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Biomedical subjects

E Puchelle

Publications and source records attributed to E Puchelle.

At least 181 records · Page 10Linked to original sources
PubMed1978

Effect of the mucoregulator S-carboxy-methyl-cysteine in patients with chronic bronchitis.

Twenty patients with stable chronic bronchitis entered a double-blind study in which changes in clinical and respiratory function and biochemical and rheological variations were examined after treatment with the mucoregulator S-carboxy-methyl-cysteine (S.C.M.C.). After one week of single-blind placebo, a two week double-blind study was initiated with placebo or oral S.C.M.C. 3 g/24h. After two weeks, a significant clinical improvement was observed in patients treated with S.C.M.C. During treatment, there was no change in respiratory function, although a drop in FEV1/VC was noted in the placebo group. A significant increase in the viscosity of the expectorations was observed after treatment with S.C.M.C. for two weeks. The levels of secretory IgA and of serum albumin in the expectorations remained stable, whereas in the placebo group, there was a slight but significant increase in serum albumin. In this group of non-infected chronic bronchitic patients, S.C.M.C. appeared to normalize the secretory function of the bronchial mucosa by preventing inflammation and enhancing the viscoelastic properties of bronchial secretions.

Aged↗
PubMed1978

[Current concepts of bronchial fluidifiers (author's transl)].

Having summarised recent studies of the biochemical and rheological nature of bronchial secretions, the authors envisage different types of drugs which modify bronchial secretions: mucolytic agents, drugs modifying local water equilibrium and mucoregulators. According to the modes of action of these drugs and the nature of the secretory disturbances, the authors propose new therapeutic schemes. The treatment of chronic bronchial hypersecretion should not necessarily aim to fluidify the secretions but should normalize their rheological properties in order to improve mucociliary transport. The various fluidifiers and regulators of bronchial secretions are in no way interchangeable and should only be used when appropriate.

Acute Disease↗
PubMed1978

Criteria for evaluating mucus functions and their disorders in chronic bronchitis.

In chronic bronchitis, disorders of the physical and chemical properties of mucus may contribute to bronchial obstruction. The abnormalities are analysed in sputum collected by physiotherapy. Measurements of the rheological properties (apparent viscosity and strain recovery), content analysis of secretory immunoglobulin A (S-IgA) and of serum albumin, and determination of the transport velocity of sputum on the ciliated frog palate provide reliable indices of the functional capacity of bronchial mucosa. The effectiveness of mucociliary clearance and coughing is analysed in patients by measuring the rate of removal of radioactive particles deposited on proximal airways. Different types of pathological secretions may be observed. In subjects with occasional cough and sputum, the secretions are characterized by a high content of S-IgA and serum albumin, and a high viscosity and low elasticity, reflecting their high degree of cross-linking. In chronic bronchitics, the S-IgA content and viscoelastic properties of sputum decrease as the illness progresses. During infection, purulent sputum exhibits high viscosity and low strain recovery. Such modifications of the rheological properties of mucus may impair mucociliary clearance. The role of the elastic component is predominant. Sputum, characterized by very low strain recovery (SR less than 4 units) or conversely by very high strain recovery (SR greater than 15 units), is transported at a low rate by mucociliary clearance. A marked hyperviscosity (no greater than 200 poises (120 N s m-2)) also appears as a limiting factor of the mucociliary clearance.

Animals↗
PubMed1978

[Pathophysiology of chronic, bronchial hypersecretion (author's transl)].

The biochemical and rheological analysis of sputum allows one to detect abnormalities of the bronchial secretion and to describe the development of the bronchial disease. The main biochemical components of sputum and their biological activities are first described. The fibrillar structure of the mucus is related to heavy weight glycoproteins and these macromolecules contribute to the viscoelastic properties of the bronchial secretion, by their capacity to combine with other proteins such as secretory immunoglobulin A (S-IgA). As the chronic bronchial hypersecretory state progresses, the glandular synthesis of mucins and/or secretory proteins decreases while the passive filtration of blood-derived proteins, such as serumalbumin, increases. Such biochemical changes are frequently associated with a rise in viscosity and a loss in elasticity of sputum. These rheological modifications result in an impairment of the mucociliary clearance and therefore contribute to airway obstruction. The assessment of different indices such as the equilibrium in mucin secretion, S-IgA/serum-albumin ratio, viscosity and elasticity of sputum and its mucociliary transport rate, should lead to a better knowledge of the defense properties of the bronchial mucosa.

Airway Obstruction↗
PubMed1977

[Quantitative bacteriology of sputum and bronchial secretions in patients with chronic bronchitis (author's transl)].

The in vitro and in vivo reproducibility of the quantitative bacteriological analysis of sputum and bronchial secretions has been studied in patients with chronic bronchitis. Sputum produced during bronchial toilet showed a significant higher bacterial numeration than that produced by physiotherapy but the bacterial species identified were identical. No significant variations were observed between the qualitative and quantitative bacteriologic flora of bronchial secretions collected by bronchoscopy from different segments of the airways. Comparison of microbial counts on sputum specimens collected at different periods of the day and at weekly intervals over several weeks revealed that the sputum of clinically stable chronic bronchitic patients contain a relatively constant and potentially pathogenic bacterial flora. The emergence of a superinfection was emphasized by the parallel increase of the leukocytic and bacterial numeration of sputum.

Bacteria↗
PubMed1977

[Bronchial mucociliary clearance in chronic bronchitics (author's transl)].

Bronchial mucociliary clearance is analysed in 13 clinically stable patients with chronic bronchitis in comparison with 7 normal non smokers by measuring the rate of removal of inhaled monodispersed particles of resin (diameter: 8.1 +/- 3.5 micrometer) tagged with 99mTc. Particles delivered with a high insufflation rate are uniformly deposited on proximal airways. The pattern of distribution is comparable in all the subjects studied. In normal non smokers, the percentage of bronchial radioactivity cleared 1 h after the inhalation was 34 +/- 11.2 percent. The patients may be divided into 2 groups: Group 1 (n = 6) is characterized by a mucociliary clearance similar to the normals while group 2 (n = 7) shows a low mucociliary transport rate (decrease of bronchial radioactivity after 4 h less than 10 percent).

Adult↗
PubMed1976

[Rheological and biochemical properties of sputum. Role of infection (author's tansl)].

Rheological and biochemical changes in sputum following repeated bronchial infections have been studied in six chronic bronchitics. Secretory IgA (IgAs) in the sputum decrease and serumalbumin increases as the number of acute bronchial infection episodes increases. Rheological properties of sputum follow a comparable course to that of secretory IgA. The decrease of the ratio-IgA-serum albumin and the loss of the viscoelastic properties of sputum reflect the non functional state of the bronchial mucosa. These changes may be considered as possible important factors altering mucus clearance and therfore favoring chronic bronchial obstruction.

Bronchi↗