ABSTRACT
Bronchial asthma is characterized by chronic lung inflammation, airway hyperresponsiveness, and airway remodelling. Astragaloside IV (3-O-ß-D-xylopyranosyl-6-O-ß-D-glucopyranosyl-cycloastragenol, AST), the primary pure saponin isolated from the root of Astragalus membranaceus, is an effective compound with distinct pharmacological effects including anti-inflammation, immunoregulation, and antifibrosis. However, the effect of AST on asthma remains unclear. In the present study, in the murine model of asthma, the airway hyperresponsiveness was relieved after treatment with AST, accompanied by a reduction of inflammatory cells. In addition, the levels of IL-4 and IL-5 decreased, while the IFN-γ level increased, in bronchoalveolar lavage fluid. The compound also significantly inhibited the synthesis of GATA-3-encoding mRNA and protein in addition to increasing the synthesis of T-bet-encoding mRNA and protein in both lung tissues and CD4+ T cells. Our findings indicate that AST treatment inhibits ovalbumin-induced airway inflammation by modulating the key master switches GATA-3 and T-bet, which results in committing T helper cells to a Th1 phenotype.
Subject(s)
Asthma/prevention & control , Astragalus propinquus/chemistry , Bronchial Hyperreactivity/prevention & control , Saponins/pharmacology , Triterpenes/pharmacology , Animals , Asthma/immunology , Asthma/physiopathology , Bronchial Hyperreactivity/immunology , Bronchoalveolar Lavage Fluid , Disease Models, Animal , Female , GATA3 Transcription Factor/genetics , Interferon-gamma/immunology , Interleukin-4/immunology , Interleukin-5/immunology , Male , Mice , Mice, Inbred BALB C , Ovalbumin/immunology , Pneumonia/immunology , Pneumonia/prevention & control , RNA, Messenger/metabolism , Saponins/isolation & purification , Triterpenes/isolation & purificationABSTRACT
OBJECTIVE: To summarize the experience in diagnosis and treatment of pulmonary hypertension caused by sleep hypoventilation. METHODS: The clinical data of 4 patients in a family with pulmonary hypertension caused by sleep hypoventilation, full brothers and sisters, 2 (Cases 1 and 2) being treated presently and 2 (Cases 3 and 4) being deceased and traced by family medical history, were retrospectively analyzed. RESULTS: Three of the 4 cases (cases 1, 3, and 4) were misdiagnosed as with cor pulmonale combined with pulmonary hypertension, and one case (case 2) was misdiagnosed as with primary pulmonary hypertension. Polysomnography (PSG) revealed alveolar hypoventilation-induced long period of oxygen desaturation at sleep in Cases 1 and 2, thus confirming the diagnosis. Pulmonary function test showed that the percentage of maximum inspiratory pressure (PImax) in predicted value (51.5% and 20.9%) and the maximum expiratory pressure (PEmax) in predicted value (51.3% and 29.6%) decreased, the percentage of mouth occlusion pressure (P0.1) in predicted value (141% and 133%) compensatively increased, and the respiratory muscle strength decreased in Cases 1 and 2, which suggested that there was neuromuscular disorder in these patients. Treated by noninvasive ventilation the symptoms of these 2 patients were improved and they were discharge at last. Subsequently, they were treated by long-term night noninvasive ventilation at home, and returned to normal work and life. During the follow-up for 22 and 12 months respectively after discharge, PSG showed that the alveolar hypoventilation-induced long period oxygen desaturation at sleep had been greatly improved, and echocardiogram showed that the pulmonary pressure was greatly decreased. CONCLUSION: For the patients with unexplained pulmonary hypertension, PSG monitoring and pulmonary function tests such as PImax, PEmax, and P0.1 help determine the etiology, and long-term night noninvasive ventilation at home can improve the outcome of sleep hypoventilation-induced pulmonary hypertension.
Subject(s)
Hypertension, Pulmonary/etiology , Hypoventilation/complications , Sleep , Female , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/genetics , Hypoventilation/diagnosis , Hypoventilation/genetics , Male , Middle Aged , Pedigree , Retrospective StudiesABSTRACT
OBJECTIVE: To investigate the perioperative management, recipient selection of end-stage lung diseases dependent on ventilator, and the strategy of ventilator weaning. METHODS: Fifteen patients underwent lung transplantation in our hospital from 2002 to 2005. Of them, three were dependent on ventilator for 89, 120 and 107 days respectively because of end-stage pulmonary emphysema before operation. Single-lung transplantation was performed in one patient and sequential bilateral single-lung transplantations were performed in two patients without extracorporeal circulation. RESULTS: The three patients were weaned from ventilator in the sixth, eleventh and twenty second day respectively after operation. They were discharged from hospital 71 d, 41 d, and 67 d respectively after operation. They had been followed up for 22, 4, and 2 months respectively before this analysis. Their quality of life improved significantly. CONCLUSION: Lung transplantation is effective for the treatment of ventilator dependent end-stage lung diseases.