Budesonide/formoterol maintenance and reliever therapy in Chinese patients with asthma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies have shown the superior efficacy of budesonide (BUD)/formoterol (FORM) maintenance and reliever therapy, but still lack evidence of its efficacy in Chinese asthma patients in a relative large patient-group. We finished this research to compare BUD/FORM maintenance and reliever therapy and high-dose salmeterol (SALM)/fluticasone (FP) maintenance plus an as-needed short-acting β(2)-agonist in Chinese patients with persistent uncontrolled asthma. This was a post hoc analysis based on a 6-month, multicenter, randomized, double-blind study (NCT00242775).</p><p><b>METHODS</b>A total of 222 eligible asthma patients from nine centers in China were randomized to either BUD/FORM+as-needed BUD/FORM (160/4.5 µg/inhalation) (640/18 µg/d; n = 111), or SALM/FP+as-needed terbutaline (0.4 mg/inhalation) (100/1000 µg/d; n = 111). The primary endpoint was time to first severe exacerbation while secondary endpoints included various measures of pulmonary function, symptom control and quality-of-life.</p><p><b>RESULTS</b>Time to first severe exacerbation over six months was lower with the BUD/FORM than with the SALM/FP treatment (risk ratio = 0.52, 95%CI 0.22 - 1.22), but the difference did not achieve statistical significance (P = 0.13). The cumulative number of severe exacerbations in the BUD/FORM group was lower than in the SALM/FP group (7.2% vs. 13.5%; risk ratio = 0.45, P = 0.028). BUD/FORM produced significantly better improvements in reliever use, cumulative mild exacerbations, symptom-free days (%), and morning/evening peak expiratory flow (PEF) than SALM/FP (P < 0.05 in all cases). The two groups achieved similar improvements in their time to first mild exacerbation, forced expiratory volume in one second (FEV(1)), asthma control questionnaire and asthma symptom scores, and percentage of nights with awakening(s). Both treatments were well tolerated.</p><p><b>CONCLUSIONS</b>In Chinese patients with persistent asthma, BUD/FORM decreased severe and mild exacerbations, decreased reliever use, increased symptom-free days, and improved morning/evening PEF compared with SALM/FP. There were no significant differences in time to first severe exacerbation or other assessments regarding daily asthma control between BUD/FORM and SALM/FP. BUD/FORM was more effective in this Chinese sub-group than in the total cohort involved in the original study.</p>

Effect of leukotriene receptor antagonist on cough variant asthma / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the curative effect of leukotriene receptor antagonist on cough variant asthma (CVA).</p><p><b>METHODS</b>Sixty-four CVA patients received treatment with bricany and montelukas and 68 control patients had bricany treatment for 4 weeks. The recurrence rate was observed in the two groups during the follow-up for 6 months.</p><p><b>RESULTS</b>The remission time of two groups were 2.5-/+3.6 and 5.3-/+3.8 days in acute phase, respectively, showing a significant difference between them (P<0.05). The recurrence rate of the two groups within 6 months were 20.09% and 40.87%, respectively, showing also significantly differences (P<0.05).</p><p><b>CONCLUSION</b>Leukotriene receptor antagonist and bricany can effectively control CVA and significantly lower the short-term recurrence rate of CVA.</p>

Oxidative stress status in patients with chronic obstructive pulmonary disease and its relation to glucocorticoid receptor levels / 南方医科大学学报

<p><b>OBJECTIVE</b>To study changes in the levels of systematic and airway local oxidative stress in patients in different stages of chronic obstructive pulmonary diseases (COPD), and explore the association between oxidative stress and glucocorticoid receptor (GR) level in the peripheral blood leukocytes.</p><p><b>METHODS</b>The levels of malonaldehyde (MDA), glutathione (GSH), superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) in induced sputum and plasma, as well as GR levels in peripheral blood leukocytes and plasma levels of cortisol and adrenocorticotrophic hormone (ACTH), were examined in 33 patients with acute exacerbations of COPD (AECOPD, group A), 27 with stable COPD (group B), and 28 healthy volunteers (including 15 smokers as group C, and 15 nonsmokers as group D).</p><p><b>RESULTS</b>MDA level in induced sputum and plasma decreased, whereas the levels of GSH, SOD and GSH-PX increased significantly in the order of groups A, B, C, and D (P<0.05). The activity of SOD in induced sputum and plasma were significantly lower in group C than in group D. No significant difference was noted in the other oxidative stress indices between groups C and D (P>0.05). The plasma levels of cortisol and ACTH showed no significant difference between the 4 groups, while the GR level in peripheral blood leukocytes increased significantly in the order of groups A, B, C and D (1565-/+719, 2069-/+488, 2739-/+926, and 4793 -/+1415 U, respectively, P<0.05). After controlling for the factor of smoking status, the plasma and sputum SOD activity were both positively correlated to GR, with the partial correlation coefficient of 0.512 and 0.564, respectively (P<0.001).</p><p><b>CONCLUSION</b>Patients in different stages of COPD, especially those with AECOPD, may sustain systematic and local oxidation and anti-oxidation imbalance. Decreased SOD activity may contribute to GR level decrement in peripheral blood leukocytes in these patients.</p>

Expression of aquaporin-1 in rat pleural mesothelial cells and its specific inhibition by RNA interference in vitro / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The discovery of water channel aquaporins (AQPs) has greatly expanded the understanding of the regulation of the water permeability of biological membranes. Aquaporin-1 (AQP1) may be involved in fluid transport in numerous pathological conditions. The objective of the present study was to examine whether AQP1 is present in cultured rat pleural mesothelial cells (PMCs) and to investigate the specific inhibitory effect of RNA interference (RNAi) on AQP1 expression in PMCs, which may provide a new method for the further studies on the relation between expression of AQP1 in PMCs and pleural fluid removal in vivo.</p><p><b>METHODS</b>PMCs were isolated and cultured from rat pleura. The expression of AQP1 in PMCs was confirmed by immunocytochemical staining and reverse transcriptase-polymerase chain reaction (RT-PCR). Two eukaryotic expression plasmid vectors of short hairpin RNA (shRNA) specific for the AQP1 gene of rat sapien were designed and constructed. The recombinant plasmid vectors were transfected into cultured rat PMCs by cation liposomes. Flow cytometry was used to screen the most effective shRNA at 48 hours after transfection. The expressions of AQP1 mRNA and protein were detected by RT-PCR and Western blotting method at 48 hours after transfection.</p><p><b>RESULTS</b>RT-PCR and immunostaining revealed that AQP1 mRNA and protein were present in cultured rat PMCs. Two effective eukaryotic expression plasmid vectors of shRNA specific for the AQP1 gene were constructed successfully. The levels of the expression of AQP1 were inhibited by 83.45%, 90.93%, respectively, at mRNA level and 41.24%, 67.60%, respectively at protein level by two recombinant plasmids at 48 hours after transfection. The expression of AQP1 in PMCs transfected with plasmid was significantly lower than that of the cells transfected with the control plasmid HK and that of the untransfected cells (P < 0.01). There was no significant difference in AQP1 expression between the control group and the group transfected with AQP1 nonspecific shRNAs (P < 0.05).</p><p><b>CONCLUSIONS</b>The expression of AQP1 was present in rat PMCs. The application of shRNA-AQP1 could markedly inhibit the expression of AQP1 in cultured rat PMCs. The use of RNAi is a promising tool for future research into the mechanisms of pleural fluid in vivo.</p>

Study on the relationship between airway bacterial infections and acute exacerbations in patients with chronic obstructive pulmonary disease / 中华流行病学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to observe the bacterial infections of respiratory tract in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).</p><p><b>METHODS</b>130 patients with AECOPD in outpatient department, emergency room or in wards were studied prospectively. Patients were divided into different groups according to both Anthonisen's classification and their lung function status. Sputum were cultured together with bacteria positive rate and types of AECOPD as well as the damage degree of lung function were analyzed.</p><p><b>RESULTS</b>Of 130 sputum samples, 50 showed positive through culture (38.5%) and 60 strains of pathogens were isolated. Predominant pathogens isolated would include Haemophilus parainfluenzae (20/60), Streptococcus pneumoniae (5/60) and Haemophilus influenzae (10/60). Positive rate of bacterial culture in type 1 AECOPD was 55.0%, higher than those of type 2 (38.3%) and type 3 (18.5%)(P = 0.01) and was increasing with the decrease of lung function of patients with AECOPD (P < 0.02).</p><p><b>CONCLUSION</b>Positive rate of bacterial culture in patients of type 1 AECOPD was the highest one. Haemophilus parainfluenzae was one of the most important pathogens in AECOPD. There seemed a correlation between positive result of bacterial culture and the severity of COPD.</p>