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Bellocq A, Gaspard W, Couffignal C, Vigan M, Guerder A, Ambard J, Caruana S, Similowski T, Garcia G, Taillé C. Outpatient pulmonary rehabilitation for severe asthma with fixed airway obstruction: Comparison with COPD. J Asthma 2019; 56:1325-1333. [PMID: 30693816 DOI: 10.1080/02770903.2018.1541351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: The benefit of exercise has been demonstrated in asthma, but the role of pulmonary rehabilitation (PR) in people with severe asthma, especially with airway obstruction, has been less investigated. The activity limitation mechanisms differ in asthma and COPD, so the effect of a PR program not specific to asthma is unclear. Methods: We retrospectively compared the effect of an ambulatory PR program in nonsmoking patients with severe asthma and airway obstruction (FEV1/FVC ratio <70% and FEV1 < 80% measured twice, not under an exacerbation) and sex-, age-, FEV1-, and BMI-matched COPD controls. Results: We included 29 patients, each with asthma and COPD. Airway obstruction was moderate (median FEV1 57% [44-64]). VO2 at peak was higher for asthma than COPD patients (19.0 [15.7-22.2] vs 16.1 [15.3-19.6] ml.min-1.kg-1, p = 0.05). After PR, asthma and COPD groups showed a significant and similar increase in constant work cycling test of 378 [114-831] s and 377 [246-702] s. Changes in Hospital Anxiety and Depression Scale (HAD) total score were similar (-2.5 [-7.0 to 0.0] vs -2.0 [-5.0 to 2.0], p > 0.05). Quality of life on the St. George's Respiratory Questionnaire (SGRQ) was significantly improved in both groups (-14.0 [-17.7 to -2.0], p < 0.005 and -8.3 [-13.0 to -3.6], p < 0.0001). Conclusion: Outpatient PR is feasible and well tolerated in patients with severe asthma with fixed airway obstruction. A nondedicated program strongly improves HAD and SGRQ scores and constant work-rate sub-maximal cycling, with similar amplitude as with COPD.
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Affiliation(s)
- Agnès Bellocq
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service d'Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée du Département R3S, Paris, France.,Sorbonne Université, INSERM, UMRS1158, Paris, France
| | - Wanda Gaspard
- Service des Maladies Respiratoires, Hôpital d'Instruction des Armées Percy, Clamart, France
| | - Camille Couffignal
- Assistance Publique-Hôpitaux de Paris, Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, Paris, France
| | - Marie Vigan
- Assistance Publique-Hôpitaux de Paris, Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, Paris, France
| | - Antoine Guerder
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et de Réanimation Médicale du Département R3S, Paris, France
| | - Julien Ambard
- Réseau Recup'Air, Agence Régionale de Santé Ile de France, Paris, France
| | - Sylvie Caruana
- Réseau Recup'Air, Agence Régionale de Santé Ile de France, Paris, France
| | - Thomas Similowski
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et de Réanimation Médicale du Département R3S, Paris, France
| | - Gilles Garcia
- Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service de Pneumologie, Le Kremlin-Bicetre, France
| | - Camille Taillé
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, DHU FIRE, Service de Pneumologie, INSERM UMR1152, Université Paris Diderot, Labex Inflamex, Paris, France
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Abstract
BACKGROUND Deletion of 9p21 is a common event in many human tumors, including head and neck squamous cell carcinoma (HNSCC). The gene CDKN2, which encodes the protein p16, a cyclin-dependent kinase-4 inhibitor, maps to 9p21. The role of CDKN2 as the tumor suppressor gene in these neoplasms is unclear. The role of loss of heterozygosity (LOH) as a prognostic tool has not been described in HNSCC. METHODS We performed deletion mapping using Southern and PCR-based LOH analysis and prospective survival analysis. RESULTS We demonstrate that LOH of 9p and, specifically, the interferon (IFN) gene cluster correlates with recurrence of HNSCC. We also demonstrate two separate areas of deletion on 9p, one centromeric to IFNbeta and telomeric to CDKN2 and the other centromeric to CDKN2 and telomeric to the polymorphic marker D9S19. All the deletions involve either the markers IFNalpha and/or D9S171 and D9S126 but not necessarily CDKN2. CONCLUSIONS These results suggest another tumor suppressor gene (TSG) may be involved in HNSCC carcinogenesis and may play a role in aggressive disease as manifest by local, regional, or distant recurrence.
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Affiliation(s)
- W M Lydiatt
- Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center and Methodist Hospital, Omaha 68198-1225, USA
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Thompson JK, Rubio JP, Caruana S, Brockman A, Wickham ME, Cowman AF. The chromosomal organization of the Plasmodium falciparum var gene family is conserved. Mol Biochem Parasitol 1997; 87:49-60. [PMID: 9233672 DOI: 10.1016/s0166-6851(97)00041-8] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The var gene family of Plasmodium falciparum encodes the protein PfEMP1 which is located on the surface of infected erythrocytes and is the receptor that mediates binding to ligands on endothelial cells. This family of proteins is responsible for antigenic variation and differences in binding phenotype to ligands such as CD36 and ICAM1. We have compared the organization of the var gene family in three in vitro cloned lines of P. falciparum and show that most var genes are located in the subtelomeric region of each chromosome closely linked to the repetitive sequence rep20. While most chromosomes possess var genes in the subtelomeric region, in each in vitro cloned line there are some chromosomes that have deleted subtelomeric repetitive regions which include var genes. Comparison of the location of var genes in a field isolate showed that it does not have any detectable subtelomeric deletions as all chromosomes contain var genes and rep20 sequences. We have detected three chromosomes (4, 7 and 12) that contain var gene loci in more stable central regions and the position of these genes on chromosome 4 in the cloned lines analysed is conserved. The location of most of the var gene family in the subtelomeric region of the genome of P. falciparum has important implications for the generation of antigenic diversity of the PfEMP1 protein.
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Affiliation(s)
- J K Thompson
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
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Abstract
We describe a surgical technique in which the middle fossa craniotomy ordinarily used for facial nerve decompression and related surgery is extended superiorly to allow the harvest of a split-thickness calvarial graft. This graft allows the tegmen defect in middle fossa surgery to be repaired without shortening the original craniotomy plate. Avoiding the usual temporoparietal depression after middle cranial fossa surgery is both a structural and cosmetic benefit for the patient.
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Affiliation(s)
- C J Linstrom
- Department of Otolaryngology, New York Eye and Ear Infirmary, NY 10003
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