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Biomedical subjects

H Fabel

Publications and source records attributed to H Fabel.

At least 55 records · Page 3Linked to original sources
PubMed1996

Seasonal onset of bronchiolitis obliterans syndrome in lung transplant recipients.

BACKGROUND: Bronchiolitis obliterans syndrome is the major complication in long-term survival of patients with lung transplants. Bronchiolitis obliterans syndrome is thought to represent a form of chronic allograft rejection and is associated with obstructive airways disease. Viral infections or other exogenous factors may trigger this condition. METHODS: Because respiratory viral infections show seasonal clustering we studied seasonal onset of bronchiolitis obliterans syndrome in 157 lung and heart-lung transplant recipients. Individual baseline values of forced expiratory volume in 1 second were evaluated according to the International Society for Heart and Lung Transplantation criteria. For bronchiolitis obliterans syndrome classification, values of forced expiratory volume in 1 second were determined by the average of two measurements made at least 1 month apart. Onset of bronchiolitis obliterans syndrome was defined as the date of the initial pulmonary function test showing a persistent decline of forced expiratory volume in 1 second. Other factors causing obstructive airways disease were excluded. RESULTS: Forty-nine patients (31%) showed development of bronchiolitis obliterans syndrome (n = 10 stage I, n = 13 stage II, n = 26 stage III) with onset of bronchiolitis obliterans syndrome 507 +/- 372 days (mean +/- standard deviation) after transplantation. Baseline value of forced expiratory volume in 1 second was reached at 270 +/- 231 days. Between January and March of each year onset of bronchiolitis obliterans syndrome developed in 23 patients (47%). In the second (April to June) and third (July to September) quarters a persistent decline of pulmonary function test results developed in 13 (27%) and 12 (24%) patients, respectively, whereas only 1 patient (2%) showed deterioration between October and December (p < 0.001). CONCLUSIONS: Seasonal clustering of onset of bronchiolitis obliterans syndrome might thus indicate underlying unknown infectious triggers.

Adult↗
PubMed1995

Bronchodilating effects of natriuretic and vasorelaxant peptides compared to salbutamol in asthmatics.

In animal studies, the bronchial effects of urodilatin (URO, CDD/ANP-95-126, INN: ularitide) were superior to those of cardiodilatin/atrial natriuretic peptide (CDD, CDD/ANP-99-126). We compared the bronchodilating properties of intravenous URO and CDD in 36 clinically stable asthmatics showing a beta 2-agonist-induced increase of the FEV1 by > or = 15%. Any aerosol medication was discontinued for at least 8 h prior to the study. After baseline measurements of lung function parameters (FEV1, VC, PEF, MEF75, MEF50, MEF25) an intravenous infusion of 5.7, 11.4 or 17.1 pmol/kg/min URO or CDD was administered for 40 min in the morning. All measurements were repeated every 10 min during the infusion, for 30 min thereafter, and after the inhalation of 1.25 mg salbutamol (SALB). Both peptides had significant effects. While 11.4 pmol/kg/min URO dilated the central airways (FEV1, PEF, MEF75) slightly more potently than the peripheral bronchioles (MEF50, MEF25), 17.1 pmol/kg/min URO was as effective as SALB at all levels of the tracheobronchial tree. CDD reached only 50% of the SALB effect without a predominant localization of its action. The cardiovascular parameters revealed a significantly stronger vasorelaxant activity of CDD. In conclusion, the dose-dependent bronchodilating properties of intravenous URO were significantly superior to those of CDD.

Adult↗
PubMed1995

Urodilatin (ularitide, INN): a potent bronchodilator in asthmatic subjects.

Atrial natriuretic peptide (CDD/ANP-99-126) has been identified as a bronchodilator in various species including humans. We investigated the effect of urodilatin (CDD/ANP-95-126) in 18 clinically stable asthmatics showing an increase of the FEV1 by > or = 15% after salbutamol inhalation. Prior to the study inhaled beta 2-agonists were withheld for 8 h. After baseline measurements of lung function parameters (FEV1, VC, PEF, MEF75, MEF50, MEF25), blood pressure, and heart rate in intravenous infusion of 20, 40 or 60 ng kg-1 min-1 urodilatin was administered for 40 min in the morning. All measurements were repeated every 10 min during the infusion, for 30 min thereafter, and after the inhalation of 1.25 mg salbutamol. Forty and 60 ng kg-1 min-1 urodilatin showed a significant effect on the central (FEV1, PEF, MEF75) and peripheral airways (MEF50, MEF25) after 10 min infusion (P < 0.05). A bronchodilation not significantly different from 1.25 mg salbutamol was induced by 40 ng kg-1 min-1 in the central airways only, while 60 ng kg-1 min-1 led to a similar effect at all levels of the bronchial tree. Lung function parameters returned to baseline within 30 min after cessation of the urodilatin infusion. Heart rate showed a tendency to increase after 40 min infusion (P < 0.05), but blood pressure did not change significantly. In conclusion, the maximal bronchodilating effect of intravenous urodilatin in clinically stable asthmatics was comparable to 1.25 mg salbutamol.

Adult↗
PubMed1994

Type A natriuretic peptides exhibit different bronchoprotective effects in rats.

The protective effect of 11.4, 22.8 or 45.6 pmol/kg/min cardiodilatin/atrial natriuretic peptide (CDD/ANP-(99-126)), urodilatin (CDD/ANP-(95-126)) or vehicle intravenously against acetylcholine-induced bronchoconstriction was compared in spontaneously breathing, halothane-anesthetized Wistar rats. The inhalation of acetylcholine induced significant alterations of the spontaneous breathing parameters evaluated by whole-body plethysmography without significant differences between the treatment groups. Forced parameters detect airflow changes with a greater sensitivity and were measured in hyperventilation-induced temporary apnoea after the challenge. The forced expiratory volume in 0.1 s revealed a significant protective effect of 11.4 pmol/kg/min urodilatin compared to the controls whereas the parameters of the forced expiratory flow-volume curve were significantly preserved by 11.4 and 22.8 pmol/kg/min urodilatin (P < 0.05). Urodilatin showed protective effects against an acetylcholine challenge whereas CDD/ANP-(99-126) was without significant influence.

Acetylcholine↗
PubMed1994

Localization of the bronchodilator effect induced by type A natriuretic peptide in asthmatic subjects.

Type A natriuretic peptide (CDD/ANP-99-126) in its circulating form was analyzed with respect to the localization of its bronchodilating effects in asthmatic subjects in vivo. The intravenous infusion of 5.7, 11.4, and 17.1 pmol kg-1 min-1 CDD/ANP-99-126 caused a significant bronchodilation of both central and peripheral airways. While the localization of the bronchodilating effects was similar to beta 2-agonists, an improvement in lung function parameters comparable to these substances was not observed. But other members of the natriuretic peptide family may reveal a stronger bronchodilating potency.

Adolescent↗
PubMed1994

Elevated surfactant protein A in bronchoalveolar lavage fluids from sarcoidosis and hypersensitivity pneumonitis patients.

Interstitial lung diseases often are accompanied by histopathologic evidence of alveolar type 2 cell alterations. In the alveolar milieu, the surfactant-specific protein A (SP-A) is a secretory product of alveolar type 2 cells. Therefore, we measured SP-A levels in bronchoalveolar lavage (BAL) fluids from patients with untreated sarcoidosis (n = 35) and hypersensitivity pneumonitis (HP [n = 10]) and compared the results with those from 21 healthy control subjects. In sarcoidosis patients, SP-A was markedly higher than in control subjects with a mean of 8.0 micrograms/ml of recovered BAL fluid +/- 0.7 SEM (p < 0.0001 compared with control subjects). In HP, SP-A values were comparable with those in sarcoidosis with a mean of 9.0 micrograms/ml +/- 1.7 SEM. Mean SP-A in the control group was 4.0 micrograms/ml +/- 0.3 SEM. These results suggest that SP-A secretion is stimulated in sarcoidosis and HP. Further studies seem justified to investigate the role of the surfactant system in interstitial lung diseases as well as the potential clinical usefulness of SP-A measurements in BAL.

Adolescent↗
PubMed1994

[Long-term effects of breathing exercises and yoga in patients with bronchial asthma].

To compare the effects of breathing exercises (BE) or Yoga (Y) on the course of bronchial asthma we studied 36 subjects with a mild disease. The patients were randomly divided into 3 groups. 2 of them participated in a 3 weeks training program of BE or Y while the third group rested without any additional treatment (control group, C). At the end of the training period the patients were asked to practise BE or Y on their own. Drug therapy and lung function parameters before and after a beta 2-agonist metered dose inhaler (albuterol, ALB) were recorded prior to the training program and in 4 weeks intervals for 4 months thereafter. The response to the beta 2-agonist was documented continuously in 28 patients. The mental state of the patients was elucidated by questionnaires.--Prior to the study a significant effect of inhaled ALB on the FEV1 was shown without any significant between group differences. Both, BE and Y, caused a significant amelioration of the mental state but only the BE induced a significant improvement of lung function parameters compared to the individual baseline values. The FEV1 increased significantly by 356.3 +/- 146.2 ml (p < 0.05) and the VC by 225.0 +/- 65.5 ml (p < 0.01). These long-term changes were not significantly different from the actual response to ALB. BE decreased the RV significantly by 306.3 +/- 111.6 ml (p < 0.05), an effect significantly higher compared to the beta 2-agonist (p < 0.01). BE in combination with ALB caused an additive effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Lung and heart-lung transplantation: indications, complications and prognosis].

Lung- and heart-lung transplantation has become a serious therapeutic option for terminally ill patients with chronic pulmonary failure. Due to the still rather high risk of acute rejection, severe pulmonary or systemic infection, and the relatively demanding postoperative care, this treatment can only be considered for patients where inspite exhausted conservative options for therapy quality of life and prognosis are not acceptable. Not only due to lack of donors single-lung transplantation has developed to be the favorite treatment for patients with interstitial lung disease (idiopathic, sarcoidosis, asbestosis etc.) and even for pulmonary hypertension unless irreversible damage to the myocardium is present. Double-lung transplantation is the treatment of choice for patients with emphysema and cystic fibrosis. Heart-lung transplantation is mainly limited to patients with a high degree of right ventricular or valve dysfunction as in Eisenmenger-Syndrome. Midterm clinical results have evolved to be very satisfactory while on the longterm basis chronic transplant dysfunction not responding to any kind of therapy causes a lot of concern. One- and two-year survival rates are 85 and 82% resp. in our program and thus are in the same range as those after heart transplantation.

Contraindications↗