American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Oct 2018
Randomized Controlled TrialDoes Armodafinil Improve Driving Task Performance and Weight Loss in Sleep Apnea? A Randomized Trial.
Patients with obstructive sleep apnea (OSA) unable to tolerate standard treatments have few alternatives. They may benefit from weight loss, but the major symptom of daytime performance impairment may remain during weight loss programs. ⋯ Armodafinil did not improve driving task performance at the primary endpoint of 6 months. Armodafinil might be a useful adjunctive to weight loss in patients with OSA rejecting conventional treatments but this needs to be directly tested in a specifically designed, properly powered clinical trial. Clinical trial registered with Australian and New Zealand Clinical Trials Registry (ACTRN 12611000847910).
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Am. J. Respir. Crit. Care Med. · Oct 2018
Comparative StudyProtein Tyrosine Phosphatase-N13 Promotes Myofibroblast Resistance to Apoptosis in Idiopathic Pulmonary Fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a progressive, fibrotic interstitial lung disease characterized by (myo)fibroblast accumulation and collagen deposition. Resistance to Fas-induced apoptosis is thought to facilitate (myo)fibroblast persistence in fibrotic lung tissues by poorly understood mechanisms. ⋯ These findings suggest that PTPN13 mediates the resistance of human lung (myo)fibroblasts to Fas-induced apoptosis and promotes pulmonary fibrosis in mice. Our results suggest that strategies aimed at interfering with PTPN13 expression or function may represent a novel strategy to reduce fibrosis in IPF.
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Am. J. Respir. Crit. Care Med. · Oct 2018
Comparative StudyBlood Neutrophils Are Reprogrammed in Bronchiectasis.
Excessive neutrophilic airway inflammation is the central feature of bronchiectasis, but little is known about neutrophils in bronchiectasis. ⋯ In bronchiectasis stable state, peripheral blood neutrophils are reprogrammed and have prolonged survival. This impairs their functional ability of bacterial phagocytosis and killing, thereby perpetuating the vicious circle in bronchiectasis.
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Am. J. Respir. Crit. Care Med. · Oct 2018
Deterioration of Regional Lung Strain and Inflammation during Early Lung Injury.
The contribution of aeration heterogeneity to lung injury during early mechanical ventilation of uninjured lungs is unknown. ⋯ Mechanical ventilation consistent with clinical practice did not generate excessive regional strain in heterogeneously aerated supine lungs. However, it allowed worsening of spatial strain distribution in these lungs, associated with increased inflammation. Our results support the implementation of early aeration homogenization in normal lungs.