Pulmonary fibrosis Subject

Identification of the molecular and cellular responses leading to the progressive development of asbestos-induced lung cancer, mesothelioma, pulmonary fibrosis, and pleural thickening and effusion has been the subject of extensive research within the past two decades. Published reviews of this work include those by Begin et al. (1992), Kamp and Weitzman (1997, 1999), Kamp et al. (1992), Luster and Simeonova (1998), Mossman and Churg (1998), Mossman et al. (1983, 1996), Rom et al. (1991), and Tanaka et al. (1998). 

The evolution of the disease does not depend on age or sex but mostly on the sensitivity of the subjects. Symptoms appear after a more or less important period (1 month to more than 28 years). Tungsten carbide pneumoconiosis is characterized by a two-step evolution the first respiratory irritative syndrome is followed, usually after 1 -15 years, by a pulmonary fibrosis that can lead, if not treated in time, to respiratory failure and death after 1-5 years. 

All organophosphates recommended as pesticides are subjected to screening for delayed neurotoxicity through research into their influence on neurotoxic esterase, as well as in direct experiments on hens. Enough data have been collected to show pesticides as potential producers of various delayed adverse effects, which may be irreversible or somewhat reversible (atherosclerosis, hepatocirrhosis, pulmonary fibrosis, demyelinization of nerve trunks). These effects should be projected and considered in human health assessments of pesticides. 

Of all the idiopathic interstitial pneumonias, usual interstitial pneumonia (UIP) [corresponding to the clinical entity of idiopathic pulmonary fibrosis (IPF)j, is the most common (Travis et al. 2002). Review of previous reports indicate the high prevalence smoking in patients with cryptogenic fibrosing alveolitis 74% of the 220 subjects reported by Turner-... 

F. Role in therapy Pulmozyme is a mucolytic enzyme used in the treatment of cystic hbrosis. Although it is not a cure, domase alfa is an effective mucolytic for adjunctive treatment. AU compliant patients with cystic fibrosis, irrespective of disease severity, who produce purulent sputum are potential candidates for Pulmozyme therapy. It is useful for liquefying the thick mucus secreted by cystic fibrosis patients, and causes both objective improvement (as measured by pulmonary function testing) and subjective symptomatic improvement. Pulmozyme reduces the frequency of respiratory infections requiring parenteral antibiotics and improves pulmonary function. 

Anderson et al. (113) administered 70-cm boluses of l-pm monodisperse particles to 11 normal volunteers and 11 patients with cystic fibrosis. In measuring the spreading of the bolus at expiration and particle deposition, they found that bolus spreading and particle deposition were increased in the CF patients compared to the normal subjects. Among the patients with CF, pulmonary function parameters indicating obstruction (i.e., FEVj/FVC ratios expressed as a percent of predicted) were significantly correlated with spreading and aerosol deposition. 

Studies of BAL and sputum have provided important insights into the early development of pulmonary inflammation in cystic fibrosis and, in particular, the role of the CFTR in promoting inflammation. However, the data have to be interpreted with caution. On the one hand, the findings could be interpreted as evidence that the airway environment in cystic fibrosis is able to support or induce a neutrophil-dominated inflammatory response in the absence of airway infection. Alternatively, the data could be interpreted as evidence that early pulmonary inflammation is a consequence of an abnormal response to exogenous stimuli within the airways resulting in a potentiation of responses that, by themselves, would not result in inflammation in normal subjects. Obviously, this could include augmented inflammatory responses to airway bacteria that might not induce an overt inflammatory response in the airways of a normal individual, but could include other noninfectious injurious events. 

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