Inflammatory Mediators Of Asthma Health Essay

Inflammatory Mediators Of Asthma Health Essay Once IgE binds to mast cells (or activated eosinophils), an amplification system operates since the cells not only release the spasmogens and other mediators specified but also can stimulate ÃŽ ² cells to produce more IgE. Furthermore, the production of IL-5, IL-4 IL-13 and IL-9 amplifies the Th2-mediated events. It is believed that asthma symptoms are manifested because of Th2 mediated immune response. Pulmonary allergic inflammation in mice lead to decrease in pulmonary IL-5 concentration, specific IgE, IgG1, and eosinophil and T cell recruitment in wild type mice in the absence of T cells. T cells are important in IL-4 dependent IgG1, IgE and Th2 cell mediated lung inflammation, further more there is evidence that CD4+T cells have a role in asthma process. For example, in murine model external protein induced T cells increases IL-5 production and produces airway eosinophilia. (Larche et al. 2003) Asthma is a complex chronic inflammatory airway disorder that involves the activation of the inflammatory and structural cells. These released inflammatory mediators cause typical pathophysiological changes of asthma (Peter et al., 2003). There are several lines of evidence that may implicate a mediator in asthma. Firstly, it may mimic features of clinical asthma. Secondly, the mediator may be produced in asthmatic patients. Thus, mediators or their metabolites may be detected in plasma (e.g. histamine), urine (e.g. LTE4), or more likely, the airways in biopsies, bronchoalveolar lavage fluid, induced sputum or exhaled air. 1.8.3.1. Histamine Histamine was the first mediator implicated in the pathophysiological changes of asthma (Barnes et al., 1998). Histamine is one of the important mediator of allergy, inflammation and bronchoconstriction. Histamine is synthesized and released by mast cells in the airway wall and by circulating and infiltrating basophils. Antigen-induced histamine secretion is initiated by the bridging of the adjacent IgE receptors on the mast cell surface. Histamine receptors are among the thousands of members of the 7-transmembrane-spanning family of receptors that couple ligand binding to intracellular reactions through interactions with another large family of guanosine triphosphate (GTP)-binding heterotrimeric proteins. H1-receptors mediate a host of intracellular events most readily characterized by changes in free cytosolic calcium levels. Histamine show different response in mammalian tissue depends upon presence of receptor on that tissue Kulkarni, (1976). 1.8.3.2. Adenosine Adenosine can act as an autocoid cause bronchoconstriction in asthmatics and increase immunologically induced mediator release from mast cells of human lung (Cushley et al., 1984; Peachell et al., 1988). Mast cells also release adenosine in response to IgE cross-linking and other stimuli for mast cell activation. 1.8.3.3. Lipid-Derived Mediators Leukotrienes Leukotrienes are potent lipid mediators produced by arachidonic acid metabolism in cell or nuclear membrane. Several types of airway inflammatory cells, like eosinophils, macrophages, mast cells, neutrophils, and epithelial cells, can synthesize LTs in response to a variety of stimuli. Leukotrienes are important inflammatory mediators involved in the pathogenesis of asthma. All the Cys-LTs are potent constrictors of bronchial smooth muscle. On a molar basis, LTD4 is 1000 times more active than histamine and constrict bronchioles (Dahlen et al., 1980). Cys-LTs, acting on Cys-LT1 receptors produce bronchospasm, airway hyper-responsiveness, proliferation of airway smooth muscle, excess production of mucus and mucosal edema and eosinophilia in the airways, and other features in asthma (Sundeep et al., 2001; Peter, 1998). Platelet Activating Factor (PAF) PAF is ether-linked phospholipid. The synthesis of PAF occurs in inflammatory cells, including platelet, neutrophils, basophils, macrophages and eosinophils. PAF induces airway smooth muscle contraction by releasing other mediators. PAF-induced bronchoconstriction is not inhibited by H1 receptor antagonist Ketotifen. However, PAF-induced bronchoconstriction can be inhibited by LT antagonists, because of involvement of LTD4 in this response. PAF stimulate chemotaxis and adhesion of eosinophils and neutrophils in-vitro (Peter et al., 2003). Prostanoids Prostanoids include prostaglandins (PGs) and thromboxane (Tx), which are generated from arachidonic acid, usually by the action of COX. In general PGF2 and PGD2 contract and PGE relax tracheal muscle. Asthmatic individuals are particularly sensitive to PGF2ÃŽ ±, which may cause intense bronchospasm. Although both PGE1 and PGE2 can produce bronchodilatation when given to such patients by aerosol, bronchoconstriction sometime is observed. Tx analogue U 46619 is a potent constrictor in asthmatic patients, and this effect is mediated in part via acetylcholine release. Prostanoids stimulate airway mucus secretion in various animal species. It inhibits the release of mediators from mast cells, monocytes, neutrophils and eosinophil inflammatory cells (Peter et al., 2003). 1.8.3.4. Cytokines Cytokines are small protein mediators that play an integral role in the coordination and persistence of inflammation in asthma. Many inflammatory cells macrophages, mast cells, eosinophils and lymphocytes) are capable of synthesizing and releasing these proteins. Th2 lymphocytes produce a panel of cytokines, including IL-5, IL-4, IL-13 and IL-9 (Barnes et al., 1998). 1.8.3.4.1. Interleukin-4 IL-4 is critical for the synthesis of IgE by B-cells and for eosinophils recruitment. IL-4 is also involved in Th2 cell differentiation. IL-4 is a key factor in the development of allergic inflammation, and they may also play a major role in exacerbating asthmatic symptoms (Adcock and Caramori, 2003). Figure 11. Role of CD4+Th2cells and Various cytokines in asthma pathogenesis. 1.8.3.4.2. Interleukin-5 It play important role in allergic asthma. IL-5 promote the maturation of eosinophils from bone marrow processor, prolongs their survival by inhibition of apoptosis, activates mature eosinophil recruitment to tissue via synergistic effect with chemoattractants such as eotaxin and promote eosinophil adhesion of vascular endothelium.IL-5 can also promote basophils to release exaggerated amounts of histamine and leukotrienes, mediators that contribute to allergic bronchospasm and congestion in asthma (Fred et al., 2000). 1.8.3.4.3. Interleukin-9 Its major actions include maturation of eosinophils, airway inflammation, airway hyper-responsiveness and mucus over production (Adcock and Caramori, 2003). 1.8.3.4.4. Interleukin-13 IL-13 is critical for the synthesis of IgE by B-cells. Activates eosinophils, monocyte. IL-13 is a key factor in the development of allergic inflammation and they may also play a major role in exacerbating asthmatic symptoms (Barnes et al., 1998). 1.8.3.5. Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) GM-CSF is one of the colony-stimulating factor that acts to regulate the growth, proliferation and maturation of hematopoietic cells.GM-CSF can enhance the release of superoxide anions, also induce eosinophil apoptosis and activation, induces release of LTs, endothelial cell migration (Barnes et al., 1998). 1.8.3.6. Reactive Oxygen Species in Asthma Reactive oxygen species (ROS) are generated by various enzymatic reactions and chemical processes or they can directly be inhaled. ROS are essential in many physiological reactions and are important for the killing of invading microorganisms. However, when airway cells and tissues are exposed to oxidative stress elicited by environmental pollutants, infections, inflammatory reactions or decreased levels of anti- oxidants, enhanced levels of ROS can have a variety of deleterious effects within the airways thereby inducing several pathophysiological conditions. It has been shown that ROS can damage DNA, lipids, proteins and carbohydrates leading to impaired cellular functions and enhanced inflammatory reactions. ROS are known to play a prominent role in the pathogenesis of various airway disorders such as adult respiratory distress syndrome (ARDS), cystic fibrosis, idiopathic fibrosis, chronic obstructive pulmonary diseases (COPD) and asthma (Gillissen and Nowak, 1998; Repine et al., 1997).

To Have Or Not To Have Caesarean Section Essay example -- essays paper

To Have Or Not To Have Caesarean Section Years ago caesarean section (c-section) was only done in cases of emergency such as when the mother’s life or the neonate’s life is in danger. However at the turn of the century, there seems to have a remarkable rise in c-section deliveries. It seems that women nowadays are willing to take the risk of surgery to avoid the stress and pain of labor rather than experience the normal trend of delivering a baby vaginally – the normal way. The majority of pregnant women believe that the best method of giving birth is the least painful but this is not necessarily the safest (Ghetti, Chan & Guise 2004). Amazingly some obstetricians have become advocates for this surgical procedure instead of advisors to what is really suitable for the individual. What it is that drives women to go for a mutilating procedure rather than a simple laceration of a normal birth? The answer is obvious. The modern women are scared of pain, of the long stretch of labor and the stress that comes along with it. But what the modern women should understand is that delivering babies by caesarean section is not the answer to a pain-free delivery (Smeltzer & Bare, 2002). Caesarean Section – Its Beginning Many people think that c-section is a modern method of delivering babies. The truth is, â€Å"†¦ caesarean section has been a part of human culture since the ancient times†¦Ã¢â‚¬ (The National Institute of Health Convention, 1998). In fact history tells about the birth of Julius Caesar by c-section, thus the term â€Å"caesarean† came into use. However, modern historians do not believe that Julius Caesar ‘s birth was by c-section since his mother had been mentioned in some part of history to be alive when Caesar was already a reigning ... ...Ghetti,C., Chan, BKS., & Guise, J. (2004). Physicians’ responses to patient requested-caesarean delivery. Retrieved March 2, 2005 form www.cinahl/chi-bin/refsvc Ignatavicious, D. & Workman, L. (2001). Medical-surgical nursing: Critical thinking collaborative care. (4thed.). Philadelphia, PA: Mosby, Inc. Lowdermilk, D. & Peryy, S. (2004). Maternity and women’s health care. (4th ed.). St. Louise, MO: Mosby, Inc. Porter, M. & Bhattachary, S. (2004). Preventing unnecessary caesarean section: Marginal benefit of a second opinion. The Lancet. 364, 1921. Rubin, R. (2004). Do you have a choice? USA Today, Sept.16, 2004, D-08. Smeltzer, S.C. & Bare, B. (2002). Medical-surgical nursing. (9thed.). Philadelphia, PA: Lippincott Williams & Wilkins. Stein, R. (2004). Findings on caesarean section rekindle debate. The Washington Post, Dec. 15, 2004, p. A-18.

Marc Antony’s Soliloquy: An Analysis

My transformation of the Shakespearean text employs many different grammatical features to create an effective, modern version of Marc Antony’s soliloquy. Features such as nominalisation, paragraphing and abstract noun groups are a few of the features used. My transformation is suitable for modern audiences, using both language and people that today’s society is familiar with. My transformed version of the soliloquy uses many grammatical techniques and features to make it as interesting and grammatically correct as possible, whilst making it a piece of writing that people today are used to reading and/or hearing. Nominalisation is an important grammatical feature, which allows you to increase the levels of linguistic complexity as the text becomes more abstract, through leaving out the action of the nominalised verb. Words like ability, possibly and determination are all examples of nominalisation, and give more meaning into a sentence without needing to make the sentence longer than necessary. Overall, this gives the text as a whole more depth and meaning. The paragraphing used sets out the different ideas being introduced into the text, organising them into different paragraphs where all the ideas flow together. Sentence structures tie together the text, ensuring that ideas flow and it is more interesting for the reader. Using different sentence types, like compound and complex, mixes up the text a bit and keeps readers engaged as they continue to read the text. Obviously, people are more likely to continue to read something if they are interested in it, and I wanted my speech to engage readers and listeners. Clause combinations help to set out and organise ideas nicely, using different types of sentences to again create interest. I have used abstract noun groups to involve the listeners in the text, letting them connect with the speech through them using their pre-conceived ideas of what the words mean. Abstract nouns, being things that you can’t actually see or touch, means that listeners have to substitute in what their meaning of the word is, therefore making them think about the text more. I wanted my speech to make people think, and the use of abstract nouns helps to achieve that. Abstract noun groups such as ‘kind-hearted and generous, strong willed and fair’ are examples of this. When I first started the modern version, I had in my mind a clear image of what I wanted it to be like. With using the different techniques and features, I believe I’ve reached my idea of what I wanted. One of the hardest things that I was faced with when I started to re-write the soliloquy was who to write about, and who’s perspective to write from. After a lot of thought, I finally decided on Margaret Thatcher and Tony Blair. I thought that it would be a good fit, for numerous reasons. Both Caesar and Thatcher were controversial people. Both had their lovers and their haters, and there was never really an in between. They were both major political figures of their time, and had large effects on their society during their rein. Not only did I feel they shared many similarities, but I’ve always been interested in Thatcher. It seems that both Caesar and Thatcher were very strong-willed, and knew exactly what they wanted. In Antony’s speech, he was mainly paying tribute to Caesar, and I knew that a figure such as Tony Blair would do the same for Thatcher. Having both speeches set at a funeral made sure that similarities were kept, same as the references to ‘after a person dies, the bad is remembered and the good forgotten’. Whilst I tried as much as I could to modernise the text, I tried to keep it quite formal. This is obviously because the speech is being performed by an ex-Prime Minister at another ex-Prime Minister’s funeral, which is quite the formal occasion. In the Shakespearean version, Antony talks about how Brutus says that Caesar is an honourable man, but he believes differently. In my version, Blair speaks about how many people often loathed Thatcher. In this, I have both similarities and differences. The language I have used is more modern, employing slang and generally newer ways of speaking. Overall, I’m very happy with my transformation of the Shakespearean text. The different grammatical features used has made the soliloquy very effective. My version is suitable for modern readers, and follows the basic storyline the original soliloquy uses.

How Did Hatshepsut Die What Caused Her Death

Hatshepsut, also known as Maatkare, was an 18th Dynasty pharaoh of Ancient Egypt. She ruled longer than any other woman we know of who was an indigenous Egyptian. She officially ruled as co-ruler with her stepson,  Thutmose  III, but had taken on powers as a pharaoh herself for between 7 and 21 years. She was one of a very few women to rule as pharaoh. Hatshepsut died at about age 50, according to a stela at Armant. That date has been resolved to January 16, 1458 BCE by some. No contemporary source, including that stela, mentions how she died. Her mummy was not in her prepared tomb, and many of the signs of her existence had been erased or written over, so the cause of death was a matter of speculation. Speculation Without a Mummy In the late nineteenth and through the twentieth century, scholars speculated on the cause of her death. She died shortly after  Thutmose III returned from a military campaign as head of the armies.  Because apparently her mummy had been lost or destroyed, and Thutmose III had apparently tried to erase her reign, counting his reign from his fathers death and erasing signs of her rule, some speculated that her stepson Thutmose III might have had her killed. Looking for the Mummy of Hatshepsut Hatshepsut had been preparing one tomb for herself as Great Royal Wife of  Thutmose II. After she declared herself the ruler, she began a new, more appropriate tomb for one who had ruled as pharaoh. She began to upgrade the tomb of her father Thutmose I, adding a new chamber. Either Thutmose III or his son, Amenhotep II, then moved Thutmose I to a different tomb, and it was suggested that Hatshepsuts mummy was placed in the tomb of her nurse instead. Howard Carter discovered two female mummies in the tomb of Hatshepsuts wetnurse, and one of those was the body identified in 2007 as the mummy of Hatshepsut by Zahi Hawass. (Zahi Hawass is an Egyptologist and former Minister of State for Antiquities Affairs in Egypt who was controversial for both self-promotion and tight control when he was in charge of archaeological sites. He was a strong advocate for the return of Egyptian antiquities to Egypt from museums of the world.) Mummy Identified as Hatshepsut: The Evidence for Cause of Death Assuming that identification is correct, we know more about likely causes of her death. The mummy shows signs of arthritis, many dental cavities and root inflammation and pockets, diabetes, and metastasized bone cancer (the original site cannot be identified; it may have been in soft tissue like the lungs or breast). She was also obese. Some other signs show the likelihood of skin disease. Those examining the mummy concluded that it is most likely that the metastasized cancer killed her. Another theory derives from the dental root inflammation and pockets. In this theory, extraction of a tooth resulted in an abscess which, in her weakened condition from cancer, was what actually killed her. Did skin cream kill Hatshepsut? In 2011, researchers in Germany identified a carcinogenic substance in a vial that is identified with Hatshepsut, leading to speculation that she may have used a lotion or salve for cosmetic reasons or to treat a skin condition, and this led to cancer. Not all accept the flask as actually connected with Hatshepsut or even contemporary to her lifetime. Unnatural Causes There was no evidence found from the mummy of unnatural causes of death, though academics had long assumed her death might have been hastened by enemies, perhaps even her stepson. But more recent scholarship does not accept that her stepson and heir was in conflict with Hatshepsut. Sources Zahi Hawass. The Search for Hatshepsut and the Discovery of Her Mummy. June 2007.Zahi Hawass. Quest for the Mummy of Hatshepsut. June 2006.John Ray. Hatshepsut: the Female Pharaoh.  History Today.  Volume 44 number 5, May 1994.Gay Robins.  Women in Ancient Egypt.  1993.Catharine H. Roehrig, editor.  Hatshepsut: From Queen to Pharaoh. 2005. Article contributors include Ann Macy Roth, James P. Allen, Peter F. Dorman, Cathleen A. Keller, Catharine H. Roehrig, Dieter Arnold, Dorothea Arnold.Secrets of Egypts Lost Queen. First aired: 7/15/07. Discovery Channel. Brando Quilico, executive producer.Joyce Tyldesley.  Hatchepsut the Female Pharaoh.  1996.