RESUMO
BACKGROUND: Spirometry is the most commonly used method for assessment of airway function in bronchial asthma but has several limitations. Forced oscillometry was developed as a patient-friendly test that requires passive cooperation of the patient breathing normally through the mouth. OBJECTIVE: To compare spirometry with forced oscillometry to assess the role of forced oscillometry in the detection of the site of airway obstruction. METHODS: This case-and-control study included 50 patients with known stable asthma and 50 age- and sex-matched healthy subjects. All participants underwent spirometry (ratio of force expiration volume in 1 second to forced vital capacity, percentage predicted for forced expiration volume in 1 second, percentage predicted for forced vital capacity, percentage predicted for vital capacity, and forced expiratory flow at 25-75%) and forced oscillometry (resistance at 5, 20, and 5-20 Hz). RESULTS: By spirometry, all patients with asthma had airway obstruction, 8% had isolated small airway obstruction, 10% had isolated large airway obstruction, and 82% had large and small airway obstruction. By forced oscillometry, 12% had normal airway resistance, 50% had isolated small airway obstruction with frequency-dependent resistance, and 38% had large and small airway obstruction with frequency-independent resistance. There was significant difference between techniques for the detection of the site of airway obstruction (P = .012). Forced oscillometry indices were negatively correlated with spirometric indices (P < .01). CONCLUSION: Forced oscillometry as an effortless test, conducted during quiet tidal breathing, and does not alter airway caliber; thus, it can detect normal airway function better than spirometry in patients with asthma. Forced oscillometry detects isolated small airway obstruction better than spirometry in bronchial asthma.
Assuntos
Obstrução das Vias Respiratórias/fisiopatologia , Resistência das Vias Respiratórias , Asma/fisiopatologia , Oscilometria/métodos , Adulto , Obstrução das Vias Respiratórias/etiologia , Feminino , Fluxo Expiratório Forçado , Volume Expiratório Forçado , Humanos , Masculino , Reprodutibilidade dos Testes , Respiração , Sensibilidade e Especificidade , Espirometria , Capacidade Vital , Adulto JovemRESUMO
OBJECTIVE: To assess the role of 10-2 visual field (VF) test in different stages of glaucoma. METHODS: In our prospective comparative study, 24-2 and 10-2 VF tests were done for 115 eyes with different stages of glaucomatous damage or glaucoma suspects. Optical coherence tomography (OCT) was performed in 79 eyes. We compared field changes of the central 10° on 10-2 and 24-2 tests and studied the correlation between the mean deviation (MD) measured by the two tests. RESULTS: In seven glaucoma suspects, glaucoma diagnosis was missed by 24-2 test but was detected by 10-2 test and confirmed by OCT. In the eyes with early damage, there was no correlation between 10-2 and 24-2 tests regarding the MD of the central 10º. In moderate and severe stages, there was a significant correlation between the results of 24-2 and 10-2 tests. CONCLUSION: We concluded that 10-2 test could help confirm glaucoma diagnosis in glaucoma suspects missed by 24-2 test before resorting to the more expensive OCT. In early glaucoma, we noted that 10-2, as confirmed by OCT, was a beneficial addition to 24-2 test for precise measurement of the MD and detection of defects of the central 10º missed by 24-2 test, where more intense treatment should be considered to preserve the threatened central visual function. In moderate and severe cases, the role of 10-2 test was not as pivotal as in early cases, but still it was useful for assessment of residual central visual function in severe cases with absolute central 10º defects on 24-2 test for proper management.
Assuntos
Glaucoma de Ângulo Aberto/diagnóstico , Doenças do Nervo Óptico/diagnóstico , Transtornos da Visão/diagnóstico , Testes de Campo Visual , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/classificação , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Hipertensão Ocular/classificação , Hipertensão Ocular/diagnóstico , Hipertensão Ocular/fisiopatologia , Disco Óptico/fisiopatologia , Doenças do Nervo Óptico/fisiopatologia , Estudos Prospectivos , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Transtornos da Visão/fisiopatologia , Adulto JovemRESUMO
The exoerythrocytic stage of Plasmodium infection is a critical window for prophylactic intervention. Using genome-wide dual RNA sequencing of flow-sorted infected and uninfected hepatoma cells we show that the human mucosal immunity gene, mucin-13 (MUC13), is strongly upregulated during Plasmodium exoerythrocytic hepatic-stage infection. We confirm MUC13 transcript increases in hepatoma cell lines and primary hepatocytes. In immunofluorescence assays, host MUC13 protein expression distinguishes infected cells from adjacent uninfected cells and shows similar colocalization with parasite biomarkers such as UIS4 and HSP70. We further show that localization patterns are species independent, marking both P. berghei and P. vivax infected cells, and that MUC13 can be used to identify compounds that inhibit parasite replication in hepatocytes. This data provides insights into host-parasite interactions in Plasmodium infection, and demonstrates that a component of host mucosal immunity is reprogrammed during the progression of infection.
Assuntos
Imunidade nas Mucosas/fisiologia , Malária/imunologia , Malária/metabolismo , Mucinas/metabolismo , Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/parasitologia , Linhagem Celular , Células Cultivadas , Proteínas de Choque Térmico HSP70/metabolismo , Hepatócitos/parasitologia , Hepatócitos/patologia , Interações Hospedeiro-Parasita , Humanos , Imunidade nas Mucosas/genética , Neoplasias Hepáticas/imunologia , Plasmodium berghei/patogenicidadeRESUMO
Reversible protein phosphorylation regulated by kinases and phosphatases controls many cellular processes. Although essential functions for the malaria parasite kinome have been reported, the roles of most protein phosphatases (PPs) during Plasmodium development are unknown. We report a functional analysis of the Plasmodium berghei protein phosphatome, which exhibits high conservation with the P. falciparum phosphatome and comprises 30 predicted PPs with differential and distinct expression patterns during various stages of the life cycle. Gene disruption analysis of P. berghei PPs reveals that half of the genes are likely essential for asexual blood stage development, whereas six are required for sexual development/sporogony in mosquitoes. Phenotypic screening coupled with transcriptome sequencing unveiled morphological changes and altered gene expression in deletion mutants of two N-myristoylated PPs. These findings provide systematic functional analyses of PPs in Plasmodium, identify how phosphatases regulate parasite development and differentiation, and can inform the identification of drug targets for malaria.