatory and immunomodulatory properties, and are used to treat patients with non-cystic fibrosis bronchiectasis (NCFB). However, the efficacy and safety of long-term treatment with macrolides in patients with bronchiectasis have been controversial. We performed a meta-analysis to assess the efficacy and safety of macrolides in adults with NCFB. ⋯ Macrolide maintenance therapy was effective in reducing pulmonary exacerbations, and improving lung function in adults with NCFB. However, it did not improve quality of life, and could have led to macrolide resistance.
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Pulm Pharmacol Ther · Aug 2014
Randomized Controlled TrialEffects of long-acting bronchodilators and prednisolone on inspiratory lung function parameters in stable COPD.
In chronic obstructive pulmonary disease (COPD), there is a poor correlation between forced expiratory volume in 1 s (FEV1) and dyspnea following bronchodilator use. Better correlations have been observed between inspiratory lung function parameters (ILPs) and dyspnea, which drives our interest in ILPs. However, the acute and prolonged effects of long-acting bronchodilators and oral corticosteroids on ILPs have not been well investigated. Therefore, the aim of this study was to investigate the effects of these treatments on the ILPs, FEV1, dyspnea (visual analog scale (VAS)) and clinical COPD questionnaire (CCQ). ⋯ After a single dose of long-acting bronchodilator salmeterol, significant improvements are observed in all ILPs and in FIV1 and PIF after tiotropium. Two weeks of oral corticosteroid treatment improved the FIV1 and FEV1. The dyspnea VAS score was only significantly correlated with the ILPs after 2 weeks of oral corticosteroid treatment.
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Pulm Pharmacol Ther · Aug 2014
Roflumilast N-oxide inhibits bronchial epithelial to mesenchymal transition induced by cigarette smoke in smokers with COPD.
Epithelial to mesenchymal transition (EMT) is under discussion as a potential mechanism of small airway remodelling in COPD. In bronchial epithelium of COPD and smokers markers of EMT were described. In vitro, EMT may be reproduced by exposing well-differentiated human bronchial epithelial cells (WD-HBEC) to cigarette smoke extract (CSE). EMT may be mitigated by an increase in cellular cAMP. ⋯ Roflumilast N-oxide may mitigate epithelial-mesenchymal transition in bronchial epithelial cells in vitro.
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Pulm Pharmacol Ther · Jun 2014
Iron laden macrophages in idiopathic pulmonary fibrosis: the telltale of occult alveolar hemorrhage?
A number of observations suggest that iron accumulates in the lungs of patients with idiopathic pulmonary fibrosis (IPF) with vascular abnormalities, including pulmonary hypertension. ⋯ The data show exaggerated accumulation of iron in IPF broncho-alveolar ELF and alveolar cells with no association with tobacco smoke, thus suggesting, occult pulmonary hemorrhage as a likely cause.