罗红霉素对哮喘大鼠气道重塑中成肌纤维细胞、TGF-β1和 IFN-γ的影响

目的: 探讨成肌纤维细胞(myofibroblast,MF) 、转化生长因子β₁ (transforming growth factor-beta 1, TGF-β₁ ) 和 IFN-γ在哮喘气道重塑中的作用,并观察罗红霉素对哮喘气道重塑的影响。方法: SD大鼠 30 只, 随机分为哮喘组、生理盐水对照组、罗红霉素治疗组, 每组 10 只。利用卵白蛋白(ovalbumin,OVA)/Al(OH)₃ 致敏与 OVA 雾化吸入激发建立大鼠哮喘模型。免疫组化测定支气管上皮下成肌纤维细胞的 α-平滑肌肌动蛋白(α-smoothmuscle actin, α-SMA) 表达含量, 并使用图像分析技术进行积分吸光度(integral optical density, IOD) 定量分析测定 。ELISA 法测定支气管肺泡灌洗液(bronchoalveolar lavage fluid, BALF) 中 TGF-β₁ 和IFN-γ的浓度。结果: 定量分析测定的 IOD 值显示哮喘组支气管上皮下成肌纤维细胞 α-SMA 表达含量较生理盐水对照组增加(P<0.01) , 罗红霉素治疗组表达含量较哮喘组减少(P<0.05) 。ELISA 法测定哮喘组 BALF 中 TGF-β₁ 浓度较对照组升高(P<0.01) , 治疗组较哮喘组浓度降低(P<0.01) , 但仍高于对照组(P<0.05) 。哮喘组BALF 中 IFN-γ浓度较对照组降低(P<0.01) , 治疗组较哮喘组浓度高(P<0.01) , 但仍低于对照组(P<0.05) 。结论: 成肌纤维细胞在气道重塑中起重要作用。罗红霉素可能通过减少 TGF-β₁ ,增加 IFN-γ的产生, 从而抑制成肌纤维细胞增殖和表达, 起到抗哮喘气道重塑作用 。     

Current wheeze,asthma, respiratory infections,and rhinitis among adults in relation to inspection data and indoor measurements in single‐family houses in Sweden—The BETSI study

In the Swedish Building Energy, Technical Status and Indoor environment study, a total of 1160 adults from 605 single‐family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate, and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally, 7.3% were smokers, 8.7% had doctor’ diagnosed asthma, 11.2% current wheeze, and 9.5% current asthma symptoms. Totally, 50.3% had respiratory infections and 26.0% rhinitis. The mean air exchange rate was 0.36/h, and the mean moisture load 1.70 g/m³. Damp foundation (OR=1.79, 95% CI 1.16‐2.78) was positively associated while floor constructions with crawl space (OR=0.49, 95% CI 0.29‐0.84) was negatively associated with wheeze. Concrete slabs with overlying insulation (OR=2.21, 95% CI 1.24‐3.92) and brick façade (OR=1.71, 95% CI 1.07‐2.73) were associated with rhinitis. Moisture load was associated with respiratory infections (OR=1.21 per 1 g/m³, 95% CI 1.04‐1.40) and rhinitis (OR=1.36 per 1 g/m³, 95% CI 1.02‐1.83). Air exchange rate was associated with current asthma symptoms (OR=0.85 per 0.1/h, 95% CI 0.73‐0.99). Living in homes with damp foundation, concrete slabs with overlying insulation, brick façade, low ventilation flow, and high moisture load are risk factors for asthma, rhinitis, and respiratory infections.     

The mother-child relationship in bronchial asthma.

The responses to the Blacky Test and an objective test of attitudes re child rearing—Parental Attitude Research Instrument (PARI), Schaefer & Bell (1955)—of mothers of children with asthma (A), were compared to those of children with rheumatic fever (RF), and a group being seen in out-patient clinic dealing with minor cuts and bruises (healthy controls, H). No differences were found on the PARI, and significance was found on only 2 cards of the Blacky. From these 2 cards, it was concluded that A mothers, as compared to the others, had a greater intensity of edipal conflict and were more inclined to be characterized as oral erotic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Asthma and Chronic Rhinosinusitis: How Similar Are They in Pathogenesis and Treatment Responses?

Severe asthma and rhinosinusitis represent frequent comorbidities, complicating the overall management of the disease. Both asthma and chronic rhinosinusitis (CRS) can be differentiated into endotypes: those with type 2 eosinophilic inflammation and those with a non-type 2 inflammation. A correct definition of phenotype/endotype for these diseases is crucial, taking into account the availability of novel biological therapies. Even though patients suffering from type 2 severe asthma—with or without CRS with nasal polyps—significantly benefit from treatment with biologics, the existence of different levels of patient response has been clearly demonstrated. In fact, in clinical practice, it is a common experience that patients reach a good clinical response for asthma symptoms, but not for CRS. At first glance, a reason for this could be that although asthma and CRS can coexist in the same patient, they can manifest with different degrees of severity; therefore, efficacy may not be equally achieved. Many questions regarding responders and nonresponders, predictors of response, and residual disease after blocking type 2 pathways are still unanswered. In this review, we discuss whether treatment with biological agents is equally effective in controlling both asthma and sinonasal symptoms in patients in which asthma and chronic rhinosinusitis with nasal polyps coexist.     

广东省佛山市3-7岁支气管哮喘患儿气质的研究

目的探讨广东省佛山市3~7岁支气管哮喘患儿与其气质的关系。方法对66例支气管哮喘患儿（哮喘组）和113例健康儿童（正常对照组）采用Carry 3~7岁儿童气质问卷（behavioral style questionnaire,BSQ）进行气质维度评分,并根据各气质维度的得分情况对2组进行气质类型测评。结果哮喘组在气质维度中的趋避性、适应性、反应强度、情绪本质、坚持性、注意分散度评分值与正常对照组比较差异均有统计学意义（均P〈0.05）;哮喘组患儿ID型、D型、S型所占比例较高,IE型和E型所占比例较低,与正常对照组比较差异均有统计学意义（均P〈0.05）。结论支气管哮喘患儿的气质类型分布和气质部分维度与正常儿童有明显差异,治疗儿童支气管哮喘时应考虑其个体气质特征,并给予适当的干预。     

舌下含服粉尘螨疫苗免疫治疗法对哮喘小鼠树突状细胞及NF-κB的影响

目的通过对哮喘模型小鼠舌下含服粉尘螨疫苗进行治疗,研究治疗前后树突状细胞（dendritic cell,DC）和NF-κB在颌下淋巴结和肺部的变化,比较高剂量疫苗和低剂量疫苗对哮喘小鼠的治疗疗效。方法采用常规方法制备舌下含服粉尘螨疫苗。28只BALB/c小鼠按随机数字表法分为正常组（A组）、哮喘模型组（B组）、粉尘螨高剂量治疗组（C组）、粉尘螨低剂量治疗组（D组）,每组7只。检测小鼠气道高反应性,观察支气管肺胞灌洗液（BALF）中细胞计数和分类,肺组织HE染色观察小鼠肺部炎症状况;通过免疫组织化学染色和体视学测量观察各组小鼠肺组织NF-κB阳性细胞的变化和颌下淋巴结33D1阳性DC的表达。结果 C组BALF中嗜酸性细胞计数、肺组织炎症细胞浸润较B组显著减少（P〈0.05）,气道高反应性下降（P〈0.01）。C、D组哮喘小鼠颌下淋巴结33D1阳性DC和肺部NF-κB阳性细胞的数密度、体密度、表面积密度均下降,C组比D组下降更明显（P〈0.01）。结论高剂量舌下含服粉尘螨疫苗治疗哮喘小鼠有显著疗效,与DC的免疫耐受和NF-κB的下调密切相关。     

HEPA filtration improves asthma control in children exposed to traffic-related airborne particles

Traffic-related airborne particles are associated with asthma morbidity. The aim of this study was to assess the impact of a high-efficiency particulate air (HEPA) filtration on the concentrations of traffic particles and the resultant effect on children with asthma. Forty-three children with asthma were enrolled in this double-blind, placebo-controlled crossover design. A HEPA air cleaner or a placebo “dummy” was placed in participants’ homes for four weeks, interrupted by a one-month washout period, before crossing over to the other treatment arm for four weeks. Air sampling and health outcomes, including asthma control (ACQ) and quality of life (AQLQ) measures, were completed prior to and at the end of each treatment arm. Indoor concentrations of traffic particles were significantly reduced with the HEPA treatment but not with the “dummy” treatment. In participants with poorly controlled asthma and lower quality of life at baseline, ACQ and AQLQ scores were significantly improved (1.3 to 0.9, P = .003 and 4.9 to 5.5, P = .02, respectively) following the HEPA treatment. In this study, HEPA filtration is associated with improved clinical outcomes and quality of life measures in children with uncontrolled asthma.     

Indoor visible mold and mold odor are associated with new‐onset childhood wheeze in a dose‐dependent manner

Evidence is accumulating that indoor dampness and mold are associated with the development of asthma. The underlying mechanisms remain unknown. New Zealand has high rates of both asthma and indoor mold and is ideally placed to investigate this. We conducted an incident case‐control study involving 150 children with new‐onset wheeze, aged between 1 and 7 years, each matched to two control children with no history of wheezing. Each participant's home was assessed for moisture damage, condensation, and mold growth by researchers, an independent building assessor and parents. Repeated measures of temperature and humidity were made, and electrostatic dust cloths were used to collect airborne microbes. Cloths were analyzed using qPCR. Children were skin prick tested for aeroallergens to establish atopy. Strong positive associations were found between observations of visible mold and new‐onset wheezing in children (adjusted odds ratios ranged between 1.30 and 3.56; P ≤ .05). Visible mold and mold odor were consistently associated with new‐onset wheezing in a dose‐dependent manner. Measurements of qPCR microbial levels, temperature, and humidity were not associated with new‐onset wheezing. The association between mold and new‐onset wheeze was not modified by atopic status, suggesting a non‐allergic association.     

班布特罗对豚鼠实验性哮喘的作用及其机理研究

目的 研究班布特罗对豚鼠实验性哮喘的作用、药效学及药动学特点及作用机制。方法 组胺和卵清蛋白诱发在体豚鼠实验性哮喘模型, 使用豚鼠离体气管片和肺条进行研究。结果 班布特罗剂量依赖性抑制组胺和卵清蛋白诱发的豚鼠哮喘, 班布特罗对豚鼠气管片无松弛作用, 而灌服其后的松弛气管片和肺条血浆呈剂量依赖性, 且对肺条的松弛作用强于气管片。其峰效应出现于给药后4 h 前后, 作用持续24 h 以上。结论 班布特罗作为特布他林的前药对豚鼠实验性哮喘的作用缓和而持久。     

中西医结合治疗支气管哮喘疗效观察

目的观察中西医结合治疗支气管哮喘的临床疗效。方法采用随机、双盲和1:1平行对照的试验方法。将60例患者随机分为治疗组和对照组,每组各30例。2组皆用西医常规治疗,其中治疗组在西医常规治疗的基础上加用中药,水煎服,每日1剂,15d为1个疗程。观察喘息症状的变化及肺部哮鸣音的消减情况。结果治疗组喘息症状及肺部哮鸣音的消减总有效率为93.33%(28/30例),对照组总有效率为73.32%(22/30例),2组治愈率与总有效率比较均有统计学意义(P<0.05)。结论中西医结合治疗支气管哮喘的临床疗效显著优于单纯西医治疗支气管哮喘的临床疗效。