RESUMEN
BACKGROUND: Chronic inflammation, typified by increased expression of IL-17A, together with airway and parenchymal remodelling are features of chronic lung diseases. Emerging evidence suggests that phenotypic heterogeneity of repair and inflammatory capacities of fibroblasts may contribute to the differential structural changes observed in different regions of the lung. OBJECTIVE: To investigate phenotypic differences in parenchymal and bronchial fibroblasts, either in terms of inflammation and remodelling or the ability of these fibroblasts to respond to IL-17A. METHODS: Four groups of primary fibroblasts were used: normal human bronchial fibroblast (NHBF), normal human parenchymal fibroblast (NHPF), COPD human bronchial fibroblast (CHBF) and COPD human parenchymal fibroblast (CHPF). Cytokine and extracellular matrix (ECM) expression were measured at baseline and after stimulation with IL-17A. Actinomycin D was used to measure cytokine mRNA stability. RESULTS: At baseline, we observed higher protein production of IL-6 in NHPF than NHBF, but higher levels of IL-8 and GRO-α in NHBF. IL-17A induced a higher expression of GRO-α (CXCL1) and IL-6 in NHPF than in NHBF, and a higher level of IL-8 expression in NHBF. IL-17A treatment decreased the mRNA stability of IL-6 in NHBF when compared with NHPF. CHPF expressed higher protein levels of fibronectin, collagen-I and collagen-III than CHBF, NHBF and NHPF. IL-17A increased fibronectin and collagen-III protein only in NHPF and collagen-III protein production in CHBF and CHPF. CONCLUSIONS AND CLINICAL RELEVANCE: These findings provide insight into the inflammatory and remodelling processes that may be related to the phenotypic heterogeneity of fibroblasts from airway and parenchymal regions and in their response to IL-17A.
Asunto(s)
Bronquios/metabolismo , Fibroblastos/metabolismo , Inflamación/etiología , Inflamación/metabolismo , Interleucina-17/metabolismo , Tejido Parenquimatoso/metabolismo , Bronquios/citología , Citocinas/genética , Citocinas/metabolismo , Matriz Extracelular , Fibroblastos/efectos de los fármacos , Expresión Génica , Humanos , Interleucina-17/farmacología , Tejido Parenquimatoso/citología , Enfermedad Pulmonar Obstructiva Crónica/etiología , Enfermedad Pulmonar Obstructiva Crónica/metabolismo , Estabilidad del ARN , ARN Mensajero/genética , ARN Mensajero/metabolismo , Proteínas Recombinantes/farmacologíaRESUMEN
RESUMO A preocupação com o tratamento do Diabetes mellitus (DM) leva a uma crescente busca por terapias alternativas, como o uso de plantas medicinais, entre as quais, destaca-se o uso de Handroanthus heptaphyllus (Mart.) Mattos (popular Ipê roxo). Neste estudo realizamos a investigação química da presença de compostos fenólicos em H. heptaphyllus e o efeito do tratamento com o extrato aquoso da casca desta planta em parâmetros bioquímicos e nos níveis de lipoperoxidação tecidual e plasmática em animais diabéticos. Metodologia: Ratos Wistar machos foram submetidos ao desenvolvimento do quadro de DM por meio da administração intraperitoneal (IP) de Aloxano monohidrato (150 mg/Kg IP). Após a confirmação de hiperglicemia (>200 mg dL-1), os animais foram distribuídos nos grupos Diabético (D; n=6) e Diabético Tratado (DT; n=6). O tratamento consistiu na administração diária do extrato aquoso da casca de H. heptaphyllus via oral (v.o.) (150mg/Kg v.o.) por quatro semanas. O extrato aquoso foi analisado qualitativamente por cromatografia de camada delgada. Resultados: A análise qualitativa do extrato aquoso da casca indicou a presença de compostos fenólicos da subclasse flavonoides. O tratamento com o extrato aquoso reduziu a glicemia de jejum a partir da 3ª semana de tratamento, melhorou a resposta glicêmica à sobrecarga de glicose, diminuiu os níveis de triglicerídeos e índice LDL (Triglicerídeos/HDL). Estes resultados sugerem o uso terapêutico do extrato aquoso das cascas de H. heptaphyllus no tratamento do DM.
ABSTRACT Alternative medicine for diabetes mellitus (DM) treatment represents a growing research area on the use of medicinal plants, of which Handroanthus heptaphyllus (mart.) Mattos (popularly known as purple ipe) is most prominent. In this study, we investigated the presence of phenolic compounds and the effects of treatment with aqueous extract of in H. heptaphyllus in biochemical profile in plasma and the levels of lipid peroxidation in tissues and plasma in diabetic animals. Male Wistar rats were induced to develop DM through intraperitoneal (IP) administration of alloxan monohydrate (150 mg/kg IP). Once hyperglycemia (>200 mg dL-1) was confirmed, the animals were divided into the Diabetic (D; n=6) and Treated Diabetic (TD; n=6) groups. The TD group received daily administration (150 mg/kg v.o.) of aqueous extract of H. heptaphyllus for four weeks. The aqueous extract was also analyzed qualitatively by layer chromatography. Qualitative analysis of the aqueous extract of the bark indicated the presence of phenolic compounds from the flavonoid subclass. The treatment with the aqueous extract reduced fasting blood glucose levels from the third week of treatment on, improved the glycemic response to the glucose tolerance test, and lowered the levels of triglycerides and the LDL index (triglycerides/HDL). These findings suggest therapeutic use of the aqueous extract of H. heptaphyllus bark in treating DM.
Asunto(s)
Ratas , Ratas/clasificación , Tabebuia/química , Compuestos Fenólicos/análisis , Plantas Medicinales/clasificación , Diabetes Mellitus/fisiopatologíaRESUMEN
BACKGROUND: Infiltration of fibrocytes (FC) in the airway smooth muscle is a feature of asthma, but the pathological significance is unknown. OBJECTIVE: We sought to explore whether FC modulate the phenotype of airway smooth muscle cells (ASMC) in asthmatic vs. control subjects. METHODS: Fibrocytes were isolated from CD14+ monocytes from asthmatic and normal subjects. Proliferation of ASMC of asthmatic or normal subjects was analysed by (3) H-thymidine incorporation, cell number counting and Ki-67 expression after treatment of ASMC with FC-conditioned medium (FCCM) or co-culture with FC. ASMC-associated cytokines/chemokines implicated in asthma (TGF-ß1, eotaxin, IL-6 and IL-8) were measured in co-culture or transwell culture of ASMC + FC by ELISA. Immunofluorescence staining was performed to localize these cytokines in ASMC. Cytokine secretion was measured in the transwell culture of ASMC + FC, where NF-κB-p65 or ERK1/2 in ASMC was silenced by siRNA. Contractile phenotype of ASMC in transwell culture was assessed by immunoblotting of α-smooth muscle actin (α-SMA) and myosin light chain kinase (MLCK). RESULTS: Fibrocytes did not affect ASMC proliferation and expression of TGF-ß1, eotaxin, α-SMA and MLCK; however, ASMC production of IL-8 and IL-6 was increased in the co-culture and transwell culture by FC. ASMC treated with FCCM were immunopositive for IL-8/IL-6 and produced more IL-8/IL-6. Furthermore, siRNA silencing of NF-κB-p65 or ERK1/2 in transwell cultures of asthmatic ASMC with normal subject FC decreased IL-8 and IL-6 production. CONCLUSIONS AND CLINICAL RELEVANCE: Fibrocytes promoted IL-8 and IL-6 production by ASMC, demonstrating a proinflammatory role for FC and a possible mechanism of the inflammatory phenotype in asthma.
Asunto(s)
Asma/metabolismo , Asma/patología , Monocitos/metabolismo , Miocitos del Músculo Liso/metabolismo , Fenotipo , Actinas/metabolismo , Adulto , Asma/diagnóstico , Asma/inmunología , Estudios de Casos y Controles , Comunicación Celular , Diferenciación Celular , Células Cultivadas , Técnicas de Cocultivo , Colágeno Tipo I/metabolismo , Femenino , Humanos , Interleucina-6/biosíntesis , Interleucina-8/biosíntesis , Masculino , Persona de Mediana Edad , Monocitos/citología , Quinasa de Cadena Ligera de Miosina/metabolismo , Transducción de SeñalRESUMEN
In light of the failure to eliminate measles by 2010, the closure of any gaps in immunisation coverage is of paramount importance to interrupt transmission and to protect vulnerable individuals. Not only vaccination-critical attitudes of parents but furthermore the medical advice by physician in charge influence the vaccine uptake. 3 groups of factors which potentially influence parental decisions on child vaccination were analysed by univariable and multivariable logistic regression for the timely uptake of the first and the second dose of measles vaccination: parents' attitudes towards immunization, the influence of medical and laypersons and the influence of the advice of a medical doctor. A total of 3 041 children were eligible for the analysis. 53.0% of these received the first and 42.9% the second MMR dose in time. If parents considered that vaccinations are important and protective as well as the consulted physician advices towards vaccinations, children had significantly higher chances of a timely vaccination. Whereas, if parents were afraid of vaccinations or get advised by an alternative practitioner, the children had lower chances of being vaccinated in time. If medical providers help parents to reduce uncertainties about vaccination the chance for children to be vaccinated in time increased. It appeared that there still are unmet information needs after the medical consultation. By and large the medical advice plays an important role for vaccination uptake and its timing. In order to raise the vaccination rates further target-population specific approaches are needed.
Asunto(s)
Actitud Frente a la Salud , Toma de Decisiones , Esquemas de Inmunización , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Padres/psicología , Aceptación de la Atención de Salud/psicología , Rol del Médico/psicología , Estudios de Cohortes , Terapias Complementarias/psicología , Femenino , Encuestas Epidemiológicas , Humanos , Inmunización Secundaria , Lactante , Estimación de Kaplan-Meier , Masculino , Vacuna contra el Sarampión-Parotiditis-Rubéola/efectos adversos , Derivación y ConsultaRESUMEN
BACKGROUND: Mechanical strain and cytokine stimulation are two important mechanisms leading to airway remodeling in asthma. The effect of mechanical strain on cytokine secretion in airway fibroblasts is not known. The aim of this study was to determine whether bronchial and nasal fibroblasts differentially alter cytokine secretion in response to mechanical strain. METHODS: We measured secretion of the pro-fibrotic cytokine, interleukin-6 (IL-6), and the pro-inflammatory cytokines, IL-8 and monocyte chemotactic protein 1, before and after mechanical strain in bronchial fibroblasts obtained from asthmatic patients [asthmatic bronchial fibroblasts (BAF)] and normal volunteers [normal bronchial fibroblasts (BNF)], and in nasal fibroblasts (NF) obtained from nasal polyps. Cells were grown on flexible membranes and a mechanical strain of 30% amplitude, 1 Hz frequency was applied for 3, 6 and 24 h. Control cells were unstrained. IL-6, IL-8 and monocyte chemotactic protein 1 was measured after 24 h strain using enzyme-linked immunoassay; mRNA was measured by real time polymerase chain reaction. We also measured mRNA for versican, a matrix proteoglycan, known to be upregulated in the asthmatic airway wall. RESULTS: In unstrained conditions, no differences in cytokine secretion were observed. After 24 h strain, BAF secreted more IL-6 than BNF. Mechanical strain increased IL-8 mRNA in BAF, BNF and NF; and IL-6 and versican mRNA, in BAF, only. CONCLUSIONS: Cytokine responses to mechanical strain varied in different airway fibroblast populations, and depended on the site of origin, and the underlying inflammatory state. Strain resulted in IL-6 upregulation and increased message for extracellular matrix protein in bronchial fibroblasts from asthmatic patients only, and may reflect these patients' propensity for airway remodeling.
Asunto(s)
Asma/patología , Fenómenos Biomecánicos/genética , Bronquios/patología , Quimiocinas/genética , Citocinas/genética , Fibroblastos/patología , Adolescente , Adulto , Asma/inmunología , Bronquios/inmunología , Estudios de Casos y Controles , Proteínas de la Matriz Extracelular/genética , Femenino , Fibroblastos/inmunología , Humanos , Interleucina-6/genética , Masculino , Regulación hacia Arriba , Adulto JovenRESUMEN
The aim of the Bavarian immunisation concept is the effective implementation of national vaccination recommendations taking into account known characteristics in Bavaria and social groups with limited access to vaccinations. Furthermore, it intends to coordinate the various players in the field of vaccine-prevention of disease. Key points of this concept are, among others, improvement of the available data, definition of vaccination aims, implementation of vaccination recall systems during the regular examination on entering primary and secondary school, coordination and enforcement of vaccination campaigns in schools as well as steps for the qualification and motivation of the physicians involved in vaccination. In addition, an independent committee for the coordination of professionals and institutions participating in vaccine prevention in Bavaria was created. This "Bayerische Landesarbeitsgemeinschaft Impfen (LAGI)", which was established at the end of 2006 includes representatives from medical associations and corporations, health insurance companies and public health agencies and is the key for the realisation and further development of this concept.
Asunto(s)
Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Promoción de la Salud/organización & administración , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , Vacunación Masiva/métodos , Vacunación Masiva/organización & administración , Alemania/epidemiología , Promoción de la Salud/métodos , HumanosRESUMEN
Between January and June 2007, a total of 90 cases of measles were notified in Passau and Rottal-Inn, two districts of Lower Bavaria in south-east Germany sharing a border with Austria.
Asunto(s)
Brotes de Enfermedades , Sarampión/epidemiología , Adolescente , Adulto , Niño , Preescolar , Alemania/epidemiología , Humanos , Lactante , Sarampión/diagnóstico , Sarampión/prevención & control , Vacuna Antisarampión/uso terapéuticoRESUMEN
Excessive airway obstruction is the cause of symptoms and abnormal lung function in asthma. As airway smooth muscle (ASM) is the effecter controlling airway calibre, it is suspected that dysfunction of ASM contributes to the pathophysiology of asthma. However, the precise role of ASM in the series of events leading to asthmatic symptoms is not clear. It is not certain whether, in asthma, there is a change in the intrinsic properties of ASM, a change in the structure and mechanical properties of the noncontractile components of the airway wall, or a change in the interdependence of the airway wall with the surrounding lung parenchyma. All these potential changes could result from acute or chronic airway inflammation and associated tissue repair and remodelling. Anti-inflammatory therapy, however, does not "cure" asthma, and airway hyperresponsiveness can persist in asthmatics, even in the absence of airway inflammation. This is perhaps because the therapy does not directly address a fundamental abnormality of asthma, that of exaggerated airway narrowing due to excessive shortening of ASM. In the present study, a central role for airway smooth muscle in the pathogenesis of airway hyperresponsiveness in asthma is explored.
Asunto(s)
Obstrucción de las Vías Aéreas/fisiopatología , Asma/fisiopatología , Hiperreactividad Bronquial/fisiopatología , Músculo Liso/fisiopatología , Adaptación Fisiológica , Apoptosis , Humanos , Contracción Muscular/fisiología , Pruebas de Función Respiratoria , Mecánica RespiratoriaRESUMEN
Excess deposition of proteoglycans (PGs) has been described in the subepithelial layer of the asthmatic airway wall. However, less is known about deposition in the airway smooth muscle (ASM) layer, and whether the pattern of deposition is altered depending upon disease severity. Endobronchial biopsies were performed in patients with severe or moderate asthma (defined using American Thoracic Society criteria) and in control subjects. Biopsies were immunostained for the PGs biglycan, lumican, versican and decorin. PG deposition was measured in the subepithelial and ASM layers, the former by calculating the area of positive staining, and the latter by determining the percentage area stained using point counting. Immunostaining for PGs was prominent in biopsies from both moderate and severe asthmatics, compared with control subjects. While there was no difference in the amount of PG in the subepithelial layer between the two asthmatic groups, the percentage area of biglycan and lumican staining in the ASM layer was significantly greater in moderate versus severe asthmatics. Differences in the deposition of proteoglycans within the airway smooth muscle layer of moderate versus severe asthmatics potentially impact on the functional behaviour of the airway smooth muscle in these two groups of patients.
Asunto(s)
Asma/metabolismo , Proteoglicanos Tipo Condroitín Sulfato/metabolismo , Proteínas de la Matriz Extracelular/metabolismo , Sulfato de Queratano/metabolismo , Músculo Liso/metabolismo , Proteoglicanos/metabolismo , Versicanos/metabolismo , Adulto , Anciano , Asma/patología , Biglicano , Bronquios/metabolismo , Bronquios/patología , Estudios de Casos y Controles , Decorina , Femenino , Humanos , Lumican , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadRESUMEN
Administration of bleomycin (BM) produces inflammation and fibrosis of the lung in humans and experimental animals. The molecular defects by which BM induces these pathological effects have not been studied in detail. We studied the expression of Smad family proteins, key molecules involved in mediating transforming growth factor (TGF)-beta signaling from the cell membrane to the nucleus, during the early and late phases of BM-induced fibrogenesis. Pulmonary fibrosis was induced in male Sprague-Dawley rats by a single intratracheal injection (1.5 units) of BM. Control rats received saline. Rats were killed at 3, 5, 7, 14, and 28 days after BM, cytosolic and nuclear proteins were extracted and isolated from lung tissues, and Smad proteins were probed with specific antibodies. In BM-exposed lung tissue, compared with control, Smad3 decreased persistently in the cytosol and increased transiently in the nucleus. There was a persistent increase in phosphorylation and nuclear accumulation of Smad2/3. Smad4 was increased transiently in both the cytosol and nucleus. A significant and progressive decrease in the expression of Smad7, the endogenous inhibitor of TGF-beta/Smad signaling, was observed after BM instillation. Collectively, our results indicate that an imbalance between agonistic Smads2-4 and antagonistic Smad7 may result in the unchecked activation of an autocrine TGF-beta loop, which contributes to the pathogenesis of BM-induced pulmonary fibrosis.
Asunto(s)
Bleomicina/toxicidad , Proteínas de Unión al ADN/genética , Fibrosis Pulmonar/inducido químicamente , Fibrosis Pulmonar/patología , Transducción de Señal/genética , Transactivadores/genética , Animales , Núcleo Celular/metabolismo , Citosol/metabolismo , Masculino , Ratas , Ratas Sprague-Dawley , Proteínas Smad , Proteína smad3 , Proteína smad7RESUMEN
BACKGROUND: Remodelling of the asthmatic airway includes increased deposition of proteoglycan (PG) molecules. One of the stimuli driving airway remodelling may be excessive mechanical stimulation. OBJECTIVE: We hypothesized that fibroblasts from asthmatic patients would respond to excessive mechanical strain with up-regulation of message for PGs. METHODS: We obtained fibroblasts from asthmatic patients (AF) and normal volunteers (NF) using endobronchial biopsy. Cells were maintained in culture until the fifth passage and then grown on a flexible collagen-coated membrane. Using the Flexercell device, cells were then subjected to cyclic stretch at 30% amplitude at 1 Hz for 24 h. Control cells were unstrained. Total RNA was extracted from the cell layer and quantitative RT-PCR performed for decorin, lumican and versican mRNA. RESULTS: In unstrained cells, the expression of decorin mRNA was greater in AF than NF. With strain, NF showed increased expression of versican mRNA and AF showed increased expression of versican and decorin mRNA. The relative increase in versican mRNA expression with strain was greater in AF than NF. CONCLUSIONS: These data support the hypothesis that proteoglycan message is increased in asthmatic fibroblasts subject to mechanical strain. This finding has implications for the mechanisms governing airway wall remodelling in asthma.
Asunto(s)
Asma/metabolismo , Fibroblastos/metabolismo , Proteoglicanos/metabolismo , Adulto , Análisis de Varianza , Asma/patología , Bronquios/patología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Estrés MecánicoRESUMEN
In 2002 nearly 36 000 cases of notifiable infectious diseases were reported in Bavaria representing a 10 % increase compared to 2001 (33 000 cases). As in 2001, around 75 % of reported cases were gastrointestinal infections. Every third infection was due to salmonella. As compared to last year, the incidence of Norwalk-like virus infections increased fivefold. These infections occurred mostly as outbreaks in nursing homes, hospitals or other institutions, affecting as many as 200 persons. Other frequently reported infections in Bavaria are tuberculosis and hepatitis. The relatively high incidence of measles is mainly due to an outbreak in Coburg. The decline in the incidence of tuberculosis observed over the last years has ceased. Around 70 % of reported hepatitis cases were due to hepatitis C. It should be noted that these cases were a mixture of new infections and ongoing infections diagnosed for the first time. Of great epidemiological importance are diseases caused by meningitis pathogens. The incidence of meningococcal infections was practically unchanged as compared to last year. Around half of them were caused by serotype B, which is currently not preventable by vaccination. Meningitis caused by Haemophilus influenzae B is continually declining due to the high vaccination rate and is very rarely reported. Several cases of FSME were described. According to investigations carried out by health departments these infections were acquired in countries not yet classified as FSME risk areas. Hence, the endemics maps of FSME have to be revised. Two years of reporting according to IfSG (infectious disease control law) yielded very encouraging results, i. e. rapid accessibility of data, flexibility, complete and standardised reporting with high quality of data. We thank all the reporting physicians and laboratories and the staff of the Bavarian health departments for their continuous support.
Asunto(s)
Enfermedades Transmisibles/epidemiología , Brotes de Enfermedades , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Estudios de Cohortes , Notificación de Enfermedades , Alemania/epidemiología , Hepatitis C/epidemiología , Humanos , Lactante , Recién Nacido , Sarampión/epidemiología , Infecciones Meningocócicas/epidemiología , Persona de Mediana Edad , Vigilancia de la Población , Factores de Riesgo , Tuberculosis/epidemiologíaRESUMEN
Large amplitude oscillations of contracted airway smooth muscle cause relative relaxation of the preparation. However, little is known about the effect of mechanical stretch on distal lung behaviour. Rat parenchymal strips were suspended in an organ bath and attached at one end to a force transducer and at the other end to a servo-controlled lever arm that effected length changes. Mechanical impedance of the strip was measured by applying a complex signal consisting of pseudorandom length oscillations of varying frequencies (0.5-19.75 Hz). A constant phase model was fit to changes in length and tension to calculate tissue damping (G) and elastance (H). Hysteresivity was calculated as G/H. Impedance was measured before and after sinusoidal length oscillation at different amplitudes (1, 3, 10 and 25% of resting length) at a frequency of 1 Hz under baseline conditions and after acetylcholine-induced constriction. Oscillations of 10 and 25% amplitudes significantly decreased the G and H of the lung strip. The effect of length oscillations was no different in control versus constricted strips. These data suggest that in the distal lung, large stretches affect the structural components of the extracellular matrix rather than the contractile elements.
Asunto(s)
Resistencia de las Vías Respiratorias/fisiología , Matriz Extracelular/fisiología , Rendimiento Pulmonar/fisiología , Mecanorreceptores/fisiología , Acetilcolina/farmacología , Resistencia de las Vías Respiratorias/efectos de los fármacos , Animales , Técnicas de Cultivo , Elasticidad , Matriz Extracelular/efectos de los fármacos , Rendimiento Pulmonar/efectos de los fármacos , Mecanorreceptores/efectos de los fármacos , Oscilometría , Ratas , Ratas Sprague-Dawley , Mecánica Respiratoria/efectos de los fármacos , Mecánica Respiratoria/fisiologíaRESUMEN
The viscoelastic properties of the pulmonary parenchyma change rapidly postparturition. We compared changes in mechanical properties with changes in tissue composition of rat lung parenchymal strips in three groups of Sprague-Dawley rats: baby (B; 10-14 days), young (Y; approximately 3 wk), and adult (A; approximately 8 wk). Strips were suspended in an organ bath, and resistance (R), elastance (E), and hysteresivity (eta) were calculated during sinusoidal oscillations before and after the addition of acetylcholine (ACh) (10(-3) M). Strips were then fixed in formalin, and sections were stained with hematoxylin and eosin, Verhoff's elastic stain, or Van Gieson's picric acid-fuchsin stain for collagen. The volume proportion of collagen (%Col), the length density of elastic fibers (L(V)/Pr(alv)), and the arithmetic mean thickness of alveolar septae (T(a)) were calculated by morphometry. Tissue was also stained for alpha-smooth muscle actin (ASMA), and the volume proportion of ASMA (%ASMA) was calculated. Hyaluronic acid (HA) was quantitated by radioimmunoassay in separate strips. R and E in B strips were significantly higher, whereas eta was significantly smaller than in Y or A strips. Changes in these parameters with ACh were greater in B strips. T(a), %ASMA, and HA were greatest in B strips, whereas %Col and L(V)/Pr(alv) were least. There were significant positive correlations between R and E vs. T(a) and between percent change in R and eta post-ACh vs. T(a) and vs. %ASMA, and significant negative correlations between R and E vs. %Col and vs. L(V)/Pr(alv) and percent increase in all three mechanical parameters post-ACh vs. %Col. These data suggest that the relatively high stiffness, R, and contractile responsiveness of parenchymal tissues observed in newborns are not directly attributable to the amount of collagen and elastic fibers in the tissue, but rather they are related to the thickened alveolar wall and the relatively greater percent of contractile cells.
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Matriz Extracelular/fisiología , Pulmón/crecimiento & desarrollo , Pulmón/fisiología , Mecánica Respiratoria/fisiología , Acetilcolina/metabolismo , Actinas/metabolismo , Animales , Colágeno/metabolismo , Elastina/metabolismo , Femenino , Ácido Hialurónico/metabolismo , Inmunohistoquímica , Técnicas In Vitro , Masculino , Fibras Musculares Esqueléticas/ultraestructura , Músculo Liso/metabolismo , Alveolos Pulmonares/ultraestructura , Ratas , Ratas Sprague-DawleyRESUMEN
Excessive mechanical ventilation results in changes in lung tissue mechanics. We hypothesized that changes in tissue properties might be related to changes in the extracellular matrix component proteoglycans (PGs). The effect of different ventilation regimens on lung tissue mechanics and PGs was examined in an in vivo rat model. Animals were anesthetized, tracheostomized, and ventilated at a tidal volume of 8 (VT(8)), 20, or 30 (VT(30)) ml/kg, positive end-expiratory pressure of 0 (PEEP(0)) or 1.5 (PEEP(1.5)) cmH(2)O, and frequency of 1.5 Hz for 2 h. The constant-phase model was used to derive airway resistance, tissue elastance, and tissue damping. After physiological measurements, one lung was frozen for immunohistochemistry and the other was reserved for PG extraction and Western blotting. After 2 h of mechanical ventilation, tissue elastance and damping were significantly increased in rats ventilated at VT(30)PEEP(0) compared with control rats (ventilated at VT(8)PEEP(1.5)). Versican, basement membrane heparan sulfate PG, and biglycan were all increased in rat lungs ventilated at VT(30)PEEP(0) compared with control rats. At VT(30)PEEP(0), heparan sulfate PG and versican staining became prominent in the alveolar wall and airspace; biglycan was mostly localized in the airway wall. These data demonstrate that alterations in lung tissue mechanics with excessive mechanical ventilation are accompanied by changes in all classes of extracellular matrix PG.
Asunto(s)
Proteoglicanos Tipo Condroitín Sulfato/metabolismo , Proteoglicanos de Heparán Sulfato/metabolismo , Pulmón/fisiología , Respiración con Presión Positiva , Proteoglicanos/metabolismo , Resistencia de las Vías Respiratorias/fisiología , Animales , Biglicano , Matriz Extracelular/química , Matriz Extracelular/metabolismo , Proteínas de la Matriz Extracelular , Immunoblotting , Inmunohistoquímica , Lectinas Tipo C , Pulmón/citología , Pulmón/metabolismo , Masculino , Respiración con Presión Positiva/efectos adversos , Respiración con Presión Positiva/métodos , Ratas , Ratas Sprague-Dawley , VersicanosRESUMEN
"Because they know what they do" should be the contribution of cancer registration to prevention. The public should be informed about the successes and failures of prevention. In addition, each doctor and each hospital should know the long-term results for its patients despite the complex interdisciplinary health care provision. At the same time, the regional results should be available and contrasted with clinical studies and international standards. An important criterion is also the quality of life of the patients, whose cooperation is more than overdue. According to the possibilities of prevention, six important levels can be differentiated. On each level the outcome should be evaluated on the basis of slightly differing criteria. Primary prevention has the largest incidence-, and thus, mortality-reduction potential, essentially caused by the giving up of smoking. However, the primary prevention of the tumor depends upon what kind of tumor it is, as primary prevention is possible to different extents. Often, secondary prevention is the earliest intervention possible, that is, the early detection of cancer in prognostically favorable stages. However, early detection only offers a chance of cure, albeit a smaller one, for some kinds of tumor. The third prevention level comprises primary care according to the state-of-the-art standards, followed by posttreatment care (disease-free phase) even when the disease is running a fatal course (palliative phase). In the terminal phase, adequate tumor-pain therapy and symptom-oriented measures stand for the sixth prevention level. Even the quality of life of the dying can be optimized. At the beginning of treatment at the latest, the quality of life should also be added to the outcome criteria. In this paper, the individual levels of prevention and possible evaluation criteria for successful prevention, which a modern cancer registration should submit, are discussed and examples given. If the evaluation of the quality of treatment and its significance for health care provision becomes the central tasks of the cancer registers, they will need to be transformed into service centers for hospitals, doctors, and patients.
Asunto(s)
Neoplasias/prevención & control , Sistema de Registros , Cuidados Posteriores , Neoplasias de la Mama/diagnóstico , Femenino , Humanos , Masculino , Tamizaje Masivo , Neoplasias/diagnóstico , Neoplasias/mortalidad , Cuidados Paliativos , Prevención Primaria , Calidad de Vida , Resultado del TratamientoRESUMEN
We tested the hypothesis that matrix glycosaminoglycans contribute to lung tissue viscoelasticity. We exposed lung parenchymal strips to specific degradative enzymes (chondroitinase ABC, heparitinase I, and hyaluronidase) and determined whether the mechanical properties of the tissue were affected. Subpleural parenchymal strips were obtained from Sprague-Dawley rats and suspended in a Krebs-filled organ bath. One end of the strip was attached to a force transducer and the other to a servo-controlled lever arm that effected sinusoidal oscillations. Recordings of tension and length at different amplitudes and frequencies of oscillation were recorded before and after enzyme exposure. Resistance, dynamic elastance, and hysteresivity were estimated by fitting the equation of motion to changes in tension and length. Quasi-static stress-strain curves were also obtained. Exposure to chondroitinase and heparitinase I caused significant increases in hysteresivity, no decrement in resistance, and similar decreases in dynamic elastance relative to control strips exposed to Krebs solution only. Conversely, measures of static elastance were different in treated versus control strips. Hyaluronidase treatment did not alter any of the mechanical measures. These data demonstrate that digestion of chondroitin sulfate and heparan sulfate alters the mechanical behavior of lung parenchymal tissues.
Asunto(s)
Glicosaminoglicanos/metabolismo , Pulmón/metabolismo , Animales , Condroitina ABC Liasa/metabolismo , Condroitina ABC Liasa/farmacología , Elasticidad/efectos de los fármacos , Hialuronoglucosaminidasa/metabolismo , Hialuronoglucosaminidasa/farmacología , Técnicas In Vitro , Pulmón/citología , Pulmón/efectos de los fármacos , Masculino , Modelos Biológicos , Polisacárido Liasas/metabolismo , Polisacárido Liasas/farmacología , Ratas , Ratas Sprague-Dawley , Estrés Mecánico , Viscosidad/efectos de los fármacosRESUMEN
Bleomycin-induced lung fibrosis results in changes in tissue mechanical properties due to alterations in the extracellular matrix (ECM). How oscillatory mechanics and changes in the matrix evolve over time has not been addressed. Sprague-Dawley rats were instilled with bleomycin sulfate (BM) (1.5 U) intratracheally; control animals (C) received saline. At 7, 14, and 28 d after BM, parenchymal strips (7 x 2 x 2 mm) were obtained and strips suspended in a Krebs-filled organ bath. One end of the strip was attached to a force (F) transducer and the other to a lever arm that effected sinusoidal length (L) oscillations. Strips were oscillated at varying amplitudes (1, 3, and 10% of resting L) and frequencies (f = 0.3, 1, 3, and 10 Hz) at an operating stress of 2 kPa. Resistance (R) and elastance (E) were estimated by fitting changes in F and L to the equation of motion. Hysteresivity (eta) was calculated as eta = (R/E) 2pif. Strips were then fixed for morphological study of collagen, elastic fibers, and the small proteoglycans (PGs), biglycan and fibromodulin (FM). R and E were significantly greater and eta significantly less in BM versus C strips (p < 0.001). The increase in R and E peaked at 14 d after BM; the decrement in eta was maximal at Day 7. Biglycan was increased in BM lung strips at all time points, FM and elastic fibers were increased at 14 and 28 d, and collagen was increased at 28 d only. Hence, changes in mechanics were maximal before collagen content had increased. In addition, we demonstrated a significant correlation between biglycan and all mechanical parameters. These data suggest that changes in PGs may be critical in determining changes in lung tissue viscoelastic behavior in this fibrosis model