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Song B, Li H, Zhang H, Jiao L, Wu S. Impact of electronic cigarette usage on the onset of respiratory symptoms and COPD among Chinese adults. Sci Rep 2024; 14:5598. [PMID: 38454045 PMCID: PMC10920732 DOI: 10.1038/s41598-024-56368-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/05/2024] [Indexed: 03/09/2024] Open
Abstract
The prevalence of dual usage and the relatively low cessation rate among e-cigarette (EC) users suggest that ECs have not demonstrated significant effectiveness as a smoking cessation tool. Furthermore, there has been a substantial increase in the prevalence of EC usage in recent years. Therefore, the objective of this study is to investigate the association between EC use and the incidence of respiratory symptoms and chronic obstructive pulmonary disease (COPD). A total of 10,326 participants aged between 20 and 55 years, without any respiratory diseases or COPD, were recruited for the study. These individuals attended employee physical examinations conducted at 16 public hospitals in Hebei province, China from 2015 to 2020. Logistic regression models were utilized to assess the association between EC use and the risk of respiratory symptoms and COPD using risk ratios along with their corresponding 95% confidence intervals. Restricted cubic spline functions were employed to investigate the dose-response non-linear relationship. The robustness of the logistic regression models was evaluated through subgroup analyses, and sensitivity analyses. During the 5-year follow-up period, a total of 1071 incident cases of respiratory symptoms and 146 incident cases of COPD were identified in this cohort study. After adjusting for relevant confounding factors, EC users demonstrated a respective increase in the risk of reporting respiratory symptoms and COPD by 28% and 8%. Furthermore, dual users who used both ECs and combustible cigarettes exhibited an elevated risk of incident respiratory symptoms and COPD by 41% and 18%, respectively, compared to those who had never used non-users of any cigarette products. The association between daily EC consumption and the development of respiratory symptoms, as well as COPD, demonstrated a significant J-shaped pattern. The potential adverse association between the consumption of ECs, particularly when used in combination with combustible cigarettes, and the development of respiratory symptoms and COPD necessitates careful consideration. Policymakers should approach ECs cautiously as a prospective smoking cessation tool.
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Affiliation(s)
- Beibei Song
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University/Hebei Key Laboratory of Respiratory Critical Care/Hebei Institute of Respiratory Diseases, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Honglin Li
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University/Hebei Key Laboratory of Respiratory Critical Care/Hebei Institute of Respiratory Diseases, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Huiran Zhang
- Department of Biological Pharmacy, Hebei Medical University, Shijiazhuang, 050000, China
| | - Libin Jiao
- Hebei Far East Communication System Engineering Company, Shijiazhuang, 050000, China
| | - Siyu Wu
- The Third Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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Miravitlles M, Bhutani M, Hurst JR, Franssen FME, van Boven JFM, Khoo EM, Zhang J, Brunton S, Stolz D, Winders T, Asai K, Scullion JE. Implementing an Evidence-Based COPD Hospital Discharge Protocol: A Narrative Review and Expert Recommendations. Adv Ther 2023; 40:4236-4263. [PMID: 37537515 PMCID: PMC10499689 DOI: 10.1007/s12325-023-02609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
Discharge bundles, comprising evidence-based practices to be implemented prior to discharge, aim to optimise patient outcomes. They have been recommended to address high readmission rates in patients who have been hospitalised for an exacerbation of chronic obstructive pulmonary disease (COPD). Hospital readmission is associated with increased morbidity and healthcare resource utilisation, contributing substantially to the economic burden of COPD. Previous studies suggest that COPD discharge bundles may result in fewer hospital readmissions, lower risk of mortality and improvement of patient quality of life. However, evidence for their effectiveness is inconsistent, likely owing to variable content and implementation of these bundles. To ensure consistent provision of high-quality care for patients hospitalised with an exacerbation of COPD and reduce readmission rates following discharge, we propose a comprehensive discharge protocol, and provide evidence highlighting the importance of each element of the protocol. We then review care bundles used in COPD and other disease areas to understand how they affect patient outcomes, the barriers to implementing these bundles and what strategies have been used in other disease areas to overcome these barriers. We identified four evidence-based care bundle items for review prior to a patient's discharge from hospital, including (1) smoking cessation and assessment of environmental exposures, (2) treatment optimisation, (3) pulmonary rehabilitation, and (4) continuity of care. Resource constraints, lack of staff engagement and knowledge, and complexity of the COPD population were some of the key barriers inhibiting effective bundle implementation. These barriers can be addressed by applying learnings on successful bundle implementation from other disease areas, such as healthcare practitioner education and audit and feedback. By utilising the relevant implementation strategies, discharge bundles can be more (cost-)effectively delivered to improve patient outcomes, reduce readmission rates and ensure continuity of care for patients who have been discharged from hospital following a COPD exacerbation.
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Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Vall d'Hebron University Hospital/Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Mohit Bhutani
- Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Frits M E Franssen
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Job F M van Boven
- Department of Clinical Pharmacy & Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- International Primary Care Respiratory Group, Leicester, UK
| | - Jing Zhang
- Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | | | - Daiana Stolz
- Clinic of Respiratory Medicine and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tonya Winders
- Global Allergy and Airways Patient Platform, Vienna, Austria
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Osaka Metropolitan University, Osaka, Japan
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3
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Smoking Cessation in Mice Does Not Switch off Persistent Lung Inflammation and Does Not Restore the Expression of HDAC2 and SIRT1. Int J Mol Sci 2022; 23:ijms23169104. [PMID: 36012370 PMCID: PMC9409159 DOI: 10.3390/ijms23169104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/24/2022] Open
Abstract
Once COPD is established, pulmonary lesions can only progress and smoking cessation by itself is not sufficient to switch off persistent lung inflammation. Similarly, in former-smoker mice, neutrophil inflammation persists and lung lesions undergo progressive deterioration. The molecular mechanisms underlying disease progression and the inefficiency of smoking cessation in quenching neutrophilic inflammation were studied in male C57 Bl/6 mice after 6 months of rest from smoking cessation. As compared with the mice that continued to smoke, the former-smoker mice showed reduced expression of histone deacetylases HDAC2 and SIRT1 and marked expression of p-p38 MAPK and p-Ser10. All these factors are involved in corticosteroid insensitivity and in perpetuating inflammation. Former-smoker mice do show persistent lung neutrophilic influx and a high number of macrophages which account for the intense staining in the alveolar structures of neutrophil elastase and MMP-9 (capable of destroying lung scaffolding) and 8-OHdG (marker of oxidative stress). “Alarmins” released from necrotic cells together with these factors can sustain and perpetuate inflammation after smoking cessation. Several factors and mechanisms all together are involved in sustaining and perpetuating inflammation in former-smoker mice. This study suggests that a better control of COPD in humans may be achieved by precise targeting of the various molecular mechanisms associated with different phenotypes of disease by using a cocktail of drug active toward specific molecules.
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Trakas N, Georgakopoulou VE, Melemeni D, Damaskos C, Mantzouranis K, Garmpis N, Gkoufa A, Papalexis P, Chlapoutakis S, Sklapani P, Mermigkis D, Lekkakou A, Tsiafaki X. Association between smoking cessation and alterations in forced expiratory volume in one second (FEV1). A Follow-Up Study from a Greek Tobacco Cessation Clinic. ADDICTION & HEALTH 2022; 14:87-95. [PMID: 36544517 PMCID: PMC9743813 DOI: 10.22122/ahj.2022.196722.1244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
Background Cigarette smoking is the most important preventable cause of several diseases such as malignancies, pulmonary and cardiovascular diseases. Smoking cessation is now supported by both behavioral counseling and medical pharmacotherapy and is the only effective approach for slowing down an accelerated decline in forced expiratory volume in one second (FEV1). Our study aims to examine changes in forced expiratory volume in one second (FEV1) after smoking cessation for smokers attending our smoking cessation clinic their correlation to smokers' demographic characteristics. Methods 114 smokers (48 males and 66 females), with a mean age of 48.36±10.49 years, were enrolled. They were classified in 4 groups, according to their age; <40 years (Group Α), 41-50 years (Group Β), 51-60 years (Group C), >60 years (Group D) and underwent Spirometry on the 1st day of visit, one month (2nd visit) and, 3 months later (3rd visit). Findings Statistically significant increase in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was observed in smokers who quit smoking in Group Α, B and C (p<0.05). In addition, a statistically significant decrease in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was noticed in smokers who continued smoking in Group B, C and D (p<0.05). Conclusion Smoking cessation achieved through smoking cessation support led to the improvement of FEV1 values within 3 months. The greatest benefit was observed in smokers under the age of 60.
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Affiliation(s)
- Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - Vasiliki Epameinondas Georgakopoulou
- Pulmonology Department, Laiko General Hospital, Athens, Greece,Correspondence to: Vasiliki Epameinondas Georgakopoulou; Pulmonology Department, Laiko General Hospital, Athens, Greece
| | | | - Christos Damaskos
- Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nikolaos Garmpis
- Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Papalexis
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Agathi Lekkakou
- Pulmonology Department, Sismanogleio Hospital, Athens, Greece
| | - Xanthi Tsiafaki
- Pulmonology Department, Sismanogleio Hospital, Athens, Greece
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Hobbs SB, Chung JH, Walker CM, Bang TJ, Carter BW, Christensen JD, Danoff SK, Kandathil A, Madan R, Moore WH, Shah SD, Kanne JP. ACR Appropriateness Criteria® Diffuse Lung Disease. J Am Coll Radiol 2021; 18:S320-S329. [PMID: 34794591 DOI: 10.1016/j.jacr.2021.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
Diffuse lung disease, frequently referred to as interstitial lung disease, encompasses numerous disorders affecting the lung parenchyma. The potential etiologies of diffuse lung disease are broad with several hundred established clinical syndromes and pathologies currently identified. Imaging plays a critical role in diagnosis and follow-up of many of these diseases, although multidisciplinary discussion is the current standard for diagnosis of several DLDs. This document aims to establish guidelines for evaluation of diffuse lung diseases for 1) initial imaging of suspected diffuse lung disease, 2) initial imaging of suspected acute exacerbation or acute deterioration in cases of confirmed diffuse lung disease, and 3) clinically indicated routine follow-up of confirmed diffuse lung disease without acute deterioration. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Stephen B Hobbs
- Vice-Chair, Informatics and Integrated Clinical Operations and Division Chief, Cardiovascular and Thoracic Radiology, University of Kentucky, Lexington, Kentucky.
| | - Jonathan H Chung
- Panel Chair; and Vice-Chair of Quality, and Section Chief, Chest Imaging, Department of Radiology, University of Chicago, Chicago, Illinois
| | | | - Tami J Bang
- Co-Director, Cardiothoracic Imaging Fellowship Committee, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; Co-Chair, membership committee, NASCI; and Membership committee, ad-hoc online content committee, STR
| | - Brett W Carter
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jared D Christensen
- Vice-Chair, Department of Radiology, Duke University Medical Center, Durham, North Carolina; and Chair, ACR Lungs-RADS
| | - Sonye K Danoff
- Johns Hopkins Medicine, Baltimore, Maryland; Board of Directors, American Thoracic Society; Senior Medical Advisor, Pulmonary Fibrosis Foundation; and Medical Advisory Board Member, The Myositis Association
| | | | - Rachna Madan
- Associate Fellowship Director, Division of Thoracic Imaging, Brigham & Women's Hospital, Boston, Massachusetts
| | - William H Moore
- Associate Chair, Clinical Informatics and Chief, Thoracic Imaging, New York University Langone Medical Center, New York, New York
| | - Sachin D Shah
- Associate Chief and Medical Information Officer, University of Chicago, Chicago, Illinois; and Primary care physician
| | - Jeffrey P Kanne
- Specialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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6
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Zhang Y, Wang L, Mutlu GM, Cai H. More to Explore: Further Definition of Risk Factors for COPD - Differential Gender Difference, Modest Elevation in PM 2. 5, and e-Cigarette Use. Front Physiol 2021; 12:669152. [PMID: 34025456 PMCID: PMC8131967 DOI: 10.3389/fphys.2021.669152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a severe respiratory disease with high morbidity and mortality, representing the third leading cause of death worldwide. Traditional risk factors for COPD include aging, genetic predisposition, cigarette smoking, exposure to environmental pollutes, occupational exposure, and individual or parental respiratory disease history. In addition, latest studies have revealed novel and emerging risk factors. In this review, differential gender difference as a factor for COPD development at different territories is discussed for the first time. First, women seem to have more COPD, while more women die of COPD or have more severe COPD, in Western societies. This seems different from the impression that COPD dominants in men, which is true in Eastern societies. It might be related to higher rate of cigarette smoking in women in developed countries (i.e., 12.0% of women in United States smoke vs. 2.2% in China). Nonetheless, women in Eastern societies are exposed to more biomass usage. Second, modest elevation in PM2.5 levels at >∼21.4-32.7 μg/m3, previously considered "cleaner air," is associated with incidence of COPD, indicating that more stringent goals should be set for the reduction of PM2.5 levels to prevent COPD development. Last but not least, e-cigarette use, which has become an epidemic especially among adolescents as officially declared by the United States government, has severe adverse effects that may cause development of COPD early in life. Built upon an overview of the established risk factors for COPD primarily focusing on cigarette smoking and environmental pollutions, the present review further discusses novel concepts, mechanisms, and solutions evolved around the emerging risk factors for COPD discussed above, understanding of which would likely enable better intervention of this devastating disease.
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Affiliation(s)
- Yixuan Zhang
- Division of Molecular Medicine, Department of Anesthesiology, Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Lu Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Gökhan M. Mutlu
- Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Hua Cai
- Division of Molecular Medicine, Department of Anesthesiology, Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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7
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Tackett AP, Keller-Hamilton B, Smith CE, Hébert ET, Metcalf JP, Queimado L, Stevens EM, Wallace SW, McQuaid EL, Wagener TL. Evaluation of Respiratory Symptoms Among Youth e-Cigarette Users. JAMA Netw Open 2020; 3:e2020671. [PMID: 33048131 PMCID: PMC8094411 DOI: 10.1001/jamanetworkopen.2020.20671] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Use of e-cigarettes (ECs) among youths has increased in recent years. e-Cigarette aerosol contains chemical constituents, such as diacetyl or benzaldehyde, which are known to affect the respiratory system. OBJECTIVE To examine the association between EC use and self-reported wheezing in a cohort of US adolescents. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from waves 3 and 4 (October 19, 2015, to January 3, 2018) of the Population Assessment of Tobacco and Health (PATH) study, a longitudinal, nationally representative cohort survey. Adolescent respondents aged 12 to 17 years who did not have asthma were included. EXPOSURES e-Cigarette use during the previous year. MAIN OUTCOMES AND MEASURES Self-reported wheezing in the past 12 months (yes or no) and EC use (no use in past year or never use, use in past year, use in past 30 days, and use in past 7 days). Survey-weighted logistic regression models adjusted for demographic characteristics and other risk factors. RESULTS Among 7049 adolescents without asthma from waves 3 and 4 of the PATH study, 49.9% were female and 54.4% were non-Hispanic White. In unadjusted models, the odds of wheezing in the past 12 months were higher for youths who had used ECs in the past year compared with those who had not (odds ratio, 1.74; 95% CI, 1.22-2.48; P = .003). In the adjusted model, after controlling for the variables of race/ethnicity, household rules about the use of tobacco, contact with a smoker in the previous 7 days, and current use of combustible tobacco products, the association of EC use with wheezing was not significant (adjusted odds ratio for EC use in the past year, 1.37 [95% CI, 0.91-2.05]; in the past 30 days, 1.35 [95% CI, 0.63-2.88]; in the past 7 days, 0.74 [95% CI, 0.28-1.97]; P = .33). CONCLUSIONS AND RELEVANCE In this cohort study, use of ECs alone was not associated with increased odds of experiencing wheezing episodes. Future studies incorporating the use of objective data appear to be needed to more accurately understand the potential respiratory harms associated with vaping among adolescents.
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Affiliation(s)
- Alayna P. Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | | | | | - Emily T. Hébert
- School of Public Health, The University of Texas Health Science Center, Austin
| | - Jordan P. Metcalf
- Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Lurdes Queimado
- Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Elise M. Stevens
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Elizabeth L. McQuaid
- Bradley/Hasbro Children’s Research Center, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
- Department of Internal Medicine, The Ohio State University, Columbus
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8
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Chaumont M, Tagliatti V, Channan EM, Colet JM, Bernard A, Morra S, Deprez G, Van Muylem A, Debbas N, Schaefer T, Faoro V, van de Borne P. Short halt in vaping modifies cardiorespiratory parameters and urine metabolome: a randomized trial. Am J Physiol Lung Cell Mol Physiol 2019; 318:L331-L344. [PMID: 31721596 PMCID: PMC7052663 DOI: 10.1152/ajplung.00268.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Propylene glycol and glycerol are e-cigarette constituents that facilitate liquid vaporization and nicotine transport. As these small hydrophilic molecules quickly cross the lung epithelium, we hypothesized that short-term cessation of vaping in regular users would completely clear aerosol deposit from the lungs and reverse vaping-induced cardiorespiratory toxicity. We aimed to assess the acute effects of vaping and their reversibility on biological/clinical cardiorespiratory parameters [serum/urine pneumoproteins, hemodynamic parameters, lung-function test and diffusing capacities, transcutaneous gas tensions (primary outcome), and skin microcirculatory blood flow]. Regular e-cigarette users were enrolled in this randomized, investigator-blinded, three-period crossover study. The periods consisted of nicotine-vaping (nicotine-session), nicotine-free vaping (nicotine-free-session), and complete cessation of vaping (stop-session), all maintained for 5 days before the session began. Multiparametric metabolomic analyses were used to verify subjects' protocol compliance. Biological/clinical cardiorespiratory parameters were assessed at the beginning of each session (baseline) and after acute vaping exposure. Compared with the nicotine- and nicotine-free-sessions, a specific metabolomic signature characterized the stop-session. Baseline serum club cell protein-16 was higher during the stop-session than the other sessions (P < 0.01), and heart rate was higher in the nicotine-session (P < 0.001). Compared with acute sham-vaping in the stop-session, acute nicotine-vaping (nicotine-session) and acute nicotine-free vaping (nicotine-free-session) slightly decreased skin oxygen tension (P < 0.05). In regular e-cigarette-users, short-term vaping cessation seemed to shift baseline urine metabolome and increased serum club cell protein-16 concentration, suggesting a decrease in lung inflammation. Additionally, acute vaping with and without nicotine decreased slightly transcutaneous oxygen tension, likely as a result of lung gas exchanges disturbances.
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Affiliation(s)
- Martin Chaumont
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Institute for Translational Research in Cardiovascular and Respiratory Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Vanessa Tagliatti
- Department of Human Biology and Toxicology, University of Mons, Mons, Belgium
| | - El Mehdi Channan
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Institute for Translational Research in Cardiovascular and Respiratory Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean-Marie Colet
- Department of Human Biology and Toxicology, University of Mons, Mons, Belgium
| | - Alfred Bernard
- Laboratory of Toxicology and Applied Pharmacology, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | - Sofia Morra
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Institute for Translational Research in Cardiovascular and Respiratory Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Guillaume Deprez
- Department of Clinical Chemistry, Université Libre de Bruxelles, Brussels, Belgium
| | - Alain Van Muylem
- Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nadia Debbas
- Department of Cardiology, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Thomas Schaefer
- Cardio-Pulmonary Exercise Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Vitalie Faoro
- Cardio-Pulmonary Exercise Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe van de Borne
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.,Institute for Translational Research in Cardiovascular and Respiratory Sciences, Université Libre de Bruxelles, Brussels, Belgium
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9
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Health impact of E-cigarettes: a prospective 3.5-year study of regular daily users who have never smoked. Sci Rep 2017; 7:13825. [PMID: 29150612 PMCID: PMC5693960 DOI: 10.1038/s41598-017-14043-2] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/03/2017] [Indexed: 01/12/2023] Open
Abstract
Although electronic cigarettes (ECs) are a much less harmful alternative to tobacco cigarettes, there is concern as to whether long-term ECs use may cause risks to human health. We report health outcomes (blood pressure, heart rate, body weight, lung function, respiratory symptoms, exhaled breath nitric oxide [eNO], exhaled carbon monoxide [eCO], and high-resolution computed tomography [HRCT] of the lungs) from a prospective 3.5-year observational study of a cohort of nine daily EC users (mean age 29.7 (±6.1) years) who have never smoked and a reference group of twelve never smokers. No significant changes could be detected over the observation period from baseline in the EC users or between EC users and control subjects in any of the health outcomes investigated. Moreover, no pathological findings could be identified on HRCT of the lungs and no respiratory symptoms were consistently reported in the EC user group. Although it cannot be excluded that some harm may occur at later stages, this study did not demonstrate any health concerns associated with long-term use of EC in relatively young users who did not also smoke tobacco.
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10
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Elicker BM, Kallianos KG, Henry TS. The role of high-resolution computed tomography in the follow-up of diffuse lung disease. Eur Respir Rev 2017; 26:26/144/170008. [PMID: 28615307 PMCID: PMC9488961 DOI: 10.1183/16000617.0008-2017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/18/2017] [Indexed: 01/15/2023] Open
Abstract
High-resolution computed tomography (HRCT) of the lung is a key component of the multidisciplinary approach to diagnosis in diffuse lung disease (DLD). HRCT also plays an important role in the follow-up of patients with established DLD. In this respect, serial HRCT examinations may provide valuable information that cannot be determined from clinical history and other diagnostic tests, such as pulmonary function tests. Important roles of HRCT in this context include assisting in determining prognosis, monitoring for the efficacy of treatment, detecting progression of disease or complications, and evaluating patients with worsening or acute symptoms. Both clinicians and radiologists should be aware of the expected evolution of HRCT changes in a variety of DLDs. The goals of this paper are to discuss: 1) the expected evolution of HRCT findings over time in common DLDs; 2) the role of serial HRCT examinations in formulating an initial diagnosis; and 3) the role of HRCT in the follow-up of patients with known DLD. HRCT plays an important role in the follow-up of patients with diffuse lung diseasehttp://ow.ly/wzY730c2gRO
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11
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Elbehairy AF, Faisal A, Guenette JA, Jensen D, Webb KA, Ahmed R, Neder JA, O'Donnell DE. Resting Physiological Correlates of Reduced Exercise Capacity in Smokers with Mild Airway Obstruction. COPD 2017; 14:267-275. [DOI: 10.1080/15412555.2017.1281901] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Amany F. Elbehairy
- Department of Medicine, Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, ON, Canada
- Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Azmy Faisal
- Faculty of Physical Education for Men, Alexandria University, Alexandria, Egypt
- School of Health Sport and Bioscience, University of East London, United Kingdom
| | - Jordan A. Guenette
- Department of Physical Therapy and UBC Centre for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - Dennis Jensen
- Department of Kinesiology & Physical Education, McGill University, Montreal, QC, Canada
| | - Katherine A. Webb
- Department of Medicine, Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, ON, Canada
| | - Rashid Ahmed
- College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, North Dakota, United States
| | - J. Alberto Neder
- Department of Medicine, Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, ON, Canada
| | - Denis E. O'Donnell
- Department of Medicine, Respiratory Investigation Unit, Queen's University and Kingston General Hospital, Kingston, ON, Canada
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Abouyared M, Szczupak M, Barbarite E, Sargi ZB, Rosow DE. Open airway reconstruction in adults: Outcomes and prognostic factors. Am J Otolaryngol 2017; 38:7-12. [PMID: 27776743 DOI: 10.1016/j.amjoto.2016.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/05/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose was to assess the success of open tracheal resection and re-anastomosis for non-malignant tracheal stenosis in adults. Successful operations were defined as T-tube or tracheostomy-free status by 6months post-operatively. MATERIALS AND METHODS Retrospective chart review was performed and data were recorded in a de-identified manner. The primary outcome was T-tube or tracheostomy-free status by 6months following tracheal resection. Clinical and demographic characteristics were evaluated as potential prognostic variables. RESULTS Thirty-two patients met inclusion criteria, with a median age of 46. Seven patients underwent tracheal resection with primary closure, without stenting. Successful tracheal resection was defined as tracheostomy or T-tube free by 6months post-operation, and this was possible in 21 patients (66%). Eighty-two percent of patients with cricoid cartilage-sparing tracheal resection had a successful outcome, versus 30% of patients who underwent cricoid cartilage resection (HR 5.02, 95% CI 1.46-17.3; p=0.011). Patients with a history of tracheostomy-dependence were four times more likely to remain tube-dependent at 6months (HR 4.15, 95% CI 1.56-10.86; p=0.004). CONCLUSIONS Tracheal stenosis remains a very difficult problem to treat. In our series, we confirm that patients with cricoid involvement or with a history of tracheostomy were more likely to be tube dependent at 6-months post-operation.
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13
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Ginsburg SB, Zhao J, Humphries S, Jou S, Yagihashi K, Lynch DA, Schroeder JD. Texture-based Quantification of Centrilobular Emphysema and Centrilobular Nodularity in Longitudinal CT Scans of Current and Former Smokers. Acad Radiol 2016; 23:1349-1358. [PMID: 27575837 DOI: 10.1016/j.acra.2016.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 11/16/2022]
Abstract
RATIONALE AND OBJECTIVES The effect of smoking cessation on centrilobular emphysema (CLE) and centrilobular nodularity (CN), two manifestations of smoking-related lung injury on computed tomography (CT) images, has not been clarified. The objective of this study is to leverage texture analysis to investigate differences in extent of CLE and CN between current and former smokers. MATERIALS AND METHODS Chest CT scans from 350 current smokers, 401 former smokers, and 25 control subjects were obtained from the multicenter COPDGene Study, a Health Insurance Portability and Accountability Act-compliant study approved by the institutional review board of each participating clinical study center. Additionally, for 215 of these subjects, a follow-up CT scan was obtained approximately 5 years later. For each CT scan, 5000 circular regions of interest (ROIs) of 35-pixel diameter were randomly selected throughout the lungs. The patterns present in each ROI were summarized by 50 computer-extracted texture features. A logistic regression classifier was leveraged to classify each ROI as normal lung, CLE, or CN, and differences in the percentages of normal lung, CLE, and CN by study group were assessed. RESULTS Former smokers had significantly more CLE (P <0.01) but less CN (P <0.001) than did current smokers, even after adjustment for important covariates such as patient age, GOLD stage, smoking history, forced expiratory volume in 1 second, gas trapping, and scanner model. Among patients with longitudinal CT scans, continued smoking led to a slight increase in CLE (P = 0.13), whereas sustained abstinence from smoking led to further reduction in CN (P <0.05). CONCLUSIONS The proposed texture-based approach quantifies the extent of CN and CLE with high precision. Differences in smoking-related lung disease between longitudinal scans of current smokers and longitudinal scans of former smokers suggest that CN may be reversible on smoking cessation.
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Affiliation(s)
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- Quantitative Imaging Lab, National Jewish Health, 1400 Jackson Street, Denver, CO 80206
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14
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Isaac A, Zhang H, Varshney S, Hamilton S, Harris JR, O’Connell DA, Biron VL, Seikaly H. Predictors of Failed and Delayed Decannulation after Head and Neck Surgery. Otolaryngol Head Neck Surg 2016; 155:437-42. [DOI: 10.1177/0194599816643531] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 03/17/2016] [Indexed: 11/15/2022]
Abstract
Objective To determine the variables that are predictive of failed decannulation (FD), delayed decannulation (DD), and days to decannulation in patients who underwent head and neck cancer resection with free tissue transfer reconstruction for head and neck squamous cell carcinoma. Design Case series with chart review. Setting Tertiary care otolaryngology–head and neck surgery referral center. Subject and Methods Patients (N = 108) were included who underwent head and neck cancer resection with free tissue transfer reconstruction and tracheostomy between 2011 and June 2014. Patients with laryngectomy, previous tracheostomy, and other airway pathology necessitating tracheotomy were excluded. Preoperative patient variables and cancer site/staging variables were analyzed, as well as extent of structures resected and type of reconstruction. Univariate and multivariate binary logistic and Cox regression analyses were used to determine predictors of FD and DD. Cox regression analysis was used to determine predictors of days to decannulation. Results Of the 108 included patients, 16 had FD, and 26 had DD. Univariate analysis demonstrated that advanced stage ( r = 0.233, P = .021), total glossectomy ( r = 0.924, P < .001), anterolateral thigh flap reconstruction ( r = 0.906, P < .001), smoking at time of surgery ( r = 0.319, P = .002), and pack years ( r = 0.322, P = .001) were associated with FD. Cox regression analysis showed that total glossectomy, exp(B) = 15.837 (95% confidence interval [95% CI]: 1.949-128.679); anterolateral thigh flap reconstruction, exp(B) = 8.439 (95% CI: 2.435-29.620); and smoking status, exp(B) = 2.970 (95% CI: 1.617-5.456) were independent predictors of days to decannulation and FD. Conclusions Patients with total glossectomy defects and those who continue to smoke are at increased risk for FD and DD. Aggressive smoking cessation programs may decrease the risk of FD and DD. Patients should be counseled about their risk profiles.
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Affiliation(s)
- Andre Isaac
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
| | - Han Zhang
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
| | - Samarth Varshney
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Stefan Hamilton
- Faculty of Medicine, Memorial University of Newfoundland, St John’s, Canada
| | - Jeffrey R. Harris
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
| | - Daniel A. O’Connell
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
| | - Vincent L. Biron
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
| | - Hadi Seikaly
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Canada
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15
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Guan Z, Lv Y, Liu J, Liu L, Yuan H, Shen X. Smoking Cessation Can Reduce the Incidence of Postoperative Hypoxemia After On-Pump Coronary Artery Bypass Grafting Surgery. J Cardiothorac Vasc Anesth 2016; 30:1545-1549. [PMID: 27554230 DOI: 10.1053/j.jvca.2016.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To determine whether smoking cessation can reduce the incidence of postoperative hypoxemia (POH) after on-pump coronary artery bypass grafting (CABG) surgery. DESIGN Prospective, single-center, observational study. SETTING Single-center university teaching hospital. PARTICIPANTS The study comprised 300 patients undergoing on-pump CABG surgery who met the inclusion criteria. Patients were divided into the following 3 groups according to smoking status: sustained quitters (n = 132)-smoking cessation for more than 1 month and less than 1 year; quitters (n = 95)-smoking cessation for more than 1 week and less than 1 month; and smokers (n = 73)-smoking at least 1 cigarette per day for at least 1 year. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The primary outcome was the incidence of POH after on-pump CABG surgery. Secondary outcomes included length of postoperative mechanical ventilation and intensive care unit stay between the POH group and non-POH group. There were significant decreases of POH incidence in the sustained quitters and quitters compared with the smokers both after intensive care unit (ICU) admission and 24 hours after surgery (18.2%, 18.9%, v 32.9%; p = 0.036 and 9.8%, 10.5%, v 26%; p = 0.003, respectively), and there was no significant difference in POH incidence between the sustained quitters and quitters. The length of postoperative mechanical ventilation was longer in smokers than in sustained quitters and quitters (15.9±6.1 h v 11.9±5.3 h and 13.0±5.8 h, respectively; p<0.05), but there were no significant differences in the length of ICU stay among the 3 groups (54.2±7.5 h v 55.1±7.5 h and 53.7±6.6 h, respectively; p = 0.333). CONCLUSIONS Smoking cessation can reduce POH after on-pump CABG surgery, and it also can shorten the length of postoperative mechanical ventilation.
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Affiliation(s)
| | - Yi Lv
- Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jingjie Liu
- Department of Neurology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lin Liu
- Departments of *Anesthesiology and
| | - Hui Yuan
- Departments of *Anesthesiology and
| | - Xin Shen
- Departments of *Anesthesiology and
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Phillips B, Veljkovic E, Boué S, Schlage WK, Vuillaume G, Martin F, Titz B, Leroy P, Buettner A, Elamin A, Oviedo A, Cabanski M, De León H, Guedj E, Schneider T, Talikka M, Ivanov NV, Vanscheeuwijck P, Peitsch MC, Hoeng J. An 8-Month Systems Toxicology Inhalation/Cessation Study in Apoe-/- Mice to Investigate Cardiovascular and Respiratory Exposure Effects of a Candidate Modified Risk Tobacco Product, THS 2.2, Compared With Conventional Cigarettes. Toxicol Sci 2016; 149:411-32. [PMID: 26609137 PMCID: PMC4725610 DOI: 10.1093/toxsci/kfv243] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Smoking cigarettes is a major risk factor in the development and progression of cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD). Modified risk tobacco products (MRTPs) are being developed to reduce smoking-related health risks. The goal of this study was to investigate hallmarks of COPD and CVD over an 8-month period in apolipoprotein E-deficient mice exposed to conventional cigarette smoke (CS) or to the aerosol of a candidate MRTP, tobacco heating system (THS) 2.2. In addition to chronic exposure, cessation or switching to THS2.2 after 2 months of CS exposure was assessed. Engaging a systems toxicology approach, exposure effects were investigated using physiology and histology combined with transcriptomics, lipidomics, and proteomics. CS induced nasal epithelial hyperplasia and metaplasia, lung inflammation, and emphysematous changes (impaired pulmonary function and alveolar damage). Atherogenic effects of CS exposure included altered lipid profiles and aortic plaque formation. Exposure to THS2.2 aerosol (nicotine concentration matched to CS, 29.9 mg/m(3)) neither induced lung inflammation or emphysema nor did it consistently change the lipid profile or enhance the plaque area. Cessation or switching to THS2.2 reversed the inflammatory responses and halted progression of initial emphysematous changes and the aortic plaque area. Biological processes, including senescence, inflammation, and proliferation, were significantly impacted by CS but not by THS2.2 aerosol. Both, cessation and switching to THS2.2 reduced these perturbations to almost sham exposure levels. In conclusion, in this mouse model cessation or switching to THS2.2 retarded the progression of CS-induced atherosclerotic and emphysematous changes, while THS2.2 aerosol alone had minimal adverse effects.
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Affiliation(s)
- Blaine Phillips
- *Philip Morris International Research Laboratories Pte Ltd, The Kendall #02-07, Science Park II, Singapore 117406
| | - Emilija Veljkovic
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Stéphanie Boué
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Walter K Schlage
- WK Schlage Biology Consulting, 51429 Bergisch Gladbach, Germany; and
| | - Gregory Vuillaume
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Florian Martin
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Bjoern Titz
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Patrice Leroy
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | | | - Ashraf Elamin
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Alberto Oviedo
- *Philip Morris International Research Laboratories Pte Ltd, The Kendall #02-07, Science Park II, Singapore 117406
| | - Maciej Cabanski
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Héctor De León
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Emmanuel Guedj
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Thomas Schneider
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Marja Talikka
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Nikolai V Ivanov
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Patrick Vanscheeuwijck
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Manuel C Peitsch
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland
| | - Julia Hoeng
- Philip Morris International R&D, Philip Morris Products S.A., 2000 Neuchâtel, Switzerland;
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Hou G, Yin Y, Han D, Wang QY, Kang J. Rosiglitazone attenuates the metalloprotease/anti-metalloprotease imbalance in emphysema induced by cigarette smoke: involvement of extracellular signal-regulated kinase and NFκB signaling. Int J Chron Obstruct Pulmon Dis 2015; 10:715-24. [PMID: 25897215 PMCID: PMC4396520 DOI: 10.2147/copd.s77514] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective We investigated how rosiglitazone attenuated cigarette smoke (CS)-induced emphysema in a rat model. In particular, we focused on its possible effects on the imbalance between metalloprotease (MMP) and anti-MMP activity, mitogen-activated protein kinase (MAPK) phosphorylation, and nuclear factor kappa-light-chain-enhancer of activated B cell (NFκB) signaling pathway over-activation. Methods A total of 36 Wistar rats were divided into three groups (n=12 each): animals were exposed to CS for 12 weeks in the absence (the CS group) or presence of 30 mg/kg rosiglitazone (the rosiglitazone-CS [RCS] group); a control group was treated with the rosiglitazone vehicle only, without any CS exposure. Histopathology of lung tissue in all groups was evaluated to grade severity of the disease. Expression levels of peroxisome proliferator-activated receptor γ (PPARγ), MMP2, and MMP9 in lung tissue were determined and compared using Western blotting and immunohistochemistry. Activation of MAPKs, NFκB, and the nuclear factor of kappa light polypeptide gene enhancer in B-cell inhibitor, alpha (IκBα) phosphorylation in lung tissue was examined by Western blotting. Results Emphysema-related pathology, based on inter-alveolar wall distance and alveolar density, was less severe in the RCS group than in the CS group. Compared with the CS group, levels of PPARγ were higher in the RCS group, and levels of MMP2 and MMP9 proteins were lower in the RCS rats. Levels of activated MAPKs and NFκB were also lower, while the IκBαphosphorylation was increased in the lung tissue of RCS rats. Conclusion Our findings suggest that oral administration of rosiglitazone attenuates the metalloprotease activity induced by CS, and the underlying mechanism might involve the activation of signaling pathways dependent on MAPKs or NFκB. Our results further suggest that PPARγ contributes to the pathogenesis of emphysema as well as airway inflammation induced by CS.
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Affiliation(s)
- Gang Hou
- Department of Respiratory Medicine, the First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yan Yin
- Department of Respiratory Medicine, the First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Dan Han
- Department of Respiratory Medicine, the First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Qiu-Yue Wang
- Department of Respiratory Medicine, the First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Jian Kang
- Department of Respiratory Medicine, the First Hospital of China Medical University, Shenyang, People's Republic of China
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18
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Cheng TO. Smoking in China: Can or should China kick the habit? Int J Cardiol 2014; 175:219-21. [DOI: 10.1016/j.ijcard.2014.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 05/05/2014] [Indexed: 11/26/2022]
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