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《Allergology international》2022,71(4):432-436
Steroid hormones, especially glucocorticoids, androgens, and estrogens, have profound influence on immunity. Recent studies using cell-type specific steroid hormone receptor-deficient mice have revealed the precise roles of some of these hormones in the immune system. Glucocorticoids are known to have strong anti-inflammatory and immunosuppressive effects and pleiotropic effects on innate and adaptive immune responses. They suppress the production of inflammatory cytokines by macrophages and DCs and the production of IFN-γ by NK cells, thus inhibiting innate immunity. By contrast, glucocorticoids enhance the immune response by inducing the expression of IL-7R and CXCR4 in T cells and the accumulation of T cells in lymphoid organs in accordance with the diurnal change of the glucocorticoid concentration. Thus, glucocorticoids suppress innate immunity but enhance adaptive immunity. Androgens suppress the homeostasis and activation of ILC2s and the differentiation of Th2 and Th17 cells and enhance the suppressive function of Tregs, thereby alleviating allergic airway inflammation. Thus, these steroid hormones have pleiotropic functions in the immune system. Further investigations are awaited on the regulation of immunity and allergy by estrogens using cell-specific steroid hormone receptor-deficient mice. 相似文献
4.
《Anaesthesia and Intensive Care Medicine》2019,20(12):681-686
Tracheal intubation is the act of placing a tube into the trachea. The tube enables oxygen delivery and removal of carbon dioxide, while also allowing for the administration of pharmacological agents. Intubation is the most reliable method of maintaining an airway under anaesthesia, and for protection against aspiration of stomach contents. Traditionally, intubation is achieved by direct visualization of the glottis, but now indirect laryngoscopy (via a videolaryngoscope) is a common alternative. Prior to embarking upon intubation, a thorough patient history and examination must be undertaken by the laryngoscopist; equipment must be prepared and checked; a trained assistant present; and an experienced anaesthetist available in case assistance is required. Once the endotracheal tube has been placed, correct positioning must be confirmed via both clinical examination and monitoring, including capnography. Tracheal intubation is a procedure that should only be undertaken by trained operators and is not without risk. It is important to note that it is failure to oxygenate patients rather than failure to intubate that ultimately leads to serious morbidity and mortality. The Difficult Airway Society has produced guidelines on how to manage unanticipated difficulty in tracheal intubation; it is essential that every practitioner trained to intubate patients is familiar with these algorithms and the key principles of safe airway management. 相似文献
5.
Mayte Ramirez Francisco Garcí a-Rí o Aleydis Vi as Concepci n Prados Jos M. Pino Jos Villamor 《The Journal of asthma》2005,41(1):109-116
The study objectives were to analyze the changes in exhaled carbon monoxide (COex) induced by histamine provocation challenge in asthmatic patients and to evaluate the relationship between COex and airway sensitivity and reactivity. Levels of COex were measured in 105 nonsmoking mildly asthmatic subjects before and after histamine provocation challenge. Dose-response curves were characterized by their sensitivity (PD20) and reactivity. Dose-response slope (DRS), continuous index of responsiveness (CIR), and bronchial reactivity index (BRI) were determined as reactivity indices. Bronchial challenge was positive for 47 subjects and negative for 58. The COex levels rose significantly after bronchial challenge in the positive response group (4.49 ± 0.4 vs. 5.74 ± 0.57 ppm, p = 0.025) and in the negative response group (2.84 ± 0.25 vs 4.00 ± 0.41 ppm, p = 0.000). An inverse relation between basal COex and PD20 was found (r = - 0.318, p = 0.030). In all subjects, a proportional direct relationship between COex and DRS (r = 0.214, p = 0.015), CIR (r = 0.401, p = 0.000), and BRI (r = 0.208, p = 0.012) was observed. On stepwise multiple linear regression analysis, COex only significantly correlated with CIR (multiple r2 = 0.174, p = 0.000). In conclusion, exhaled CO determination is a noninvasive inflammatory marker of the respiratory tract, which shows an acceptable association with airway hyperresponsiveness. 相似文献
6.
Stephan Haarmann Andi Setiawan Budihardja Thomas Mücke Christian Schwaegerl Klaus Dietrich Wolff 《Mund-, Kiefer- und Gesichtschirurgie》2007,11(6):363-367
Mechanical airway obstruction secondary to retropharyngeal bleeding is rare. In most cases such a complication is described
after head and neck trauma. Complicating factors include anticoagulant therapy, tumour, aneurysm, infection or major cervical
spine injury. A precise initial diagnosis is necessary to avoid a life-threatening situation. Lateral X-ray and computed tomography
is essential for safe management.
Treatment depends upon size of the haematoma as well as the clinical course of the patient. Smaller haematomas may be observed.
Lager haematomas and those that fail to reabsorb should undergo drainage.
相似文献
7.
目的:探讨钙激活钾通道(KCa)、延迟整流型钾通道(Kdr)和ATP敏感型钾通道(KATP)在哮喘豚鼠气道高反应中的作用。 方法: 采用离体气管环张力实验,观察加入特异性钾通道阻断剂后,与不加阻断剂相比气管环对组胺反应的量效曲线的差异。 结果: (1)加入KCa阻断剂TEA后,对照组气管环对组胺的反应变化不显著,而哮喘组气管环对10-4mol/L、10-3mol/L组胺的收缩反应均显著低于不加TEA的气管环(P<0.01),量效曲线明显下移;(2)加入Kdr阻断剂4-AP后,对照组气管环对10-3mol/L组胺的最大收缩反应明显下降(P<0.05),组胺的量效曲线下移,哮喘组气管环对10-4mol/L、10-3mol/L组胺的收缩反应均低于不加4-AP的气管环(P<0.01),且下降程度较对照组大(P<0.05),量效曲线明显下移;(3)加入KATP阻断剂glibenclamide后,对照组和哮喘组气管环对组胺的量效曲线与不加glibenclamide的气管环相比变化均无明显差异。 结论: 在豚鼠哮喘模型中,KCa和Kdr活性的降低在气道高反应的发生中起介导作用,KATP作用不明显。 相似文献
8.
目的 拟比较以两种不同方法测定低水平压力支持通气(pressure support ventilation,PSV)病人的气道阻断压(P0.1)与自主呼吸时常规方法测定值的相关性。方法 12例机械通气病人,断开呼吸机自主呼吸时以常规方法测定P0.1得到P0.1-SB:在PSV水平为5cmH20,以常规方法和按压呼气末暂停键测定P0.1分别得到P0.1-PSV5和P0.1-PSV5eeo.分析后二者与前者之间的相关性。结果 P0.1-SB与P0.1-PSV5之间差异无显著性,P0.1-PSV5ee0分别小于P0.1-SB与P0.1-PSV5,差异有显著性;P0.1-PSV5eeo与P0.1-PSV5和P0.1-SB之间的相关系数均为0.97。结论 按压呼气末暂停键测定PSV水平为5cmH2O的P0.1值与常规方法测定的PSV水平为5cmH2O以及自主呼吸时的测定值相比,其值偏小,但前者与后二者之间具有良好的相关性。 相似文献
9.
Efficacy of an air-cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy 总被引:3,自引:2,他引:1
The efficacy of an air-cleaning device equipped with a high efficiency particulate air (HEPA) filter (without further avoidance measures) was studied in patients allergic to house dust mite. The effects of the air-cleaner on indoor Dermatophagoides sp. levels, symptom score and bronchial hyperresponsiveness in nine mite-allergic patients were assessed using a cross-over controlled study. No significant effect was demonstrated on indoor Dermatophagoides sp. levels when comparing the period of air-cleaner activity (2 months) with the control period (2 months). The Dermatophagoides sp. levels in the houses studied were lower than the risk level for asthmatic attacks, making it difficult to assess any effect on asthma; however, neither bronchial hyperresponsiveness nor rhinitis symptom score were changed by air-cleaner activity. During the trial period, however the mean level of Dermatophagoides sp. allergen in the houses changed spontaneously from 4.4 micrograms/g (mean level in the first 2 trial months) to 1.75 micrograms/g of dust (second 2 months) (P less than 0.05). Owing to this change, the mean rhinitis symptom score also decreased (P less than 0.05), even if no significant correlation was demonstrated (r = 0.4 P = 0.089). HEPA filter air-cleaners appear insufficient as substitutes for standard avoidance measures in mite allergic patients. 相似文献
10.
Sensory neuropeptides are not directly involved in bronchial hyperresponsiveness induced by interleukin-8 in guinea-pigs in vivo 总被引:1,自引:0,他引:1
M. FUJIMURA M. TSUJIURA M. NOMURA M. MIZUGUCHI T. MATSUDA K. MATSUSHIMA 《Clinical and experimental allergy》1996,26(3):357-362
Background Interleukin-8 (IL-8) hus been shown to be a chemotactic factor for netitrophils, T-lymphocytes and eosinophils. Repeated intranasal administration of IL-8 enhances bronchial responsiveness to inhaled histamine in guinea-pigs. Neuropeptides which arc released trotn C-fibre nerve-endings have been postulated to induce bronchial hyperresponsiveness through neurogenic inflammation. Objective This study was conducted to examine whether sensory neuropeptides are involved in the IL-8-induced bronchial hyperresponsiveness. Methods IL-8 at a dose of 5μg/kg was administered intranasally to guinea-pigs twice a week for 3 weeks. One day after the last administration, animals were anesthetized and artificially ventilaled through tracheal cannula, and lateral pressure at the tracheal cannula (Pao) was measured as an overall index of airway responses lo increasing concentrations of inhaled histamine (25, 50, 100, and 200 μg/mL). A NKI and NK2 dual antagonist FK224(10mg/kg), a selective NK1 antgonist FK888 (10mg/kg) or vehicle was intravenously administered 10min before measurement of bronchial responsiveness. Result The IL-8 treatment significantly enhanced bronchial responsiveness to histamine (ANOVA P < 0.01). FK224 or FK888 did not alter the IL-8-induced bronchial hyperresponsiveness. Conclusion We conclude that repeated intranasal administratioti of IL-8 causes bronchial hyperresponsiveness (BHR) and that neuropeptides such as neurokinin A and substance P do not directly contribute to the development of BHR induced by IL-8. 相似文献