"Our findings suggest that macrophages from the lungs of patients with COPD have a defect in a process called phagocytosis involved in the uptake of bacteria. We discovered that activation of the Nrf2 pathway induced by sulforaphane restored the ability of lung macrophages to bind and take up bacteria," said Shyam Biswal, PhD, professor in the Bloomberg School's Department of Environmental Health Sciences and senior author of the study. "The study provides proof of concept that activating the Nrf2 pathway can restore the ability of macrophage to phagocytose, or bind with bacteria, and clear it from the lungs of patients with COPD."
Although epidural steroid injections (also called epidural corticosteroid injections) may be helpful to confirm a diagnosis, they should be used primarily after a specific presumptive diagnosis has been established. Also, injections should not be used in isolation, but rather in conjunction with a program stressing muscle flexibility, strengthening, and functional restoration.
Epidural injections and intradiscal injections have been used in the treatment of non-radicular degenerative disc disease with limited success. Proper follow-up after injections to assess the patient's treatment response and ability to progress in the rehabilitation program is essential. A limited number of injections can be tried to reduce pain, but careful monitoring of the response is required prior to a second or third injection.
Those patients who still have some residual pain after the first injection should receive a second and third injection and patients who did not get any benefit from the first injection should not receive another one. Patient selection is very important in deciding on the type of injections patients should receive. Transforaminal injections (different approach to the epidural space) may produce longer pain relief and may also predict whether a patient might benefit from surgery or not (for details, see review McLain et al, Spine Journal 2005). For patients with the diagnosis of lumbar canal stenosis, improvement after such injections may be longer lasting than it was initially thought (Kapural et al., 2005).