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Results for “Therapeutic modulation”

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PubMed2005

Therapeutic modulation of allergic airways disease with leukotriene receptor antagonists.

Although asthma is one of the most common chronic respiratory conditions, it often remains unrecognized and undertreated, while patients are often reluctant to comply with regular inhaled anti-inflammatory and bronchodilator therapy. Allergic rhinitis co-exists with asthma in as many as 40% of patients, and can be regarded as a continuum of the same inflammatory disease process. Corticosteroids are the 'gold standard' first-line treatment for both conditions, and have a significant impact upon underlying inflammation, symptoms and long-term outcome. Cysteinyl leukotrienes are potent airway inflammatory mediators, suggesting that treatment antagonizing their effects could play a role in disease management. In recent years, leukotriene receptor antagonists have provided a further therapeutic option in the management of allergic airways disease. These drugs are orally active, can be administered once daily, and provide a systemic approach to the management of patients with asthma and allergic rhinitis. We review the pharmacology of leukotriene receptor antagonists, their potential role in clinical practice in patients with allergic airways disease, and likely areas for further research.

Adrenergic beta-Agonists↗
PubMed2006

Therapeutic modulation of cytokines in chronic infectious diseases.

The recent increase in immunocompromised patient populations, including HIV-infected patients, cancer patients with chemotherapy-induced neutropenia, and transplant recipients receiving immunosuppressive therapy, has led to an increased incidence of clinically significant chronic opportunistic infections. Traditional treatment of chronic persistent infections has strongly relied on the use of antimicrobial drugs. However, unsatisfactory results with drug monotherapy and emergence of resistant strains have prompted the use of adjunctive cytokine therapies for the treatment of these infections. During the past decade, a wide spectrum of immunomodulators has been tested in human clinical trials and animal models of chronic infections caused by a variety of bacteria, fungi, viruses and parasites. This review compiles recent information on advances in the use of cytokines as a therapeutic strategy in chronic bacterial, parasitic, fungal and viral infections.

Animals↗
PubMed2006

B lineage cells in the inflammatory central nervous system environment: migration, maintenance, local antibody production, and therapeutic modulation.

B cells have long played an enigmatic role in the scenario of multiple sclerosis pathogenesis. This review summarizes recent progress in our understanding of B-cell trafficking, survival, and differentiation in the central nervous system (CNS). We propose four possible routes of intrathecal immunoglobulin-producing cells. The inflammatory CNS provides a unique, B-cell-friendly environment, in which B lineage cells, notably long-lived plasma cells, can survive for many years, perhaps even for a lifetime. These new findings offer a plausible explanation for the notorious persistence and stability of cerebrospinal fluid oligoclonal bands. Furthermore, we highlight similarities and differences of intrathecal immunoglobulin production in multiple sclerosis patients and patients with other CNS inflammatory conditions. Finally, we outline the possibly double-edged effects of B cells and immunoglobulin in the CNS and discuss various therapeutic strategies for targeting the B-cell response.

Animals↗
PubMed2006

Therapeutic modulation of the psychoneuroimmune system by medical acupuncture creates enhanced feelings of well-being.

PURPOSE: This article includes an explanation of how stressors disrupt physiologic regulatory mechanisms leading to disease states, how environmental challenges alter the function of the psychoneuroimmune system, and how correction of aberrant action potentials will stabilize homeostatic regulatory functions, inducing an escape response from stressors and leading to enhanced feelings of well-being. An explanation of how medical acupuncture accomplishes this stabilization concludes the article. DATA SOURCE: Extensive review of the worldwide scientific literature from the 1970s through current literature, on acupuncture, neurophysiology, and psychoneuroimmune system, using the theoretical framework of Martha Rogers. CONCLUSIONS: It is estimated that 80% of all illnesses are stress induced, although the physiologic mechanisms by which stress induces detrimental changes are not well understood by the medical profession. Introducing specific rhythmic electrical impulses slightly more intense than the nervous system already generates with the intervention of medical acupuncture can therapeutically alter aberrant signals induced by stressors, which may result in the release of neuropeptides and stabilization of homeostatic regulation so that health outcomes are improved. As neurological activity is altered, the firing pattern of nerves is changed. This is a change in the electrical pattern that leads to a change in the biochemical pattern. Thus, medical acupuncture is a therapy that is in agreement with Martha Rogers' conceptual model. Therapeutic techniques may improve the individual's level of wellness by direct actions toward homeostatic stabilization of the autonomic nervous system. These techniques will not change the amount of stressors a person is subject to but will change the physiological response to them. When the nervous system is in homeostatic balance, individuals will report enhanced feelings of well-being, be more effective in coping with their conditions of living, and therefore be less susceptible to illness. IMPLICATIONS FOR PRACTICE: Nurse practitioners have an opportunity to expand into an unused dimension for nursing care through direct treatment of the central and autonomic nervous system that will influence the psychoneuroimmune system. A prescriptive theory explaining medical acupuncture provides for therapeutic interventions at the primary, secondary, and tertiary level of care. Primary preventive interventions alter the effects of stress before it leads to illness by assisting homeostatic stability of the autonomic nervous system. Secondary interventions allow treatment of many health conditions regulated by neurological activity. Tertiary care provides a method to assist autonomic regulation when the body is no longer able to maintain homeostatic stability because of chronic illness or injury.

Action Potentials↗
PubMed2006

Therapeutic modulation of growth factors and cytokines in regenerative medicine.

Regeneration that takes place in the human body is limited throughout life. Therefore, when organs are irreparably damaged, they are usually replaced with an artificial device or donor organ. The term "regenerative medicine" covers the restoration or replacement of cells, tissues, and organs. Stem cells play a major role in regenerative medicine by providing the way to repopulate organs damaged by disease. Stem cells have the ability to self renew and to regenerate cells of diverse lineages within the tissue in which they reside. Stem cells could originate from embryos or adult tissues. Growth factors are proteins that may act locally or systemically to affect the growth of cells in several ways. Various cell activities, including division, are influenced by growth factors. Cytokines are a family of low-molecular-weight proteins that are produced by numerous cell types and are responsible for regulating the immune response, inflammation, tissue remodeling and cellular differentiation. Target cells of growth factors and cytokines are mesenchymal, epithelial and endothelial cells. These molecules frequently have overlapping activities and can act in an autocrine or paracrine fashion. A complex network of growth factors and cytokines guides cellular differentiation and regeneration in all organs and tissues. The aim of this paper is to review the role of growth factors and cytokines in different organs or systems and explore their therapeutic application in regenerative medicine. The role of stem cells combined with growth factors and cytokines in the regeneration of vascular and hematopoietic, neural, skeletal, pancreatic, periodontal, and mucosal tissue is reviewed. There is evidence that supports the use of growth factors and cytokines in the treatment of neurological diseases, diabetes, cardiovascular disease, periodontal disease, cancer and its complication, oral mucositis. After solving the ethical issues and establishing clear and reasonable regulations, regenerative medicine through stem cell application combined with specific growth factors and cytokines will have great potential in curing a variety of human diseases.

Animals↗
PubMed1996

Therapeutic modulation of free radical-mediated reperfusion injury of the liver and its surgical implications.

It is well known that ischemia causes functional and structural damage to liver cells, and that the status of energy metabolism provides an important means of assessing the functional viability of the ischemic organ. However, the specific sequence leading to ischemic liver cell injury is not yet fully understood; therefore, it is clinically and pathophysiologically important to elucidate the mechanism of cellular injury during hepatic ischemia and subsequent reperfusion. Whereas the conventional view attributes this injury process to the ischemia itself, recent studies have demonstrated that a variable but often substantial proportion of this injury is caused by reactive oxygen metabolites that are generated at the time of reperfusion. This article presents an outline of the mechanism of cellular injury caused during hepatic ischemia and subsequent reperfusion resulting from certain types of surgery, with special reference to the xanthine-xanthine oxidase system and the activation of neutrophils and macrophages.

Animals↗
PubMed2005

Hepatic high-density lipoprotein receptors: roles in lipoprotein metabolism and potential for therapeutic modulation.

High-density lipoprotein (HDL) plays an important role in protection against atherosclerosis. A major part of HDL's antiatherogenic role is through mediating reverse cholesterol transport from peripheral cells, such as macrophages and other cells in the artery wall, to the liver. Hepatic HDL receptors should, therefore, play an important role in either mediating or modulating HDL-dependent reverse cholesterol transport. The scavenger receptor class B type I (SR-BI) was first identified as a hepatic HDL receptor almost 10 years ago and is well characterized at the molecular level. This review highlights recent studies that provide insight into the cellular pathways involved in SR-BI-mediated lipid transfer between bound lipoproteins and cells, supports a role for this receptor in reverse cholesterol transport and protection against experimental atherosclerosis in mice, and explores the consequences of sequence variations in the gene encoding SR-BI in humans.

Animals↗
PubMed1991

Vascular smooth muscle cell proliferation and its therapeutic modulation in hypertension.

The increased growth potential of vascular smooth muscle cells (VSMCs) represents one of the crucial anomalies responsible for the development of essential hypertension, diabetic macroangiopathy, and atherosclerosis. The exaggerated response to growth factors of VSMC from spontaneously hypertensive rats (SHRs) persists in culture when compared with normotensive Wistar-Kyoto control rats, indicating an intrinsic defect in the hypertension-producing mechanism. This greater proliferation is characterized by two intermediate phenotypes: (1) accelerated entry into the S phase of the cell cycle, which results from hyperresponsiveness to epidermal growth factor and platelet-derived growth factor, and (2) abnormal contact inhibition. The enhanced expression of transforming growth factor beta 1 (TGF-beta 1) messenger ribonucleic acid in SHRs precedes this altered contact inhibition, and only VSMCs from SHRs respond to exogenously added TGF-beta 1 at a high cell density, which suggests that abnormal TGF-beta 1 autoregulation may be implicated in the second phenotype. Platelets contain major growth factors for VSMC. Platelet extracts from hypertensive and diabetic patients present augmented growth-promoting activity on VSMCs, which is most evident when both diseases occur simultaneously. Growth-promoting activity may be further influenced by antihypertensive therapy. This growth-promoting activity is increased by hydrochlorothiazide but not by indapamide, atenolol, or captopril in diabetic hypertensive and nondiabetic hypertensive patients. In conclusion, VSMCs in hypertension manifest an intrinsic growth defect that is modulated by extrinsic platelet growth factors and antihypertensive drugs.

Animals↗
PubMed2004

Magnetically modulated therapeutic systems.

Magnetically targeted drug delivery by particulate carriers is an efficient method of delivering drugs to localized disease sites, such as tumors. High concentrations of chemotherapeutic or radiological agents can be achieved near the target site without any toxic effects to normal surrounding tissue. Non-targeted applications of magnetic microspheres and nanospheres include their use as contrast agents (MRI) and as drug reservoirs that can be activated by a magnet applied outside the body. Historic and current applications of magnetic microspheres will be discussed, as well as future directions and problems to be overcome for the efficient and beneficial use of magnetic carriers in clinical practice. More information about the field and an extensive bibliography is available at "."

Animals↗
PubMed2006

Therapeutic modulation of synaptic connectivity with desynchronizing brain stimulation.

In a modeling study, we show that synaptic connectivity can effectively be reshaped by an appropriate modulation of neuronal dynamics. To this end, we incorporate synaptic plasticity with symmetric spike-timing characteristics into a population of bursting neurons, which are interacting via chemical synapses. Under spontaneous conditions, qualitatively different stable dynamical states may coexist. We observe states characterized either by pathological synchrony or by uncorrelated activity. Suitably designed stimulation protocols enable to shift the neuronal population from one dynamical state to another. Due to low-frequency periodic pulse train stimulation, the population learns pathologically strong interactions, as known from the kindling phenomenon. In contrast, desynchronizing stimulation, e.g., multi-site coordinated reset stimulation, enables the network to unlearn pathologically strong synaptic interactions, so that a powerful long-term anti-kindling is achieved. We demonstrate that anti-kindling can be achieved even with weak and/or short desynchronizing stimuli, which are not able to cause a complete desynchronization in the course of the stimulation. Our results show that desynchronizing stimulation may serve as a novel curative approach for the therapy of neurological diseases connected with pathological cerebral synchrony.

Algorithms↗
PubMedDate not supplied

Functional imaging and neurophysiological assessment of spinal and brain therapeutic modulation in humans.

We summarize here our experience in the neurophysiological and neuroimaging assessment of spinal and brain neuromodulation for pain relief. Techniques reviewed include somatosensory evoked potentials (SEPs), nociceptive spinal (RIII) reflexes, and positron emission tomography (PET), which have been applied both to investigate the mechanisms and to optimize the application of neurostimulation procedures. SEPs are especially useful in the preoperative assessment of patients with neuropathic pain, as they allow the establishment of the functional state of the dorsal column system. Patients with strongly abnormal SEPs due to ganglionic or preganglionic pathology are not likely to benefit from spinal (SCS) or peripheral (TENS) neurostimulation, because ascending fibers disconnected from their soma will undergo rapid degeneration and not be excitable. In the postoperative period, nociceptive spinal reflexes yield objective data concerning the effects of neurostimulation on spinal circuitry. In our experience, the best clinical results are achieved in patients with preserved preoperative SEPs, in whom neurostimulation entails profound attenuation of nociceptive reflexes.PET-scan imaging techniques have recently been used to demonstrate changes in cerebral blood flow during new neuromodulation schemes such as motor cortex stimulation for pain control (MCS). PET studies highlight the thalamus as the key structure mediating functional MCS effects. Thalamic activation would trigger a cascade of synaptic events influencing activity in other pain-related structures including the anterior cingulate gyrus, insula, and upper brainstem. The combination of clinical electrophysiology and functional neuroimaging provides insight into the mechanisms of action of neuromodulation procedures, guides clinical decision, and contributes to optimize patient selection.

Central Nervous System Diseases↗