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Dallas, TX, United States

Marple B.F.,Southwestern Medical Center at Dallas
American Journal of Rhinology and Allergy | Year: 2010

Background: Allergic rhinitis (AR), the most common chronic allergic condition in outpatient medicine, is associated with immense health care costs and socioeconomic consequences. AR's impact may be partly from interacting of respiratory conditions via allergic inflammation. This study was designed to review potential interactive mechanisms of AR and associated conditions and consider the relevance of a bidirectional "unified airway" respiratory inflammation model on diagnosis and treatment of inflammatory airway disease. Methods: MEDLINE was searched for pathophysiology and pathophysiological and epidemiologic links between AR and diseases of the sinuses, lungs, middle ear, and nasopharynx. Results: Allergic-related inflammatory responses or neural and systemic processes fostering inflammatory changes distant from initial allergen provocation may link AR and comorbidities. Treating AR may benefit associated respiratory tract comorbidities. Besides improving AR outcomes, treatment inhibiting eosinophil recruitment and migration, normalizing cytokine profiles, and reducing asthma-associated health care use in atopic subjects would likely ameliorate other upper airway diseases such as acute rhinosinusitis, chronic rhinosinusitis (CRS) with nasal polyposis (NP), adenoidal hypertrophy, and otitis media with effusion. Conclusion: Epidemiological concordance of AR with several airway diseases conforms to a bidirectional "unified airway" respiratory inflammation model based on anatomic and histological upper and lower airway connections. Epidemiology and current understanding of inflammatory, humoral, and neural processes make links between AR and disorders including asthma, otitis media, NP, and CRS plausible. Combining AR with associated conditions increases disease burden; worsened associated illness may accompany worsened AR. AR pharmacotherapies include antihistamines, leukotriene antagonists, intranasal corticosteroids, and immunotherapy; treatments attenuating proinflammatory responses may also benefit associated conditions. Copyright © 2010, OceanSide Publications, Inc. Source

Walker D.,Southwestern Medical Center at Dallas
Seminars in cutaneous medicine and surgery | Year: 2011

Dermatologists are presented with a diversity of therapeutic modalities for the treatment of inflammatory, sclerosing, and neoplastic conditions, but with the development of various new irradiation devices that utilize specific parts of the electromagnetic spectrum, phototherapy has become a more viable, accessible, and efficacious option in the treatment of these conditions. The ultraviolet (UV) range (10-400 nm) is further subdivided into UVA and UVB, each of which has been particularly useful in a number of skin conditions. The most commonly used forms of UV irradiation are UVA1, psoralen plus UVA (PUVA), and narrowband (NB) UVB. Each of these modalities differ in their mechanism of action, indications, and side effect profiles, and it is important that clinicians be familiar with these differences. Today, phototherapy is a valuable option in the treatment of many nonpsoriatic conditions including atopic dermatitis, sclerosing skin conditions such as morphea, vitiligo, and mycosis fungoides. Due to its relative safety, phototherapy may be used in most populations, including children and pregnant women. However, contraindications and side effects are known and should be considered before patients begin a phototherapeutic regimen. Copyright © 2011 Elsevier Inc. All rights reserved. Source

Dyer J.S.,Ohio State University | Rosenfeld C.R.,Southwestern Medical Center at Dallas
Seminars in Reproductive Medicine | Year: 2011

Epidemiological studies have suggested that metabolic programming is one of the critical factors contributing to the etiology of obesity as well as concurrent increase in related chronic diseases (e.g., type 2 diabetes and cardiovascular disease). Metabolic programming is the phenomenon whereby a nutritional stress/stimulus applied during critical periods of early development permanently alters an organism's physiology and metabolism, the consequences of which are often observed much later in life. The idea of metabolic programming originated from the fetal origins hypothesis proposed by Barker in which he suggested that disproportionate size at birth of the newborn due to an adverse intrauterine environment correlated well with an increased risk of adult-onset ill health outcomes (type 2 diabetes, hypertension, and cardiovascular disease). The fetal origins hypothesis, proposed by Barker, suggests that adequate nutrition during fetal development is critical. Overnutrition is a form of malnutrition that has increased in the United States over the past several decades in which nutrients are oversupplied relative to the amounts required for normal growth, development, and metabolism. Evidence for the effects of maternal obesity and overnutrition on metabolic programming is reviewed during critical prenatal, perinatal, and postnatal periods. Copyright © 2011 by Thieme Medical Publishers, Inc. Source

Lehrman M.A.,Southwestern Medical Center at Dallas
Trends in Biochemical Sciences | Year: 2015

The mechanism for flipping large lipid-linked oligosaccharides across membranes has remained a paradox. Perez. et al. now report the structure of the PglK protein of. C. jejuni, a flippase for a bacterial lipid-linked oligosaccharide, and reveal an unexpected whip-like mechanism. © 2015 Elsevier Ltd. Source

Zhong D.,Southwestern Medical Center at Dallas | Blount P.,Southwestern Medical Center at Dallas
Biochemistry | Year: 2013

The bacterial mechanosensitive channel of large conductance (MscL) directly senses and responds to membrane tension. It serves as an "emergency release valve" upon acute decreases in the osmotic environment, thus preventing cell lysis. It is one of the best studied mechanosensitive channels and serves as a paradigm of how a channel senses and responds to its membrane environment. The MscL protein is highly conserved, found throughout the bacterial kingdom, and has been shown to encode a functional mechanosensitive channel in all species where it has been studied. However, channels from different species have shown some functional variance; an extreme example is the Mycobacterium tuberculosis MscL, which when heterologously expressed in Escherichia coli requires significantly more membrane tension for gating than the endogenous E. coli MscL. We previously speculated that the membrane environment or factors not found in E. coli promoted the proper gating of the M. tuberculosis MscL channel in its native environment. Here, by reconstituting the M. tuberculosis and E. coli MscL channels in various lipids, we demonstrate that inclusion of phosphatidylinositol, a lipid found in M. tuberculosis but not E. coli, is sufficient for gating of the M. tuberculosis MscL channel within a physiological range of membrane tension. © 2013 American Chemical Society. Source

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