RESUMEN
BACKGROUND: Asthmatic children present variable degrees of airway inflammation, remodeling, and resistance, which correlate with disease control and severity. The chronic inflammatory process of the airway triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. OBJECTIVE: To investigate whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present a correlation with the resistance of the respiratory system and of the proximal and distal airways. METHODS: 39 Asthmatic children (persistent mild and moderate) and 39 non-asthmatic children (both between 6 and 13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, and pulmonary and systemic immune responses. RESULTS: Asthmatic children showed an increased number of blood eosinophils (p < 0.04), basophils (p < 0.04), monocytes (p < 0.002) and lymphocytes (p < 0.03). In addition, asthmatic children showed impaired lung function, as demonstrated by FEV1 (p < 0.0005) and FEV1/FVC (p < 0.004), decreased total resistance of the respiratory system (R5Hz; p < 0.009), increased resistance of the proximal airways (R20Hz; p < 0.02), increased elastance (Z5Hz; p < 0.02) and increased reactance (X5Hz; p < 0.002) compared to non-asthmatic children. Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p < 0.0001) and in the serum (p < 0.0001); TGF-beta in the BC (p < 0.0001) and in the serum (p < 0.004); IL-5 in the BC (p < 0.02) and in the serum (p < 0.01); IL-4 in the serum (p < 0.0002). CONCLUSIONS: Impulse oscillometry is a sensitive method to detect airway resistance in persistent mild and moderate asthmatic children, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.
Asunto(s)
Remodelación de las Vías Aéreas (Respiratorias) , Resistencia de las Vías Respiratorias , Asma , Humanos , Asma/fisiopatología , Asma/inmunología , Niño , Remodelación de las Vías Aéreas (Respiratorias)/fisiología , Femenino , Masculino , Adolescente , Resistencia de las Vías Respiratorias/fisiología , Pruebas de Función Respiratoria , Citocinas/sangreRESUMEN
BACKGROUND: Alterations of the circadian rhythm negatively impact several aspects of the health, including the lung function. Chronic shiftwork scale classically induces alterations in the circadian rhythm. However, its effects on pulmonary immune response are unknown. AIMS: To evaluate the impact of chronic alteration of circadian rhythm on pulmonary function and immune response. METHODS: In this context, a 12 × 24 hours and 12 × 48 hours work scale in shiftwork scale policemen (n = 25; 38.73 ± 6.92 years old) were compared with fixed work scale (8 h/d) civil men (n = 25; 34.00 ± 9.60 years old) who were evaluated for perceived stress, sleepiness, physical activity levels, anthropometric characteristics, lung function, pulmonary and systemic cellular and humoral immune response. RESULTS: Policemen presented increased levels of perceived stress (P < .0008), impaired sleepiness (P < .04) and lung function as demonstrated by reduced forced vital capacity (FVC) (P < .053) and FEV1 (P < .043) when compared with civil men. In addition, increased levels of exhaled nitric oxide (P < .037) and of IL-2 (P < .0046) in the breath condensate revealed that policemen presented chronic lung inflammation compared with civil men. Although the whole blood analysis did not showed any differences between the two groups concerning the number of leucocytes, the humoral response revealed that policemen presented increased levels of IL-2 (P < .002) and lower levels of IL-10 (P < .001), clearly displaying a clinical status of low-grade inflammation. CONCLUSIONS: Chronic alteration of circadian rhythm in shiftwork scale policemen results in impaired lung function, beyond to impair pulmonary and systemic immune function.