June 8, 2013

Nrf2 Is a Protective Factor against Oxidative Stresses Induced by Diesel Exhaust Particle in Allergic Asthma

Oxidative Medicine and Cellular Longevity
Volume 2013 (2013), Article ID 323607, 5 pages
http://dx.doi.org/10.1155/2013/323607

Review Article

Nrf2 Is a Protective Factor against Oxidative Stresses Induced by Diesel Exhaust Particle in Allergic Asthma

Ying-Ji Li,¹ Tomoyuki Kawada,¹ and Arata Azuma²

¹Department of Hygiene and Public Health, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
²Pulmonary Medicine/Infection and Oncology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan

Received 11 January 2013; Revised 18 March 2013; Accepted 8 April 2013

Academic Editor: Hye-Youn Cho

Copyright © 2013 Ying-Ji Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Epidemiological studies have shown that air pollutants, such as diesel exhaust particle (DEP), are implicated in the increased incidence of allergic airway disorders. In vitro studies of molecular mechanisms have focused on the role of reactive oxygen species generated directly and indirectly by the exposure to DEP. Antioxidants effectively reduce the allergic inflammatory effects induced by DEP bothin vitro and in vivo. On the other hand, Nrf2 is a transcription factor essential for the inducible and/or constitutive expression of phase II and antioxidant enzymes. Disruption of Nrf2 enhances susceptibility to airway inflammatory responses and exacerbation of allergic inflammation induced by DEP in mice. Host responses to DEP are regulated by a balance between antioxidants and proinflammatory responses. Nrf2 may be an important protective factor against oxidative stresses induced by DEP in airway inflammation and allergic asthma and is expected to contribute to chemoprevention against DEP health effects in susceptible individuals.

A long term case series study of the effect of omalizumab on chronic spontaneous urticaria.

Ann Dermatol. 2013 May; 25(2): 242–245.

Published online 2013 May 10. doi: 10.5021/ad.2013.25.2.242

PMCID: PMC3662923

A Long Term Case Series Study of the Effect of Omalizumab on Chronic Spontaneous Urticaria

Anna Cecilie Lefévre, Mette Deleuran, and Christian Vestergaard corresponding author

Author information ► Article notes ► Copyright and License information ►

Pharmacology of antihistamines.

Indian J Dermatol. 2013 May-Jun; 58(3): 219–224.

doi: 10.4103/0019-5154.110832

PMCID: PMC3667286

Pharmacology of Antihistamines

Martin K Church and Diana S Church1

Author information ► Article notes ► Copyright and License information ►

Abstract

H1-antihistamines, the mainstay of treatment for urticaria, were developed from anticholinergic drugs more than 70 years ago. They act as inverse agonists rather than antagonists of histamine H1-receptors which are members of the G-protein family. The older first generation H1-antihistamines penetrate readily into the brain to cause sedation, drowsiness, fatigue and impaired concentration and memory causing detrimental effects on learning and examination performance in children and on impairment of the ability of adults to work and drive. Their use should be discouraged. The newer second-generation H1-antihistamines are safer, cause less sedation and are more efficacious. Three drugs widely used for symptomatic relief in urticaria, desloratadine, levocetirizine and fexofenadine are highlighted in this review. Of these levocetirizine and fexofenadine are the most potent in humans in vivo. However, levocetirizine may cause somnolence in susceptible individuals, whereas fexofenadine has a relatively short duration of action and may be required to be given twice daily for all round daily protection. Although desloratadine is less potent, it has the advantages of rarely causing somnolence and having a long duration of action.

Keywords: Cetirizine, desloratadine, fexofenadine, H1-antihistamines, hydroxyzine, levocetirizine,loratadine

Spirometry in children

Volume 22 Issue 2 June 2013

Clinical Review

Spirometry in children

Pages 221-229
Kana Ram Jat

Department of Pediatrics, Government Medical College and Hospital, Sector-32, Chandigarh-160030, India

Received 15 December 2012 • Accepted 17 February 2013 • Online 29 May 2013

Abstract
Respiratory disorders are responsible for considerable morbidity and mortality in children. Spirometry is a useful investigation for diagnosing and monitoring a variety of paediatric respiratory diseases, but it is underused by primary care physicians and paediatricians treating children with respiratory disease. We now have a better understanding of respiratory physiology in children, and newer computerised spirometry equipment is available with updated regional reference values for the paediatric age group. This review evaluates the current literature for indications, test procedures, quality assessment, and interpretation of spirometry results in children. Spirometry may be useful for asthma, cystic fibrosis, congenital or acquired airway malformations and many other respiratory diseases in children. The technique for performing spirometry in children is crucial and is discussed in detail. Most children, including preschool children, can perform acceptable spirometry. Steps for interpreting spirometry results include identification of common errors during the test by applying acceptability and repeatability criteria and then comparing test parameters with reference standards. Spirometry results depict only the pattern of ventilation, which may be normal, obstructive, restrictive, or mixed. The diagnosis should be based on both clinical features and spirometry results. There is a need to encourage primary care physicians and paediatricians treating respiratory diseases in children to use spirometry after adequate training.

Cite as: Jat KR. Spirometry in children. Prim Care Respir J 2013;22(2):221-229. DOI: http://dx.doi.org/10.4104/pcrj.2013.00042

Keywords
spirometry, preschool children, forced vital capacity, forced expiratory volume in one second

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Association between the Asthma Predictive Index and levels of exhaled nitric oxide in infants and toddlers with recurrent wheezing

Arch. argent. pediatr. vol.111 no.3 Buenos Aires June 2013

http://dx.doi.org/10.5546/aap.2013.191

ORIGINAL ARTICLE

Association between the Asthma Predictive Index and levels of exhaled nitric oxide in infants and toddlers with recurrent wheezing

Juan Emilio Balinotti, M.D.^a, Alejandro Colom, M.D.^a, Carlos Kofman, M.D.^a and Alejandro Teper, M.D.^a

a. Respiratory Center Dr. Alberto R.Álvarez. Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina.

E-mail address: Juan Emilio Balinotti, M.D., juanbalinotti@gmail.com

Funding: This study was conducted with the support of an annual fellowship grant called the Florencio Fiorini Medical Research Stimulation, year 2009, granted by the Fundación Florencio Fiorini and the Asociación MédicaArgentina.

Conflict of interest: None.

Received: 10-29-2012
Accepted: 1-18-2013

http://dx.doi.org/10.5546/aap.2013.191

ABSTRACT

It is difficult to make an early identification of which children with recurrent wheezing will develop asthma in the following years. The Asthma Predictive Index (API) is a questionnaire based on clinical and laboratory parameters used for this end. The measurement of fractional exhaled nitric oxide (FE_NO) has been used as a marker of eosinophilic airway infammation in asthma patients.
Objective. To determine the association between the Asthma Predictive Index and FE_NO levels in children younger than 3 years old with recurrent wheezing.
Materials and methods. Observational, cross sectional study. Children younger than 36 months old with 3 or more episodes of bronchial obstruction in the past year who were inhaled corticosteroid-naive or leukotriene receptor antagonist-naive were included. After recording clinical data, FE_NO was measured by a chemiluminescence analyzer during tidal breathing (online method).
Results. A total of 52 children aged 5-36 months old were included. Patients with a positive API accounted for 60% of the population and had higher levels of FE_NO than those with a negative API, with a median (range) of 13.5 ppb (0.7-31) versus 5.6 ppb (0.1-20.8), respectively (p - 0.01). A high FE_NO (+ 8 ppb) was observed in 74% of children with a positive API and in 26% of those with a negative API (p - 0.01).
Conclusions. This study found an association between high levels of exhaled nitric oxide and a positive Asthma Predictive Index in children younger than 3 years old with recurrent wheezing.

Key words: Asthma predictive algorithm; Exhaled nitric oxide; Recurrent wheezing; Infants and toddlers.

Article

The larynx in cough.

Review

The larynx in cough

Guri S Sandhu and Romana Kuchai

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Cough 2013, 9:16 doi:10.1186/1745-9974-9-16

Published: 3 June 2013

Abstract (provisional)

About 40% of the population will experience chronic cough at some point during their lives and it tends to be more common in women (Thorax 58:901--7, 2003). Post-nasal drip (or upper airway cough syndrome), gastro-esophageal reflux disease and asthma are considered the most common causes. Yet only a small percentage of patients with these common conditions experience chronic cough. Also there is no agreed measure of post-nasal drip and controversy exists about the diagnosis of reflux above the upper esophageal sphincter (laryngopharyngeal reflux) based on observable changes to the larynx. The approach of the otolaryngologist is to consider the upper and lower airways as a continuum and that a common pathology can have an impact on all these anatomical sites.A multidisciplinary approach is advocated, utilising the skills of the respiratory physician, otolaryngologist, gastroenterologist and speech pathologist.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

A review on guidelines for management and treatment of common variable immunodeficiency

Summary

Expert Review of Clinical Immunology

June 2013, Vol. 9, No. 6, Pages 561-575 , DOI 10.1586/eci.13.30

(doi:10.1586/eci.13.30)

Review

A review on guidelines for management and treatment of common variable immunodeficiency

Hassan Abolhassani ¹, Babak Torabi Sagvand ¹, Tahaamin Shokuhfar ¹, Babak Mirminachi ¹, Nima Rezaei ^1,² and Asghar Aghamohammadi^*¹

* Author for correspondence

Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency in adults. As symptoms of CVID are usually heterogeneous and unspecific, diagnosis and follow-up of CVID can be challenging. In light of this, a broad review of advances in management and treatment of CVID is performed here in order to reach a distinct protocol. However, it should be noted that owing to the nature of the disease, it can only be treated symptomatically but not cured. There is little evidence to guide appropriate or universal guidelines to improve the current status of management of the disease. The most satisfactory treatments of CVID could be achieved by the use of immunoglobulin replacement, antibiotics, immunosuppressants and hematopoietic stem cell transplantation. This review is written based on the importance of clinical surveillance of asymptomatic CVID cases and early recognition of different clinical complications. Moreover, for each complication, appropriate interventions for improving outcomes are mentioned.

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