Inhaled steroids and bone metabolism in clinical perspective

Inhaled corticosteroids have become the mainstay of maintenance treatment in asthma adults, and they are also being advocated for early use in children. The systemic side effects of inhaled steroids are much less than those from systemic steroids needed for comparable asthma control. Long term use of systemic corticosteroids is known to cause osteoporosis, and the risks from inhaled therapy are currently under study. There are reports of changes in biochemical parameters of bone metabolism due to inhaled corticosteroids, suggesting depression of bone formation and increase in bone resorption. However, the significance of biochemical changes in relation to bone mass and architecture is not known. Cross-sectional studies of bone mass suggest that dosages of more than 1 mg daily in adults may be associated with a decrease in bone mineral density. Longitudinal studies are needed to confirm the findings and define more clearly the profile and risk factors of bone loss. Current data in children show that inhaled corticosteroid in the usual therapeutic dose range has no detrimental effect on long term statural growth, while effects of peak bone mass are not yet known. The magnitude of measurable adverse effects were found to be dose-dependent, hence, the use of a minimum effective dose is recommended. Patients on inhaled corticosteroid therapy should maintain optimal intake of calcium and vitamin D. Physical activity should be encouraged and oestrogen replacement therapy in postmenopausal women considered.published_or_final_versio

Chemotherapy for advanced non-small-cell lung cancer: Role of paclitaxel and gemcitabine

Objective. To review the role of chemotherapy in advanced non-small-cell lung cancer, focusing on cisplatin-based regimens and two new drugs: paclitaxel and gemcitabine. Data sources. Medline search of the relevant English literature. Study selection. Open and randomised comparative (phases II and III) studies, and meta-analyses of cytotoxic drugs/regimens used to treat advanced non-small-cell lung cancer. Data extraction. The following factors were studied and compared: symptomatic response rates; tumour response rates; median survival time and 1-year survival rates; and side effects of cisplatin-, paclitaxel-, and gemcitabine-based regimens. Data synthesis. Using cisplatin-based chemotherapy achieves significant relief of disease-related symptoms of advanced non-small-cell lung cancer and a slight improvement in the median survival time (by approximately 1.5 months). New cytotoxic drugs that are effective and have good safety profiles include paclitaxel and gemcitabine. When used as single agents, these two drugs give response rates of approximately 25%. When used with cisplatin/carboplatin, response rates increase to 45% to 62% and 1-year survival rates increase to 40% to 60%. Conclusion. Paclitaxel, gemcitabine, and other drugs such as decetaxel and vinorelbine are promising new chemotherapeutic agents in the treatment of advanced non-small-cell lung cancer. These drugs can palliate disease symptoms and improve the median survival time. The optimal dose and treatment schedules, however, are yet to be defined.published_or_final_versio

Differential effects of epigallocatechin gallate on cigarette smoke-induced upregulation of CINC-1 and IL-6 in Rat H9c2 cardiomyocytes

INTRODUCTION: Cigarette smoke (CS) containing numerous harmful substances is considered to precipitate spasm of micro vessels, which is supported as a cause of idiopathic-dilated cardiomyopathy, as well as have a toxic effect on the myocardium. The mechanism is currently unclear, but both oxidative stress and inflammatory responses may play an essential role in the CS-induced biological processes. Several antioxidant agents have been used in the control of the inflammatory responses. The aim of this study was to investigate the effect of epigallocatechin gallate (EGCG), the major component of polyphenols in green tea, on CS-induced inflammatory responses in rat H9c2 cardiomyocyte …published_or_final_versio

Intermittent hypoxia-induced endothelial activation in EA.hy926 cells in vitro

INTRODUCTION: Obstructive sleep apnoea is characterised by repetitive episodes of complete or partial upper airway collapse during sleep, leading to recurrent drop in arterial oxygenation (intermittent hypoxia [IH]) and sleep fragmentation. Repetitive IH with rapid reversal to normoxia initiates a series of pathological events such as oxidative stress, inflammation, and sympathetic activation, all of which contributes to endothelial dysfunction (a predictor and precursor of atherosclerosis). The aim of the current study was to investigate the effect of IH on the activation of endothelial cells in a cellular model in …published_or_final_versio

Neurcognitive and psychosocial outcomes of obstructive sleep apnea in Hong Kong Chinese

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Effects of cigarette smoke on 5-hydrotrytamine metabolism in human bronchial epithelial cells

INTRODUCTION: Serotonin (5-hydrotrytamine, 5-HT) plays an important role in pulmonary functions. It is synthesised from tryptophan by aromatic 1-amino acid decarboxylase (AADC) and released at the sites, which binds to 5-HT receptors at the postsynaptic ends. Excess or turnover 5-HT will be recycled back into cells via 5-HT reuptake transporter (SERT), stored or subsequently metabolised by monoamine oxidase A (MAO-A) inside the cells. With the influence of smoking on serotoninergic neurons, we hypothesised that there may be a potential 5-HT analogue in cigarette smoke. We aimed to study the effect of 5-HT on interleukin (IL)–8 release and the effects of cigarette smoke on the metabolism of 5-HT in human bronchial epithelial …published_or_final_versio

Suppression of inflammation during adipogenic differentiation in human preadipocytes

INTRODUCTION: Preadipocytes are present in adipose tissues throughout adult life that can differentiate into mature adipocytes in response to environmental factors. However, little is known about the secretory inflammation-associated cytokines / chemokines during adipogenic differentiation. METHODS: Human preadipocytes-subcutaneous (HPA-s) cells were cultured to 80% confluence. From preadipocytes to mature adipocytes, a total of six induction cycles …published_or_final_versio

Efficacy and side effects of an oral appliance in the treatment of mild and moderate obstructive sleep apnoea in Chinese subjects

Conference Theme: Challenges to specialists in the 21st centurypublished_or_final_versio

Lymphangioleimyomatosis: the Hong Kong experience

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Preventive therapy on bone loss in asthmatic patients on high dose inhaled steroids

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