Characteristics of Respiratory Diseases in Older People

Abstract: Pneumonia among old people is the fourth leading cause of death, and its mortality has remained the same for the last 100 years despite development of antibiotics. We have elucidated the onset mechanism of pneumonia among old people and developed methods for its prevention. Its primary cause is considered to be cerebrovascular disorders in the basal ganglia, and absence of substance P causes sub-clinical aspiration, which in turn causes pneumonia. Prevention of pneumonia is now possible without the use of antibiotics by increasing substance P. As old people are immune-compromised by depressed state, measures against depression are important for preventing infections such as pneumonia and common cold. The older the patient is, the more intense the effect of gene appears. It was shown that elderly persons with L polymorphism of heme oxygenase (HO)-1 gene are more susceptible to pulmonary emphysema. Systemic examination of the elderly, particularly their physiological characteristic, is essential for treatment of elderly persons with respiratory diseases

Rhinovirus and airway allergy

Rhinoviruses cause the majority of common colds, which often provoke wheezing in patients with asthma. The precise mechanisms responsible for the rhinovirus infection-induced exacerbations of bronchial asthma remain uncertain. However, several reports have demonstrated airway hyperresponsiveness, increases in chemical mediators in airway secretions, such as kinin and histamine, and airway inflammation in patients with bronchial asthma after rhinovirus infection. Rhinovirus infection induces the accumulation of inflammatory cells in airway mucosa and submucosa, including neutrophils, lymphocytes and eosinophils. Rhinovirus affects the barrier function of airway epithelial cells and activates airway epithelial cells and other cells in the lung to produce proinflammatory cytokines, including various types of interleukins, granulocyte-macrophage colony stimulating factor and RANTES, and histamine. Rhinovirus also stimulates the expression of intercellular adhesion molecule-1 (ICAM-1) and low-density lipoprotein receptors in the airway epithelium, receptors for major and minor rhinoviruses. Rhinovirus infection is inhibited by treatment with soluble ICAM-1 and by the reduction of ICAM-1 expression in airway epithelial cells after treatment with either glucocorticoid or erythromycin. Both soluble ICAM-1 and erythromycin have been reported to reduce the symptoms of common colds. Herein, we review the pathogenesis and management of rhinovirus infection-induced exacerbation of bronchial asthma and the relationship between rhinovirus infection and airway allergy