title: The role of apoptosis in respiratory diseases.
abstract: OBJECTIVE
  The purpose of this article is to define apoptosis and describe how this cellular pathway is relevant to the pathogenesis of different respiratory diseases. This will assist clinical nurse specialists in understanding how new drugs and therapies inhibit and stimulate apoptotic pathways.
  
  
  BACKGROUND
  Clinical nurse specialists need to expand their knowledge concerning the role of apoptosis so that they can better expand their spheres of influence. The 4 stages of apoptosis are discussed, as well as the various apoptotic pathways involved with asthma, emphysema, and acute respiratory distress syndrome that promote and inhibit apoptosis in patients.
  
  
  CONCLUSIONS
  It is crucial for clinical nurse specialists to know what apoptosis is and how it relates to different pathophysiologic states. The challenge facing clinical nurse specialists is how to be kept informed and current concerning molecular and cellular mechanisms that are important in the practice setting. Strategies needed to maintain expertise include acquiring new knowledge, developing new skills, and changing attitudes about molecular biology. Apoptosis must become a significant part of any health professionals' continuing educational program because it has been recognized as the pathway to most any disease. Clinical nurse specialists who understand apoptosis and its pathways can use this knowledge to aid in the prevention and treatment of respiratory diseases.
authors.affiliation: Department of Molecular and Integrative Physiology, School of Nursing, University of Kansas Medical Center, Kansas City 66160-7504, and Geary Community Hospital, Emergency Department, Junction City, KS, USA. jpierce@kumc.edu
authors.forename: Janet D
authors.initials: JD
authors.lastname: Pierce
authors.forename: Jana
authors.initials: J
authors.lastname: Pierce
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stremming
authors.forename: Mahtab
authors.initials: M
authors.lastname: Fakhari
authors.forename: Richard L
authors.initials: RL
authors.lastname: Clancy
mesh_terms: D017209:Apoptosis / Q000187:drug effects / Q000502:physiology*; D001249:Asthma / Q000209:etiology* / Q000628:therapy; D002983:Clinical Competence; D004249:DNA Damage / Q000502:physiology; D004646:Emphysema / Q000209:etiology* / Q000628:therapy; D053222:Fas Ligand Protein / Q000502:physiology; D053200:Fas-Associated Death Domain Protein / Q000502:physiology; D006301:Health Services Needs and Demand; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000172:deficiency; D008967:Molecular Biology / Q000193:education; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration; D024802:Nurse's Role; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000628:therapy; D012307:Risk Factors; D015398:Signal Transduction / Q000502:physiology; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000502:physiology; D050998:bcl-2 Homologous Antagonist-Killer Protein / Q000502:physiology
chemical_list: D053222:Fas Ligand Protein; D053200:Fas-Associated Death Domain Protein; D036341:Intercellular Signaling Peptides and Proteins; D053221:TNF-Related Apoptosis-Inducing Ligand; D050998:bcl-2 Homologous Antagonist-Killer Protein