Chronic Inflammation

Our aim was to investigate the existence of an association between B cell responsiveness to hepatitis C virus (HCV) core protein and progression of liver disease. In fact, the persistence of HCV infection is permitted by avoidance of viral clearance, despite chronic inflammation in the liver; this process ends with the development of hepatocellular carcinoma in many patients. On the basis of computerized prediction of antigenicity of the genomic sequence of HCV core protein, three 15-mer peptides (named Q15V, R15P, and G15V) were synthesized to be used as antigens in an enzyme immunoassay. Sera from 97 patients (65 males and 32 females) were tested: 43 patients had mild chronic liver disease (steatofibrosis, chronic persistent, or chronic active hepatitis) and 54 had cirrhosis, which was complicated by hepatocellular carcinoma (HCC) in 19. Seventy-six patients were positive to anti-HCV testing by second generation ELISA and 21 were negative. Rates of positivity for synthetic peptide...

The chronic inflammation of arterial walls is associated with the development of atherosclerosis. Earlier we reported that avenanthramide (Avn) s-enriched extract of oats (AvnsO) significantly suppressed interleukin (IL)-1β-stimulated secretion of proinflammatory cytokines, such as IL-6, IL-8, and MCP-1, by human aortic endothelial cells (HAEC). The main objective of the current study was to determine if the mechanism of inhibitory effect of these polyphenols from oats on the expression of proinflammatory cytokines is mediated through modulation of nuclear factor κB (NF-κB)-dependent transcription. Confluent HAEC monolayers were treated for 24 h with AvnsO, and synthetically prepared Avn-c suppressed IL-β-stimulated activation of NF-κB in a concentration-dependent manner. CH3-Avn-c, a synthetically prepared methyl ester derivative of Avn-c with a high biological potency, significantly and dose dependently decreased mRNA expression and secretion of IL-6, IL-8, and MCP-1 by HAEC as determined by real-time RT-PCR and ELISA, and it inhibited IL-1β-and TNFα-stimulated NF-κB activation as determined by a NF-κB DNA binding assay and a NF-κB luciferase reporter assay. AvnsO and Avn-c as well as CH3-Avn-c also inhibited the NF-κB-dependent reporter gene expression activated by TNFR-associated factor 2 and 6 (TRAF2, TRAF6) and NFκB-inducing kinase (NIK). CH3-Avn-c also significantly and dose dependently decreased the phosphorylation level of IκB kinase (IKK) and IκB, and prevented IκB degradation as measured by Western blotting. In addition, CH3-Avn-c markedly increased the overall levels of high mass ubiquitin-conjugated protein levels while it mildly inhibited proteasome activity. These observations suggest that Avns, unique polyphenols from oats, decrease the expression of endothelial proinflammatory cytokines at least in part through inhibition of NF-κB activation by inhibiting the phosphorylation of IKK and IκB, and by suppressing proteasome activity.

White blood cell (WBC) count is a known risk factor for atherosclerotic vascular disease in adult women. Polycystic ovary syndrome (PCOS) is potentially a risk factor for atherosclerosis and cardiovascular disease. The aim of the present study was to investigate leukocyte count in PCOS. One hundred and fifty PCOS women matched for age and body mass index with 150 healthy women were enrolled. WBC count, C-reactive protein, and a complete anthropometrical, metabolic, and hormonal evaluation were performed in both groups. Serum insulin, glucose level, and lipid profile were also measured in each subject. WBC count was significantly higher (P < 0.0001) in PCOS with (interquartile range in parentheses) 7260 (393) cells/mm 3 , compared with controls with 5220 (210) cells/mm 3. C-reactive protein levels were significantly increased (P < 0.0001) in PCOS with 2 (1) mg/liter compared with healthy women with 0.7 (0.8) mg/liter. In both groups, there was a significant (P < 0.0001) linear correlation between WBC count and homeostasis model assessment score (PCOS, r ‫؍‬ 0.94; controls, r ‫؍‬ 0.91). Multiple linear regression analysis showed that other hormone levels are not predictors of leukocyte count both in PCOS and control women. In conclusion, our data demonstrate that PCOS women have an increased WBC count that correlates with homeostasis model assessment values.

Objective: The pathogenesis of vulvar vestibulitis syndrome remains unknown but may be related to a localized chronic in¯ammation. The relation between this syndrome and a polymorphism at position 3953 in the interleukin-1b gene was examined. Allele 2 of this gene has been associated with increased pro-in¯ammatory immunity. Study design: Buccal or vestibular swabs from 59 women with strictly de®ned vulvar vestibulitis and from 48 healthy women were tested by polymerase chain reaction for the presence of two alleles at the 3953 interleukin-1b locus. Results: Allele 2 of the interleukin-1b gene was identi®ed in 27 (46%) women with vulvar vestibulitis as opposed to 12 (25%) control women (P 0:03). The interleukin-1b 1,1 genotype was present in 36 (75%) controls as opposed to 32 (54%) vulvar vestibulitis syndrome patients (P 0:02). All subjects had been previously tested for induced interleukin-1b production in response to bacterial lipopolysaccharide. In both patients and controls, possession of allele 2 was associated with a small but non-statistically signi®cant increase in induced interleukin-1b production. Conclusion: Allele 2 in the interleukin-1b gene is more common in women with vulvar vestibulitis syndrome than in other women. Susceptibility to vulvar vestibulitis syndrome might be in¯uenced by carriage of this polymorphism. #

Chemokines, a class of small secreted proteins, direct immune cells to their target sites and play an important role in chronic inflammations and allergies. To study their interactions with their cellular receptors or potential inhibitors large quantities of chemokines are required. Here we present a fast and efficient strategy to purify the human chemokine interleukin-8 (IL-8, CXCL8). The chemokine is expressed with a pelB-leader peptide that is cleaved off its N-terminus by an endogenous bacterial peptidase. This yields wild-type 72aa IL-8 with a serine at its N-terminus. IL-8 is recovered in the soluble fraction after lysis while pelB-IL8 fusion protein remains in the pellet. Interleukin-8 is purified via cation exchange chromatography and heparin affinity chromatography using a single inexpensive buffer system. No dialysis or membrane filtration steps are required and the final protein fractions may be used without any desalting steps. The use of 0.5% Triton X-114 in the lysis buffer leads to low endotoxin levels in the resulting protein.

There are various musculoskeletal manifestations of HIV infection. A recent report of 6 cases has described a strong relationship between HIV infection and increased signal intensity in Hoffa's fat pad on fluid sensitive sequences. These changes were attributed to chronic inflammation. We describe a case of MRI signal abnormality of Hoffa's fat pad in a patient with HIV infection, where biopsy was performed and confirmed non-specific inflammation.

Salivary gland lesions are uncommon in children and may be related to the parotid, submandibular or sublingual glands. Inflammatory lesions are the most common cause of salivary gland abnormalities in children and can be due to acute viral, acute suppurative, or recurrent acute or chronic inflammation. Intraparotid lymphadenitis may also occur, as in cat-scratch disease or in other causes of cervical lymphadenitis. Salivary gland neoplasms are rare in children, and most of them are benign including mainly hemangioma, pleomorphic adenoma, or lymphangioma. Other lesions, such as sialolithiasis, mucocele, or ranula, may also be seen. Ultrasonography should be the initial imaging study used for the examination of salivary gland lesions in children, given the fact that most of such lesions are benign and are shown up clearly by sonography. In most cases, this technique permits the differentiation of intraglandular and extraglandular lesions, and may suggest the correct diagnosis. The entire lesion could not be totally depicted by US however, and other imaging techniques such as CT or MRI may be necessary. Vascular lesions can be demonstrated more clearly through the use of color Doppler imaging. Some of the lesions may appear similar, and clinical correlation is important for the differential diagnosis. This article discusses the sonographic appearance and clinical manifestations of the spectrum of salivary gland abnormalities that may occur in children.

Several diseases are characterized by chronic inflammation, a condition frequently associated with angiogenesis and fibrogenesis that account for the development of granulation tissue. Nuclear Factor kappa-lightchain-enhancer of activated B cells (NF-κB) is a crucial modulator of intracellular prosurvival signaling pathways and is implicated in the pathogenesis of inflammatory process. In this study, we have investigated the role of NF-κB in the angiogenic and fibrogenic response induced by λ-carrageenin in a rat model of chronic inflammation at 1, 3, and 5 days. The subcutaneous implant of λcarrageenin-soaked sponges in rat induced a time-related increase of granulation tissue formation accompanied by intense neovascularization. These λ-carrageenin-induced changes were significantly reduced by coinjection of wildtype oligodeoxynucleotide (WT ODN) decoy to NF-κB. Molecular, morphological, and ultrastructural analysis performed on whole granulation tissue demonstrated: (1) inhibition of NF-κB/DNA binding activity; (2) downregulation of cyclooxygenase-2, matrix metalloproteinase-9, tumor necrosis factor-α, and vascular endothelial growth factor; (3) upregulation of thrombospondin (TSP)-1 at 1 day and TSP-2 at 5 days; and (4) increase in Bax to Bcl-2 ratio. Our findings show that the blockade of NF-κB activation by WT ODN decoy prevents the development of granulation tissue induced by λ-carrageenin-soaked sponge implant upregulating Bax as well as TSP-1 and TSP-2 expression.

Intussusceptive angiogenesis is a process that forms new blood vessels by the intraluminal division of a single blood vessel into two lumens. Referred to as nonsprouting or intussusceptive angiogenesis, this angiogenic process has been described in morphogenesis and chronic inflammation. Mechanical forces are relevant to the structural changes associated with intussusceptive angiogenesis because of the growing evidence that physiologic forces influence gene transcription. To provide a detailed analysis of the spatial distribution of physiologic shear stresses, we developed a 3D finite element model of the intraluminal intussusceptive pillar. Based on geometries observed in adult intussusceptive angiogenesis, physiologic shear stress distribution was studied at pillar sizes ranging from 1μm to 10μm. The wall shear stress calculations demonstrated a marked spatial dependence with discrete regions of high shear stress on the intraluminal pillar and lateral vessel wall. Further, the intussusceptive pillar created a "dead zone" of low wall shear stress between the pillar and vessel bifurcation apex. We conclude that the intraluminal flow fields demonstrate sufficient spatial resolution and dynamic range to participate in the regulation of intussusceptive angiogenesis by intraluminal flow fields.

Objective: To determine whether routine biopsy of the lacrimal sac wall at dacryocystorhinostomy (DCR) is indicated. Methods: A prospective study and literature review. In 193 consecutive endoscopic DCRs performed on 164 patients (108 females and 56 males) part of the medial wall of the lacrimal sac was sent for histological examination. The mean age of the patients was 64 years with a range of 2.5-89 years. Previous reported series were reviewed. Results: Of the 193 specimens, 44 (23%) showed normal histology, 146 (76%) showed varying degrees of non-specific chronic inflammation, and three (1.2%) showed specific pathology. Of the three specimens that showed specific pathology two showed sarcoidosis and one showed transitional cell papilloma. The two specimens with sarcoidosis were obtained from one patient who underwent bilateral surgery. In this and the six previous reported series only seven of 1294 specimens (0.5%) showed specific pathology, which was definitely not suspected preoperatively or intraoperatively, and only one of these (0.08%) was found to be malignant (a lymphoma). Conclusions: Biopsy of the lacrimal sac wall at DCR is not indicated routinely and is only indicated if there is a reason to suspect pathology other than chronic inflammation preoperatively or intraoperatively. L acrimal obstruction may be proximal (single or common canalicular obstruction), distal (sac or duct obstruction), functional, or a combination of these. 1 A diagnosis of functional obstruction is made when syringing and probing demonstrate no obstruction of the lacrimal system and yet the more physiological investigation of scintigraphy demonstrates reduced passage of radiolabelled tracer through the lacrimal system.

The development of squamous metaplasia or carcinoma is a rare occurrence in the setting of a ruptured or leaking silicone breast implant capsule. However, the oncogenic process in such a context is yet another intriguing example of how chronic inflammation plays an integral role in the tumorigenic process. Recent papers have shed light on how inflammation involving M2-tpe macrophages, lymphocytes, and other inflammatory cells at first provide the cytokines necessary to fend off an inciting foreign-body attack such as silicone from a ruptured or leaking implant. Although such a response is beneficial in keeping infection or foreign material in check, there are instances when the response may be exaggerated. It is thought that the extent and length of the response, the balance between pro-inflammatory/ anti-apoptotic and anti-inflammatory/pro-apoptotic, as well as genetic factors play important roles in determining the final result of an inflammatory insult.

Chemerin was initially described as a protein with a complex function in the immune system. This protein has recently been identified as a new adipokine that regulates the development and metabolic function of adipocytes as well as glucose metabolism in the liver and skeletal muscle. Several research lines indicate that chemerin levels in plasma are elevated in obese patients and,

Planning for a Baby:  https://youtu.be/2iwLh6XCnq8

Pregnancy with IBD: https://youtu.be/br0kciD8xJk

Motherhood with IBD: https://youtu.be/TQjt8pnMv4I


Our aim is to provide an understanding of the experience of women with inflammatory bowel disease (IBD) who have made the transition to motherhood. A total of 22 mothers with IBD were recruited from around the United Kingdom. Semi-structured interviews were conducted and analyzed using thematic analysis. The central concept—Blurred Lines—offers a novel frame for understanding the transition to motherhood with IBD through identifying parallels between having IBD and becoming, and being, a mother. Parallels clustered into three main themes: Need for Readiness, Lifestyle Changes, and Monitoring Personal and Physical Development. Hence, women with IBD are in some ways well prepared for the challenges of motherhood even though, as a group, they tend to restrict their reproductive choices. We recommend health professionals initiate conversations about reproduction early and provide a multidisciplinary approach to pregnancy and IBD in which women have confidence that their ongoing treatment will be integrated successfully with their maternity care.

The anti-inflammatory activity of hexane leaf extract of Aspilia africana C.D. Adams (Compositae) was evaluated in rodents using the xyleneinduced ear edema, egg albumin-and agar-induced paw edema, formaldehyde-induced arthritis, cotton pellet granuloma, gastric ulcerogenic, acetic acid-induced vascular permeability and dextran-induced in vivo leukocyte migration tests. Results showed that the extract (5 mg/ear) inhibited topical edema in the mouse ear and at 200 and 400 mg/kg (i.p.), it significantly (P < 0.05) suppressed the development of egg albumin-and agarinduced paw edema, and the global edematous response to arthritis induced by formaldehyde in rats. Oral administration of the extract (200 or 400 mg/kg) evoked a significant (P < 0.05) dose-related ulceration of the rat gastric mucosa and inhibition of vascular permeability induced by acetic acid in mice. The extract also significantly (P < 0.05) reduced total leukocyte and neutrophils counts in a non-dose-related manner. However, it significantly (P < 0.05) increased lymphocyte counts and stimulated the growth of granuloma tissues induced by subcutaneously implanted cotton pellets in rats. Phytochemical tests showed that the extract contained sterols and terpenoids. These findings suggest that the leaves of Aspilia africana possess anti-inflammatory activity in acute and certain aspects of chronic inflammation, which may derive from inhibition of prostaglandins synthesis, inhibition of increased vascular permeability, inhibition of neutrophil migration into inflamed tissues, and stimulation of lymphocyte accumulation, which may enhance tissue repair and healing. The terpenoids present in the leaves may account for the anti-inflammatory activity.

Exposure to discrimination or unfair treatment has emerged as an important risk factor for illness and disease that disproportionately affects racial and ethnic minorities. Discriminatory experiences may operate like other stressors in that they activate physiological responses that adversely affect the maintenance of homeostasis. Research suggests that inflammation plays a critical role in the pathophysiology of stress-related diseases. Recent findings on discrimination and inflammation are discussed. We highlight limitations in the current evidence and provide recommendations for future studies that seek to examine the association between discrimination and inflammation.

Through the advances in public health, most humans on earth are now assured to live to at least 60 years, regardless of their geographical location and socioeconomic status. Between 2015 and 2050, the proportion of the world's population 60 years and above will be expected to increase from 900 million to 2.1 billion, while the average global life expectancy will be expected to increase by additional 10 years. Experts have ascribed this development as the most significant social transformation of the 21st century. However, although the world may have successfully learned how to live longer, it has not necessarily learned how to live healthier. In most situations, old age is associated with significant loss of physical and mental functionalities, increased risk of developing multiple diseases (including COVID-19), and reduced quality of life. This association has been described as the most important global public health challenge of the 21st century. The objective of this article is to investigate the scientific plausibility of slowing down the aging process and to identify evidence-based strategies of achieving healthy aging. A review of related online free-full articles written in the English language published from 2000 to 2021 was done. It was noticed that the pace and quality of aging can be significantly influenced by controlling the lifestyle determinants of aging. Although the science of healthy aging is still evolving, there is enough evidence for healthcare professionals to recommend evidence-based strategies for achieving healthy aging to the public and policymakers.

Asthma is the most common chronic inflammatory disorder of the airways among children. It is a complex clinical disease characterized by airway obstruction, airway inflammation and airway hyperresponsiveness to a variety of stimuli. The development of allergic asthma exists of three phases, namely the induction phase, the early-phase asthmatic reaction (EAR) and the late-phase asthmatic reaction (LAR). Each phase is characterized by the production and interplay of various cell-derived mediators. In the induction phase, T helper cytokines are important in the development of asthma. Most important mediators in the EAR are preformed mediators, newly synthesized lipid mediators and cytokines that are produced by mast cells. During the LAR, inflammatory molecules are produced by various cell types, such as eosinophils, neutrophils, T cells, macrophages, dendritic cells, and structural cells. Chronical inflammation leads to structural changes of the airway architecture. In this review, the most important mediators involved in the induction phase, the early-phase and late-phase asthmatic reaction are discussed. (K. Bloemen), [email protected] (S. Verstraelen).

Chronic obstructive pulmonary disease (COPD) is a major global health problem and is predicted to become the third most common cause of death by 2020. Apart from the important preventive steps of smoking cessation, there are no other specific treatments for COPD that are as effective in reversing the condition, and therefore there is a need to understand the pathophysiological mechanisms that could lead to new therapeutic strategies. The development of experimental models will help to dissect these mechanisms at the cellular and molecular level. COPD is a disease characterized by progressive airflow obstruction of the peripheral airways, associated with lung inflammation, emphysema and mucus hypersecretion. Different approaches to mimic COPD have been developed but are limited in comparison to models of allergic asthma. COPD models usually do not mimic the major features of human COPD and are commonly based on the induction of COPD-like lesions in the lungs and airways using noxious...

The increasing incidence of obesity and the metabolic syndrome is disturbing. The activation of inflammatory pathways, used normally as host defence response, reminds us of the seriousness of this condition. There is most probably more than one cause for the activation of inflammation, a timeline of events related to the deterioration of metabolic homeostasis presenting along variable routes. Apparently, metabolic overload evokes several stress reactions, such as oxidative, inflammatory, organelle, and cell hypertrophy stresses, generating vicious cycles that amplify each other leading to dysfunction. Adipocyte hypertrophy, through purely physical reasons, facilitates cell rupture, what will evoke an inflammatory reaction. Inability of adipose tissue development to engulf all incoming fat leads to fat deposition in other organs, mainly in the liver, with marked consequences on insulin resistance. The oxidative stress which accompanies feeding, particularly when there is an excessive ingestion of fat and/or other macronutrients without concomitant ingestion of antioxidant-rich foods/beverages, may contribute to the inflammatory markers attributed to obesity. Moreover, recent data on the microbiota and its interaction with food and with obesity brought new hypothetic mechanisms for the obesity/fat diet relationship with inflammation. Beyond these common confounders, other phenomena, for instance, psychological and/or circadian rhythm disturbances, may likewise contribute to the raise of oxidative/inflammatory status. The difficulty in the management of the obesity/metabolic syndrome pathologies is linked to their multifactorial nature where environmental, genetic, and psychosocial factors interact through highly complex networks.

The last 7 years have seen over seven times as many publications indexed by Medline dealing with pomegranate and Punica granatum than in all the years preceding them. Because of this, and the virtual explosion of interest in pomegranate as a medicinal and nutritional product that has followed, this review is accordingly launched. The pomegranate tree, Punica granatum, especially its fruit, possesses a vast ethnomedical history and represents a phytochemical reservoir of heuristic medicinal value. The tree/fruit can be divided into several anatomical compartments: (1) seed, (2) juice, (3) peel, (4) leaf, (5) flower, (6) bark, and (7) roots, each of which has interesting pharmacologic activity. Juice and peels, for example, possess potent antioxidant properties, while juice, peel and oil are all weakly estrogenic and heuristically of interest for the treatment of menopausal symptoms and sequellae. The use of juice, peel and oil have also been shown to possess anticancer activities, including interference with tumor cell proliferation, cell cycle, invasion and angiogenesis. These may be associated with plant based anti-inflammatory effects, The phytochemistry and pharmacological actions of all Punica granatum components suggest a wide range of clinical applications for the treatment and prevention of cancer, as well as other diseases where chronic inflammation is believed to play an essential etiologic role.

j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / m o l m u t C o m m u n i t y a d d r e s s : w w w. e l s e v i e r. c o m / l o c a t e / m u t r e s a b s t r a c t Allergic asthma is a complex and chronic inflammatory disorder which is associated with airway hyper-responsiveness and tissue remodelling of the airway structure. Although originally thought to be a Th2-driven inflammatory response to inhaled innocuous allergen, the immune response in asthma is now considered highly heterogeneous. There are now various in vivo systems which have been designed to examine the pathways leading to the development of this chronic immune response and reflect, in part this heterogeneity. Furthermore, the emergence of endogenous immunoregulatory pathways and active pro-resolving mediators hold great potential for future therapeutic intervention. In this review, the key cellular and molecular mediators relating to chronic allergic airway disease are discussed, as well as emerging players in the regulation of chronic allergic inflammation.

The anti-inflammatory activities of flavonols (quercetin, rutin and morin) and flavanones (hesperetin and hesperidin) were investigated in animal models of acute and chronic inflammation. Rutin was only effective in the chronic process, principally in adjuvant arthritis. On neurogenic inflammation induced by xylene, only the flavanones were effective; besides, these compounds were the most effective on subchronic process. The most important compound in reducing paw oedema induced by carrageenan was quercetin.

All books in this series illustrate point-of-care testing and critically evaluate the potential of antioxidant supplementation in various medical disorders associated with oxidative stress. Future volumes will be updated as warranted by emerging new technology, or from studies reporting clinical trials.

Almost 25 centuries ago, Hippocrates, the father of medicine, proclaimed "Let food be thy medicine and medicine be thy food." Exploring the association between diet and health continues today. For example, we now know that as many as 35% of all cancers can be prevented by dietary changes. Carcinogenesis is a multistep process involving the transformation, survival, proliferation, invasion, angiogenesis, and metastasis of the tumor and may take up to 30 years. The pathways associated with this process have been linked to chronic inflammation, a major mediator of tumor progression. The human body consists of about 13 trillion cells, almost all of which are turned over within 100 days, indicating that 70,000 cells undergo apoptosis every minute. Thus, apoptosis/cell death is a normal physiological process, and it is rare that a lack of apoptosis kills the patient. Almost 90% of all deaths due to cancer are linked to metastasis of the tumor. How our diet can prevent cancer is the focus of this review. Specifically, we will discuss how nutraceuticals, such as allicin, apigenin, berberine, butein, caffeic acid, capsaicin, catechin gallate, celastrol, curcumin, epigallocatechin gallate, fisetin, flavopiridol, gambogic acid, genistein, plumbagin, quercetin, resveratrol, sanguinarine, silibinin, sulforaphane, taxol, γ-tocotrienol, and zerumbone, derived from spices, legumes, fruits, nuts, and vegetables, can modulate inflammatory pathways and thus affect the survival, proliferation, invasion, angiogenesis, and metastasis of the tumor. Various cell signaling pathways that are modulated by these agents will also be discussed.

The interplay between tumors and their immunologic microenvironment is complex and difficult to decipher, but its understanding is of seminal importance for the development of novel prognostic markers and therapeutic strategies. This chapter discusses tumor-immune interactions in several human cancers that illustrate various aspects of this complexity and proposes an integrated scheme of the impact of local immune reactions on clinical outcome. Thus, the fact that a strong infiltration of memory T cells with a Th1 and cytotoxic pattern is the strongest predictor for recurrence and metastasis is exemplified in colorectal cancer in which intratumoral chemokines shape an efficient immune reaction. Based on these data, we propose an immune score that predicts recurrence in early stage (UICC-TNM stage I-II) cancers. Studies on non-small lung cancers have confirmed findings of colorectal cancers and have addressed the question of the sites where antitumor immune reactions may take place. ...

Abstrak: Asma merupakan penyakit inflamasi kronik saluran napas yang ditandai dengan mengi episodik, batuk, dan rasa sesak di dada akibat penyumbatan saluran napas. Secara umum faktor risiko yang dapat memicu terjadinya asma terbagi atas faktor genetik dan lingkungan. Tujuan pengobatan asma adalah tercapainya kontrol asma secara klinis. Tatalaksana asma yang efektif merupakan hasil hubungan yang baik antara dokter dan pasien, dengan tujuan pasien mandiri. Edukasi merupakan bagian dari interaksi antara dokter dan pasien.

Background Right Ventricular Outflow Tract {RVOT} reconstruction using a conduit may be used in Tetralogy of Fallot patients who would otherwise require a trans-annular patch with the advantages of avoidance of free pulmonary regurgitation with its deleterious short and long term effects. Whereas an ideal conduit remains undefined, Contegra® bovine jugular vein bioprosthesis has been increasingly favored for this purpose worldwide. Present study summarizes the early and midterm outcome of Contegra bioprosthesis in RVOT reconstruction in patients of Tetralogy of Fallot (TOF). Methods Between Jan 2000 to April 2009, 34 patients of TOF required conduit reconstruction of RVOT using Contegra at our centre. Hospital records of these patients were retrospectively reviewed. Results Patients were in the age range of 2 to 20 years [mean age 3.2 years] and weighing between 12 to 57 kg [mean weight 15 kg].There were two early and no late deaths at a mean follow up of 23 months [range 6–110 months]. There were no reintervention or reoperations. All patients had trans-thoracic echo before leaving hospital with a mean pulmonary valve pressure gradient of 11.7 ± 6.1 mmHg. During the whole follow-up, there was no pressure gradient detectable across the conduit valve in 15 patients (44%). The maximal transvalvular peak gradients of 22–28 mmHg were measured in 3 patients (8%). Also, there was no valvular incompetence at all detectable in 20 patients (58%). Grade 1 regurgitation was seen in 10 patients (29%). Conclusions The Contegra bovine xenograft offers many advantages. It is suitable for patients of all age groups and is technically simple and safe to implant and provides excellent midterm hemodynamic results.

Iron is an essential micronutrient, as it is required for adequate erythropoietic function, oxidative metabolism and cellular immune responses. Although the absorption of dietary iron (1-2 mg/d) is regulated tightly, it is just balanced with losses. Therefore, internal turnover of iron is essential to meet the requirements for erythropoiesis (20-30 mg/d). Increased iron requirements, limited external supply, and increased blood loss may lead to iron deficiency (ID) and iron-deficiency anemia. Hepcidin, which is made primarily in hepatocytes in response to liver iron levels, inflammation, hypoxia and anemia, is the main iron regulatory hormone. Once secreted into the circulation, hepcidin binds ferroportin on enterocytes and macrophages, which triggers its internalization and lysosomal degradation. Thus, in chronic inflammation, the excess of hepcidin decreases iron absorption and prevents iron recycling, which results in hypoferremia and iron-restricted erythropoiesis, despite normal iron stores (functional ID), and anemia of chronic disease (ACD), which can evolve to ACD plus true ID (ACD + ID). In contrast, low hepcidin expression may lead to iron overload, and vice versa . Laboratory tests provide evidence of iron depletion in the body, or reflect iron-deficient red cell production. The appropriate combination of these laboratory tests help to establish a correct diagnosis of ID status and anemia.

The rise of the AIDS epidemic made the requirement for T cells in our continuous protection from pathogens critically apparent. The striking frequency with which AIDS patients exhibited profound neurological pathologies brought attention to many chronic infections that are latent within the immune-privileged CNS. One of the most common lethal opportunistic infections of these patients was with the protozoan parasite, Toxoplasma gondii. Reactivation of Toxoplasma cysts within the brain causes massive tissue destruction evidenced as multiple ring-enhancing lesions on MRI and is called toxoplasmic encephalitis (TE). TE is not limited to AIDS patients, but rather is a risk for all severely immunocompromised patients, including recipients of chemotherapy or transplant recipients. The lessons learned from these patient populations are supported by T cell depletion studies in mice. Such experiments have demonstrated that CD4+ and CD8+ T cells are required for protection against TE. Although it is clear that these T cell subsets work synergistically to fight infection, much evidence has been generated that suggests CD8+ T cells play a dominant role in protection during chronic toxoplasmosis. In other models of CNS inflammation, such as intracerebral infection with LCMV and experimental autoimmune encephalomyelitis (EAE), infiltration of T cells into the brain is harmful and even fatal. In the brain of the immunocompetent host, the well-regulated T cell response to T. gondii is therefore an ideal model to understand a controlled inflammatory response to CNS infection. This review will examine our current understanding of CD8+ T cells in the CNS during T. gondii infection in regards to the (1) mechanisms governing entry into the brain, (2) cues that dictate behavior within the brain, and (3) the functional and phenotypic properties exhibited by these cells.

Postprandial hyperglycemia is increasingly recognized as an independent risk factor for cardiovascular disease. Glycemic “spikes” may adversely affect vascular structure and function via multiple mechanisms, including (acutely and/or chronically) oxidative stress, inflammation, low-density lipoprotein oxidation, protein glycation, and procoagulant activity. Postprandial glycemia can be reliably predicted by considering both the amount and type of carbohydrate. In particular, the glycemic index (GI), a measure of postprandial glycemic potency weight for weight of carbohydrate, has provided insights that knowledge of the sugar or starch content has not. In prospective observational studies, dietary GI and/or glycemic load independently predict cardiovascular disease, with relative risk ratios of 1.2 to 1.7 comparing highest and lowest quintiles. In randomized controlled trials in overweight subjects, diets based on low-GI carbohydrates have produced better cardiovascular-related outcomes than conventional low-fat diets. Taken together, the findings suggest that health professionals may be able to improve cardiovascular outcomes by recommending the judicious use of low-GI/glycemic load foods.

In the past decade it has become clear that the gut constitutes an important frontier of the body, which not only regulates the selective entry of nutrients while keeping vigilant against pathogens but also is largely responsible for shaping the immune response to educate the organism to recognize self from non-self. The very notion of self has undergone a dramatic change, with the acknowledgment that our &#x27;selves&#x27; include a plethora of microbial species that actively participate in our body&#x27;s homeostasis. The immune system continuously adapts to the microbiota in a cyclic, dynamic cross talk where intestinal epithelial cells play an important role in instructing noninflammatory responses for a steady-state control of bacterial growth, or triggering inflammatory mechanisms that can clear the gut from harmful invaders. The system is complex and robust in the sense that many players with partially overlapping roles act to keep the integrity of the intestinal mucosal barr...

Background & aims: Multiple definitions for malnutrition syndromes are found in the literature resulting in confusion. Recent evidence suggests that varying degrees of acute or chronic inflammation are key contributing factors in the pathophysiology of malnutrition that is associated with disease or injury. Methods: An International Guideline Committee was constituted to develop a consensus approach to defining malnutrition syndromes for adults in the clinical setting. Consensus was achieved through a series of meetings held at the ASPEN and ESPEN Congresses. Results: It was agreed that an etiology-based approach that incorporates a current understanding of inflammatory response would be most appropriate. The Committee proposes the following nomenclature for nutrition diagnosis in adults in the clinical practice setting. ''Starvation-related malnutrition'', when there is chronic starvation without inflammation, ''chronic disease-related malnutrition'', when inflammation is chronic and of mild to moderate degree, and ''acute disease or injury-related malnutrition'', when inflammation is acute and of severe degree. Conclusions: This commentary is intended to present a simple etiology-based construct for the diagnosis of adult malnutrition in the clinical setting. Development of associated laboratory, functional, food intake, and body weight criteria and their application to routine clinical practice will require validation. Ó

Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic ...

La paquimeningitis craneal hipertrófica idiopática es una enfermedad poco común que cursa con inflamación crónica y engrosamiento de la duramadre. Se manifiesta con cefalea y compromiso de pares craneales; las imágenes de resonancia que evidencian un engrosamiento de la duramadre y que realzan con la administración de gadolinio ayudan en el diagnóstico.Se reporta un caso de autopsia de un varón de 69 años que consultó por dolor de cabeza crónico asociado a pérdida de la visión en el transcurso de 3 meses por compromiso del nervio óptico, con diagnóstico de paquimeningitis hipertrófica. El líquido cefalorraquídeo mostró cambios inflamatorios y la duramadre extirpada evidenció inflamación granulomatosa crónica, sin signos de vasculitis ni de proceso infeccioso o neoplásico.La paquimeningitis hipertrófica idiopática es un diagnóstico de exclusión. El estudio exhaustivo, tanto bacteriológico como histopatológico, no identificó ninguna causa específica de esta hipertrofia difusa de la duramadre.Cranial idiopathic hypertrophic pachymeningitis is a rare disorder characterized by chronic inflammation causing thickening of the dura mater. Headache, multiple cranial neuropathy and magnetic resonance images showing GD-DTPA-enhanced thickened dura can aid diagnosis.We report the autopsy case of a 69-year-old man with chronic headache and visual loss due to optic nerve damage developing over a 3-month period, who was diagnosed with hypertrophic pachymeningitis. Cerebrospinal fluid showed inflammatory changes. The sample of hypertrophied dura mater revealed chronic granulomatous inflammation without signs of vasculitis or infectious or neoplastic processes.Idiopathic hypertrophic pachymeningitis is an exclusion diagnosis. Exhaustive tests (both bacteriological and histopathological) to identify the cause of dural thickening in our patient proved unsuccessful.Garezurreko pakimeningitis hipertrofiko idiopatikoa ez da gaixotasun arrunta; inflamazio kronikoa eta duramaterra loditzea eragiten du. Zefalearekin eta pare kranialaren konpromisoarekin agertzen da. Duramaterra lodi dutela erakusten duten erresonantziaren irudiek, eta gadolinioa administratzeak eragindako nabarmentzeak diagnostikoa egiten laguntzen dute.69 urteko gizon baten autopsiaren kasu bat azalduko dugu. Gizon horrek buruko min kronikoagatik egin zigun kontsulta; hiru hilabeteren buruan, nerbio optikoa kaltetu zitzaionez, ikusmena galdu zuen, eta pakimeningitis hipertrofikoa diagnostikatu zitzaion. Likido zefalorakideoak aldaketa inflamatorioak izan zituen eta kendu zitzaion duramaterrak inflamazio granulomatoso kronikoa agerian utzi zuen, baina ez zuen baskulitisaren edo prozesu infekzioso edo neoplasikoaren zantzurik.Baztertze diagnostiko bat da pakimeningitis hipertrofiko idiopatikoa. Egin genion azterketa bakteriologikoak eta histopatologikoak ez zuen duramaterraren hipertrofia zehaztugabe horren arrazoi berezirik identifikatu.

The 12/15-lipoxygenase enzymes react with fatty acids producing active lipid metabolites that are involved in a number of significant disease states. The latter include type 1 and type 2 diabetes (and associated complications), cardiovascular disease, hypertension, renal disease, and the neurological conditions Alzheimer's disease and Parkinson's disease. A number of elegant studies over the last thirty years have contributed to unraveling the role that lipoxygenases play in chronic inflammation. The development of animal models with targeted gene deletions has led to a better understanding of the role that lipoxygenases play in various conditions. Selective inhibitors of the different lipoxygenase isoforms are an active area of investigation, and will be both an important research tool and a promising therapeutic target for treating a wide spectrum of human diseases.

A  pilot  study  was  conducted  to  study  the  phytochemical  and  antiinflammatory  activities  of  methanol  extract  of  leaves  of Basella
rubra. Phytochemical  studies  were  carried  out  to  determine  the  bio
active  constituents  present  in  the  methanol  extract of  B.  rubra.
Oxazolone  induced  inflammation  model  was  used  to  evaluate  the
methanolic  extract  of  B.  rubra  for  its  anti-inflammatory  activity.
Treatment of animals with methanol extract of leaves of  B. rubraat
dose  level  of  500mg/kg  b.w.  was  performed  and  found to  possess
marked activity of cure of inflammation induced by Oxazolone. The
changes  in  body  weight,  colon  structure,  histopathological  changes
and inflammation score were examined between control and treated
groups.  Rats  treated  with  only  Oxazolone  showed  changes  in
hematoxylin and eosin sections with wide areas of mucosal necrosis
with  elongated  irregularly  branched  glands  including  loss  of
differentiation  (goblet  cells).  Treatment  with  methanol  extract  of
leaves of  B. rubrasignificantly recovered in the colon inflammation.
The results of our study suggest that methanolic extract of leaves of
B.  rubra has  beneficial  effects  on  the  experimental  induced
inflammation.  This  reveals  that  Basella  rubra could  be  serves  as  a
potential anti -inflammatory and chemotherapeutic drug.