ABSTRACT
The effects of natural antioxidants on nitric oxide (NO) modulation and oxidative status were determined in rat epithelial lung cells (L-2). Cells were stimulated with cytokines and treated with one of the following: resveratrol, soybean saponin group B (SSB), quercetin, genistein, olive leaf polyphenol concentrate (OLPC), or N-acetyl-L-cystein (NAC). NAC had no effect on NO levels, whereas resveratrol and OLPC were found to be effective in reducing nitrite levels, modifying iNOS mRNA, and decreasing free radical production. OLPC affected the levels of MnSOD while resveratrol did not, indicating that they act via different pathways. Quercetin and genistein reduced nitrite levels without affecting iNOS levels, presumably by scavenging NO. SSB did not affect nitrite levels, but exposure did reduce iNOS mRNA expression and protein levels, possibly due to antioxidant activity. Naturally occurring antioxidants, in particular resveratrol and OLPC, may have therapeutic potential in the treatment of inflammatory diseases.
Subject(s)
Antioxidants/pharmacology , Biological Products/pharmacology , Food , Lung/metabolism , Nitric Oxide/metabolism , Oxidative Stress/drug effects , Animals , Blotting, Western , Carbohydrate Sequence , Cell Survival/drug effects , Cyclic GMP/metabolism , Cytokines/biosynthesis , Epithelial Cells/drug effects , Epithelial Cells/metabolism , Lung/cytology , Molecular Sequence Data , Nitrates/metabolism , Nitric Oxide Synthase Type II/metabolism , RNA/biosynthesis , RNA/isolation & purification , Rats , Reverse Transcriptase Polymerase Chain Reaction , Superoxide Dismutase/metabolismABSTRACT
UNLABELLED: Recent case reports described primary esophageal achalasia (PEA) at an older age, even in the very elderly. However, very few cases over the age of eighty were published and there is no data on the clinical presentation and the appropriate treatment at this age. A retrospective record review at a six-hundred bed university-affiliated hospital revealed the diagnosis of PEA in eleven patients over the age of eighty (age range 81-90 years), during a 5-year period. Seven patients complained of cough and dyspnea, most of them also suffered from dysphagia. One patient complained of chest pain. The diagnosis was made in most patients by using a barium meal or gastroscopy, without manometry. Exceedingly few patients had a prolonged response to nitrates or to calcium channel blockers. However, a prolonged one year response was achieved after botulinum toxin injection or pneumatic dilatation. IN CONCLUSION: In contrast to younger patients, the elderly patient with PEA usually does not complain of chest pain but rather of cough and dyspnea. The therapeutic approach should include surgery only in the very fit elderly due to a possible high complication rate. Botulinum toxin injection or pneumatic dilatation are the preferred treatment options.
Subject(s)
Esophageal Achalasia/epidemiology , Aged , Aged, 80 and over , Deglutition Disorders/etiology , Female , Humans , Male , Retrospective StudiesABSTRACT
BACKGROUND: The efficacy and safety of Symbicort (budesonide and formoterol in a single inhaler) were compared with those of a high dose of the commonly used corticosteroid fluticasone propionate in patients with moderate persistent asthma. METHODS: This randomized, double-blind, double-dummy, parallel-group study involved 373 patients with asthma (mean age 42 years; FEV(1) 78% of predicted; reversibility 21%). After a 2-week run-in period, during which patients received budesonide 200 microg twice daily, they were randomly assigned to treatment with either Symbicort Turbuhaler (budesonide/formoterol 160/4.5 microg, one inhalation twice daily) or Flovent/Flixotide Diskus (fluticasone propionate 250 microg twice daily) for 12 weeks. RESULTS: Significantly greater increases in morning PEF, the primary efficacy variable, were observed in patients treated with budesonide/formoterol compared with fluticasone propionate (27.4 L/min vs 7.7 L/min; p < 0.001). Evening PEF and clinic FEV(1) also favored budesonide/formoterol compared with fluticasone propionate (p < 0.001), as did use of reliever medication (p = 0.04) and the proportion of reliever-free days (p < 0.001). There were also numerical improvements in symptom-free days (60.4% vs 55.5%), night-time awakenings (7.9% vs 9.6%) and asthma-control days (57.8% vs 52.4%) in favor of budesonide/formoterol. The risk of an exacerbation was reduced by 32% in the budesonide/formoterol group compared with the fluticasone propionate group (p < 0.05). Both treatments were well tolerated. CONCLUSION: Symbicort (budesonide/formoterol in a single inhaler) was more effective than a high dose of fluticasone propionate in improving lung function, reducing use of reliever medication and improving control of moderate persistent asthma.
