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Airway physiology

Melinda A Ma, Rajesh Kumar, Paul M Macey, Frisca L Yan-Go, Ronald M Harper
INTRODUCTION: Obstructive sleep apnea (OSA) is a male-predominant condition, characterized by repeated upper-airway collapse with continued diaphragmatic efforts during sleep, and is accompanied by severe physiological consequences. Multiple morphological aspects, including epiglottis cross-sectional area (CSA) and oropharyngeal airway length (OPAL), can contribute to airway collapsibility in the condition. This study focused on the effects of OSA severity, sex, and race on OPA dimensions...
2016: Nature and Science of Sleep
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
September 2016: Journal of Hypertension
Giovanna Chidini, Daniele De Luca, Giorgio Conti, Paolo Pelosi, Stefano Nava, Edoardo Calderini
OBJECTIVE: Neurally adjusted ventilatory assist has been shown to improve patient-ventilator interaction in children with acute respiratory failure. Objective of this study was to compare the effect of noninvasive neurally adjusted ventilatory assist versus noninvasive flow-triggered pressure support on patient-ventilator interaction in children with acute respiratory failure, when delivered as a first-line respiratory support. DESIGN: Prospective randomized crossover physiologic study...
September 30, 2016: Pediatric Critical Care Medicine
Jeffrey Dorrity, Nicholas Wirtz, Oleg Froymovich, David Hamlar
Surgical intervention for obstructive sleep apnea (OSA) is a complex topic. The discussion involves intricate procedures targeting specific areas of the upper airway. Because of the wide variety of physiologic and anatomic causes of this disorder it is important to tailor the treatment to offer the patient the best possible outcome. Genioglossus, hyoid, and tongue base procedures should be considered among theses treatment options.
October 11, 2016: Otolaryngologic Clinics of North America
Peter B Terry, Richard J Traystman
Oxygen delivery and carbon dioxide removal being critical to cell survival, mammals have developed collateral vascular and ventilation systems to ensure tissue viability. Collateral ventilation, defined as ventilation of alveoli via pathways that bypass normal airways, is present in humans and many other species. The presence of collateral ventilation can be beneficial in certain disease states, while its relative absence can predispose to other diseases. These well defined anatomical pathways contribute little to ventilation in normal humans, but modulate ventilation perfusion imbalance in a variety of diseases including obstructive diseases such as asthma and emphysema...
October 14, 2016: Annals of the American Thoracic Society
Charles C Reilly, Caroline J Jolley, Caroline Elston, John Moxham, Gerrard F Rafferty
The electromyogram recorded from the diaphragm (EMGdi) and parasternal intercostal muscle using surface electrodes (sEMGpara) provides a measure of neural respiratory drive (NRD), the magnitude of which reflects lung disease severity in stable cystic fibrosis. The aim of this study was to explore perception of NRD and breathlessness in both healthy individuals and patients with cystic fibrosis. Given chronic respiratory loading and increased NRD in cystic fibrosis, often in the absence of breathlessness at rest, we hypothesised that patients with cystic fibrosis would be able to tolerate higher levels of NRD for a given level of breathlessness compared to healthy individuals during exercise...
January 2016: ERJ Open Research
Juan Carlos Lopez-Rodriguez, Rodrigo Barderas, Mercedes Echaide, Jesus Perez-Gil, Mayte Villalba, Eva Batanero, Antonio Cruz
Aeroallergens are airborne substances -mainly proteins- capable of triggering Th2-immune responses in respiratory allergies. They enter into the body through the upper airways, reaching the mucosa afterwards. Mucosae lining at the luminal side consists of an epithelial barrier completely covered by mucus and pulmonary surfactant. Both, pulmonary surfactant and plasma membrane of the epithelial cells represent two physiological phospholipid-based barriers where allergens first impact before triggering their biological effects...
October 10, 2016: Langmuir: the ACS Journal of Surfaces and Colloids
Vinciane Saint-Criq, Michael A Gray
Salt and fluid absorption and secretion are two processes that are fundamental to epithelial function and whole body fluid homeostasis, and as such are tightly regulated in epithelial tissues. The CFTR anion channel plays a major role in regulating both secretion and absorption in a diverse range of epithelial tissues, including the airways, the GI and reproductive tracts, sweat and salivary glands. It is not surprising then that defects in CFTR function are linked to disease, including life-threatening secretory diarrhoeas, such as cholera, as well as the inherited disease, cystic fibrosis (CF), one of the most common life-limiting genetic diseases in Caucasian populations...
October 6, 2016: Cellular and Molecular Life Sciences: CMLS
David C Adams, Lida P Hariri, Alyssa J Miller, Yan Wang, Josalyn L Cho, Martin Villiger, Jasmin A Holz, Margit V Szabari, Daniel L Hamilos, R Scott Harris, Jason W Griffith, Brett E Bouma, Andrew D Luster, Benjamin D Medoff, Melissa J Suter
The inability to visualize airway smooth muscle (ASM) cells in vivo is a major obstacle in understanding their role in normal physiology and diseases. At present, there is no imaging modality available to assess ASM in vivo. Confocal endomicroscopy lacks the penetration depth and field of view, and conventional optical coherence tomography (OCT) does not have sufficient contrast to differentiate ASM from surrounding tissues. We have developed a birefringence microscopy platform that leverages the micro-organization of tissue to add further dimension to traditional OCT...
October 5, 2016: Science Translational Medicine
Gonzalo Hernández, Concepción Vaquero, Laura Colinas, Rafael Cuena, Paloma González, Alfonso Canabal, Susana Sanchez, Maria Luisa Rodriguez, Ana Villasclaras, Rafael Fernández
Importance: High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Among the advantages of high-flow oxygen therapy are comfort, availability, lower costs, and additional physiopathological mechanisms. Objective: To test if high-flow conditioned oxygen therapy is noninferior to NIV for preventing postextubation respiratory failure and reintubation in patients at high risk of reintubation...
October 5, 2016: JAMA: the Journal of the American Medical Association
Laura Lucarini, Mariaconcetta Durante, Cecilia Lanzi, Alessandro Pini, Giulia Boccalini, Laura Calosi, Flavio Moroni, Emanuela Masini, Guido Mannaioni
Idiopathic pulmonary fibrosis is a severe disease characterized by excessive myofibroblast proliferation, extracellular matrix and fibrils deposition, remodelling of lung parenchyma and pulmonary insufficiency. Drugs able to reduce disease progression are available, but therapeutic results are unsatisfactory; new and safe treatments are urgently needed. Poly(ADP-ribose) polymerases-1 (PARP-1) is an abundant nuclear enzyme involved in key biological processes: DNA repair, gene expression control, and cell survival or death...
October 4, 2016: Journal of Cellular and Molecular Medicine
Ravishekar Ravi Kannan, Z J Chen, Narender Singh, Andrzej Przekwas, Renishkumar Delvadia, Geng Tian, Ross Walenga
The models used for modeling the airflow in the human airways are either 0D compartmental or full 3D Computational Fluid Dynamics (CFD) models. In the former, airways are treated as compartments and the computations are performed with several assumptions, thereby generating a low fidelity solution. The CFD method displays extremely high fidelity since the solution is obtained by solving the conservation equations in a physiologically consistent geometry. However, CFD models (i) require millions of degrees of freedom (DOF) to accurately describe the geometry and to reduce the discretization errors, (ii) have convergence problems and (iii) require several days to simulate a few breathing cycles...
October 5, 2016: International Journal for Numerical Methods in Biomedical Engineering
Amir Soltani, Eugene Haydn Walters, David W Reid, Shakti Dhar Shukla, Kaosia Nowrin, Chris Ward, H Konrad Muller, Sukhwinder Singh Sohal
BACKGROUND: This study assessed the effects of inhaled corticosteroid (ICS) on airway vascular remodeling in chronic obstructive pulmonary disease (COPD). METHODS: Thirty-four subjects with mild-to-moderate COPD were randomly allocated 2:1 to ICS or placebo treatment in a double-blinded clinical trial over 6 months. Available tissue was compared before and after treatment for vessel density, and expression of VEGF, TGF-β1, and TGF-β1-related phosphorylated transcription factors p-SMAD 2/3...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Elizabeth Moses, Teresa Wang, Sean Corbett, George R Jackson, Eduard Drizik, Catalina Perdomo, Claudia Perdomo, Eric Kleerup, Daniel Brooks, George O'Connor, Steven Dubinett, Patrick Hayden, Marc E Lenburg, Avrum Spira
Little evidence is available regarding the physiological effects of exposure to electronic cigarette (ECIG) aerosol. We sought to determine the molecular impact of ECIG aerosol exposure in human bronchial epithelial cells. Gene expression profiling was conducted in primary human bronchial epithelial cells (HBECs) grown at Air Liquid Interface and exposed to one of four different ECIG aerosols, traditional cigarette (TCIG) smoke, or clean air. Findings were validated experimentally with qPCR and a reactive oxygen species immunoassay...
October 3, 2016: Toxicological Sciences: An Official Journal of the Society of Toxicology
S Vamsee Raju, Hyunki Kim, Stephen A Byzek, Li Ping Tang, John E Trombley, Patricia Jackson, Lawrence Rasmussen, J Michael Wells, Emily Falk Libby, Erik Dohm, Lindy Winter, Sharon L Samuel, Kurt R Zinn, J Edwin Blalock, Trenton R Schoeb, Mark T Dransfield, Steven M Rowe
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the US. The majority of COPD patients have symptoms of chronic bronchitis, which lacks specific therapies. A major impediment to therapeutic development has been the absence of animal models that recapitulate key clinical and pathologic features of human disease. Ferrets are well suited for the investigation of the significance of respiratory diseases, given prior data indicating similarities to human airway physiology and submucosal gland distribution...
September 22, 2016: JCI Insight
Benjamin Steines, David D Dickey, Jamie Bergen, Katherine J D A Excoffon, John R Weinstein, Xiaopeng Li, Ziying Yan, Mahmoud H Abou Alaiwa, Viral S Shah, Drake C Bouzek, Linda S Powers, Nicholas D Gansemer, Lynda S Ostedgaard, John F Engelhardt, David A Stoltz, Michael J Welsh, Patrick L Sinn, David V Schaffer, Joseph Zabner
The physiological components that contribute to cystic fibrosis (CF) lung disease are steadily being elucidated. Gene therapy could potentially correct these defects. CFTR-null pigs provide a relevant model to test gene therapy vectors. Using an in vivo selection strategy that amplifies successful capsids by replicating their genomes with helper adenovirus coinfection, we selected an adeno-associated virus (AAV) with tropism for pig airway epithelia. The evolved capsid, termed AAV2H22, is based on AAV2 with 5 point mutations that result in a 240-fold increased infection efficiency...
September 8, 2016: JCI Insight
Alison Wimms, Holger Woehrle, Sahisha Ketheeswaran, Dinesh Ramanan, Jeffery Armitstead
Obstructive sleep apnea (OSA) has traditionally been seen as a male disease. However, the importance of OSA in women is increasingly being recognized, along with a number of significant gender-related differences in the symptoms, diagnosis, consequences, and treatment of OSA. Women tend to have less severe OSA than males, with a lower apnea-hypopnea index (AHI) and shorter apneas and hypopneas. Episodes of upper airway resistance that do not meet the criteria for apneas are more common in women. Prevalence rates are lower in women, and proportionally fewer women receive a correct diagnosis...
2016: BioMed Research International
Wanli Li, Xinjiang An, Mingyu Fu, Chunli Li
Pneumonia refers to lung inflammation caused by different pathogens or other factors, and is a common pediatric disease occurring in infants and young children. It is closely related to the anatomical and physiological characteristics of infants and young children and is more frequent during winter and spring, or sudden changes in temperature. Pneumonia is a serious disease that poses a threat to children's health and its morbidity and mortality rank first, accounting for 24.5-65.2% of pediatric inpatients...
October 2016: Experimental and Therapeutic Medicine
Jian Zhang, Ling Lin, Konghan Pan, Jiancang Zhou, Xiaoyin Huang
High-flow nasal cannula (HFNC) oxygen therapy has several physiological advantages over traditional oxygen therapy devices, including decreased nasopharyngeal resistance, washing out of the nasopharyngeal dead space, generation of positive pressure in the pharynx, increasing alveolar recruitment in the lungs, humidification of the airways, increased fraction of inspired oxygen and improved mucociliary clearance. Recently, the use of HFNC in treating adult critical illness patients has significantly increased, and it is now being used in many patients with a range of different disease conditions...
October 2, 2016: Journal of International Medical Research
Dorian S Olivera, Heidi Hoard-Fruchey, Alfred M Sciuto
Therapeutic development against exposure to toxic gases is hindered by the lack of appropriate models to evaluate candidate compounds prior to animal efficacy studies. In this study, an in vitro, air-liquid interface exposure model has been tested to examine its potential application for screening treatments for phosgene (carbonyl chloride)-induced pulmonary injury. Epithelial cultures on Transwell® inserts, combined with a Vitrocell® exposure apparatus, provided a physiologically relevant exposure environment...
October 4, 2016: Toxicology Mechanisms and Methods
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