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Plavsic A, Bonaci-Nikolic B, Milenkovic B, Miskovic R, Kusic N, Dimitrijevic M, Arandjelovic S, Milosevic K, Buha I, Tomic Spiric V. Asthma Inflammatory Phenotypes: How Can We Distinguish Them? J Clin Med 2024; 13:526. [PMID: 38256660 PMCID: PMC10816410 DOI: 10.3390/jcm13020526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/07/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES induced sputum is used to assess different inflammatory phenotypes in asthma, but is not used routinely. We aimed to determine the proportion of inflammatory asthma phenotypes based on induced sputum, to find biomarkers that can discriminate between phenotypes, and to evaluate biomarkers in patients with and without biological therapy in different inflammatory asthma phenotypes. MATERIALS AND METHODS this cross-sectional study investigated clinical characteristics, asthma control tests, skin prick test, impulse oscillometry (IOS), spirometry, induced sputum, biomarkers (IgE, eosinophils, fractional exhaled nitric oxide (FeNO), serum periostin, IL-5, IL-6, IL-8, IL-17A, IL-33) in 80 asthmatics. A total of 17/80 patients were treated with biologics (10 with omalizumab, 7 with benralizumab). RESULTS a total of 31% of patients had eosinophilic asthma (EA), 30% had mixed granulocytic asthma (MGA), 24% had paucigranulocytic asthma (PGA), and 15% had neutrophilic asthma (NA). The difference was found in blood eosinophils (p = 0.002), the highest observed in EA. The cut-off ≥ 240/μL eosinophils, with 64% sensitivity and 72.7% specificity, identified EA (AUC = 0.743, p = 0.001). A higher IL-8 level was associated with NA (p = 0.025). In 63 non-biologic asthma group, eosinophils were higher in EA than in NA, MGA, and PGA (p = 0.012, p = 0.028, and p = 0.049, respectively). A higher IL-17A was associated with EA without biologics (p = 0.004). A significantly higher IL-5 was found in EA treated with biologics, in comparison with EA without biologics (p = 0.043). The number of leucocytes and neutrophils was higher in MGA without biologics (p = 0.049, p = 0.019), while IL-5, IL-6, and IL-8 levels were higher in MGA treated with biologics (p = 0.012, p = 0.032, p = 0.038, respectively). CONCLUSIONS EA and MGA were the most prevalent asthma phenotypes. Blood eosinophils can identify EA, both in patients with and without biologics. Apart from the clinical profile, a broad spectrum of biomarkers for assessing inflammatory phenotypes is necessary for an adequate therapy approach to patients with asthma.
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Affiliation(s)
- Aleksandra Plavsic
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
| | - Branka Bonaci-Nikolic
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
| | - Branislava Milenkovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
- Clinic for Pulmonology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Rada Miskovic
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
| | - Natasa Kusic
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
| | - Milan Dimitrijevic
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
| | - Snezana Arandjelovic
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
| | - Katarina Milosevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
- Department of Pulmonology and Allergology, University Children’s Hospital, 11000 Belgrade, Serbia
| | - Ivana Buha
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
- Clinic for Pulmonology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Vesna Tomic Spiric
- Clinic for Allergy and Immunology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia; (B.B.N.); (R.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (B.M.)
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Toennesen B, Schmid JM, Sørensen BS, Fricker M, Hoffmann HJH. A five-gene qPCR signature can classify type 2 asthma comparably to microscopy of induced sputum from severe asthma patients. Eur Clin Respir J 2023; 11:2293318. [PMID: 38178813 PMCID: PMC10763913 DOI: 10.1080/20018525.2023.2293318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
Asthma is a heterogenous disease characterized by airway inflammation and variable expiratory airflow limitation resulting in variable respiratory symptoms. Characterization of airway inflammation is important to choose the optimal treatment for severe asthma patients eligible for biological treatment. However, counting cells in induced sputum samples are a time-consuming process, highly dependent on personal skills. Replacing eosinophil and neutrophil cell counting with qPCR for transcripts of selected mast cell, and basophil genes may provide more reproducible results. Aims The objective of this study was to compare qPCR with microscopy in asthma endotyping. Methods A qPCR method measuring five mast cell/basophil genes was applied on induced sputum samples from 30 severe asthma patients and compared with microscopy. Target gene Ct-values (CPA3, GATA2, HDC, MS4A2, TPSAB1/TPSB2) were referenced to household β-actin Ct values as a measure of relative mRNA abundance of the target in each sample. Target/β-actin-ratios in eosinophilic and non-eosinophilic groups determined by microscopy with an eosinophil threshold of 3% in 400 cells were compared using Mann-Whitney U Test. Spearman´s correlations were used to test for correlation between targets vs. FENO and targets vs. blood eosinophil counts. Results The study demonstrated a statistical difference in relative mRNA abundance for four mast cell/basophil specific genes. CPA3, GATA2, HDC and MS4A2 were elevated in eosinophilic asthma versus non-eosinophilic asthma patients. The study found that GATA2, CPA3, MS4A2 and TPSAB1/TPSB2 transcripts are positively correlated with FENO. Neither the five mast cell genes nor the five-gene signature correlated with blood eosinophils. The five-gene signature with a target/β-actin-ratio cut-off ≥2 generated sensitivity = 87%, specificity = 94%, NPV = 88% and PPV = 92% compared to microscopy. Conclusion This study confirms the contribution of mast cells in the pathogenesis of EA and suggests that mast cell mRNA markers could be one of the biomarkers used to identify EA.
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Affiliation(s)
- B. Toennesen
- Department of Clinical Medicine, Aarhus University & Department of Respiratory Diseases and Allergy, Aarhus, Denmark
| | - J. M. Schmid
- Department of Clinical Medicine, Aarhus University & Department of Respiratory Diseases and Allergy, Aarhus, Denmark
| | - B. S. Sørensen
- Department of Clinical Medicine, Aarhus University & Department of Clinical Biochemistry, Aarhus, Denmark
| | - M. Fricker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia & Hunter Medical Research Institute, New Lambton Heights, NSW, Australia, Newcastle, Australia
| | - H. J. H. Hoffmann
- Department of Clinical Medicine, Aarhus University & Department of Respiratory Diseases and Allergy, Aarhus, Denmark
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Mishra D, Singh A, Yadav RK, Verma M. Diagnostic Utility of Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) on Induced Sputum Versus Gastric Aspirate Samples for the Diagnosis of Paediatric Pulmonary Tuberculosis. Cureus 2023; 15:e47246. [PMID: 38022348 PMCID: PMC10654686 DOI: 10.7759/cureus.47246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) in children is neglected, mainly due to a lack of sensitive diagnostic tools. Paediatric TB is now a global priority. More paediatric TB cases are being recorded as a result of the introduction of Xpert® Mycobacterium tuberculosis (MTB)/rifampicin (RIF) (Cepheid Inc., Sunnyvale, USA). This study was undertaken to evaluate the performance of Xpert MTB/RIF in the diagnosis of pulmonary TB in children. METHODS We recruited 70 paediatric patients with probable pulmonary TB and their gastric aspirate (GA), and induced sputum (IS) samples were collected between January 2021 and June 2022 in Saifai, Etawah, Uttar Pradesh, at the Microbiology Department of the Uttar Pradesh University of Medical Sciences (U.P.U.M.S.). All samples were subjected to smear examination, Bacterial Activation of Continuous Temperature and Environmental Control - Mycobacterial Growth Indicator Tube (BACTEC-MGIT) culture, and Xpert MTB/RIF. RESULTS The specimens included 70 GAs and 70 IS samples. The total number of specimens were 140 and we collected GA as well as IS from each of the patient enrolled in the study. When compared to microscopy, GeneXpert provides a quicker and earlier detection of paediatric TB. The sensitivity of the cartridge-based nucleic acid amplification test (CBNAAT) against mycobacterial growth indicator tube (MGIT) was 75.0% for GA samples and 63.64% for IS samples. CONCLUSION Paediatric TB, owing to its paucibacillary nature and difficulty in the collection of samples, makes the diagnosis difficult by conventional methods. Our study shows that smear and culture yield in GA samples are superior to those of IS samples and the sensitivity of Xpert MTB/RIF assay is also significantly different in GA and IS samples, but a combination of GA and IS yielded the best results.
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Affiliation(s)
- Dipti Mishra
- Microbiology, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Amit Singh
- Microbiology, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Rajesh K Yadav
- Pediatrics, Uttar Pradesh University of Medical Sciences, Etawah, IND
| | - Mudit Verma
- Community Medicine, Uttar Pradesh University of Medical Sciences, Etawah, IND
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Dragonieri S, Bikov A, Capuano A, Scarlata S, Carpagnano GE. Methodological Aspects of Induced Sputum. Adv Respir Med 2023; 91:397-406. [PMID: 37887074 PMCID: PMC10603896 DOI: 10.3390/arm91050031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023]
Abstract
We aimed to conduct a state-of-the-art review of the current literature and offer further insights into the methodological aspects concerning induced sputum. The increasing popularity of sputum induction as a non-invasive and cost-effective method for obtaining lower airway secretions from patients who cannot produce sputum naturally has led to extensive research and applications in respiratory conditions like asthma and COPD. This technique allows for analysis of the cellular and biochemical components of the sputum to take place, providing insights into airway inflammation, immune cells, and help in predicting treatment response. Furthermore, induced sputum enables various analyses, including microRNA and gene expression studies and immunophenotyping. The procedure is generally safe and well tolerated, even in patients with airflow limitations; however, monitoring lung function is essential, especially in those with airway hyperresponsiveness. Optimal saline solution concentration and inhalation duration have been investigated, recommending a 15-20 min induction with hypertonic saline. Expectoration involves coughing at the end of each inhalation time. Careful handling during sputum processing is necessary for obtaining accurate results in cell cytology, immunocytochemistry, and in situ hybridization. Overall, induced sputum offers significant advantages as a preferred alternative for large-scale and repeated airway sampling, despite some technical demands and limitations.
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Affiliation(s)
- Silvano Dragonieri
- Department of Respiratory Diseases, University of Bari, 70124 Bari, Italy; (S.D.); (A.C.); (G.E.C.)
| | - Andras Bikov
- Manchester Academic Health Science Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, UK
| | - Alessandro Capuano
- Department of Respiratory Diseases, University of Bari, 70124 Bari, Italy; (S.D.); (A.C.); (G.E.C.)
| | - Simone Scarlata
- Department of Internal Medicine, Unit of Respiratory Pathophysiology and Thoracic Endoscopy, Bio-Medical Campus, 00128 Rome, Italy;
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Mangattu Parambil PB, Mohapatra AK, Behera D, Subhankar S, Jagaty SK, Singh P. Determination of sputum eosinophil count and serum absolute eosinophil count in patients with bronchial asthma and its correlation with disease severity and response to treatment. J Family Med Prim Care 2023; 12:2053-2057. [PMID: 38024908 PMCID: PMC10657076 DOI: 10.4103/jfmpc.jfmpc_487_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Sputum eosinophils can be used to assess severity of disease and response to treatment in bronchial asthma. Eosinophilic inflammation in the airways can also be marked by blood eosinophilia. In this study, we tried to determine the sputum eosinophil count and serum absolute eosinophil count in patients with asthma and correlate them with disease severity and treatment response. Materials and Methods It was a cross-sectional intervention study including all consecutive cases with a diagnosis of bronchial asthma based on spirometry and clinical history. An induced sputum sample and blood were sent for eosinophil count to the laboratory. All the patients were started on inhaled corticosteroids and followed up at the end of 1 month with spirometry, sputum eosinophil count and AEC. Statistical Package for the Social Sciences for Windows v20.0 (IBM SPSS Corp.; Armonk, NY, USA) was used for statistical analysis. Results There was no significant difference in the mean sputum eosinophil count (%) in mild, moderate and severe disease (f = 0.24; P = 0.79) or in AEC (f = 1.48; P = 0.24). At follow-up, all patients with moderate and severe disease showed significant improvement in FEV1 (P = 0.0001). The mean sputum eosinophil count and AEC (%) in the three subgroups was also seen to decrease at the end of the follow-up period (f = 0.08; P = 0.9 and f = 2.75; P = 0.07, respectively). Conclusion Sputum eosinophils and AEC are important markers of airway inflammation. All our patients showed improvement in FEV1, sputum eosinophil count and AEC after 1 month of treatment thus confirming the role of ICS in the treatment of eosinophilic asthma.
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Affiliation(s)
| | - Amrut K. Mohapatra
- Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Debasis Behera
- Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Saswat Subhankar
- Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suman K. Jagaty
- Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pratima Singh
- Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Bouhamdi A, Es-Sabbahi B, Amiali R, Serraj M, Biaz M, Benjelloun MC, Amara B. Thirteen Cases of Pulmonary Pneumocystis in HIV-Negative Patients. Cureus 2023; 15:e43409. [PMID: 37706120 PMCID: PMC10496727 DOI: 10.7759/cureus.43409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 09/15/2023] Open
Abstract
We report 13 cases of pulmonary pneumocystis (PCP) in human immunodeficiency virus (HIV)-uninfected patients. Of eight males and five females, with a mean age of 55 years, one had breast neoplasia, two had common variable immunodeficiency (CVID), one had an autoimmune disease "Goodpasture's syndrome", and one had idiopathic fibrosis (nonspecific interstitial pneumonia/fibrosis (NIP)) undergoing prolonged corticosteroid therapy for two years, with no known immunosuppression in the remaining cases. The clinical picture was characterized by constant dyspnea and severe hypoxia in 11 cases. Lymphopenia was present in nine cases with an average rate of 920.76 elements/mm3. The diagnosis was confirmed by isolation of Pneumocystis jirovecii (PCJ) from induced sputum, except in two cases where analysis of bronchoalveolar lavage (BAL) fluid was required. With trimethoprim/sulfamethoxazole (TMP/SMX) and corticosteroid therapy, the course was favorable in all cases. Prophylactic treatment was indicated in three cases.
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Affiliation(s)
- Abir Bouhamdi
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
| | - Btissame Es-Sabbahi
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
| | - Rajae Amiali
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
| | - Mounia Serraj
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
| | - Mohamed Biaz
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
| | - Mohamed Chakib Benjelloun
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
| | - Bouchra Amara
- Pulmonology Department, Hassan II University Hospital, University of Sidi Mohammed Ben Abdellah, Fez, MAR
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7
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Brandsma J, Schofield JPR, Yang X, Strazzeri F, Barber C, Goss VM, Koster G, Bakke PS, Caruso M, Chanez P, Dahlén SE, Fowler SJ, Horváth I, Krug N, Montuschi P, Sanak M, Sandström T, Shaw DE, Chung KF, Singer F, Fleming LJ, Adcock IM, Pandis I, Bansal AT, Corfield J, Sousa AR, Sterk PJ, Sánchez-García RJ, Skipp PJ, Postle AD, Djukanović R. Stratification of asthma by lipidomic profiling of induced sputum supernatant. J Allergy Clin Immunol 2023; 152:117-125. [PMID: 36918039 DOI: 10.1016/j.jaci.2023.02.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Asthma is a chronic respiratory disease with significant heterogeneity in its clinical presentation and pathobiology. There is need for improved understanding of respiratory lipid metabolism in asthma patients and its relation to observable clinical features. OBJECTIVE We performed a comprehensive, prospective, cross-sectional analysis of the lipid composition of induced sputum supernatant obtained from asthma patients with a range of disease severities, as well as from healthy controls. METHODS Induced sputum supernatant was collected from 211 adults with asthma and 41 healthy individuals enrolled onto the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes) study. Sputum lipidomes were characterized by semiquantitative shotgun mass spectrometry and clustered using topologic data analysis to identify lipid phenotypes. RESULTS Shotgun lipidomics of induced sputum supernatant revealed a spectrum of 9 molecular phenotypes, highlighting not just significant differences between the sputum lipidomes of asthma patients and healthy controls, but also within the asthma patient population. Matching clinical, pathobiologic, proteomic, and transcriptomic data helped inform the underlying disease processes. Sputum lipid phenotypes with higher levels of nonendogenous, cell-derived lipids were associated with significantly worse asthma severity, worse lung function, and elevated granulocyte counts. CONCLUSION We propose a novel mechanism of increased lipid loading in the epithelial lining fluid of asthma patients resulting from the secretion of extracellular vesicles by granulocytic inflammatory cells, which could reduce the ability of pulmonary surfactant to lower surface tension in asthmatic small airways, as well as compromise its role as an immune regulator.
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Affiliation(s)
- Joost Brandsma
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, Southampton, United Kingdom.
| | - James P R Schofield
- National Institute for Health Research Southampton Biomedical Research Centre, Southampton, United Kingdom; Centre for Proteomic Research, Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - Xian Yang
- Data Science Institute, Imperial College, London, United Kingdom
| | - Fabio Strazzeri
- Mathematical Sciences, University of Southampton, Southampton, United Kingdom
| | - Clair Barber
- National Institute for Health Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Victoria M Goss
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Grielof Koster
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, Southampton, United Kingdom
| | - Per S Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Massimo Caruso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Pascal Chanez
- Department of Respiratory Diseases, Aix-Marseille University, Marseille, France
| | - Sven-Erik Dahlén
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Stephen J Fowler
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom; Manchester Academic Health Centre and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Ildikó Horváth
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Norbert Krug
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Paolo Montuschi
- Department of Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy; National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Marek Sanak
- Department of Medicine, Jagiellonian University, Krakow, Poland
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Dominick E Shaw
- National Institute for Health Research Biomedical Research Unit, University of Nottingham, Nottingham, United Kingdom
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Florian Singer
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Paediatrics and Adolescent Medicine, Division of Paediatric Pulmonology and Allergology, Medical University of Graz, Graz, Austria
| | - Louise J Fleming
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Ian M Adcock
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Ioannis Pandis
- Data Science Institute, Imperial College, London, United Kingdom
| | - Aruna T Bansal
- Acclarogen Ltd, St John's Innovation Centre, Cambridge, United Kingdom
| | | | - Ana R Sousa
- Respiratory Therapy Unit, GlaxoSmithKline, London, United Kingdom
| | - Peter J Sterk
- Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Paul J Skipp
- Centre for Proteomic Research, Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - Anthony D Postle
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ratko Djukanović
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, Southampton, United Kingdom
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Freund O, Rotem-Green M, Rahat M, Gershman E, Ophir N, Fireman E, Shenhar-Tsarfaty S, Bar-Shai A. Nanoparticles in induced sputum - a window to airway inflammation among active smokers. Nanomedicine (Lond) 2023; 18:303-315. [PMID: 36975802 DOI: 10.2217/nnm-2022-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Aims: To evaluate the role of nanoparticles (NP) in sputum samples of active smokers as markers of inflammation and disease. Materials & methods: 29 active smokers were included (14 with chronic obstructive pulmonary disease [COPD]) and underwent clinical assessment, pulmonary function tests, sputum induction (with NP analysis) and blood sampling. Results: Higher particle and NP concentrations and smaller mean size directly correlated with clinical parameters such as the COPD Assessment Test score and impulse oscillometry results. Similar correlations were found between NPs and increased sputum IL-1β, IL-6 and TNF-α. Among COPD patients, higher IL-8 and lower IL-10 serum levels also correlated with NP concentrations. Conclusion: This proof-of-concept study shows the potential of sputum NPs as markers of airway inflammation and disease.
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Affiliation(s)
- Ophir Freund
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Michal Rotem-Green
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Maya Rahat
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Evgeni Gershman
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Noa Ophir
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Elizabeth Fireman
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Shani Shenhar-Tsarfaty
- Internal Medicine C, Tel Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
| | - Amir Bar-Shai
- The Institute of Pulmonary Medicine, Tel-Aviv Sourasky Medical Center & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6423906, Israel
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9
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Murphy RC, Chow YH, Lai Y, Al-Shaikhly T, Petroni DH, Black M, Hamerman JA, Lacy-Hulbert A, Piliponsky AM, Hallstrand TS. Identification of mast cell progenitor cells in the airways of individuals with allergic asthma. Allergy 2023; 78:547-549. [PMID: 36038252 PMCID: PMC9892201 DOI: 10.1111/all.15498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/01/2022] [Accepted: 08/25/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Ryan C. Murphy
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
- Center for Lung Biology, Department of Medicine, University of Washington, Seattle, Washington
| | - Yu-Hua Chow
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
- Center for Lung Biology, Department of Medicine, University of Washington, Seattle, Washington
| | - Ying Lai
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
- Center for Lung Biology, Department of Medicine, University of Washington, Seattle, Washington
| | - Taha Al-Shaikhly
- Division of Allergy and Infectious Disease, University of Washington, Seattle, Washington
- Center for Lung Biology, Department of Medicine, University of Washington, Seattle, Washington
| | - Daniel H. Petroni
- Division of Allergy and Infectious Disease, University of Washington, Seattle, Washington
- Seattle Allergy and Asthma Research Institute, Seattle, Washington, USA
| | - Michele Black
- Department of Immunology, University of Washington, Seattle, Washington, USA
| | - Jessica A. Hamerman
- Department of Immunology, University of Washington, Seattle, Washington, USA
- Immunology Program, Benaroya Research Institute, Seattle, Washington, USA
| | - Adam Lacy-Hulbert
- Department of Immunology, University of Washington, Seattle, Washington, USA
- Immunology Program, Benaroya Research Institute, Seattle, Washington, USA
| | | | - Teal S. Hallstrand
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington
- Center for Lung Biology, Department of Medicine, University of Washington, Seattle, Washington
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10
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Feng B, Zhou T, Guo Z, Jin J, Zhang S, Qiu J, Cao J, Li J, Peng X, Wang J, Xing Y, Ji R, Qiao L, Liang Y. Comprehensive analysis of immune-related genes for classification and immune microenvironment of asthma. Am J Transl Res 2023; 15:1052-1062. [PMID: 36915798 PMCID: PMC10006808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/14/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To determine the effects of immune-related genes (IRGs) and immune landscape of induced sputum, and develop novel, non-invasive diagnostic molecular therapeutic targets for asthma. METHODS GSE76262 datasets were used to identify differentially expressed IRGs in asthma. Key IRGs were detected using a protein-protein interaction network. Receiver operating characteristic (ROC) curves were analyzed to investigate the diagnostic value of key IRGs. Gene set enrichment analysis (GSEA) was performed with WebGestalt. Single-sample gene set enrichment analysis and CIBERSORT were used to investigate the immune landscape of induced sputum. RESULTS A total of 75 potential IRGs were associated with asthma, most of which were involved in the NF-kappa B signaling pathway. ROC analysis showed AUC values for the hub pathway ranging from 0.676-0.767, with moderate diagnostic value for asthma. We also identified IRGs-related cytokines (TNF-α, IL-1β, IL-8 and IL-6) in 76 asthma and 91 control serum samples to further explore diagnostic efficacy, showing a cumulative AUC of 0.998 for these four related cytokines. Analysis of immune cell infiltration levels showed that follicular helper T cells, activated dendritic cells, activated mast cells and eosinophils were significantly higher and macrophages M0 and macrophages M2 were significantly reduced in sputum from patients with asthma. CONCLUSIONS IRGs-related cytokines and immune infiltration may contribute to the diagnosis and immune classification of asthma.
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Affiliation(s)
- Bin Feng
- Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| | - Tong Zhou
- Medical College of Soochow University Suzhou 215006, Jiangsu, China
| | - Zhiyi Guo
- Medical College of Soochow University Suzhou 215006, Jiangsu, China
| | - Jieyu Jin
- Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| | - Sheng Zhang
- Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| | - Jun Qiu
- Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| | - Jun Cao
- Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
| | - Jia Li
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai JiaoTong University School of Medicine Shanghai 201209, China
| | - Xia Peng
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai JiaoTong University School of Medicine Shanghai 201209, China
| | - Juan Wang
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai JiaoTong University School of Medicine Shanghai 201209, China
| | - Yanru Xing
- Basecare Medical Device Co., Ltd. Suzhou 215006, China
| | - Renxin Ji
- The School of International Medical Technology of Shanghai Sanda University Shanghai 201209, China
| | - Longwei Qiao
- Center for Reproduction and Genetics, School of Gusu, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University Suzhou 215006, Jiangsu, China
| | - Yuting Liang
- Center for Clinical Laboratory, The First Affiliated Hospital of Soochow University Suzhou 215006, Jiangsu, China
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11
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Chen M, Xu K, He Y, Jin J, Mao R, Gao L, Zhang Y, Wang G, Gao P, Xie M, Liu C, Chen Z. CC16 as an Inflammatory Biomarker in Induced Sputum Reflects Chronic Obstructive Pulmonary Disease (COPD) Severity. Int J Chron Obstruct Pulmon Dis 2023; 18:705-717. [PMID: 37139166 PMCID: PMC10150740 DOI: 10.2147/copd.s400999] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/06/2023] [Indexed: 05/05/2023] Open
Abstract
Purpose The progression of an abnormal inflammatory response plays a crucial role in the lung function decline of chronic obstructive pulmonary disease (COPD) patients. Compared to serum biomarkers, inflammatory biomarkers in induced sputum would be a more reliable reflection of inflammatory processes in the airways. Patients and Methods A total of 102 COPD participants were divided into a mild-to-moderate group (FEV1%pred≥ 50%, n=57) and a severe-to-very-severe group (FEV1%pred<50%, n=45). We measured a series of inflammatory biomarkers in induced sputum and analyzed their association with lung function and SGRQ in COPD patients. To evaluate the relationship between inflammatory biomarkers and the inflammatory phenotype, we also analyzed the correlation between biomarkers and airway eosinophilic phenotype. Results We found increased mRNA levels of MMP9, LTB4R, and A1AR and decreased levels of CC16 mRNA in induced sputum in the severe-to-very-severe group. After adjustment for age, sex and other biomarkers, CC16 mRNA expression was positively associated with FEV1%pred (r=0.516, p=0.004) and negatively correlated with SGRQ scores (r=-0.3538, p=0.043). As previously known, decreased CC16 was related to the migration and aggregation of eosinophils in airway. It was also found that CC16 had a moderate negative correlation with the eosinophilic inflammation in airway (r=-0.363, p=0.045) in our COPD patients. Conclusion Low CC16 mRNA expression levels in induced sputum were associated with low FEV1%pred and a high SGRQ score in COPD patients. Sputum CC16 as a potential biomarker for predicting COPD severity in clinical practice might attribute to the involvement of CC16 in airway eosinophilic inflammation.
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Affiliation(s)
- Mengjie Chen
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Kan Xu
- Geriatric Department of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Yuting He
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Jianjun Jin
- Research Center of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Ruolin Mao
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Lei Gao
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Yi Zhang
- Air Liquide Holding Co., Ltd, Shanghai, People’s Republic of China
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Peng Gao
- Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, People’s Republic of China
| | - Min Xie
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical 10 College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Chunfang Liu
- Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China
- Chunfang Liu, Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wlmq Road, Shanghai, People’s Republic of China, Email
| | - Zhihong Chen
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
- Correspondence: Zhihong Chen, Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, No. 180 Fenglin Road, Shanghai, People’s Republic of China, Tel +86-21-64041990-2445, Fax +86-21-64187165, Email
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12
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Nawa M, Mwansa J, Mwaba J, Kaonga P, Mukubesa AN, Simuyandi M, Chisenga CC, Alabi P, Mwananyanda L, Thea DM, Chilengi R, Kwenda G. Microbiologic and virulence characteristics of Moraxella catarrhalis isolates from Zambian children presenting with acute pneumonia. Pediatr Pulmonol 2022; 57:3084-3093. [PMID: 36056795 DOI: 10.1002/ppul.26138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 07/18/2022] [Accepted: 08/27/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Moraxella catarrhalis is one of the bacterial pathogens associated with childhood pneumonia, but its clinical importance is not clearly defined. OBJECTIVE This study aimed to investigate the microbiologic and virulence characteristics of M. catarrhalis isolates obtained from children with pneumonia in Lusaka, Zambia. METHODS This retrospective, cross-sectional study analyzed 91 M. catarrhalis isolates from induced sputum samples of children less than 5 years of age with pneumonia enrolled in the Pneumonia Etiology Research for Child Health study in Lusaka, Zambia between 2011 and 2014. Bacteria identification and virulence genes detection were performed by PCR and DNA sequencing, while antimicrobial susceptibility testing was determined by the Kirby-Bauer method. RESULTS All the M. catarrhalis isolates were obtained from good-quality sputum samples and were the predominant bacteria. These isolates harbored virulence genes copB (100%), ompE (69.2%), ompCD (71.4%), uspA1 (92.3%), and uspA2 (69.2%) and were all β-lactamase producers. They showed resistance to ampicillin (100%), amoxicillin (100%), trimethoprim-sulfamethoxazole (92.3%), ciprofloxacin (46.2%), chloramphenicol (45.1%), erythromycin (36.3%), tetracycline (25.3%), cefuroxime (11.0%), and amoxicillin-clavulanate (2.2%), with 71.4% displaying multi-drug resistant phenotype but all susceptible to imipenem (100%). CONCLUSION This study showed that M. catarrhalis isolates were the predominant or only bacterial isolates from the sputum samples analyzed. The findings provide supportive evidence for the pathogenic potential role of this bacterium in pediatric pneumonia. High multidrug resistance was also observed amongst the isolates, which can result in affected patients not responding to standard treatment, leading to prolonged illness, increased healthcare costs, and risk of death.
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Affiliation(s)
- Mukena Nawa
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.,Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - James Mwansa
- Department of Postgraduate Studies and Research, School of Medicine, Lusaka Apex Medical University, Lusaka, Zambia
| | - John Mwaba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.,Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Patrick Kaonga
- Department of Internal Medicine, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Andrew N Mukubesa
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | | | | | - Peter Alabi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Lawrence Mwananyanda
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Roma Chilengi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
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13
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Curto E, Mateus-Medina ÉF, Crespo-Lessmann A, Osuna-Gómez R, Ujaldón-Miró C, García-Moral A, Galván-Blasco P, Soto-Retes L, Ramos-Barbón D, Plaza V. Identification of Two Eosinophil Subsets in Induced Sputum from Patients with Allergic Asthma According to CD15 and CD66b Expression. Int J Environ Res Public Health 2022; 19:13400. [PMID: 36293979 PMCID: PMC9602830 DOI: 10.3390/ijerph192013400] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Two subsets of eosinophils have been described: resident eosinophils with homeostatic functions (rEOS) in healthy subjects and in patients with nonallergic eosinophilic asthma, and inflammatory eosinophils (iEOS) in blood and lung samples from patients with allergic asthma. We explored if it would be possible to identify different subsets of eosinophils using flow cytometry and the gating strategy applied to induced sputum. We conducted an observational cross-sectional single-center study of 62 patients with persistent allergic asthma. Inflammatory cells from induced sputum samples were counted by light microscopy and flow cytometry, and cytokine levels in the supernatant were determined. Two subsets of eosinophils were defined that we call E1 (CD66b-high and CD15-high) and E2 (CD66b-low and CD15-low). Of the 62 patients, 24 were eosinophilic, 18 mixed, 10 paucigranulocytic, and 10 neutrophilic. E1 predominated over E2 in the eosinophilic and mixed patients (20.86% vs. 6.27% and 14.42% vs. 4.31%, respectively), while E1 and E2 were similar for neutrophilic and paucigranulocytic patients. E1 correlated with IL-5, fractional exhaled nitric oxide, and blood eosinophils. While eosinophil subsets have been identified for asthma in blood, we have shown that they can also be identified in induced sputum.
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Affiliation(s)
- Elena Curto
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Éder F. Mateus-Medina
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Astrid Crespo-Lessmann
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Rubén Osuna-Gómez
- Inflammatory Diseases Unit, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
| | - Cristina Ujaldón-Miró
- Cellular Immunotherapy and Gene Therapy Group (GITG), Oncology, Hematology and Transplantation Laboratory, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain
| | - Alba García-Moral
- Pediatric Allergy Unit, Pediatric Allergy Section, Pediatric Pneumology and Cystic Fibrosis, Pediatrics Service, Hospital Universitari Vall d’Hebron, 08041 Barcelona, Spain
| | - Paula Galván-Blasco
- Allergology Section, Department of Internal Medicine, Hospital Universitari Vall d’Hebron, 08041 Barcelona, Spain
| | - Lorena Soto-Retes
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - David Ramos-Barbón
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
| | - Vicente Plaza
- Asthma Unit, Respiratory and Allergy Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
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14
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Giacalone VD, Moncada-Giraldo D, Margaroli C, Brown MR, Silva GL, Chandler JD, Peng L, Tirouvanziam R, Guglani L. Pilot study of inflammatory biomarkers in matched induced sputum and bronchoalveolar lavage of 2-year-olds with cystic fibrosis. Pediatr Pulmonol 2022; 57:2189-2198. [PMID: 35637404 DOI: 10.1002/ppul.26023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/08/2022] [Accepted: 05/29/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND In this pilot study, we investigated whether induced sputum (IS) could serve as a viable alternative to bronchoalveolar lavage (BAL) and yield robust inflammatory biomarkers in toddlers with cystic fibrosis (CF) featuring minimal structural lung disease. METHODS We collected IS, BAL (right middle lobe and lingula), and blood, and performed chest computed tomography (CT) scans from 2-year-olds with CF (N = 11), all within a single visit. Inflammatory biomarkers included 20 soluble immune mediators and neutrophil elastase (NE), as well as frequency and phenotype of T cells, monocytes/macrophages, and neutrophils. RESULTS At the molecular level, nine mediators showed similar levels in IS and BAL (CXCL1, CXCL8, IL-1α, IL-1RA, IL-6, CCL2, CXCL10, M-CSF, VEGF-A), four were higher in IS than in BAL (CXCL5, IL-1β, CXCL11, TNFSF10), and two were present in IS, but undetectable in BAL (IL-10, IFN-γ). Meanwhile, soluble NE had lower activity in IS than in BAL. At the cellular level, T-cell frequency was lower in IS than in BAL. Monocytes/macrophages were dominant in IS and BAL with similar frequencies, but differing expression of CD16 (lower in IS), CD115, and surface-associated NE (higher in IS). Neutrophil frequency and phenotype did not differ between IS and BAL. Finally, neutrophil frequency in IS correlated positively with air trapping. CONCLUSIONS IS collected from 2-year-olds with CF yields biomarkers of early airway inflammation with good agreement with BAL, notably with regard to molecular and cellular outcomes related to neutrophils and monocytes/macrophages.
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Affiliation(s)
- Vincent D Giacalone
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Diego Moncada-Giraldo
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Camilla Margaroli
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Milton R Brown
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - George L Silva
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Joshua D Chandler
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Limin Peng
- Department of Biostatistics and Bioinformatics, Emory University School of Public Health, Atlanta, Georgia, USA
| | - Rabindra Tirouvanziam
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Lokesh Guglani
- Department of Pediatrics, Emory University, Atlanta, Georgia, USA.,Center for CF and Airways Disease Research, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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15
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Haase LM, Birk T, Poland CA, Holz O, Müller M, Bachand AM, Mundt KA. Cross-sectional Study of Workers Employed at a Copper Smelter-Effects of Long-term Exposures to Copper on Lung Function and Chronic Inflammation. J Occup Environ Med 2022; 64:e550-e558. [PMID: 35902212 PMCID: PMC9426729 DOI: 10.1097/jom.0000000000002610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to assess the effect of exposure to copper-containing dust on lung function and inflammatory endpoints among workers of a German copper plant, effects rarely studied before. METHODS One hundred four copper-exposed smelter workers and 70 referent workers from the precious metal and lead facilities were included, with different metal exposures in both groups due to the different process materials. Body plethysmography, exhaled nitric oxide (FeNO) measurements, and blood sampling were conducted in all workers. Smoking status and the use of respiratory protective equipment were considered. In a subgroup of 40 nonsmoking volunteers (28 copper-exposed and 12 referents), sputum biomarkers were assessed. RESULTS Median lung function values of both copper-exposed and the referent groups were within reference ranges of "healthy" individuals, and statistical differences between the groups were mostly not evident. Similarly, differences in blood and sputum biomarkers were too small to be biologically relevant. CONCLUSION The results suggest the absence of the detectable effects of copper-containing dust exposure on lung function or chronic inflammation within the investigated cohort.
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16
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Zissler UM, Thron A, Eckrich J, Bakhtiar S, Schubert R, Zielen S. Bronchial inflammation biomarker patterns link humoral immunodeficiency with bronchiectasis-related small airway dysfunction. Clin Exp Allergy 2022; 52:760-773. [PMID: 35353925 DOI: 10.1111/cea.14140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/09/2022] [Accepted: 03/27/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The progression of chronic destructive lung disease in patients with humoral immunodeficiency (ID) and concomitant development of bronchiectasis is difficult to prevent. Lung function tests in these patients typically show bronchial obstruction of the small airways in combination with increased air trapping in the distal airways, which is consistent with small airway dysfunction. OBJECTIVE The objective was to assess the grade of chronic lower airway inflammation and small airway dysfunction from induced sputum and the corresponding local pro-inflammatory mediator pattern to discriminate patients affected by bronchiectasis-related Small Airway Dysfunction (SAD). METHODS In a prospective design, 22 patients with ID (14 CVID, 3 XLA, 3 hyper-IgM syndrome, 1 hyper-IgE syndrome and low IgG levels due to treatment with rituximab and 1 SCID after BMT and persistent humoral defect) and 21 healthy controls were examined. Lung function, Fraction Expiratory Nitric Oxide (FeNO) and pro-inflammatory cytokine levels were compared in subsets of patients with (ID + BE) and without bronchiectasis (ID) pre-stratified using high-resolution computed tomography (HRCT) scans and control subjects. RESULTS Analysis of induced sputum showed significantly increased total cell counts and severe neutrophilic inflammation in ID. The concomitant SAD revealed higher total cell numbers compared to ID. Bronchial inflammation in ID is clearly mirrored by pro-inflammatory mediators IL-1β, IL-6 and CXCL-8, whilst TNF-α revealed a correlation with lung function parameters altered in the context of bronchiectasis-related Small Airway Dysfunction. CONCLUSIONS In spite of immunoglobulin substitution, bronchial inflammation was dominated by neutrophils and was highly increased in patients with ID + BE. Notably, the pro-inflammatory cytokines in patients with ID were significantly increased in induced sputum. The context-dependent cytokine pattern in relation to the presence of concomitant bronchiectasis associated with SAD in ID patients could be helpful in delimiting ID patient subgroups and individualizing therapeutic approaches.
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Affiliation(s)
- Ulrich M Zissler
- Center of Allergy & Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, German Research Center for Environmental Health, Germany, Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Aljoscha Thron
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - Jonas Eckrich
- Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Bonn, Germany
| | - Shahrzad Bakhtiar
- Division for Stem Cell Transplantation, Immunology and Intensive Care Unit, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - Ralf Schubert
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
| | - Stefan Zielen
- Division of Allergology, Pulmonology and Cystic Fibrosis, Department for Children and Adolescents, Goethe University, Frankfurt, Germany
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17
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Chen F, Liang Y, Zeng Z, Du L, Xu C, Guo Y, Xie C. Association of increased basic salivary proline-rich protein 1 levels in induced sputum with type 2-high asthma. Immun Inflamm Dis 2022; 10:e602. [PMID: 35344278 PMCID: PMC8959441 DOI: 10.1002/iid3.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The aim of this study is to reveal whether basic salivary proline-rich protein BstNI subfamily 1 (PRB1) may be used as a diagnostic biomarker for type 2-high asthma. METHODS PRB1 protein levels in the induced sputum of 67 subjects with asthma and 27 controls were determined by an enzyme-linked immunosorbent assay. Correlation analyses between PRB1 in the induced sputum and airway inflammatory indicators were also performed. RESULTS PRB1 protein levels were significantly upregulated in the induced sputum of asthmatic patients (p =0.0098) and correlated with clinical eosinophil-related indicators and type 2 airway inflammation. These results indicate that PRB1 is a promising biomarker for type 2-high asthma. CONCLUSIONS The expression of PRB1 in induced sputum is a potential biomarker for type 2-high asthma. The results of this study present new insights into the diagnosis and treatment of asthma.
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Affiliation(s)
- Fengjia Chen
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yuxia Liang
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Zhimin Zeng
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Lijuan Du
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Changyi Xu
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yubiao Guo
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Canmao Xie
- Division of Pulmonary and Critical Care MedicineThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
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18
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Musiol S, Alessandrini F, Jakwerth CA, Chaker AM, Schneider E, Guerth F, Schnautz B, Grosch J, Ghiordanescu I, Ullmann JT, Kau J, Plaschke M, Haak S, Buch T, Schmidt-Weber CB, Zissler UM. TGF-β1 Drives Inflammatory Th Cell But Not Treg Cell Compartment Upon Allergen Exposure. Front Immunol 2022; 12:763243. [PMID: 35069535 PMCID: PMC8777012 DOI: 10.3389/fimmu.2021.763243] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/29/2021] [Indexed: 12/22/2022] Open
Abstract
TGF-β1 is known to have a pro-inflammatory impact by inducing Th9 and Th17 cells, while it also induces anti-inflammatory Treg cells (Tregs). In the context of allergic airway inflammation (AAI) its dual role can be of critical importance in influencing the outcome of the disease. Here we demonstrate that TGF-β is a major player in AAI by driving effector T cells, while Tregs differentiate independently. Induction of experimental AAI and airway hyperreactivity in a mouse model with inducible genetic ablation of the gene encoding for TGFβ-receptor 2 (Tgfbr2) on CD4+T cells significantly reduced the disease phenotype. Further, it blocked the induction of pro-inflammatory T cell frequencies (Th2, Th9, Th17), but increased Treg cells. To translate these findings into a human clinically relevant context, Th2, Th9 and Treg cells were quantified both locally in induced sputum and systemically in blood of allergic rhinitis and asthma patients with or without allergen-specific immunotherapy (AIT). Natural allergen exposure induced local and systemic Th2, Th9, and reduced Tregs cells, while therapeutic allergen exposure by AIT suppressed Th2 and Th9 cell frequencies along with TGF-β and IL-9 secretion. Altogether, these findings support that neutralization of TGF-β represents a viable therapeutic option in allergy and asthma, not posing the risk of immune dysregulation by impacting Tregs cells.
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Affiliation(s)
- Stephanie Musiol
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Francesca Alessandrini
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Constanze A Jakwerth
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Adam M Chaker
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany.,Department of Otorhinolaryngology, Klinikum rechts der Isar, TUM School of Medicine, Technical University Munich, Munich, Germany
| | - Evelyn Schneider
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Ferdinand Guerth
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Benjamin Schnautz
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Johanna Grosch
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Ileana Ghiordanescu
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Julia T Ullmann
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Josephine Kau
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Mirjam Plaschke
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Stefan Haak
- Institute of Laboratory Animal Science, University of Zurich, Zurich, Switzerland
| | - Thorsten Buch
- Institute of Laboratory Animal Science, University of Zurich, Zurich, Switzerland
| | - Carsten B Schmidt-Weber
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
| | - Ulrich M Zissler
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM) and Helmholtz Center Munich, German Research Center for Environmental Health, Members of the German Center of Lung Research (DZL), Munich, Germany
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19
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Ditz B, Kistemaker LEM, van den Berge M, Vonk JM, Gosens R, Kerstjens HAM. Responsivity and Reproducibility of Sputum Inflammatory Biomarkers During COPD Exacerbation and Stable Phases - A Pilot Study. Int J Chron Obstruct Pulmon Dis 2021; 16:3055-3064. [PMID: 34785892 PMCID: PMC8590961 DOI: 10.2147/copd.s326081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/27/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction There is a great interest to identify airway biomarkers to evaluate the potential and efficacy of anti-inflammatory therapeutic interventions. In this pilot study, we compared cytokine mRNA and protein levels of IL-6, IL-8, CCL2, CCL4, and TNF-α, as well as LTB-4 expression regarding their reproducibility and responsivity in induced sputum in COPD patients. Methods We recruited a cohort of 17 patients with a moderate COPD exacerbation, necessitating antibiotics and/or oral corticosteroids. Patients were followed for two consecutive stable phase visits. Cytokine mRNA and protein levels were measured in induced sputum samples. Results IL-6 and CCL4 protein levels decreased from exacerbation to stable phase, whereas their mRNA expression showed the same trend (not statistically significant). Coefficients of variation were overall lower (ie, more favorable for responsiveness) at protein levels compared to mRNA levels. No significant differences were observed in the reproducibility between cytokine mRNA expression and protein measurements. IL-6, IL-8, CCL2, and TNF-α gene expression levels yielded moderate to high intraclass correlation coefficients and/or Spearman correlation coefficients between both stable phase samples in contrast to their protein levels. Conclusion Our findings suggest that several protein levels yield better responsivity with lower noise-to-signal ratios compared to their respective mRNA levels. In contrast, cytokine mRNA expression was more reproducible as it varied less in a stable state than proteins. Future studies are needed with a larger sample size to further evaluate the differences of responsivity and reproducibility between cytokine mRNA and protein measurements, not only during exacerbations.
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Affiliation(s)
- B Ditz
- Department of Pulmonary Diseases, University Medical Center, University of Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - L E M Kistemaker
- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Molecular Pharmacology of Groningen, University of Groningen, Groningen, the Netherlands.,Aquilo BV, Groningen, the Netherlands
| | - M van den Berge
- Department of Pulmonary Diseases, University Medical Center, University of Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - J M Vonk
- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - R Gosens
- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Molecular Pharmacology of Groningen, University of Groningen, Groningen, the Netherlands
| | - H A M Kerstjens
- Department of Pulmonary Diseases, University Medical Center, University of Groningen, Groningen, the Netherlands.,Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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20
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Kim YH, Jang H, Kim SY, Jung JH, Kim GE, Park MR, Hong JY, Kim MN, Kim EG, Kim MJ, Kim KW, Sohn MH. Gram-negative microbiota is related to acute exacerbation in children with asthma. Clin Transl Allergy 2021; 11:e12069. [PMID: 34667591 PMCID: PMC8507365 DOI: 10.1002/clt2.12069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The upper-airway microbiota may be associated with the pathogenesis of asthma and useful for predicting acute exacerbation. However, the relationship between the lower-airway microbiota and acute exacerbation in children with asthma is not well understood. We evaluated the characteristics of the airway microbiome using induced sputum from children with asthma exacerbation and compared the microbiota-related differences of inflammatory cytokines with those in children with asthma. METHODS We analysed the microbiome using induced sputum during acute exacerbation of asthma in children. We identified microbial candidates that were prominent in children with asthma exacerbation and compared them with those in children with stable asthma using various analytical methods. The microbial candidates were analysed to determine their association with inflammatory cytokines. We also developed a predictive functional profile using PICRUSt. RESULTS A total of 95 children with allergic sensitisation including 22 with asthma exacerbation, 67 with stable asthma, and 6 controls were evaluated. We selected 26 microbial candidates whose abundances were significantly increased, decreased, or correlated during acute exacerbation in children with asthma. Among the microbial candidates, Campylobacter, Capnocytophaga, Haemophilus, and Porphyromonas were associated with inflammatory cytokines including macrophage inflammatory protein (MIP)-1β, programmed death-ligand 1, and granzyme B. Both Campylobacter and MIP-1β levels were correlated with sputum eosinophils. Increased lipopolysaccharide biosynthesis and decreased glycan degradation were observed in children with asthma exacerbation. CONCLUSION Gram-negative microbes in the lower airway were related to acute exacerbation in children with asthma. These microbes and associated cytokines may play a role in exacerbating asthma in children.
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Affiliation(s)
- Yoon Hee Kim
- Department of PediatricsGangnam Severance HospitalSeoulKorea
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
| | - Haerin Jang
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Soo Yeon Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Jae Hwa Jung
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Ga Eun Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Mi Reu Park
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Jung Yeon Hong
- Division of Cardiovascular Disease ResearchDepartment for Chronic Disease Convergence ResearchKorea National Institute of HealthCheongjuKorea
| | - Mi Na Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Eun Gyul Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Min Jung Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsYongin Severance HospitalYonginKorea
| | - Kyung Won Kim
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
| | - Myung Hyun Sohn
- Institute of AllergySeverance Biomedical Science InstituteBrain Korea 21 Project for Medical ScienceYonsei University College of MedicineSeoulKorea
- Department of PediatricsSeverance HospitalSeoulKorea
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21
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Jakwerth CA, Chaker AM, Guerth F, Oelsner M, Pechtold L, Zur Bonsen LS, Ullmann JT, Krauss-Etschmann S, Erb A, Kau J, Plaschke M, Winkler M, Kurz A, Kloss A, Esser-von Bieren J, Schmidt-Weber CB, Zissler UM. Sputum microRNA-screening reveals Prostaglandin EP3 receptor as selective target in allergen-specific immunotherapy. Clin Exp Allergy 2021; 51:1577-1591. [PMID: 34514658 DOI: 10.1111/cea.14013] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/08/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Several microRNAs (miRs) have been described as potential biomarkers in liquid biopsies and in the context of allergic asthma, while therapeutic effects on the airway expression of miRs remain elusive. In this study, we investigated epigenetic miR-associated mechanisms in the sputum of grass pollen-allergic patients with and without allergen-specific immunotherapy (AIT). METHODS Induced sputum samples of healthy controls (HC), AIT-treated and -untreated grass pollen-allergic rhinitis patients with (AA) and without asthma (AR) were profiled using miR microarray and whole-transcriptome microarray analysis of the same samples. miR targets were predicted in silico and used to identify inverse regulation. Local PGE2 levels were measured using ELISA. RESULTS Two hundred and fifty nine miRs were upregulated in the sputum of AA patients compared with HC, while only one was downregulated. The inverse picture was observed in induced sputum of AIT-treated patients: while 21 miRs were downregulated, only 4 miRs were upregulated in asthmatics upon AIT. Of these 4 miRs, miR-3935 stood out, as its predicted target PTGER3, the prostaglandin EP3 receptor, was downregulated in treated AA patients compared with untreated. The levels of its ligand PGE2 in the sputum supernatants of these samples were increased in allergic patients, especially asthmatics, and downregulated after AIT. Finally, local PGE2 levels correlated with ILC2 frequencies, secreted sputum IL-13 levels, inflammatory cell load, sputum eosinophils and symptom burden. CONCLUSIONS While profiling the sputum of allergic patients for novel miR expression patterns, we uncovered an association between miR-3935 and its predicted target gene, the prostaglandin E3 receptor, which might mediate AIT effects through suppression of the PGE2 -PTGER3 axis.
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Affiliation(s)
- Constanze A Jakwerth
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Adam M Chaker
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Ferdinand Guerth
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Madlen Oelsner
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Lisa Pechtold
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Lynn S Zur Bonsen
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Julia T Ullmann
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Susanne Krauss-Etschmann
- Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany.,Institute of Experimental Medicine, Christian-Albrechts University Kiel, Kiel, Germany
| | - Anna Erb
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Josephine Kau
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Mirjam Plaschke
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Marlene Winkler
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Alexandra Kurz
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Antonia Kloss
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany.,Department of Otorhinolaryngology, TUM School of Medicine, Technical University Munich, Klinikum rechts der Isar, Munich, Germany
| | - Julia Esser-von Bieren
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Carsten B Schmidt-Weber
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
| | - Ulrich M Zissler
- Center of Allergy & Environment (ZAUM), Technical University of Munich (TUM), Helmholtz Center Munich, German Research Center for Environmental Health, Member of the German Center for Lung Research (DZL), CPC-M, Munich, Germany
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22
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Zissler UM, Jakwerth CA, Guerth F, Lewitan L, Rothkirch S, Davidovic M, Ulrich M, Oelsner M, Garn H, Schmidt‐Weber CB, Chaker AM. Allergen-specific immunotherapy induces the suppressive secretoglobin 1A1 in cells of the lower airways. Allergy 2021; 76:2461-2474. [PMID: 33528894 DOI: 10.1111/all.14756] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND While several systemic immunomodulatory effects of allergen-specific immunotherapy (AIT) have been discovered, local anti-inflammatory mechanisms in the respiratory tract are largely unknown. We sought to elucidate local and epithelial mechanisms underlying allergen-specific immunotherapy in a genome-wide approach. METHODS We induced sputum in hay fever patients and healthy controls during the pollen peak season and stratified patients by effective allergen immunotherapy or as untreated. Sputum was directly processed after induction and subjected to whole transcriptome RNA microarray analysis. Nasal secretions were analyzed for Secretoglobin1A1 (SCGB1A1) and IL-24 protein levels in an additional validation cohort at three defined time points during the 3-year course of AIT. Subsequently, RNA was extracted and subjected to an array-based whole transcriptome analysis. RESULTS Allergen-specific immunotherapy inhibited pro-inflammatory CXCL8, IL24, and CCL26mRNA expression, while SCGB1A1, IL7, CCL5, CCL23, and WNT5BmRNAs were induced independently of the asthma status and allergen season. In our validation cohort, local increase of SCGB1A1 occurred concomitantly with the reduction of local IL-24 in upper airways during the course of AIT. Additionally, SCGB1A1 was identified as a suppressor of epithelial gene expression. CONCLUSIONS Allergen-specific immunotherapy induces a yet unknown local gene expression footprint in the lower airways that on one hand appears to be a result of multiple regulatory pathways and on the other hand reveals SCGB1A1 as novel anti-inflammatory mediator of long-term allergen-specific therapeutic intervention in the local environment.
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Affiliation(s)
- Ulrich M. Zissler
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Member of the Helmholtz I&I Initiative Munich Germany
| | - Constanze A. Jakwerth
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
| | - Ferdinand Guerth
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
| | - Larissa Lewitan
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Department of Otorhinolaryngology and Head and Neck Surgery Medical School Technical University of Munich Munich Germany
| | - Sandra Rothkirch
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Department of Otorhinolaryngology and Head and Neck Surgery Medical School Technical University of Munich Munich Germany
| | - Miodrag Davidovic
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Department of Otorhinolaryngology and Head and Neck Surgery Medical School Technical University of Munich Munich Germany
| | - Moritz Ulrich
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Department of Otorhinolaryngology and Head and Neck Surgery Medical School Technical University of Munich Munich Germany
| | - Madlen Oelsner
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
| | - Holger Garn
- Institute of Laboratory Medicine and Pathobiochemistry Philipps University MarburgMedical FacultyMember of the German Center of Lung Research Marburg Germany
| | - Carsten B. Schmidt‐Weber
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Member of the Helmholtz I&I Initiative Munich Germany
| | - Adam M. Chaker
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Center MunichGerman Research Center for Environmental Health Munich Germany
- Member of the German Center for Lung Research (DZL) Munich Germany
- Department of Otorhinolaryngology and Head and Neck Surgery Medical School Technical University of Munich Munich Germany
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23
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Campisi M, Liviero F, Maestrelli P, Guarnieri G, Pavanello S. DNA Methylation-Based Age Prediction and Telomere Length Reveal an Accelerated Aging in Induced Sputum Cells Compared to Blood Leukocytes: A Pilot Study in COPD Patients. Front Med (Lausanne) 2021; 8:690312. [PMID: 34368190 PMCID: PMC8342924 DOI: 10.3389/fmed.2021.690312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Aging is the predominant risk factor for most degenerative diseases, including chronic obstructive pulmonary disease (COPD). This process is however very heterogeneous. Defining the biological aging of individual tissues may contribute to better assess this risky process. In this study, we examined the biological age of induced sputum (IS) cells, and peripheral blood leukocytes in the same subject, and compared these to assess whether biological aging of blood leukocytes mirrors that of IS cells. Biological aging was assessed in 18 COPD patients (72.4 ± 7.7 years; 50% males). We explored mitotic and non-mitotic aging pathways, using telomere length (TL) and DNA methylation-based age prediction (DNAmAge) and age acceleration (AgeAcc) (i.e., difference between DNAmAge and chronological age). Data on demographics, life style and occupational exposure, lung function, and clinical and blood parameters were collected. DNAmAge (67.4 ± 5.80 vs. 61.6 ± 5.40 years; p = 0.0003), AgeAcc (-4.5 ± 5.02 vs. -10.8 ± 3.50 years; p = 0.0003), and TL attrition (1.05 ± 0.35 vs. 1.48 ± 0.21 T/S; p = 0.0341) are higher in IS cells than in blood leukocytes in the same patients. Blood leukocytes DNAmAge (r = 0.927245; p = 0.0026) and AgeAcc (r = 0.916445; p = 0.0037), but not TL, highly correlate with that of IS cells. Multiple regression analysis shows that both blood leukocytes DNAmAge and AgeAcc decrease (i.e., younger) in patients with FEV1% enhancement (p = 0.0254 and p = 0.0296) and combined inhaled corticosteroid (ICS) therapy (p = 0.0494 and p = 0.0553). In conclusion, new findings from our work reveal a differential aging in the context of COPD, by a direct quantitative comparison of cell aging in the airway with that in the more accessible peripheral blood leukocytes, providing additional knowledge which could offer a potential translation into the disease management.
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Affiliation(s)
- Manuela Campisi
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Filippo Liviero
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Piero Maestrelli
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Gabriella Guarnieri
- Respiratory Pathophysiology Unit, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Sofia Pavanello
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
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Tyrak KE, Pajdzik K, Jakieła B, Kupryś-Lipińska I, Ćmiel A, Kacorzyk R, Trąd G, Kuna P, Sanak M, Mastalerz L. Biomarkers for predicting response to aspirin therapy in aspirin-exacerbated respiratory disease. Clin Exp Allergy 2021; 51:1046-1056. [PMID: 33905579 PMCID: PMC9292205 DOI: 10.1111/cea.13886] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 01/18/2023]
Abstract
Background Aspirin desensitization followed by daily aspirin use is an effective treatment for aspirin‐exacerbated respiratory disease (AERD). Objective To assess clinical features as well as genetic, immune, cytological and biochemical biomarkers that might predict a positive response to high‐dose aspirin therapy in AERD. Methods We enrolled 34 AERD patients with severe asthma who underwent aspirin desensitization followed by 52‐week aspirin treatment (650 mg/d). At baseline and at 52 weeks, clinical assessment was performed; phenotypes based on induced sputum cells were identified; eicosanoid, cytokine and chemokine levels in induced sputum supernatant were determined; and induced sputum expression of 94 genes was assessed. Responders to high‐dose aspirin were defined as patients with improvement in 5‐item Asthma Control Questionnaire score, 22‐item Sino‐Nasal Outcome Test (SNOT‐22) score and forced expiratory volume in 1 second at 52 weeks. Results There were 28 responders (82%). Positive baseline predictors of response included female sex (p = .002), higher SNOT‐22 score (p = .03), higher blood eosinophil count (p = .01), lower neutrophil percentage in induced sputum (p = .003), higher expression of the hydroxyprostaglandin dehydrogenase gene, HPGD (p = .004) and lower expression of the proteoglycan 2 gene, PRG2 (p = .01). The best prediction model included Asthma Control Test and SNOT‐22 scores, blood eosinophils and total serum immunoglobulin E. Responders showed a marked decrease in sputum eosinophils but no changes in eicosanoid levels. Conclusions and Clinical Relevance Female sex, high blood eosinophil count, low sputum neutrophil percentage, severe nasal symptoms, high HPGD expression and low PRG2 expression may predict a positive response to long‐term high‐dose aspirin therapy in patients with AERD.
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Affiliation(s)
- Katarzyna E Tyrak
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Kinga Pajdzik
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Bogdan Jakieła
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Izabela Kupryś-Lipińska
- Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Adam Ćmiel
- Department of Applied Mathematics, AGH University of Science and Technology, Cracow, Poland
| | - Radosław Kacorzyk
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Gabriela Trąd
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Piotr Kuna
- Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Marek Sanak
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Lucyna Mastalerz
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
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25
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Li W, Meng X, Hao Y, Chen M, Jia Y, Gao P. Elevated sputum IL-36 levels are associated with neutrophil-related inflammation in COPD patients. Clin Respir J 2021; 15:648-656. [PMID: 33559376 DOI: 10.1111/crj.13338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/30/2020] [Accepted: 02/02/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Interleukin (IL)-36, including IL-36α, IL-36β, and IL-36γ in the IL-1 family, are agonists of their receptors. IL-36 expression is associated with inflammation, including lung infection in humans. However, there is no information on its role in the inflammation of different types of chronic obstructive pulmonary disease (COPD). OBJECTIVE This study focused on the sputum IL-36α, IL-36β, and IL-36γ levels in stable COPD patients and their relationship with lung function and other cytokines in different inflammatory types of COPD patients. METHODS Sputum specimens were collected from 73 stable COPD patients and 20 age- and gender-matched healthy controls. The levels of sputum IL-36α, IL-36β, and IL-36γ and other cytokines were quantified and sputum cells were characterized. The potential relationship between the levels of sputum IL-36α, IL-36β, or IL-36γ and lung functional measures, inflammatory cells, and cytokines was analyzed. RESULTS In comparison with the healthy controls, sputum IL-36α and IL-36γ levels significantly increased in COPD (106.8 pg/mL vs. 76.9 pg/mL P =.001, 397.9 pg/mL vs. 359.5 pg/mL P =.006). The sputum IL-36α and IL-36γ levels were significantly higher in the neutrophilic and mixed granulocytic types than that in the eosinophilic and paucigranulocytic types of COPD patients. The sputum IL-36α levels were positively correlated with sputum IL-36γ levels and the numbers of sputum neutrophils, and the sputum IL-36γ levels were positively correlated with the numbers of sputum lymphocytes in COPD patients. CONCLUSIONS Elevated levels of sputum IL-36α and IL-36γ were detected in COPD patients and may provide insights into the inflammatory pathways in neutrophilic COPD.
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Affiliation(s)
- Wei Li
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Jilin University, Changchun, Jilin, 130041, China
| | - Xiaoli Meng
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Jilin University, Changchun, Jilin, 130041, China
| | - Yuqiu Hao
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Jilin University, Changchun, Jilin, 130041, China
| | - Mo Chen
- Respiratory Medicine, Changchun Center Hospital, Changchun, Jilin, China
| | - Yuxi Jia
- Department of Orthopedics| Application Demonstration Center of Precision Medicine Molecular Diagnosis, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Peng Gao
- Department of Respiratory and Critical Care Medicine, the Second Hospital of Jilin University, Changchun, Jilin, 130041, China
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26
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Carstensen S, Holz O, Hohlfeld JM, Müller M. Quantitative analysis of endotoxin-induced inflammation in human lung cells by Chipcytometry. Cytometry A 2021; 99:967-976. [PMID: 33860615 DOI: 10.1002/cyto.a.24352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 11/07/2022]
Abstract
Chipcytometry is a tool that uses iterative staining cycles with multiple antibodies for a detailed characterization of cells. Cell recognition is based on morphological features. Cells fixed on microfluidic chips can be stored and shipped enabling a centralized analysis, which is important for assessments in multi-center clinical trials. The method was initially implemented for the analysis of cells from peripheral blood. We adapted it to more heterogeneous human lung cells from bronchoalveolar lavage (BAL) fluid and induced sputum (IS). We aimed to assess the performance of Chipcytometry to detect and quantify the endotoxin induced inflammatory response in healthy subjects. BAL and IS samples of 10 healthy subjects were collected prior to and following segmental and inhaled endotoxin challenge. Samples were analyzed by Chipcytometry and were compared with flow cytometry, and differential cell count (DCC). Chipcytometry clearly detected the endotoxin induced inflammatory response which was characterized by a massive increase of neutrophils (BAL: 2.5% to 54.7%; IS: 40.5% to 71.1%) and monocytes (BAL: 7.7% to 24.7%; IS: 8.0% to 14.5%). While some differences between detection methods exist, the overall results were comparable. The ability of Chipcytometry to verify fluorescent signals with morphological features improved the precision of rare cell analysis such as of induced sputum lymphocytes. In conclusion, Chipcytometry enables the quantitative analysis of cells from BAL fluid and IS. Advantages over DCC and flow cytometry include the storage of cells on chips, the ability for re-analysis and the mapping of surface marker binding to morphological information. It therefore appears to be a promising method for use in clinical respiratory drug development.
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Affiliation(s)
- Saskia Carstensen
- Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
| | - Olaf Holz
- Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
- German Center for Lung Research (BREATH), Hannover, Germany
| | - Jens M Hohlfeld
- Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
- German Center for Lung Research (BREATH), Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Meike Müller
- Clinical Airway Research, Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
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27
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Niemeier-Walsh C, Ryan PH, Meller J, Ollberding NJ, Adhikari A, Indugula R, Reponen T. The mycobiomes and bacteriomes of sputum, saliva, and home dust. Indoor Air 2021; 31:357-368. [PMID: 32969526 DOI: 10.1111/ina.12750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
Respiratory microbiome is an understudied area of research compared to other microbiomes of the human body. The respiratory tract is exposed to an array of environmental pollutants, including microbes. Yet, we know very little about the relationship between environmental and respiratory microbiome. The primary aim of our study was to compare the mycobiomes and bacteriomes between three sample types from the same participants, including home dust, saliva, and sputum. Samples were collected from 40 adolescents in a longitudinal cohort. We analyzed the samples using 16s bacterial rDNA and ITS fungal rDNA gene sequencing, as well as quantitative PCR with universal fungal and bacterial primers. Results showed that home dust had the greatest alpha diversity between the three sample types for both bacteria and fungi. Dust had the highest total fungal load and the lowest total bacterial load. Sputum had greater bacterial diversity than saliva, but saliva had greater fungal diversity than sputum. The distribution of major bacterial phyla differed between all sample types. However, the distribution of major fungal classes differed only between sputum and saliva. Future research should examine the biological significance of the taxa found in each sample type based on microbial ecology and associations with health effects.
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Affiliation(s)
| | - Patrick H Ryan
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jarek Meller
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Atin Adhikari
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Reshmi Indugula
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
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28
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Pastor L, Vera E, Marin JM, Sanz-Rubio D. Extracellular Vesicles from Airway Secretions: New Insights in Lung Diseases. Int J Mol Sci 2021; 22:ijms22020583. [PMID: 33430153 PMCID: PMC7827453 DOI: 10.3390/ijms22020583] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
Lung diseases (LD) are one of the most common causes of death worldwide. Although it is known that chronic airway inflammation and excessive tissue repair are processes associated with LD such as asthma, chronic obstructive pulmonary disease (COPD) or idiopathic pulmonary fibrosis (IPF), their specific pathways remain unclear. Extracellular vesicles (EVs) are heterogeneous nanoscale membrane vesicles with an important role in cell-to-cell communication. EVs are present in general biofluids as plasma or urine but also in secretions of the airway as bronchoalveolar lavage fluid (BALF), induced sputum (IS), nasal lavage (NL) or pharyngeal lavage. Alterations of airway EV cargo could be crucial for understanding LD. Airway EVs have shown a role in the pathogenesis of some LD such as eosinophil increase in asthma, the promotion of lung cancer in vitro models in COPD and as biomarkers to distinguishing IPF in patients with diffuse lung diseases. In addition, they also have a promising future as therapeutics for LD. In this review, we focus on the importance of airway secretions in LD, the pivotal role of EVs from those secretions on their pathophysiology and their potential for biomarker discovery.
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Affiliation(s)
- Laura Pastor
- Translational Research Unit, Instituto de Investigación Sanitaria de Aragón (IISAragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (L.P.); (E.V.); (J.M.M.)
| | - Elisabeth Vera
- Translational Research Unit, Instituto de Investigación Sanitaria de Aragón (IISAragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (L.P.); (E.V.); (J.M.M.)
- Respiratory Service, Hospital Universitario Miguel Servet, University of Zaragoza, 50009 Zaragoza, Spain
| | - Jose M. Marin
- Translational Research Unit, Instituto de Investigación Sanitaria de Aragón (IISAragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (L.P.); (E.V.); (J.M.M.)
- Respiratory Service, Hospital Universitario Miguel Servet, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERes), 28029 Madrid, Spain
| | - David Sanz-Rubio
- Translational Research Unit, Instituto de Investigación Sanitaria de Aragón (IISAragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (L.P.); (E.V.); (J.M.M.)
- Correspondence:
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29
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Matsunaga NY, Gianfrancesco L, Mazzola TN, Oliveira MS, Morcillo AM, Ribeiro MÂGO, Ribeiro JD, Hashimoto S, Toro AADC. Differences between patients who achieved asthma control and those who remain uncontrolled after standardized severe asthma care strategy. J Asthma 2020; 59:418-425. [PMID: 33263446 DOI: 10.1080/02770903.2020.1852415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess clinical, functional, and inflammatory patterns of children and adolescents with severe uncontrolled asthma, and investigate the differences between patients who achieved asthma control and those who remain uncontrolled after standardized asthma care strategy. METHODS Screening all children and adolescents with asthma from the Pediatric Pulmonology Outpatient Clinic of Unicamp, Brazil, and included those with severe uncontrolled asthma according to GINA guidelines criteria. Patients were assessed at baseline and after by demographic and medication data, questionnaires (Asthma Control Test and Pediatric Asthma Quality of Life Questionnaire), Six-Minute Walk Test, skin prick test, spirometry, induced sputum, and blood collection (total immunoglobulin E and eosinophil count). Cytokine dosage was analyzed in sputum supernatant and serum by Cytometric Bead Array. RESULTS Thirty-three patients with severe uncontrolled asthma were included (median age 10.9 [7.00-17.60] years). All patients presented satisfactory adherence to treatment and 50% of them achieved good asthma control after six-month follow-up (p < 0.001). Patients who achieved asthma control reported higher intervals since their last exacerbation episode (p = 0.008) and higher quality of life scores (p < 0.001) as compared to patients who remained uncontrolled. We found no changes in lung function markers, inflammatory biomarkers, or cytokine levels between patients with uncontrolled and controlled asthma. CONCLUSION Participation of six months in a structured outpatient clinic for children with severe asthma had a notable improvement in control and quality of life of patients. This demonstrates the importance of a global assessment, focused on peculiarities presented by patients with severe uncontrolled asthma.
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Affiliation(s)
- Natasha Yumi Matsunaga
- Child and Adolescent Health Postgraduate Program, State University of Campinas, Campinas, São Paulo, Brazil.,Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil
| | - Lívea Gianfrancesco
- Child and Adolescent Health Postgraduate Program, State University of Campinas, Campinas, São Paulo, Brazil.,Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil
| | - Taís Nitsch Mazzola
- Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil
| | - Marina Simões Oliveira
- Child and Adolescent Health Postgraduate Program, State University of Campinas, Campinas, São Paulo, Brazil.,Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil
| | - André Moreno Morcillo
- Department of Paediatric Respiratory Medicine, Emma Children's hospital and Department of Respiratory Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Maria Ângela Gonçalves Oliveira Ribeiro
- Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil
| | - José Dirceu Ribeiro
- Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil.,Department of Pediatrics, School of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Simone Hashimoto
- Department of Paediatric Respiratory Medicine, Emma Children's hospital and Department of Respiratory Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Adyleia Aparecida Dalbo Contrera Toro
- Faculty of Medical Sciences, Laboratory of Pulmonary Physiology, Center for Investigation in Pediatrics, State University of Campinas, Campinas, São Paulo, Brazil.,Department of Pediatrics, School of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
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30
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Latorre M, Bacci E, Seccia V, Bartoli ML, Cardini C, Cianchetti S, Cristofani L, Di Franco A, Miccoli M, Puxeddu I, Celi A, Paggiaro P. Upper and lower airway inflammation in severe asthmatics: a guide for a precision biologic treatment. Ther Adv Respir Dis 2020; 14:1753466620965151. [PMID: 33263506 PMCID: PMC7716065 DOI: 10.1177/1753466620965151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and aims: Severe asthma may require the prescription of one of the biologic drugs currently available, using surrogate markers of airway inflammation (serum IgE levels and allergic sensitization for anti-IgE, or blood eosinophils for anti-IL5/IL5R). Our objective: to assess upper and lower airway inflammation in severe asthmatics divided according to the eligibility criteria for one of the target biologic treatments. Methods: We selected 91 severe asthmatics, uncontrolled despite high-dose ICS-LABA, and followed for >6 months with optimization of asthma treatment. Patients underwent clinical, functional and biological assessment, including induced sputum and nasal cytology. They were then clustered according to the eligibility criteria for omalizumab or mepolizumab/benralizumab. Results: Four clusters were selected: A (eligible for omalizumab, n = 23), AB (both omalizumab and mepolizumab, n = 26), B (mepolizumab, n = 22) and C (non-eligible for both omalizumab and mepolizumab, n = 20). There was no difference among clusters for asthma control (Asthma Control Test and Asthma Control Questionnaire 7), pre-bronchodilator forced expiratory volume in 1 s, serum IgE and fractional exhaled nitric oxide levels. Sputum eosinophils were numerically higher in clusters AB and B, in agreement with the higher levels of blood eosinophils. Allergic rhinitis was more frequent in clusters A and AB, while chronic rhinosinusitis with nasal polyps prevalence increased progressively from A to C. Eosinophils in nasal cytology were higher in clusters AB, B and C. Conclusion: Eosinophilic upper and lower airway inflammation is present in the large majority of severe asthmatics, independently from the prescription criteria for the currently available biologics, and might suggest the use of anti-IL5/IL5R or anti IL4/13 also in patients without blood eosinophilia. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Manuela Latorre
- Pulmonary Unit, Nuovo Ospedale Apuano, UO Pneumologia, Via Enrico Mattei 21, Massa, Italy.,Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | - Elena Bacci
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | | | - Maria Laura Bartoli
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | - Cristina Cardini
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | - Silvana Cianchetti
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | | | - Antonella Di Franco
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Toscana, Italy
| | - Ilaria Puxeddu
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Toscana, Italy
| | - Alessandro Celi
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
| | - Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Toscana, Italy
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Stafler P, Zaks-Hoffer G, Scheuerman O, Ben-Zvi H, Mussaffi H, Mei-Zahav M, Steuer G, Levine H, Bar-On O, Mantin H, Prais D, Blau H. Diagnostic value of sputum cultures in children under 2 years of age with chronic suppurative lung diseases. Pediatr Pulmonol 2020; 55:3421-3428. [PMID: 33006230 DOI: 10.1002/ppul.25103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/04/2020] [Accepted: 09/27/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Acquiring sputum cultures from infants is considered challenging. We describe their yield in infants with cystic fibrosis (CF) and other chronic suppurative lung diseases (CSLDs). METHODS Retrospective medical record review over a 4-year period, for infants aged 0-2 years with ≥2 airway bacterial cultures acquired by deep suction or induced sputum ≥4 weeks apart. Data included demographics, culture results, and clinical status. RESULTS A total of 98 infants (16 CF) were evaluated and 534 sputum cultures acquired, 201 in CF and 333 in CSLD. There were 12 (2-23), median (range) cultures/CF infant, and 3 (2-21)/CSLD infant. Age at first culture was 3.8 (1-19.5) months for CF and 10.4 (0.5-22) months for CSLD; p = .016. In total, 360 cultures (67%) were positive for any bacteria, with 170/234 (73%) positive during exacerbations, compared with 190/300 (63%) during routine visits; p = .05. More infants with CF than CSLD had cultures positive for Staphylococcus aureus (SA; 75% vs. 34%; p = .004) throughout the period. Pseudomonas aeruginosa (PA) was common in both CF and CSLD (56% and 44%, respectively; p = .42) and increased over time for CF but was high throughout for CSLD. The number of hospital days before PA acquisition was 6 (10.2) for CF and 28.8 (38.7) for CSLD (p = .003). No CF but 6/82 (7%) CSLD infants had chronic PA (p = .56). CONCLUSIONS Sputum cultures showed that infection, in particular PA, is common in CF and CSLD whereas SA is more common in CF. Prospective studies are warranted to elucidate the role of active surveillance in guiding antibiotic therapy.
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Affiliation(s)
- Patrick Stafler
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Gal Zaks-Hoffer
- Pediatrics B, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Genetics Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Oded Scheuerman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Pediatrics B, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Haim Ben-Zvi
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.,Microbiology Laboratory, Rabin Medical Center, Petach Tikva, Israel
| | - Huda Mussaffi
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Meir Mei-Zahav
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Guy Steuer
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Hagit Levine
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ophir Bar-On
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Hadas Mantin
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Dario Prais
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Hannah Blau
- Graub CF Center Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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32
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Nejman-Gryz P, Górska K, Paplińska-Goryca M, Proboszcz M, Krenke R. Periostin and Thymic Stromal Lymphopoietin-Potential Crosstalk in Obstructive Airway Diseases. J Clin Med 2020; 9:E3667. [PMID: 33203095 DOI: 10.3390/jcm9113667] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/23/2020] [Accepted: 11/13/2020] [Indexed: 01/13/2023] Open
Abstract
Periostin and thymic stromal lymphopoietin (TSLP) are newly described markers of obstructive airway diseases and the mechanism by which both markers participate in immune response remains poorly understood. The aim of our study was to determine periostin and TSLP concentration in serum and induced sputum (IS) in patients with atopic asthma, chronic obstructive pulmonary disease (COPD), and controls, as well as to evaluate the potential link between periostin, TSLP, and Th2 immune response. Serum and IS levels of periostin, TSLP, IL-4, and IL-13 were determined in 12 atopic asthmatics, 16 COPD sufferers, and 10 controls. We noticed a significantly higher IS periostin and TSLP concentration at protein and mRNA level in asthmatics compared to the two other groups; additionally, periostin and TSLP were correlated positively with IS eosinophil count. A strong positive correlation between IS periostin and TSLP protein levels (r = 0.96) as well as mRNA expression level (r = 0.95) was found in patients with asthma. The results of our study show that periostin and TSLP are associated with eosinophilic airway inflammation and seem to be important drivers of atopic asthma but not COPD pathobiology. Very strong correlations between local periostin, TSLP, eosinophils, and IL-4 in asthma point to the link between periostin–TSLP and Th2 response.
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Lai T, Xiang F, Zeng J, Huang Y, Jia L, Chen H, Wu J, Xie J, Liu S, Deng W, Zheng W, Huang Y, Zhang Q, Luo Q, Mo F, Long L, Zhang W, Chen W, Han H. Reliability of induced sputum test is greater than that of throat swab test for detecting SARS-CoV-2 in patients with COVID-19: A multi-center cross-sectional study. Virulence 2020; 11:1394-1401. [PMID: 33073676 PMCID: PMC7575004 DOI: 10.1080/21505594.2020.1831342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p < 0.01). Patients were divided according to time span from onset of illness to sample collection into the more-than-30-day (n = 26) and less-than-30-day (n = 30) groups. The positive rate for induced sputum was also significantly higher than for throat swabs in the less-than-30-day group (53.3% vs 10.0%, respectively; p < 0.001). For the more-than-30-day group, all paired samples were negative for SARS-CoV-2. Blood oxygen saturation, respiratory rate, and heart rate remained stable during sputum induction and no staff were infected. Because induced sputum is more reliable and has a lower false-negative rate than throat swabs, we believe induced sputum is more useful for the confirmation of COVID-19 and is safer as a criterion for release from quarantine.
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Affiliation(s)
- Tianwen Lai
- Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Fangfei Xiang
- Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University , Guangzhou, Guangdong, China
| | - Jianfeng Zeng
- Department of Pulmonary Medicine and Tuberculosis, The Third People's Hospital of Shenzhen , Shenzhen, Guangdong, China
| | - Yingzi Huang
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University , Nanjing, Jiangsu, China
| | - Liping Jia
- Department of Respiratory Medicine, Huanggang Central Hospital , Huanggang, Hubei, China
| | - Hui Chen
- Department of Intensive Care Medicine, The First Affiliated Hospital of Soochow University , Suzhou, Jiangsu, China
| | - Jiayuan Wu
- Department of Clinical Research, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Jianfeng Xie
- Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University , Nanjing, Jiangsu, China
| | - Shuna Liu
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Wei Deng
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Weiqiang Zheng
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Yang Huang
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Qinfu Zhang
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Qingfeng Luo
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Fan Mo
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Lieming Long
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Wuying Zhang
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Wenna Chen
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
| | - Huanqin Han
- Infectious Diseases Center, Affiliated Hospital of Guangdong Medical University , Zhanjiang, Guangdong, China
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Tyrak KE, Pajdzik K, Konduracka E, Ćmiel A, Jakieła B, Celejewska‐Wójcik N, Trąd G, Kot A, Urbańska A, Zabiegło E, Kacorzyk R, Kupryś‐Lipińska I, Oleś K, Kuna P, Sanak M, Mastalerz L. Artificial neural network identifies nonsteroidal anti-inflammatory drugs exacerbated respiratory disease (N-ERD) cohort. Allergy 2020; 75:1649-1658. [PMID: 32012310 PMCID: PMC7383769 DOI: 10.1111/all.14214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/16/2019] [Accepted: 01/02/2020] [Indexed: 11/27/2022]
Abstract
Background To date, there has been no reliable in vitro test to either diagnose or differentiate nonsteroidal anti‐inflammatory drug (NSAID)–exacerbated respiratory disease (N‐ERD). The aim of the present study was to develop and validate an artificial neural network (ANN) for the prediction of N‐ERD in patients with asthma. Methods This study used a prospective database of patients with N‐ERD (n = 121) and aspirin‐tolerant (n = 82) who underwent aspirin challenge from May 2014 to May 2018. Eighteen parameters, including clinical characteristics, inflammatory phenotypes based on sputum cells, as well as eicosanoid levels in induced sputum supernatant (ISS) and urine were extracted for the ANN. Results The validation sensitivity of ANN was 94.12% (80.32%‐99.28%), specificity was 73.08% (52.21%‐88.43%), and accuracy was 85.00% (77.43%‐92.90%) for the prediction of N‐ERD. The area under the receiver operating curve was 0.83 (0.71‐0.90). Conclusions The designed ANN model seems to have powerful prediction capabilities to provide diagnosis of N‐ERD. Although it cannot replace the gold‐standard aspirin challenge test, the implementation of the ANN might provide an added value for identification of patients with N‐ERD. External validation in a large cohort is needed to confirm our results.
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Affiliation(s)
- Katarzyna Ewa Tyrak
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Kinga Pajdzik
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Ewa Konduracka
- Coronary and Heart Failure Department Jagiellonian University School of MedicineJohn Paul II Hospital Cracow Poland
| | - Adam Ćmiel
- Department of Applied Mathematics AGH University of Science and Technology Cracow Poland
| | - Bogdan Jakieła
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | | | - Gabriela Trąd
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Adrianna Kot
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Anna Urbańska
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Ewa Zabiegło
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Radosław Kacorzyk
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | | | - Krzysztof Oleś
- Department of Oncological and Reconstructive Surgery The Maria Sklodowska‐Curie Memorial Cancer Center and Institute of Oncology Gliwice Poland
| | - Piotr Kuna
- Department of Internal Medicine, Asthma and Allergy Medical University of Łódź Łódź Poland
| | - Marek Sanak
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
| | - Lucyna Mastalerz
- 2nd Department of Internal Medicine Jagiellonian University Medical College Cracow Poland
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Guo C, Sun X, Diao W, Shen N, He B. Correlation of Clinical Symptoms and Sputum Inflammatory Markers with Air Pollutants in Stable COPD Patients in Beijing Area. Int J Chron Obstruct Pulmon Dis 2020; 15:1507-1517. [PMID: 32617002 PMCID: PMC7326189 DOI: 10.2147/copd.s254129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/08/2020] [Indexed: 11/23/2022] Open
Abstract
Short-term exposure to major air pollutants can increase the risk of acute exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, evidence on the mechanism of acute exacerbation of COPD (AECOPD) caused by air pollutants is still limited. A total of 78 patients with stable COPD and 58 healthy controls were recruited in Peking University Third Hospital in China from December 2014 to January 2015. The correlation and lag effect over 7 days (lag1–7) of 6 air pollutants with clinical symptoms and inflammatory markers in induced sputum were analyzed. PM2.5, NO2 and CO were positively correlated with the COPD assessment test (CAT) score at lag 5, PM10 was positively correlated with the CAT score at lag 3, MMP-9 and IL-8 were positively correlated with PM2.5, PM10 and NO2 at lag 2, and CO was positively correlated with each other marker at lag 4. Short-term exposure to PM2.5, PM10, NO2, and CO can cause a neutrophil-mediated airway inflammatory response, followed by increased clinical symptoms. If the PM2.5, PM10, NO2 and CO exposure levels increase during air pollution monitoring, the early usage of medication or reduction of exposure to pollutants can effectively reduce the clinical symptoms of patients.
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Affiliation(s)
- Chenxia Guo
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, People's Republic of China
| | - Xiaoyan Sun
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, People's Republic of China
| | - Wenqi Diao
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, People's Republic of China
| | - Ning Shen
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, People's Republic of China
| | - Bei He
- Department of Respiratory Medicine, Peking University Third Hospital, Beijing, People's Republic of China
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Ramsey KA, Chen ACH, Radicioni G, Lourie R, Martin M, Broomfield A, Sheng YH, Hasnain SZ, Radford-Smith G, Simms LA, Burr L, Thornton DJ, Bowler SD, Livengood S, Ceppe A, Knowles MR, Noone PG, Donaldson SH, Hill DB, Ehre C, Button B, Alexis NE, Kesimer M, Boucher RC, McGuckin MA. Airway Mucus Hyperconcentration in Non-Cystic Fibrosis Bronchiectasis. Am J Respir Crit Care Med 2020; 201:661-670. [PMID: 31765597 DOI: 10.1164/rccm.201906-1219oc] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Rationale: Non-cystic fibrosis bronchiectasis is characterized by airway mucus accumulation and sputum production, but the role of mucus concentration in the pathogenesis of these abnormalities has not been characterized.Objectives: This study was designed to: 1) measure mucus concentration and biophysical properties of bronchiectasis mucus; 2) identify the secreted mucins contained in bronchiectasis mucus; 3) relate mucus properties to airway epithelial mucin RNA/protein expression; and 4) explore relationships between mucus hyperconcentration and disease severity.Methods: Sputum samples were collected from subjects with bronchiectasis, with and without chronic erythromycin administration, and healthy control subjects. Sputum percent solid concentrations, total and individual mucin concentrations, osmotic pressures, rheological properties, and inflammatory mediators were measured. Intracellular mucins were measured in endobronchial biopsies by immunohistochemistry and gene expression. MUC5B (mucin 5B) polymorphisms were identified by quantitative PCR. In a replication bronchiectasis cohort, spontaneously expectorated and hypertonic saline-induced sputa were collected, and mucus/mucin concentrations were measured.Measurements and Main Results: Bronchiectasis sputum exhibited increased percent solids, total and individual (MUC5B and MUC5AC) mucin concentrations, osmotic pressure, and elastic and viscous moduli compared with healthy sputum. Within subjects with bronchiectasis, sputum percent solids correlated inversely with FEV1 and positively with bronchiectasis extent, as measured by high-resolution computed tomography, and inflammatory mediators. No difference was detected in MUC5B rs35705950 SNP allele frequency between bronchiectasis and healthy individuals. Hypertonic saline inhalation acutely reduced non-cystic fibrosis bronchiectasis mucus concentration by 5%.Conclusions: Hyperconcentrated airway mucus is characteristic of subjects with bronchiectasis, likely contributes to disease pathophysiology, and may be a target for pharmacotherapy.
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Affiliation(s)
- Kathryn A Ramsey
- Marsico Lung Institute.,Department of Pediatrics, Pediatric Respiratory Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alice C H Chen
- Inflammatory Disease Biology and Therapeutics Group, Mater Research Institute, Translational Research Institute, and.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | | | - Rohan Lourie
- Inflammatory Disease Biology and Therapeutics Group, Mater Research Institute, Translational Research Institute, and.,Department of Anatomical Pathology, Mater Misericordiae Limited, South Brisbane, Queensland, Australia
| | - Megan Martin
- Department of Respiratory Medicine, Mater Adult Hospital, South Brisbane, Queensland, Australia
| | - Amy Broomfield
- Department of Anatomical Pathology, Mater Misericordiae Limited, South Brisbane, Queensland, Australia
| | - Yong H Sheng
- Inflammatory Disease Biology and Therapeutics Group, Mater Research Institute, Translational Research Institute, and
| | - Sumaira Z Hasnain
- Inflammatory Disease Biology and Therapeutics Group, Mater Research Institute, Translational Research Institute, and
| | - Graham Radford-Smith
- Inflammatory Bowel Diseases Research Laboratory, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Lisa A Simms
- Inflammatory Bowel Diseases Research Laboratory, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Lucy Burr
- Inflammatory Disease Biology and Therapeutics Group, Mater Research Institute, Translational Research Institute, and.,Department of Respiratory Medicine, Mater Adult Hospital, South Brisbane, Queensland, Australia
| | - David J Thornton
- Wellcome Trust Centre for Cell-Matrix Research, Lydia Becker Institute for Immunology and Inflammation, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom; and
| | - Simon D Bowler
- Department of Respiratory Medicine, Mater Adult Hospital, South Brisbane, Queensland, Australia
| | | | | | | | | | | | - David B Hill
- Marsico Lung Institute.,Department of Physics and Astronomy, and
| | | | | | - Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | - Michael A McGuckin
- Inflammatory Disease Biology and Therapeutics Group, Mater Research Institute, Translational Research Institute, and.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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37
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Bush A. Which Child with Asthma is a Candidate for Biological Therapies? J Clin Med 2020; 9:jcm9041237. [PMID: 32344781 PMCID: PMC7230909 DOI: 10.3390/jcm9041237] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/21/2023] Open
Abstract
In asthmatic adults, monoclonals directed against Type 2 airway inflammation have led to major improvements in quality of life, reductions in asthma attacks and less need for oral corticosteroids. The paediatric evidence base has lagged behind. All monoclonals currently available for children are anti-eosinophilic, directed against the T helper (TH2) pathway. However, in children and in low and middle income settings, eosinophils may have important beneficial immunological actions. Furthermore, there is evidence that paediatric severe asthma may not be TH2 driven, phenotypes may be less stable than in adults, and adult biomarkers may be less useful. Children being evaluated for biologicals should undergo a protocolised assessment, because most paediatric asthma can be controlled with low dose inhaled corticosteroid if taken properly and regularly. For those with severe therapy resistant asthma, and refractory asthma which cannot be addressed, the two options if they have TH2 inflammation are omalizumab and mepolizumab. There is good evidence of efficacy for omalizumab, particularly in those with multiple asthma attacks, but only paediatric safety, not efficacy, data for mepolizumab. There is an urgent need for efficacy data in children, as well as data on biomarkers to guide therapy, if the right children are to be treated with these powerful new therapies.
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Affiliation(s)
- Andrew Bush
- Imperial College & Royal Brompton Harefield NHS Foundation Trust, London SW£ dNP, UK
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38
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Celejewska‐Wójcik N, Wójcik K, Ignacak‐Popiel M, Ćmiel A, Tyrak K, Gielicz A, Kania A, Nastałek P, Sanak M, Mastalerz L. Subphenotypes of nonsteroidal antiinflammatory disease-exacerbated respiratory disease identified by latent class analysis. Allergy 2020; 75:831-840. [PMID: 31803947 PMCID: PMC7216982 DOI: 10.1111/all.14141] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Induced sputum (IS) allows to measure mediators of asthmatic inflammation in bronchial secretions. NSAID-exacerbated respiratory disease (NERD) is recognized as a distinct asthma phenotype, usually with a severe course, eosinophilic airway inflammation, and increased production of pro-inflammatory eicosanoids. A more insightful analysis of NERD patients has shown this phenotype to be nonhomogeneous. OBJECTIVE We aimed to identify possible subphenotypes in a cohort of NERD patients with the means of latent class analysis (LCA). METHODS A total of 95 asthma patients with aspirin hypersensitivity underwent sputum induction. High-performance liquid chromatography or gas chromatography coupled with mass spectrometry was used to profile eicosanoids in induced sputum supernatant (ISS). Sixteen variables covering clinical characteristics, IS inflammatory cells, and eicosanoids were considered in the LCA. RESULTS Three classes (subphenotypes) were distinguished within the NERD cohort. Class 1 subjects had mild-to-moderate asthma, an almost equal distribution of inflammatory cell patterns, the lowest concentrations of eicosanoids, and logLTE4 /logPGE2 ratio. Class 2 represented severe asthma with impaired lung function despite high doses of steroids. High sputum eosinophilia was in line with higher pro-inflammatory LTE4 in ISS and the highest logLTE4 /logPGE2 ratio. Class 3 subjects had mild-to-moderate asthma and were also characterized by eosinophilic airway inflammation, yet increased production of pro- (LTE4 , PGD2 and 11-dehydro-TBX2 ) was balanced by anti-inflammatory PGE2 . The value of logLTE4 /logPGE2 was between values calculated for classes 1 and 3, similarly to disease control and severity. CONCLUSIONS LCA revealed three distinct NERD subphenotypes. Our results support a more complex pathobiology of aspirin hypersensitivity. Considering NERD heterogeneity, the relationship between inflammatory pathways and clinical manifestations of asthma may lead to more individualized treatment in difficult to treat patients in the future.
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Affiliation(s)
- Natalia Celejewska‐Wójcik
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Krzysztof Wójcik
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Maria Ignacak‐Popiel
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Adam Ćmiel
- Department of Applied MathematicsAGH University of Science and TechnologyCracowPoland
| | - Katarzyna Tyrak
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Anna Gielicz
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Aleksander Kania
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Paweł Nastałek
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Marek Sanak
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
| | - Lucyna Mastalerz
- II Department of Internal MedicineFaculty of MedicineJagiellonian University Medical CollegeCracowPoland
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Bernatowicz PL, Golec P, Bielecki P, Kowal K. Systemic corticosteroid therapy augments ex vivo release of sCD163 by peripheral blood monocytes of asthmatic patients. Postepy Dermatol Alergol 2020; 37:61-5. [PMID: 32467686 DOI: 10.5114/ada.2020.93384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/18/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction The CD163 is exclusively expressed by mononuclear phagocytes as a transmembrane protein, which synthesis is regulated by anti- and pro-inflammatory signals. After shedding from the cell surface it exists in body fluids as a soluble protein (sCD163) which exerts anti-inflammatory effects. Aim To evaluate serum concentration and ex vivo production of sCD163 by peripheral blood mononuclear cells (PBMC) in asthmatic patients treated with inhaled (ICS) or oral corticosteroids (OCS). Material and methods The study was performed on 35 allergic asthma patients (AAs) including 15 treated with ICS (ICS-AAs), 10 with OCS (OCS-AAs), 10 during asthma exacerbation (EX-AAs) before OCS had been started and 13 non-atopic healthy subjects (HCs) as a control group. PBMC were cultured in vitro for up to 144 h. The concentration of sCD163 in serum and the culture supernatants was evaluated with ELISA. Results The greatest serum sCD163 concentration was demonstrated in EX-AAs, which was significantly greater than that in other studied subgroups. The concentration of sCD163 in PBMC culture supernatants was greater in AAs than in HCs (p = 0.006). Among individual asthma subgroups the greatest concentration of sCD163 was demonstrated in PBMC culture supernatants of OCS-AAs, which was significantly greater than in ICS-AAs (p < 0.001) and EX-AAs (p < 0.001), both being significantly greater than in HCs (p < 0.001). Conclusions In AAs, enhanced capability of PBMCs to release sCD163 may be at least partially responsible for the anti-inflammatory effects of systemic corticosteroid therapy.
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Louhaichi S, Mlika M, Hamdi B, Hamzaoui K, Hamzaoui A. Sputum IL-26 Is Overexpressed in Severe Asthma and Induces Proinflammatory Cytokine Production and Th17 Cell Generation: A Case-Control Study of Women. J Asthma Allergy 2020; 13:95-107. [PMID: 32099415 PMCID: PMC7006858 DOI: 10.2147/jaa.s229522] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 01/12/2020] [Indexed: 12/16/2022] Open
Abstract
Objective Asthma inflammation is a complex pathway involving numerous mediators. Interleukin-26 (IL-26), a member of the IL-10 cytokine family, is abundant in human airways and induces the production of proinflammatory cytokines. Our aim was to investigate the possible role of IL-26 in severe asthma. We analysed the expression of IL-26 in severe asthma both in peripheral blood and induced sputum. Patients and Methods A total of 50 adult women with severe asthma were recruited and compared to 30 healthy controls (HC). Serum and sputum fluid (SF) levels of IL-26 and IL-17 were defined by ELISA. IL-26 mRNA expression and IL-26 protein were analysed using RT-PCR and Western blot. In vitro, we studied the effect of recombinant IL-26 (rIL-26) and SF-IL-26 on cultured CD4+ T cells and monocytes, comparing patients and controls. Results Concentrations of IL-26 are higher in serum and induced sputum of asthmatic patients than in HC. Moreover, IL-26 protein and mRNA expression were significantly elevated in asthma sputum cells compared to PBMCs. We observed a positive correlation between body mass index (BMI) and sputum fluid IL-26, while the correlation between IL-26 and lung function tests (FEV1% and FEV1/FVC ratio) was negative. IL-17A was highly expressed in SF and correlated positively with IL-26. In patients’ sputum IL-26 and IL-17A were significantly associated with neutrophils. Stimulation of cultured CD4+ T cells with monocytes by recombinant IL-26 promoted the generation of RORγt+ Th17+ cells inducing the production of IL-17A, IL-1β, IL-6 and TNF-α cytokines. IL-26 expressed in SF was biologically active and induced IL-17 secretion in the presence of IL-1β and IL-6 cytokines. Conclusion These findings show that IL-26 is highly produced in asthmatic sputum, induces pro-inflammatory cytokine secretion by monocytes/macrophages, and favours Th17 cell generation. IL-26 thereby appears as a novel pro-inflammatory cytokine, produced locally in the airways that may constitute a promising target to treat asthma inflammatory process.
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Affiliation(s)
- Sabrine Louhaichi
- Research Laboratory 19SP02 "Chronic Pulmonary Pathologies: From Genome to Management", Abderrahman Mami Hospital, Ariana, Tunisia.,Medicine Faculty of Tunis, Department of Basic Sciences, Tunis El Manar University, Tunis, Tunisia.,Department of Paediatric and Respiratory Diseases, Abderrahman Mami Hospital, Pavillon B, Ariana, Tunisia
| | - Mona Mlika
- Medicine Faculty of Tunis, Department of Basic Sciences, Tunis El Manar University, Tunis, Tunisia.,Pathology Department, Abderrahman Mami Hospital, Ariana, Tunisia
| | - Besma Hamdi
- Research Laboratory 19SP02 "Chronic Pulmonary Pathologies: From Genome to Management", Abderrahman Mami Hospital, Ariana, Tunisia.,Medicine Faculty of Tunis, Department of Basic Sciences, Tunis El Manar University, Tunis, Tunisia.,Department of Paediatric and Respiratory Diseases, Abderrahman Mami Hospital, Pavillon B, Ariana, Tunisia
| | - Kamel Hamzaoui
- Research Laboratory 19SP02 "Chronic Pulmonary Pathologies: From Genome to Management", Abderrahman Mami Hospital, Ariana, Tunisia.,Medicine Faculty of Tunis, Department of Basic Sciences, Tunis El Manar University, Tunis, Tunisia
| | - Agnès Hamzaoui
- Research Laboratory 19SP02 "Chronic Pulmonary Pathologies: From Genome to Management", Abderrahman Mami Hospital, Ariana, Tunisia.,Medicine Faculty of Tunis, Department of Basic Sciences, Tunis El Manar University, Tunis, Tunisia.,Department of Paediatric and Respiratory Diseases, Abderrahman Mami Hospital, Pavillon B, Ariana, Tunisia
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Wardzyńska A, Pawełczyk M, Głobińska A, Makowska JS, Kowalski ML. The profile of respiratory pathogens in induced sputum of elderly and non-elderly asthmatics. Cent Eur J Immunol 2019; 44:384-9. [PMID: 32140050 DOI: 10.5114/ceji.2019.92790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 05/07/2018] [Indexed: 11/20/2022] Open
Abstract
Introduction Respiratory pathogens are thought to be involved in the pathogenesis and exacerbations of asthma at all ages; however, little is known about the airway microbiome in the elderly. Aim of the study To identify respiratory pathogens in the induced sputum (IS) of elderly asthmatics, and to determine the association between pathogens and the markers of asthma activity. Material and methods Twenty-nine subjects with stable asthma, 15 above 65 years of age and 14 aged 30-49 years, underwent clinical evaluation, fractional exhaled nitric oxide measurement, and sputum induction. Pathogens were detected by multiplex reverse transcription polymerase chain reaction. The periostin concentration of IS supernatants was measured by enzyme-linked immunosorbent assay. Serum eosinophil cationic protein and total IgE levels were measured by Immun<sup>o</sup>CAP. Results Elderly patients, as compared to non-elderly, had significantly higher eosinophilia in IS, although other markers of eosinophilic inflammation were comparable. Half of the subjects were positive for Haemophilus influenzae. Chlamydophila pneumoniae was found in two subjects. Respiratory viruses were detected in more than 70% of patients. The detection rates and profiles of atypical bacteria and respiratory viruses were similar in both groups. Only in the elderly asthmatics was influenza A positivity associated with lower predicted FVC%, RSV A positivity connected with decreased tIgE concentration, and RSV B positivity related to a lower percentage of lymphocytes in IS. Conclusions Despite the existence of differences in some clinical and inflammatory characteristics of asthma between elderly and non-elderly asthmatics, the pathogen detection rates in the IS from the two groups are similar.
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Abstract
Aim: Asthma inflammatory phenotypes facilitate treatment, their clinical characteristics and biomarkers were analyzed. Materials & methods: A total of 176 asthmatics were divided into eosinophilic asthma (EA), neutrophilic asthma (NA), paucigranulocytic asthma and mixed-granulocytic asthma by induced sputum. Results: EA, NA and paucigranulocytic asthma patients were 65 (36.9%), 31 (17.6%) and 75 (42.6%). Sputum IL-5 and IL-13, blood IL-13, fractional exhaled nitric oxide (FeNO) were related to EA, the areas under the receiver operating characteristic curve were 0.790, 0.846, 0.828, 0.830, combined FeNO with blood IL-13 was 0.872. Sputum and blood IL-8, blood IL-17 were related to NA, their area under the receiver operating characteristic curve was 0.939, 0.844, 0.821, combined blood IL-8 with IL-17 was 0.882. Conclusion: Blood IL-13 and FeNO, blood IL-8 and IL-17 were alternative biomarkers of EA and NA, respectively.
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Affiliation(s)
- Wei Gao
- Chinese PLA Medical School, Beijing, 100853, PR China.,Respiratory & Critical Care Unit, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Guo-Jing Han
- Respiratory & Critical Care Unit, Chinese PLA General Hospital, Beijing, 100853, PR China
| | - Yu-Jin Zhu
- Tianjin Municipal Corps Hospital of CAPF, Tianjin, 300000, PR China
| | - Dan Mao
- Department of Critical Care Medicine, 968th Hospital of Chinese PLA, Jinzhou, 121000, PR China
| | - Hong Hu
- Chinese PLA Medical School, Beijing, 100853, PR China.,Respiratory & Critical Care Unit, Chinese PLA General Hospital, Beijing, 100853, PR China
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Zar HJ, Workman LJ, Prins M, Bateman LJ, Mbhele SP, Whitman CB, Denkinger CM, Nicol MP. Tuberculosis Diagnosis in Children Using Xpert Ultra on Different Respiratory Specimens. Am J Respir Crit Care Med 2019; 200:1531-1538. [PMID: 31381861 PMCID: PMC6909828 DOI: 10.1164/rccm.201904-0772oc] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/05/2019] [Indexed: 11/16/2022] Open
Abstract
Rationale: Microbiological confirmation of pulmonary tuberculosis in children is desirable.Objectives: To investigate the diagnostic accuracy and incremental yield of Xpert MTB/RIF Ultra (Ultra; Cepheid), a new rapid test, on repeated induced sputum, nasopharyngeal aspirates, and combinations of specimens.Methods: Consecutive South African children hospitalized with suspected pulmonary tuberculosis were enrolled.Measurements and Main Results: Induced sputum (IS) and nasopharyngeal aspirates (NPAs) were obtained. NPAs were frozen; IS underwent liquid culture, and an aliquot was frozen. Ultra was performed on thawed NPAs and IS specimens individually. Children were categorized as confirmed, unconfirmed, or unlikely tuberculosis according to NIH consensus case definitions. The diagnostic accuracy of Ultra was compared with liquid culture on IS. In total, 195 children (median age: 23.3 mo; 32 [16.4%] HIV-infected) had one IS and NPA, and 130 had two NPAs. There were 40 (20.5%) culture-confirmed cases. Ultra was positive on NPAs in 26 (13.3%) and on IS in 31 (15.9%). Sensitivity and specificity of Ultra on one NPA were 46% and 98%, respectively, and similar by HIV status. Sensitivity and specificity of Ultra on one IS were 74.3% and 96.9% respectively. Combining one NPA and one IS increased sensitivity to 80%. Sensitivity using Ultra on two NPAs was 54.2%, increasing to 87.5% with an IS Ultra.Conclusions: IS provides a better specimen than repeated NPA for rapid diagnosis using Ultra. However, Ultra testing of combinations of specimens provides a novel strategy that can be adapted to identify most children with confirmed pulmonary tuberculosis.
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Affiliation(s)
- Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health and
| | - Lesley J. Workman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health and
| | - Margaretha Prins
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health and
| | - Linda J. Bateman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health and
| | - Slindile P. Mbhele
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Cynthia B. Whitman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health and
| | - Claudia M. Denkinger
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
- Center of Infectious Diseases, University of Heidelberg, Heidelberg, Germany and
| | - Mark P. Nicol
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
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44
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Proboszcz M, Mycroft K, Paplinska-Goryca M, Górska K, Nejman-Gryz P, Jankowski P, Zak N, Krenke R. Relationship between Blood and Induced Sputum Eosinophils, Bronchial Hyperresponsiveness and Reversibility of Airway Obstruction in Mild-to-Moderate Chronic Obstructive Pulmonary Disease. COPD 2019; 16:354-361. [PMID: 31631716 DOI: 10.1080/15412555.2019.1675150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Blood eosinophilia has been proposed as a surrogate marker for airway eosinophilia and as a predictor of treatment response in chronic obstructive pulmonary disease (COPD). The aim of the study was to assess the relationship between blood and sputum eosinophils and to investigate the association between blood and sputum eosinophil count and clinical features of mild-to-moderate COPD. We performed a retrospective analysis of blood and sputum eosinophil count, as well as demographic and lung function data in a cohort of 90 stable, steroid-naive (Global Initiative for Chronic Obstructive Lung Disease 1 or 2) COPD patients and 20 control subjects. Blood and sputum eosinophil count did not correlate both in patients with COPD (r = -0.04 p = 0.705) and in controls (r = 0.05, p = 0.838). Sputum eosinophilia (≥3%) was present in 40% of COPD patients. The median blood eosinophil count in patients with COPD was 180 (interquartile range 90-270)/μL; patients with low blood eosinophils (<180/μL) did not differ from those with high blood eosinophils (≥180/μL) in terms of forced expiratory volume in 1 second, bronchial reversibility or hyperresponsiveness. This was also the case when COPD patients with and without sputum eosinophilia were compared. At the same time, positive bronchial reversibility and positive bronchial hyperresponsiveness were observed in 2 (11%) COPD patients with high blood eosinophils and in 1 (5%) patient with sputum eosinophilia. There was a weak, albeit significant correlation (r = 0.22 p = 0.041) between blood eosinophil count and age in patients with COPD. Peripheral eosinophil count poorly reflects sputum eosinophils and lung function in stable steroid-naive mild-to-moderate COPD patients.
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Affiliation(s)
- Malgorzata Proboszcz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Mycroft
- Students' Research Group "Alveolus," Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Paplinska-Goryca
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Patrycja Nejman-Gryz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Jankowski
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Zak
- Students' Research Group "Alveolus," Medical University of Warsaw, Warsaw, Poland
| | - Rafal Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
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45
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Semik-Orzech A, Skoczyński S, Pierzchała W. Serum estradiol concentration, estradiol-to-progesterone ratio and sputum IL-5 and IL-8 concentrations are increased in luteal phase of the menstrual cycle in perimenstrual asthma patients. Eur Ann Allergy Clin Immunol 2019; 49:161-170. [PMID: 28752719 DOI: 10.23822/eurannaci.1764-1489.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background. The results of the research on perimenstrual asthma (PMA) pathophysiology are inconsistent, and the role of sex hormones remains inconclusive. The aim of the study was to evaluate the influence of serum sex steroid (and other) hormones concentrations on lower airway inflammation of PMA patients. Methods. Thirty-three women of childbearing age diagnosed as: PMA (n = 13), non-PMA asthmatics (n = 10), and healthy controls (n = 10) were prospectively followed for 12 weeks over 2 consecutive menstrual cycles. On the 10th and 26th day of each cycle serum 17β-estradiol, progesterone, testosterone, androstendion, dehydroepiandrosteron, cortisol, thyroid-stimulating hormone and prolactin were measured, and sputum was induced. Sputum inflammatory cell count and IL-5, -6, -8, -10 concentrations were determined. Results. When compared to non-PMA asthmatics, the luteal phase of the cycle in PMA subjects was associated with increased serum estradiol concentration, estradiol-to-progesterone ratio (p < 0.001, p = 0.001, respectively) and sputum IL-5 and IL-8 concentrations (p = 0.045, p = 0.039, respectively). Decreased serum testosterone levels (p < 0.05) and a trend to increased serum prolactin levels in both phases of the menstrual cycle in PMA subjects were observed. Sputum analysis in PMA patients revealed increased total inflammatory cell count in both phases of the menstrual cycle (p < 0.05), when compared to non-PMA asthmatics. Conclusions. The luteal phase of the cycle in PMA patients is associated with increased serum estradiol levels with concurrent higher sputum concentration of IL-5 and IL-8. Serum testosterone levels are decreased, and total number of sputum inflammatory cells is increased in PMA patients in both phases of the menstrual cycle.
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Affiliation(s)
- A Semik-Orzech
- Department of Pneumology, School of Medicine, Medical University of Silesia, Katowice, Poland. Phone: +48 32 789 46 51 E-mail:
| | - S Skoczyński
- Department of Pneumology, School of Medicine, Medical University of Silesia, Katowice, Poland. Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
| | - W Pierzchała
- Department of Pneumology, School of Medicine, Medical University of Silesia, Katowice, Poland
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46
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Guo XX, Deng NS, Chen QH, Yu HY, Ding XH, Hu SP, Nie HX. Application of Inflammatory Markers in Induced Sputum in Stable Chronic Obstructive Pulmonary Disease Patients with Positive Bronchodilation Tests. Curr Med Sci 2019; 39:560-7. [PMID: 31346991 DOI: 10.1007/s11596-019-2074-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/21/2019] [Indexed: 01/02/2023]
Abstract
Positive bronchodilation (BD) tests can be noticed in some stable chronic obstructive pulmonary disease (COPD) patients. The characteristics of airway inflammation in this entity remain unclear. Our study aimed to identify the characteristics of airway inflammation in stable COPD patients with positive BD tests. The airway inflammation was assessed in 88 patients with stable COPD using the examination of induced sputum in the aftermath of lung function and BD tests. Cellular counts and the levels of molecular markers including eosinophil cationic protein (ECP), myeloperoxidase (MPO), interleukin-5 (IL-5), and IL-8 were assayed by Wright's stain, Immuno-CAP system, and ELISA, RT-PCR. Among the 88 patients with stable COPD, 20 (22.7%) showed positive BD tests. The values of eosinophils (4.7%±3.4%) and ECP (90.1±41.6 ng/mL) in induced sputum in stable COPD patients with positive BD tests were markedly elevated as compared with those in stable COPD patients with negative BD tests or in healthy controls (all P>0.05), but significantly lower than those in asthmatic patients (all P<0.01). The IL-5 in sputum supernatant was significantly decreased in stable COPD patients with positive BD tests as compared with the patients with asthma (12.5±7.8 vs. 48.2±26.0 ng/mL;.P<0.01). However, healthy controls exhibited similar concentrations of IL-5 in induced sputum with patients with stable COPD, whether with positive or negative BD tests (all P>0.05). Moreover, the values of neutrophils (61.8%±15.1%), MPO (574.0±111.8 ng/mL), and IL-8 (32.6±13.4 ng/mL) in induced sputum in stable COPD patients with positive BD tests were significantly higher than those in asthmatics or normal controls (all P<0.01). However, the values of the above inflammatory markers in induced sputum were similar among stable COPD patients with positive or negative BD tests (all P>0.05). The stable COPD patients with positive BD tests may present not only eosinophilic airway inflammation but also neutrophilic airway inflammation.
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47
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Soloveva IА, Sobko EA, Demko IV, Kraposhina AY, Loktionova MM, Gordeeva NV. Features of cellular structure of the induced sputum and profile of cytokines at sintropiya of bronchial asthma and obesity at young patients. TERAPEVT ARKH 2019; 90:25-32. [PMID: 30701852 DOI: 10.26442/terarkh201890325-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIM To estimate changes of cellular structure of the induced sputum at young patients with bronchial asthma at interrelations with BMI and level of cytokines in blood plasma. MATERIALS AND METHODS 164 patients with bronchial asthma were divided into 2 groups taking into BMI: the 1st group included patients with bronchial asthma and BMI from 18 to 25 kg/m2, patients with bronchial asthma and BMI from 30 to 40 kg/m2 entered into the 2nd group. The group of control was made by 40 almost healthy volunteers. Estimated existence of excess weight and defined obesity degree according to recommendations of World Health Organization. Studied the level of control of bronchial asthma, cellular structure of the induced sputum, the IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-15, IL-17, TNF-α, INF-γ levels in plasma of peripheral blood. RESULTS There are presented the results of the research of cellular profile of the induced sputum and profile of cytokines at patients with bronchial asthma depending on BMI and severity of the disease. The received results testify to prevalence of eosinophilic type of an inflammation in the group of patients with BMI less than 25 kg/m2 whereas at patients mainly paucigranulation inflammation decided on obesity. The highest content of the Il-17 was registered at patients with bronchial asthma and obesity as in comparison with indicators of patients with normal BMI, and with almost healthy that, perhaps, is the reason of low effect of steroid therapy at these patients. CONCLUSION Endotype assessment before basic antiinflammatory therapy at patients with the first time diagnosed bronchial asthma, will be able to help with selection of the most optimum treatment to each specific patient.
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Affiliation(s)
- I А Soloveva
- Krasnoyarsk state medical university named after prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russia.,Regional Clinical Hospital, Krasnoyarsk, Russia
| | - E A Sobko
- Krasnoyarsk state medical university named after prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russia.,Regional Clinical Hospital, Krasnoyarsk, Russia
| | - I V Demko
- Krasnoyarsk state medical university named after prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russia.,Regional Clinical Hospital, Krasnoyarsk, Russia
| | - A Yu Kraposhina
- Krasnoyarsk state medical university named after prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russia
| | - M M Loktionova
- Krasnoyarsk state medical university named after prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russia
| | - N V Gordeeva
- Krasnoyarsk state medical university named after prof. V.F. Voino-Yasenetsky, Krasnoyarsk, Russia.,Regional Clinical Hospital, Krasnoyarsk, Russia
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Mastalerz L, Tyrak KE, Ignacak M, Konduracka E, Mejza F, Ćmiel A, Buczek M, Kot A, Oleś K, Sanak M. Prostaglandin E 2 decrease in induced sputum of hypersensitive asthmatics during oral challenge with aspirin. Allergy 2019; 74:922-932. [PMID: 30446997 DOI: 10.1111/all.13671] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/01/2018] [Accepted: 11/05/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND A special regulatory role for prostaglandin E2 (PGE2 ) has been postulated in nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD). OBJECTIVE To investigate the effect of systemic aspirin (acetylsalicylic acid) administration on airway PGE2 biosynthesis in induced sputum supernatant (ISS) among subjects with NERD or aspirin-tolerant asthma with chronic rhinosinusitis with nasal polyposis (ATA-CRSwNP), as well as healthy controls (HC). METHODS Induced sputum (IS) was collected from patients with NERD (n = 26), ATA-CRSwNP (n = 17), and HC (n = 21) at baseline and after aspirin challenge. Sputum differential cell count and IS supernatant (ISS) levels of prostanoids, PGE2 , 8-iso-PGE2 , tetranor-PGE-M, 8-iso-PGF2 α, and leukotriene C4 , D4 , and E4 , were determined using mass spectrometry. Urinary excretion of LTE4 was measured by ELISA. RESULTS NERD subjects had elevated sputum eosinophilic count as compared to ATA-CRSwNP and HC (median NERD 9.1%, ATA-CRSwNP 2.1%, and HC 0.4%; P < 0.01). Baseline ISS levels of PGE2 were higher in asthmatics as compared to HC at baseline (NERD vs HC P = 0.04, ATA-CRSwNP vs HC P < 0.05). Post-challenge ISS levels of PGE2 compared to baseline significantly decreased in NERD and HC (P < 0.01 and P = 0.01), but not in ATA-CRSwNP. In NERD, a similar decrease in PGE2 as in HC resulted from 2.8 times lower dose of aspirin. CONCLUSION Aspirin-precipitated bronchoconstriction is associated with a decrease in airway PGE2 biosynthesis. These results support the mechanism of PGE2 biosynthesis inhibition as a trigger for bronchoconstriction in NERD.
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Affiliation(s)
- Lucyna Mastalerz
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Katarzyna E. Tyrak
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Maria Ignacak
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Ewa Konduracka
- Coronary and Heart Failure Department Jagiellonian University School of Medicine John Paul II Hospital Cracow Poland
| | - Filip Mejza
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Adam Ćmiel
- Department of Applied Mathematics AGH University of Science and Technology Cracow Poland
| | - Michał Buczek
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Adrianna Kot
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Krzysztof Oleś
- Department of Oncological and Reconstructive Surgery The Maria Sklodowska‐Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch Gliwice Poland
| | - Marek Sanak
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
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Papaporfyriou A, Papaioannou AI, Hillas G, Konstantelou E, Tseliou E, Koulouris N, Papiris S, Bakakos P, Kostikas K, Loukides S. Inflammatory profile in optimally treated patients with adult versus early-onset asthma. Postgrad Med 2019; 131:324-329. [PMID: 30920326 DOI: 10.1080/00325481.2019.1600884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: The age of asthma onset is often implicated in clinical manifestation, diagnosis, and management of the disease. Aim: To define demographic, clinical and functional features and inflammatory characteristics in induced sputum in patients with adult-onset asthma. Methods: Optimally treated patients from asthma clinics of two tertiary hospitals were included in the study. Patients underwent assessment of demographic characteristics, severity and treatment regimes, pulmonary function tests, and skin prick tests, as well as measurement of blood eosinophils and sputum induction for the assessment of sputum inflammatory cells, IL-8 and IL-13 levels in the supernatant. Results: Of the 333 patients recruited, 234 (70.2%) had adult-onset asthma. Adult-onset asthmatics were older, had a higher BMI, a shorter disease duration, and were less often atopic, compared to patients with early onset asthma. Higher proportions of patients with severe asthma presented increased levels of FeNO and blood eosinophils, both in the early and the adult-onset patient groups. Finally, obese patients with early onset asthma were characterized by less atopy compared to non-obese patients in the same group. Conclusion: Adult-onset asthma was characterized by less sputum eosinophilia, a nonatopic profile and a higher BMI compared to early-onset asthma. The presence of blood eosinophilia and increased FeNO in patients with severe asthma was comparable in the two groups.
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Affiliation(s)
- Anastasia Papaporfyriou
- a 2nd Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Andriana I Papaioannou
- a 2nd Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Geogrios Hillas
- b 5th Pulmonary Department , "Sotiria" Chest Diseases Hospital , Athens , Greece
| | - Elissavet Konstantelou
- c 1st Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Eleni Tseliou
- d 2nd Respiratory Medicine Department , "Sotiria" Chest Diseases Hospital , Athens , Greece
| | - Nikolaos Koulouris
- c 1st Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Spyros Papiris
- a 2nd Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Petros Bakakos
- c 1st Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Konstantinos Kostikas
- a 2nd Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
| | - Stelios Loukides
- a 2nd Respiratory Medicine Department , University of Athens Medical School , Athens , Greece
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50
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Praca E, Jalou H, Krupp N, Delecaris A, Hatch J, Slaven J, Gunst SJ, Tepper RS. Effect of CPAP on airway reactivity and airway inflammation in children with moderate-severe asthma. Respirology 2019; 24:338-344. [PMID: 30444283 PMCID: PMC6743322 DOI: 10.1111/resp.13441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/05/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVE Asthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well-controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased >2-fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate-severe asthma, who require chronic use of corticosteroids, then this non-pharmacological therapy might provide a beneficial alternative or supplemental therapy in these subjects. METHODS Children aged 8-17 years with moderate-severe asthma were treated with 4 weeks of nocturnal CPAP (8-10 cm H2 O) or sham CPAP (<2 cm H2 O). Adherence was monitored with a modem installed in the equipment or by memory cards. Airway reactivity, assessed by methacholine bronchial challenge, was measured prior to and following treatment. RESULTS The percentage of subjects adherent to treatment was similar in both groups (19/27 CPAP vs 19/28 sham, ~70%). There was a tendency for PC20 to increase with treatment in both groups (3.0-5.3 mg/mL CPAP vs 3.2 to 4.3 mg/mL sham, P = 0.083); however, the change did not differ significantly between groups (P = 0.569). CONCLUSION We found that the 4-week treatment with nocturnal CPAP did not produce a twofold suppression of airway reactivity in children with moderate-severe asthma.
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Affiliation(s)
- Eduardo Praca
- Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hasnaa Jalou
- Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nadia Krupp
- Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Angela Delecaris
- Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Joseph Hatch
- Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - James Slaven
- Department of Biostatistics, Indiana University Schools of Medicine and Public Health, Indianapolis, IN, USA
| | - Susan J Gunst
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert S Tepper
- Department of Pediatrics, Division of Pulmonology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
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