15 research outputs found

    The pharmacogenomics of inhaled corticosteroids and lung function decline in COPD.

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    Inhaled corticosteroids (ICS) are widely prescribed for patients with chronic obstructive pulmonary disease (COPD), yet have variable outcomes and adverse reactions, which may be genetically determined. The primary aim of the study was to identify the genetic determinants for forced expiratory volume in 1 s (FEV1) changes related to ICS therapy.In the Lung Health Study (LHS)-2, 1116 COPD patients were randomised to the ICS triamcinolone acetonide (n=559) or placebo (n=557) with spirometry performed every 6 months for 3 years. We performed a pharmacogenomic genome-wide association study for the genotype-by-ICS treatment effect on 3 years of FEV1 changes (estimated as slope) in 802 genotyped LHS-2 participants. Replication was performed in 199 COPD patients randomised to the ICS, fluticasone or placebo.A total of five loci showed genotype-by-ICS interaction at p<5×10-6; of these, single nucleotide polymorphism (SNP) rs111720447 on chromosome 7 was replicated (discovery p=4.8×10-6, replication p=5.9×10-5) with the same direction of interaction effect. ENCODE (Encyclopedia of DNA Elements) data revealed that in glucocorticoid-treated (dexamethasone) A549 alveolar cell line, glucocorticoid receptor binding sites were located near SNP rs111720447. In stratified analyses of LHS-2, genotype at SNP rs111720447 was significantly associated with rate of FEV1 decline in patients taking ICS (C allele ÎČ 56.36 mL·year-1, 95% CI 29.96-82.76 mL·year-1) and in patients who were assigned to placebo, although the relationship was weaker and in the opposite direction to that in the ICS group (C allele ÎČ -27.57 mL·year-1, 95% CI -53.27- -1.87 mL·year-1).The study uncovered genetic factors associated with FEV1 changes related to ICS in COPD patients, which may provide new insight on the potential biology of steroid responsiveness in COPD

    Irrigação intranasal: avaliação dos efeitos do uso de soluçÔes hidroeletrolíticas na mucosa de ratos Nasal irrigation: effects of hydroelectrolytic solutions on rats mucosa

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    A irrrigação intranasal tem grande importĂąncia como terapia adjuvante de doenças nasossinusais. Entretanto, faltam estudos que avaliem as alteraçÔes histolĂłgicas que as diferentes soluçÔes utilizadas podem causar na mucosa do nariz. OBJETIVO: Analisar os aspectos histolĂłgicos da mucosa nasal de ratos apĂłs irrigação local com diferentes soluçÔes hidroeletrolĂ­ticas. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: 120 ratos Wistar foram divididos igualmente em 4 grupos. O grupo nĂșmero 1 recebeu solução salina a 0,9%. Os grupos 2 e 3 receberam soluçÔes contendo Cloreto de SĂłdio associado a Cloreto de PotĂĄssio e Glicose, em diferentes concentraçÔes. O grupo 4 foi o grupo controle. Duas vezes ao dia, 0,1ml (2 gotas) das soluçÔes foram aplicados na narina esquerda dos ratos, atravĂ©s de uma seringa. Metade dos animais de cada grupo foi sacrificado apĂłs a primeira semana e a metade restante apĂłs a quarta semana de tratamento. Os fragmentos de mucosa obtidos foram processados e estudados em microscopia Ăłptica, utilizando a hematoxilina e eosina. RESULTADOS: PĂŽde-se observar que a infiltração de cĂ©lulas inflamatĂłrias foi estatisticamente mais intensa no grupo 2, em 1 e 4 semanas de administração das soluçÔes (p<0,05), quando comparada ao grupo controle. A formação de glĂąndulas intraepiteliais foi estatisticamente mais evidente no grupo 1, quando comparada aos grupos 3 e 4 (p<0,05). CONCLUSÃO: A solução salina hipertĂŽnica testada causou a menor reação tecidual na mucosa nasal de ratos quando comparada ao grupo controle. NĂŁo foram encontradas vantagens na utilização da solução salina a 0,9% em comparação com o uso das demais soluçÔes em estudo.<br>Nasal irrigation is an important adjuvant therapy for nasosinusis diseases. Many hydroelectrolytic solutions have been used for it, but studies are lacking to analyze the histological reactions they may cause to the nasal mucosa. PURPOSE: to examine the histological patterns in nasal mucosa after application of three different hydroelectrolytic solutions. STUDY DESIGN: Experimental. MATERIAL AND METHOD: 120 Wistar rats were equally divided into four groups. Group number 1 received a 0.9% saline solution. Group's number 2 and 3 received solutions composed by Sodium Chloride, associated to Potassium Chloride and Glucose in different concentrations. Group 4 was the control group. Twice a day, 0.1ml (2 drops) of the solutions were applied to the rats left nostril, using a bulb syringe. Half of the rats of each group were sacrificed after 1 week and the rest after 4 weeks of nasal irrigation. The collected nasal septal mucosa was studied on H&E stain, under optic microscopy. RESULTS: Inflammatory cell infiltration was statistically more intense for the group 2, in both 1 and 4 weeks of drug administration (p<0,05), when compared to the control group. Intraepithelial glandular formation was statistically more evident in the group 1, when compared to the groups 3 and 4 (p<0,05). CONCLUSION: The hypertonic hydroelectrolytic solution tested caused the lowest tissue reaction on rats' nasal mucosa when compared with the control group. No advantages were found in using 0,9% saline solution in comparison with the others solutions tested

    Plasma Fibronectin Concentration in Obese/Overweight Pregnant Women: A Possible Risk Factor for Preeclampsia

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    Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P < 0.05) higher values than non-obese pregnant women in second and third trimesters. FN in obese/overweight pregnant women correlated positively with mean arterial blood pressure (MAP: r = 0.414, P = 0.04). About 28.57% of the pregnant women with FN above cut off point of 330 Όg/ml at 18–24 weeks of gestation developed preeclampsia. This value increased to 40.0% when only the obese/overweight women were considered. On analysis of both fibronectin >330 Όg/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women
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