Zhang Zhenxiang

The change of interleukin-6 and tumor necrosis factor in patients with obstructive sleep apnea syndrome.

SummaryThe levels of lipopolysaccharide (LPS)-induced interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-α) expression in culture of peripheral blood mononuclear cells (PBMC) and the plasma levels of IL-6 and TNF-α in the patients with obstructive sleep apnea syndrome (OSAS) were measured and the relationship between OSAS and IL-6 or TNF-α expression studied. Both IL-6 and TNF-α were detected by using ELISA in 22 patients with OSAS and 16 normal controls. The levels of LPS-induced IL-6 (787.82±151.97 pg/ml) and TNF-α (4165.45±1501.43 pg/ml) expression in the supernatant of the culture of PBMC and plasma level of IL-6 (50.67±4.70 pg/ml) and TNF-α (299.09±43.57 pg/ml) in the patients with OSAS were significantly higher than those in the normal controls (in the supernatant of the culture of PBMC: 562.69±197.54 pg/ml and 1596.25±403.08 pg/ml respectively; in the plasma; 12.69±2.75 pg/ml and 101.88±21.27 pg/ml respectively). There were significantly positive correlation between the levels of IL-6 and TNF-α and the percentage of time of apnea and hyponea, as well as the percentage of time spending at SaO2 below 90 % in the total sleep time. It was concluded that LPS-induced IL-6 and TNF-α levels as well as plasma IL-6 and TNF-α levels in the patients with OSAS were up-regulated, which may be associated with the pathogenesis of OSAS.

The Diagnosis Value and Its Implication of Impulse Oscillometry in Obstructive Sleep Apnea Syndrome Patients

SummaryThe change of measurements of impulse oscillometry (IOS) in obstructive sleep apnea syndrome (OSAS) patients and its mechanism were observed. The respiratory impedance was measured by using IOS technique and polysomnography (PSG) was monitored synchronously in 36 OSAS patients, 14 patients with chronic obstructive pulmonary disease (COPD) and 12 normal controls. Results showed that R20 in OSAS group was significantly higher than in COPD group and control group (P < 0. 01). R5-R20 in OSAS group was lower than that in COPD group, but significantly higher than that in control group (P< 0. 01). The levels of R20 and R5-R20 were positively correlated with severity degree of the disease. In addition, apnea-hyponea index (AHI) was positively correlated with R5 and R20 with the correlation index (r)being 0. 66 and 0. 86 respectively. The lowest SO2 was negatively correlated with R5 and R5-R20, with r being -0. 66 and -0. 79 respectively. The mean SO2 was negatively correlated with R5 and R5-R20 with r being -0. 81 and -0. 69 respectively. IOS technique could be used as a valuable tool for assessing the degree of upper airway obstruction in the patients with OSAS, and could help to explore its pathological mechanism.

Effects of theophylline on plasma levels of interleukin-4, cyclic nucleotides and pulmonary functions in patients with chronic obstructive pulmonary disease

SummaryIn order to measure the plasma levels of interleukin-4 (IL-4). cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in patients with chronic obstructive pulmonary disease (COPD) and observe the effects of oral theophylline on them, we divided 28 COPD patients into COPD experimental group and COPD control group. Plasma levels of IL-4, cAMP and cGMP as well as parameters of pulmonary function tests were measured in these 2 groups before and after 2 weeks of treatment with oral theophylline (Protheo, 400 mg, qd) or placebo. Plasma levels of IL-4 and cGMP were significantly elevated in patients with COPD as compared with normal controls (P< 0. 05), while cAMP and cAMP/cGMP were significantly lower than those in controls (P < 0. 01). Plasma level of IL-4 was inversely correlated with forced expiratory volume at the first second (FEV1) and with maximum expiratory flow rate at 50 % of forced vital capacity (V50) (bothr= −0.46,P< 0.05) while it was directly correlated with the scores of the clinical manifestations (r=0.57,P< 0.05) in COPD patients. Two weeks after treatment with theophylline, IL-4 and cGMP in COPD experimental group were decreased significantly while cAMP and cAMP/ cGMP increased significantly (P< 0. 05). The change of IL-4 was inversely correlated with the changes of FEV1, and V50(r=−0.53 and -0.54, respectively,P< 0. 05). Two weeks after placebo treatment, the COPD control group did not show such changes. We are led to conclude that IL-4 might play a role in the pathogenesis of the airway inflammation and air flow limitation in COPD patients and the mechanisms of theophylline’s therapeutic efrects of attenuating air-flow limitation may partially depend on its anti-inflammatory effects on the airways which, in turn, is dependent on its inhibitory effects on some inflammatory mediators such as IL-4.

The Effect of Astragapolysaccharide on the Lymphocyte Proliferation and Airway Inflammation in Sensitized Mice

SummaryIn order to investigate the regulating role of Astragapolysaccharide (APS) in the mice model of asthmatic airway inflammation, the airway eosinophil number, spleen T lymphocyte proliferation, level of IL-2 production and their relationships were studied in sensitized mice and sensitized mice treated with different concentrations of APS. The results showed that the number of eosinophils as well as lymphocytes in the airway of the sensitized animals were significantly increased, and a marked positive correlation between the inflammation cells and spleen T lymphocyte proliferation was found. Moreover, there was a positive correlation between inflammation cells and the level of IL-2 production. The APS of given dosage could significantly reduce the number of eosinophils in the airway of the sensitized animals. At the same time the level of IL-2 secreted by spleen T lymphocytes stimulated with ConA was also significantly decreased and there was a marked positive correlation between them. Our results suggested that APS of given dosage could prevent antigen-induced the number of eosinophils infiltrating into the airway of sensitized mice and inhibit the proliferation and activation of lymphocyte and IL- 2 production. Through its immuno-regulating effect, APS can be helpful in the treatment of asthma.

The regulating effects of protein kinase C on the tone of guinea-pig trachea and human lobus bronchi.

SummaryThe regulating effects of protein kinase C (PKC) on the tone of guinea-pig trachea and human lobus bronchi were investigated by measuring the tone of isolated tracheal and bronchial strips. The effects of PKC on the tone of guinea-pig tracheal and human lobus bronchi were observed and compared. The results showed that: (1) PKC activator PMA induced concentration-dependent relaxation in guinea-pig isolated trachea strips. This relaxation was completely ablated by the pretreatment with 5 × 10t-6mol/L Ro31-8220 which is a PKC-specific inhibitor, but was not affected by the removal of epithelium (EP), or by the pretreatment with propranolol (β-receptor blocker) or atropin (M-receptor blocker); (2) PMA led to concentration-dependent contraction in human lobus bronchi. This contractile response was completely depressed by the pretreatment with 5 × 10t-6 mol/L Ro31-8220 and was partly inhibited by 1 × 10t-5 mol/L isoptin (Ca2+-antagonist). but was not significantly affected by propranolol or atropin. It is concluded that PKC is involved in the regulation of airway smooth muscle tone. The regulating effects may vary in different animals.

Effects of intrinsic nitric oxide on the expression of interleukin-4 and IFN-γ mRNA in the bronchial and lung tissues of sensitized rats

SummaryTo investigate the effects of intrinsic nitric oxide (NO) on the expression of interleukin-4 (IL-4) mRNA and interferon-γ (IFN-γ) mRNA in the airway inflammation of asthma, the rat models of asthmatic inflammaiton were established by sensitizing and then challenging the animals with ovalbumin. The 24 animals were randomly divided into control group, sensitized group, sensitized and L-Arg-treated group as well as L-NAME-treated group equally. By using in situ hybridization combined with compute physiological quantitative imaging analysis techniques, the influence of intrinsic NO on the expression of IL-4 mRNA and IFN-γ mRNA in the airway inflammatory cells was observed. In situ hybridization study demonstrated that IL-4 mRNA expression was obviously increased as compared with that in the control group, mainly distributed in the inflammatory cells in the submucous of airways in the sensitized group. The increase of intensity of IL-4 mRNA expression was positively correlated with the numbers of eosinophil (Eos) and lymphocyte (both with P < 0.05) in the sensitized group. There was no statistically difference in IFN-γ expression between the control group and the sensitized group. Imaging analysis showed that L-NAME could inhibit the expression of IL-4 mRNA (P < 0.05) and increase the expression of IFN-γ mRNA (P < 0.05), while L-Arg could increase the expression of IL-4 mRNA in inflammatory cells (P < 0.05). It was indicated that a suitable levels of intrinsic NO can influence the expression of IL-4 mRNA of Th2 lymphocytes and the expression of IFN-γ mRNA of Thl lymphocytes and in turn, promote the development of asthmatic airway inflammation.

A comparative study of the influences of pulmonary arterial pressure and pulmonary capillary wedge pressure on impedance rheopneumogram in patients with three different diseases

SummaryIn the present study right heart catheterization and impedance rheopneumogram examinations were performed simultaneously on 21 patients suffering from congenital cardiovascular diseases with atrial or ventricular septal defect accompanied by the left to right shunt (CCD) and 17 patients suffering from rheumatic valvular disease with mitral stenosis (MS) in order to investigate the differences in the impedance rheopneumogram parameters between CCD patients and patients with chronic obstructive pulmonary disease (COPD) as well as between MS and COPD patients. The results showed that when patients with different diseases had the same level of pulmonary arterial pressure, CCD patients had significantly higher Hs than COPD patients, while MS patients had significantly higher Hd/Hs ratio than COPD patients and CCD patients. The linear regressional equation between Hd/Hs ratio and pulmonary capillary wedge pressure (PCWP) was as follows: PCWP(kPa) = 0.17+0.98 × Hd/Hs (n = 155,Y = 0.422,P< 0.001). These results suggest that, (1) impedance rheopneumographic regressional equations with Hs as one of the major variables suitable for predicting secondary pulmonary hypertension in COPD patients are not suitable for use on CCD patients, (2) Hd/Hs ratio is useful in clinical work as an index for differential diagnosis between MS and Cor Pulmonale, and (3) PCWP can be roughly and noninvasively measured based on the measurement of impedance rheopneumogram parameter Hd/Hs.

Noninvasive quantitative diagnosis of pulmonary artery hypertension with impedance rheopneumogram in patients with chronic obstructive pulmonary disease

SummaryIn order to evaluate the value of impedance rheopneumogram (IRP) in predicting pulmonary arterial pressure (PAP) and pulmonary arterial hypertension (PAH) noninvasively and quantitatively, 150 patients with chronic obstructive pulmonary disease (COPD) were examined by IRP and right heart catheterization simultaneously. It was found that some parameters derived from IRP correlated well with PAP, the strongest correlation being demonstrated by Q-B/B-Y ratio (γ = 0.74,P<0.001) and Hs (γ = −0.56,P<0.001). We made a multi-stepwise regressional analysis and, obtained an equation to predict PAP from IRP parameters: PAP (kPa) = [−2.26−5.05xlnHs+27.02 × (Q-B/B-Y)] × 0.133 (γ = 0.78,P<0.001) Other 30 COPD patients were selected to assess the effectiveness of the equation, We found that the sensitivity and specificity of the equation in identifying PAH were 83% and 93% respectively.