Background: Asthmatic children present variable degrees of airway inflammation, remodeling and resistance, which correlates with disease control and severity. Chronic inflammatory process of the airways triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. This study has investigated for the first time, whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present correlation with the resistance of respiratory system and of proximal and distal airways. Methods: 24 asthmatic children (persistent mild and moderate) and 24 non-asthmatic children (both between 6-13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, pulmonary and systemic immune response. Results: Asthmatic children showed an increased number of blood eosinophils (p<0.04), basophils (p<0.04), monocytes (p<0.002) and lymphocytes (p<0.03). In addition, asthmatic children showed an impaired lung function, as demonstrated by FEV1%pred. (p<0.0005) and FEV1/FVC (p<0.004), decreased total resistance of respiratory system (R5Hz; p<0.009), increased resistance of proximal airways (R20Hz; p<0.02), increased elastance (Z5Hz; p<0.02) and increased reactance (X5Hz; p<0.002). Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p<0.0001) and in the serum (p<0.0001); TGF-beta in the BC (p<0.0001) and in the serum (p<0.004); IL-5 in the BC (p<0.02) and in the serum (p<0.01); IL-4 in the serum (p<0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in asthmatic children, reflecting airway remodeling, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.

Background: Alterations of the circadian rhythm negatively impact several aspects of the health, including the lung function. Chronic shiftwork scale classically induces alterations in the circadian rhythm. However, its effects on pulmonary immune response are unknown. Aims: To evaluate the impact of chronic alteration of circadian rhythm on pulmonary function and immune response. Methods: In this context, a 12h x 24h and 12h x 48h work scale in shiftwork scale policemen (n = 25; 38,73±6,92 years old) were compared with fixed work scale (8h/day) civil men (n = 25; 34,00±9,60 years old) who were evaluated for perceived stress, sleepiness, physical activity levels, anthropometric characteristics, sleepiness levels, lung function, pulmonary and systemic cellular and humoral immune response. Results: Policemen presented increased levels of perceived stress (p<0.0008), impaired sleepiness (p<0.04) and lung function as demonstrated by reduced FVC (p<0.053) and FEV1 (p<0.043) when compared to civil men. In addition, increased levels of exhaled nitric oxide (p<0.037) and of IL-2 (p<0.0046) in the breath condensate revealed that policemen presented chronic lung inflammation compared to civil men. Although the whole blood analysis did not showed any differences between the two groups concerning the number of leukocytes, the humoral response revealed that policemen presented increased levels of IL-2 (p<0.002) and lower levels of IL-10 (p<0.001), clearly displaying a clinical status of low grade inflammation. Conclusions: Chronic alteration of circadian rhythm in shiftwork scale policemen results in impaired lung function, beyond to impair pulmonary and systemic immune function.

Background: Asthmatic children present variable degrees of airway inflammation, remodeling and resistance, which correlates with disease control and severity. Chronic inflammatory process of the airways triggers airway remodeling, which reflects the degree of airway resistance. Pro-inflammatory and pro-fibrotic mediators are centrally involved in this process. This study has investigated for the first time, whether the levels of pulmonary and systemic pro-inflammatory and pro-fibrotic mediators present correlation with the resistance of respiratory system and of proximal and distal airways. Methods: 24 asthmatic children (persistent mild and moderate) and 24 non-asthmatic children (both between 6-13 years old) were evaluated for anthropometric characteristics, lung function and mechanics, pulmonary and systemic immune response. Results: Asthmatic children showed an increased number of blood eosinophils (p<0.04), basophils (p<0.04), monocytes (p<0.002) and lymphocytes (p<0.03). In addition, asthmatic children showed an impaired lung function, as demonstrated by FEV1%pred. (p<0.0005) and FEV1/FVC (p<0.004), decreased total resistance of respiratory system (R5Hz; p<0.009), increased resistance of proximal airways (R20Hz; p<0.02), increased elastance (Z5Hz; p<0.02) and increased reactance (X5Hz; p<0.002). Moreover, the following inflammatory factors were significantly higher in asthmatic than non-asthmatic children: GM-CSF in the breath condensate (BC) (p<0.0001) and in the serum (p<0.0001); TGF-beta in the BC (p<0.0001) and in the serum (p<0.004); IL-5 in the BC (p<0.02) and in the serum (p<0.01); IL-4 in the serum (p<0.0002). Conclusions: Impulse oscillometry is a sensitive method to detect airway resistance in asthmatic children, reflecting airway remodeling, an event followed by increased levels of pro-inflammatory and pro-fibrotic mediators.

Background: The respiratory system changes with age and understanding these changes may help detect and prevent respiratory dysfunctions in the elderly. In addition, although the influence of smoking on lung function is well known, its influence on lung function and mechanics of elderly are unknown. Impulse oscillometry system (IOS) is a technique for measurements of lung mechanics, which don’t need patient effort and a minimal collaboration, beyond to reflect more precisely airway resistance/obstruction and lung tissue elastance than spirometric measurements. Aims: Thus, the present study aimed to investigate whether IOS could be or not be sensible enough to differentiate the effects of smoking in the pulmonary response of non-smokers from smokers’ elderlies. Methods: The present study compared 30 elderlies never smokers (70,96 ± 6,61) with 30 elderlies’ current smokers (69,96 ± 5,94 years old and 35,33 ± 24,93/packs/year tobacco load), without asthma or any other pulmonary disease in terms of lung function and mechanics. Results: The following differences between elderly never smokers versus smokers for spirometric values were found (FVC p<0.02; FEV1 p<0.04; FEV1/FVC p<0.04; PEF p<0.01; MEF25% p<0.02; MEF50% p<0.02; MEF75% p<0.01, IVC p<0.01) and for oscilometric values (Z5hz p<0.03; R5Hz 0.01; R20Hz p<0.04; X5Hz p<0.02), while RFres and R5Hz-R20Hz did not present differences (p>0.05). Conclusions: Impulse oscilometry can detect small airway resistance/obstruction to better differentiate the functional pulmonary alterations among never smokers from smokers’ elderlies.