Rhythmic changes in Fabry disease: Inversion and non-oscillatory pattern in 6-sulfatoxymelatonin daily profile

Fabry disease is a progressive disease characterized by an enzymatic deficiency of acid alpha-galactosidase and glycosphingolipids storage within the lysosomes. The disease has two phenotypes: classic and nonclassic. Excessive daytime sleepiness is a common sign reported by patients and can be caused by a circadian rhythm sleep disorder. Activity and rest cycle, variation of body temperature and melatonin biosynthesis are known rhythmicity markers. In the face of these evidences, our goal was to evaluate the rhythmic profile in Fabry’s disease patients using rhythmicity markers. For this purpose, we recruited 17 patients diagnosed with Fabry disease (11 classic and 6 nonclassic variant) that answered the Epworth Sleepiness Scale and the Morningness–Eveningness questionnaire adapted from Horne and Ostberg; recorded activity and body temperature rhythms by an actigraphy during at least 10 days and collected urine to assess 6-sulfatoxymelatonin excretion load during the day (from the second urine in the morning until 7 p.m.) and night (starting from 7 p.m. until the first urine in the morning of the following day). We observed that control subjects presented higher excretion load of 6-sulfatoxymelatonin during the night (p < 0.05, d = 7.8), as expected. Patients with the nonclassic variant presented an inversion on 6-sulfatoxymelatonin daily profile (p < 0.05, d = 3.8) and there was no difference between the day and night profile of classic variant patients when compared to the other two groups. Patients with the classic variant also presented temperature period greater than 24 hours (p < 0.05, d = 2.0). Therefore, we came to the conclusion that there is an alteration in the circadian rhythms in Fabry disease patients, evidenced by modifications in the 6-sulfatoxymelatonin daily profile and in the body temperature rhythm period.     

维生素E对暴露于高温及PM2.5中COPD大鼠呼吸系统的保护性作用*

目的:探讨维生素E改善暴露于高温与PM_2.5对慢性阻塞性肺疾病(COPD)大鼠呼吸系统功能损伤的作用。方法:将54只7周龄SPF级雄性Wistar大鼠随机分成9个实验组(n=6),利用烟草烟雾和气管内滴注脂多糖建立COPD大鼠模型,而后对其进行PM_2.5(0 mg/ml、3.2 mg/ml)气管滴注染毒和维生素E腹腔注射(20 mg/ml)干预,随后高温组进行高温(40℃)暴露,每天一次(8 h),持续3 d。末次暴露后检测肺功能,HE染色制作肺组织病理切片,采用试剂盒测定大鼠肺组织中诱导性一氧化氮合酶(iNOS)、肿瘤坏死因子(TNF-α)、单核细胞趋化蛋白1(MCP-1)的表达水平。结果:与对照组相比,高温和PM_2.5暴露使COPD大鼠肺功能降低(P＜0.05),各PM_2.5染毒组中MCP-1含量均有显著升高(P＜0.05),高温组中iNOS活性显著增高(P＜0.05);与单纯PM_2.5染毒组相比,在常温健康和高温COPD维生素E干预组的TNF-α含量均显著降低(P＜0.05),三组维生素干预组中MCP-1含量均显著降低(P＜0.05),高温COPD维生素干预组中iNOS活性显著降低(P＜0.05)。结论:高温与PM_2.5可引起并进一步加重COPD大鼠的炎症反应,维生素E作为一种抗氧化剂,可明显改善上述损伤作用,从而保护机体。     

沈阳市夏冬季慢性阻塞性肺疾病患者 上呼吸道微生态状况

目的探讨在沈阳市夏、冬两季不同空气污染程度条件下,慢性阻塞性肺疾病(COPD)急性发作期患者上呼吸道菌群的改变,了解明确暴露于不同大气污染天气下,患者口咽部、呼吸道黏膜微生物菌群的动态变化,为由大气污染引起的呼吸道感染防治提供科学依据。方法选取2017年11月-2018年1月,以及2018年7月-9月沈阳市某三甲医院呼吸科COPD急性发作期各30例患者的咽拭标本,对需养菌和厌氧菌进行分离培养、纯化、16SrDNA鉴定。结果分析沈阳市两季节COPD急性发作期65～85岁患者的咽后壁菌落,得到夏季大气污染情况较轻空气中颗粒物质较少时,需氧菌的优势菌以口腔链球菌为主,厌氧菌以微小消化链球菌为主;空气污染较重的冬季需氧菌的优势菌以灰色奈瑟菌为主,厌氧菌以韦荣球菌为主。结论相比于夏季,冬季患者咽后壁的菌群多样性更为丰富,优势菌与夏季也有不同,考虑与季节不同空气污染程度不同有关。     

肺部菌群和肠道菌群在两种常见肺疾病中 作用的研究进展

哮喘、慢性阻塞性肺疾病(COPD)是常见高发的肺部疾病,相关发病机制尚待阐明。近年来,菌群对哮喘、COPD的发生发展的作用越来越引起重视。本文梳理了近期肺部菌群和肠道菌群在哮喘、COPD中的作用及机制相关文献,分别从肺部菌群和肠道菌群的角度,分析它们对哮喘、COPD的作用机制以及肺部菌群和肠道菌群之间相互调控的联系,以期进一步深入了解菌群在常见肺部疾病中的意义,为寻找更有效的防治哮喘、COPD的作用靶点或者分子提供相关可借鉴的思路。     

Rocking Promotes Sleep in Mice through Rhythmic Stimulation of the Vestibular System

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Dynamic REM Sleep Modulation by Ambient Temperature and the Critical Role of the Melanin-Concentrating Hormone System

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地奈德福莫特罗联合异丙托溴胺治疗慢性阻塞性肺疾病急性加重期的疗效及对FeNO、cTnI的影响

摘要 目的：探讨布地奈德福莫特罗联合异丙托溴胺治疗 慢性阻塞性肺疾病急性加重期的疗效及对呼出气一氧化氮（FeNO）、心肌肌钙蛋白（cTnI）的影响 。方法：选择2020年7月-2021年5月在我院接受治疗的80例慢性阻塞性肺疾病急性加重期患者,采用随机数表法分为试验组（n=41）和对照组（n=39）。对照组给予异丙托溴胺治疗,试验组在对照组的基础上联合布地奈德福莫特罗治疗。比较两组临床疗效、FeNO、cTnI、白细胞介素6（IL-6）、超敏C反应蛋白（CRP）、临床症状改善情况及不良反应发生情况。结果：治疗后,两组总有效率比较差异显著（P<0.05）;治疗前,试验组和对照组FeNO、cTnI比较无显著差异;治疗后,试验组和对照组FeNO、cTnI均随着时间的推移而降低,且试验组均低于对照组,差异显著（P<0.05）;治疗前,试验组和对照组血清IL-6及CRP比较无显著差异;治疗后,试验组和对照组血清IL-6及CRP均随着时间的推移而降低,且试验组均低于对照组,差异显著（P<0.05）;试验组憋喘、咳嗽、哮鸣音及湿啰音消失需要的时间均显著低于对照组,差异显著（P<0.05）;两组不良反应总发生率为9.76%、17.95%,无显著差异（P>0.05）。结论：在慢性阻塞性肺疾病急性加重期中应用布地奈德福莫特罗联合异丙托溴胺治疗疗效显著,可有效改善患者FeNO、cTnI水平,且不会增加并发症。