Search PubMed⌕ Search

Biomedical subjects

M Aubier

Publications and source records attributed to M Aubier.

At least 109 records · Page 6Linked to original sources

[Current bronchodilator strategies in the treatment of asthma].

The drugs used in asthma must act on the two major mechanisms of the disease: bronchial obstruction and inflammation of the airways. Two main classes of drugs are available to reach these targets: bronchodilators, headed by beta 2-stimulants, and anti-inflammatory drugs of the corticosteroid family. Bronchodilatation obtained with beta 2-stimulants is the first and most effective treatment of asthma. These drugs are usually administered by inhalation: metered-dose aerosols with or without inhalation chambers, or nebulization for severe asthma. Very high doses can be used without fear of side-effects, the principal objective of this treatment being to relieve bronchial obstruction. In the absence of rapid and lasting improvement, bronchodilators must always be combined with corticosteroids. In all cases medical supervision immediately following the asthma attack is necessary and the patient should subsequently be placed under the care of pneumologists.

Adrenergic beta-Agonists↗

Effects of halothane on surfactant biosynthesis by rat alveolar type II cells in primary culture.

BACKGROUND: Pulmonary surfactant, which is synthesized by alveolar type II cells (ATII cells) almost exclusively, plays a major role in maintaining alveolar homeostasis by reducing surface tension at the fluid-gas interface. Phosphatidylcholine (PC), the main surfactant lipid component, is largely responsible for this surface activity. The effects of halothane on the phospholipid metabolism of the pulmonary surfactant by ATII cells are unknown, even though these cells are exposed directly to volatile anesthetics during anesthesia and even though any alteration in surfactant biosynthesis by anesthetics may have deleterious effects on lung function and thereby facilitate postoperative pulmonary complications. In the current study, the effects of halothane exposure on surfactant synthesis by rat ATII cells in primary culture were investigated. METHODS: ATII cells were isolated from adult rat lungs and used for the experiments after 24 h in primary culture. The ability of ATII cells to synthesize surfactant was assessed by the incorporation of radioactive precursors in PC. Cytotoxicity was measured by the rate of lactate dehydrogenase release into the culture medium, and the lactate metabolism was taken as an index of glycolytic metabolism. All metabolic measurements were made after 24 h in primary culture. Effects of various halothane concentrations (1, 2, 4, and 8%) exposure for 4 h were studied, as were the effects of 2% halothane for various durations of exposure (2, 4, 8, and 12 h). The reversibility of halothane effects on PC synthesis was assessed after a 2% halothane exposure for 4 h. PC secretion and adenosine triphosphate cellular content were also measured for 4 h exposure at the various halothane concentrations. RESULTS: During a 4-h exposure, PC synthesis was reduced by 10, 24, 29 and 36% for 1, 2, 4, and 8% halothane respectively when compared with control values. At 2% halothane concentration, the observed decreases in PC synthesis were 12, 24, 31 and 34% for 2, 4, 8, and 12 h exposure, respectively. The inhibitory effect of halothane was completely reversed 2 h after the end of exposure. PC secretion was unaffected by increasing halothane concentrations during a 4-h exposure. Halothane did not produce cell damage except for the longest exposure durations (8 and 12 h) at 2% vapor concentration. Whatever the exposure conditions, lactate production by ATII cells exposed to halothane was greater than production by unexposed cells. CONCLUSIONS: These results indicate that halothane decreases the biosynthesis of pulmonary surfactant by ATII cells in primary culture and alters the high energy phosphate metabolism of these cells.

Adenosine Triphosphate↗

Enlarged mediastinal lymph nodes in bronchogenic carcinoma: assessment with dynamic contrast-enhanced MR imaging. Work in progress.

PURPOSE: To determine whether dynamic contrast material-enhanced magnetic resonance (MR) imaging can help differentiate between malignant and benign mediastinal lymph nodes (MLNs) in bronchogenic carcinoma. MATERIALS AND METHODS: Nine patients with biopsy-proved lung carcinoma underwent dynamic contrast-enhanced MR imaging before undergoing thoracic surgery. MR studies included spin-echo, electrocardiographically gated axial and coronal sequences and transaxial gradient-echo breath-hold sequences, which were performed after administration of a bolus of gadoterate meglumine. The enhancement curves were established on the basis of mean signal intensities from regions of interest at the level of tumor and the enlarged MLN. MR images were compared with pathologic specimens obtained at surgical resection. RESULTS: Metastatic MLNs exhibited their peak enhancement at 60-80 seconds, with a slow decrease until 6 minutes. Granulomatous and anthracotic lymph nodes displayed a slight enhancement, with no peak within 6 minutes (P < .01). CONCLUSION: Dynamic contrast-enhanced MR images may provide informative data about the nature of enlarged MLNs in the preoperative assessment of lung carcinoma. Further studies are needed to investigate its usefulness in clinical practice.

Aged↗

Role of nitric oxide and prostaglandins in the regulation of diaphragmatic arteriolar tone in the rat.

We evaluated by intravital microscopy in rats the relative importance of nitric oxide (NO) and prostaglandins in 1) the maintenance of basal diaphragmatic arteriolar tone and 2) the response of diaphragmatic arterioles to the endothelium-dependent vasodilator acetylcholine (ACh). One hundred two mechanically ventilated rats were studied. Separate applications of N omega-nitro-L-arginine (L-NNA) and mefenamic acid (MA), which are specific inhibitors of NO and prostaglandin synthesis, respectively, elicited a significant reduction in basal diaphragmatic arteriolar diameter. A dramatic potentiation of the effect of each inhibitor was observed when both agents were applied simultaneously. ACh application induced a significant and dose-dependent increase in arteriolar diameter that was not significantly modified by the separate application of L-NNA or MA. Conversely, the simultaneous administration of L-NNA and MA almost completely prevented ACh-induced arteriolar dilatation. Dilatation in response to sodium nitroprusside was not significantly modified in the presence of both inhibitors. These results suggest that NO and prostaglandins act in concert to regulate basal diaphragmatic arteriolar tone and to mediate diaphragmatic arteriolar response to ACh.

Acetylcholine↗

Pulmonary Kaposi's sarcoma revealed by a solitary nodule in a patient with acquired immunodeficiency syndrome.

Kaposi's sarcoma is very common in patients with AIDS. Usually, skin lesions are associated with various visceral involvements. A homosexual patient with AIDS presented with cough and dyspnea, which were followed months later by hemoptysis. He had no skin lesions or endobronchial Kaposi's sarcoma at any time. His chest radiograph showed only an irregular solitary nodule. It exhibited very slow development over time. Surgery was performed, and this solitary nodule proved to be pulmonary Kaposi's sarcoma. Pulmonary Kaposi was the sole manifestation of this associated AIDS sarcoma. This very unusual case report of pulmonary Kaposi sarcoma indicates that this diagnosis should be considered in patients with AIDS presenting with a solitary pulmonary nodule.

Acquired Immunodeficiency Syndrome↗

Effects of mechanical ventilation on diaphragmatic contractile properties in rats.

We measured in rats the effects of 48 h of mechanical ventilation on the weight, contractile properties, and enzymatic profile of the diaphragm, the soleus and the extensor digitorium longus (EDL) muscles. Eighteen animals were randomly divided into a mechanically ventilated (MV, n = 9) group or a control (C, n = 9) group. During the 48 h of mechanical ventilation, animals in the MV group were anesthetized with sodium thiopental and enterally fed with a gastric catheter. Group C animals were neither anesthetized nor mechanically ventilated during the 48-h experimental period, and they had access to food and water ad libitum. Muscular contractile properties were measured in vitro by analysis of force-frequency curves and twitch characteristics. The weights of the three muscles were significantly reduced in the MV group compared with those in the C group. This was accompanied in the diaphragm by a reduction in the normalized force generated for all the frequencies of stimulation, except 20 Hz, whereas twitch characteristics were not modified. The forces generated by the soleus and EDL were not significantly reduced in the MV group compared with those in the C group. Diaphragm, soleus, and EDL citrate synthase and lactate dehydrogenase activities were not significantly different in the two groups. We conclude that mechanical ventilation for 48 h in rats produces a selective force reduction in the diaphragm.

Animals↗

Compartmentalized cytokine production within the human lung in unilateral pneumonia.

The in situ inflammatory response developing in the human lung during a localized bacterial infection was studied in 15 patients with unilateral community-acquired pneumonia (CAP). The local response in the involved lung was compared with that in the contralateral, noninvolved lung as well as with the systemic blood response. Eight healthy volunteers served as control subjects. Concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) were measured by ELISA in bronchoalveolar lavage (BAL) fluids (n = 15), serum (n = 15), and alveolar macrophage and monocyte culture supernatants (n = 8). The concentrations of TNF-alpha, IL-beta and IL-6 in BAL fluid were significantly higher in the involved lung than in the paired noninvolved lung (p < or = 0.01) or in healthy subjects (p < or = 0.02, p < or = 0.01, and p < or = 0.001, respectively). Serum IL-6 concentrations were higher in patients than in control subjects, whereas IL-1 beta and TNF-alpha concentrations did not differ in the two groups. Alveolar macrophages from the involved lung spontaneously released higher concentrations of IL-1 beta, IL-6, and TNF-alpha (p < or = 0.05) than did macrophages from the noninvolved lung, which served as controls. However, macrophages were hyporesponsive in terms of cytokine production to further stimulation by lipopolysaccharide (LPS) in the noninvolved and involved lung compared with controls, whereas peripheral blood monocytes were not.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Diaphragmatic function in severely malnourished patients with anorexia nervosa. Effects of renutrition.

The effects of malnutrition and refeeding on nutritional indices, pulmonary function, and diaphragmatic contractile properties were studied in severely malnourished patients with anorexia nervosa. Fifteen patients were evaluated upon hospital admission (Day 0) and on Days 7, 30, and 45 after starting feeding. Spirometry, lung volumes, and arterial blood gases were measured at each time interval, as were contractile properties of the diaphragm as assessed by transdiaphragmatic pressure generated during electrical phrenic nerve stimulation (Pdistim) and a maximal sniff maneuver (Pdisniff). Anthropomorphic and biochemical measurements were performed at each time interval. Patients were severely malnourished upon admission; mean body weight was 37.1 +/- 4.7 kg (63% ideal body weight). During nutritional support, body weight increased significantly to 42.9 +/- 4.6 kg on Day 45 (p < 0.01), as did muscle mass: 11.2 +/- 4.1 kg on Day 0, to 16.6 +/- 4.9 kg on Day 45 (p < 0.01). Vital capacity and FEV1 increased significantly by Day 30 (p < 0.05). Lung volumes were unchanged. Mean arterial blood gas values were also within the normal range at Day 0; PaO2, 92.6 +/- 2.4 mm Hg and PacO2, 41.0 +/- 1.5 mm Hg. Four patients, however, had an increased PacO2 (> 42 mm Hg) at Day 0, which returned to normal by Day 30. Diaphragmatic contractility was severely depressed initially; Pdistim, 15.9 +/- 1.4 cm H2O; Pdisniff, 65.4 +/- 5 cm H2O; but it significantly increased with nutritional support by Day 30 to 22.5 +/- 1.9 and 84.6 +/- 4.7 cm H2O, respectively. We conclude that diaphragmatic function is severely impaired in malnuorished patients free of other coexisting

Acute Disease↗

Alveolar type II epithelial cells produce interleukin-6 in vitro and in vivo. Regulation by alveolar macrophage secretory products.

The aims of this study were (a) to determine if rat alveolar type II (ATII) cells and human pulmonary epithelial-derived cells (A549 cell line) could generate IL-6 in vitro, (b) to characterize the cytokine regulation of IL-6 gene and protein expression in these cells, and (c) to detect the in vivo expression of immunoreactive IL-6 by human ATII cells. Rat ATII cells in primary culture secreted bioactive IL-6 and immunostained with an anti-IL-6 antiserum. Spontaneous IL-6 secretion by rat ATII cells amounted to 5,690 +/- 770 pg/ml/10(6) cells (n = 12) and was fivefold higher than spontaneous rat alveolar macrophages IL-6 secretion (1,052 +/- 286 pg/ml/10(6) cells, n = 8, P = 0.001). Rat alveolar macrophage conditioned media (CM) increased IL-6 secretion by rat ATII cells through the effect of IL-1 and TNF. IL-6 gene expression and IL-6 secretion by A549 cells was induced by IL-1 beta, TNF alpha, and by human alveolar macrophages and THP1 cells CM. Induction was abolished when CM were preincubated with anti-IL-1 beta and anti-TNF alpha antibody. The combination of IFN gamma and LPS induced the expression of IL-6 mRNA by A549 cells whereas LPS alone had no effect. Immunohistochemical staining evidenced the expression of immunoreactive IL-6 by hyperplastic ATII cells in fibrotic human lung, a condition in which alveolar macrophages are known to be activated. ATII cells in normal human lung did not express immunoreactive IL-6. Our findings demonstrate that ATII cells may be an important source of IL-6 in the alveolar space thereby participating to the regulation of the intra-alveolar immune response.

Animals↗

[Bronchial hyperreactivity other than that seen in asthma].

Although generally associated with asthma, bronchial hyper-responsiveness has been observed in several clinical situations. Indeed, it has been clearly shown that patients with allergic rhinitis exhibit frequently bronchial hyperresponsiveness. The latter may be an important factor in the development of chronic airway obstruction. Airway hyperresponsiveness to direct bronchoconstrictors, histamine and metacholine, is seen also in subjects with chronic airflow limitation. Several lines of reasoning suggest that this may be different than the airway hyperresponsiveness seen in asthmatics and may predominantly relate to the degree of airflow obstruction. Consequently, in the presence of resting airflow obstruction, histamine and metacholine tests are difficult to interpret vis-a-vis a diagnosis of asthma. Some studies suggest accelerated decline of lung function in subjects with chronic airflow limitation and airway hyperresponsiveness. In interstitial lung disease preliminary data form subjects with lung diseases localized to the pulmonary interstitium suggest no (or very little) tendency to airway hyperresponsiveness. However, more data are necessary. Subjects with bilateral lung transplantation appear to develop mild, generally asymptomatic airway hyperresponsiveness which has been suggested to be due to cholinergic denervation hyper-sensitivity. Finally, asthmatics and nonasthmatics both may develop increased degrees of airway responsiveness following viral respiratory tract infections. Virus-induced airway inflammation is likely important in the pathogenesis of asthma in some subjects.

Airway Obstruction↗

Partial inhibition by epithelium of tracheal smooth muscle relaxation induced by the potassium channel activator, BRL 38227.

1. A method is described whereby either the serosal (Out) or epithelial (In) sides of rat isolated tracheae were selectively perfused. Perfusion with BRL 38227 (10(-8)-5 x 10(-6) M; In/Out) of preparations with intact epithelium (+ EP) precontracted with carbachol (10(-6) M; Out/In) produced complete relaxation. Perfusion with aminophylline (10(-5)-10(-3) M; In) of + EP preparations precontracted with carbachol (10(-6) M; Out) also produced complete relaxation. 2. In preparations precontracted with carbachol (10(-6) M) epithelium removal (- EP) increased the sensitivity to the relaxant effect of BRL 38227 (In), but not BRL 38227 (Out) [- log EC50, + EP/- EP; carbachol (In), BRL 38227 (Out): 6.76 +/- 0.11 vs 6.67 +/- 0.15; carbachol (Out), BRL 38227 (In): 5.93 +/- 0.06 vs 6.25 +/- 0.07]. Removal of the epithelium increased also the sensitivity to BRL 38227 (In) of preparations precontracted with a lower concentration (5 x 10(-7) M) of carbachol (Out). [- log EC50, + EP/- EP, carbachol (Out), BRL 38227 (In): 6.19 +/- 0.14 vs 6.58 +/- 0.17]. 3. Removal of the epithelium did not affect the sensitivity to BRL 38227 (In) of preparations precontracted with a higher concentration (5 x 10(-6) M) of carbachol (Out). 4. In both + EP and - EP preparations precontracted with carbachol (10(-6) M; Out), BRL 38227 (In) had a more potent relaxant effect than aminophylline (In) (EC50, BRL 38227 vs aminophylline, + EP/- EP: 5.93 +/- 0.06 vs 3.66 +/- 0.11/6.25 +/- 0.07 vs 3.77 +/- 0.11). 5. In preparations precontracted with carbachol (10-6 M; Out), removal of the epithelium did not affect the sensitivity to aminophylline (In) but increased the degree of precontraction (Tmax) following epithelial but not serosal stimulation with carbachol.6. We conclude that BRL 38227, a K+ channel activator, is a potent relaxant of rat tracheal smooth muscle precontracted with carbachol, and that the effect can be partially inhibited by the presence of an intact tracheal epithelium, whereas the relaxant effect of aminophylline is not.

Aminophylline↗

Cell surface carbohydrates modulate neutrophil adherence to alveolar type II cells in vitro.

We characterized the influence of phosphorylated sugars and cell surface sialic acids on the adherence of human polymorphonuclear leukocyte (PMN) to rat alveolar type II cell (ATII cells) and human-derived A549 cell monolayers in vitro. Percent adherence of radiolabeled polymorphonuclear leukocytes was assessed after incubating cells with the carbohydrates, enzymes, or lectins to be tested. Lactose-1-phosphate (Lact1P) and maltose-1-phosphate (Malt1P) (10 mM) inhibited adherence of PMN to ATII cells and A549 cells. Maximal inhibition followed treatment of both PMN and rat ATII cells and amounted to 85 +/- 7% with Lact1P and 92 +/- 3% with Malt1P. Inhibition was concentration dependent. Incubation of PMN with mannose-6-phosphate reduced adherence to rat ATII cells and A549 cells by 36 +/- 11 and 39 +/- 8%, respectively. Maximal concentrations of sugars did not alter cellular viability. Neuraminidase-induced desialilation of ATII cells increased adherence of PMN by 36 +/- 7% to rat ATII cells and by 86 +/- 18% to A549 cells. Masking of terminal sialic acids on rat ATH cells with Limulus polyphemus agglutinin (100 micrograms/ml) increased adherence by 50 +/- 2%. These results indicate that cell surface carbohydrates are involved in the regulation of the adhesive interaction between PMN and ATII cells in vitro.

Animals↗

Cell surface carbohydrates of rat alveolar type II cells in primary culture.

Cell surface carbohydrates have been shown to be altered during cellular differentiation. Alveolar type II (ATII) cells in culture gradually lose their differentiated phenotype. Therefore, the aim of this study was: (1) to characterize changes in terminal carbohydrates of cell surface glycoproteins of rat ATII cells cultured for 1 to 5 days on plastic, and (2) to assess the concomitant changes in sialidase and sialyltransferase activity of ATII cell homogenates. Cells were surface-labeled with potassium-[3H]-borohydride after oxidation by sodium periodate at millimolar concentrations, galactose oxidase or neuraminidase plus galactose oxidase, allowing for the specific labeling of terminal sialic acids, terminal galactose/N-acetylgalactosamine (Gal/GalNAc), or terminal an penultimate Gal/GalNAc residues, respectively. Glycoproteins were separated by SDS-PAGE. On day 1, cells were heavily coated with sialic acids, since no labeling could be introduced with galactose oxidase alone. From day 1 to day 5, we observed a selective and progressive desialylation of two glycoproteins (200 and 165 kD). At the same time, the ATII cells' sialidase activity (pH 4.2) exhibited an 8-fold increase (60.3 +/- 4.0 pmol/min/mg protein on day 1 versus 406.9 +/- 3.7 pmol/min/mg protein on day 5), whereas the sialyltransferase activity increased 2-fold (212 +/- 8 fmol/min/mg protein on day 1 versus 395 +/- 82 fmol/min/mg protein on day 5) and the supernatant sialidase activity was unchanged (2.8 +/- 0.7 pmol/min/ml on day 5). Thus, the phenotypic changes of ATII cells in primary culture are accompanied by a partial cell surface desialylation and an increase in intracellular sialidase activity.

Animals↗

[Chronic respiratory insufficiency. Non-invasive long-term ventilation methods].

The techniques of non-invasive ventilation have reappeared in force as an assortment of therapeutic techniques since the end of the 1980's. At the same time there was a transient renewed interest in perithoracic ventilation favouring the use of new methods of connection to the patient (e.g. poncho). The principal feature has been the use of intermittent positive pressure ventilation by the nasal route, which rapidly became essential for home therapy in patients with chronic restrictive respiratory failure notably in those secondary to thoracic deformation and to neuromuscular pathology. The concept of resting the respiratory muscles has been the basis for techniques of ventilatory assistance and in part the nasal route has now replaced home ventilation using a tracheotomy. Also in certain types of acute respiratory failure, nasal ventilation widely preferred over endotracheal ventilation.

Chronic Disease↗

[Different aspects of surgery of cancer developing after severe bullous pulmonary emphysema].

The authors report the case of a 64-year-old patient with a peripheral tumour of the left upper lobe developing in a context of bilateral major lesions of bullous emphysema with predominance on the right. Surgery first enabled the resection of large dystrophic compressive bullae of the right upper lobe, then, secondly, atypical resection of the culmen for excision of the peripheral tumour and dystrophic bullae of the left upper lobe. Twelve months later, a tumour recurrence led to left total pneumonectomy. Two radically different surgical approaches for carcinoma in a context of severe bullous emphysema are illustrated by this same patient. While the objective of functional improvement was associated with the oncological quality of excision at the time of the first stage of treatment, it was subsequently possible to perform major excision surgery with notable loss of functional capacity thanks to the benefits of the first operation.

Adenocarcinoma↗