Tracheal Mucosa Research Articles

Efficiency, Efficacy, and Safety of EZ-Blocker Compared with Left-sided Double-lumen Tube for One-lung Ventilation

Double-lumen tubes (DLTs) or bronchial blockers are commonly used for one-lung ventilation. DLTs are sometimes difficult or even impossible to introduce, and the incidence of postoperative hoarseness and airway injuries is higher. Bronchial blockers are more difficult to position and need more frequent intraoperative repositioning. The design of a Y-shaped bronchial blocker, the EZ-Blocker (Teleflex Life Sciences Ltd., Athlone, Ireland) (EZB), combines some advantages of both techniques. The objective of this study was to assess whether EZB performs clinically better than left-sided DLTs (Broncho-cath; Mallinckrodt, Athlone, Ireland) without causing more injury. Primary outcome was the frequency of initial malpositions. Eligible patients were adults scheduled for surgery requiring one-lung ventilation who met criteria for placement of both devices. In this parallel trial, 100 consecutive and blinded patients were assigned randomly using a computer-generated list to two groups. The incidence of malposition and ease and time of placement were recorded. Blinded assessors investigated quality of lung deflation, postoperative complaints, and damage to the airway. Placement of a DLT was unsuccessful twice. The incidence of initial malposition was high and comparable between EZBs (37 of 50) and DLTs (42 of 49) (P = 0.212). Placing single-lumen tubes and EZBs took more time but was rated easier. Quality of lung deflation was comparable. Fewer patients in the EZB group complained of sore throat at day 1. There was a higher incidence of tracheal hematoma and redness and bronchial hematoma in the DLT group. The EZB is an efficient and effective device for one-lung ventilation and causes less injury and sore throat than a DLT.

Obstructive Fibrinous Tracheal Pseudomembrane

Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare cause of failed extubation. OFTP may be more common than described in the literature. OFTP results from ischemic injury to tracheal mucosa and may be the initial stage of the development of tracheal stenosis. Early diagnosis and treatment can prevent re intubation and mortality. We present a rare case of OFTP. The patient was intubated for 3 days for asthma exacerbation and was appropriately discharged. The patient was seen the second time in the emergency room and was treated for asthma exacerbation on the same day. Because of persistent symptoms after 3 days, CT scan of the chest was performed, which indicated necrotizing tracheitis with gas formation within the tracheal wall. Bronchoscopy showed no evidence of necrosis, but there was a thick white plaque toughly adherent to the tracheal wall.

Single-Staged Laryngotracheal Reconstruction for Idiopathic Tracheal Stenosis

This study retrospectively evaluated the results of surgically treated idiopathic tracheal stenosis. Of the 220 patients surgically treated for idiopathic subglottic and tracheal stenosis in the participating hospitals, we reviewed the surgical records of all patients with idiopathic tracheal stenosis. This subgroup required resection of all of the involved mucosa but frequently had undergone more conservative treatments that damaged the tracheal mucosa and cartilage and complicated the definitive surgical treatment. During the study period, 60 women (93.8%) and 4 men (6.2%), who were a mean age of 50 years (range, 19 to 77 years), were surgically treated for idiopathic tracheal stenosis, with no operative deaths. Of these 64 patients, 38 (59.3%) had undergone previous treatments in other centers: dilation, 26 (40.6%); laser only, 19 (31%); laser plus tracheal prosthesis, 5 (7.8%); tracheostomy, 7 (11.6%); T tube, 2 (3%); and laryngotracheal operations, 5 (7.8%). All patients were treated with a single-staged tracheal or laryngotracheal operation, of which 59 (98%) successful. Four of the most complex stenoses, with vocal cords and cricoid plate involvement, underwent reoperation for restenosis or larynx inconsistency. One patient was considered biologically unfit for reoperation and required a permanent T tube for restenosis. Half of the operations were temporary tracheostomies with T tube for larynx modelling. The most frequent postoperative complications were dysphonic voice in 10 patients (although in 7 instances this began months or years before the operation), granulation tissue in 10, aspiration in 3, and wound infections in 2. Idiopathic stenosis occurred predominantly (90% of cases) in women. Single-staged laryngotracheal correction was successful in 97%. Technique selection, with or without temporary laryngeal stenting, must be individualized with respect to the vocal cords' mobility, function, and distance from the stenosis.

Do lower cuff pressures reduce damage to the tracheal mucosa? A scanning electron microscopy study in neonatal pigs

Modern high volume-low pressure (HVLP) endotracheal tubes (ETT) cuffs can seal the trachea using baseline cuff pressures (CP) lower than peak inspiratory airway pressures (PIP). The aim of the study was to determine whether this technique reduces the damage to the tracheal mucosa compared to constant CP of 20 cmH(2)O. Eighteen piglets were intubated with an ID 4.0 mm HVLP cuffed ETT (Microcuff PET) and artificially ventilated with 20 cmH(2)O PIP and 5 cmH(2)O PEEP. Animals were randomly allocated to two groups of CP: group A (just seal; n = 9) and group B (20 cmH(2)O; n = 9), controlled constantly with a manometer during the following 4-h study period under sevoflurane anesthesia. After euthanasia, cuff position was marked in situ. Damage in the cuff region was evaluated with scanning electron microscopy (SEM) examination by grading of mucosal damage and by estimating percentage of intact mucosal area both by a blinded observer. Maximal CP to seal the trachea in group A ranged from 12 to 18 cmH(2)O (median: 14 cmH(2)O). Using a mixed effects model approach, the estimated mean effect of group B vs group A was an increase of 17.9% (SE 8.1%) higher proportion of pictures with an area of at least 5% intact mucosa (P = 0.042). Minimal sealing pressures with cyclic pressure changes from CP did not result in decreased damage to the tracheal mucosa compared to constant CP of 20 cmH(2)O in this short-term animal trial.

Desnutrição materna durante a lactação em ratos Wistar: efeitos sobre as fibras elásticas da matriz extracelular na traqueia dos filhotes

To investigate the effects of maternal protein malnutrition during lactation on the elastic fibers in the tracheas of Wistar rat pups. At delivery, 12 male pups of two Wistar rat dams were equally divided into two groups: control, in which the dam received water and standard rat chow ad libitum during lactation; and protein-restricted (PR), in which the dam received water ad libitum and an isoenergetic PR diet (8% protein). At 21 days of age, the pups were killed and their tracheas were excised. The elastic fibers were stained with Weigert's resorcin-fuchsin (after oxidation) and evaluated under light microscopy. Morphometric determinations were performed by stereology, with the point-counting method, and expressed as volumetric densities. Elastic fibers, most having a longitudinal distribution, were identified beneath the tracheal mucosa. In addition, well-defined circular layers of elastic fibers were found around the inner and outer surfaces of the cartilaginous ring. There were no differences between the groups regarding the organization and distribution of the elastic fibers. The volumetric density of the elastic fibers of the pups in the control and PR groups was 2.46 ± 0.99% and 3.25 ± 1.13%, respectively (p < 0.01). The volumetric density of elastic fibers appears to be greater in rat pups breastfed by dams receiving a PR diet than in those breastfed by dams receiving a normal diet.

External Tracheal Stabilization Technique for Acquired Tracheomalacia Using a Tailored Silicone Tube

Here, we describe an external tracheal stabilization technique used in a patient with tracheomalacia. A 56-year-old man presented with tracheomalacia due to prolonged mechanical ventilation. The malacic tracheal segment was approximately 2 cm in length. The malacic segment was covered with a silicone tube sutured in place using Prolene sutures (Ethicon, Somerville, NJ). Several anchoring sutures were placed between the tracheal mucosa and the silicone tube without violating the mucosal continuity. The patient was discharged on postoperative day 5 without complication. This method of external tracheal stabilization is a less invasive alternative for the management of this particular patient.

The genes of all seven CYP3A isoenzymes identified in the equine genome are expressed in the airways of horses

In the present study, we examined the gene expression of cytochrome P450 3A (CYP3A) isoenzymes in the tracheal and bronchial mucosa and in the lung of equines using TaqMan probes. The results show that all seven CYP3A isoforms identified in the equine genome, that is, CYP3A89, CYP3A93, CYP3A94, CYP3A95, CYP3A96, CYP3A97 and CYP3A129, are expressed in the airways of the investigated horses. Though in previous studies, CYP3A129 was found to be absent in equine intestinal mucosa and liver, this CYP3A isoform is expressed in the airways of horses. The gene expression of the CYP3A isoenzymes varied considerably between the individual horses studied. However, in most of the horses CYP3A89, CYP3A93, CYP3A96, CYP3A97 and CYP3A129 were expressed to a high extent, while CYP3A94 and CYP3A95 were expressed to a low extent in the different parts of the airways. The CYP3A isoenzymes present in the airways may play a role in the metabolic degradation of inhaled xenobiotics. In some instances, the metabolism may, however, result in bioactivation of the xenobiotics and subsequent tissue injury.

Protease-Activated Receptor 2 Mediates Mucus Secretion in the Airway Submucosal Gland

Protease-activated receptor 2 (PAR2), a G protein-coupled receptor expressed in airway epithelia and smooth muscle, plays an important role in airway inflammation. In this study, we demonstrated that activation of PAR2 induces mucus secretion from the human airway gland and examined the underlying mechanism using the porcine and murine airway glands. The mucosa with underlying submucosal glands were dissected from the cartilage of tissues, pinned with the mucosal side up at the gas/bath solution interface of a physiological chamber, and covered with oil so that secretions from individual glands could be visualized as spherical bubbles in the oil. Secretion rates were determined by optical monitoring of the bubble diameter. The Ca2+-sensitive dye Fura2-AM was used to determine intracellular Ca2+ concentration ([Ca2+]i) by means of spectrofluorometry. Stimulation of human tracheal mucosa with PAR2-activating peptide (PAR2-AP) elevated intracellular Ca2+ and induced glandular secretion equal to approximately 30% of the carbachol response in the human airway. Porcine gland tissue was more sensitive to PAR2-AP, and this response was dependent on Ca2+ and anion secretion. When the mouse trachea were exposed to PAR2-AP, large amounts of secretion were observed in both wild type and ΔF508 cystic fibrosis transmembrane conductance regulator mutant mice but there is no secretion from PAR-2 knock out mice. In conclusion, PAR2-AP is an agonist for mucus secretion from the airway gland that is Ca2+-dependent and cystic fibrosis transmembrane conductance regulator-independent.

Case reports: Iatrogenic bronchial rupture following the use of endotracheal tube introducers

Endotracheal tube introducers are often used in difficult tracheal intubations, but they are rarely deemed responsible for airway injuries. There have been only a few reports of severe complications, such as pharyngeal perforation, mainstem bronchus bleeding, perforation of the tracheal mucosa, and tracheal abrasion associated with hemopneumothorax. Using a computed tomography (CT) scan, we illustrate two cases of non-severe airway injuries related to endotracheal tube introducers. We present two cases of distal bronchial lacerations caused by introducers. The first occurrence was caused by a Muallem ET Tube Stylet (METTS) in a patient who underwent surgery for a total thyroidectomy and presented hemoptysis at suction after tracheal intubation. The second occurrence was caused by an Eschmann® Tracheal Tube Introducer (gum elastic bougie) in a patient whose trachea was intubated before a radiofrequency ablation of a single lung metastasis. There was evidence of blood on the tip of the bougie after withdrawal. In both cases, a CT scan showed a post-traumatic bronchial laceration with an acquired bronchial ectasia surrounded by ground-glass opacity due to alveolar hemorrhage. The patients had no other clinical complications, and bronchial lesions resolved spontaneously at control CT scan. These two cases show that airway damage related to endotracheal tube introducers may not be exceptional. It is not unusual to have some blood on an airway management device, and the rate and severity of these lesions are unknown. However, damage to the airway can be avoided by adapting preventive techniques during tracheal intubation.

Closure of tracheoesophageal fistula with two‐layer tracheal‐esophagoplasty and tracheal advancement

Closure of tracheoesophageal fistula with two‐layer tracheal‐esophagoplasty and tracheal advancement

Tracheal ballooning in congenital diaphragmatic hernia and tracheomalacia

A baby diagnosed antenatally at 20 weeks gestation with left congenital diaphragmatic hernia (CDH) had balloon occlusion of his trachea in-utero at 25 weeks gestation which was removed at 35 weeks. The delivery was induced at 37 weeks because of premature rupture of membranes from 26 weeks. He was born in good condition and had repair of his left CDH on day 2 of life. Intraoperatively noted to have left diaphragmatic agenesis and required large patch to close the defect. Postoperative was difficult to wean from positive pressure ventilation. He had bronchoscopy and bronchogram which showed dilated and malacic lower trachea which ballooned with application of significant end expiratory pressure, and collapsed on expiration. He was referred to the tracheal unit where a custom made absorbable tracheal stent was inserted at 4 weeks of age. He was then gradually weaned off ventilator and discharged to ward. Following this he has had multiple emergency admissions to intensive care with sudden respiratory distress needing invasive ventilation. On one such admission, he was noted to have tracheal bleeding presumed to be caused by stent eroding into the tracheal mucosa which settled with positive pressure ventilation. A follow-up bronchoscopy at 10 weeks of age showed granuloma at the end of the stent just above the carina blocking 50% of the lumen and needing balloon dilatation. He continues to be on non-invasive ventilation and weaning gradually. Congenital diaphragmatic hernia has traditionally been associated with very high mortality rates. Most infants died of pulmonary hypoplasia and severe pulmonary hypertension. With different postnatal treatment strategies for CDH, survival improved dramatically from less than 20% several decades ago to more than 70% today. Fetal intervention has evolved as well, to a minimally invasive approach that involves a single endoscopic port and occlusion of the fetal trachea. Recent studies have shown that while this has considerably decreased the morbidity and fetal mortality of the in utero procedure, its results do not exceed the overall results of contemporary postnatal treatment however there might be a role in specific subgroup of fetuses with severe CDH and poor chances of survival.

Giant Tracheocele with Multiple Congenital Anomalies

Tracheocele--an outpouching of tracheal mucous membrane--is an uncommon entity. It can occur as a congenital or acquired form. The congenital entity remains mostly dormant until adulthood, and then it typically presents as a herniation with multiple air-filled sacs. The acquired form develops as the result of blunt trauma, recurrent pulmonary infection, intubation, instrumentation, or surgery, and it typically presents as a single paratracheal cavity. We present an extremely rare case of a tracheocele associated with multiple congenital anomalies involving the face, limbs, and heart.

Clinical observation of relapsing polychondritis: a report of 23 patients

To explore the clinical characteristics of relapsing polychondritis (RP) for its early diagnosis and treatment. A retrospective analysis was performed for the clinical data and prognoses for 23 RP patients from April 1996 to October 2011 at Departments of Respiratory Medicine, Rheumatism and Otorhinolaryngology, First Affiliated Hospital, Zhengzhou University. Lesion locations included auricle (n = 19), joints (n = 17), nose (n = 14), respiratory tract (n = 10), eyes (n = 6), inner ear (n = 4), costal cartilage (n = 3) and kidney (n = 1). Laboratory examinations revealed elevated erythrocyte sedimentation rate (ESR) (n = 18), elevated C-reactive protein (CRP) (n = 16) and positive rheumatoid factor (n = 2). Laryngeal mucosa was edematous and the vocal cords were paralyzed in the cases with airway involvement under laryngofiberscopy. Tracheal mucosa was highly edematous and tracheal lumen narrowed in the cases examined under bronchofibroscope. Laryngeal mucosa was swollen, glottic chink narrowed, laryngeal cartilage partially absorbed and deformed in the cases examined with neck computed tomography (CT). Tracheal mucosa was thickened, tracheal lumen narrowed and tracheal cartilage was deformed and calcified in the cases on chest CT. Pathological examination on tracheal cartilage showed that cartilage tissue was degenerative and fibrotic. And the proliferation of granulation tissue and the infiltration of inflammatory cells were present around cartilage tissue. Twenty-three RP patients received the therapies of antibiotics, glucocorticosteroid, immunosuppressive agent, tracheotomy or tracheal stent implantation. Two cases died of asphyxia. One case died of myocardial infarct. The symptoms of other 20 cases improved in different degrees. The clinical manifestations are diverse in RP patients. The prognoses of patients with airway involvement are worse and may be improved by an early diagnosis and correct treatment.

Relapsing polychondritis detected in PET/CT

We report a case of relapsing polychondritis (RP) in a patient in whom PET/CT using 18F-FDG performed due to a suspicion of malignancy led to the diagnosis of RP. A previously healthy man, aged 57 years, was admitted to hospital for the diagnosis of chronic fever and weight loss of about 5 kg. Extensive laboratory and imaging evaluation showed only elevated C-reactive protein levels up to 180 mg/l (normal value <10 mg/l) and erythrocyte sedimentation rate up to 118 mm/h. Endoscopic evaluation showed signs of chronic laryngitis and sinusitis, oesophageal candidiasis, chronic gastritis and a benign sigmoid polyp. Antibacterial and antifungal therapy did not cause any significant improvement in the fever or laboratory findings. PET/CT using 18F-FDG showed diffuse 18F-FDG accumulation in all costal cartilages and in the sternal angle (SUVmax = 4.5). Additionally, symmetrically increased 18F-FDG activity in the joints of the upper extremities (elbows and wrists) was found. A moderately increased 18F-FDG concentration in the hypopharynx was also visible. The CT scan demonstrated thickened tracheal mucosa that did not show any 18F-FDG activity. The characteristic complex of signs and symptoms after exclusion of malignancy led to the diagnosis of RP – a rare autoimmune disease characterized by inflammation of cartilaginous tissues of the larynx, trachea and ears [1–3]. The patient was treated with glucocorticosteroids that provided rapid improvement of the symptoms and laboratory parameters.

Novo modelo de endoprótese traqueal autoexpansível de fabricação nacional: estudo experimental em coelhos

We aimed to test a new model of self-expanding tracheal stent so that it might be made available for clinical use. Using direct laryngoscopy, we placed polyurethane-coated, nitinol stents into the middle third of the trachea in 25 New Zealand rabbits. After a mean observation period of 26 days, we evaluated stent migration, degree of expansion, attachment, adherence, formation of granulation tissue, presence of inflammatory infiltrate, parietal involvement, and epithelial lining. The results showed complete radial expansion, little adherence to the tracheal mucosa, and low tissue attachment, as well as high rates of granuloma formation and stent migration. This new model proved to be biocompatible and showed a behavior similar to that of other stents on the market.

Tracheopathia osteoplastica

Tracheopathia osteoplastica is a very rare disease of the tracheobronchial tree with unknown origin and etiopathogenesis. The characteristic features are intramucosal nodules in the tracheal and/or bronchial mucosa. The clinical symptoms are unspecific and in most of the cases are consequences of airway stenosis. A collective of patient cases (4 tracheobronchial biopsies and 16 autopsy cases) was established to study the histology of tracheopathia osteoplastica and consisted of surgical pathology specimens (biopsies) and autopsy material. The study revealed two different types of tracheal ossification and nodule formation: (1) degenerative changes with nodule formation and ossification (tracheopathia osteoplastica tuberosa) and (2) diffuse degeneration of the tracheal cartilage with ossification of the outer third of the cartilaginous rings (tracheopathia osteoplastica peripherica). The histological changes indicate that tracheopathia osteoplastica is a type of sclerosing tracheopathy but the degenerative focus is at an unusual place (in the middle of the cartilage). No type of new cartilage formation was found in any of the cases.

Effective treatment of post-pneumonectomy bronchopleural fistula by conical fully covered self-expandable stent

The aim of the study was to assess the feasibility, efficacy and safety of the use of a conical self-expandable stent for the treatment of post-pneumonectomy bronchopleural fistula (PPBPF). Between April 2008 and November 2010, six patients underwent treatment for the PPBPF by the introduction of a tracheobronchial conical fully covered self-expandable nitinol stent with the aim of excluding the bronchial dehiscence from the airflow. We secured the prosthesis to the tracheal mucosa with titanium helical fasteners tacks. Five patients presented with a bronchial fistula larger than 5mm following right (4) or left (1) pneumonectomy. One patient had an anastomotic dehiscence after right tracheal sleeve pneumonectomy. A chest tube showed the absence of empyema in all cases. Immediate resolution of the bronchial air leak was obtained in all the patients. Permanent closure of the bronchial dehiscence without recurrence was achieved in all the patients at a mean follow-up time of 13 months (range 3-32). The bronchial stent was successfully removed in all patients without sequelae 71-123 days after its implantation. The use of the conical self-expandable Silmet(®) stent has proved to be an effective, safe and fast method to treat even large PPBPFs.

Reply to Anile et al.

We appreciate the interest showed by Anile et al. [1] in our article. We thank the authors for sharing their experience with four cases of obstructive fibrinous tracheal pseudomembrane (OFTP) removed by rigid bronchoscopy (RB) [2] and for the opportunity to clarify some of the key points regarding such issues. First, OFTP is a diagnostic challenge. In most cases, it is misdiagnosed as benign post-intubation tracheal stenosis, and the patient is referred to the thoracic surgery unit for endoscopic and/or surgical treatment. Chest CT scans show a tracheal stenosis without radiological signs for which pseudomembrane may be suspected, while its observation during flexible bronchoscopic (FB) is difficult for the reasons reported by the same authors [2]. However, last week we performed an FB in a patient who had tracheostomy. The patient presented with acute respiratory failure. We found an annular lesion with a septum that was partially torn and downwardly detached with obstruction of tracheal lumen. Remembering our previous experience, a diagnosis of OFTP was made. Thus, we believe that pseudomembrane is considered as a rare event because it is poorly known, but it might be much more common than thought. Stridor and respiratory failure are common findings after extubation due to a variety of causes. Thus, pseudomembranes may be detached and removed by tracheal suctioning and/or reintubation, and thus might remain unrecognized [3]. Secondly, the pathogenesis of OFTP remains unclear. Deslee et al. [4] postulated that ischaemic injury due to pressure at the site of the endotracheal cuff is the first step of developing pseudomembrane. However, formation of pseudomembrane has been associated with various other conditions including pulmonary infection, traumatic intubation, aspiration of gastric contents, diabetic microcirculation changes as reported by Talwar et al. [5]. Two of the four cases reported by the authors [2] had Candidal infection. However, it would be interesting to know whether the other two patients presented other predisposing factors for development of pseudomembrane. In our patient, in theory, the traumatic intubation may cause superficial damage to tracheal mucosa that, in addition to injury due to endotracheal cuff, develops pseudomembrane. Conversely, real tracheal ischaemic injury at the site of intubation, resulting from more profound tissue injury may lead to stenosis afterward [3]. Whether the use of marijuana is a risk factor of OFTP remains to be validated. Thirdly, we agree with the authors that the removal of pseudomembrane should be performed via RB. It allows the extraction of it in one piece while maintaining sufficient ventilation during the procedure. Lins et al. [3] in a recent review reported that, in only 4 of 22 cases, the ablation of membrane was made during FB. No case was reported by the authors [3] in which pseudomembrane was spontaneously coughed up to confirm that our case is unique in literature. In closure, OFTP should always be considered in the differential diagnosis of OFTP that requires immediate treatment. However, if you have experienced previous episodes of pseudomembrane, it will help you in diagnosing new cases in the future!

Anesthesia in an adult patient with tracheal hemangiomas: one-lung ventilation for lung lobectomy

Primary tracheal tumors are rare in adults, and careful airway management is required during anesthesia for affected patients. We report the case of a patient with tracheal hemangiomas undergoing nontracheal operation. A 61-year-old woman was scheduled for a lung operation. During preoperative examination, hemangiomas were detected on the tracheal mucosa. As she was asymptomatic and the degree of airway stenosis was small, treatment was not required for the hemangiomas, and left upper lobectomy for lung cancer was scheduled. After induction of general anesthesia, a regular tracheal tube was inserted under fiberoptic bronchoscopy, with care taken to prevent damage to the hemangiomas. An endobronchial blocker was inserted for one-lung ventilation. The operation was performed uneventfully, and the tracheal tube was replaced postoperatively with a laryngeal mask airway while the patient was under deep anesthesia and neuromuscular blockade. The mask was removed after confirming lack of bleeding from the hemangiomas. No hypoxia or other complications occurred during or after the operation.

Influence of Orai1 intervention on mouse airway epithelium reactions in vivo and in vitro

BackgroundOrai1 is crucial for store-operated Ca2+ entry and Ca2+ release–activated Ca2+ channel activities. However, little is known about its function in allergic diseases. ObjectiveTo assess the influence of Orai1 intervention on mouse airway epithelium reactions in vivo and in vitro. MethodsWe used immunohistochemical staining, enzyme-linked immunosorbent assay, and real-time reverse transcription–polymerase chain reaction to evaluate Orai1 expression in nasal and tracheal mucosa epithelium of nonsensitized, control, and 2-aminoethoxydiphenyl borate (2-APB)–treated groups in vivo and in vitro. In addition, we analyzed concentrations of interleukin 1β, interleukin 6, macrophage inflammatory protein 2, and tumor necrosis factor α in nasal lavage fluid, bronchoalveolar lavage fluid, and culture supernatant and their messenger RNAs in nasal and tracheal mucosa and cultured nasal and tracheal epithelium. ResultsAdministration of 2-APB into the nostrils suppressed Orai1 expression in nasal and tracheal mucosa of treated mice compared with that in control mice and restrained the mediators in nasal lavage fluid, bronchoalveolar lavage fluid, and airway mucosa of treated groups compared with those in control groups. Similarly, the 2-APB intervention also alleviated Orai1 and the production of the mediators in culture supernatant and cultured airway epithelium under allergic conditions. ConclusionsOur results indicate that 2-APB could effectively ameliorate reactions of upper and lower airway epithelial cells in mice in allergic states in vivo and in vitro.