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Extrapulmonary – Treatable traits
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
The UA includes the nasal cavities, pharynx and larynx, and its main functions are to warm, humidify and filter inspired air. In Western societies, around 5–15% of the adult general population has asthma, 20–25% have rhinitis and 14% have or have had atopic dermatitis. In some patients, these atopic diseases may be mild, with few symptoms or exacerbations each year, whereas other patients may experience daily symptoms and need chronic medication. The figures of severity in a population sample are somewhat uncertain due to a lack of a gold standard for epidemiological studies of asthma, rhinitis and skin lesions and a lack of objective measurements in those studies. Internationally, there is growing awareness that upper and lower respiratory tract diseases should be managed concurrently as they affect one unified airway. The entire airway tract shares basic inflammatory mechanisms, particularly those in which you find type-2 inflammation. The prevalence of chronic rhinosinusitis (CRS) is 2–6% in Europe and 1% in China; clinically, the disease can be divided into two different phenotypes: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). Allergic rhinitis (AR) and CRSwNP involve type-2 inflammation, whereas CRSsNP and non-AR (also called vasomotor rhinitis) often involves non-type-2 inflammation.
John Fry (1922–1994)
Published in Neil Metcalfe, 100 Notable Names from General Practice, 2018
Fry’s MD thesis was entitled ‘Clinical patterns of respiratory tract diseases in a general practice: 1950–1954’. His interest in respiratory illnesses, he wrote, was due to the fact ‘they account for over 25% of all work in general practice’. He wrote the first textbook of clinical general practice, collaborating with eight general practitioners in 1953, entitled Clinical Medicine in General Practice. This was regarded at the time as ‘a training manual to assist a new speciality to emerge’ by the 1951 BMA president, Lord Henry Cohen (1900–1977). One of Fry’s major articles, ‘Are all ‘T’s and A’s’ really necessary?’, was published in the BMJ in 1957 and it queried how many tonsillectomies and adenoidectomies in children were actually required. It was one of the first papers to question standard practice, a seed of evidence-based medicine. Subsequently he published a further book, The Catarrhal Child (1961) which indicated that tonsillitis was a self-resolving disease and that the anxiety levels of parents regarding the condition was not an indication for surgery. Having earned respect for his publications, he was appointed as an editor for Medical Care, which was founded in 1963.
Adenovirus
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
HAdVs are a common cause of respiratory infection in persons of all ages. Both acute upper (pharyngitis and tonsillitis) and lower (bronchitis, bronchiolitis, and pneumonia) respiratory tract diseases have been attributed to HAdVs. Fever, pharyngitis, tonsillitis, cough, and sore throat are the most common symptoms in affected children and young adults.56 Lower respiratory tract infections include tracheobronchitis, bronchiolitis, and pneumonia.
Emerging strategies in nanotechnology to treat respiratory tract infections: realizing current trends for future clinical perspectives
Published in Drug Delivery, 2022
Minhua Chen, Zhangxuan Shou, Xue Jin, Yingjun Chen
A heterogeneous lung lining fluid is distributed continuously throughout the respiratory tract. The trachea, bronchi, and bronchioles (conducting parts) are lined with a mucus gel, while the pulmonary surfactants and alveolar sub-phase fluid line the alveoli (A. W. Ng et al., 2004). Mucus is composed of water, globular proteins, lipids, DNA, mucins, salts, and cellular debris. It acts as a protective layer and helps in lubrication Mucus blocks the passage of pathogens and foreign substances to the underlying epithelium. Mucins are glycoproteins that contribute to the viscoelasticity of the mucus membrane (Zanin et al., 2016). In pathological conditions, the microenvironment of the respiratory tract is affected. The chronic bacterial infections in Cystic fibrosis change the pH of the respiratory tract from almost neutral to acidic. This altered pH induces conformational changes in the structure of mucin protein which can impact the interaction of nanoparticles and mucus (Poschet et al., 2002; F. Wan et al., 2020). Furthermore, respiratory tract diseases lead to excessive production and dehydration of mucus that also disrupt the interactivity of mucus and therapeutics. The production of extremely viscous mucus in a certain pathological environment may lead to embolism in the trachea, bronchi, and bronchioles, thus further obstructing the passage of drugs from the respiratory tract. The low clearance rate and higher accumulation of mucus create room for microbial growth and thus cause infection.
Physical stability of dry powder inhaler formulations
Published in Expert Opinion on Drug Delivery, 2020
Nivedita Shetty, David Cipolla, Heejun Park, Qi Tony Zhou
Pulmonary drug delivery for treatment of lung disease has advantages over systemically administered therapy for a number of reasons, including: to avoid first-pass metabolism and the possibility for enzymatic inactivation, to enable the delivery of higher drug concentrations to the lungs for improved efficacy, and to reduce systemic side effects [1,2]. Thus, pulmonary drug delivery has been explored extensively in recent years for the treatment of various respiratory tract diseases such as chronic obstructive pulmonary disorder (COPD), asthma, pneumonia, and chronic pulmonary infections. Inhalation also offers a noninvasive route for the delivery of therapeutic drugs to treat systemic diseases [3,4]. Pulmonary drug delivery has become one of the most accepted systems for the treatment of respiratory disorders [5].
Time-course transcriptomic alterations reflect the pathophysiology of polyhexamethylene guanidine phosphate-induced lung injury in rats
Published in Inhalation Toxicology, 2019
Mi-Kyung Song, Dong Im Kim, Kyuhong Lee
It is well known that the PHMG-P exposure induces the pulmonary fibrosis in animal model. In this study, we confirmed fibrotic changes following 10 weeks of PHMG-P exposure through lung-histopathology analysis. GO analysis showed that lung fibrosis was ranked the highest and included nine genes [calcitonin-related polypeptide alpha (CALC)A, chymase (CMA)1, connective tissue growth factor (CTGF), elastin (ELN), gremlin (GREM)1, heme oxygenase (HMOX)1, insulin-like growth factor (IGF)1, IL6, and tissue inhibitor of metalloproteinase (TIMP)1]. The exposure-time-specific genes induced by PHMG-P were further analyzed using the CTD and IPA to elucidate the implications of altered genes in lung diseases and disorders. Among all disease categories in the CTD, association analysis was performed for only the respiratory tract disease category. Analysis of 34 short-term exposure-specific genes revealed that five genes were involved in six respiratory tract-related diseases (i.e., respiratory tract diseases, respiratory tract infections, lung diseases, bronchial diseases, respiratory hypersensitivity, and bronchial hyper-reactivity) (Table 5).