Effects of breathing cold and warm air on lung function and physical performance in asthmatic and nonasthmatic athletes during exercise in the cold.
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Adult↗
Biomedical subjects
L Bjermer
Publications and source records attributed to L Bjermer.
[Leukotrienes and asthma. Clinical and experimental experiences with leukotriene receptor antagonists and leukotriene synthesis inhibitors].
Leucotrienes are synthesized from arachidonic acid. They are potent proinflammatory mediators that contribute to bronchial hyperreactivity. Antileukotrienes constitute a new group of antiasthmatic drugs. Zafirlucast, a leukotriene receptor antagonist, is now registered in Ireland and Finland for the treatment of mild to moderate asthma. We have studied the literature on antileukotrienes and have focused on their ability to prevent or inhibit symptoms in asthma. When patients with mild to moderate asthma are pretreated with an antileukotriene, the bronchoconstriction following provocation with cold, dry air, exercise or allergen is significantly reduced. ASA-sensitive asthmatics with adenoids and a lost sense of smell achieved a significant increase in FEV1s and regained their sense of smell after administration of an antileukotriene. Ongoing studies will tell us whether antileukotrienes have a significant steroid-sparing effect as compared with placebo, after which recommendations can be made concerning the future use of these interesting medicaments.
Anti-Asthmatic Agents↗
Long-acting beta(2)-agonists: how are they used in an optimal way?
Inhaled long-acting beta(2)-agonists are frequently used for the treatment of asthma. When introduced to the market, the drug was accompanied by a debate among physicians and scientists raising warnings against the use of beta(2)-agonists, leading to a risk of tachyphylaxis and worsening of asthma control. During recent years, much of these warnings have been counter proved and there has been a tendency to institute treatment with long-acting beta(2)-agonists somewhat earlier in the course than before. However, the exact place for long-acting beta(2)-agonists in the asthma treatment plans, still needs to be established. While beta(2)-agonists have been shown to have anti-inflammatory activity in vitro and after single allergen exposure, this effect seems to disappear with regular treatment. The same phenomena have been shown to protect against obstruction caused by metacholine inhalation or exercise. Although the protective effect diminishes or even disappears, no signs of rebound phenomena or increased susceptibility to provocative stimulus has been shown. Thus, in contrast to earlier reports after regular use of short-acting beta(2)-agonists, no signs of tachyphylaxis have been reported after use of long-acting beta(2)-agonists. Moreover, the bronchodilatatory effect seems to be fairly stable after regular treatment, even though some reports claims that this effect diminishes over time. The present article is a review of some data involved in this debate. The authors conclude that long-acting beta(2)-agonists are a valuable contribution to the asthma treatment repertoire. However, the drugs should be regarded as long-acting bronchodilatators, supplementing the use of inhaled corticosteroids. The rapid appearing tolerance towards allergen-induced and provoked bronchial obstruction prevents these drugs from being used as monotherapy; they should be used only in combination with sufficient anti-inflammatory treatment, i.e. inhaled corticosteroids.
Adrenergic beta-Agonists↗
Pulmonary embolism: detection with MR perfusion imaging of lung--a feasibility study.
PURPOSE: To evaluate the feasibility of magnetic resonance (MR) perfusion imaging in the human lung to help detect perfusion defects distal to suspected pulmonary embolism. MATERIALS AND METHODS: Seven patients suspected of having pulmonary embolism first underwent ventilation-perfusion lung scintigraphy followed by MR perfusion imaging with rapid acquisition of two sets of dynamic images in the coronal and transaxial planes. A bolus of 0.05 mmol per kilogram of body weight gadopentetate dimeglumine or gadodiamide was administered. Single images obtained in each section that showed peak signal intensity from the first passage of contrast material were evaluated visually. An analysis of change in signal intensity over time was performed both on a pixel-by-pixel basis and in selected regions of interest. RESULTS: In the seven patients, a total of 18 regions of lung tissue with perfusion defects were shown on the ventilation-perfusion scans. In 16 of these regions, MR perfusion images showed a reduced peak signal intensity during first passage of the contrast agent. Perfusion defects could be detected in both the coronal and the transaxial planes on MR perfusion images. CONCLUSION: MR perfusion imaging was feasible for detection of perfusion defects distal to a pulmonary embolism.
Adult↗
[Scandinavian guidelines for asthma. Nationalforeningen til Bekaempelse af Lungesygdomme].
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Asthma↗
Upregulation of gap junction protein connexin43 in alveolar epithelial cells of rats with radiation-induced pulmonary fibrosis.
The degree of immunoreactive connexin43 (C x 43) in rat lung was evaluated during the development of radiation-induced pulmonary fibrosis in rat by a double immunofluorescence technique using polyclonal antisera to Cx43 and monoclonal antibodies to cytokeratins on cryostat sections. In normal rat lungs, Cx43 was detected in pneumocytes type II and I, in large blood vessel endothelia, in peribronchial smooth muscle cells, and in some peribronchial and perivascular interstitial cells. As early as 1 week after irradiation, enhanced immunoreactivity for Cx43 in the epithelial cells was detected. In severely injured lungs (about 3 months after irradiation), Cx43 was found also in the cytoplasm of type II pneumocytes. These findings were confirmed by western blot data. Western blot analysis also revealed increased phosphorylation of Cx43. It remains to be investigated whether the increased content of Cx43 in irradiated rat lung may be due to an enhanced number of gap junctions between type I and II alveolar epithelial cells.
Actins↗
Prevalence of asthma in young cross-country skiers in central Scandinavia: differences between Norway and Sweden.
An increased prevalence of asthma in cross-country skiers has been reported previously. This study was conducted in order to evaluate the prevalence of asthma among young, elite cross-country skiers in Trøndelag, Norway and Jämtland, Sweden. These two regions in central Scandinavia have different climates during the winter season, with a coastal type in Trøndelag while Jämtland is characterized by a colder, drier, inland type of climate. The study population consisted of 171 skiers (118 from Norway, 53 from Sweden). The investigation included an asthma questionnaire, spirometry and methacholine provocation testing. The prevalence of self-reported asthma-related symptoms was 46% in Norway and 51% in Sweden. The prevalence of bronchial hyper-responsiveness (BHR) was significantly different between the two regions. In Norway, 14% of the skiers were hyper-responsive to methacholine compared to 43% in Sweden (P < 0.001). Moreover, the estimated prevalence of clinically diagnosed asthma was 12% in Norway and 42% in Sweden (P < 0.001). The self-reported frequency of respiratory allergy was higher in Sweden (32%) than in Norway (11%). However, on an individual basis, self-reported allergy did not predict occurrence of asthma or BHR. In conclusion, there is a high prevalence of BHR and asthma among young, elite cross-country skiers in central Scandinavia, especially in Sweden. Cross-country skiing may be a risk factor for the development of asthma. Longitudinal studies of cross-country skiers, and studies to acquire further knowledge of the mechanisms involved in the development of asthma are indicated.
Adolescent↗
Obstructive symptoms in athletes: is it asthma and what to do about it?
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Anti-Inflammatory Agents↗
Extracellular phospholipase A2 expression in sarcoidosis.
This study was conducted in order to focus upon the Ca2- dependent secretory non-pancreatic phospholipase A2 (npPLA2) enzyme and its possible role in the pathophysiology of sarcoidosis. Serum samples were taken from 24 patients with sarcoidosis to determine the levels of npPLA2. Moreover, in another group of patients with active chest x-ray stage II and III sarcoidosis, bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial lung biopsies (TBL) were taken. Highly significant increase of npPLA2 in serum was found in patients compared to controls (p < 0.001). Furthermore, those patients with stable and inactive disease and those who were under treatment with corticosteroids, tended to have lower values than those with active disease and those who were untreated. An intense accumulation of npPLA2 was found in smooth muscle tissue in lung biopsy specimens, in close connection with fibroblast accumulation and deposition of collagen. These cells also stained positive for alpha-smooth muscle actin (alpha-SMA). In addition, when using the technique of in situ hybridization, expression of npPLA2-mRNA was found in the fibroblast layer surrounding the epitheloid cell granulomas. These fibroblasts did not stain positive for alpha-SMA. Our data suggest that npPLA2 is actively involved, and has an important role, in the pathophysiology of sarcoidosis.
Actins↗
[Guidelines for understanding and treating chronic obstructive lung diseases. Institute for Pharmacotherapy].
A group of chest physicians, general practitioners, clinical pharmacologist and pharmacists appointed by the Institute of Pharmacotherapy, University of Oslo has evaluated the present knowledge about treatment of chronic obstructive lung disease. The group discusses today's medical treatment of this rather numerous group of patients. It is stated that, to a high degree, the treatment of these patients lacks proper documentation, and that treatment needs to be tested out on an individual basis. The group proposes a flow chart for this purpose.
Humans↗
Experimental evaluation of the effect of filtration of diesel exhaust by biologic exposure indicators.
The airway resistance, compliance of the respiratory system, transfer factor, and alveolar volume of 33 healthy rabbits were studied before and after exposure to diluted diesel exhaust generated in an experimental motor. Three diesel fuels and two particle traps were tested. Subsequent to the post-exposure lung function measurements, the animals were sacrificed and the lungs were processed for morphologic examination. The concentrations of particles, nitrogen dioxide, and formaldehyde were measured. The inflammatory airway changes were most pronounced in animals exposed to exhaust from standard fuel. Small changes were identified in animals exposed to exhaust filtered through the catalytic trap as well or exposed to unfiltered exhaust from fuels intended for densely built-up areas. Increase in compliance of the respiratory system was associated with the concentration of soot particles and formaldehyde. Compliance decreased significantly in animals exposed to exhaust from standard fuel filtered through the particle traps and increased almost significantly in animals exposed to unfiltered exhaust from the same fuel.
Air Pollutants↗
Bronchoalveolar lavage studies in children without parenchymal lung disease: cellular constituents and protein levels.
We evaluated bronchoalveolar lavage fluid (BAL) for cellular constituents, concentration of total protein (TP), albumin (AL), fibronectin (FN), and hyaluronic acid (HA) in 16 children aged 2-32 months without pulmonary inflammatory or parenchymal disease to establish reference values. We compared our data to those reported in older children and in normal adult volunteers. BAL results were obtained simultaneously from the right middle lobe and the lingula. Results indicated that children younger than 3 years of age had a higher number of cells/mL than older children and adults (59.9 x 10(4) vs. 17.6 x 10(4) and 12 x 10(4)). Differential cell count revealed that the percentages of alveolar macrophages (AM), lymphocytes (LYM), and eosinophils (EOS) were similar to those obtained in older children and in adults, whereas the percentage of neutrophils (NEU) was higher in younger children (NEU 5.5 vs 1.6 and 1.2%, respectively) than in older children and adults. The latter difference was even greater in infants under 12 months of age (NEU 7.6%). The concentrations of TP, AL, FN, and HA in children's BAL samples were compared to values reported for adults. There were no differences between infants and children 13-32 months of age or normal adults. BAL fluid obtained simultaneously from the middle lobe and lingula were not significantly different. In conclusion, this is the first report on BAL values (cellular and noncellular constituents) in children younger than 3 years. The results may be used as reference values for further studies in children with parenchymal lung disease in this age group.
Adult↗
Effects of intrapleural mitoxantrone and mepacrine on malignant pleural effusion--a randomised study.
30 patients with malignant pleuritis were randomised to be treated, either with intrapleural instillation of mepacrine chloride or with mitoxantrone. The patients were evaluated with chest X-ray and a symptom questionnaire during a follow-up period of 12 weeks. Mitoxantrone levels in the pleural space and plasma were measured at different time points in some of the patients. High concentrations of mitoxantrone were found in the pleural fluid while the plasma concentrations were low, giving a plasma/intracavity ratio generally of less than 1:60. The chest X-rays showed excellent results for both treatment modalities. However, the patients treated with mepacrine chloride experienced greater discomfort with fever and pain, and those treated with mitoxantrone reported significantly less dyspnoea and less asthenia after 4 weeks. We conclude that both treatments are equally effective in preventing the recurrence of malignant effusion. However, mitoxantrone seems to have further advantages when it comes to improving the quality of life.
Adult↗
Effects of IL-2 treatment on different compartments of the irradiated rat lung analysed by bronchoalveolar lavage and lung tissue morphology.
In recent years, interleukin-2 (IL-2) has been used as an immunomodulatory agent in the treatment of various malignant tumours. However, this treatment has been limited by serious side-effects, including toxic reactions in the lung. The effects of IL-2 treatment on inflammatory cell populations in the normal and irradiated rat lung were investigated in this study. IL-2 was continuously administered as a subcutaneous infusion over a 6 week study period. Irradiation was given in a single dose (25 Gy) the day after starting IL-2 treatment. Evaluation with bronchoalveolar lavage fluid (BALF) analysis and lung tissue morphology was made 6 weeks after irradiation. In nonirradiated rats, IL-2 treatment induced significant increases in the total number of inflammatory cells in the perivascular, interstitial and peribronchial tissues as well as in the alveolar space. These increases were not reflected in BALF; on the contrary, a significant decrease of the total numbers of inflammatory cells was found in BALF. Irradiation alone caused a more pronounced inflammatory response was significant increases of all inflammatory cells in all lung compartments, which was also reflected in BALF. Concomitant treatment with IL-2 and irradiation induced an enhanced accumulation of inflammatory cells in the perivascular and peribronchial tissues compared with irradiation alone. Thus, both irradiation and IL-2 treatment induce inflammatory reactions in the lung, but there were signs of synergistic effects seen in this study. Furthermore, the results also emphasize the difficulties in making sophisticated conclusions from BALF analyses alone.
Animals↗
Sephadex-induced granulomatous alveolitis in rat: effects of antigen manipulation.
A granulomatous alveolitis, with multinuclear cell formation combined with an eosinophilic peribronchiolitis, was achieved in rats by intratracheal administration of sephadex beads (G-200, Pharmacia, Sweden). The pattern of inflammation and the degree of postgranulomatous fibrosis were substantially dampened when the particles were dispersed by ultrasonification. The animals were analyzed with bronchoalveolar lavage and tissue morphology.
Animals↗
Lipopolysaccharide (LPS) inhalation in healthy subjects causes bronchoalveolar neutrophilia, lymphocytosis, and fibronectin increase.
Eight healthy volunteers were exposed to purified lipopolysaccharide (LPS) by controlled inhalation. Bronchoalveolar lavage (BAL) 3 hours after exposure revealed a pronounced neutrophilia, increase in lymphocytes, fibronectin concentration, and decrease in alveolar macrophage phagocytosis, as compared to a reference BAL.
Administration, Inhalation↗
Increase in mast cells and hyaluronic acid correlates to radiation-induced damage and loss of serous acinar cells in salivary glands: the parotid and submandibular glands differ in radiation sensitivity.
The detailed mechanisms which can explain the inherent radiosensitivity of salivary glands remain to be elucidated. Although DNA is the most plausible critical target for the lethal effects of irradiation, interactions with other constituents, such as cell membrane and neuropeptides, have been suggested to cause important physiological changes. Moreover, mast cells seem to be closely linked to radiation-induced pneumonitis. Therefore, in the present study the effects of fractionated irradiation on salivary glands have been assessed with special regard to the appearance of mast cells and its correlation with damage to gland parenchyma. Sprague-Dawley strain rats were unilaterally irradiated to the head and neck with the salivary glands within the radiation field. The irradiation was delivered once daily for 5 days to a total dose of 20, 35 and 45 Gy. The contralateral parotid and submandibular glands served as intra-animal controls and parallel analysis of glands was performed 2, 4, 10 or 180 days following the last radiation treatment. Morphological analysis revealed no obvious changes up to 10 days after the irradiation. At 180 days a radiation dose-dependent loss of gland parenchyma was seen, especially with regard to serious acinar cells in parotid gland and acinar cells and serous CGT (convoluted granular tubule) cells in the submandibular gland. These changes displayed a close correlation with a concomitant dose-dependent enhanced density of mast cells and staining for hyaluronic acid. This cell population seems to conform with the features of the connective tissue mast cell type. The parotid seems to be more sensitive to irradiation than the submandibular gland. Thus, the present results further strengthen the role of and the potential interaction of mast cells with radiation-induced tissue injury and alterations in normal tissue integrity.
Animals↗
Experimental granulomatous alveolitis in rat. Effect of antigen manipulation, smoke exposure and route of administration.
When Sephadex beads (0.45mg/kg b.w) are instilled intratracheally into rats, a granulomatous alveolitis with giant cell formation and fibrosis occurs. Moreover, the events in the alveolar region are paralleled by an eosinophil-dominated peribronchitis/bronchiolitis and perivasculitis. Bronchoalveolar lavage (BAL) shows a very distinct feature with an early pronounced neutrophil increase, followed by an increase of eosinophils and lymphocytes. BAL findings returned to normal after 1-2 weeks, but tissue morphology showed persistent inflammation with large numbers of eosinophils and to a lesser degree mononuclear cells, peribronchially and perivascularly several weeks after the instillation. Fragmentation of the Sephadex beads by ultrasonication dramatically diminished the response, giving a transient neutrophil alveolitis, without eosinophils and with no granuloma formation. On the other hand, when the Sephadex dose was divided into three, given 10 days apart, a more pronounced fibrosing activity occurred, with mast cells appearing in the collagen rich granulomas. Finally, smoke exposure had a significant suppressive effect upon the response. The numbers of cells in the interstitium as well as in the peribronchial and perivascular tissue were markedly decreased in the smoke exposed group compared to the controls. This decrease was mainly due to decreased numbers of mononuclear cells, while the numbers of eosinophils remained unchanged.
Animals↗