Induced sputum in the management of COPD: clinical implications

Sputum induction can be used as a non-invasive technique to investigate airway inflammation in asthma and COPD. We reported the case of a 68 year old man with COPD, stage III GOLD, that underwent sputum induction during two exacerbation episodes. The first cell count showed a typical sputum neutrophilia, whereas the second showed sputum eosinophilia. On the basis of sputum cellularity, we decided to treat the first episode with a course of antibiotics and the second exacerbation with a course of antibiotics and oral steroids. The patient showed improvement in both cases, obtaining clinical stabilisation. The induced sputum cell count could be a useful technique in a clinical setting to evaluate the cellular characteristics of airway inflammation during COPD exacerbation and modulate the antinflammatory therapy

L'importanza del macrofago nella malattia tubercolare

Mycobacterium tuberculosis is an intracellular pathogen with a particular defensive systems allowing its survival, and even growth, inside the hostile environment constituted by the macrophage. Such cell is provided with killing mechanisms consisting in reactive oxygen and nitrogen intermediates and is coadiuvated, in this microbicidal ativity, by the gamma-interpheron produced by the T-Lymphocyte. The mycobacterium, by its side, has the property of limiting such microbicidal macrophage activity thank to the production of adequate enzymatic systems. Opposed to these defensive properties of the microorganism, GSH (as well as its precursor N-acetylcysteine) is essential for the intracellular killing of the mycobacterium both directly and through the production of GSNO

Profilassi delle infezioni virali aereotrasmesse : il ruolo della immunostimolazione con bactolisati

One of the most severe complications of influenza, in particular of the avian, is the bacterial upper or especially lower bronchopulmonary superinfection which may lead to the feared respiratory distress syndrome. The preventive measures are essentially based on medications aimed at selectively strengthening the individual immune system against specific viruses (the vaccine is but not yet available) and on the immunostimulation with bacteriolysates, bacterial extracts which are similar to non specific vaccines modulating and reinforcing individual defences

Meiobenthos in earthen ponds used for semi-intensive shrimp farming (New Caledonia, South Pacific)

We analysed the temporal variability of meiobenthic (meiofauna and protists) abundance and community structure in the sediments of two shrimp farms located in New Caledonia. In each farm, sediment samples were collected weekly from February to June 2006 at two ponds, and analysed for quantity and composition of sedimentary organic matter, meiofaunal abundance, taxa richness and community composition. Independently of the initial conditions, sedimentary contents of biopolymeric C and total phytopigment varied significantly during shrimp rearing, although not consistently in the two ponds. Changes in the quantity and biochemical composition of sedimentary organic matter were associated with changes in total meiofaunal abundance and taxa richness, as well as in total and rare (<1% of total abundance) meiobenthic community composition. We show that the slight eutrophication of the sediment during the shrimp rearing cycle determined significant effects on the meiofaunal community composition as well as on the relative importance of metazoan vs. protists abundance. The results of this study suggest that the study of meiobenthic communities represents a reliable descriptor of the environmental quality of shrimp farming ponds

Six-minute walking distance improvement after pulmonary rehabilitation is associated with baseline lung function in complex COPD patients: a retrospective study.

Introduction. Conflicting results have been so far reported about baseline lung function, as predicting factor of pulmonary rehabilitation (PR) efficacy. Aim. To ascertain whether or not baseline lung function could predict a benefit in terms of a significant change in 6-min walk test (6MWT)after PR. Methods. Seventy-five stable moderate-to-severe COPD inpatients with comorbidities (complex COPD), allocated to a three-week PR program, were retrospectively evaluated. Pulmonary function, 6MWT, dyspnea (BDI/TDI), and quality of life (EQ-VAS) were assessed before and after PR program. The patients were divided into two groups depending on the change in 6MWT (responders > 30m and nonresponders ≤ 30m). Logistic regression analysis was used. Results. After PR,6MWTperformanceall outcomemeasures significantly improved (㕃 < 0.01). Compared tononresponders (㕁=38), the responders (㕁=37) had lower values in baseline lung function (㕃 < 0.01). Logistic regression analysis showed that FEV1 <50% pred and TL, CO <50% pred were independent predictors of PR efficacy. Conclusions. Our study shows that in stable moderate- to-severe complex COPD inpatients, baseline lung function may predict the response to PR in terms of 6MWT. We also found that complex COPD patients with poor lung function get more benefit from PR

Six-Minute Walking Distance Improvement after Pulmonary Rehabilitation Is Associated with Baseline Lung Function in Complex COPD Patients: A Retrospective Study

INTRODUCTION: Conflicting results have been so far reported about baseline lung function, as predicting factor of pulmonary rehabilitation (PR) efficacy. AIM: To ascertain whether or not baseline lung function could predict a benefit in terms of a significant change in 6-min walk test (6 MWT) after PR. METHODS: Seventy-five stable moderate-to-severe COPD inpatients with comorbidities (complex COPD), allocated to a three-week PR program, were retrospectively evaluated. Pulmonary function, 6 MWT, dyspnea (BDI/TDI), and quality of life (EQ-VAS) were assessed before and after PR program. The patients were divided into two groups depending on the change in 6 MWT (responders > 30 m and nonresponders 64 30 m). Logistic regression analysis was used. Results. After PR, 6 MWT performance all outcome measures significantly improved (P < 0.01). Compared to nonresponders (N = 38), the responders (N = 37) had lower values in baseline lung function (P < 0.01). Logistic regression analysis showed that FEV1 < 50% pred and TL, CO < 50% pred were independent predictors of PR efficacy. CONCLUSIONS: Our study shows that in stable moderate-to-severe complex COPD inpatients, baseline lung function may predict the response to PR in terms of 6 MWT. We also found that complex COPD patients with poor lung function get more benefit from PR

Decreased maturation of dendritic cells in the central airways of COPD patients is associated with VEGF, TGF-β and vascularity.

Dendritic cells (DCs) have a pivotal role in the onset and regulation of innate and adaptive immune responses. Moreover, DCs can interact with angiogenic modulators, resulting in modification of their biology and participation in angiogenesis. Objectives: This study was designed to evaluate the relationship between the density of DCs, vascularity and expression of angiogenic factors [vascular endothelial growth factor (VEGF), transforming growth factor (TGF)-β and basic fibroblast growth factor (bFGF)] in the central airways of chronic obstructive pulmonary disease (COPD) patients. Methods: The study included 20 patients with moderate/ severe COPD and 8 healthy control subjects. Bronchial biopsies were evaluated by immunohistochemistry. Specimens were examined for CD83 and CD207 to mark mature and immature DCs, respectively, for collagen IV to evaluate vascularity, and for VEGF, TGF-β and bFGF