Navegando por Palavras-chave "Emphysema"
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- ItemSomente MetadadadosAvaliação dos efeitos dos componentes dos óleos essenciais (timol, carvacrol e p-cimeno) no enfisema pulmonar induzido por instilação de elastase em camundongos(Universidade Federal de São Paulo, 2016-03-23) Pereira, Ellen Games Jacob [UNIFESP]; Prado, Carla Maximo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Pulmonary emphysema is the most important component of Chronic Obstructive Pulmonary Disease (COPD) and is characterized by destruction of alveolar walls resulting in an enlargement and progressively airflow limitation. Although COPD represents the fourth leading cause of mortality in the world there is still no specific therapeutic measures for the treatment, which is still symptomatic. Phytotherapy, including essential oils, is widely used to treat various diseases, however, in most cases, there is not enough scientific evidence. Objective: To evaluate the effects of treatment with thymol, carvacrol and p-cymene, monoterpenes derived from essential oils of Brazilian plant species, the changes in respiratory mechanics and pulmonary histopathology induced by instillation of elastase. Methodology: Male C57BL6 mice were used, which were given saline or elastase. 30 minutes after instillation of elastase animals were treated with thymol, carvacrol, p-cymene or vehicle. These treatments were repeated on days 7, 14, 21 and 28. Animals that received saline were treated with vehicle only. On the 28th, after 30 minutes of treatment they were evaluated: mechanics of the respiratory system; exhaled nitric oxide (NoEx), pulmonary inflammation and cytokines in the bronchoalveolar lavage (BAL), evaluation of the content of collagen fibers and alveolar diameter and expression of MMP-9, TIMP-1, NF-kB and 8-iso-PGF- 2? by immunohistochemistry. Statistical analysis was performed using the SigmaStat using analysis of variance One way ANOVA. Results: The elastase group had pulmonary emphysema (increase of Lm), an increase of macrophages and IL-6, IL-8, IL-1? and IL-17 levels in BAL, in addition to increased deposition of fibers collagen and expression of MMP-9, TIMP-1, isoprostane and NF-kB in the lung parenchyma. Still, there was an increase of NoEx these animals. The treatments with thymol, carvacrol and p-cymene reduced pulmonary inflammation, the cytokines IL-6, IL-8, IL-17 and IL-1? the values Lm and collagen deposition in the lung parenchyma, as well as MMP-9 expression, NF-KB and isoprostane in lung tissue. TIMP 1 levels in the treated groups were higher than the control group but similar to animals receiving no treatment elastase. Treatment with thymol still reduced exhaled NO. Conclusion: These compounds reduced the inflammation and tissue destruction attenuated and reduced collagen deposition associated with MMP-9 reduced. These effects can be attributed to reduced NF-kB expression of pro-inflammatory cytokines (IL-17, IL-1?) and also reduce oxidative stress. Apparently, the position or the hydroxyl radical presence does not interfere with the biological effects of these compounds in the emphysema model. Other mechanisms of action have yet to be evaluated.
- ItemSomente MetadadadosA comparative study of extracellular matrix remodeling in two murine models of emphysema(F Hernandez, 2013-02-01) Lopes, F. D. T. Q. S.; Toledo, A. C.; Olivo, C. R.; Prado, Carla Maximo [UNIFESP]; Leick-Maldonado, Edna Aparecida [UNIFESP]; Medeiros, M. C.; Santos, A. B. G.; Garippo, A.; Martins, M. A.; Mauad, T.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)A single instillation of porcine pancreatic elastase (PPE) results in significant airspace enlargement on the 28th day after instillation, whereas cigarette smoke (CS) exposure requires 6 months to produce mild emphysema in rodents. Considering that there are differences in the pathogenesis of parenchymal destruction in these different experimental models, it is likely that there may be different patterns of extracellular matrix (ECM) remodeling. To evaluate ECM remodeling, C57BL/6 mice were submitted to either a nasal drop of PPE (PPE 28 Days) or exposed for 6 months to cigarette smoke (CS 6 months). Control groups received either an intranasal instillation of saline solution (Saline 28 Days) or remained without any smoke inhalation for six months (Control 6 months). We measured the mean linear intercept and the volume proportion of collagen type I, collagen type III, elastin and fibrillin. We used emission-scanning confocal microscopy to verify the fiber distribution. Both models induced increased mean linear intercept in relation to the respective controls, being larger in the elastase model in relation to the CS model. In the CS model, emphysema was associated with an increase in the volume proportion of fibrillin, whereas in the PPE model there was an increase in the parenchymal elastin content. In both models, there was an increase in collagen type III, which was higher in the CS-exposed mice. We concluded that ECM remodeling is different in the two most used experimental models of emphysema.
- ItemAcesso aberto (Open Access)Doença pulmonar obstrutiva crônica ocupacional(Sociedade Brasileira de Pneumologia e Tisiologia, 2006-05-01) Bagatin, Ericson; Jardim, José Roberto [UNIFESP]; Stirbulov, Roberto; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); Santa Casa de São Paulo Faculdade de Ciências MédicasOccupational chronic obstructive pulmonary disease, despite having been widely discussed for nearly half a century, is still rarely addressed in Brazil. Various studies, especially those that were population-based, have revealed the relationship between occupational exposure to aerosols and impairment of the airways. This chapter aims to remind physicians of the diagnosis of occupational chronic obstructive pulmonary disease by presenting a succinct review of the literature on the theme, which should be incorporated into the Global Initiative for Chronic Obstructive Lung Disease, in terms of the scope of the diagnostic basis as well as in terms of the questionnaire specific for the disease. Collecting detailed work histories and characterizing exposure to inhaled agents known to have deleterious effects on the respiratory system will surely result in improved approaches to making diagnoses and prognoses of this disease, as well as contributing to its greater control.
- ItemAcesso aberto (Open Access)Enfisema orbitário compressivo após asseio nasal: relato de caso(Conselho Brasileiro de Oftalmologia, 2009-04-01) Furlani, Bruno de Albuquerque [UNIFESP]; Diniz, Bruno [UNIFESP]; Bitelli, Luis Gustavo; Martins, Elisabeth Nogueira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Orbital emphysema is the abnormal presence of air in the orbit. Occurrence in the absence of orbital fracture is rare. We report a case of a 40-year-old female presenting unilateral orbital emphysema after vigorous nose blowing. She developed sudden visual loss as a result of elevated intraocular pressure and urgent treatment was required. She underwent an orbital decompression, performed using a 24-gauge needle puncture adjacent to the supraorbital notch. After treatment, she reported considerable decrease of symptoms.
- ItemSomente MetadadadosExercise ventilatory inefficiency adds to lung function in predicting mortality in copd(Hindawi Publishing Corp, 2016) Neder, J. Alberto [UNIFESP]; Alharbi, Abdullah; Berton, Danilo C.; Alencar, Maria Clara N. [UNIFESP]; Arbex, Flavio F. [UNIFESP]; Hirai, Daniel M. [UNIFESP]; Webb, Katherine A.; O'Donnell, Denis E.Severity of resting functional impairment only partially predicts the increased risk of death in chronic obstructive pulmonary disease (COPD). Increased ventilation during exercise is associated with markers of disease progression and poor prognosis, including emphysema extension and pulmonary vascular impairment. Whether excess exercise ventilation would add to resting lung function in predicting mortality in COPD, however, is currently unknown. After an incremental cardiopulmonary exercise test, 288 patients (forced expiratory volume in one second ranging from 18% to 148% predicted) were followed for a median (interquartile range) of 57 (47) months. Increases in the lowest (nadir) ventilation to CO2 output (VCO2) ratio determined excess exercise ventilation. Seventy-seven patients (26.7%) died during follow-up: 30/77 (38.9%) deaths were due to respiratory causes. Deceased patients were older, leaner, had a greater co-morbidity burden (Charlson Index) and reported more daily life dyspnea. Moreover, they had poorer lung function and exercise tolerance (p < 0.05). A logistic regression analysis revealed that ventilation/VCO2 nadir was the only exercise variable that added to age, body mass index, Charlson Index and resting inspiratory capacity (IC)/total lung capacity (TLC) ratio to predict all-cause and respiratory mortality (p < 0.001). Kaplan-Meier analyses showed that survival time was particularly reduced when ventilation/VCO2 nadir > 34 was associated with IC/TLC 0.34 or IC/TLC 0.31 for all-cause and respiratory mortality, respectively (p < 0.001). Excess exercise ventilation is an independent prognostic marker across the spectrum of COPD severity. Physiological abnormalities beyond traditional airway dysfunction and lung mechanics are relevant in determining the course of the disease.
- ItemAcesso aberto (Open Access)Polialveolose: patogênese do enfisema lobar congênito?(Associação Médica Brasileira, 1998-06-01) Giudici, Roseli [UNIFESP]; Leao, Luiz Eduardo Villaca [UNIFESP]; Moura, Luiz Antonio Ribeiro de [UNIFESP]; Wey, Sergio Barsanti [UNIFESP]; Ferreira, Rimarcs Gomes [UNIFESP]; Crotti, P.l.r. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: Congenital lobar emphysema is an unusual condition and its pathogenesis remains unknown. The variety of findings in pathology studies of the ressected specimens led to increasing academic interest. About 50 per cent of the cases have no definitive diagnosis in pathology. The most recent theory proposes an increased number of alveoli within each acinus (polyalveolar lobe). PURPOSE: The aim of this paper is to report the morphometric measures of surgical specimens of 12 patients with congenital lobar emphysema, using the Emery and Mithal technique (radial alveolar count). METHODS: We made a case-control study, classifying the cases by age. Mann-Whitney´s U test and linear regression techniques were used in data analysis: Mann-Whitney´s U in comparing the cases and respective controls and linear regression to evaluate the influence of age in the measures found. RESULTS: The results revealed a significantly higher radial alveolar count than expected for the age group under 3 years; no difference was observed in the age group between 3 and 7 years and in children older than 7, the radial alveolar count was lower than expected. The normal development of the lung consists in an increasing number of alveoli increase from birth until adulthood, but this number remains constant, independent of age in congenital lobar emphysema. CONCLUSIONS: Such findings allow us to conclude that polyalveolar lobe can and must be diagnosed by a simple and practical method, such as the radial alveolar count, which decreases the incidence of the unknown etiology. The findings of an increased number of alveoli on patients younger than 3 is related to congenital lobar emphysema, since the number of alveoli does not increase in congenital lobar emphysema, just the opposite to what one would expect in the normal development of the lung.
- ItemSomente MetadadadosrBmTI-6 attenuates pathophysiological and inflammatory parameters of induced emphysema in mice(Elsevier Science Bv, 2018) Duran, Adriana Feliciano Alves; Neves, Luana de Paiva; Silva, Flavia Ribeiro Santos da; Machado, Gabriel Capella; Ferreira, Graziele Cristina; Lourenco, Juliana D.; Tanaka, Aparecida Sadae [UNIFESP]; Martins, Milton de Arruda; Lopes, Fernanda Degobbi Tenorio Quirino dos Santos; Sasaki, Sergio Daishi [UNIFESP]Protease/anti-protease imbalance is the main pathogenic mechanism of emphysema and protease inhibitors have been recognized as potential molecules to treat the disease conditions. In this work the rBmTI-6 first domain (rBmTI-6-D1), a recombinant Kunitz-type serine proteinase inhibitor, was used to verify its effect in prevention or minimization of PPE-induced emphysema in mice. C57BL/6 mice were submitted to a PPE-induced emphysema model and treated with rBmTI-6-D1 before the emphysema development. We showed that the rBmTI-6D1 treatment was sufficient to avoid the loss of elastic recoil, an effective decrease in alveolar enlargement and in the number of macrophages and lymphocytes in bronchoalveolar lavage fluid. Proteolytic analysis showed a significant increase in elastase activity in PPE-VE (induced emphysema) group that is controlled by rBmTI-6D1. Kallikrein activity was decreased in the PPE-rBmTI6 (induced emphysema and inhibitor treated) group when compared to PPE-VE group. Although rBmTI-6-D1, did not present a neutrophil elastase (NE) inhibitory activity, the results show that the inhibitor interfered in the pathway of NE secretion in PPE-emphysema mice model. The role of rBmTI-6-D1 in the prevention of emphysema development in the mice model, apparently, is related with a control of inflammatory response due the trypsin/kallikrein inhibitory activity of rBmTI-6-D1. (C) 2018 Elsevier B.V. All rights reserved.
- ItemAcesso aberto (Open Access)Respiratory mechanics do not always mirror pulmonary histological changes in emphysema(Faculdade de Medicina / USP, 2011-01-01) Anciaes, Adriana Martins; Olivo, Clarice Rosa; Prado, Carla Máximo [UNIFESP]; Kagohara, Keila H.; Pinto, Tatiana da Silva; Moriya, Henrique T.; Mauad, Thais; Martins, Mílton de Arruda; Lopes, Fernanda Degobbi Tenorio Quirino dos Santos; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To verify the accordance of functional and morphometric parameters during the development of emphysema. METHODS: BALB/c mice received a nasal drop of either papain or saline solution and were studied after 1, 3, 15, 28, and 40 days. Functional parameters, such as airway resistance, tissue damping, and tissue elastance, were analyzed. To evaluate the structural changes and possible mechanisms involved in this disease, we measured the mean linear intercept, the volume proportions of elastic and collagen fibers, the number of macrophages, the numbers of cells expressing metalloprotease 12 and 8-isoprostane in lung parenchyma. RESULTS: We only observed decreases in tissue elastance and tissue damping on the 28th day, with a concomitant increase in the mean linear intercept, indicating the presence of emphysema. However, only the mean linear intercept values remained increased until the 40th day. The volume proportion of collagen fibers was increased from the 15th day to the 40th day, whereas the volume proportion of elastic fibers was only increased on the 40th day. The number of macrophages increased beginning on the 1st day. The expression of metalloproteinase 12 was increased from the 3rd day until the 40th day. However, 8-isoprostane expression was only increased on the 1st and 3rd days. CONCLUSIONS: In this study, morphometric parameters were found to be more reliable for detecting the presence of emphysema than the functional parameters measured by respiratory mechanics. Further investigations are necessary to understand how the extracellular matrix remodeling observed in the lung parenchyma could be involved in this process.