| 1. |
- Gustafsson, Anna, et al.
(författare)
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Antisecretory factor in breastmilk is associated with reduced incidence of sepsis in preterm infants
- 2023
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Ingår i: Pediatric Research. - 0031-3998 .- 1530-0447. ; 95:3, s. 762-69
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antisecretory Factor (AF) is a protein present in breastmilk that regulates inflammatory processes. We aimed to investigate the level of AF in mothers’ own milk (MOM) in relation to sepsis and other neonatal morbidities in preterm infants. Methods: Samples of breastmilk and infant plasma were collected at 1, 4, and 12 weeks after birth from 38 mothers and their 49 infants born before 30 weeks gestation. AF-compleasome in MOM was determined by a sandwich enzyme-linked immunosorbent assay (ELISA) and inflammatory markers in infant plasma by a panel of 92 inflammatory proteins. Neonatal treatments and outcomes were recorded. Results: The level of AF in MOM week 1 was lower for infants with later sepsis compared to no sepsis (p = 0.005). Corrected for nutritional intake of MOM, higher levels of AF decreased the risk for sepsis, OR 0.24. AF in MOM week 1 was negatively correlated to inflammatory proteins in infant plasma week 4, markedly IL-8, which was also associated with infant sepsis. Overall, higher AF levels in MOM was associated with fewer major morbidities of prematurity. Conclusion: Mother’s milk containing high levels of antisecretory factor is associated with reduced risk for sepsis and inflammation in preterm infants. Impact: High level of antisecretory factor (AF) in mothers’ own milk is associated with less risk for later sepsis in preterm infants.Receiving mothers’ milk with low AF levels during the first week after birth is correlated with more inflammatory proteins in infant’s plasma 2–4 weeks later.Human breastmilk has anti-inflammatory properties, and antisecretory factor in mothers’ own milk is a component of potential importance for infants born preterm.The findings suggest that food supplementation with AF to mothers of preterm infants to increase AF-levels in breastmilk may be a means to decrease the risk of inflammatory morbidities of prematurity.
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| 2. |
- Gustafsson, Anna, et al.
(författare)
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Changes in Antisecretory Factor in Human Milk During the Postpartum and Length of Gestation.
- 2022
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Ingår i: Journal of human lactation : official journal of International Lactation Consultant Association. - : SAGE Publications. - 1552-5732. ; 38:1, s. 131-140
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Tidskriftsartikel (refereegranskat)abstract
- Preterm infants are more susceptible to inflammatory complications than term infants. Human milk contains numerous bioactive components protecting the newborn infant. Antisecretory factor, a protein regulating secretory and inflammatory processes by complex binding with complement factors, is present in human milk.To describe antisecretory factor (1) in mother's own milk in term and preterm infants; and (2) in donor milk before and after Holder pasteurization.The study was prospective, longitudinal, explorative, and descriptive. Antisecretory factor-compleasome was determined using sandwich enzyme-linked immunosorbent assay in longitudinal human milk samples over 12 weeks from mothers (N = 87) of term (n = 41) and of preterm (n = 46) infants and 20 anonymized donor human milk samples before and after Holder pasteurization.Antisecretory factor-compleasome was overall higher in colostrum versus mature milk (p < .001) and no difference was found in term or preterm colostrum (p = .82). In mature milk, compleasome was higher and more variable in the preterm group (p = .01). After Holder pasteurization, compleasome levels increased (p < .001).Antisecretory factor followed the pattern of other immunological factors with high levels in colostrum. After preterm birth, levels of antisecretory factor were higher and more variable in mature milk. Holder pasteurization did not degrade antisecretory factor, indicating preserved anti-inflammatory properties in donor human milk.
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| 3. |
- Johansson, Ewa-Lena, et al.
(författare)
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Physical Therapy Treatment of Impaired Chest Mobility in Patients with Airway Sensory Hyperreactivity
- 2017
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Ingår i: Physiotherapy Research International. - : Wiley. - 1358-2267. ; 22:2
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose. In sensory hyperreactivity (SHR), patients have symptoms from the airways and the chest induced by environmental irritants like scenting products and cigarette smoke. They are characterized by increased cough reaction to inhaled capsaicin compared with healthy controls. Lung function tests are normal, and asthma medications have no or little effect. In a recent published article, patients with SHR were found to have impaired chest mobility and increased pain sensitivity. The purpose of this study was to evaluate if a physiotherapeutic intervention can increase chest mobility in SHR, influence these patients' symptoms and reduce capsaicin cough sensitivity. Methods. Forty-one SHR patients were initially randomized in to groups, one for training and one for symptom registration in this controlled training study. It consisted of a daily training programme containing simple movements to increase the flexibility of the chest, a breathing exercise and a relaxation session as well as symptom registration. Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors. Pain sensitivity was assessed using pressure algometry and a standardized capsaicin inhalation threshold provocation-evaluated cough sensitivity. Results. Twenty seven patients were left for analyses after 12 weeks and 26 patients after 24 weeks. Chest mobility and upper thoracic respiratory movements improved (p<0.01), feeling of chest pressure and the capsaicin cough sensitivity decreased (p<0.01). The patients also showed of significantly lowered pain pressure thresholds measured with algometry, compared with healthy controls (p<0.001). Conclusion. Improvement of chest mobility after physiotherapeutic intervention indicates that these patients may have acquired a dysfunctional breathing pattern. The regular use of a training programme and structural breathing instructions can be used to improve chest mobility, chest symptoms and capsaicin cough sensitivity in patients with SHR and signs of dysfunctional breathing. Copyright (C) 2016 John Wiley & Sons, Ltd.
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| 4. |
- Johansson, Ewa-Lena, et al.
(författare)
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Respiratory movement and pain thresholds in airway environmental sensitivity, asthma and COPD
- 2012
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 106:7, s. 1006-1013
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Patients with "sensory hyperreactivity" (SHR) have airway environmental sensitivity, chronic cough and dyspnoea. Cough, chest discomfort and sense of difficulties getting air are some of the symptoms these patients seek medical attendance for. The patients have increased cough sensitivity to inhaled capsaicin, mediated by ion channel receptors on sensory nerves also known to react to pain stimuli. Whether a link exists between capsaicin airway sensitivity and pain sensitivity has not yet been evaluated. The aim was to investigate chest mobility, respiratory movement and pain sensitivity in SHR patients compared with patients with asthma, chronic obstructive pulmonary disease (COPD) and alleged healthy control subjects. Methods: Thirty-five patients diagnosed with SHR, 19 with COPD, 32 with asthma and 28 control subjects were included. Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors. Pain sensitivity was assessed using a pressure algometer. Results: Groups differed significantly in lung function, respiratory rate and pain sensitivity but also in chest expansion and abdominal breathing movement. In comparison with the control and asthma groups but not the COPD patients, SHR patients had an increased respiratory rate and reduced abdominal movement during deep breathing. All patient groups showed lower pain thresholds than the controls. Conclusion: Patients with SHR have evident signs of dysfunctional breathing and appeared to be most similar to the COPD group except for lung function. Lower pain thresholds among the patients indicate a general up-regulation of the sensory nerve system. (C) 2012 Elsevier Ltd. All rights reserved.
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| 5. |
- Andersson, Ewa K., et al.
(författare)
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Relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care : An interview study
- 2019
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 6:2, s. 276-282
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this study was to describe relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care. Design An explorative descriptive qualitative design was used. Methods The data were collected using semi-structured interviews with a purposeful sample of eight relatives and analyzed using a qualitative content analysis. Results Results show that creating and sharing the life story of a close family member could help relatives handle grief and stress. It was perceived as an important, yet difficult, task to ensure that the close family member got good quality care. The creation of a meaningful life story takes time and requires cooperation with family members and other significant people.
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| 6. |
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| 7. |
- Fagevik Olsén, Monika, 1964, et al.
(författare)
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Long COVID - respiratory symptoms in non-hospitalised subjects - a cross-sectional study
- 2023
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 25:5, s. 283-290
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to describe and analyse the variety of respiratory appearances in Long COVID subjects who were not hospitalised during the acute phase of the infection. Methods: A consecutive series of 60 subjects participated (x) over bar 10.8 months (SD 4.5) after the acute phase of the infection. Respiratory function was tested concerning lung volumes, expiratory flow, muscle strength, physical capacity including concurrent oxygen saturation, chest expansion, lung sounds, pain and breathing pattern. Differences between those with or without positive test and duration of symptoms more or less than 6 months were analysed with T-test, Chi-square test and Fisher's exact test. Results: Decreased forced vital capacity was found in 6/60 (10%), and forced expiratory volume in 1 s and 7/60 (12%), low maximal inspiratory pressure in 38/58 (54%) and low maximal expiratory pressure in 10/58 (17%). Decreased physical capacity was registered in 36/52 (69%), and thoracic expansion in 26/46 (56%). Pathologic lung sounds had 15/58 (26%) and six patients desaturated during the test of physical capacity. A majority (36/58, 67%) presented pain in the ribcage. All but three patients (95%) showed a dysfunctional breathing pattern in sitting and standing. Only poor and fair correlations were found between age, duration and level of physical capacity compared to spirometry, respiratory muscle strength and thoracic expansion. Conclusion: Abnormal breathing pattern and respiratory movements as well as pain, and reduced lung volumes, flow, respiratory muscle strength, physical capacity and thoracic expansion may be involved in Long COVID. The breathing symptoms should therefore be looked for in a wider picture beyond spirometry and oximetry.
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| 8. |
- Fagevik Olsén, Monika, 1964, et al.
(författare)
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Variations in respiratory and functional symptoms at four months after hospitalisation due to COVID-19: a cross-sectional study
- 2024
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Ingår i: BMC PULMONARY MEDICINE. - 1471-2466. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Much remains unknown about complex respiratory symptoms after COVID-19. Here we aimed to describe and analyse patients' various respiratory symptoms 4 months after discharge from hospitalisation for COVID-19, focusing on sex, previous pulmonary disease, and prolonged mechanical ventilation. Methods This cross-sectional study involved five hospitals and included 52 patients with self-assessed respiratory dysfunction at 4 months after discharge from hospitalisation for severe COVID-19. Their average age was 63 years, 38% were women, 15 had a previous diagnosed pulmonary disease, and 29 were current or previous smokers. Additionally, 31 had required intensive care-among whom 21 were intubated and 11 needed mechanical ventilation for >= 20 days. Respiratory function was tested concerning lung volumes, expiratory flow, muscle strength, physical capacity (including concurrent oxygen saturation), thoracic expansion, and respiratory movements. Results Among 52 patients, 47 (90%) had one or several objectively measured respiratory function abnormalities. Decreased thoracic expansion was observed in 32 patients (62%), abnormal respiratory movements in 30 (58%), decreased vital capacity in 21 (40%), low physical function in 13 (26%), and desaturation during the test in 9 (17%). Respiratory inspiratory muscle strength was more commonly diminished than expiratory strength (27% vs. 8%). We did not observe differences between men and women, or between patients with versus without diagnosed pulmonary disease, except that those with pulmonary disease had significantly lower physical capacity assessed with 6MWD (70% vs. 88% predicted, p = 0.013). Compared to those who did not, patients who required >= 20 days of mechanical ventilation performed similarly on most tests, except that all thoracic breathing movements were significantly smaller (p < 0.05). The numbers and combinations of abnormal findings varied widely, without clear patterns. Conclusion Patients with remaining respiratory symptoms 4 months after discharge from hospitalization due to COVID-19 may suffer from various abnormal breathing functions, and dysfunctional breathing that is not detected using traditional measurements. These patients may benefit from multidimensional measuring of breathing movement, thoracic expansion, and respiratory muscle strength, along with traditional measurements, to assess their symptoms and enable prescription of optimal treatment interventions and rehabilitation.
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| 9. |
- Gatzinsky, Kliment, 1959, et al.
(författare)
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Elevated intracranial pressure after head trauma can be suppressed by antisecretory factor—a pilot study
- 2020
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Ingår i: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 162:7, s. 1629-37
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Tidskriftsartikel (refereegranskat)abstract
- © 2020, The Author(s). Background: Control of intracranial pressure (ICP) is a key element in neurointensive care for directing treatment decisions in patients with severe traumatic brain injury (TBI). The anti-inflammatory protein antisecretory factor (AF) has been demonstrated to reduce experimentally induced high ICP in animal models. This report describes the first steps to investigate the uptake, safety, and influence of AF for reduction of elevated ICP in patients with TBI in a clinical setting. Method: Four patients with severe TBI (Glasgow Coma Scale < 9) that required neurointensive care with ICP monitoring due to signs of refractory intracranial hypertension were investigated. One hundred milliliters of Salovum®, a commercially available egg yolk powder with high contents of AF peptides, was administrated either via nasogastric (patients 1 and 2) or rectal tube (patients 2, 3, and 4) every 8 h for 2 to 3 days as a supplement to the conventional neurointensive care. ICP was registered continuously. Plasma levels of AF were measured by enzyme-linked immunosorbent assay (ELISA) to confirm that Salovum® was absorbed appropriately into the bloodstream. Results: In the first two patients, we observed that when delivered by the nasogastric route, there was an accumulation of the Salovum® solution in the stomach with difficulties to control ICP due to impaired gastric emptying. Therefore, we tested to administer Salovum® rectally. In the third and fourth patients, who both showed radiological signs of extensive brain edema, ICP could be controlled during the course of rectal administration of Salovum®. The ICP reduction was statistically significant and was accompanied by an increase in blood levels of AF. No adverse events that could be attributed to AF treatment or the rectal approach for Salovum® administration were observed. Conclusions: The outcomes suggest that AF can act as a suppressor of high ICP induced by traumatic brain edema. Use of AF may offer a new therapeutic option for targeting cerebral edema in clinical practice.
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| 10. |
- Jennische, Eva, 1949, et al.
(författare)
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Immunohistochemical staining patterns using epitope-specific antibodies indicate conformation variants of antisecretory factor/S5a in the CNS.
- 2006
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Ingår i: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. - : Wiley. - 0903-4641. ; 114:7-8, s. 529-38
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Tidskriftsartikel (refereegranskat)abstract
- Antisecretory factor (AF/S5a/Rpn10) was originally identified through its ability to counteract pathological secretion. AF is also a potent anti-inflammatory agent, a neuromodulator, and an important component of the proteasome. Human AF has a calculated molecular mass of 41 kDa and a pI of 4.7. No family of AF-like proteins has been identified. AF has multiple functions in the cell, and different functional forms could exist as a result of post-translational modifications. Epitope-specific antibodies covering the entire length of AF were used to investigate whether modified forms of AF could be detected in the porcine spinal cord by Western blots, 2D gels, and immunohistochemistry (IHC). Western blot and 2D gels showed that all antisera detected a single protein with very similar molecular mass and pI. However, IHC resulted in an epitope-specific subcellular staining pattern. Antisera recognizing epitopes in the N-terminal part of AF, containing the antisecretory activity, showed a more restricted localisation than antisera directed at the C-terminal part, containing the ubiquitin-binding sites. We suggest that AF can exist in several conformational variants, perhaps due to differences in redox state and/or pH in the various cellular compartments. Such conformational changes could be of functional importance.
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