Paediatric respiratory reviews
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Defective expression and function of the cystic fibrosis transmembrane conductance regulator (CFTR) in cystic fibrosis (CF) airway epithelial cells are associated with airway mucus hypersecretion, inflammation and infection that begin early in life and lead, at an advanced stage of the disease, to severe airway obstruction with hyperviscous and adhesive airway mucus. Whether the abnormalities of airway mucus are already present at birth before infection is debatable. In CF, the impaired Cl(-) and HCO(3)(-) secretion associated with increased epithelial Na(+) absorption results in dehydration of airway mucus, decreased antimicrobial functions and impaired mucociliary clearance. ⋯ Alterations in mucin and lipid composition induce an increased viscosity and adhesiveness to the airways that can affect the mucociliary and cough transport. The increased content of pro-inflammation cytokines such as interleukin-8 (IL-8) suggest that, before infection, airway inflammation occurs very early in CF. The development of non-invasive techniques and humanised animal models (xenografts) represents a major opportunity to identify early abnormalities in CF airway mucus.
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Paediatr Respir Rev · Mar 2002
ReviewDiagnostic techniques for obstructive sleep apnoea: is polysomnography necessary?
Obstructive sleep apnoea (OSA) is a common condition of childhood with significant associated morbidity. The comprehensive evaluation of children who present with suggestive symptoms involves the overnight recording and assessment of both sleep and respiration by polysomnography in a sleep laboratory. These studies require resources and facilities that are not widely available and thus simpler, more available and less expensive alternatives have been sought. This review discusses the available alternatives to polysomnography for the evaluation of the child with suspected obstructive sleep apnoea.
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Paediatr Respir Rev · Sep 2001
ReviewParental smoking: asthma and wheezing illnesses in infants and children.
Parental smoking has an important impact on asthma and wheezing illnesses in infants and children. In utero exposure is associated with impaired lung growth and wheezing illnesses, particularly in preschool children. ⋯ There are no consistent data to confirm an effect of in utero or postnatal cigarette smoke exposure on the prevalence of asthma but there is evidence of increased severity of symptoms. The detrimental effects of parental smoking on lung growth will have an impact on respiratory health throughout life.