Chronická obstrukční plicní nemoc a astma mají řadu odlišných, ale i společných charakteristik v diagnostice a léčbě. V diferenciální diagnostice mají významnou úlohu různé etiologické faktory, u CHOPN hlavně inhalované škodliviny, u astmatu alergické spouštěče. Hlavní odlišení obou nemocí spočívá v průkazu bronchiální obstrukce a její reverzibility, ev. bronchiální hyperreaktivity a laboratorních (hlavně imunologických) nálezech. Diagnóza obou nemocí je obecně podceněna, chyby při stanovení definitivních diagnóz jsou časté. Správná diagnóza má významný vliv na včasnou a optimální léčbu dle tíže CHOPN nebo kontroly a tíže astmatu. Do terapie CHOPN byl v ČR zaveden v roce 2011 indacaterol (Onbrez Breezhaler) a roflumilast (Daxas). Moderní účinný a finančně nákladný lék astmatu, protilátka proti IgE (Omalizumab-Xolair), má speciální úzkou indikaci.
Chronic obstructive pulmonary disease (COPD) and asthma have several different but also similar characteristics in diagnosis and therapy. There are different etiologic factors they play the main role (in COPD mostly inhaled harmful irritants, in asthma allergic triggers. The most important parameter of differences between COPD and asthma are lung function results of bronchial obstruction and its reversibility. Both diseases are generally under diagnosed and some mistakes are frequent. Correct diagnoses have important influence on early and optimal therapy according the stage of COPD, and control and severity of asthma. Indacaterol (Onbrez Breezhaler) and roflumilast (Daxas) were introduced in the year 2011 into the therapy of COPD in the Czech Republic. New modern effective and expensive treatment of asthma with antibody against IgE (Omalizumab-Xolair) has special indication.
- Keywords
- astma,
- MeSH
- Aminopyridines administration & dosage therapeutic use MeSH
- Administration, Inhalation MeSH
- Biological Therapy MeSH
- Asthma * diagnosis epidemiology etiology classification MeSH
- Pulmonary Disease, Chronic Obstructive * diagnosis epidemiology etiology classification MeSH
- Diagnostic Errors prevention & control MeSH
- Diagnostic Techniques, Respiratory System MeSH
- Diagnosis, Differential * MeSH
- Child MeSH
- Adrenal Cortex Hormones administration & dosage therapeutic use MeSH
- Indans administration & dosage therapeutic use MeSH
- Humans MeSH
- Signs and Symptoms MeSH
- Severity of Illness Index MeSH
- Therapeutics MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Review MeSH
Pulmonary surfactant has a relaxing effect on the airway smooth muscle (ASM), which suggests its role in the pathogenesis of respiratory diseases associated with hyperreactivity of the ASM, such as asthma and chronic obstructive pulmonary disease (COPD). The ASM tone may be directly or indirectly modified by bacterial wall component lipopolysaccharide (LPS). This study elucidated the effect of LPS on the ASM reactivity and the role of surfactant in this interaction. The experiments were performed using ASM of adult guinea pigs by in vitro method of tissue organ bath (ASM unexposed-healthy or exposed to LPS under in vitro conditions) and ASM of animals intraperitoneally injected with LPS at a dose 1 mg/kg of b.w. once a day during 4-day period. Variable response of LPS was controlled by cyclooxygenase inhibitor indomethacin and relaxing effect of exogenous surfactant was studied using leukotriene and histamine receptor antagonists. The exogenous surfactant has relaxing effect on the ASM, but does not reverse LPS-induced smooth muscle contraction. The results further indicate participation of prostanoids and potential involvement of leukotriene and histamine H1 receptors in the airway smooth muscle contraction during LPS exposure.
- MeSH
- Acetates MeSH
- Quinolines MeSH
- Muscle, Smooth drug effects MeSH
- Lipopolysaccharides MeSH
- Guinea Pigs MeSH
- Pulmonary Surfactants pharmacology MeSH
- Pyrilamine MeSH
- Muscle Relaxation drug effects MeSH
- Animals MeSH
- Check Tag
- Guinea Pigs MeSH
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
