OPUS 4 | Medizin

Analysis of airway secretions in a model of sulfur dioxide induced chronic obstructive pulmonary disease (COPD) (2006)

Ulrich Wagner Petra Staats Hans-Christoph Fehmann Axel Fischer Tobias Welte Jan David Alexander Groneberg

Hypersecretion and chronic phlegm are major symptoms of chronic obstructive pulmonary disease (COPD) but animal models of COPD with a defined functional hypersecretion have not been established so far. To identify an animal model of combined morphological signs of airway inflammation and functional hypersecretion, rats were continuously exposed to different levels of sulfur dioxide (SO2, 5 ppm, 10 ppm, 20 ppm, 40 ppm, 80 ppm) for 3 (short-term) or 20–25 (long-term) days. Histology revealed a dose-dependent increase in edema formation and inflammatory cell infiltration in short-term-exposed animals. The submucosal edema was replaced by fibrosis after long-term-exposure. The basal secretory activity was only significantly increased in the 20 ppm group. Also, stimulated secretion was significantly increased only after exposure to 20 ppm. BrdU-assays and AgNOR-analysis demonstrated cellular metaplasia and glandular hypertrophy rather than hyperplasia as the underlying morphological correlate of the hypersecretion. In summary, SO2-exposure can lead to characteristic airway remodeling and changes in mucus secretion in rats. As only long-term exposure to 20 ppm leads to a combination of hypersecretion and airway inflammation, only this mode of exposure should be used to mimic human COPD. Concentrations less or higher than 20 ppm or short term exposure do not induce the respiratory symptom of hypersecretion. The present model may be used to characterize the effects of new compounds on mucus secretion in the background of experimental COPD.

Chronic cough due to occupational factors (2006)

Jan David Alexander Groneberg Dennis Nowak Anke Wussow Axel Fischer

Within the large variety of subtypes of chronic cough, either defined by their clinical or pathogenetic causes, occupational chronic cough may be regarded as one of the most preventable forms of the disease. Next to obstructive airway diseases such as asthma or chronic obstructive pulmonary disease, which are sometimes concomitant with chronic cough, this chronic airway disease gains importance in the field of occupational medicine since classic fiber-related occupational airway diseases will decrease in the future. Apart from acute accidents and incidental exposures which may lead to an acute form of cough, there are numerous sources for the development of chronic cough within the workplace. Over the last years, a large number of studies has focused on occupational causes of respiratory diseases and it has emerged that chronic cough is one of the most prevalent work-related airway diseases. Best-known examples of occupations related to the development of cough are coal miners, hard-rock miners, tunnel workers, or concrete manufacturing workers. As chronic cough is often based on a variety of non-occupational factors such as tobacco smoke, a distinct separation into either occupational or personally -evoked can be difficult. However, revealing the occupational contribution to chronic cough and to the symptom cough in general, which is the commonest cause for the consultation of a physician, can significantly lead to a reduction of the socioeconomic burden of the disease.

kurz und kn@pp news / Institut für Allgemeinmedizin Johann Wolfgang Goethe-Universität Frankfurt am Main (2006)

kurz und kn@pp news : Nr. 4 (2006)

* Pressespiegel 2005 * Neues zu unserem Fehlerberichtssystem „Jeder Fehler zählt“ * Einladung zum vierten Hessischen Hausärztetag 2006 * Wissenschaftliche Beratung für die Zeitschrift STERN * Fertigstellung der neuen DEGAM Leitlinie Ohrenschmerzen * Institutsumbau abgeschlossen * Sicherheit bei Multimedikation in der Hausarztpraxis

kurz und kn@pp news : Nr. 5 (2006)

* Lehrärzte von Studenten hervorragend bewertet! * Anamneseerhebung und Gesprächsführung * Neue Online-Datenbank zum Berichtssystem „Jeder Fehler zählt“ * Fehlerforschung wird fortgesetzt - interessierte Praxen gesucht!

kurz und kn@pp news : Nr. 6 (2006)

* Curriculum „Case Management in der hausärztlichen Versorgung“ * DEGAM-Leitlinie Nr. 9 „Herzinsuffizienz“ erscheint * „Chronic Care“ aktuell * PRoMPT-Projekt hat 609 Patienten eingeschlossen * Medizin ist eine Kunst, die sich der Wissenschaft annähert

kurz und kn@pp news : Nr. 7 (2006)

* Akademische Lehrpraxen im festlichen Rahmen akkreditiert * Geschlossenes Fehlerberichtssystem startet in Kürze * Arbeitsgruppe EbM Frankfurt mit Lehrpreis ausgezeichnet * US-Forschungsstipendium der Max-Kade-Foundation und der DFG für Jochen Gensichen * Zwei neue Studien zur Patientensicherheit * Städtische Bühnen Frankfurt unterstützen PRoMPT-Projekt

short @nd sweet news : Nr. 5 (2006)

* Training physicians judged excellent by students! * Medical history compilation and discussion guidance * New online databank for reporting system "every error counts" * Error research to be continued - Practices wanted!

short @nd sweet news : Nr. 6 (2006)

* Curriculum - "Case Management in General Medical Care" * DEGAM Guideline Nr. 9 on Congestive Heart Failure to be published * "Chronic Care" - an update * PRoMPT Project recruits 609 patients * Medicine is an Art which approximates Science

Arteriogenesis versus angiogenesis: similarities and differences (2006)

Matthias Heil Inka Eitenmüller Thomas Schmitz-Rixen Wolfgang Schaper

Cardiovascular diseases account for more than half of total mortality before the age of 75 in industrialized countries. To develop therapies promoting the compensatory growth of blood vessels could be superior to palliative surgical surgical interventions. Therefore, much effort has been put into investigating underlying mechanisms. Depending on the initial trigger, growth of blood vessels in adult organisms proceeds via two major processes, angiogenesis and arteriogenesis. While angiogenesis is induced by hypoxia and results in new capillaries, arteriogenesis is induced by physical forces, most importantly fluid shear stress. Consequently, chronically elevated fluid shear stress was found to be the strongest trigger under experimental conditions. Arteriogenesis describes the remodelling of pre-existing arterio-arteriolar anastomoses to completely developed and functional arteries. In both growth processes, enlargement of vascular wall structures was proposed to be covered by proliferation of existing wall cells. Recently, increasing evidence emerges, implicating a pivotal role for circulating cells, above all blood monocytes, in vascular growth processes. Since it has been shown that monocytes/macrophage release a cocktail of chemokines, growth factors and proteases involved in vascular growth, their contribution seems to be of a paracrine fashion. A similar role is currently discussed for various populations of bone-marrow derived stem cells and endothelial progenitors. In contrast, the initial hypothesis that these cells -after undergoing a (trans-)differentiation- contribute by a structural integration into the growing vessel wall, is increasingly challenged.

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