| 51511. |
|
|
| 51512. |
|
|
| 51513. |
- Lindén, Anders, 1961, et al.
(författare)
-
Neutrophils, interleukin-17A and lung disease
- 2005
-
Ingår i: The European respiratory journal. - 0903-1936. ; 25:1, s. 159-72
-
Tidskriftsartikel (refereegranskat)abstract
- It is now established that an excessive and sustained mobilisation of neutrophils is a hallmark of several chronic inflammatory lung disorders, including severe obstructive lung disease. This article reviews evidence that the cytokine interleukin (IL)-17A is a major orchestrator of sustained neutrophilic mobilisation. Current evidence suggests that IL-17A is produced by T-lymphocytes, and that it exerts an orchestrating effect on the accumulation and associated activity of neutrophils in the bronchoalveolar space indirectly, through an induced release of specific cytokines and colony-stimulating factors in resident lung cells. Although the involvement of IL-17A in inflammatory lung disorders is supported by several recent studies, its causative role is still uncertain. However, the unique position of interleukin-17A at the interface between acquired and innate immunity puts this cytokine forward as an important signal for the reinforcement of host defence; it also implies that interleukin-17A may constitute a useful target for pharmacotherapeutic intervention.
|
|
| 51514. |
|
|
| 51515. |
- Lindén, Anja, et al.
(författare)
-
Protocolised reduction of non-resuscitation fluids versus usual care in patients with septic shock (REDUSE): a protocol for a multicentre feasibility trial
- 2023
-
Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 13:2
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction Administration of large volumes of fluids is associated with poor outcome in septic shock. Recent data suggest that non-resuscitation fluids are the major source of fluids in the intensive care unit (ICU) patients suffering from septic shock. The present trial is designed to test the hypothesis that a protocol targeting this source of fluids can reduce fluid administration compared with usual care.Methods and analysis The design will be a multicentre, randomised, feasibility trial. Adult patients admitted to ICUs with septic shock will be randomised within 12 hours of admission to receive non-resuscitation fluids either according to a restrictive protocol or to receive usual care. The healthcare providers involved in the care of participants will not be blinded. The participants, outcome assessors at the 6-month follow-up and statisticians will be blinded. Primary outcome will be litres of fluids administered within 3 days of randomisation. Secondary outcomes will be proportion of randomised participants with outcome data on all-cause mortality; days alive and free of mechanical ventilation within 90 days of inclusion; any acute kidney injury and ischaemic events in the ICU (cerebral, cardiac, intestinal or limb ischaemia); proportion of surviving randomised patients who were assessed by European Quality of Life 5-Dimensions 5-Level questionnaire and Montreal Cognitive Assessment; proportion of all eligible patients who were randomised and proportion of participants experiencing at least one protocol violation.Ethics and dissemination Ethics approval has been obtained in Sweden. Results of the primary and secondary outcomes will be submitted for publication in a peer-reviewed journal.
|
|
| 51516. |
- Lindén, Anja, et al.
(författare)
-
Protocolized reduction of non-resuscitation fluids versus usual care in septic shock patients (REDUSE) : a randomized multicentre feasibility trial
- 2024
-
Ingår i: Critical care (London, England). - : BMC. - 1364-8535 .- 1466-609X. ; 28:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/PURPOSE: Non-resuscitation fluids constitute the majority of fluid administered for septic shock patients in the intensive care unit (ICU). This multicentre, randomized, feasibility trial was conducted to test the hypothesis that a restrictive protocol targeting non-resuscitation fluids reduces the overall volume administered compared with usual care.METHODS: Adults with septic shock in six Swedish ICUs were randomized within 12 h of ICU admission to receive either protocolized reduction of non-resuscitation fluids or usual care. The primary outcome was the total volume of fluid administered within three days of inclusion.RESULTS: Median (IQR) total volume of fluid in the first three days, was 6008 ml (interquartile range [IQR] 3960-8123) in the restrictive fluid group (n = 44), and 9765 ml (IQR 6804-12,401) in the control group (n = 48); corresponding to a Hodges-Lehmann median difference of 3560 ml [95% confidence interval 1614-5302]; p < 0.001). Outcome data on all-cause mortality, days alive and free of mechanical ventilation and acute kidney injury or ischemic events in the ICU within 90 days of inclusion were recorded in 98/98 (100%), 95/98 (98%) and 95/98 (98%) of participants respectively. Cognition and health-related quality of life at six months were recorded in 39/52 (75%) and 41/52 (79%) of surviving participants, respectively. Ninety out of 134 patients (67%) of eligible patients were randomized, and 15/98 (15%) of the participants experienced at least one protocol violation.CONCLUSION: Protocolized reduction of non-resuscitation fluids in patients with septic shock resulted in a large decrease in fluid administration compared with usual care. A trial using this design to test if reducing non-resuscitation fluids improves outcomes is feasible.TRIAL REGISTRATION: Clinicaltrials.gov, NCT05249088, 18 February 2022. https://clinicaltrials.gov/ct2/show/NCT05249088.
|
|
| 51517. |
- Lindén, Anders, 1961
(författare)
-
Rationale for targeting interleukin-17 in the lungs
- 2003
-
Ingår i: Current opinion in investigational drugs (London, England. - 1472-4472. ; 4:11, s. 1304-12
-
Tidskriftsartikel (refereegranskat)abstract
- An increasing body of evidence suggests that an exaggerated accumulation of activated neutrophils in the airways can cause decline of the clinical state in several lung diseases, including acute, severe asthma. In spite of this, an effective pharmacotherapy against this type of exaggerated neutrophil activity has yet to be developed. This review presents the scientific rationale for targeting the T-cell cytokine interleukin (IL)-17 in inflammatory lung diseases, to normalize neutrophil activity. Evidence leads to the conclusion that the production and release of IL-17 orchestrates neutrophil activity in the lungs. Hypothetically, local blockade of IL-17 may prove effective to normalize exaggerated neutrophil activity in lung diseases.
|
|
| 51518. |
- Lindén, Anders, 1961
(författare)
-
Role of interleukin-17 and the neutrophil in asthma
- 2001
-
Ingår i: International archives of allergy and immunology. - 1018-2438. ; 126:3, s. 179-84
-
Tidskriftsartikel (refereegranskat)abstract
- Recent clinical evidence shows that acute, severe exacerbations of asthma are associated with recruitment and activation of neutrophils in the airways. There is also experimental evidence from rodents that T-lymphocytes are involved in the recruitment of neutrophils following allergen challenge in sensitised airways. This review addresses the potential role of neutrophils and the cytokine interleukin-17 (IL-17) in severe asthma. IL-17 is produced and released as a free protein from T-lymphocytes of the memory (CD45RO+) subset. Evidence from rats in vivo suggests that IL-17 can recruit and activate neutrophils in the airways; the recruitment is mediated by the rat correlate to the neutrophil chemoattractant interleukin-8 (IL-8) macrophage inflammatory protein-2 (MIP-2). Endogenous peptidases modulate neutrophil recruitment by acting on NK-1 receptors in rat airways in vivo. Human bronchial epithelial cells in vitro respond to stimulation with IL-17 by increasing the production and release of the human neutrophil chemoattractant IL-8. This release of IL-8 is functionally significant; it causes neutrophil chemotaxis in vitro. Furthermore, this IL-8 release is sensitive to a glucocorticoid and is potentiated by the pro-inflammatory cytokine, tumour necrosis factor-alpha (TNF-alpha) in vitro. In addition, IL-17 stimulates human bronchial epithelial cells in vitro to release the neutrophil-activating factor IL-6. This effect of IL-17 on IL-6, and IL-8 is in part mediated via mitogen-activated protein kinases. In conclusion, as indicated in rat airways in vivo and in human bronchial epithelial cells in vitro, IL-17 may constitute a link between the activation of certain T-lymphocytes and mobilisation of neutrophils in the airways, via induced release of C-X-C chemokines and tachykinins. Further studies are required to answer the question whether free, soluble IL-17 protein plays this role in the airways of patients with severe asthma.
|
|
| 51519. |
- Lindén, Carl-Gustav, et al.
(författare)
-
Hyperlocal Media in the Nordic Region
- 2019
-
Ingår i: Nordicom Review. - : Walter de Gruyter GmbH. - 1403-1108 .- 2001-5119. ; 40:S2, s. 3-13
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 51520. |
- Linden, Charlotte, et al.
(författare)
-
Raising teenage children in disadvantaged neighbourhoods : the experiences and challenges of immigrant mothers in Sweden
- 2022
-
Ingår i: Journal of Family Studies. - : Routledge. - 1322-9400 .- 1839-3543. ; , s. 1-24
-
Tidskriftsartikel (refereegranskat)abstract
- Parenting is arguably the most critical factor in protecting teenagers from problem behaviours, such as delinquency and substance use. For immigrant mothers, however, the ability to care for their children might be negatively affected by challenges related to acculturation and area deprivation. The aim of this study was to raise this issue by examining parenting challenges and needs among immigrant mothers of teenagers living in disadvantaged neighbourhoods in Sweden. Such knowledge is crucial for society to be able to adequately support families in promoting their teenagers well-being. Based on an intersectional framework and qualitative interviews with 14 mothers, four themes related to challenges and needs emerged: structural challenges, cultural transition, psychosocial problems, and social support. The themes were highly intertwined and demonstrated substantial distress among immigrant mothers in relation to their parenting and protecting their children. Mothers’ were, therefore, highly engaged in parenting and expressed a desire and motivation to improve their parenting through social support. The introduction of culturally sensitive parenting support specifically aimed at this marginalized group of parents is encouraged.
|
|
