Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 16.460
Filtrar
2.
Life Sci ; 241: 117166, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31843527

RESUMO

AIMS: Congenital diaphragmatic hernia (CDH) is a lethal birth defect characterized by congenital lung malformation, and the severity of pulmonary hypoplasia directly affects the prognosis of infants with CDH. Using a nitrofen-induced CDH rat model, we previously reported that Foxa2 expression was downregulated in CDH lungs by proteomics analysis. Here, we investigate the role of miR-130a-5p/Foxa2 axis in lung development of the nitrofen-induced CDH and evaluate its potential role in vivo prenatal therapy. MAIN METHODS: Nitrofen was orally administrated on embryonic day (E) 8.5 to establish a rat CDH model, and fetal lungs were collected on E13.5, E15.5, E17.5, E19.5 and E21.5. The binding sites of miR-130a-5p on Foxa2 mRNA were identified using bioinformatics prediction software and were validated via luciferase assay. The expression levels of miR-130a-5p and Foxa2 were detected using qRT-PCR, ISH, IHC and western blotting. The role of miR-130a-5p/Foxa2 axis in CDH-associated lung development was investigated in ex vivo lung explants. KEY FINDINGS: We found that Foxa2 was downregulated in CDH lung tissues, and Foxa2 upregulating improved CDH branching morphogenesis in ex vivo lung explants. Meanwhile, we also showed that miR-130a-5p was significantly upregulated in CDH lungs and thus inversely correlated with Foxa2. Increasing miR-130a-5p abundance with mimics decreases Foxa2-driven Shh/Gli1 signaling and inhibits branching morphogenesis in ex vivo lung explants. SIGNIFICANCE: This study was the first to show that the miR-130a-5p/Foxa2 axis played a crucial role in CDH-associated pulmonary hypoplasia. These findings may provide relevant insights into the prenatal diagnosis and prenatal therapy of CDH.


Assuntos
Desenvolvimento Fetal/genética , Regulação da Expressão Gênica no Desenvolvimento , Fator 3-beta Nuclear de Hepatócito/metabolismo , Hérnias Diafragmáticas Congênitas/patologia , Pulmão/citologia , MicroRNAs/genética , Organogênese , Animais , Proliferação de Células , Células Cultivadas , Feminino , Proteínas Hedgehog/genética , Proteínas Hedgehog/metabolismo , Fator 3-beta Nuclear de Hepatócito/genética , Herbicidas/toxicidade , Hérnias Diafragmáticas Congênitas/induzido quimicamente , Hérnias Diafragmáticas Congênitas/metabolismo , Pulmão/fisiologia , Masculino , Éteres Fenílicos/toxicidade , Gravidez , Ratos , Ratos Sprague-Dawley , Proteína GLI1 em Dedos de Zinco/genética , Proteína GLI1 em Dedos de Zinco/metabolismo
4.
Afr Health Sci ; 19(2): 1988-1992, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656481

RESUMO

Background: Previous trials have investigated the effect of hepatitis C on lung functions; however, the role of viral load levels is unclear. The aim of this study was to investigate the effect of HCV viremia status on lung functions. Methods: This study was in 60 patients with chronic hepatitis C (CHC). Patients were classified into three groups (non-viremic, low-viremic and high-viremic) based on serum HCV RNA levels. Spirometric parameters (FEV1, FVC, FEV1/FVC) and the proportion of patients with spirometric abnormalities were compared between three groups. Results: High-viremic and low-viremic patients showed a significantly higher prevalance of spirometric abnormality than observed in non-viremic patients (p=0.02). Moreover, there was a significant moderate correlation between viremia level and the percentage of spirometric abnormalities (Cramer's U value=0.452, p=0.002). High-viremic patients were 14.2 times more likely to exhibiting pulmonary dysfunction than non-viremic patients. Additionally, spirometric parameters FEV1 and FVC were significantly reduced in high-viremic and low-viremic patients compared to those in non-viremic patients (p=0.013 and p<0.001 respectively). Conclusion: These results indicate that persistent HCV infection may be associated with reduced pulmonary functions, especially in patients with high viremia levels. Therefore, these patients should be carefully monitored for lung function.


Assuntos
Hepacivirus/isolamento & purificação , Anticorpos Anti-Hepatite C/análise , Hepatite C Crônica/diagnóstico , Pulmão/fisiologia , RNA Viral/sangue , Viremia/diagnóstico , Adulto , Feminino , Hepatite C Crônica/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Testes de Função Respiratória , Espirometria , Carga Viral , Viremia/epidemiologia , Viremia/virologia
5.
Best Pract Res Clin Anaesthesiol ; 33(2): 165-177, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31582096

RESUMO

The impact of positive pressure ventilation extends the effect on lungs and gas exchange because the altered intra-thoracic pressure conditions influence determinants of cardiovascular function. These mechanisms are called heart-lung interactions, which conceptually can be divided into two components (1) The effect of positive airway pressure on the cardiovascular system, which may be more or less pronounced under various pathologic cardiac conditions, and (2) The effect of cyclic airway pressure swing on the cardiovascular system, which can be useful in the interpretation of the individual patient's current haemodynamic state. It is imperative for the anaesthesiologist to understand the fundamental mechanisms of heart-lung interactions, as they are a foundation for the understanding of optimal, personalised cardiovascular treatment of patients undergoing surgery in general anaesthesia. The aim of this review is thus to describe what the anaesthesiologist needs to know about heart-lung interactions.


Assuntos
Anestesiologistas/normas , Competência Clínica/normas , Hemodinâmica/fisiologia , Pulmão/fisiologia , Respiração com Pressão Positiva/normas , Função Ventricular/fisiologia , Pressão Sanguínea/fisiologia , Humanos , Respiração com Pressão Positiva/métodos
7.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 350-356, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31631602

RESUMO

Objective: To investigate the influence of continuous low-volume ventilation in cardiopulmonary bypass (CPB) on the expression of krebs von den lungen-6 (KL-6) and perioperative pulmonary function in adults undergoing valve surgery. Methods: From 2017 Sept. to 2018 Jan., 60 patients who received valve replacement surgery were prospectively comprised in this study. We randomly allocated these patients into control group ( n=30, non-ventilation) and experimental group ( n=30, continuous low-volume ventilation during CPB). At different perioperative time points, we identified the dynamic changes of pulmonary function and biomarkers which expressed in serum and bronchoalveolar lavage fluid (BALF). Meanwhile, we also compared perioperative clinical outcomes of the two groups. Results: The expression of serum KL-6 and BALF KL-6 in the two groups were both statistically significant( P<0.05). The oxygenation index increased with time and reached to the top point at T 1, then subsequently decreased with time ( P<0.05). The alveolar-arterial oxygen tension difference (P A-aO 2) in the two groups fluctuate with time, the differences have no statistical significance. According to linear correlation, the serum KL-6 level was negatively correlated with oxygenation indexes ( r=-0.525, P=0.003), while it was positively correlated with P A-aO 2 ( r=0.489, P=0.006). There were no significant differences between the two groups in clinical outcomes. Conclusion: Continuing low-volume ventilation during CPB could decrease the expression level of KL-6, while it has no significant influence on perioperative outcomes.


Assuntos
Ponte Cardiopulmonar , Doenças das Valvas Cardíacas/cirurgia , Pulmão/fisiologia , Mucina-1/genética , Ventilação Pulmonar , Biomarcadores , Líquido da Lavagem Broncoalveolar , Humanos
8.
PLoS Comput Biol ; 15(10): e1007408, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31622332

RESUMO

Surfactant Replacement Therapy (SRT), which involves instillation of a liquid-surfactant mixture directly into the lung airway tree, is a major therapeutic treatment in neonatal patients with respiratory distress syndrome (RDS). This procedure has proved to be remarkably effective in premature newborns, inducing a five-fold decrease of mortality in the past 35 years. Disappointingly, its use in adults for treating acute respiratory distress syndrome (ARDS) experienced initial success followed by failures. Our recently developed numerical model has demonstrated that transition from success to failure of SRT in adults could, in fact, have a fluid mechanical origin that is potentially reversible. Here, we present the first numerical simulations of surfactant delivery into a realistic asymmetric conducting airway tree of the rat lung and compare them with experimental results. The roles of dose volume (VD), flow rate, and multiple aliquot delivery are investigated. We find that our simulations of surfactant delivery in rat lungs are in good agreement with our experimental data. In particular, we show that the monopodial architecture of the rat airway tree plays a major role in surfactant delivery, contributing to the poor homogeneity of the end distribution of surfactant. In addition, we observe that increasing VD increases the amount of surfactant delivered to the acini after losing a portion to coating the involved airways, the coating cost volume, VCC. Finally, we quantitatively assess the improvement resulting from a multiple aliquot delivery, a method sometimes employed clinically, and find that a much larger fraction of surfactant reaches the alveolar regions in this case. This is the first direct qualitative and quantitative comparison of our numerical model with experimental studies, which enhances our previous predictions in adults and neonates while providing a tool for predicting, engineering, and optimizing patient-specific surfactant delivery in complex situations.


Assuntos
Surfactantes Pulmonares/administração & dosagem , Surfactantes Pulmonares/uso terapêutico , Animais , Simulação por Computador , Hidrodinâmica , Pulmão/fisiologia , Fluxo Expiratório Máximo/fisiologia , Modelos Anatômicos , Modelos Estatísticos , Ratos , Ratos Long-Evans , Ratos Sprague-Dawley , Ratos Wistar , Tensoativos
9.
Br J Nurs ; 28(18): 1196-1200, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597050

RESUMO

Bronchiolitis obliterans syndrome (BOS) following allogenic haematopoietic stem cell transplant is considered the manifestation of chronic graft versus host disease (cGvHD) in the lung, and affects about 14% of patients with cGvHD, mainly in the first 2 years after transplant. Despite advances in assessment, diagnosis and treatment, the clinical prognosis remains poor for patients with pulmonary manifestations of cGvHD. A pilot study of 50 patients was devised to establish whether a relationship exists between forced expiratory volume in 1 second (FEV1) via pulmonary function test (PFT) and the equivalent peak expiratory flow (PEF) via peak flow handheld spirometry in cGvHD patients receiving extracorporeal photopheresis (ECP). Only PEF observed within 2 days of PFT could be compared with data at month 3, 6, 9 and 12. This pilot study illustrated that monitoring via handheld peak flow readings has the potential to become an acceptable method of monitoring lung function longitudinally in cGvHD patients.


Assuntos
Doença Enxerto-Hospedeiro/fisiopatologia , Pulmão/fisiologia , Testes de Função Respiratória/métodos , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Fluxo Expiratório Forçado , Doença Enxerto-Hospedeiro/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Fotoferese , Projetos Piloto , Reprodutibilidade dos Testes , Espirometria/instrumentação , Espirometria/métodos , Adulto Jovem
10.
Physiol Int ; 106(3): 261-271, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31602997

RESUMO

It has been shown that the tissue oxygen index (TOI) measured by near-infrared spectroscopy oscillates at very low frequencies during recovery after exercise and that this oscillation is derived from interactions among biochemical substances involved in oxidative metabolism in skeletal muscle. As a further step, we examined whether TOI in muscle interacts through oscillation with factors related to oxygen in the cardiorespiratory system. For this examination, coherence and phase difference between the TOI in the vastus lateralis and heart rate (HR) and between TOI and arterial oxygen saturation (SpO2) were sequentially determined during recovery (2-60 min) after severe cycle exercise with a workload of 7.5% of body weight for 20 s. Significant coherence between TOI and HR was obtained in the very low-frequency band (approximate range: 0.002-0.03 Hz) and in the low-frequency band (approximate range: 0.06-0.12 Hz). The phase difference was negative in the low-frequency band and positive in the very low-frequency band. The coherence between TOI and SpO2 was significant in the very low-frequency band. The phase difference was negative. There were no sequential changes in these coherences and phase differences. The results suggest that TOI in skeletal muscle interrelates with factors related to the heart and lungs.


Assuntos
Exercício/fisiologia , Coração/fisiologia , Pulmão/fisiologia , Músculo Esquelético/fisiologia , Consumo de Oxigênio/fisiologia , Oxigênio/metabolismo , Adulto , Gasometria/métodos , Teste de Esforço/métodos , Frequência Cardíaca/fisiologia , Humanos , Pulmão/metabolismo , Masculino , Contração Muscular/fisiologia , Músculo Esquelético/metabolismo , Músculo Quadríceps/metabolismo , Músculo Quadríceps/fisiologia , Adulto Jovem
11.
Zhonghua Shao Shang Za Zhi ; 35(10): 733-739, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31658544

RESUMO

Objective: To preliminarily investigate the effect of intraoperative goal-directed fluid management (GDFM) on pulmonary function and oxygen dynamics in patients with severe burns. Methods: From February 2017 to May 2018, 30 patients admitted to Burn Department of our hospital with severe burns who met the criteria for inclusion and needed escharectomy and skin grafting were enrolled in this prospective randomized controlled trial. The patients were divided into group GDFM of 15 cases [14 males and 1 female, (45±14) years old] and conventional liquid management group of 15 cases [12 males and 3 females, (42±10) years old] according to the random number table. During escharectomy and skin grafting, volume of patients in group GDFM was managed according to the GDFM scheme, based on cardiac output index, stroke volume variation, stroke volume index, hemoglobin, central venous oxygen saturation (ScvO(2)), and other parameters; volume of patients in conventional liquid management group was managed according to clinical experience and conventional liquid management scheme, based on mean arterial pressure, central venous pressure, urine output, hemoglobin, and other parameters. At post operation hour (POH) 1, 6, 12, and 24, arterial and venous blood was collected from patients of the two groups to determine the levels of extravascular lung water index (ELWI), global end-diastolic volume index (GEDI), oxygenation index, ScvO(2), central venous-to-arterial blood carbon dioxide partial pressure difference (Pcv-aCO(2)), lactic acid, pH value, bicarbonate ion, and base excess routinely. Data were processed with Fisher's exact probability test, t test, analysis of variance for repeated measurement, and least significant difference test. Results: (1) The ELWI of patients in group GDFM was (4.3±1.1) mL/kg at POH 1, which was significantly lower than (6.5±3.6) mL/kg in conventional liquid management group (t=2.26, P<0.05). The ELWI levels of patients in group GDFM at POH 6, 12, and 24 were (6.8±2.2), (6.6±2.0), and (6.9±1.6) mL/kg, respectively, significantly higher than the level at POH 1 within the same group (P<0.01), and similar to (8.5±3.1), (7.8±2.3), and (8.0±3.5) mL/kg in conventional liquid management group (t=1.73, 1.53, 1.10, P>0.05). The GEDI levels between patients of the two groups were similar, and there was no significantly statistical difference between the two groups as a whole (treatment factor main effect F=2.35, time factor main effect F=0.44, interaction F=0.07, P>0.05). (2) The oxygenation index of patients in group GDFM was (350±78) mL/kg at POH 1, which was significantly higher than (259±109) mL/kg in conventional liquid management group (t=2.63, P<0.05). In conventional liquid management group, the oxygenation index of patients at POH 6 was significantly higher than that at POH 1, 12, or 24 (P<0.01). The ScvO(2) levels of patients in group GDFM at POH 1, 6, and 12 were 0.516±0.105, 0.679±0.121, and 0.713±0.104, respectively, which were significantly higher than 0.382±0.194, 0.545±0.194, and 0.595±0.191 in conventional liquid management group (t=2.35, 2.27, 2.10, P<0.05). The ScvO(2) levels of patients in the two groups at POH 6, 12, and 24 were significantly higher than those levels at POH 1 within the same group (P<0.01), and the ScvO(2) of patients in conventional liquid management group at POH 24 was significantly higher than that at POH 6 or 12 within the same group (P<0.05 or P<0.01). The Pcv-aCO(2) levels of patients in group GDFM were significantly lower than those in conventional liquid management group at POH 1 and 6 (t=2.55, 2.71, P<0.05). The Pcv-aCO(2) of patients in group GDFM at POH 12 was significantly lower than that at POH 6 or 24 within the same group (P<0.05). (3) The blood lactic acid levels and pH values between patients of the two groups were similar at POH 1, 6, 12, and 24 (t=0.89, 0.19, 0.26, 0.23; 1.55, 0.71, 0.77, 0.77, P>0.05). In conventional liquid management group, the blood lactic acid levels of patients at POH 6, 12, and 24 were significantly lower than the level at POH 1 within the same group (P<0.05), and the pH values of patients at POH 6, 12, and 24 were significantly higher than the value at POH 1 within the same group (P<0.05). The levels of bicarbonate ion and base excess between patients of the two groups were similar, and there were no significantly statistical differences between the two groups as a whole (treatment factor main effect F=0.06, 0.11, time factor main effect F=2.07, 1.59, interaction F=1.45, 0.91, P>0.05). Conclusions: GDFM is helpful to improve the pulmonary function and oxygen dynamics in patients with severe burns in the short term after escharectomy and skin grafting. It has certain significance in preventing and reducing pulmonary edema and pulmonary complications in patients with severe burn after operation.


Assuntos
Queimaduras/terapia , Hidratação/métodos , Pulmão/fisiologia , Oxigênio , Adulto , Queimaduras/complicações , Pressão Venosa Central , Feminino , Metas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Transplante de Pele , Resultado do Tratamento
13.
Dokl Biochem Biophys ; 487(1): 247-250, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31559590

RESUMO

According to the results of theoretical and experimental analysis of the characteristics of the propagation of acoustic vibrations in the respiratory system, it is necessary to determine the resonant frequency of the respiratory tract to increase the vital capacity of the lungs by opening reserve alveoli by acoustic stimulation of the respiratory system and then to affect the respiratory system with scanning tonal sounds in the maximum sound absorption range (at a level of ±3 dB of the maximum absorption coefficient value).


Assuntos
Absorção Fisico-Química , Estimulação Acústica , Pulmão/fisiologia , Modelos Biológicos , Som , Pulmão/efeitos da radiação
15.
Respir Res ; 20(1): 172, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370853

RESUMO

Genome wide association (GWA) studies have reproducibly identified signals on chromosome 4q24 associated with lung function and COPD. GSTCD (Glutathione S-transferase C-terminal domain containing) represents a candidate causal gene in this locus, however little is currently known about the function of this protein. We set out to further our understanding of the role of GSTCD in cell functions and homeostasis using multiple molecular and cellular approaches in airway relevant cells. Recombinant expression of human GSTCD in conjunction with a GST activity assay did not identify any enzymatic activity for two GSTCD isoforms questioning the assignment of this protein to this family of enzymes. Protein structure analyses identified a potential methyltransferase domain contained within GSTCD, with these enzymes linked to cell viability and apoptosis. Targeted knockdown (siRNA) of GSTCD in bronchial epithelial cells identified a role for GSTCD in cell viability as proliferation rates were not altered. To provide greater insight we completed transcriptomic analyses on cells with GSTCD expression knocked down and identified several differentially expressed genes including those implicated in airway biology; fibrosis e.g. TGFBR1 and inflammation e.g. IL6R. Pathway based transcriptomic analyses identified an over-representation of genes related to adipogenesis which may suggest additional functions for GSTCD. These findings identify potential additional functions for GSTCD in the context of airway biology beyond the hypothesised GST activity and warrant further investigation.


Assuntos
Estudo de Associação Genômica Ampla/métodos , Homeostase/fisiologia , Pulmão/fisiologia , Miócitos de Músculo Liso/fisiologia , Proteínas/genética , Mucosa Respiratória/metabolismo , Animais , Células CHO , Cricetinae , Cricetulus , Humanos , Pulmão/citologia , Proteínas/metabolismo , Mucosa Respiratória/citologia
16.
BMC Pulm Med ; 19(1): 148, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409407

RESUMO

BACKGROUND: Oxygen toxicity is one potential side effect of hyperbaric oxygen therapy (HBOT). Previous small studies showed mild reductions in pulmonary functions reflecting reductions in small airway conductance after repetitive hyperbaric oxygen sessions. However, there are no updated data with well performed pulmonary tests that address the pulmonary effect of the currently used HBOT protocols. The aim of this study was to evaluate the effect of HBOT on pulmonary functions of patients receiving the currently used HBOT protocol. METHODS: Prospective analysis included patients, 18 years or older, scheduled for 60 daily HBOT sessions between 2016 and 2018. Each session was 90 min of 100% oxygen at 2 ATA with 5 min air breaks every 20 min, 5 days per week. Pulmonary functions, measured at baseline and after HBOT, included forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1) and peak expiratory flow rate (PEF). RESULTS: The mean age was 60.36 ± 15.43 and 62.5% (55/88) were males. Most of the patients (83/88, 94.3%) did not have any pulmonary disease prior to inclusion and 30.7% (27/88) had a history of smoking. Compared to baseline values, at the completion of 60 HBOT sessions, there were no significant changes in FEV1 (0.163), FEV1/FVC ratio (0.953) and FEF25-75% (0.423). There was a statistically significant increase though not clinically relevant increase in FVC (0.1 ± 0.38 l) and PEF (0.5 ± 1.4 l) with a 0.014 and 0.001 respectively. CONCLUSION: Regarding pulmonary functions, repeated hyperbaric oxygen exposure based on the currently used HBOT protocol is safe. Surprisingly, there was a modest non clinically significant though statistically significant improvement in PEF and FVC in the current cohort of patients who were without chronic lung diseases. TRIAL REGISTRATION: Clinicaltrials.gov, trial ID: NCT03754985 , (Nov 2018) Retrospectively registered.


Assuntos
Oxigenação Hiperbárica , Pulmão/fisiologia , Idoso , Feminino , Volume Expiratório Forçado , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório , Estudos Prospectivos , Capacidade Vital
17.
JAMA ; 322(6): 546-556, 2019 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-31408135

RESUMO

Importance: While air pollutants at historical levels have been associated with cardiovascular and respiratory diseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema. Objective: To assess the longitudinal association of ambient ozone (O3), fine particulate matter (PM2.5), oxides of nitrogen (NOx), and black carbon exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function. Design, Setting, and Participants: This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018. Exposures: Residence-specific air pollutant concentrations (O3, PM2.5, NOx, and black carbon) were estimated by validated spatiotemporal models incorporating cohort-specific monitoring, determined from 1999 through the end of follow-up. Main Outcomes and Measures: Percent emphysema, defined as the percent of lung pixels less than -950 Hounsfield units, was assessed up to 5 times per participant via cardiac CT scan (2000-2007) and equivalent regions on lung CT scans (2010-2018). Spirometry was performed up to 3 times per participant (2004-2018). Results: Among 7071 study participants (mean [range] age at recruitment, 60 [45-84] years; 3330 [47.1%] were men), 5780 were assigned outdoor residential air pollution concentrations in the year of their baseline examination and during the follow-up period and had at least 1 follow-up CT scan, and 2772 had at least 1 follow-up spirometric assessment, over a median of 10 years. Median percent emphysema was 3% at baseline and increased a mean of 0.58 percentage points per 10 years. Mean ambient concentrations of PM2.5 and NOx, but not O3, decreased substantially during follow-up. Ambient concentrations of O3, PM2.5, NOx, and black carbon at study baseline were significantly associated with greater increases in percent emphysema per 10 years (O3: 0.13 per 3 parts per billion [95% CI, 0.03-0.24]; PM2.5: 0.11 per 2 µg/m3 [95% CI, 0.03-0.19]; NOx: 0.06 per 10 parts per billion [95% CI, 0.01-0.12]; black carbon: 0.10 per 0.2 µg/m3 [95% CI, 0.01-0.18]). Ambient O3 and NOx concentrations, but not PM2.5 concentrations, during follow-up were also significantly associated with greater increases in percent emphysema. Ambient O3 concentrations, but not other pollutants, at baseline and during follow-up were significantly associated with a greater decline in forced expiratory volume in 1 second per 10 years (baseline: 13.41 mL per 3 parts per billion [95% CI, 0.7-26.1]; follow-up: 18.15 mL per 3 parts per billion [95% CI, 1.59-34.71]). Conclusions and Relevance: In this cohort study conducted between 2000 and 2018 in 6 US metropolitan regions, long-term exposure to ambient air pollutants was significantly associated with increasing emphysema assessed quantitatively using CT imaging and lung function.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Pulmão/fisiologia , Enfisema Pulmonar , Idoso , Idoso de 80 Anos ou mais , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Carbono/efeitos adversos , Carbono/análise , Estudos de Coortes , Progressão da Doença , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Óxidos de Nitrogênio/efeitos adversos , Óxidos de Nitrogênio/análise , Ozônio/efeitos adversos , Ozônio/análise , Material Particulado/efeitos adversos , Material Particulado/análise , Enfisema Pulmonar/epidemiologia , Enfisema Pulmonar/fisiopatologia , Testes de Função Respiratória , Tomografia Computadorizada por Raios X , Estados Unidos/epidemiologia
18.
Med J Aust ; 211(6): 271-276, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31420881

RESUMO

Space flight presents a set of physiological challenges to the space explorer which result from the absence of gravity (or in the case of planetary exploration, partial gravity), radiation exposure, isolation and a prolonged period in a confined environment, distance from Earth, the need to venture outside in the hostile environment of the destination, and numerous other factors. Gravity affects regional lung function, and the human lung shows considerable alteration in function in low gravity; however, this alteration does not result in deleterious changes that compromise lung function upon return to Earth. The decompression stress associated with extravehicular activity, or spacewalk, does not appear to compromise lung function, and future habitat (living quarter) designs can be engineered to minimise this stress. Dust exposure is a significant health hazard in occupational settings such as mining, and exposure to extraterrestrial dust is an almost inevitable consequence of planetary exploration. The combination of altered pulmonary deposition of extraterrestrial dust and the potential for the dust to be highly toxic likely makes dust exposure the greatest threat to the lung in planetary exploration.


Assuntos
Medicina Aeroespacial , Pulmão/fisiologia , Modelos Biológicos , Voo Espacial , Humanos , Lua
19.
Braz J Med Biol Res ; 52(8): e8513, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31365695

RESUMO

Phenotypic differences have been described between patients with systemic sclerosis (SSc)-associated interstitial lung disease (ILD) and SSc-associated pulmonary hypertension, including performance differences in the 6-min walk test (6MWT). Moreover, the correlations between the 6MWT and traditional pulmonary function tests (PFTs) are weak, indicating the need to search for new parameters that explain exercise performance. Thus, our objective was to evaluate the impact of ventilation distribution heterogeneity assessed by the nitrogen single-breath washout (N2SBW) test and peripheral muscle dysfunction on the exercise capacity in patients with SSc-ILD and limited involvement of the pulmonary parenchyma. In this cross-sectional study, 20 women with SSc-ILD and 20 matched controls underwent PFTs (including spirometry, diffusing capacity for carbon monoxide (DLco), and the N2SBW test) and performed the 6MWT and knee isometric dynamometry. The 6-min walking distance (6MWD, % predicted) was strongly correlated with the phase III slope of the single-breath nitrogen washout (phase III slopeN2SBW) (r=-0.753, P<0.0001) and reasonably correlated with the forced vital capacity (FVC) (r=0.466, P=0.008) and DLco (r=0.398, P=0.011). The peripheral oxygen saturation (SpO2) during exercise was not significantly correlated with any of the pulmonary or muscle function parameters. The phase III slopeN2SBW was the only predictive variable for the 6MWD, whereas quadriceps strength and FVC/DLco were predictive variables for SpO2. Ventilation distribution heterogeneity is one factor that contributes to a lower 6MWD in SSc-ILD patients. In addition, muscle dysfunction and abnormal lung diffusion at least partly explain the decreased SpO2 of these patients.


Assuntos
Tolerância ao Exercício/fisiologia , Hipertensão Pulmonar/fisiopatologia , Doenças Pulmonares Intersticiais/fisiopatologia , Pulmão/fisiologia , Testes de Função Respiratória/métodos , Escleroderma Sistêmico/complicações , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Hipertensão Pulmonar/etiologia , Pulmão/fisiopatologia , Doenças Pulmonares Intersticiais/etiologia , Medidas de Volume Pulmonar/métodos , Pessoa de Meia-Idade , Ventilação Pulmonar , Doença de Raynaud/complicações , Tomografia Computadorizada por Raios X/métodos , Capacidade Vital/fisiologia , Teste de Caminhada/métodos
20.
Biol Pharm Bull ; 42(8): 1253-1267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31366863

RESUMO

Systemic platelet behaviors in experimental animals are often assessed by infusion of isotope-labeled platelets and measuring them under anesthesia. However, such procedures alter, therefore may not reveal, real-life platelet behaviors. 5-Hydroxytryptamine (5HT or serotonin) is present within limited cell-types, including platelets. In our studies, by measuring 5HT as a platelet-marker in non-anesthetized mice, we identified stimulation- and time-dependent accumulations in liver, lung, and/or spleen as important systemic platelet behaviors. For example, intravenous, intraperitoneal, or intragingival injection of lipopolysaccharide (LPS, a cell-wall component of Gram-negative bacteria), interleukin (IL)-1, or tumor necrosis factor (TNF)-α induced hepatic platelet accumulation (HPA) and platelet translocation into the sinusoidal and perisinusoidal spaces or hepatocytes themselves. These events occurred "within a few hours" of the injection, caused hypoglycemia, and exhibited protective or causal effects on hepatitis. Intravenous injection of larger doses of LPS into normal mice, or intravenous antigen-challenge to sensitized mice, induced pulmonary platelet accumulation (PPA), as well as HPA. These reactions occurred "within a few min" of the LPS injection or antigen challenge and resulted in shock. Intravenous injection of 5HT or a catecholamine induced a rapid PPA "within 6 s." Intravenous LPS injection, within a minute, increased the pulmonary catecholamines that mediate the LPS-induced PPA. Macrophage-depletion from liver and spleen induced "day-scale" splenic platelet accumulation, suggesting the spleen is involved in clearing senescent platelets. These findings indicate the usefulness of 5HT as a marker of platelet behaviors, and provide a basis for a discussion of the roles of platelets as both "defenders" and "guardians."


Assuntos
Plaquetas/fisiologia , Fígado/fisiologia , Pulmão/fisiologia , Serotonina/fisiologia , Baço/fisiologia , Animais , Humanos , Camundongos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA