Cytokines profile in cystic fibrosis patients with nasal polyps.

UNLABELLED: Nasal polyposis often complicates the progress of patients with cystic fibrosis and there has been little study about the importance of cytokines in the polyps of such individuals. OBJECTIVE: To assess RNAm expression for interleukins 4, 5, 6, 8, GM-CSF and IFN-gamma by RT-PCR in eosinophilic and non-eosinophilic polyps of patients with cystic fibrosis. MATERIAL AND METHOD: A total of 124 persons were evaluated, of which thirteen patients with cystic fibrosis and nasosinusal polyps were selected--three were eosinophilic and ten were non-eosinophilic. The control group was composed of eleven individuals with normal otorhinolaryngological exam and the mean age was 18 years (3-57). The middle turbinate mucosa and nasal polyps were biopsied from the control group and the cystic fibrosis group respectively, and these were analyzed with RT-PCR. The middle turbinate mucosa was biopsied in the control group and in the cystic fibrosis group polyps that was analyzed to RT-PCR. The polyps of cystic fibrosis patients were also further anaylsed for subjected to a second biopsy in order to determine the percentage of eosinophils. IL-4, IL-5, IL-6, IL-8, IFN-gamma and GM-CSF transcriptions were analyzed. RESULTS: There was no difference in IL-5, IL-8 and GM-CSF when compared to the eosinophilic, non-eosinophilic and control groups (p>0.05). When compared to the eosinophilic and non-eosinophilic groups, higher IL-4 and IL-6 values (p=0.01 and p=0.01 respectively) were observed. When analyzed separately with the control group, IL-4 (p=0.01) expression was higher in the eosinophilic group, while IFN-gamma (p=0.03) was lower in the non-eosinophilic group. IL-5, IL-8, GM-CSF are non-specific cytokines present in the nasosinusal sinonasal polyps of cystic fibrosis patients. IL-4 and IL-6 are important mediators in the eosinophilic sinonasal polyps, while low IFN-gamma may be related to lower eosinophils in non-eosinophilic polyps.

Padrão respiratório e movimento toracoabdominal de crianças respiradoras orais / Breathing pattern and thoracoabdominal motion in mouth-breathing children

OBJETIVO: Caracterizar o padrão respiratório e o movimento toracoabdominal de crianças respiradoras orais, na faixa etária entre oito e dez anos, e compará-lo ao de seus pares respiradoras nasais. MÉTODOS: Estudo observacional realizado em laboratório universitário. O número amostral calculado com base em um estudo piloto com dez crianças em cada grupo, perfazendo um total de 20 crianças, foi de 50 para um nível de significância de 0,05 e um poder estatístico de 0,80. Participaram do estudo 26 crianças respiradoras orais e 25 respiradoras nasais. A pletismografia respiratória por indutância calibrada foi o instrumento utilizado para a análise das seguintes variáveis, entre outras: freqüência respiratória (FR), contribuição da caixa torácica para o volume corrente ( por centoCT/Vc), ângulo de fase (Angfase) e a razão entre o tempo para alcançar o pico de fluxo inspiratório e o tempo inspiratório (PifT/Ti). A saturação periférica da hemoglobia em oxigênio (SpO2) foi medida pela oximetria de pulso. A análise estatística foi realizada por meio do teste t de Student para grupos independentes e do teste U de Mann-Whitney, em função da distribuição das variáveis. RESULTADOS: No total, 4.816 ciclos respiratórios foram analisados, sendo 2.455 de respiradores orais e 2.361 de respiradores nasais, com média de 94 ciclos por criança. Não houve diferença significativa entre os grupos nas variáveis estudadas (FR=20,00±2,68 versus 20,73±2,58, p=0,169; por centoCT/Vc=39,30±11,86 versus 38,36±10,93, p=0,769; Angfase=14,53±7,97 versus 13,31±7,74, p=0,583; PifT/Ti=57,40±7,16 versus 58,35±5,99, p=0,610; SpO2=96,42±1,52 por cento versus 96,88±1,01 por cento, p=0,208; respectivamente). CONCLUSÕES: Estes resultados sugerem que as crianças respiradoras orais apresentam padrão respiratório e movimento toracoabdominal semelhantes às de respiradores nasais de mesma faixa etária.

OBJECTIVE: To characterize the breathing pattern and thoracoabdominal motion of mouth-breathing children aged between eight and ten years and to compare these characteristics with those of nose-breathing children of the same ages. METHODS: This observational study was carried out in a university laboratory. The sample size of 50 subjects was estimated based on the results of a pilot study with ten children in each group (total of 20 children) and considering a significance level of 0.05 and statistical power of 0.80. Twenty-six mouth-breathing and 25 nose-breathing children participated. Calibrated respiratory inductive plethysmography was used to analyze the following variables, among others: respiratory frequency (f), rib cage contribution towards tidal volume ( percentRC/Vt), phase angle (PhAng) and the ratio between time taken to reach peak inspiratory flow and total inspiratory time (PifT/Ti). Peripheral oxygen saturation of hemoglobin (SpO2) was measured using pulse oximetry. Statistical analysis was performed using the Student's t test for independent groups or the Mann-Whitney U test, according to the sample distribution of the variables. RESULTS: A total of 4,816 respiratory cycles were analyzed: 2,455 from mouth-breathers and 2,361 from nose-breathers, with a mean of 94 cycles per child. No statistically significant differences were observed between the groups, for the variables studied (f=20.00±2.68 versus 20.73±2.58, p=0.169; percentRC/Vt=39.30±11.86 versus 38.36±10.93, p=0.769; PhAng=14.53±7.97 versus 13.31±7.74, p=0.583; PifT/Ti=57.40±7.16 versus 58.35±5.99, p=0.610; SpO2=96.42±1.52 percent versus 96.88± 1.01 percent, p=0.208; respectively). CONCLUSIONS: These results suggest that mouth-breathing children show breathing patterns and thoracoabdominal motion that are similar to those of nose-breathing children in the same age group.