American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Sep 2014
Randomized Controlled TrialRandomized Controlled Trial of Calcitriol in Severe Sepsis.
Vitamin D and its metabolites have potent immunomodulatory effects in vitro, including up-regulation of cathelicidin, a critical antimicrobial protein. ⋯ Calcitriol administration did not increase plasma cathelicidin protein levels in critically ill patients with sepsis and had mixed effects on other immunomodulatory markers. Additional phase II trials investigating the dose and timing of calcitriol as a therapeutic agent in specific sepsis phenotypes may be warranted. Clinical trial registered with www.clinicaltrials.gov (NCT 01689441).
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Am. J. Respir. Crit. Care Med. · Sep 2014
Long-term Effects of Traffic Particles on Lung Function Decline in the Elderly.
Few studies have been performed on air pollution effects on lung function in the elderly, a vulnerable population with low reserve capacity, and even fewer have looked at changes in the rate of lung function decline. ⋯ Our results support adverse effects of long-term exposure to traffic particles on lung function level and rate of decline in the elderly and suggest that functionally significant differences in health and risk of disability occur below the annual Environmental Protection Agency National Air Quality Standards.
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Am. J. Respir. Crit. Care Med. · Sep 2014
Clinical TrialEvaluation of CPAP Therapy on Renin-angiotensin System Activity in Obstructive Sleep Apnea.
Obstructive sleep apnea (OSA) has been associated with kidney function loss, which may be related to changes in the renin-angiotensin system (RAS). ⋯ CPAP therapy was associated with improved renal hemodynamics and down-regulation of renal RAS activity, suggesting a potential therapeutic benefit for kidney function.
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Am. J. Respir. Crit. Care Med. · Sep 2014
Is Previous Respiratory Disease a Risk Factor for Lung Cancer?
Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. ⋯ Findings from this large international case-control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer.
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Am. J. Respir. Crit. Care Med. · Sep 2014
Polymeric Immunoglobulin Receptor Downregulation in COPD: Persistence in the Cultured Epithelium and Role of Transforming Growth Factor-β.
The generation of protective secretory IgA relies on the epithelial polymeric immunoglobulin receptor (pIgR). pIgR expression is reduced in chronic obstructive pulmonary disease (COPD), but correlation to disease severity and underlying mechanisms remains unknown. ⋯ pIgR down-regulation in COPD correlates with disease severity, and the bronchial epithelium reconstituted in vitro from these patients retains its aberrant imprinting for pIgR expression. This study also links pIgR down-regulation to TGF-β-driven reprogramming of the bronchial epithelium, which results in impaired lung IgA immunity in patients with COPD.