American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Oct 2008
Comparative StudyEpithelial endoplasmic reticulum stress and apoptosis in sporadic idiopathic pulmonary fibrosis.
The molecular pathomechanisms underlying idiopathic pulmonary fibrosis (IPF) are elusive, but chronic epithelial injury has recently been suggested as key event. ⋯ Severe ER stress response in the AECIIs of patients with sporadic IPF may underlie the apoptosis of this cell type and development of fibrosis in this disease.
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Am. J. Respir. Crit. Care Med. · Oct 2008
Randomized Controlled Trial Multicenter Study Comparative StudyDuration of withdrawal of life support in the intensive care unit and association with family satisfaction.
Most deaths in the intensive care unit (ICU) involve withholding or withdrawing multiple life-sustaining therapies, but little is known about how to proceed practically and how this process affects family satisfaction. ⋯ Withdrawal of life support is a complex process that depends on patient and family characteristics. Stuttering withdrawal is a frequent phenomenon that seems to be associated with family satisfaction. Extubation before death should be encouraged if possible.
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Am. J. Respir. Crit. Care Med. · Oct 2008
Comparative StudySynergy between natriuretic peptides and phosphodiesterase 5 inhibitors ameliorates pulmonary arterial hypertension.
Phosphodiesterase 5 (PDE5) inhibitors (e.g., sildenafil) are selective pulmonary vasodilators in patients with pulmonary arterial hypertension. The mechanism(s) underlying this specificity remains unclear, but studies in genetically modified animals suggest it might be dependent on natriuretic peptide bioactivity. ⋯ These data demonstrate that PDE5 is a key regulator of cGMP-mediated vasodilation by ANP in the pulmonary, but not systemic, vasculature, thereby explaining the pulmonary selectivity of PDE5 inhibitors. Exploitation of this mechanism (i.e., PDE5 and neutral endopeptidase inhibition) represents a novel, orally active combination therapy for pulmonary arterial hypertension.
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Am. J. Respir. Crit. Care Med. · Oct 2008
Comparative StudyPotential role of high-mobility group box 1 in cystic fibrosis airway disease.
High-mobility group box 1 (HMGB1) is a potent inflammatory mediator elevated in sepsis and rheumatoid arthritis, although its role in cystic fibrosis (CF) lung disease is unknown. ⋯ HMGB1 expression contributes to pulmonary inflammation and lung matrix degradation in CF airway disease and deserves further investigation as a biomarker and potential therapeutic target.
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Am. J. Respir. Crit. Care Med. · Oct 2008
Wheezing rhinovirus illnesses in early life predict asthma development in high-risk children.
Virus-induced wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood. ⋯ Among outpatient viral wheezing illnesses in infancy and early childhood, those caused by RV infections are the most significant predictors of the subsequent development of asthma at age 6 years in a high-risk birth cohort.