Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006271 (bronchiolitis)
 5,174 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lung transplantation results in dramatic improvement in pulmonary function which allows the patients to resume a normal lifestyle. When the lung allograft is free of infection and rejection, lung volumes and gas exchange are within normal limits after heart-lung and double lung transplantation, both at rest and during exercise. After single lung transplantation, lung volumes remain below predicted values and some patients show mild oxygen desaturation with exercise. Infection, acute rejection, and chronic rejection (bronchiolitis obliterans) produce an obstructive ventilatory defect. In addition, there is a bronchial hyperreactivity to cholinergic stimulation; this hyperreactivity might be related to airway denervation and upregulation of muscarinic receptors or might be triggered by the bronchial inflammation induced by rejection. Control of breathing is normal at rest, during exercise, in response to CO2 rebreathing, and during sleep. This indicates that pulmonary afferents play a negligible role in the control of breathing in adult humans. Most transplanted patients show a significant reduction in maximum oxygen consumption and have an early anaerobiosis during exercise; this response may be accounted for, at least in part, by a persistent state of physical deconditioning, and by an inadequate adaptation of cardiac output in heart-lung transplant recipients.
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PMID:[Functional respiratory physiology and physiopathology of lung transplant patients]. 901 12

Respiratory syncytial virus (RSV) bronchiolitis in infancy is known to be followed by chronic respiratory symptoms and airway hyperresponsiveness in a subgroup of patients. To further investigate the pathogenesis of RSV-induced chronic airway pathology, we infected young guinea-pigs at 4 weeks of age with RSV applied as an aerosol (n=30), and control guinea-pigs with virus-free culture medium (n=24). Infection was confirmed by positive antibody titre to RSV after 6 weeks, and by typical pathological changes of bronchiolitis after 1 week in six animals from each group. Airway hyperresponsiveness was measured weekly for 5 weeks by histamine challenge, using body-plethysmographic measurement of compressed air (CA). The provocative concentration of histamine producing significant airway obstruction (i.e. CA = 0.1 mL) (PC0.1 mL CA in mg x mL(-1)) was calculated from dose-response curves. Six weeks postinfection, the lungs were investigated for the presence of inflammation and of viral antigen by immunofluorescence and immunohistochemistry using a rabbit hyperimmune serum and monoclonal antibodies. Airway responsiveness was increased in the RSV group 1 week postinfection compared to the control group (PC0.1 mL CA median 2.50 vs >10 mg x mL(-1); p<0.001) and this persisted up to 5 weeks postinfection (PC0.1 mL CA median 1.61 vs >10 mg x mL(-1); p<0.001). During the same period, viral antigen persisted in the lungs of infected animals, although there was less inflammation at 6 weeks postinfection than at 1 week postinfection. In guinea-pigs, respiratory syncytial virus infection of the airways causes persistent airway hyperresponsiveness over a period of at least 5 weeks. During this time, viral antigen, but not inflammation, remains detectable in the lungs and might be responsible for ongoing airway hyperresponsiveness.
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PMID:Persistence of airway hyperresponsiveness and viral antigen following respiratory syncytial virus bronchiolitis in young guinea-pigs. 907 98

The role of Mycoplasma pneumoniae and viruses in the various clinical presentations of acute respiratory-tract infection (ARTI) was studied in Saudi children seen at King Khalid University Hospital (KKUH) between January 1995 and January 1996. The study population comprised 511 children (age < 14 years) of both sexes. Nasopharyngeal aspirates (NPA) and acute-phase sera were collected. Convalescent sera were only available from 334 of the patients (with an interval of 15-42 days between collection of the acute and corresponding convalescent sera). Respiratory syncytial virus (RSV) was the most commonly detected virus, found in 69% of patients. Mycoplasma pneumoniae, found in 9% of the patients, appeared to be the second most common causative agent (this is the first time the prevalence of this agent in ARTI among Saudi children has been studied), followed by influenza A virus (present in 8% of the patients). RSV was highly prevalent during the colder months (October-April), with a peak in January-February, whereas there was little seasonal fluctuation in the prevalence of M. pneumoniae. Although most (60%) of the M. pneumoniae infections were in patients aged > 60 months, RSV was detected in 22% of the patients aged 1-5 months of age and only in 6% of those aged > 60 months. Infection with M. pneumoniae was found mainly in children with broncho-pneumonia (12 cases) and lobar pneumonia (three cases). Most of those infected with RSV had bronchiolitis (53 cases), followed by broncho-pneumonia (24 cases) and bronchial asthma (20 cases). As their prevalences were low, it was difficult to draw any conclusions about possible associations between the other viral agents encountered (influenza, para-influenza and adenovirus) and clinical disease.
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PMID:Role of Mycoplasma pneumoniae in acute respiratory-tract infections in Saudi paediatric patients. 979 33

Patients with compromised immune function suffer a wide variety of lung insults. Infections are the most common causes of both acute and chronic lung diseases, but many noninfectious conditions affect the lungs. The clinical presentation of these noninfectious conditions often mimic infections, thus causing diagnostic dilemmas. The spectrum of noninfectious lung injury and response in the immunosuppressed host includes interstitial edema, interstitial fibrosis, diffuse idiopathic pneumonia, acute respiratory distress syndrome, and obliterative bronchiolitis. Alveolar hemorrhage may complicate any of these conditions. Lung injury in the immunosuppressed host is associated with a diversity of etiologies: sepsis, irradiation, graft rejection, reperfusion injury, graft-versus-host disease, and chemotherapeutic agents and other drug reactions. These injuries most often present as diffuse pulmonary infiltrates on chest radiograph. Establishing a specific diagnosis and etiology for the injury is often problematic. From a pragmatic standpoint, excluding the possibility of infection is the principal aim of diagnostic testing.
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PMID:Noninfectious lung disease in the immunocompromised host. 1051 34

Lung transplantation has become an accepted treatment for end-stage pulmonary parenchymal and vascular diseases. Infections still are the most common cause of early and late morbidity and mortality in lung transplant recipients. Bacterial infections comprise approximately half of all infectious complications. Cytomegalovirus (CMV) infections and disease have become less frequent, because of prophylaxis with ganciclovir. Because CMV is also involved in the pathogenesis of obliterative bronchiolitis, the frequency of this infection may also reduce the occurrence of this main obstacle to successful lung transplantation. Invasive fungal infections remain a problem, but they have also decreased in frequency because of better control of risk factors such as CMV disease and preemptive antifungal therapy. Nonherpes respiratory viral infections have emerged as a serious problem. Their severity may be reduced by treatment with ribavirin. Meticulous postoperative surveillance, however, is still crucial for the management of lung transplant patients with respect to early detection and treatment of rejection and infection.
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PMID:Epidemiology and management of infections after lung transplantation. 1138 24

Infectious complications are frequent following lung transplantation. Tracheobronchial aspergillosis is the predominant fungal infection in these patients. Infections with Scedosporium apiospermium (Pseudoallescheria boydii) and Scedosporium prolificans (Scedosporium inflatum) have mainly been described in bone marrow transplant recipients and only occasionally in solid organ transplant recipients. We analysed risk factors, the clinical course and outcome of seven lung transplant recipients who developed pulmonary scedosporium infection. Scedosporium apiospermium was documented in bronchoalveolar lavage (BAL) of all seven and Scedosporium prolificans in the BAL of four of these patients. Scedosporium was detected 9-58 months after transplantation. Five of the seven patients had been treated for several months with itraconazole because of previous detection of aspergillus in BAL. All seven patients with scedosporium infection showed airway problems, including early ischemic airway stenosis in one and bronchiolitis obliterans syndrome in the other six patients. Combined treatment with itraconazole and fluconazole was not able to eradicate scedosporium. Four of the seven patients died with advanced bronchiolitis obliterans 3-35 months after the diagnosis of pulmonary scedosporium infection. Three patients are currently alive 3, 6 and 7 years after transplantation, showing persistent scedosporium infection. In conclusion, pulmonary scedosporium infection was seen in lung transplant recipients with structurally abnormal airways and under long-term therapy with itraconazole. Eradication of scedosporium proved difficult, but under combined treatment with itraconazole and fluconazole this opportunistic infection did not disseminate.
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PMID:Pulmonary scedosporium infection following lung transplantation. 1184 50

The aim of this study was to present neurological complications of influenza infections. Infections caused by influenza viruses can be very serious and may lead even to death resulted from the post-infectious complications. The most often occurring complications are pneumonia, bronchitis, bronchiolitis, myocarditis and otitis media. The other group is neurological post-influenza complications, including dementia, epileptic disorders, cerebrovascular disease, febrile convulsions, toxic encephalopathy, encephalitis, meningitis, subarachnoid hemorrhages, lethargic encephalitis, psychosis or increase in the number of cases of Parkinson's disease. The first way of prevention of influenza is vaccination that results in healthy, social and economic benefits.
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PMID:[Neurological complication of influenza infections]. 1219 26

The 2 groups of human coronaviruses (HCoVs) represented by the prototype strains HCoV 229E and HCoV OC43 are mostly known as viruses responsible for common cold syndrome. HCoVs are difficult to detect, and epidemiological data are rare. From October 2000 through April 2001, we tested 1803 respiratory samples for HCoV by reverse-transcriptase polymerase chain reaction. From 8 February through 27 March 2001, HCoV OC43 was detected in samples obtained from 30 (6%) of 501 patients. The other viruses detected were respiratory syncytial virus (6.1%), parainfluenza virus 3 (1%), influenza virus A (7.8%), influenza virus B (7.2%), rhinovirus (6.4%), enterovirus (1%), and adenovirus (2%). Infection with HCoV OC43 was detected in patients of all age groups. The following clinical symptoms were noted: fever (in 59.8% of patients), general symptoms (in 30%), digestive problems (in 56.8%), rhinitis (in 36.6%), pharyngitis (in 30%), laryngitis (in 3.3%), otitis (in 13.3%), bronchitis (in 16.6%), bronchiolitis (in 10%), and pneumonia (in 6.6%). This study shows that an outbreak of HCoV OC43 respiratory infection was responsible for the lower respiratory tract symptoms observed in nearly one-third of patients identified by active surveillance for coronavirus infection.
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PMID:An outbreak of coronavirus OC43 respiratory infection in Normandy, France. 1268 10

Intranasal infection of BALB/c mice with respiratory syncytial virus (RSV)-A2 (0.5 x 10(8) - 2.0 x 10(8) plaque-forming units, PFU) produced disease characterized by weight loss (2-3 g) and mortality (60%-100%) with the mean day of death ranging from 6-7 d after infection. The extent of RSV disease was inoculum titer-dependent and required a replication competent virus. Lung titers of virus peaked at 0.5-1 x 10(6) PFU/g wet weight. Bronchoalveolar lavage fluid (BALF) levels of IL-1beta, TNF-alpha, INF-gamma IL-12, IL-6, MIP-1alpha, RANTES, and protein were elevated, whereas IL-2, IL-4, IL-5, IL-13, and IL-10 were unchanged. Histological assessment of lungs revealed marked inflammatory pathology characterized by bronchiolitis, vasculitis, and interstitial pneumonia. Whole-body plethysmography revealed significant disease-associated deficits of respiratory function. Therapy with ribavirin administered either by the intranasal, subcutaneous, or oral route significantly reduced disease in a dose-dependent manner. Delaying the initiation of therapy resulted in a loss of activity for ribavirin. Synagis administered either intramuscularly as a single dose in prophylaxis or intranasally in prophylaxis, followed by therapy, also significantly reduced disease in a dose-dependent manner. Infection of mice with a high titer inoculum of RSV-A2 resulted in severe and fatal pulmonary disease that was responsive to treatment. This model may be useful to characterize the in vivo activity of experimental therapies for RSV infection.
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PMID:Primary infection of mice with high titer inoculum respiratory syncytial virus: characterization and response to antiviral therapy. 1579 Dec 94

While bronchiolitis obliterans organizing pneumonia (BOOP) has been associated with the use of sirolimus (SIR), the incidence in a consecutive group of patients given SIR to replace a calcineurin-inhibitor (CI) is unknown. Twenty-nine consecutive cardiac transplant recipients were switched from a CI to SIR to ameliorate CI-associated nephropathy or coronary graft atherosclerosis. Seven patients (24%) developed BOOP. The clinical characteristics and biopsy results of these patients are presented. The clinical course and response to withdrawal of SIR in all and steroids in four of seven patients suggested the diagnosis of BOOP. Chest X-rays and CT scans showed typical findings of BOOP in all seven patients. Infection was excluded in all patients. Biopsy results were characteristic of BOOP in six of seven patients. Six patients recovered and one died. BOOP is a common and potentially serious adverse event in cardiac transplant patients switched from a CI to SIR, especially when SIR is started late post-transplantation.
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PMID:BOOP is common in cardiac transplant recipients switched from a calcineurin inhibitor to sirolimus. 1588 46


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