Airway inflamation

Aerosolised medicines have been used for centuries to treat respiratory diseases, with inhalation therapy for the airways focused primarily on the treatment of asthma and chronic obstructive pulmonary disease (COPD). The development of new products for delivery to the lungs for these respiratory diseases includes new steroids and beta agonists plus combination products featuring both agents. New classes of anti-asthma medication are also being developed for inhalation with the aim of delivering them directly to the inflamed airways. 

Inflamed limg tissue (hypersensitivity pneumonitis, HP), complete obliteration of a large proportion of the airways (severe BO), and damage to the air sacs (emphysema) will reduce the DLco measurement. 

One of the major toxicity issues in cannabis consumption relates to the fact that it is most often smoked. Cannabis and tobacco smoke, apart from having different psychoactive constituents, are actually very similar in their composition (Hoffman et ai. 1975). Cannabis smoke is mutagenic, which gives it carcinogenic potential (Nahas and Latour 1992). Although no specific reports of lung cancer or emphysema from cannabis smoke exist, it is at least as harmful as tobacco smoke, containing three times as much tar and five times as much carbon monoxide (Wu et al. 1988). Cannabis smoke inflames the airways and reduces respiratory capacity. Airway obstruction and squamous metaplasias may also occur. 

Pro and Anti-inflammatory Functions of Adenosine A3 Receptor in the Inflamed Airway (Table 11.1)... 

Macropht e-Dendritic Cell Emulation of T Cell Function(s) in Inflamed Lunpf and Airway Tissues... 

Ohno, I., Lea, RG., Flanders, K.C., Clark, D.A., Banwatt, D., Dolovich, J., Denburg, J., Harley, C.B., Gauldie, J. and Jor-dana, M. (1992). Eosinophils in chronically inflamed human upper airway tissues express transforming growth factor beta 1 gene (TGF beta 1). J. Clin. Invest. 89, 1662-1668. 

Airways inflammation has been demonstrated in all forms of asthma, and an association between the extent of inflammation and the clinical severity of asthma has been demonstrated in selected studies. It is accepted that both central and peripheral airways are inflamed. 

To assess the effect of macrolide antibiotics on IL-8 production by inflamed airway epithelium, bronchial epithelial cells were obtained from 10 patients (3 with DPB, 5 with sinobronchial syndrome, 1 with nonatopic asthma associated with chronic sinusitis, and 1 with diffuse bronchiectasis, mean age of 54.8, all were non-or ex-smokers) under fiber optic bronchoscopy as previously reported [64, 65]. Spontaneous IL-8 release by airway epithelial cells from inflamed airways was significantly suppressed with the addition of EM and CAM, but not with ABPC in vitro [60]. Khair et al. [19] reported that EM inhibited release of IL-8 as well as of IL-6 from H. influenzae endotoxin-stimulated normal bronchial epithelial cells. 

Takizawa H., Ohtoshi, T., Kawasaki, S., Kohyama, T., Sato, M., Tanaka, M., Kasama, T., Kobayashi, K., Nakajima, J., and Ito, K. (1997). Erythromycin modulates IL-8 expression in human bronchial epithelial cells Studies with normal and inflamed airway epithelium. Am. J. Respir. Crit. Care Med. 156, 266-271. 

Other subtypes of Na+ channels such as the tetrodotoxin (TTX)-resistant Na+ channels are also expressed by airway afferent nerves. Capsaicin-sensitive neurones are sensitized by inflammatory mediators, such as PGE2, an effect partly mediated by an increase in TTX-resistant Na+ currents (Kwong and Lee 2005). These neurones are inactivated in the normal airways, but are recruited in inflamed airways to contribute to cough sensitization (Mazzone et al. 2005). Therefore, selective inhibitors of TTX-resistant Na+ channels may be useful as cough suppressants in chronic cough. 

Ozone (O3), a major constituent of smog, is a health hazard at ground level— it inflames the airways, worsens lung ailments, and increases the risk of death from heart or lung disease. In the stratosphere, however, a layer of ozone shields the Earih from harmful solar radiation, with the greatest concentrations lying between 12 and 15 miles above the Earth s surface. 

Truong-Tran, A. Q. Grosser, D. Ruffin, R. E. Apoptosis in the normal and inflamed airway epithelium role of zinc in epithelial protection and procaspase-3 regulation. Biochem. Pharmacol. 2003, 66, 1459-1468. 

Choking agents Chlorine characteristic Phosgene hay/mown grass Chlorine rapid onset mild (more severe over hours Phosgene 1-24 h Sore throat/painful eyes throat/chest tightness dyspnoea wheeze Laryngeal oedema/inflamed throat pulmonary oedema Upper airway sepsis... 

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