Modification by antioxidant supplementation of changes in human lung function associated with air pollutant exposure: A systematic review.

BMC Public Health. 2011 Jul 5;11(1):532

Authors: Tashakkor AY, Chow KS, Carlsten C

ABSTRACT: BACKGROUND: Outdoor air pollution, given its demonstrated negative effects on the respiratory system, is a growing public health concern worldwide, particularly in urban cities. Human exposure to pollutants such as ozone, nitrogen oxides, combustion-related particulate matter and oxides of sulfur is responsible for significant cardiopulmonary morbidity and mortality in both adults and children. Several antioxidants have shown an ability to partially attenuate the negative physiological and functional impacts of air pollutants. This study systematically presents current data on the potential benefits of antioxidant supplementation on lung function outcomes associated with air pollutant exposures in intact humans. METHODS: Electronic databases (MEDLINE, EMBASE, BIOSIS Previews, Web of Sciences, Environmental Sciences & Pollution Management and TOXNET) were systematically searched for all studies published up to April 2009. Search terms relating to the concepts of respiratory tract diseases, respiratory function tests, air pollution, and antioxidants were used. Data was systematically abstracted from original articles that satisfied selection criteria for inclusion. For inclusion, the studies needed to have evaluated human subjects, given supplemental antioxidants, under conditions of known levels of air pollutants with measured lung function before and after antioxidant administration and/or air pollution exposure. Selected studies were summarized and conclusions presented. RESULTS: Eight studies investigated the role of antioxidant supplementation on measured lung function outcomes after subject exposure to air pollutants under controlled conditions; 5 of these studies concluded that pollutant-induced airway hyper-responsiveness and diminution in lung function measurements were attenuated by antioxidant supplementation. The remaining five studies took place under ambient (uncontrolled) exposures and unanimously concluded that antioxidant supplementations attenuate the negative effects of urban air pollution on lung function. CONCLUSIONS: The data evaluating modification of changes in lung function associated with air pollutant exposure by antioxidant supplementation, in intact humans, is limited. Of 13 studies (from 12 publications) dedicated to this concern, ten demonstrated an attenuation of pollution-associated decrements. There is growing evidence for the benefit of anti-oxidant supplementation in moderating the effects of air pollution on lung function, but more research on human participants is needed to inform this topic.

PMID: 21729301 [PubMed - as supplied by publisher]

WITHDRAWN: Bronchopulmonary hygiene physical therapy for chronic obstructive pulmonary disease and bronchiectasis.

Cochrane Database Syst Rev. 2011;7:CD000045

Authors: Jones AP, Rowe BH

Bronchopulmonary hygiene physical therapy is a form of chest physical therapy including chest percussion and postural drainage to remove lung secretions. These are applied commonly to patients with both acute and chronic airway diseases. Despite controversies in the literature regarding its efficacy, it remains in use in a variety of clinical settings. The various forms of this therapy are labour intensive and need to be evaluated.

PMID: 21735379 [PubMed - in process]

Pharmacological treatment of severe, therapy resistant asthma in children: what can we learn from where?

Eur Respir J. 2011 Jul 7;

Authors: Bush A, Pedersen S, Hedlin G, Baraldi E, Barbato A, de Benedictis F, Carlsen KL, de Jongste J, Piacentini G,

There is a lack of high-quality evidence on what treatment should be used in children with properly characterised severe, therapy-resistant asthma. Data has to be largely extrapolated from trials in children with mild asthma, and adults with severe asthma. Therapeutic options can be divided into medications used in lower doses for children with less severe asthma, and those used in other paediatric diseases but not for asthma (for example, methotrexate). In the first category are high dose inhaled corticosteroids (ICS) (up to 2000 mcg·day(-1) fluticasone equivalent), oral prednisolone, the anti-IgE antibody omalizumab, high dose long acting β-2 agonists, low-dose oral theophylline, and intramuscular triamcinolone. If peripheral airway inflammation is thought to be a problem, the use of fine particle ICS or low-dose oral corticosteroids may be considered. More experimental therapies include oral macrolides, cyclosporin, cytotoxic drugs such as methotrexate and azathioprine, gold salts, immunoglobulins, subcutaneous β-2 agonist treatment, and, in those sensitized to fungi, oral antifungal therapy with itraconazole or voriconazole. Those with recurrent severe exacerbations, particularly in the context of good baseline asthma control, are particularly difficult to treat; baseline control and lung function must be optimised with the lowest possible dose of ICS, and allergen triggers and exposures minimised. The use of high dose ICS, leukotriene receptor antagonists or both at the time of exacerbations can be considered. There is no evidence on which therapeutic option to recommend. Better evidence is required for all these treatment options, underscoring the need for the international and co-ordinated approach which we have previously advocated.

PMID: 21737557 [PubMed - as supplied by publisher]

Immunochemistry and Lung Cancer: Application in Diagnosis, Prognosis and Targeted Therapy.

Oncology. 2011 Jul 6;80(3-4):247-256

Authors: Nanguzgambo AB, Razack R, Louw M, Bolliger CT

Immunochemistry is now an established ancillary technique in lung cancer diagnosis. Not only does it help in supporting the morphological diagnosis of malignancy, but its role now extends to the determination of cell lineage, ascertaining the primary site of tumour origin and contributing to decisions on prognosis and treatment. Early detection and confirmation of lung cancer facilitate early treatment decisions. Lung cancer management now has a multidisciplinary approach which includes cytopathologists and clinicians. Some clinicians may not understand what immunochemistry is and what its role is in lung cancer diagnosis, prognosis and therapy. The purpose of this paper is to define immunochemistry, on the background of basic respiratory airway epithelial structure and cancer biology, and discuss its application in the diagnosis, treatment and determination of prognosis of lung cancer.

PMID: 21734416 [PubMed - as supplied by publisher]