Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Systemic or topical treatment with antifungal agents are applied for the treatment of chronic pulmonary aspergillosis (fungus ball type, mural thickness type). Recently, the concomitant treatment with elastase inhibitor has been studied for the purpose of relieving tissue destruction by inhibiting elastase derived from aspergillus species. In the present study, we have examined the clinical effect of the topical treatment with Amphotericin B in patients with chronic pulmonary aspergillosis, and the concomitant use of Ulinastatin has also been examined in patients with symptoms such as hemosputum and hemoptysis. Amphotericin B was administered by transcatheter intracavity injection or transbronchial intrapulmonary injection. In some patients, inhalation was concomitantly employed. Amphotericin B was challenged by inhalation before starting the topical treatment, and if the patient experienced an asthma like attack, the present therapies were not conducted. Ulinastatin was administered by intravenous drip infusion concomitantly with antifungal agents and hemostatics. As a result, improvements regarding antifungal effects and clinical symptoms were found in 12 out of 15 patients treated with Amphotericin B. Further, early disappearance of hemosputum and hemoptysis was seen in 11 out of 23 episodes in 14 patients concomitantly treated with Ulinastatin. The treatment-related side effects, leading to discontinuation of those therapies, did not occur. Immunoresponse of allergy was studied in the patients ineligible for Amphotericin B topical treatment and the non-responders to Ulinastatin, and aspergillus specific IgE antibodies in serum were increased in the majority of patients. From the above results, it is desirable to carry out the topical treatment in chronic pulmonary aspergillosis. Also, it was considered valuable to apply the concomitant treatment with Ulinastatin, elastase inhibitor, to patients with severe clinical symptoms of hemosputum and hemoptysis.
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PMID:[Treatment of chronic pulmonary aspergillosis (fungus ball type, mural thickness type)]. 907 Oct 95

We studied the clinical features of 59 chronic pulmonary aspergillosis cases (aspergilloma, chronic necrotizing pulmonary aspergillosis) which we experienced in our hospital. To diagnose this disease, X-rays, sputum culture and serologic tests were mainly examined, X-ray findings were a fungus ball type in 47% of cases and thickened wall of a cavity type in 32%. Positive sputum culture found was A. fumigatus 78%, A. niger 13% and A. flavus 2%. Positive rates of serologic tests showed precipitating antibody 81% and antigen 11%; 39% of beta-D glucan exceeded the reference value. As clinical symptoms, bloody sputum and hemoptysis were found at high frequency. Antifungal agents were administered intravenously or topically for treatment, primarily AMPH-B, ITCZ and MCFG. As adjuvant therapy, we administered Ulinastatin which is an elastase inhibitor for use against hemoptysis, and we performed steroid combination for cases considered to be associated with allergy. In all of 6 cases of chronic necrotizing pulmonary aspergillosis which were administered MCFG, X-ray findings improved. A pathogenic factor, elastase was isolated from Aspergillus spp., and we also found the elastase inhibitor from this series. Five of 12 strains of A. fumigatus, and one of 2 strains of A. flavus expressed elastase inhibitory activity when we screened for the culture supernatant of various Aspergillus spp. of a clinical isolate. Elastase inhibitory activity from A. niger was very weak. Culture supernatants from 5 strains of A. fumigatus and one strain of A. flavus were stable for a fever, and human leucocyte elastase was inhibited, but these did not inhibit porcine pancreas elastase. We are aiming at clinical application and plan to continue further study.
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PMID:[Clinical analysis of chronic pulmonary aspergillosis and discovery of an elastase inhibitor]. 1694 Sep 51