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Mechanism of airway clearance

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https://www.readbyqxmd.com/read/29925291/the-safety-and-utility-of-phenobarbital-use-for-the-treatment-of-severe-alcohol-withdrawal-syndrome-in-the-medical-intensive-care-unit
#1
Margarita Oks, Krystal L Cleven, Lauren Healy, Mabel Wei, Mangala Narasimhan, Paul H Mayo, Nina Kohn, Seth Koenig
BACKGROUND: Alcohol withdrawal syndrome (AWS) is a common reason for admission to a medical intensive care unit (MICU) and requires significant hospital resource utilization. Benzodiazepines are first-line therapy for AWS in many intensive care units. We propose the use of symptom-triggered phenobarbital for the treatment of AWS as a safe alternative to benzodiazepines. METHODS: This was a retrospective observational study of a 4-year period, 2011 to 2015, of all patients with AWS admitted to the MICU of 1 tertiary care hospital and treated with phenobarbital...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29890184/antiviral-drug-screening-by-assessing-epithelial-functions-and-innate-immune-responses-in-human-3d-airway-epithelium-model
#2
Bernadett Boda, Sacha Benaoudia, Song Huang, Rosy Bonfante, Ludovic Wiszniewski, Eirini D Tseligka, Caroline Tapparel, Samuel Constant
Respiratory viral infections cause mild to severe diseases, such as common cold, bronchiolitis and pneumonia and are associated with substantial burden for society. To test new molecules for shortening, alleviating the diseases or to develop new therapies, relevant human in vitro models are mandatory. MucilAir™, a human standardized air-liquid interface 3D airway epithelial culture holds in vitro specific mechanisms to counter invaders comparable to the in vivo situation, such as mucus production, mucociliary clearance, and secretion of defensive molecules...
June 8, 2018: Antiviral Research
https://www.readbyqxmd.com/read/29869791/precision-medicine-in-united-airways-disease-a-treatable-traits-approach
#3
REVIEW
Anthony Ca Yii, Tunn-Ren Tay, Xue Ning Choo, Mariko Sy Koh, Augustine Kh Tee, De-Yun Wang
United airways disease (UAD) is the concept that the upper and lower airways, which are anatomically and immunologically related, form a single organ. According to this concept, upper and lower airway diseases are frequently comorbid because they reflect manifestations of a single underlying disease at different sites of the respiratory tract. Allergic asthma-allergic rhinitis is the archetypal UAD, but emerging data indicate that UAD is a heterogeneous condition and consists of multiple phenotypes (observable clinical characteristics) and endotypes (pathobiologic mechanisms)...
June 5, 2018: Allergy
https://www.readbyqxmd.com/read/29851510/quantifying-ciliary-dynamics-during-assembly-reveals-step-wise-waveform-maturation-in-airway-cells
#4
Alina Oltean, Andrew J Schaffer, Philip V Bayly, Steven L Brody
Motile cilia are essential for clearance of particulates and pathogens from airways. For effective transport, ciliary motor proteins and axonemal structures interact to generate the rhythmic, propulsive bending, but the mechanisms that produce a dynamic waveform remain incompletely understood. Biomechanical measures of human cilia motion and their relationships to cilia assembly are needed to illuminate the biophysics of normal cilia function, and to quantify dysfunction in ciliopathies. To these ends, we analyzed cilia motion from high-speed video microscopy of ciliated cells sampled from human lung airways compared to primary-culture cells that undergo ciliogenesis in vitro...
May 31, 2018: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29812963/cystic-fibrosis-translating-molecular-mechanisms-into-effective-therapies
#5
Mark T Jennings, Patrick A Flume
Cystic Fibrosis (CF) is a genetic disease the affects approximately 75,000 individuals around the world. Long regarded as a lethal and life-limiting disease, with the most severe manifestations expressed in the progressive decline of lung function, treatment advances focusing on airway clearance and management of chronic lung infection have resulted in improved outcomes for individuals with CF. These advances have been realized in conjunction with an improved understanding of the genetic basis of this disease, dating back to the discovery of the CF gene in 1989...
May 29, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29792391/role-of-neutrophils-in-equine-asthma
#6
Benjamin Uberti, Gabriel Morán
Neutrophilic bronchiolitis is the primary lesion in asthma-affected horses. Neutrophils are key actors in host defense, migrating toward sites of inflammation and infection, where they act as early responder cells toward external insults. However, neutrophils can also mediate tissue damage in various non-infectious inflammatory processes. Within the airways, these cells likely contribute to bronchoconstriction, mucus hypersecretion, and pulmonary remodeling by releasing pro-inflammatory mediators, including the cytokines interleukin (IL)-8 and IL-17, neutrophil elastase, reactive oxygen species (ROS), and neutrophil extracellular traps (NETs)...
May 24, 2018: Animal Health Research Reviews
https://www.readbyqxmd.com/read/29789655/cigarette-smoke-promotes-hiv-infection-of-primary-bronchial-epithelium-and-additively-suppresses-cftr-function
#7
S Chinnapaiyan, R Dutta, J Bala, T Parira, M Agudelo, M Nair, H J Unwalla
Recurrent lung infections are a common cause of morbidity and mortality in people living with HIV and this is exacerbated in smokers even when administered combination antiretroviral therapy (cART). The incidence of pneumonia is increased with smoking and treatment interruption and is directly dependent on viral load in patients when adjusted for CD4 counts. CFTR dysfunction plays an important role in aberrant airway innate immunity as it is pivotal in regulating mucociliary clearance (MCC) rates and other antibacterial mechanisms of the airway...
May 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29760213/changes-in-iga-protease-expression-are-conferred-by-changes-in-genomes-during-persistent-infection-by-nontypeable-haemophilus-influenzae-in-chronic-obstructive-pulmonary-disease
#8
Mary C Gallo, Charmaine Kirkham, Samantha Eng, Remon S Bebawee, Yong Kong, Melinda M Pettigrew, Hervé Tettelin, Timothy F Murphy
Nontypeable Haemophilus influenzae (NTHi) is an exclusively human pathobiont that plays a critical role in the course and pathogenesis of chronic obstructive pulmonary disease (COPD). NTHi causes acute exacerbations of COPD and also causes persistent infection of the lower airways. NTHi expresses four IgA protease variants (A1, A2, B1, and B2) that play different roles in virulence. Expression of IgA proteases varies among NTHi strains, but little is known about the frequency and mechanisms by which NTHi modulates IgA protease expression during infection in COPD...
May 14, 2018: Infection and Immunity
https://www.readbyqxmd.com/read/29712964/an-in-vitro-transepithelial-migration-assay-to-evaluate-the-role-of-neutrophils-in-respiratory-syncytial-virus-rsv-induced-epithelial-damage
#9
Yu Deng, Jenny A Herbert, Claire M Smith, Rosalind L Smyth
Large numbers of neutrophils migrate into the lungs of children with severe Respiratory Syncytial Virus (RSV) disease. It is unclear how these cells contribute to viral clearance and recovery from infection or whether they contribute to disease pathology. We have developed a novel in vitro model to study neutrophil migration through airway epithelial cells (AECs), the main cellular target of RSV infection. Our model reproduces a physiologically relevant cell polarity and directionality of neutrophil migration...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29698625/sphingolipids-as-targets-for-inhalation-treatment-of-cystic-fibrosis
#10
Katrin Anne Becker, Joachim Riethmüller, Aaron P Seitz, Aaron Gardner, Ryan Boudreau, Markus Kamler, Burkhard Kleuser, Edward Schuchman, Charles C Caldwell, Michael J Edwards, Heike Grassmé, Malcolm Brodlie, Erich Gulbins
Studies over the past several years have demonstrated the important role of sphingolipids in cystic fibrosis (CF), chronic obstructive pulmonary disease and acute lung injury. Ceramide is increased in airway epithelial cells and alveolar macrophages of CF mice and humans, while sphingosine is dramatically decreased. This increase in ceramide results in chronic inflammation, increased death of epithelial cells, release of DNA into the bronchial lumen and thereby an impairment of mucociliary clearance; while the lack of sphingosine in airway epithelial cells causes high infection susceptibility in CF mice and possibly patients...
April 24, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29676177/acetylcholine-induced-ciliary-beat-of-the-human-nasal-mucosa-is-regulated-by-the-pannexin-1-channel-and-purinergic-p2x-receptor
#11
Ba H Do, Toyoaki Ohbuchi, Tetsuro Wakasugi, Hiroki Koizumi, Mitsuru Yokoyama, Nobusuke Hohchi, Hideaki Suzuki
Background Airway mucociliary transport is an important function for the clearance of inhaled foreign particulates in the respiratory tract. The present study aimed at investigating the regulatory mechanism of acetylcholine (Ach)-induced ciliary beat of the human nasal mucosa in ex vivo. Methods The inferior turbinate mucosa was collected from patients with chronic hypertrophic rhinitis during endoscopic surgery. The mucosa was cut into thin strips, and ciliary movement was observed under a phase-contrast light microscope with a high-speed digital video camera...
April 20, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#12
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29617698/pseudomonas-aeruginosa-and-klebsiella-pneumoniae-adaptation-to-innate-immune-clearance-mechanisms-in-the-lung
#13
Sebastian A Riquelme, Danielle Ahn, Alice Prince
Many different species of gram-negative bacteria are associated with infection in the lung, causing exacerbations of chronic obstructive pulmonary disease, cystic fibrosis (CF), and ventilator-associated pneumonias. These airway pathogens must adapt to common host clearance mechanisms that include killing by antimicrobial peptides, antibiotics, oxidative stress, and phagocytosis by leukocytes. Bacterial adaptation to the host is often evident phenotypically, with increased extracellular polysaccharide production characteristic of some biofilm-associated organisms...
April 4, 2018: Journal of Innate Immunity
https://www.readbyqxmd.com/read/29596479/the-immediate-effects-of-a-single-autogenic-drainage-session-on-ventilatory-mechanics-in-adult-subjects-with-cystic-fibrosis
#14
Elliot Wallaert, Thierry Perez, Anne Prevotat, Gregory Reychler, Benoit Wallaert, Olivier Le Rouzic
INTRODUCTION: The aim of this study was to gain insight into the physiological changes occurring in subjects with cystic fibrosis (CF) after autogenic drainage (AD). Changes in respiratory system resistance (Rrs), reactance (Xrs), and spirometry were analyzed in adult CF subjects after a single AD physiotherapy session. METHODS: This prospective observational study was conducted during the annual check-up of adult CF subjects in stable condition. Spirometry and Rrs and Xrs measurements using the forced oscillations technique at 5, 11, and 19 hertz (Hz) were performed before and 30 min after a 20-min AD session...
2018: PloS One
https://www.readbyqxmd.com/read/29531450/immediate-effects-of-acapella-%C3%A2-on-dynamic-lung-compliance-in-mechanically-ventilated-patients-with-acute-respiratory-distress-syndrome-a-case-series
#15
Priya Sharma, V Prem, Sakshee Jain
Background and Aims: One potential complication of acute respiratory distress syndrome (ARDS) is reduced dynamic compliance, saturation for peripheral oxygenation (SpO2 ) and increased sputum in patients that are mechanically ventilated. Airway clearance technique is the treatment given for patients on mechanically ventilator with ARDS. The purpose of the case series is to know the immediate effects of Acapella® on dynamic lung compliance (Cdyn) in subject with ARDS. Subjects and Methods: Patients who are on ventilator for more than 48hrs were included in the study...
February 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29530625/non-pharmacological-techniques-for-the-extremes-of-the-cough-spectrum
#16
REVIEW
Arietta Spinou
Cough can be viewed as a continuum where extremes represent disease phenotypes. Under this unified concept, non-pharmacological treatment for the extremes of the cough spectrum includes both cough augmentation and cough control techniques. Supporting the cough motor output and exercising the cognitive control on coughing are the main directions of these techniques. Cough augmentation can be provided to patients who present low ability to generate adequate peak cough flows, with the aim to develop the sheering forces that are essential for effective airway clearance...
March 9, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29507722/mechanical-insufflation-exsufflation-for-airway-clearance-in-adults-with-cystic-fibrosis
#17
Madeline Gaynor, Jamie Wood
In cystic fibrosis (CF), acute exacerbations can decrease the effectiveness of patients' usual airway clearance techniques (ACT). In order to maintain effective airway clearance and preserve lung function, these ACT must be adapted to prevent further dyspnoea and fatigue and improve ease of expectoration. Mechanical insufflation-exsufflation (MI-E) is widely used in neuromuscular disorders to facilitate airway clearance and augment cough but has rarely been used in CF despite potential indications. The NIPPY Clearway, an airway clearance device with multiple modes including MI-E, can be set to deliver multiple insufflations prior to a single exsufflation...
May 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29478908/bronchiectasis-new-therapies-and-new-perspectives
#18
REVIEW
James D Chalmers, Sanjay H Chotirmall
European Respiratory Society guidelines for the management of adult bronchiectasis highlight the paucity of treatment options available for patients with this disorder. No treatments have been licensed by regulatory agencies worldwide, and most therapies used in clinical practice are based on very little evidence. Development of new treatments is needed urgently. We did a systematic review of scientific literature and clinical trial registries to identify agents in early-to-late clinical development for bronchiectasis in adults...
February 22, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29467332/chronic-%C3%AE-2ar-stimulation-limits-cftr-activation-in-human-airway-epithelia
#19
John J Brewington, Jessica Backstrom, Amanda Feldman, Elizabeth L Kramer, Jessica D Moncivaiz, Alicia J Ostmann, Xiaoting Zhu, L Jason Lu, John P Clancy
Traditional pulmonary therapies for cystic fibrosis (CF) target the downstream effects of CF transmembrane conductance regulator (CFTR) dysfunction (the cause of CF). Use of one such therapy, β-adrenergic bronchodilators (such as albuterol), is nearly universal for airway clearance. Conversely, novel modulator therapies restore function to select mutant CFTR proteins, offering a disease-modifying treatment. Recent trials of modulators targeting F508del-CFTR, the most common CFTR mutation, suggest that chronic β-agonist use may undermine clinical modulator benefits...
February 22, 2018: JCI Insight
https://www.readbyqxmd.com/read/29458306/a-mechanistic-review-of-particle-overload-by-titanium-dioxide
#20
Hajime Kawasaki
Chronic exposure to titanium dioxide (TiO2 ) induces slight but significant pulmonary inflammation in experimental animals, and among potential mechanisms, particle overload is likely. Although mechanisms of particle overload are poorly understood, excess accumulation of dust particles in dust containing macrophages (dust cells) can impair their mobility, resulting in reduced clearance ability. Accordingly, retention half-times of inhaled TiO2 increase linearly with lung burden in rodents, and mathematical (Michaelis-Menten-like) models for pulmonary clearance rates of TiO2 as a function of lung burden have suggested an alternative mechanism for particle overload, involving excess accumulation of macrophages in the translocation pathway due to the narrow exit to the ciliated airway region, and leading to reduced pulmonary TiO2 clearance rates...
October 2017: Inhalation Toxicology
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