Cigarette Smoke Decreases the Maturation of Lung Myeloid Dendritic Cells.

BACKGROUND: Conflicting data exist on the role of pulmonary dendritic cells (DCs) and their maturation in patients with chronic obstructive pulmonary disease (COPD). Herein, we investigated whether disease severity and smoking status could affect the distribution and maturation of DCs in lung tissues of patients undergoing elective pneumectomy or lobectomy for suspected primary lung cancer. MATERIALS AND METHODS: A total of 75 consecutive patients were included. Spirometry testing was used to identify COPD. Lung parenchyma sections anatomically distant from the primary lesion were examined. We used flow cytometry to identify different DCs subtypes-including BDCA1-positive myeloid DCs (mDCs), BDCA3-positive mDCs, and plasmacytoid DCs (pDCs)-and determine their maturation markers (CD40, CD80, CD83, and CD86) in all participants. We also identified follicular DCs (fDCs), Langerhans DCs (LDCs), and pDCs in 42 patients by immunohistochemistry. RESULTS: COPD was diagnosed in 43 patients (16 current smokers and 27 former smokers), whereas the remaining 32 subjects were classified as non-COPD (11 current smokers, 13 former smokers, and 8 never smokers). The number and maturation of DCs did not differ significantly between COPD and non-COPD patients. However, the results of flow cytometry indicated that maturation markers CD40 and CD83 of BDCA1-positive mDCs were significantly decreased in smokers than in non-smokers (P = 0.023 and 0.013, respectively). Immunohistochemistry also revealed a lower number of LDCs in COPD patients than in non-COPD subjects. CONCLUSIONS: Cigarette smoke, rather than airflow limitation, is the main determinant of impaired DCs maturation in the lung.

Ortopedia prequirúrgica en niños fisurados: Reporte de caso clínico / Presurgical orthopedics in children with cleft palate: Case Report

La fisura labiopalatina requiere ortopedia prequirúrgica para alinear los segmentos maxilares fisurados previo a la queiloplastía primaria. Caso Clínico. Recién nacido de género masculino atendido en el Hospital Regional de Concepción con diagnóstico de fisura labiopalatina bilateral completa, tratado con ortopedia prequirúrgica, siendo posible apreciar la evolución al término del primer año, las ventajas por el uso de la técnica de Grayson, así como la interacción del equipo multidisciplinario que participó del caso. Conclusión. La ortopedia prequirúrgica resulta eficaz en la rehabilitación de niños fisurados, al actuar como coadyuvante de la lactancia y alimentación del niño y permitiendo llevar tempranamente elementos óseos y partes blandas afectadas a una posición anatómica favorable, lo cual otorga mejores resultados quirúrgicos, tanto estéticos como funcionales. La queiloplastía primaria se ve favorecida por la reducción de la tensión en los tejidos blandos y del ancho de la fisura palatina y alveolar...

Cleft lip and palate requires presurgical orthopedics to achieve the normal alignment of the cleft maxillary segments prior to Primary Cheiloplasty. Clinical case A male newborn treated at the Hospital Regional of Concepción diagnosed with complete bilateral cleft lip and palate treated with presurgical orthopedics. Evolution was observed after the first year, as well as the advantages of the Grayson technique and the interaction of the participating multidisciplinary team. Conclusion. Preoperative orthopedic treatment is effective in the rehabilitation of cleft children, as it is a contributing factor to breastfeeding and child feeding. It also makes it possible to move the affected bony and soft tissue elements to a position which is anatomically favorable at an early stage. This results in better surgical outcomes: both aesthetic and functional. Primary cheiloplasty is thus facilitated by a reduction in the tension of soft tissues and of the width of the alveolar cleft palate...

C-reactive protein and serum amyloid a overexpression in lung tissues of chronic obstructive pulmonary disease patients: a case-control study.

BACKGROUND: Although researchers have consistently demonstrated systemic inflammation in chronic obstructive pulmonary disease (COPD), its origin is yet unknown. We aimed to compare the lung bronchial and parenchymal tissues as potential sources of major acute-phase reactants in COPD patients and resistant smokers. METHODS: Consecutive patients undergoing elective surgery for suspected primary lung cancer were considered for the study. Patients were categorized as COPD or resistant smokers according to their spirometric results. Lung parenchyma and bronchus sections distant from the primary lesion were obtained. C-reactive protein (CRP) and serum amyloid A (SAA1, SAA2 and SAA4) gene expressions were evaluated by RT-PCR. Protein levels were evaluated in paraffin embedded lung tissues by immunohistochemistry and in serum samples by nephelometry. RESULTS: Our study included 85 patients with COPD and 87 resistant smokers. In bronchial and parenchymal tissues, both CRP and SAA were overexpressed in COPD patients. In the bronchus, CRP, SAA1, SAA2, and SA4 gene expressions in COPD patients were 1.89-fold, 4.36-fold, 3.65-fold, and 3.9-fold the control values, respectively. In the parenchyma, CRP, SAA1, and SAA2 gene expressions were 2.41-, 1.97-, and 1.76-fold the control values, respectively. Immunohistochemistry showed an over-stained pattern of these markers on endovascular cells of COPD patients. There was no correlation with serum protein concentration. CONCLUSIONS: These results indicate an overexpression of CRP and SAA in both bronchial and parenchymal tissue in COPD, which differs between both locations, indicating tissue/cell type specificity. The endothelial cells might play a role in the production of theses markers.