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Mechanism of airway clearance

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https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/29453412/pulmonary-antigen-encounter-regulates-the-establishment-of-tissue-resident-cd8-memory-t-cells-in-the-lung-airways-and-parenchyma
#10
Sean R McMaster, Alexander N Wein, Paul R Dunbar, Sarah L Hayward, Emily K Cartwright, Timothy L Denning, Jacob E Kohlmeier
Resident memory CD8 T (TRM ) cells in the lung parenchyma (LP) and airways provide heterologous protection against influenza virus challenge. However, scant knowledge exists regarding factors necessary to establish and maintain lung CD8 TRM . Here we demonstrate that, in contrast to mechanisms described for other tissues, airway, and LP CD8 TRM establishment requires cognate antigen recognition in the lung. Systemic effector CD8 T cells could be transiently pulled into the lung in response to localized inflammation, however these effector cells failed to establish tissue residency unless antigen was present in the pulmonary environment...
February 16, 2018: Mucosal Immunology
https://www.readbyqxmd.com/read/29424930/inhaled-mannitol-for-cystic-fibrosis
#11
REVIEW
Sarah J Nevitt, Judith Thornton, Clare S Murray, Tiffany Dwyer
BACKGROUND: Several agents are used to clear secretions from the airways of people with cystic fibrosis. Mannitol increases mucociliary clearance, but its exact mechanism of action is unknown. The dry powder formulation of mannitol may be more convenient and easier to use compared with established agents which require delivery via a nebuliser. Phase III trials of inhaled dry powder mannitol for the treatment of cystic fibrosis have been completed and it is now available in Australia and some countries in Europe...
February 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29402960/spatiotemporal-organization-of-cilia-drives-multiscale-mucus-swirls-in-model-human-bronchial-epithelium
#12
Mustapha-Kamel Khelloufi, Etienne Loiseau, Marc Jaeger, Nicolas Molinari, Pascal Chanez, Delphine Gras, Annie Viallat
Mucociliary clearance is a biomechanical mechanism of airway protection. It consists of the active transport along the bronchial tree of the mucus, a fluid propelled by the coordinated beating of a myriad of cilia on the epithelial surface of the respiratory tract. The physics of mucus transport is poorly understood because it involves complex phenomena such as long-range hydrodynamic interactions, active collective ciliary motion, and the complex rheology of mucus. We propose a quantitative physical analysis of the ciliary activity and mucus transport on a large panel of human bronchial cultures from control subjects, patients with asthma and chronic obstructive pulmonary disease obtained from endobronchial biopsies...
February 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29391451/atp12a-promotes-mucus-dysfunction-during-type-2-airway-inflammation
#13
Alison T Lennox, Stefanie L Coburn, John A Leech, Elisa M Heidrich, Thomas R Kleyman, Sally E Wenzel, Joseph M Pilewski, Timothy E Corcoran, Mike M Myerburg
Allergic airway disease is known to cause significant morbidity due to impaired mucociliary clearance, however the mechanism that leads to the mucus dysfunction is not entirely understood. Interleukin 13 (IL-13), a key mediator of Type 2 (T2) inflammation, profoundly alters the ion transport properties of airway epithelium. However, these electrophysiological changes cannot explain the thick, tenacious airway mucus that characterizes the clinical phenotype. Here we report that IL-13 dramatically increases the airway surface liquid (ASL) viscosity in cultured primary human bronchial epithelial cells and thereby inhibits mucus clearance...
February 1, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29382534/salvianolic-acid-b-improves-airway-hyperresponsiveness-by-inhibiting-muc5ac-overproduction-associated-with-erk1-2-p38-signaling
#14
Yan Guan, Jian-Ping Zhu, Jian Shen, Yong-Liang Jia, Ya-Chao Jin, Xin-Wei Dong, Qiang-Min Xie
Salvianolic acid B (SalB) is one of the main water-soluble composites from Chinese medicine Dansen (Radix miltiorrhiza). It is used for clinical treatment of various diseases including cardiovascular, lung, Liver, renal and cancers. However, the effects of SalB to allergy induced airway mucin hypersecretion, inflammation and hyperresponsiveness (AHR) remains not clear. Overproduction of airway MUC5AC is a central effector of inflammation that is strongly associated with AHR in asthmatic attack. In this study, we investigated the anti-asthmatic activity and mechanism of SalB in a murine model and human epithelial cells by monitoring changes in mucin expression and secretion, airway inflammation, AHR, and signaling pathways...
January 27, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29373331/the-physiology-of-neonatal-resuscitation
#15
Stuart B Hooper, Marcus J Kitchen, Graeme R Polglase, Charles C Roehr, Arjan B Te Pas
PURPOSE OF REVIEW: As the infant's physiology changes dramatically after birth, modern neonatal resuscitation approaches should detect and be modified in response to these changes. This review describes the changes in respiratory physiology at birth and highlights approaches that can assist these changes. RECENT FINDINGS: To better target assistance given to infants at birth, the changes in lung physiology have been classified into three phases. The first phase involves lung aeration...
April 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29367592/persistent-activation-of-interlinked-type-2-airway-epithelial-gene-networks-in-sputum-derived-cells-from-aeroallergen-sensitized-symptomatic-asthmatics
#16
Anya C Jones, Niamh M Troy, Elisha White, Elysia M Hollams, Alexander M Gout, Kak-Ming Ling, Anthony Kicic, Stephen M Stick, Peter D Sly, Patrick G Holt, Graham L Hall, Anthony Bosco
Atopic asthma is a persistent disease characterized by intermittent wheeze and progressive loss of lung function. The disease is thought to be driven primarily by chronic aeroallergen-induced type 2-associated inflammation. However, the vast majority of atopics do not develop asthma despite ongoing aeroallergen exposure, suggesting additional mechanisms operate in conjunction with type 2 immunity to drive asthma pathogenesis. We employed RNA-Seq profiling of sputum-derived cells to identify gene networks operative at baseline in house dust mite-sensitized (HDMS) subjects with/without wheezing history that are characteristic of the ongoing asthmatic state...
January 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29321377/development-of-an-airway-mucus-defect-in-the-cystic-fibrosis-rat
#17
Susan E Birket, Joy M Davis, Courtney M Fernandez, Katherine L Tuggle, Ashley M Oden, Kengyeh K Chu, Guillermo J Tearney, Michelle V Fanucchi, Eric J Sorscher, Steven M Rowe
The mechanisms underlying the development and natural progression of the airway mucus defect in cystic fibrosis (CF) remain largely unclear. New animal models of CF, coupled with imaging using micro-optical coherence tomography, can lead to insights regarding these questions. The Cftr-/- (KO) rat allows for longitudinal examination of the development and progression of airway mucus abnormalities. The KO rat exhibits decreased periciliary depth, hyperacidic pH, and increased mucus solid content percentage; however, the transport rates and viscoelastic properties of the mucus are unaffected until the KO rat ages...
January 11, 2018: JCI Insight
https://www.readbyqxmd.com/read/29319936/submucosal-gland-mucus-strand-velocity-is-decreased-in-chronic-rhinosinusitis
#18
Kiranya E Tipirneni, Shaoyan Zhang, Do-Yeon Cho, Jessica Grayson, Daniel F Skinner, Calvin Mackey, Lindsay Moore, Denzel Cole, Catherine G Banks, Bradford A Woodworth
BACKGROUND: Chronic rhinosinusitis (CRS) may be initiated by innately impaired host defense mechanisms that predispose the upper airways to infection. Recent evidence suggests tethering of submucosal gland mucus strands represents an inciting event within cystic fibrosis (CF) airways, occurring prior to onset of chronic infection. Submucosal gland hypertrophy and defective mucociliary clearance (MCC) are present in actively inflamed sinuses, but mucus strand velocity may also be affected as a secondary event, further contributing to chronic disease...
April 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29311363/il-1-signaling-prevents-alveolar-macrophage-depletion-during-influenza-and-streptococcus-pneumoniae-coinfection
#19
Shruti Bansal, Vijaya Kumar Yajjala, Christopher Bauer, Keer Sun
Influenza and bacterial coinfection is a significant cause of hospitalization and death in humans during influenza epidemics and pandemics. However, the fundamental protective and pathogenic mechanisms involved in this complex virus-host-bacterium interaction remain incompletely understood. In this study, we have developed mild to lethal influenza and Streptococcus pneumoniae coinfection models for comparative analyses of disease pathogenesis. Specifically, wild-type and IL-1R type 1-deficient ( Il1r1-/- ) mice were infected with influenza virus and then superchallenged with noninvasive S...
February 15, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29289553/advanced-aging-causes-diaphragm-functional-abnormalities-global-proteome-remodeling-and-loss-of-mitochondrial-cysteine-redox-flexibility-in-mice
#20
Rachel C Kelley, Brian McDonagh, Leonardo F Ferreira
AIM: Inspiratory muscle (diaphragm) function declines with age, contributing to exercise intolerance and impaired airway clearance. Studies of diaphragm dysfunction in rodents have focused on moderate aging (~24months); thus, the impact of advanced age on the diaphragm and potential mechanisms of dysfunction are less clear. Therefore, we aimed to define the effects of advanced age on the mechanics, morphology, and global and redox proteome of the diaphragm. METHODS: We studied diaphragm from young (6months) and very old male mice (30months)...
March 2018: Experimental Gerontology
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