American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Apr 2015
Randomized Controlled TrialCalcium Channel Blocker Reduces Airway Remodeling in Severe Asthma: a Proof-of-concept Study.
Severe asthma is a major public health issue throughout the world. Increased bronchial smooth muscle (BSM) mass, a characteristic feature of airway remodeling in severe asthma, is associated with resistance to high-intensity treatment and poor prognosis. In vitro, the Ca(2+)-channel blocker gallopamil decreased the proliferation of BSM cells from patients with severe asthma. ⋯ Gallopamil treatment for 12 months reduces BSM remodeling and prevents the occurrence of asthma exacerbations. Clinical trial registered with www.clinicaltrials.gov (NCT 00896428).
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Am. J. Respir. Crit. Care Med. · Apr 2015
Association of Hospital-Level Volume of Extracorporeal Membrane Oxygenation Cases and Mortality - Analysis of the Extracorporeal Life Support Organization Registry.
Recent pediatric studies suggest a survival benefit exists for higher-volume extracorporeal membrane oxygenation (ECMO) centers. ⋯ In this international, case-mix-adjusted analysis, higher annual hospital ECMO volume was associated with lower mortality in 1989-2013 for neonates and adults; the association among adults persisted in 2008-2013.
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Am. J. Respir. Crit. Care Med. · Apr 2015
Human Trachealis and Main Bronchi Smooth Muscle Are Normo-Responsive in Asthma.
Airway smooth muscle (ASM) plays a key role in airway hyperresponsiveness (AHR) but it is unclear whether its contractility is intrinsically changed in asthma. ⋯ Our data show that, in contrast to some animal models of AHR, human tracheal and main bronchial smooth muscle contractility is not increased in asthma. Specifically, our results indicate that it is highly unlikely that ASM half-maximum effective concentration (EC50) or Vmax contribute to AHR in asthma, but, because of high variability, we cannot conclude whether or not asthmatic ASM is hyperreactive.