Tick salivary protein Cystatin: structure, anti-inflammation and molecular mechanism.

Ticks are blood-sucking ectoparasites that secrete immunomodulatory substances in saliva to hosts during engorging. Cystatins, a tick salivary protein and natural inhibitor of Cathepsins, are attracting growing interest globally because of the immunosuppressive activities and the feasibility as an antigen for developing anti-tick vaccines. This review outlines the classification and the structure of tick Cystatins, and focuses on the anti-inflammatory effects and molecular mechanisms. Tick Cystatins can be divided into four families based on structures and cystatin 1 and cystatin 2 are the most abundant. They are injected into hosts during blood feeding and effectively mitigate the host inflammatory response. Mechanically, tick Cystatins exert anti-inflammatory properties through the inhibition of TLR-NF-κb, JAK-STAT and p38 MAPK signaling pathways. Further investigations are crucial to confirm the reduction of inflammation in other cell types like neutrophils and mast cells, and fully elucidate the underlying mechanism (like the structural mechanism) to make Cystatin a potential candidate for the development of novel anti-inflammation agents.

Bi-level positive airway pressure ventilation for post-extubation respiratory support under deep anesthesia in hypertension patients / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the effect of bi-level positive airway pressure ventilation (BiPAP) for post-extubation respiratory support under deep anesthesia in hypertension patients.@*METHODS@#Forty primary hypertension patients who were scheduled for lower abdominal surgery or total hip joint replacement were randomly divided into 2 groups: one was extubated when being awake (Group A, n = 20, and the other was extubated under deep anesthesia (Group B, n = 20). The combined inhalation and the intravenous general anesthesia were performed on all patients, and inhalation anesthesia was maintained with only continued infusion of propofol when major procedure of surgery had been finished. In Group A, anesthesia was ceased when the surgery was finished, and trachea was removed after the patients awoke. In Group B, anesthesia was ceased immediately before the extubation, and trachea was removed under deep anesthesia, followed by an uninvasive ventilation of BiPAP. Blood pressure (BP, heart rate ( HR, and bispectral index (BIS) before or after the extubation, artery blood-gass analysis in BIPAP, and the incidence rate of complication in the recovery period were recorded.@*RESULTS@#In Group A, BP and HR increased significantly after the patients awoke (P < 0.01) and after the extubation (P < 0.05), compared with the data before the surgery and before the extubation. In Group B, however, BP and HR had no difference before and after the extubation, and the data of blood gas maintained approximately normal. The incidence rate of glos- soptosis in Group B was obviously higher than those in Group A (P < 0.01), while complications such as cough during the recovery stage in Group A were more than those in Group B (P <0.05).@*CONCLUSION@#BiPAP is suitable for post-extubation respiratory support under deep anesthesia in hypertension patients.