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The effect of posture on theophylline kinetics was examined in six healthy men who took 450 mg slow‐release aminophylline orally at the same time of day on two separate occasions. On one day they remained standing and on the other supine throughout. Plasma theophylline was measured hourly for 6 h from ingestion. Mean theophylline levels were significantly higher in the standing position at all times (P less than 0.01). We conclude that diurnal variation in theophylline kinetics can be explained, at least in part, by differences in posture.
Some patients with severe inflammatory disease fail to respond to glucocorticoids, and oxidative stress contributes to this insensitivity. Importin receptors are associated with nuclear translocation of the glucocorticoid receptor (GR), which is essential for glucocorticoid function. We hypothesized that importin-7 is central to GR nuclear translocation and glucocorticoid sensitivity. We investigated the effects of importin-7 siRNA on fluticasone propionate (FP)-induced GR nuclear localization and suppression of IL-1β-induced CXCL8 and the effects of hydrogen peroxide (H2O2) plus IL-1β costimulation on importin-7 expression, function, and glucocorticoid responsiveness in a human macrophagecell line (U937). H2O2 significantly reduced FP-induced GR nuclear localization (3.4±0.51- vs. 5.7±0.85-fold increase, P<0.05) and suppression of IL-1β-induced CXCL8 (62.3±2.3 vs. 85.1±7.0%, P<0.05). Knockdown of importin-7 by 38.4 ± 11.5% (compared with control siRNA) significantly reduced FP-mediated GR nuclear localization (3.5±0.5- vs. 5.7±0.85-fold increase, P<0.05) and suppression of IL-1β-induced CXCL8 expression (40.2±16.1 vs. 68.4±3.0%, P<0.05). H2O2 plus IL-1β had no direct effect on importin-7 but caused a significant loss (61.2±12.6% compared with baseline) of nuclear RanGTP, an essential cofactor for importin-7-mediated nuclear import of cargo proteins. The importin-7 complex is essential for glucocorticoid function, and the expression of its cofactor RanGTP is reduced during oxidative stress-induced glucocorticoid insensitivity.
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Educational aims To discuss the similarities and differences in inflammation between chronic obstructive pulmonary disease (COPD) and asthma. To consider the clinical relevance of these differences. To speculate about the therapeutic implications of this basic research. Summary Both asthma and COPD are characterised by airway obstruction, which is variable and reversible in asthma but is progressive and largely irreversible in COPD. In both diseases, there is chronic inflammation of the respiratory tract, mediated by increased expression of multiple inflammatory proteins, including cytokines, chemokines, adhesion molecules, inflammatory enzymes and receptors. In both diseases, there are acute episodes or exacerbations, when the intensity of this inflammation increases. The similarity between these airway diseases prompted the suggestion in the 1960s that asthma and COPD are part of a spectrum of a common disease (chronic obstructive lung disease) and this came to be known as the “Dutch hypothesis”. This was countered by the “British hypothesis”, which maintained that these diseases were separate entities; the debate continues today, with evidence both for and against these two views [1, 2].