Nasalotherapy for treatment asthma and – Breathing chronic inflammatory diseases

Partes: 1, 2

PURPOSES

This document has for aim to propose and to explain
the nasalotherapy as a therapeutic procedure for some
chronic illnesses of the breathing apparatus that have an
important inflammatory process.

To contribute with new elements for understanding the
physiopathogenesys of human asthma and to propose a new treatment
that involves a great part of the morbid processes that
contribute to its pathogenesis.

To postulate a theory that explains the possible
mechanisms of action of the nasalotherapy with local anesthetics
in the relief of patient with bronchial asthma and chronic
inflammatory processes of the respiratory tract.

INTRODUCTION

The respiratory diseases are the most common cause of
consultation and hospitalization.

Among the wide range of pathologies that affect the
respiratory tract, the bronchial asthma, the acute bronchitis,
and the chronic bronchitis, the chronic

Tonsillitis, the chronic sinusitis, and the chronic
rhinitis stand out for its high frequency of consultation, and
also for its high prevalence in the general
population.

The pathologies up mentioned have their own
physiopathogenesys, but all of them present a common denominator:
the acute or chronic inflammatory process.

Regardless of the physiopathogenesys of each one of
these pathologies, the inflammatory process not resolved leads to
their long standing, chronicity and new episodes beacuse of the
damages of the epithelia produced by the presence of a great
amount of inflammatory mediators such as histamine, neurotoxins,
prostaglandins, tromboxanes, cytokines , leukotrienes,
etc.

The high number of consultation for the same cause in a
high group of these patients leads us to the conclusion that the
antinflamatory therapies in the conventional protocols for this
group of pathologies don't satisfy the expectations of the
practitioner dealer neither of the patients.

The nasalotherapy, proposal therapeutics that
uses the membranes stabilizing and antinflamatory properties of
the local anesthetics (lidocaine chloridrate or procaine
chloridrate) which provides an antinflamatory effect, and a
stabilization of the epithelia more long standing than that of
the aines and the steroids, with less remodeling and less
epithelial damage.

The nasalotherapy is a non invasive procedure, of
easy application that uses the mucosa of the air ways (nasal
mucosa) to induce an antinflammatory effect and a stabilization
of the breathing epithelia in patient with chronic breathing
illnesses with a high inflammatory process.

The nasalotherapy is therapeutic method developed
by the author of this document, who has used it in a large number
of patients, obtaining good results in a large amount of
cases.

PHYSIOPATHOGENESIS

Obstruction of the airways in asthma is due to a
combination of factors, which includes smooth muscle spasm,
bronchial constriction, and edema of the mucosa, increase of the
mucus secretion, and infiltration especially by eosinophyls in
the walls of the airways, with important injury, and remodeling
of epithelium (2).

Within the multiple causes of bronchial constriction we
found the iatrogenic liberation of allergenic and no allergenic
mediators, autonomic disturb, inflammation by viral,
environmental and idiopathic contamination, adrenoreceptor
blockade, inhibition of the synthesis of prostaglandin,
psychological factors and physic exercise (8).

The activity of elements such as the autonomous
nervous system, the bronchial smooth muscle, and the complement
system, the calcium ions (Ca++), the epithelium and the
epithelial cell membranes of respiratory tract, the inflammatory
mediators released by cells membranes (mast cells, eosinophils
and T lymphocytes), and the liposolubility of certain substances
are important in order to understand the pathogenesis of the
bronchial asthma and its answer to the treatment proposed in this
document.

Mast cells, eosinophils and T
lymphocytes

They are the main cells in the development of the
inflammation in asthma. The evidence of the central role of the
mast cells and eosinophils in the intermittent inflammation has
been accumulated from a great amount of studies using the
technique of the nasal biopsy and the fybrooptic bronchoscope on
the mucous tissue obtained from the lower airway (13).

Epithelium

Airway epithelium is something more than a simple
physical barrier for protecting the underlying tissue against the
environmental aggressions.

Epithelial cells play an important role in the
initiation of allergic disease of the airways and in the
maintenance of the chronic inflammation in the long lasting
disease (4).

Epithelial cells release cytokines and proinflammatory
mediators, which attract the eosinophils settling a cycle of
events that perpetuate the inflammation (4).

Concentration of mast cells in nasal epithelium is
200-400 per mm3. (In rhinitis episodes the concentration is more
than 2.000 mast cells per mm3.

Leukotrienes

The products derived from the metabolism of the
araquidónico acid, the Leukotrienes, are powerful
bronchoconstrictor agents, and they increase mucus production and
micro vascular dilatation, and play a very important role in the
inflammation and airway obstruction (4).

Autonomic nervous system

Adrenergic fibers and cholinergic fibers both innervate
the bronchial smooth muscle. In the lung, the cholinergic
stimulus produces muscular contraction, and the adrenergic
stimulus produces relaxation (BETA-receptors). The Cholinergic
action causes stimulation on the bronchial glands increasing the
secretion (1).

Bronchial smooth muscle

The main autonomic effectors are the smooth muscle; it
is characterized by the instability of its membrane potential and
for showing continuous and irregular contractions.

Smooth muscle contains actina and myosin and its
contraction process supposes ATP hydrolysis, and an interaction
between actina and myosin initiated by calcium ions (Ca++)
(1).

Calcium

Free calcium ions (Ca++) regulate the permeability of
the cellular membrane, the excitability of the autonomic nervous
system, the muscular contractility, and its presence is necessary
for complement system activation (2).

Cellular membrane

The cell membrane structure of the respiratory tract
epithelium and that of the inflammatory cells with their lipid
components constitute an important part within the pathogenesis
of the asthma and in the treatment proposed in this
document.

The factors that determine the penetration of the
cellular membrane by some substance are the pores of the
membrane, the lipid solubility, the electrical charge and the
molecular size of the substance.

Complement system

The complement system activation by the classic pathway
or by the alternating pathway finishes in the conformation of the
membrane attack complex (MAC), whose action on the membrane of
the inflammatory cells depends on the lipid component of the
membrane, and on the lipophylic properties of the MAC.

Biological activities associated with the complement
which contribute to the asthma pathogenesis are the cell rupture
(liberation of inflammatory mediators), and the activation of the
membrane receptors, and the anaphiylotoxinic activity (C3C5) that
increases the vascular permeability, the smooth muscle
contraction and the mast cells degranulation (histamine
liberation) (2).

The complement system also contributes to the
chemiotaxis and to the increase of cellular adhesion
(phagocytosis).

Partes: 1, 2

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