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Hemmung der monozytären Zytokinproduktion (IL-1β, IL-6, TNF-α) durch die ätherische Öle Myrtol N, Orangenöl und Eukalyptusöl in vitroPenzel, Carolin 17 January 2011 (has links) (PDF)
COPD wird zunehmend als eine von den Atemwegen und der Lunge ausgehende systemische Erkrankung verbunden mit einer systemischen Entzündungsreaktion verstanden. Monozyten wird eine Schlüsselrolle in der Inflammation zugeschrieben, so dass sich die Suche nach einer verträglichen, antientzündlich wirkenden Substanz als therapeutische Konsequenz ergibt. Ätherische Öle wurden in letzter Zeit verstärkt bezüglich ihrer antientzündlichen Wirkung evaluiert. Methodik: Die Untersuchung wurde als offene, single- center Studie durchgeführt. Primärer Endpunkt war die Reduktion der aus in vitro von COPD- Patienten (n=26) kultivierten Monozyten sezernierten Zytokine TNF-α, IL-1β und IL-6. Die Zellen wurden mit LPS mit Myrtol N, Eukalyptus-, oder Orangenöl über 20 Stunden coinkubiert und die Zytokinkonzentrationen im Zellüberstand mittels ELISA quantifiziert. Ergebnisse: Die Zellvitalität nach Inkubation betrug jeweils >80%. Orangenöl: Eine Konzentration von 1,5*10-4% nicht aber 1,5*10-3% reduzierte das extrazellulär sezernierte IL-6 um 7,5%. Extrazelluläres IL-1β wurde bei 1,5*10-4% um 17,1% reduziert. Bei Konzentrationen von 1,5*10-3%, 1,5*10-4% und 1,5*10-6% blieb TNF-α nahezu konstant. 1,5*10-5% führte dagegen zu einer TNF-α- Steigerung um 17,24%. Myrtol N: IL-6 sank bei Konzentrationen von 1,5*10-3% -1,5*10-5% um 4,76%, 2,81% und 7,02%. IL-1β blieb bei Konzentrationen von 1,5*10-3% - 1,5*10-5% nahezu konstant (Reduktion:-3,66%, -2,91%, +6,73%). 1,5*10-5% senkte TNF-α um 27,5% (p=0,341), während Konzentrationen von 1,5*10-3% und 1,5*10-4% TNF-α nicht beeinflussten. Eukalyptusöl: Bei Konzentrationen von 1,5*10-3% und 1,5*10-4% kam es zu einem leichten Anstieg von IL-6 um 7,89% und 2,42%. 1,5*10-5% führte zu einer leichten IL-6- Reduktion (-3,11%). IL-1β wurde von Eukalyptusöl (1,5*10-3% und 1,5*10-4%) tendenziell um 4,38% und 6,76% reduziert. TNF-α wurde durch Eukalyptusöl (1,5*10-3%-1,5*10-5%) dagegen um 18-22% gesteigert. Schlussfolgerung: Ein eindeutiger antiinflammatorischer Effekt der Öle konnte in dem hier auf Monozyten basierenden Zellmodel durch die Arbeit nicht verifiziert werden.
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Reduced proliferation and increased TSLP expression by lung fibroblasts from COPD patientsTripathi, Soma 14 January 2014 (has links)
Chronic obstructive pulmonary disease (COPD) is identified with partially reversible airflow limitation, chronic bronchitis, small airway remodelling, and alveolar destruction. COPD is also progressive in nature. TSLP (Thymic stromal lymphopoietin), an Interleukin (IL)-7 like cytokine expressed by structural cells, is a determinant of inflammation. We aimed to characterize human lung fibroblasts (HLF) from human donors with COPD as well as patients without COPD (non-COPD), comparing proliferation and TSLP release. Statins can exert anti-proliferative and anti-inflammatory effects, and their use has been linked to improved lung health, thus we also examined the effect of statins on proliferation and cytokine release by lung fibroblasts from COPD and non-COPD donors. Primary HLF cultures from three COPD diagnosed and non- COPD donors were used. Proliferation was measured using laser scanning cytometry (LSC) counting of H33248-stained cells with 5% fetal bovine along with the addition of simvastatin (0.1µM and 0.5µM). TNFα (tumor necrosis factor α) and/or IL-1β (interleukin 1β) (10ng/mL), and various concentrations of cigarette smoke extract (CSE) were used to stimulate cells. TSLP release, mRNA abundance and transcriptional activity were measured by ELISA, Real Time Polymerase Chain Recation (RT- PCR) and luciferase assay, respectively. RT-PCR was also utilized to profile TNFα and Interleukin 1β receptors. We also ascertained the effect of various stimuli on receptor-mediated signaling pathways using Western blotting. Impact of simvastatin (1-10µM) on TSLP release was determined by ELISA.
During exponential growth phase, HLF from COPD donors proliferated 46.7% slower than from non-COPD. Simvastatin (0.5µM) inhibited proliferation, as indicated by 53% (P<0.01) and 48% (P< 0.001) fewer COPD and non-COPD donor HLFs at Day 6 culture. At baseline COPD HLFs make approximately 2-fold (P<0.05) more TSLP/cell compared to non-COPD HLFs. TNFα and/or IL-1β (10ng/ml, 48h) induced approximately 1.8 to 2.3-fold (P<0.05) more TSLP release in COPD HLFs. Interestingly, simvastatin had no impact on basal TSLP release, but in the presence of TNFα (5µM, 72h), TSLP release was actually increased approximately 2.19-fold (COPD) and 1.8-fold (non-COPD). TSLP mRNA levels were maximum at 6h in both COPD and non-COPD HLFs and relative TSLP mRNA was approximately 15-fold higher in COPD HLFs compared to non-COPD HLFs (P<0.01). This correlated with human TSLP promoter luciferase reporter assays that showed baseline transcription in COPD HLFs is markedly (approximately 17-fold) higher than non-COPD HLFs. In TNFα-stimulated cultures, TSLP luciferase activity was approximately 10-fold higher in COPD HLFs compared to HLFs from non-COPD. There was no difference in mRNA abundance of receptor subunits for TNFα or IL-1β between patient groups. Phosphorylation of mitogen activated protein kinases, ERK1/2 and p38MAPK, were also comparatively higher in COPD HLFs when stimulated with TNFα suggesting increased response via TNFα receptors. Additionally, in TNFα-stimulated cultures, Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) transcriptional activity was approximately 2.6-fold higher in COPD HLFs as compared to HLFs from non-COPD donors.
Collectively our data show that proliferation of HLFs from COPD subjects is lower and can be further reduced by simvastatin. COPD HLFs exhibit increased basal and cytokine-stimulated TSLP mRNA expression, transcription and release, suggesting these cells carry stable intrinsic differences in regulatory mechanisms. Differences in TSLP levels are not due to differential abundance of TNFα and IL-1β receptors although the intracellular responses mediated by TNF α receptor is higher in COPD HLFs. Simvastatin augments TNFα-induced TSLP release in COPD and non-COPD HLFs. These data indicate further investigation of the role of TSLP and its response to therapy, in COPD is warranted.
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COPD und BegleiterkrankungenHellmann, Sebastian 16 May 2011 (has links) (PDF)
Die COPD ist eine Erkrankung mit hoher Prävalenz, die in den nächsten Jahren weiter zunehmen wird. Aufgrund der ausgeprägten klinischen Symptomatik, der hohen Mortalitätsrate und des stetig steigenden Alters in der Bevölkerung wird die COPD aus gesundheits- und sozio-ökonomischen Gründen in den nächsten Jahren immer mehr an Bedeutung gewinnen. Daher ist eine Risikostratifizierung der Erkrankung COPD nicht nur für die Betroffenen von starker Bedeutung.
In der Robert-Koch-Klinik, dem Thoraxzentrum des Klinikums St. Georg Leipzig und Lehrkrankenhaus der Universität Leipzig wurden vom 01.01.2002 bis zum 01.03.2009 insgesamt 366 Patienten mit COPD in die Studie aufgenommen, nach international anerkannten Leitlinien in Schweregrade eingeteilt und retrospektiv hinsichtlich ihrer Begleiterkrankungen analysiert.
Ziel der Arbeit war eine Evaluation von bedeutsamen Begleiterkrankungen der COPD. Dabei wurden die Häufigkeiten und Arten der Begleiterkrankungen in Zusammenhang mit den Schweregraden der COPD und deren Auswirkungen auf die Hospitalisationsrate untersucht und die Frage beantwortet, ob und wenn ja welche Risikofaktoren für das Erwerben der Begleiterkrankungen eine Rolle spielen.
Das vorliegende Kollektiv war im Mittel 62,7±9,6 Jahre alt, bestand zu 64% aus Männern und hatte einen BMI von im Mittel 26,1±5,9. Die Patienten waren überwiegend Raucher oder Ex-Raucher. Als Begleiterkrankungen wurden die KHK mit 20,5%, die arterielle Hypertonie mit 58,5%, die Hyperlipoproteinämie mit 11,7%, der Diabetes Mellitus mit 21,4%, embolische Ereignisse mit 10,7% und die Osteoporose mit 15,3% nachgewiesen. Innerhalb des Beobachtungszeitraumes wurden 75,4% ein weiteres Mal in das Krankenhaus stationär aufgenommen.
Nur bei der Begleiterkrankung Hyperlipoproteinämie ließ sich eine statistisch signifikante Assoziation mit den COPD-Schweregraden nachweisen. Bei der Anzahl der Wiederaufnahmen ergab sich ein statistisch signifikanter Zusammenhang mit dem Schweregrad der COPD-Erkrankung. Eine inverse Assoziation konnte zwischen dem BMI und dem ansteigenden COPD-Schweregrad berechnet werden. Das Geschlecht, das CRP und das Raucherverhalten konnten dagegen statistisch nicht mit dem steigenden Schweregrad der Erkrankung assoziiert werden.
Im Einklang mit der aktuellen Literatur ließ sich in unseren Daten eine hohe Prävalenz bei Erkrankten mit COPD hinsichtlich der Begleiterkrankungen KHK, arterielle Hypertonie, Diabetes mellitus und Osteoporose nachweisen. Es ließ sich kein erhöhtes Auftreten der Anzahl von embolischen Ereignissen bei COPD-Erkrankten feststellen. Nur bei der Osteoporose konnte eine ansteigende Prävalenzhäufigkeit in den COPD-Stadien erkannt werden, die allerdings nicht statistisch signifikant war.
Die Anzahl der stationären Wiederaufnahmen stiegen dagegen statistisch signifikant analog zum Schweregrad der COPD-Erkrankung an, während sich der Schweregrad der COPD invers zum BMI verhielt.
In einer zusammenfassenden Bewertung konnte diese Arbeit den Zusammenhang zwischen der COPD und der Häufigkeit der aufgeführten Begleiterkrankungen zeigen. Es wurde dokumentiert, dass Patienten mit COPD für die untersuchten Begleiterkrankungen eine starke Prädisposition haben. Die Osteoporose, der BMI und die Hospitalisationsrate scheinen mit dem Schweregrad der COPD zusammenzuhängen, so dass insbesondere hinsichtlich dieser genannten Faktoren ein systematisches Screening erfolgen sollte. Die Erkenntnis der engen Beziehung der Begleiterkrankungen, insbesondere die mit dem Schweregrad zunehmende Prävalenz der Osteoporose, spielt in der Prävention COPD-Erkrankter und für deren Prognose eine große Rolle, da durch frühe Therapie Sekundärschäden verhindert werden könnten.
Dies Arbeit zeigt, dass die COPD, unter Berücksichtigung der steigenden Morbidität der Grunderkrankung und der mit ihr verbundenen Begleiterkrankungen sowie der steigenden sozioökonomischen Kosten durch vermehrte Krankenhausaufenthalte, in Zukunft ein zentrales Thema in der Medizin werden wird und verdeutlicht die Forderung nach weiterer Forschung auf diesem Gebiet.
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Effect of semaphorin 3E on airway smooth muscle cell in chronic obstructive pulmonary disease (COPD)Alsubait, Duaa 08 April 2015 (has links)
Introduction:
Our objective is to investigate whether Semaphorin 3E (sema3E) regulates human airway smooth muscle cell (HASMC) proliferation in chronic obstructive pulmonary disease (COPD).
Methods:
HASMCs and tissues were isolated from COPD patients. Sema3E and plexinD1 expressions were studied using Q-PCR, FACS, IHC and immunoblotting. Cell proliferation was evaluated using FACS.
Results:
HASM cells from COPD patients express p61kDa-Sema3E isoform and plexinD1 at mRNA and protein level. Lung tissue from COPD and healthy subjects display Sema3E immunoreactivity. Treatment with Sema3E inhibits HASM cell proliferation mediated by PDGF in healthy, but not in COPD. HASM cells from COPD patient display surface expression of Sema3E.
Conclusion:
The absence of effect of recombinant Sema3E in COPD is due the constitutive expression and release of p61kDa-Sema3E isoform, which may account for airway remodeling in COPD. / May 2015
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Primary Care Provider's Perceptions of Spirometry Use for Diagnosis and Management of COPDShah, Krupa Rashmin, Shah, Krupa Rashmin January 2017 (has links)
Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of death worldwide and requires close monitoring and follow up to prevent exacerbations that lead to hospitalizations (CDC, 2015). COPD is often underdiagnosed or misdiagnosed for asthma and also under-treated because providers are not utilizing the recommended diagnostic tool, spirometry, for patients who present with chronic respiratory symptoms (Decramer et al., 2015). The purpose of this study is to assess perceived barriers to spirometry use among primary care providers (PCP) including nurse practitioners (NP) and physician assistants (PA) within Arizona. The aim of this project is to assess for commonalities in barriers and determine practice and educational implications and areas for future research to increase knowledge about the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines so that spirometry is performed more frequently.
A survey was administered to PCPs (NPs and PAs) in Arizona through medical professional organizations. Basic demographic data was collected, in addition to questions assessing practice assessment, perceived barriers to spirometry, and utilization of smoking cessation methods and COPD prevention methods. A total of 47 responses were used for the data analysis. Females accounted for 87% (n=41) of the total sample size, and males accounted for 13% (n=6). There were 89% (n=42) NPs and 11% (n=5) PAs. Only 53% (n=25) stated that they have access to a spirometer and 47% (n=22) stated they did not have access to the tool. The most common barriers to spirometry use were concerns about testing quality and accuracy (28%, n=13), cost of the tool (23%, n=11), uncertainty about interpretation (21%, n=10), and unfamiliarity (21%, n=10). Other causes include concerns for reimbursement (11%, n=6), not enough time with patient (11%, n=5), preference to send for pulmonary function tests (11%, n=5), and lastly uncertain about impact of results on clinical practice (6%, n=3).
In conclusion, the results call for further practice and educational interventions to mitigate these barriers and provide better support to providers who care for those with chronic respiratory symptoms. Further research into this issue can help lead to interventions and increase knowledge about the GOLD guidelines to improve patient outcomes.
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Inhalation devices in COPD ManagementRomaniuk Verge, Kathy Unknown Date
No description available.
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Life's changing landscape - exploring the experiences of people with COPD: an analysis of public narratives.Polak Scowcroft, Caroline Elizabeth 08 January 2014 (has links)
In this study, data and information publicly available on the Internet were analysed to examine the self-reported experiences of people with COPD. Chronic Obstructive Pulmonary Disease (COPD) is a chronic progressive disease that may exist with and worsen many other conditions of ageing. The theoretical basis for analysis draws on the social model of disability that stresses the disabling aspects of the environment, as opposed to the individual’s medical condition. This allows the voices and stories of people living life with COPD to be the focus of this research. In this study, I found that people with COPD who post their stories to the Internet display a wide range of emotions and experiences of living with COPD. The people with COPD discuss, amongst other things, how COPD has affected their home life and activities of daily living, their work and finances, their spouse or carer, and especially appreciate the friendships and support found at pulmonary rehabilitation and through belonging to a support group. These people appear to be very open and authentic in their writings, wishing to reach out to others with the condition to offer hope, support and advice, in adapting to changing circumstances as the condition progresses. People expressed gratitude at being part of a community of fellow people with COPD. This collection of stories shows that, despite having a disabling condition, people with COPD can demonstrate resilience and resourcefulness to successfully adjust the landscape of their lives, and the realities of living with a disability, to maintain a good quality of life for as long as possible.
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Life's changing landscapes - exploring the experiences of people with COPD: an analysis of public narratives.Polak Scowcroft, Caroline Elizabeth 08 January 2014 (has links)
In this study, data and information publicly available on the Internet were analysed to examine the self-reported experiences of people with COPD. Chronic Obstructive Pulmonary Disease (COPD) is a chronic progressive disease that may exist with and worsen many other conditions of ageing. The theoretical basis for analysis draws on the social model of disability that stresses the disabling aspects of the environment, as opposed to the individual’s medical condition. This allows the voices and stories of people living life with COPD to be the focus of this research. In this study, I found that people with COPD who post their stories to the Internet display a wide range of emotions and experiences of living with COPD. The people with COPD discuss, amongst other things, how COPD has affected their home life and activities of daily living, their work and finances, their spouse or carer, and especially appreciate the friendships and support found at pulmonary rehabilitation and through belonging to a support group. These people appear to be very open and authentic in their writings, wishing to reach out to others with the condition to offer hope, support and advice, in adapting to changing circumstances as the condition progresses. People expressed gratitude at being part of a community of fellow people with COPD. This collection of stories shows that, despite having a disabling condition, people with COPD can demonstrate resilience and resourcefulness to successfully adjust the landscape of their lives, and the realities of living with a disability, to maintain a good quality of life for as long as possible.
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Sambandet mellan parodontit och KOL / The association between periodontitis and COPDAxelsson, Linn, Jonskog Eriksson, Elinor January 2014 (has links)
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease. The disease is the fourth leading cause of death and more than 5 percent of the adult population worldwide is affected. The aim of this study was to investigate the association between periodontitis and COPD. Search for material for the literature review was done in the medical database PubMed where the keywords were: "Chronic obstructive pulmonary disease" and "Periodontal health or periodontal disease". The result is based on twelve studies that were extracted and analyzed. The studies have investigated pocket depth, attachment loss, plaque index, bleeding on probing and bone loss. Ten studies compared a COPD group with a healthy control group, one study compared two COPD groups and one study examined a COPD group and a group with other lung diseases. Most studies found that people with COPD had a higher incidence of pocket depth, attachment loss, plaque index, bleeding on probing and bone loss. The conclusion of the literature review is that there is an association between periodontitis and COPD and that smoking is a link between the two diseases. / Kronisk obstruktiv lungsjukdom (KOL) är en kronisk lungsjukdom. Sjukdomen är den fjärde vanligaste dödsorsaken och mer än 5 procent av den vuxna befolkningen i världen är drabbade. Syftet med litteraturstudien var att undersöka sambandet mellan parodontit och KOL. Sökning efter material till litteraturstudien gjordes i den medicinska databasen PubMed där sökorden var: ”Chronic obstructive pulmonary disease” och ”Periodontal health or periodontal disease”. Resultatet är baserat på tolv vetenskapliga studier som har analyserats och granskats. Studierna har undersökt fickdjup, fästeförlust, plackindex, blödning vid sondering och benförlust. Tio studier jämförde en KOL-grupp med en frisk kontrollgrupp, en studie jämförde två KOL-grupper och en studie undersökte en KOL-grupp och en grupp med andra lungsjukdomar. Flertalet studier kom fram till att personer med KOL hade högre förekomst av fickdjup, fästeförlust, plackindex, blödning vid sondering och benförlust. Slutsatsen är att det fanns ett samband mellan parodontit och KOL och att rökning har en koppling mellan sjukdomarna.
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Inhalation devices in COPD ManagementRomaniuk Verge, Kathy 06 1900 (has links)
Chronic obstructive pulmonary disease (COPD) is expected to become the third most common cause of mortality in the world (GOLD Committee, 2009). COPD management continues to play a large role in everyday medical practice and inhalation therapy will continue to be a mainstay of COPD treatment. Very little is known about how prescribers choose drug-delivery devices for their clients with COPD. This study examined the current practice related to COPD inhalation devices among physicians working in a small rural community hospital. . Results showed that the most frequently prescribed device for patients was a DPI in the community setting and that nebulizers are most commonly prescribed in the emergency department. Physicians reported various factors that they consider when prescribing an inhalation device; ease of use for the patient, disease severity, cost to the patient, and therapeutic response. Physicians expressed that disease severity as the most important factor.
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