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      Serum magnesium and stable asthma: Is there a link?

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          Abstract

          Background:

          Although magnesium is used through intravenous and inhalation route in the management of asthma, actual prevalence of hypomagnesemia in asthma is not known. We conducted this study: 1) to detect the prevalence of hypomagnesemia in stable asthma and 2) to assess the significance of hypomagnesemia in these patients.

          Design:

          Prospective clinical study.

          Setting:

          Department of Respiratory Medicine, Calcutta National Medical College, Kolkata.

          Period of Study:

          Four months from January, 2007, to April, 2007.

          Materials and Methods:

          Fifty patients attending outpatients department of respiratory medicine with stable asthma were randomly selected. They were assessed clinically and their serum magnesium levels were measured. This was compared with the serum magnesium values of 45 nonasthmatic healthy controls.

          Results:

          Out of 50 patients, 14 had hypomagnesemia. Possible relationship of hypomagnesemia with tachycardia, tachypnoea, severity of asthma, medication use, and previous and future exacerbations were analyzed.

          Conclusion:

          There was statistically significant association of hypomagnesemia with tachypnoea, severe asthma, use of long-acting β-agonist, inhaled corticosteroids, theophylline, use of ≥ 3 medications, previous and future exacerbations but not with tachycardia or use of short-acting β 2 -agonist or montelukast.

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          Most cited references 24

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          The nature of the neuromuscular block produced by magnesium.

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            Magnesium: its proven and potential clinical significance.

            Magnesium is the fourth most abundant cation in the body and is present in more than 300 enzymatic systems, where it is crucial for adenosine triphosphate (ATP) metabolism. Deficiency states result in increased insulin resistance, as well as increased smooth muscle and platelet reactivity. Magnesium deficiency has been shown to correlate with a number of chronic cardiovascular diseases, including hypertension, diabetes mellitus, and hyperlipidemia. Intravenous magnesium has been used therapeutically in critical situations such as status asthmaticus, torsades de pointes, and preeclampsia. Few controlled studies exist regarding the therapeutic uses of oral magnesium supplementation in chronic cardiovascular diseases. Randomized clinical trials are urgently needed to determine whether magnesium supplementation will alter the natural history of these disease states.
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              Pathobiology of magnesium deficiency: a cytokine/neurogenic inflammation hypothesis.

              During the progression of Mg deficiency in a rodent model, we have observed dramatic increases in serum levels of inflammatory cytokines [interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha)] after 3 wk on a Mg-deficient diet. Sequential analyses of these cytokine changes in the serum of rats revealed an initial rise at day 12, followed by a major elevation in all three cytokine levels by day 21. Of greater interest was an early peak in the serum level of the neuropeptide substance P after only 5 days on the diet. This "neuronal" tachykinin is thought to be released from neural tissues, and it is known to stimulate production of certain cytokines, including IL-1, IL-6, and TNF-alpha. In addition, there was a concomitant increase in histamine levels, which may have resulted from stimulation and degranulation of mast cells by substance P. Thus we hypothesize that the release of substance P may be the earliest pathophysiological event leading to stimulation of the inflammatory cytokines, which may then stimulate the free radical mechanisms of injury previously confirmed by our work.
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                Author and article information

                Journal
                Lung India
                LI
                Lung India : Official Organ of Indian Chest Society
                Medknow Publications (India )
                0970-2113
                0974-598X
                Oct-Dec 2010
                : 27
                : 4
                : 205-208
                Affiliations
                Department of Respiratory Medicine, North Bengal Medical College, Susruta Nagar, Darjeeling, India
                [1 ] Department of Critical Care Medicine, Columbia Asia Hospital, Kolkata, India
                [2 ] Department of Respiratory Medicine, Calcutta National Medical College, Kolkata, India
                [3 ] Department of Respiratory Medicine, Calcutta National Medical College, Kolkata, India
                Author notes
                Address for correspondence: Dr. Sibes Kumar Das, Souhardya Appartment, 1 st Floor, Flat – A, West Bankimpally, Madhyamgram, Kolkata - 129, India. E-mail: sibesdas67@ 123456gmail.com
                Article
                LI-27-205
                10.4103/0970-2113.71944
                2988169
                21139715
                © Lung India

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Original Article

                Respiratory medicine

                link, serum magnesium, stable asthma

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