Endothelial Dysfunction and Pentraxin-3 in Clinically Stable Adult Asthma Patients.

BACKGROUND AND OBJECTIVE: Asthma is associated with low-grade systemic inflammation, prothrombotic state, and premature atherosclerosis. Objective: To evaluate the relationships between asthma, inflammatory biomarkers, and parameters of endothelial dysfunction. MATERIAL AND METHODS: We analyzed flow-mediated dilatation (FMD) of the brachial artery and intima-media thickness (IMT) of the common carotid artery using ultrasound in 92 clinically stable adult asthmatics and 62 well-matched controls. We also measured blood levels of selected inflammatory and asthma-specific biomarkers, including interleukin (IL) 4, IL-5, IL-6, IL-10, IL-12 (p70), IL-17A, IL-23, and interferon γ, as well as a disintegrin and metalloproteinase domain-containing protein 33 (ADAM-33). In addition, we assessed endothelial damage using 2 laboratory biomarkers: circulating von Willebrand factor (vWF) and pentraxin-3. We analyzed relationships between the study variables and asthma severity, lung function abnormalities, airway remodeling indices on computed tomography, and transthoracic echocardiography parameters. RESULTS: Asthmatics had higher IL-6, IL-10, and ADAM-33 levels. They were also characterized by 23% lower FMD% and 15% thicker IMT, as compared with controls (P<.001, both). In asthma, vWF was related to age (ß=0.28 [95%CI, 0.15-0.41]) and remained inversely associated with FEV1 (ß=-0.2 [95%CI, -0.05 to -0.35]). Surprisingly, a negative correlation was revealed between vWF and pentraxin-3 (ß=-0.17 [95%CI, -0.3 to -0.04]). Pentraxin-3 remained positively associated with airway remodeling indices. CONCLUSIONS: Asthma is characterized by endothelial dysfunction associated with airway obstruction. The biological role of pentraxin-3 is unknown, although our data suggest a protective role against endothelial damage and atherosclerosis.

Endothelial Dysfunction and Pentraxin-3 in Clinically Stable Adult Asthma Patients

Background: Asthma is associated with low-grade systemic inflammation, prothrombotic state, and premature atherosclerosis. Objective: To evaluate the relationships between asthma, inflammatory biomarkers, and parameters of endothelial dysfunction. Material and Methods: We analyzed flow-mediated dilatation (FMD) of the brachial artery and intima-media thickness (IMT) of the common carotid artery using ultrasound in 92 clinically stable adult asthmatics and 62 well-matched controls. We also measured blood levels of selected inflammatory and asthma-specific biomarkers, including interleukin (IL) 4, IL-5, IL-6, IL-10, IL-12 (p70), IL-17A, IL-23, and interferon γ, as well as a disintegrin and metalloproteinase domain–containing protein 33 (ADAM-33). In addition, we assessed endothelial damage using 2 laboratory biomarkers: circulating von Willebrand factor (vWF) and pentraxin-3. We analyzed relationships between the study variables and asthma severity, lung function abnormalities, airway remodeling indices on computed tomography, and transthoracic echocardiography parameters. Results: Asthmatics had higher IL-6, IL-10, and ADAM-33 levels. They were also characterized by 23% lower FMD% and 15% thicker IMT, as compared with controls (P<.001, both). In asthma, vWF was related to age (ß=0.28 [95%CI, 0.15-0.41]) and remained inversely associated with FEV1 (ß=–0.2 [95%CI, –0.05 to –0.35]). Surprisingly, a negative correlation was revealed between vWF and pentraxin-3 (ß=–0.17 [95%CI, –0.3 to –0.04]). Pentraxin-3 remained positively associated with airway remodeling indices. Conclusions: Asthma is characterized by endothelial dysfunction associated with airway obstruction. The biological role of pentraxin-3 is unknown, although our data suggest a protective role against endothelial damage and atherosclerosis (AU)

Antecedentes: El asma se asocia con inflamación sistémica de bajo grado, con un estado protrombótico y la existencia de aterosclerosisprematura.Objetivo: Evaluar las relaciones entre asma, biomarcadores inflamatorios y parámetros de disfunción endotelial.Material y métodos: Se ha analizado la dilatación mediada por flujo (DMF) de la arteria braquial y el grosor íntima-media (GIM) dela arteria carótida común mediante ecografía, en 92 adultos asmáticos clínicamente estables y 62 controles. También se midieron losniveles sanguíneos de determinados biomarcadores inflamatorios específicos de asma, incluyendo interleucina (IL) -4, IL-5, IL-6, IL-10,IL-12 (p70), IL-17A, IL-23, interferón γ, así como desintegrina y la metaloproteinasa que contiene el dominio proteína 33 (ADAM-33),junto con marcadores de laboratorio de daño endotelial: pentraxina-3 circulante y actividad plasmática del factor von Willebrand (vWF).Analizamos las relaciones de las variables estudiadas con la gravedad del asma, las anomalías de la función pulmonar, los índices detomografía computarizada (TC) pulmonar de remodelación de las vías respiratorias y los parámetros de ecocardiografía transtorácica.Resultados: Los asmáticos tuvieron mayores niveles de IL-6, IL-10 y ADAM-33. También se caracterizaron por tener un 23% menos deDMF y un 15% más grueso el GIM, en comparación con los controles (p <0,001, ambos). En el asma, vWF se relacionó con la edad (ß =0,28 [IC 95%: 0,15 a 0,41]) y se mantuvo en una relación inversa con FEV1 (ß = -0,2 [IC 95%: -0,05 a -0,35]). Sorprendentemente, seobservó una correlación negativa entre vWF y pentraxina-3 (ß = -0,17 [IC 95%: -0,3 a -0,04]). La pentraxin-3 se asoció positivamentecon los índices CT de remodelación de la vía aérea...(AU)

Disseminated nocardiosis mimicking exacerbation of pulmonary sarcoidosis.

Nocardiosis is a rare, mixed suppurative and granulomatous, bacterial infection that can affect various organs, but most commonly lungs. Clinical manifestation is usually uncharacteristic; can mimic fungal, parasitic and mycobacterial infections or malignancy. Presentation can be also similar to that of the other granulomatous diseases, among them sarcoidosis. We present an unusual case of disseminated nocardiosis in a patient diagnosed before with sarcoidosis and treated with glucocorticoids. Clinical symptoms initially mimicked exacerbation of pulmonary sarcoidosis. The course of disease was severe.

[Extramedullary hemopoiesis presenting as a tumor of the posterior mediastinum in a patient with hemolytic anemia]. / Pozaszpikowe ogniska krwiotworzenia pod postacia guza sródpiersia tylnego u chorego na niedokrwistosc hemolityczna.

Extramedullary hemopoietic focus is a rare cause of tuberous enlargement of the posterior mediastinum. A 62-year-old man who had been diagnosed as having congenital spherocytic anemia 20 years ago, was admitted to hospital with initial diagnosis of pneumonia. Chest X-ray disclosed inflammatory infiltration in the lower lobe of the right lung and a tumor in the posterior mediastinum. Pneumonia subsided following treatment with antibiotics. Spiral computer tomography with concomitant transthoracic biopsy of the lesion, confirmed the presence of tumor located on the right side of the spinal column, as well as the presence of two minor focci on its opposite side. Cytological examination revealed extramedullary hemopoiesis. Differential diagnosis of tumor in posterior mediastinum, should take into consideration the possibility of extramedullary hemopoietic focci.