Artigo de Revisão/Review Article
Avaliação da inflamação das vias aéreas. Vias áreas superiores e compartimento broncopulmonar
Airways inflammation evaluation. Upper and lower airways
1 Interna do 5.º ano da especialidade de Imunoalergologia dos HUC, Serviço de Imunoalergologia Departamento de Ciências Pneumológicas e Alergológicas dos Hospitais da Universidade de Coimbra 3000-075 Coimbra
2 Assistente Hospitalar Graduado em Imunoalergologia dos HUC, Serviço de Imunoalergologia Departamento de Ciências Pneumológicas e Alergológicas dos Hospitais da Universidade de Coimbra 3000-075 Coimbra
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Vias áreas superiores e compartimento broncopulmonar" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "443" "paginaFinal" => "460" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Luísa Geraldes, Ana Todo-Bom, Carlos Loureiro" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Luísa" "apellidos" => "Geraldes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 1 => array:3 [ "nombre" => "Ana" "apellidos" => "Todo-Bom" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] 2 => array:3 [ "nombre" => "Carlos" "apellidos" => "Loureiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Interna do 5.º ano da especialidade de Imunoalergologia dos HUC, Serviço de Imunoalergologia Departamento de Ciências Pneumológicas e Alergológicas dos Hospitais da Universidade de Coimbra 3000-075 Coimbra" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar Graduado em Imunoalergologia dos HUC, Serviço de Imunoalergologia Departamento de Ciências Pneumológicas e Alergológicas dos Hospitais da Universidade de Coimbra 3000-075 Coimbra" "etiqueta" => "2" "identificador" => "af0010" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Airways inflammation evaluation. Upper and lower airways" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-12-12" "fechaAceptado" => "2009-01-12" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570267" "palabras" => array:4 [ 0 => "Asma" 1 => "exames auxiliares de diagnós-tico" 2 => "inflamação" 3 => "rinite" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570266" "palabras" => array:4 [ 0 => "Asthma" 1 => "evaluation methods" 2 => "inflammation" 3 => "rhinitis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Faz-se uma revisão sobre métodos de avaliação da inflamação nas vias aéreas que contribuam para o diag-nóstico, terapêutica e prognóstico de patologias como a rinossinusite e a asma. Serão também considerados métodos susceptíveis de fornecer informação relevante sobre inflamação na DPOC.</p><p id="sp0105" class="elsevierStyleSimplePara elsevierViewall">A inflamação crónica das vias aéreas condiciona fenó-menos obstrutivos objectivados na função respiratória basal, na hiperreactividade brônquica e nasal e em quadros clínicos de dificuldade respiratória. A tomo-grafia computorizada informa sobre as dimensões do lúmen, a espessura das paredes brônquicas e os índices de densidade pulmonar, alterações que decorrem da inflamação e remodelação das vias aéreas.</p><p id="sp0205" class="elsevierStyleSimplePara elsevierViewall">Um processo inflamatório localizado nas vias respira-tórias é susceptível de ser detectado por modificações em marcadores sistémicos de inflamação.</p><p id="sp0305" class="elsevierStyleSimplePara elsevierViewall">Os métodos directos recorrem a análise imunoisto-química de tecidos e de fluidos em condições basais ou após estimulação. Os eosinófilos aumentam em biópsias, lavados nasais e broncoalveolares na asma e na rinite e modificam-se com a terapêutica. Ocorrem alterações nas proteínas e expressão de RNAm de me-diadores envolvidos na activação celular.</p><p id="sp0405" class="elsevierStyleSimplePara elsevierViewall">A expectoração induzida identifica inflamação eosi-nofílica que se relaciona inversamente com a função ventilatória.</p><p id="sp0505" class="elsevierStyleSimplePara elsevierViewall">Em cada ciclo respiratório o ar é enriquecido em compostos voláteis produzidos no decurso da respira-ção celular. A FENO é o biomarcador mais estudado e os seus níveis estão elevados na asma.</p><p id="sp6505" class="elsevierStyleSimplePara elsevierViewall">No condensado do ar expirado identificam-se espé-cies reactivas de oxigénio, derivados de membrana, citocinas e quimiocinas pró-inflamatórias. Se a avaliação não invasiva da inflamação for fidedig-na e reprodutível, será imprescindível na monitoriza-ção das doenças das vias aéreas.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (3): 443-460</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">It is done a review of evaluation methods of the inflammation in upper airways and bronchi used for diagnosis, therapeutic approach and prognosis of pa-thologies like rhinosinusitis and asthma. It is also analysed methods that supply relevant information of inflammation in COPD.</p><p id="sp0115" class="elsevierStyleSimplePara elsevierViewall">The chronic inflammation of the airways is associated to respiratory distress, obstruction in basal lung function tests and to bronchial and nasal hyperreactivity. Computerized tomography informs about lu-men dimensions, bronchial walls thickness and pulmonary density. These changes are associated to inflammation and to remodelling of the airways. Localized inflammation in respiratory tract can be detected by modifications of systemic inflammatory markers.</p><p id="sp0215" class="elsevierStyleSimplePara elsevierViewall">The direct evaluation of inflammatory airways changes are based on immune, histological and chemical analysis of lung tissue obtained by biopsies and by fluids recoil in basal conditions or after stimulation. The eosinophils are increased in biopsies and in nasal and bronchoalveolar lavage in asthma and rhinitis and can change with therapy. Proteins and mRNA expression of cellular activation mediators are also observed.</p><p id="sp0315" class="elsevierStyleSimplePara elsevierViewall">The induced sputum identifies eosinophilic inflammation that is inversely associated with lung function parameters.</p><p id="sp0415" class="elsevierStyleSimplePara elsevierViewall">In each respiratory cycle the air is enriched in organic volatile compounds produced by cellular breathing. FENO is the bio marker more deeply studied in asthma and its increase is well documented in this disorder.</p><p id="sp0515" class="elsevierStyleSimplePara elsevierViewall">In the exhaled air condensed, reactive oxygen species, membrane mediators, cytokines, and chemokines are identified. If the non invasive evaluation of inflammation became reliable and reproducible it will be indispensable in monitoring the airways diseases.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (3): 443-460</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:67 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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Article information
ISSN: 08732159Original language: Portuguese
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