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Métodos Terapéuticos y Terapias MTCI
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2.
Am J Respir Crit Care Med ; 149(3 Pt 1): 687-93, 1994 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-8118638

RESUMEN

Bacterial supernatants (BS) obtained from broth cultures of Pseudomonas aeruginosa cause bronchoconstriction in sheep, suggesting that BS contain proinflammatory metabolites. In this study we investigated the mechanism(s) responsible for this bronchial effect. BS were obtained from 48 h cultures and sterilized by filtration. Sheep (n = 6) were intubated and swallowed an esophageal balloon for the measurement of specific lung resistance (SRL). Aerosols of BS (3 ml total) immediately increased SRL (541%). Neither aerosolized broth (control) nor inhaled endotoxin in excess of that contained in the BS had an effect. BS challenges were repeated on separate occasions except that the sheep were treated 30 min before challenge with the anticholinergic agent atropine (0.2 mg/kg, intravenously); the anti-allergic agent nedocromil (1 mg/kg, aerosol); the histamine H1 antagonist chlorpheniramine (2 mg/kg); or the bradykinin (BK) B2 receptor antagonists NPC-567 (5 mg/ml, aerosol) or NPC-17761 (1 mg/ml aerosol). The results showed that greater than 90% protection (p < 0.05) was achieved when the animals were pretreated with atropine, nedocromil sodium, or either of the two BK antagonists, but only 27 +/- 21% protection was seen with chlorpheniramine pretreatment. These findings are characteristic of a BK-mediated response. Analysis of bronchoalveolar lavage fluid obtained before and after BS challenge confirmed that i-kinins, but not histamine, increased (p < 0.05) from 61 +/- 7 to 304 +/- 55 pg/ml. Control (broth) challenges produced no such change. To identify the metabolites involved, we tested the effects of aerosolizing two suspected components of BS, 1-hydroxyphenazine (1-HP) and pyocyanine (PYO) in five sheep.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Enfermedades Bronquiales/inducido químicamente , Endotoxinas/farmacología , Fenazinas/farmacología , Pseudomonas aeruginosa , Piocianina/farmacología , Administración por Inhalación , Aerosoles , Resistencia de las Vías Respiratorias/efectos de los fármacos , Animales , Atropina/uso terapéutico , Bradiquinina/análogos & derivados , Bradiquinina/antagonistas & inhibidores , Bradiquinina/uso terapéutico , Antagonistas de los Receptores de Bradiquinina , Enfermedades Bronquiales/complicaciones , Enfermedades Bronquiales/tratamiento farmacológico , Enfermedades Bronquiales/fisiopatología , Líquido del Lavado Bronquioalveolar/química , Clorfeniramina/uso terapéutico , Constricción Patológica/inducido químicamente , Constricción Patológica/complicaciones , Constricción Patológica/tratamiento farmacológico , Constricción Patológica/fisiopatología , Evaluación Preclínica de Medicamentos , Femenino , Inflamación , Cininas/análisis , Nedocromil/uso terapéutico , Fenazinas/metabolismo , Premedicación , Pseudomonas aeruginosa/metabolismo , Piocianina/metabolismo , Ovinos
4.
N Engl J Med ; 299(11): 564-9, 1978 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-355877

RESUMEN

We studied the effect of vitamin E on the development of bronchopulmonary dysplasis in neonates with respiratory-distress syndrome. Twenty infants received vitamin E administered intramuscularly during the acute phase of the syndrome, and 20 infants served as controls. Administration of vitamin E significantly increased the serum vitamin E concentration. Nine vitamin-treated and 13 control patients required supplemental oxygen for longer than 250 hours; all were treated with positive-pressure ventilation and endotracheal continuous distending airway pressure. Six of those 13 controls had x-ray changes consistent with bronchopulmonary dysplasia, and four died. None of the nine vitamin-treated patients had changes characteristic of bronchopulmonary dysplasia (P = 0.046), and all survived. Administration of vitamin E during the acute phase of the respiratory-distress syndrome appears to modify the development of bronchopulmonary dysplasis.


Asunto(s)
Enfermedades Bronquiales/prevención & control , Enfermedades del Prematuro/prevención & control , Enfermedades Pulmonares/prevención & control , Terapia por Inhalación de Oxígeno/efectos adversos , Síndrome de Dificultad Respiratoria del Recién Nacido/complicaciones , Vitamina E/uso terapéutico , Enfermedades Bronquiales/inducido químicamente , Enfermedades Bronquiales/diagnóstico por imagen , Ensayos Clínicos como Asunto , Femenino , Humanos , Recién Nacido , Enfermedades del Prematuro/inducido químicamente , Enfermedades del Prematuro/diagnóstico por imagen , Inyecciones Intramusculares , Enfermedades Pulmonares/inducido químicamente , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Oxígeno/toxicidad , Radiografía , Respiración Artificial , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Vitamina E/administración & dosificación , Vitamina E/sangre
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