Biomedical subjects
Publications and source records attributed to Iwona Grzelewska-Rzymowska.
Asthma is a chronic inflammatory disease of the airways in which many cell types play a role. These cells are involved in the regulation of the airways inflammation and initiate the process of remodelling by the release of cytokines and growth factors. In the article the authors describe changes in airways wall in asthmatic patients and their clinical consequences.
BACKGROUND: Acute exacerbations of chronic bronchitis (AECB) are the most common complication of chronic bronchitis. The majority of AECB are caused by infection. The choice of appropriate antibacterial therapy for AECB is becoming more difficult and is usually empirically. Cefaclor and cefuroxime are used for ambulatory treatment of AECB. MATERIAL/METHODS: This multicenter, randomized, single blind study was undertaken in order to compare efficacy and safety of cefaclor AF (500 mg BID) and cefuroxime axetil (250 mg BID) in 10 days treatment of ambulatory patients with AECB. 170 adults were enrolled into the study. Clinical responses were assessed on 17th-24th day after randomization. RESULTS: Both antibiotics had high over 97% effectiveness in the treatment of AECB. There was statistically significant 1.7 times higher rate of patients with cough release after cefaclor treatment compared to cefuroxime (p<0.03). There was a significantly 2.25 higher rate of patients with AECB symptoms release like: increasing dyspnea, sputum volume and sputum purulence or cough in cefaclor group compared to cefuroxime (p<0.0187). Both treatments resulted in significant improvement of pulmonary peak expiratory flow (PEF). There were no differences between the rates of gastrointestinal and other side effects in both groups. CONCLUSIONS: 1. Cefaclor and cefuroxime have similar high efficacy and safety in 10 days treatment of patients with AECB. 2. Cefaclor treatment significantly higher 2.25 times reduces the rate of principle symptoms of AECB compared to cefuroxime. 3. Both antibiotics treatment significantly increase PEF, with higher tendency observed in after cefaclor treatment.
Bronchial hyperresponsiveness, an exaggerated bronchoconstrictor response to a variety of nonspecific stimuli, is regarded as one of the most important feature in bronchial asthma. It can be demonstrated by bronchial provocation tests with pharmacological or physical stimuli. The measured level of responsiveness to these agents is considered to reflect the lability of the airways and the severity of the disease. Acute exposure to allergen causes an increase of airway responsiveness. The significant correlation between the allergen-induced increase in hyperresponsiveness and the severity of the late asthmatic reaction suggests the same underlying mechanisms that include an influx of inflammatory cells in the airways occurring during late phase of response to allergens. Marked inflammation with infiltration of eosinophils and disruption of airway epithelium has been also described on autopsies of patients who died of acute asthma but also on bronchial biopsies of subjects with mild asthma. Development and persistence of increased nonspecific bronchial responsiveness are possibly associated with these inflammatory changes.
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