Respiratory distress syndrome, adult

PA S1 S01.131 Neutrophil elastase Drug target for emphysema, cystic fibrosis, adult respiratory distress syndrome, rheumatoid arthritis and other diseases... 

In the past number of years a number of studies have shown that in a variety of diseases there is a significant oxidation of Met residues to Met(O) in specific proteins that results in a loss of biological activity. These diseases include cataracts, rheumatoid arthritis, adult respiratory distress syndrome and emphysema. The most convincing evidence that Met(O) in proteins may be involved in the etiology of a pathological condition comes from studies with a-l-PI. It is well accepted that a-l-PI is inactivated upon oxidation of its Met residues. A decreased activity of a-l-PI in lung tissue that would result in an increased elastase activity has been associated with pulmonary emphysema. In patients who have a... 

Quinlan, G.J., Evans, T.W. and Gutteridge, J.M.C. (1994). Linoleic acid and protein thiol changes suggestive of oxidative damage in the plasma of patients with adult respiratory distress syndrome. Free Bad. Res. Commun. 20, 299-306. 

Cross, C.E., Forte, T., Stocker, R., Louie, S., Yamamoto, Y., Ames, B.N. and Frei, B. (1990). Oxidative stress and abnormal cholesterol metabolism in patients with adult respiratory distress syndrome. J. Lab. Clin. Med. 115, 396-404. 

MacNaugJiton, P.D. and Evans, T.W. (1992). Management of adult respiratory distress syndrome. Lancet 339, 469-472. 

Ognibene, F.P., Martin, S.E. and Parker, M.M. (1986). Adult respiratory distress syndrome in patients with severe neutropenia. N. Engl. J. Med. 315, 547-551. 

P. falciparum malaria is a life-threatening emergency. Complications include hypoglycemia, acute renal failure, pulmonary edema, severe anemia (high parasitism), thrombocytopenia, heart failure, cerebral congestion, seizures, coma, and adult respiratory distress syndrome. 

Dyspnea (31%), pulmonary edema, and adult respiratory distress syndrome... 

F7. Fink, A., Geva, D Zung, A., Konichezky, S., Eliraz, A., and Bentwich, Z., Adult respiratory distress syndrome Roles of leukotriene, C4 and platelet activating factor. Crit. Care Med. 18, 905-910(1990). 

J6. Jebsen, S., Herlevsen, P., Knudsen, P Bud, M. I and Klausen, N. O., Antioxidant treatment with A/-acetylcysteine during adult respiratory distress syndrome A prospective randomized, placebo-controlled study. Cril. Care Med. 20,918-923 (1992). 

L5. Leff, J. A., Parsons, P. E., and Day, C. E Serum antioxidants as predictors of adult respiratory distress syndrome in patients with sepsis. Lancet 341,777-780 (1993). 

P14. Pohl, W., Kindas-Mugge, J., Kohn, H., Fitzal, S Micksche, M., and Kummer, F., Elevated heat shock protein 72 expression by human alveolar macrophages during the adult respiratory distress syndrome. Am. Rev. Respir. Dis. 147, A70(Abst) (1993). 

Damage to connective caused by leakage of elastases leads to damage associated with inflammatory diseases, such as pulmonary emphysema, adult respiratory distress syndrome, septic shock, cystic fibrosis, carcinogenesis, chronic bronchitis, and rheumatoid arthritis. Compounds that directly inhibit elastase or its release from human neutrophils are of enormous pharmaceutical and cosmetological interest in the development of new anti-inflammatory drugs. A possible source for elastase inhibitors are the medicinal Asteraceae and Droseraceae, particularly those used as traditional medicine in Asia. 

Suggested Alternatives for Differential Diagnosis Bronchitis, pneumonia, meningitis, gastroenteritis, septic shock, congestive heart failure and pulmonary edema, pleural effusion, costochondritis, prostatitis, adult respiratory distress syndrome (ARDS), HIV infection and AIDS, and Q fever. 

Commonly reported side effects include bone and muscle pain. Serious (sometimes life threatening) but rare side effects have included splenic rupture and adult respiratory distress syndrome. Neupogen is manufactured and marketed by Amgen Inc. 

Respiratory alkalosis secondary to hyperventilation is usually observed secondary to CNS stimulation of ventilatory centers as a result of trauma, sepsis, or shock. Lung auscultation may reveal crackles (pulmonary edema) or absence of breath sounds (pneumothorax, hemothorax). Chest roentgenogram can confirm early suspicions or disclose an undetected abnormality such as pneumonia (pulmonary infiltrates). Continued insult to the lungs may result in adult respiratory distress syndrome. 

However, it is now recognised that neutrophils can contribute to host-tissue damage if they are activated to secrete reactive oxidants and granule enzymes, and if the local concentrations of anti-oxidants and protease inhibitors within the tissue are low or defective. Thus, inappropriate neutrophil activation leading to host-tissue damage has been implicated in reperfusion injury, Crohn s disease, adult respiratory distress syndrome (ARDS) and rheumatoid arthritis. In these conditions, it is envisaged that neutrophils accumulate in tissues and become inappropriately activated to secrete their cytotoxic products, which then initiate or contribute to host-tissue damage. 

Failure to synthesise sufficient surfactant or the synthesis of abnormal surfactant, so that surface tension cannot be lowered, may play a role in several conditions respiratory distress syndrome of the newborn sudden infant death ( cot death ) and adult respiratory distress syndrome. The enzymes involved in the synthesis of surfactant only appear during the third trimester of pregnancy, so that surfactant is not produced in premature babies and they have difficulty breathing. 

ARDS 2% of patients were reported to have adult respiratory distress syndrome (ARDS) during clinical studies. 

AMS acute myocardial syndrome ANC absolute neutrophil count ANS autonomic nervous system APACHE Acute Physiologic and Chronic Health Evaluation ICU illness severity scoring system APAP acetaminophen [N-acetyl-p-aminof enol] aPTT activated partial thromboplastin time ARB angiotensin 11 receptor blocker ARDS adult respiratory distress syndrome... 

Death from adult respiratory distress syndrome was reported in one person who sprayed nickel with a metal arc process without wearing personal protective equipment (Rendall et al. 1994). Several days after the exposure, urinary concentrations of nickel were 700 pg/L, in comparison to levels of <0.1-13.3 pg/L in persons not occupationally exposed to nickel (Sunderman 1993). The death occurred 13 days after the 90-minute exposure to an estimated concentration of 382 mg nickel/m of principally metallic nickel with the majority of particle sizes less than 1.4 pm. Histological examination of the lungs revealed alveolar wall damage and edema in alveolar spaces, and in the kidneys marked tubular necrosis was noted. 

Bemacki et al. 1978 Torjussen and Andersen 1979). Although high levels of nickel were found in the urine of a man who died of adult respiratory distress syndrome 13 days after being exposed to a very high concentration of metallic nickel (Rendall et al. 1994), it is not clear if metallic nickel would be absorbed from healthy lungs. 

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