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Li C, Chen J, Yuan W, Zhang W, Chen H, Tan H. Preventive effect of ursolic acid derivative on particulate matter 2.5-induced chronic obstructive pulmonary disease involves suppression of lung inflammation. IUBMB Life 2020; 72:632-640. [PMID: 31840927 DOI: 10.1002/iub.2201] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/31/2019] [Indexed: 01/07/2023]
Abstract
Respiratory diseases like chronic obstructive pulmonary disease (COPD) are associated with the presence of particulate matter 2.5 (PM2.5) in the air. In the present study, the effect of synthesized ursolic acid derivatives on mice model of PM2.5-induced COPD was investigated in vivo. The mice model of COPD was established by the administration of 25 μL of PM2.5 suspension through intranasal route daily for 1 week. The levels of oxidative stress markers and inflammatory cytokines like tumor necrosis factors-α and interleukin-6 in the mice bronchoalveolar fluids increased markedly on administration with PM2.5. However, treatment with ursolic acid derivative caused a significant suppression in PM2.5-induced increase in oxidative stress markers and inflammatory cytokines in dose-dependent manner. Hematoxylin and eosin staining showed excessive inflammatory cell infiltration in pulmonary tissues in mice with COPD. The inflammatory cell infiltration was inhibited on treatment of the mice with ursolic acid derivative. The ursolic acid derivative treatment increased level of superoxide dismutase in mice with COPD. The lung injury induced by PM2.5 in mice was also prevented on treatment with ursolic acid derivative. Thus, ursolic acid derivative inhibits pulmonary tissues damage in mice through suppression of inflammatory cytokine and oxidative enzymes. Therefore, ursolic acid derivative can be of therapeutic importance for treatment of PM2.5-induced COPD.
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Affiliation(s)
- Cuini Li
- Department of Pharmacy, Guangzhou Haizhu District Changgang Street Community Service Center, Guangzhou, Guangdong, China
| | - Junxian Chen
- The First College of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Weiwei Yuan
- Department of Internal Medicine, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, Guangdong, China
| | - Wei Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hong Chen
- Department of Internal Medicine, Huizhou Hospital of Traditional Chinese Medicine, Huizhou, Guangdong, China
| | - Hongtao Tan
- Department of Traditional Chinese Medicine, Huizhou Huiyang Maternity and Child Health Care Hospital, Huizhou, Guangdong, China
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Tran D, Lim M, Vogrin S, Jayaram L. Point of Care Portable Spirometry in the Diagnosis and Treatment of Inpatients with Chronic Obstructive Pulmonary Disease. Lung 2020; 198:143-150. [PMID: 31894409 DOI: 10.1007/s00408-019-00314-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Spirometry is required to accurately diagnose chronic obstructive pulmonary disease (COPD). Following an acute exacerbation, it is recommended that spirometry be performed after a delay of 4-6 weeks to allow stability and a measure of 'baseline' lung function. However, poor attendance at these appointments can occur, leading to an inability to confirm the diagnosis of COPD or assess the severity of airflow obstruction. Portable spirometry (PS) is a proven surrogate device that may provide a convenient method to address these issues. The purpose of this study was to compare PS values, obtained prior to hospital discharge to laboratory-based spirometry (LS) results undertaken 4 weeks later. METHODS Thirty-three eligible inpatients with a clinically determined exacerbation of COPD were recruited. Patients underwent PS prior to discharge and LS 4 weeks later. RESULTS Reliability of PS values at discharge compared with outpatient LS 4 weeks later was excellent (intraclass correlation coefficient > 0.9). The PS confirmed a new diagnosis of COPD at the bedside in 29% of patients and excluded COPD in 6% at both time points. Patients were found to have a similar severity of airflow obstruction on both PS and LS, with clinical stability maintained between visits. The PS and LS may be used interchangeably for earlier diagnosis of COPD. PS at the point of discharge from hospital offers a unique opportunity to diagnose and facilitate COPD management from hospital to primary care.
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Affiliation(s)
- Donald Tran
- The University of Melbourne, Melbourne, Australia.,Department of Medicine, Respiratory & Sleep Disorders, Western Health, Melbourne, Australia
| | - Melvin Lim
- Department of Medicine, Respiratory & Sleep Disorders, Western Health, Melbourne, Australia
| | - Sara Vogrin
- The University of Melbourne, Melbourne, Australia
| | - Lata Jayaram
- The University of Melbourne, Melbourne, Australia. .,Department of Medicine, Respiratory & Sleep Disorders, Western Health, Melbourne, Australia.
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Zhang J, Li S, Sun L, Chen Y, Zhang L, Zhang Z. Therapeutic effects of stemonine on particulate matter 2.5-induced chronic obstructive pulmonary disease in mice. Exp Ther Med 2017; 14:4453-4459. [PMID: 29104656 DOI: 10.3892/etm.2017.5092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 06/06/2017] [Indexed: 01/04/2023] Open
Abstract
Particulate matter 2.5 (PM2.5) is a growing concern worldwide due to its association with respiratory diseases, including chronic obstructive pulmonary disease (COPD). Stemonine, a traditional Chinese herb, has been demonstrated to exhibit anti-inflammatory and antioxidant properties, making it a potential drug for the treatment of respiratory diseases. The therapeutic effects of stemonine on mice with PM2.5-induced COPD were investigated in the present study. Kunming mice were randomly divided into the following five groups (n=10/group): Control, model, low-dose stemonine, moderate-dose stemonine and high-dose stemonine. The model mice received an intranasal instillation of PM2.5 suspension (40 mg/kg). The levels of specific enzymes, markers of oxidative stress, and the inflammatory cytokines tumor necrosis factor (TNF)-α and interleukin (IL)-6 were measured in the bronchoalveolar lavage fluid of the mice using ELISA kits. Hematoxylin and eosin staining was performed to determine inflammatory changes to the lung tissue. It was demonstrated that stemonine could significantly alleviate lung injury by decreasing the levels of enzymes and cytokines associated with inflammation and oxidative stress in a dose-dependent manner. In addition, stemonine dose-dependently increased the amount of superoxide dismutase. These results suggest that stemonine reduces lung inflammation in mice with PM2.5-induced COPD, providing a novel approach for the treatment of PM2.5-induced respiratory diseases.
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Affiliation(s)
- Jinbo Zhang
- Center for Preventive Treatment of Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264016, P.R. China
| | - Shiqing Li
- Department of Encephalopathy, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264016, P.R. China
| | - Li Sun
- Department of Gynecology and Obstetrics, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264016, P.R. China
| | - Yanxia Chen
- Department of Rehabilitation, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264016, P.R. China
| | - Lei Zhang
- Department of Heart Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264016, P.R. China
| | - Zhenghui Zhang
- Center for Preventive Treatment of Disease, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong 264016, P.R. China
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Blee J, Roux RK, Gautreaux S, Sherer JT, Garey KW. Dispensing inhalers to patients with chronic obstructive pulmonary disease on hospital discharge: Effects on prescription filling and readmission. Am J Health Syst Pharm 2016; 72:1204-8. [PMID: 26150570 DOI: 10.2146/ajhp140621] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The effects of dispensing inhalers to patients with chronic obstructive pulmonary disease (COPD) on hospital discharge were evaluated. METHODS Data were collected in 2011-12 for patients with COPD who had hospital orders for the study inhalers (preintervention group) and after implementation of the multidose medication dispensing on discharge (MMDD) service (2013-14) (postintervention group). The primary objective of this study was to assess inhaler adherence and readmission rates before and after MMDD implementation. Adherence was defined as filling the discharge prescription for the multidose inhaler at a Harris Health pharmacy within three days of discharge or having at least seven days of medication left in an inhaler from a previous prescription that was filled or refilled before hospital admission. All patients in the postintervention group were considered adherent, since every patient was given the remainder of his or her multidose inhaler when discharged. RESULTS Data from 620 patients (412 in the preintervention group, 208 in the postintervention group) were collected. During the preintervention time period, 88 of 412 patients were readmitted within 30 days compared with 18 of 208 patients during the postintervention period (p < 0.001). The intervention was associated with a significant reduction in 30-day readmissions (p = 0.0016) and 60-day readmissions (p = 0.0056). CONCLUSION A targeted pharmacy program to provide COPD patients being discharged from the hospital with the multidose inhalers they had used during hospitalization was associated with improved medication adherence, as measured by prescription filling behavior, and reduced rates of 30- and 60-day hospital readmissions.
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Affiliation(s)
- John Blee
- John Blee, Pharm.D., M.S., BCPS, is Pharmacy Manager, Houston Methodist Sugar Land Hospital, Sugarland, TX. Ryan K. Roux, Pharm.D., M.S., is Director of Pharmacy Operations; and Stefani Gautreaux, Pharm.D., M.B.A., is Inpatient Pharmacy Operations Manager, M. D. Anderson Cancer Center, Houston. Jeffrey T. Sherer, Pharm.D., M.P.H., is Clinical Associate Professor; and Kevin W. Garey, Pharm.D., M.S., FASHP, is Professor and Chair, College of Pharmacy, University of Houston, Houston
| | - Ryan K Roux
- John Blee, Pharm.D., M.S., BCPS, is Pharmacy Manager, Houston Methodist Sugar Land Hospital, Sugarland, TX. Ryan K. Roux, Pharm.D., M.S., is Director of Pharmacy Operations; and Stefani Gautreaux, Pharm.D., M.B.A., is Inpatient Pharmacy Operations Manager, M. D. Anderson Cancer Center, Houston. Jeffrey T. Sherer, Pharm.D., M.P.H., is Clinical Associate Professor; and Kevin W. Garey, Pharm.D., M.S., FASHP, is Professor and Chair, College of Pharmacy, University of Houston, Houston
| | - Stefani Gautreaux
- John Blee, Pharm.D., M.S., BCPS, is Pharmacy Manager, Houston Methodist Sugar Land Hospital, Sugarland, TX. Ryan K. Roux, Pharm.D., M.S., is Director of Pharmacy Operations; and Stefani Gautreaux, Pharm.D., M.B.A., is Inpatient Pharmacy Operations Manager, M. D. Anderson Cancer Center, Houston. Jeffrey T. Sherer, Pharm.D., M.P.H., is Clinical Associate Professor; and Kevin W. Garey, Pharm.D., M.S., FASHP, is Professor and Chair, College of Pharmacy, University of Houston, Houston
| | - Jeffrey T Sherer
- John Blee, Pharm.D., M.S., BCPS, is Pharmacy Manager, Houston Methodist Sugar Land Hospital, Sugarland, TX. Ryan K. Roux, Pharm.D., M.S., is Director of Pharmacy Operations; and Stefani Gautreaux, Pharm.D., M.B.A., is Inpatient Pharmacy Operations Manager, M. D. Anderson Cancer Center, Houston. Jeffrey T. Sherer, Pharm.D., M.P.H., is Clinical Associate Professor; and Kevin W. Garey, Pharm.D., M.S., FASHP, is Professor and Chair, College of Pharmacy, University of Houston, Houston
| | - Kevin W Garey
- John Blee, Pharm.D., M.S., BCPS, is Pharmacy Manager, Houston Methodist Sugar Land Hospital, Sugarland, TX. Ryan K. Roux, Pharm.D., M.S., is Director of Pharmacy Operations; and Stefani Gautreaux, Pharm.D., M.B.A., is Inpatient Pharmacy Operations Manager, M. D. Anderson Cancer Center, Houston. Jeffrey T. Sherer, Pharm.D., M.P.H., is Clinical Associate Professor; and Kevin W. Garey, Pharm.D., M.S., FASHP, is Professor and Chair, College of Pharmacy, University of Houston, Houston.
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Pan D, Liu R, Ren S, Li C, Chang Q. Prediction of Pulmonary Arterial Hypertension in Chronic Obstructive Lung Disease from Three-Dimensional Vectorcardiographic Parameters. Ann Noninvasive Electrocardiol 2015; 21:280-6. [PMID: 26414072 DOI: 10.1111/anec.12305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/12/2015] [Accepted: 06/20/2015] [Indexed: 11/30/2022] Open
Abstract
AIM The objective of our study was to assess diagnostic value of three-dimensional (3D) vectorcardiographic (VCG) parameters in detecting pulmonary arterial hypertension (PAH) in chronic obstructive lung disease (COLD) with and without right ventricular hypertrophy (RVH). METHODS The study group of 62 patients with COPD was stratified on the basis of color Doppler echocardiographic findings into three subgroups: non-PAH (n = 23), PAH without RVH (n = 22), and PAH with RVH (n = 17). Pairwise differences between the subgroups were evaluated by one-way analysis of variance, and Pearson correlation analysis was used to evaluate the significance of the correlations between pulmonary arterial systolic pressure (PASP) and various VCG parameters. RESULTS The azimuth of the QRS vector decreased from -24° in the non-PAH group to -62° in PAH without RVH and to -140° in PAH with RVH (P < 0.01 for pairwise differences between all three groups). Similar significant decrease was observed for the azimuth of the ventricular gradient (VG) vector. Spatial QRS/T angle increased from 69° in the non-PAH group to 115° in PAH without RVH (P < 0.01). In the PAH group with RVH, QRS/T angle was 94° (P < 0.05 for difference from the non-PAH group). There was a significant correlation between PASP and QRS/T angle (r = 0.89, P < 0.05) and between PASP and the azimuth of the VG vector (r = 0.86, P < 0.05). PASP increase from linear regression model was 0.8 mmHg for a QRS/T angle increase by 10° and 1.3 mmHg for each 10° increase in the azimuth of the VG vector. CONCLUSION 3DVCG parameters are potentially useful for predicting PASP in COLD patients, and possibly also for differentiation between COLD patients with PAH and RVH from those without RVH.
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Affiliation(s)
- Dianzhu Pan
- Department of Respiration Medicine of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China
| | - Renguang Liu
- The Cardiovascular Institute of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China
| | - Shuzhen Ren
- The Cardiovascular Institute of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China
| | - Changjun Li
- Department of Respiration Medicine of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China
| | - Qinghua Chang
- The Cardiovascular Institute of the First Affiliated Hospital of Liaoning Medical University, Jinzhou, Liaoning Province, China
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