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Rewerts LC, Stuke LE, Hunt JP, Marr AB, Schoen JE, Greiffenstein P, Smith AA. Risk Factors for Empyema Following Penetrating Diaphragmatic Injuries. Am Surg 2024:31348241248700. [PMID: 38642333 DOI: 10.1177/00031348241248700] [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] [Indexed: 04/22/2024]
Abstract
Empyema resulting as a complication of penetrating diaphragmatic injuries is a subject that requires further investigation, and the aim of this study was to determine the risk factors associated with empyema in patients with penetrating trauma. Consecutive adult trauma patients from a level 1 trauma center were searched for penetrating diaphragm injuries. Data were collected on patient demographics, pre-existing conditions, injury type and severity, hospital interventions, in-hospital complications, and outcomes. Patients were stratified by empyema formation and univariant analyses were performed. 164 patients were identified, and 17 patients (10.4%) developed empyema. Empyema was associated with visible abdominal contamination (35.3% vs 15%, P = .04), thoracotomy (35.5% vs 13.6%, P = .03), pneumonia (41.2% vs 14.3%, P = .01), sepsis (35.3% vs 8.8%, P = .006), increased hospital length of stay (25.5 vs 10.1 days, p =<.001), increased intensive care unit length of stay (9.6 vs 4.3 days, P = .01), and decreased in-hospital mortality (0% vs 20.4%, P = .04).
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Affiliation(s)
- Lydia C Rewerts
- School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
| | - Lance E Stuke
- Department of Surgery, School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
| | - John P Hunt
- Department of Surgery, School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
| | - Alan B Marr
- Department of Surgery, School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
| | - Jonathan E Schoen
- Department of Surgery, School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
| | - Patrick Greiffenstein
- Department of Surgery, School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
| | - Alison A Smith
- Department of Surgery, School of Medicine, LSU Health Sciences Center, New Orleans, LA, USA
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Manyak GA, Bassiri A, Alvarado CE, Sarnaik KS, Sinopoli J, Tapias L, Linden PA, Towe CW. Is Minimally Invasive Resection of Large Thymoma Appropriate? Am Surg 2024:31348241246180. [PMID: 38584508 DOI: 10.1177/00031348241246180] [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] [Indexed: 04/09/2024]
Abstract
BACKGROUND Current practice patterns suggest open rather than minimally invasive (MIS) approaches for thymomas >4 cm. We hypothesized there would be similar perioperative outcomes and overall survival between open and MIS approaches for large (>4 cm) thymoma resection. METHODS The National Cancer Database was queried for patients who underwent thymectomy from 2010 to 2020. Surgical approach was characterized as either open or MIS. The primary outcome was overall survival and secondary outcomes were margin status, and length of stay (LOS). Differences between approach cohorts were compared after a 1:1 propensity match. RESULTS Among 4121 thymectomies, 2474 (60%) were open and 1647 (40%) were MIS. Patients undergoing MIS were older, had fewer comorbidities, and had smaller tumors (median; 4.6 vs 6 cm, P < .001). In the unmatched cohort, MIS and open had similar 90-day mortality (1.1% vs 1.8%, P = .158) and rate of positive margin (25.1% vs 27.9%, P = .109). MIS thymectomy was associated with shorter LOS (2 (1-4) vs 4 (3-6) days, P < .001). Propensity matching reduced the bias between the groups. In this cohort, overall survival was similar between the groups by log-rank test (P = .462) and multivariate cox hazard analysis (HR .882, P = .472). Multivariable regression showed shorter LOS with MIS approach (Coef -1.139, P < .001), and similar odds of positive margin (OR 1.130, P = .150). DISCUSSION MIS has equivalent oncologic benefit to open resection for large thymomas, but is associated with shorter LOS. When clinically appropriate, MIS thymectomy may be considered a safe alternative to open resection for large thymomas.
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Affiliation(s)
- Grigory A Manyak
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
- Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Aria Bassiri
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Christine E Alvarado
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Kunaal S Sarnaik
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
- Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Jilian Sinopoli
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Leonidas Tapias
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Philip A Linden
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
| | - Christopher W Towe
- Division of Thoracic and Esophageal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center and Case Western Reserve School of Medicine, Cleveland, OH, USA
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Santos-Silva C, Ferreira-Cardoso H, Silva S, Vieira-Marques P, Valente JC, Almeida R, A Fonseca J, Santos C, Azevedo I, Jácome C. Feasibility and Acceptability of Pediatric Smartphone Lung Auscultation by Parents: Cross-Sectional Study. JMIR Pediatr Parent 2024; 7:e52540. [PMID: 38602309 PMCID: PMC11024396 DOI: 10.2196/52540] [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: 09/07/2023] [Revised: 11/23/2023] [Accepted: 01/02/2024] [Indexed: 04/12/2024] Open
Abstract
Background The use of a smartphone built-in microphone for auscultation is a feasible alternative to the use of a stethoscope, when applied by physicians. Objective This cross-sectional study aims to assess the feasibility of this technology when used by parents-the real intended end users. Methods Physicians recruited 46 children (male: n=33, 72%; age: mean 11.3, SD 3.1 y; children with asthma: n=24, 52%) during medical visits in a pediatric department of a tertiary hospital. Smartphone auscultation using an app was performed at 4 locations (trachea, right anterior chest, and right and left lung bases), first by a physician (recordings: n=297) and later by a parent (recordings: n=344). All recordings (N=641) were classified by 3 annotators for quality and the presence of adventitious sounds. Parents completed a questionnaire to provide feedback on the app, using a Likert scale ranging from 1 ("totally disagree") to 5 ("totally agree"). Results Most recordings had quality (physicians' recordings: 253/297, 85.2%; parents' recordings: 266/346, 76.9%). The proportions of physicians' recordings (34/253, 13.4%) and parents' recordings (31/266, 11.7%) with adventitious sounds were similar. Parents found the app easy to use (questionnaire: median 5, IQR 5-5) and were willing to use it (questionnaire: median 5, IQR 5-5). Conclusions Our results show that smartphone auscultation is feasible when performed by parents in the clinical context, but further investigation is needed to test its feasibility in real life.
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Affiliation(s)
| | | | - Sónia Silva
- Department of Pediatrics, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Pedro Vieira-Marques
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - José Carlos Valente
- MEDIDA – Serviços em Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | - Rute Almeida
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João A Fonseca
- MEDIDA – Serviços em Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Cristina Santos
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês Azevedo
- Department of Pediatrics, Centro Hospitalar Universitário de São João, Porto, Portugal
- Department of Obstetrics, Gynecology and Pediatrics, Faculty of Medicine, Universidade do Porto, Porto, Portugal
- EpiUnit, Institute of Public Health, Universidade do Porto, Porto, Portugal
| | - Cristina Jácome
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
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Sebina I, Ngo S, Rashid RB, Alorro M, Namubiru P, Howard D, Ahmed T, Phipps S. CXCR3 + effector regulatory T cells associate with disease tolerance during lower respiratory pneumovirus infection. Immunology 2024. [PMID: 38584001 DOI: 10.1111/imm.13790] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
Lifestyle factors like poor maternal diet or antibiotic exposure disrupt early life microbiome assembly in infants, increasing the risk of severe lower respiratory infections (sLRI). Our prior studies in mice indicated that a maternal low-fibre diet (LFD) exacerbates LRI severity in infants by impairing recruitment of plasmacytoid dendritic cells (pDC) and consequently attenuating expansion of lung regulatory T (Treg) cells during pneumonia virus of mice (PVM) infection. Here, we investigated whether maternal dietary fibre intake influences Treg cell phenotypes in the mediastinal lymph nodes (mLN) and lungs of PVM-infected neonatal mice. Using high dimensional flow cytometry, we identified distinct clusters of regulatory T cells (Treg cells), which differed between lungs and mLN during infection, with notably greater effector Treg cell accumulation in the lungs. Compared to high-fibre diet (HFD)-reared pups, frequencies of various effector Treg cell subsets were decreased in the lungs of LFD-reared pups. Particularly, recruitment of chemokine receptor 3 (CXCR3+) expressing Treg cells was attenuated in LFD-reared pups, correlating with lower lung expression of CXCL9 and CXCL10 chemokines. The recruitment of this subset in response to PVM infection was similarly impaired in pDC depleted mice or following anti-CXCR3 treatment, increasing immunopathology in the lungs. In summary, PVM infection leads to the sequential recruitment and expansion of distinct Treg cell subsets to the lungs and mLN. The attenuated recruitment of the CXCR3+ subset in LFD-reared pups increases LRI severity, suggesting that strategies to enhance pDCs or CXCL9/CXCL10 expression will lower immune-mediated pathogenesis.
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Affiliation(s)
- Ismail Sebina
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sylvia Ngo
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Ridwan B Rashid
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Mariah Alorro
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Patricia Namubiru
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Howard
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Tufael Ahmed
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Simon Phipps
- Respiratory Immunology Laboratory, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Travis HJ, Andry GV, Rutner CC, Lacy E, Derouen KJ, Maristany M, Smith AA, Greiffenstein PP. Prehospital Needle Decompression of Suspected Tension Pneumothorax: Outcomes and Consequences. Am Surg 2024:31348241241739. [PMID: 38578102 DOI: 10.1177/00031348241241739] [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] [Indexed: 04/06/2024]
Abstract
Tension pneumothorax (TPT) identified in the prehospital setting requires prehospital needle decompression (PHND). This study aimed to evaluate complications from PHND when it was performed without meeting clinical criteria. A retrospective review was performed of patients undergoing (PHND) from 2016 through 2022 at a level 1 trauma center. Patient data who received PHND were reviewed. Of 115 patients, 85 did not meet at least one clinical criterion for PHND. The majority of patients in this cohort 76 (89%) required a chest tube and 22 (25%) had an iatrogenic pneumothorax from PHND. 5 patients (6%) were admitted due to iatrogenic PHND. Two vascular injuries in this population were directly due to PHND and required emergency operative repair. This study shows the negative consequences of PHND when performed without clear indications. Several patients underwent unnecessary procedures with significant clinical consequences.
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Affiliation(s)
- Harrison J Travis
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Gilbert V Andry
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Colin C Rutner
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Elizabeth Lacy
- Division of Trauma/Critical Care Surgery Department, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Kaleb J Derouen
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Michael Maristany
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Alison A Smith
- Division of Trauma/Critical Care Surgery Department, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Patrick P Greiffenstein
- Division of Trauma/Critical Care Surgery Department, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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6
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Rischard F, Altman N, Szmuszkovicz J, Sciurba F, Berman-Rosenzweig E, Lee S, Krishnan S, Truong N, Wood J, Finn AV. Long-Term Effects of COVID-19 on the Cardiopulmonary System in Adults and Children: Current Status and Questions to be Resolved by the National Institutes of Health Researching COVID to Enhance Recovery Initiative. Chest 2024; 165:978-989. [PMID: 38185377 PMCID: PMC11026169 DOI: 10.1016/j.chest.2023.12.030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024] Open
Abstract
TOPIC IMPORTANCE Long COVID may occur in at least 10% of patients recovering from SARS-CoV-2 infection and often is associated with debilitating symptoms. Among the organ systems that might be involved in its pathogenesis, the respiratory and cardiovascular systems may be central to common symptoms seen in survivors of COVID-19, including fatigue, dyspnea, chest pain, cough, and exercise intolerance. Understand the exact symptomatology, causes, and effects of long COVID on the heart and lungs may help us to discover new therapies. To that end, the National Institutes of Health is sponsoring a national study population of diverse volunteers to support large-scale studies on the long-term effects of COVID-19. REVIEW FINDINGS The National Institutes of Health Researching COVID to Enhance Recovery (RECOVER) initiative currently is recruiting participants in the United States to answer critical questions about long COVID. The study comprises adult and pediatric cohorts as well as an electronic health record cohort. Based on symptoms, individuals undergo prespecified medical testing to understand whether abnormalities can be detected and are followed up longitudinally. Herein, we outline current understanding of the clinical symptoms and pathophysiologic features of long COVID with respect to the cardiopulmonary system in adults and children and then determine how the clinical, electronic health record, and autopsy cohorts of the RECOVER initiative will attempt to answer the most pressing questions surrounding the long-term effects of COVID-19. SUMMARY Data generated from the RECOVER initiative will provide guidance about missing gaps in our knowledge about long COVID and how they might be filled by data gathered through the RECOVER initiative.
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Affiliation(s)
- Franz Rischard
- Department of Medicine, University of Arizona, Tucson, AZ
| | - Natasha Altman
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jacqueline Szmuszkovicz
- Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Division of Cardiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Frank Sciurba
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Simon Lee
- Heart Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Sankaran Krishnan
- Boston Children's Health Physicians, New York Medical College, Valhalla, NY
| | - Ngan Truong
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - John Wood
- Department of Pediatrics and Radiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Aloke V Finn
- CVPath Institute, Gaithersburg, University of Maryland School of Medicine, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.
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7
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Liu AW, Brown Iii W, Madu NE, Maiorano AR, Bigazzi O, Medina E, Sorric C, Hays SR, Odisho AY. Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study. JMIR Mhealth Uhealth 2024; 12:e51236. [PMID: 38506896 PMCID: PMC10993125 DOI: 10.2196/51236] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/27/2023] [Accepted: 12/12/2023] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Patient engagement attrition in mobile health (mHealth) remote patient monitoring (RPM) programs decreases program benefits. Systemic disparities lead to inequities in RPM adoption and use. There is an urgent need to understand patients' experiences with RPM in the real world, especially for patients who have stopped using the programs, as addressing issues faced by patients can increase the value of mHealth for patients and subsequently decrease attrition. OBJECTIVE This study sought to understand patient engagement and experiences in an RPM mHealth intervention in lung transplant recipients. METHODS Between May 4, 2020, and November 1, 2022, a total of 601 lung transplant recipients were enrolled in an mHealth RPM intervention to monitor lung function. The predictors of patient engagement were evaluated using multivariable logistic and linear regression. Semistructured interviews were conducted with 6 of 39 patients who had engaged in the first month but stopped using the program, and common themes were identified. RESULTS Patients who underwent transplant more than 1 year before enrollment in the program had 84% lower odds of engaging (odds ratio [OR] 0.16, 95% CI 0.07-0.35), 82% lower odds of submitting pulmonary function measurements (OR 0.18, 95% CI 0.09-0.33), and 78% lower odds of completing symptom checklists (OR 0.22, 95% CI 0.10-0.43). Patients whose primary language was not English had 78% lower odds of engaging compared to English speakers (OR 0.22, 95% CI 0.07-0.67). Interviews revealed 4 prominent themes: challenges with devices, communication breakdowns, a desire for more personal interactions and specific feedback with the care team about their results, understanding the purpose of the chat, and understanding how their data are used. CONCLUSIONS Care delivery and patient experiences with RPM in lung transplant mHealth can be improved and made more equitable by tailoring outreach and enhancements toward non-English speakers and patients with a longer time between transplant and enrollment. Attention to designing programs to provide personalization through supplementary provider contact, education, and information transparency may decrease attrition rates.
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Affiliation(s)
- Andrew W Liu
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
| | - William Brown Iii
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
- Department of Medicine, University of California, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, United States
| | - Ndubuisi E Madu
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
| | - Ali R Maiorano
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
| | - Olivia Bigazzi
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
| | - Eli Medina
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
| | - Christopher Sorric
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
| | - Steven R Hays
- Department of Medicine, University of California, San Francisco, CA, United States
| | - Anobel Y Odisho
- Center for Digital Health Innovation, University of California, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
- Department of Urology, University of California, San Francisco, CA, United States
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8
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Burggren W, Fahlman A, Milsom W. Breathing patterns and associated cardiovascular changes in intermittently breathing animals: (Partially) correcting a semantic quagmire. Exp Physiol 2024. [PMID: 38502538 DOI: 10.1113/ep091784] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
Many animal species do not breathe in a continuous, rhythmic fashion, but rather display a variety of breathing patterns characterized by prolonged periods between breaths (inter-breath intervals), during which the heart continues to beat. Examples of intermittent breathing abound across the animal kingdom, from crustaceans to cetaceans. With respect to human physiology, intermittent breathing-also termed 'periodic' or 'episodic' breathing-is associated with a variety of pathologies. Cardiovascular phenomena associated with intermittent breathing in diving species have been termed 'diving bradycardia', 'submersion bradycardia', 'immersion bradycardia', 'ventilation tachycardia', 'respiratory sinus arrhythmia' and so forth. An examination across the literature of terminology applied to these physiological phenomena indicates, unfortunately, no attempt at standardization. This might be viewed as an esoteric semantic problem except for the fact that many of the terms variously used by different authors carry with them implicit or explicit suggestions of underlying physiological mechanisms and even human-associated pathologies. In this article, we review several phenomena associated with diving and intermittent breathing, indicate the semantic issues arising from the use of each term, and make recommendations for best practice when applying specific terms to particular cardiorespiratory patterns. Ultimately, we emphasize that the biology-not the semantics-is what is important, but also stress that confusion surrounding underlying mechanisms can be avoided by more careful attention to terms describing physiological changes during intermittent breathing and diving.
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Affiliation(s)
- Warren Burggren
- Developmental Integrative Biology Group, Department of Biological Sciences, University of North Texas, Denton, Texas, USA
| | - Andreas Fahlman
- Fundación Oceanogràfic, Valencia, Spain
- Kolmården Wildlife Park, Kolmården, Sweden
- IFM, Linkoping University, Linkoping, Sweden
| | - William Milsom
- Department of Zoology, University of British Columbia, Vancouver, British Columbia, Canada
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9
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Mitra S, Anand U, Ghorai M, Vellingiri B, Jha NK, Behl T, Kumar M, Radha, Shekhawat MS, Proćków J, Dey A. Corrigendum: Unravelling the therapeutic potential of botanicals against chronic obstructive pulmonary disease (COPD): molecular insights and future perspectives. Front Pharmacol 2024; 15:1365790. [PMID: 38515842 PMCID: PMC10955126 DOI: 10.3389/fphar.2024.1365790] [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: 01/05/2024] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fphar.2022.824132.].
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Affiliation(s)
- Sicon Mitra
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - Uttpal Anand
- CytoGene Research & Development LLP, Lucknow, Uttar Pradesh, India
| | - Mimosa Ghorai
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Balachandar Vellingiri
- Human Molecular Cytogenetics and Stem Cell Laboratory, Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - Tapan Behl
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Chandigarh, India
| | - Manoj Kumar
- Chemical and Biochemical Processing Division, ICAR-Central Institute for Research on Cotton Technology, Mumbai, India
| | - Radha
- School of Biological and Environmental Sciences, Shoolini University of Biotechnology and Management Sciences, Solan, India
| | - Mahipal S. Shekhawat
- Department of Plant Biology and Biotechnology, Kanchi Mamunivar Government Institute for Postgraduate Studies and Research, Puducherry, India
| | - Jarosław Proćków
- Department of Plant Biology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, India
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10
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Ayed-Boussema I, Rjiba K, M'nassri A, Hamdi H, Abid S. Subchronic exposure to fenpyroximate causes multiorgan toxicity in Wistar rats by disrupting lipid profile, inducing oxidative stress and DNA damage. Biomarkers 2024; 29:68-77. [PMID: 38299991 DOI: 10.1080/1354750x.2024.2313663] [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: 05/15/2023] [Accepted: 01/29/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Fenpyroximate (FEN) is an acaricide that inhibits the complex I of the mitochondrial respiratory chain in mites. Data concerning mammalian toxicity of this acaricide are limited; thus the aim of this work was to explore FEN toxicity on Wistar rats, particularly on cardiac, pulmonary, and splenic tissues and in bone marrow cells. METHODS rats were treated orally with FEN at 1, 2, 4, and 8 mg/Kg bw for 28 days. After treatment, we analyzed lipid profile, oxidative stress and DNA damage in rat tissues. RESULTS FEN exposure increased creatinine phosphokinase (CPK) and lactate dehydrogenase (LDH) activities, elevated total cholesterol (T-CHOL), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) concentrations, while decreasing high-density lipoprotein cholesterol (HDL-C). It inhibited acetylcholinesterase (AChE) activity, enhanced lipid peroxidation, protein oxidation, and modulated antioxidant enzymes activities (superoxide dismutase, catalase, glutathione peroxidase, and glutathione S-transferase). Comet assay indicated that FEN induced a dose-dependent DNA damage, contrasting with the micronucleus test showing no micronuclei formation. Nonetheless, FEN exhibited cytotoxicity to bone marrow cells, as evidenced by a reduction in the number of immature erythrocytes among total cells. CONCLUSION FEN appears to carry out its genotoxic and cytotoxic activities most likely through an indirect pathway that involves oxidative stress.
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Affiliation(s)
- Imen Ayed-Boussema
- Laboratory of Research on Biologically Compatible Compounds, LR01SE17, University of Monastir, Faculty of Dental Medicine, Monastir, Tunisia
- Faculty of Science of Gafsa, University of Gafsa, Gafsa, Tunisia
| | - Karima Rjiba
- Laboratory of Research on Biologically Compatible Compounds, LR01SE17, University of Monastir, Faculty of Dental Medicine, Monastir, Tunisia
- Faculty of Science of Gafsa, University of Gafsa, Gafsa, Tunisia
| | - Asma M'nassri
- Laboratory of Research on Biologically Compatible Compounds, LR01SE17, University of Monastir, Faculty of Dental Medicine, Monastir, Tunisia
- Faculty of Science of Gafsa, University of Gafsa, Gafsa, Tunisia
| | - Hiba Hamdi
- Laboratory of Research on Biologically Compatible Compounds, LR01SE17, University of Monastir, Faculty of Dental Medicine, Monastir, Tunisia
| | - Salwa Abid
- Laboratory of Research on Biologically Compatible Compounds, LR01SE17, University of Monastir, Faculty of Dental Medicine, Monastir, Tunisia
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11
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Vennu V. Association between chronic disease, sensory impairment, walking limitation, and activities of daily living of community-dwelling older Indians. Medicine (Baltimore) 2024; 103:e37318. [PMID: 38428896 PMCID: PMC10906618 DOI: 10.1097/md.0000000000037318] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/30/2024] [Indexed: 03/03/2024] Open
Abstract
Due to the paucity of existing evidence, this study aims to investigate the relationship between chronic disease, sensory impairment, walking limitation, and difficulty in activities of daily living (ADLs) in community-dwelling older Indians. This cross-sectional study included data from 31,394 individuals aged ≥ 60 years from the 2017 to 2018 Longitudinal Ageing Study in India. Participants were divided into 2 groups: 12,993 with chronic disease, sensory impairment, and a walking limitation, and 18,401 healthy individuals without such conditions. Participants with any chronic disease were further divided into 2 groups: sensory impairment (n = 12,462), and a walking limitation (n = 4745). Self-reported close-ended questionnaires with yes or no were used to assess each chronic disease (such as hypertension, diabetes, lung disorders, joint disorders, or heart disease), sensory impairment (vision or hearing), and walking limitation. A walking limitation was defined as being when a person could only walk at their usual pace for less than 500 meters on a flat surface. ADLs were assessed and classified as physical ADLs including basic physical requirements like dressing. Instrumental ADLs (IADLs) included more complicated community-based tasks like meal preparation. Findings showed that older Indians with chronic disease, sensory impairment, and a walking limitation were more likely to be significantly associated with physical ADLs (adjusted odds ratio [aOR] = 1.85, 95% confidence interval [CI] = 1.34-1.57, P < .0001) and IADLs (aOR = 1.45, 95% CI = 1.70-2.03, P < .0001) than those without such conditions. Among older Indians with chronic disease, sensory impairment was more likely associated with physical ADLs (aOR = 1.98, 95% CI = 1.82-2.16, P < .0001) and IADLs (aOR = 1.26, 95% CI = 1.15-1.37, P < .0001) followed by a walking limitation (aOR = 1.53, 95% CI = 1.42-1.65, P < .0001; aOR = 1.27, 95% CI = 1.17-1.38, P < .0001, respectively). These findings suggest that older Indians with chronic disease, sensory impairment, and walking limitation, can experience increased difficulty in overall and individual physical ADL and IADL than those without these conditions. Older Indians with any chronic condition who had sensory impairment or a walking limitation were also more likely to have difficulty with physical ADLs and IADLs.
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Affiliation(s)
- Vishal Vennu
- Department of Rehabilitation, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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12
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Mercan A, Beşe SA, Köksal ZG, Kara SS, Uysal P, Erge D. Impulse oscillometry assessment of respiratory function in pediatric patients with a history of COVID-19. Pediatr Pulmonol 2024. [PMID: 38390766 DOI: 10.1002/ppul.26926] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE While coronavirus disease 2019 (COVID-19) is generally considered to exhibit a less severe clinical course in children than in adults, studies have demonstrated that respiratory symptoms can endure for more than 3 months following infection in at least one-third of pediatric cases. The present study evaluates the respiratory functions of children aged 3-15 years within 3-6 months of their recovery from COVID-19 using impulse oscillometry (IOS) and compares them with the values of healthy children. METHODS Included in this prospective cross-sectional study were 63 patients (patient group) aged 3-15 years who contracted COVID-19 between December 2021 and May 2022, as well as 57 healthy children as a control group, matched for age and sex. The demographic, clinical, and laboratory data of the patients were recorded, and respiratory function was assessed based on airway resistance (zR5, zR20, R5-20) and reactance (zX5, zX20, reactance area [AX], resonant frequency [Fres]) using an IOS device. RESULTS There were no significant differences in the age, weight, height, and body weight z score values of the two groups (p > .05). While the zR5 and R5-20 levels of the patient group were higher (p = .008 and p < .001, respectively) than those of the controls, the zR20, AX, and Fres values did not differ significantly between the groups (p > .05). The parameters indicating the reactance, including zX5 and zX20, were significantly lower in the patient group than in the control group (p = .028 and p < .001, respectively). CONCLUSION Total and peripheral airway resistances were found to be elevated in children who had recovered from COVID-19 in the preceding 3-6 months.
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Affiliation(s)
- Adnan Mercan
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Simge Atar Beşe
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Zeynep Güleç Köksal
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Soner Sertan Kara
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Pınar Uysal
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Duygu Erge
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Aydın Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
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13
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Feng X, Shi Y, Zhang Y, Lei F, Ren R, Tang X. Opportunities and Challenges for Inhalable Nanomedicine Formulations in Respiratory Diseases: A Review. Int J Nanomedicine 2024; 19:1509-1538. [PMID: 38384321 PMCID: PMC10880554 DOI: 10.2147/ijn.s446919] [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: 11/09/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
Lungs experience frequent interactions with the external environment and have an abundant supply of blood; therefore, they are susceptible to invasion by pathogenic microorganisms and tumor cells. However, the limited pharmacokinetics of conventional drugs in the lungs poses a clinical challenge. The emergence of different nano-formulations has been facilitated by advancements in nanotechnology. Inhaled nanomedicines exhibit better targeting and prolonged therapeutic effects. Although nano-formulations have great potential, they still present several unknown risks. Herein, we review the (1) physiological anatomy of the lungs and their biological barriers, (2) pharmacokinetics and toxicology of nanomaterial formulations in the lungs; (3) current nanomaterials that can be applied to the respiratory system and related design strategies, and (4) current applications of inhaled nanomaterials in treating respiratory disorders, vaccine design, and imaging detection based on the characteristics of different nanomaterials. Finally, (5) we analyze and summarize the challenges and prospects of nanomaterials for respiratory disease applications. We believe that nanomaterials, particularly inhaled nano-formulations, have excellent prospects for application in respiratory diseases. However, we emphasize that the simultaneous toxic side effects of biological nanomaterials must be considered during the application of these emerging medicines. This study aims to offer comprehensive guidelines and valuable insights for conducting research on nanomaterials in the domain of the respiratory system.
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Affiliation(s)
- Xujun Feng
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yuan Shi
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Ye Zhang
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Fei Lei
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Rong Ren
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xiangdong Tang
- Department of Respiratory and Critical Care Medicine, Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
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14
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Yousry C, Goyal M, Gupta V. Excipients for Novel Inhaled Dosage Forms: An Overview. AAPS PharmSciTech 2024; 25:36. [PMID: 38356031 DOI: 10.1208/s12249-024-02741-w] [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: 07/22/2023] [Accepted: 01/05/2024] [Indexed: 02/16/2024] Open
Abstract
Pulmonary drug delivery is a form of local targeting to the lungs in patients with respiratory disorders like cystic fibrosis, pulmonary arterial hypertension (PAH), asthma, chronic pulmonary infections, and lung cancer. In addition, noninvasive pulmonary delivery also presents an attractive alternative to systemically administered therapeutics, not only for localized respiratory disorders but also for systemic absorption. Pulmonary delivery offers the advantages of a relatively low dose, low incidence of systemic side effects, and rapid onset of action for some drugs compared to other systemic administration routes. While promising, inhaled delivery of therapeutics is often complex owing to factors encompassing mechanical barriers, chemical barriers, selection of inhalation device, and limited choice of dosage form excipients. There are very few excipients that are approved by the FDA for use in developing inhaled drug products. Depending upon the dosage form, and inhalation devices such as pMDIs, DPIs, and nebulizers, different excipients can be used to provide physical and chemical stability and to deliver the dose efficiently to the lungs. This review article focuses on discussing a variety of excipients that have been used in novel inhaled dosage forms as well as inhalation devices.
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Affiliation(s)
- Carol Yousry
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini, Cairo, 11562, Egypt
- Department of Pharmaceutics and Industrial Pharmacy, School of Pharmacy, Newgiza University, Giza, Egypt
| | - Mimansa Goyal
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA
| | - Vivek Gupta
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John's University, 8000 Utopia Parkway, Queens, New York, 11439, USA.
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15
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Jung W, Ahn A, Lee G, Kong S, Kang D, Lee D, Kim TE, Shim YM, Kim HK, Cho J, Cho J, Shin DW. Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial. JMIR Res Protoc 2024; 13:e54707. [PMID: 38349712 PMCID: PMC10900087 DOI: 10.2196/54707] [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: 11/20/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Lung cancer diagnosis affects an individual's quality of life as well as physical and emotional functioning. Information on survivorship care tends to be introduced at the end of treatment, but early intervention may affect posttreatment adjustment. However, to the best of our knowledge, no study has explored the effect of early information intervention on the return to work, family, and societal roles of lung cancer survivors. OBJECTIVE We report the study protocol of a comprehensive care prehabilitation intervention designed to facilitate lung cancer survivors' psychological adjustment after treatment. METHODS A comprehensive care program was developed based on a literature review and a qualitative study of patients with lung cancer and health professionals. The Lung Cancer Comprehensive Care Program consists of educational videos and follow-up visits by a family medicine physician. To prevent contamination, the control group received routine education, whereas the intervention group received routine care and intervention. Both groups completed questionnaires before surgery (T0) and at 1-month (T1), 6-month (T2), and 1-year (T3) follow-up visits after surgery. The primary outcome was survivors' psychological adjustment to cancer 6 months after pulmonary resection. RESULTS The historical control group (n=441) was recruited from September 8, 2021, to April 20, 2022, and the intervention group (n=350) was recruited from April 22, 2022, to October 17, 2022. All statistical analyses will be performed upon completion of the study. CONCLUSIONS This study examined the effectiveness of an intervention that provided general and tailored informational support to lung cancer survivors, ranging from before to the end of treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT05078918; https://clinicaltrials.gov/ct2/show/NCT05078918. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54707.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Alice Ahn
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, United States
| | - Genehee Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Sunga Kong
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Danbee Kang
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Dongok Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Tae Eun Kim
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jongho Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Juhee Cho
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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16
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Swift J, O'Kelly N, Barker C, Woodward A, Ghosh S. A Digital Respiratory Ward in Leicester, Leicestershire, and Rutland, England, for Patients With COVID-19: Economic Evaluation of the Impact on Acute Capacity and Wider National Health Service Resource Use. JMIR Form Res 2024; 8:e47441. [PMID: 38349716 PMCID: PMC10866202 DOI: 10.2196/47441] [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: 03/22/2023] [Revised: 12/04/2023] [Accepted: 12/22/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic stressed global health care systems' acute capacity and caused a diversion of resources from elective care to the treatment of acute respiratory disease. In preparing for a second wave of COVID-19 infections, England's National Health Service (NHS) in Leicester, Leicestershire, and Rutland sought to protect acute capacity in the winter of 2020-2021. Their plans included the introduction of a digital ward where patients were discharged home early and supported remotely by community-based respiratory specialists, who were informed about patient health status by a digital patient monitoring system. OBJECTIVE The objective of the digital ward was to maintain acute capacity through safe, early discharge of patients with COVID-19 respiratory disease. The study objective was to establish what impact this digital ward had on overall NHS resource use. METHODS There were no expected differences in patient outcomes. A cost minimization was performed to demonstrate the impact on the NHS resource use from discharging patients into a digital COVID-19 respiratory ward, compared to acute care length of stay (LOS). This evaluation included all 310 patients enrolled in the service from November 2020 (service commencement) to November 2021. Two primary methods, along with sensitivity analyses, were used to help overcome the uncertainty associated with the estimated comparators for the observational data on COVID-19 respiratory acute LOS, compared with the actual LOS of the 279 (90%) patients who were not discharged on oxygen nor were in critical care. Historic comparative LOS and an ordinary least squares model based on local monthly COVID-19 respiratory median LOS were used as comparators. Actual comparator data were sourced for the 31 (10%) patients who were discharged home and into the digital ward for oxygen weaning. Resource use associated with delivering care in the digital ward was sourced from the digital system and respiratory specialists. RESULTS In the base case, the digital ward delivered estimated health care system savings of 846.5 bed-days and US $504,197 in net financial savings across the 2 key groups of patients-those on oxygen and those not on oxygen at acute discharge (both P<.001). The mean gross and net savings per patient were US $1850 and US $1626 in the base case, respectively, without including any savings associated with a potential reduction in readmissions. The 30-day readmission rate was 2.9%, which was below comparative data. The mean cost of the intervention was US $223.53 per patient, 12.1% of the estimated gross savings. It was not until the costs were increased and the effect reduced simultaneously by 78.4% in the sensitivity analysis that the intervention was no longer cost saving. CONCLUSIONS The digital ward delivered increased capacity and substantial financial savings and did so with a high degree of confidence, at a very low absolute and relative cost.
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Affiliation(s)
- Jim Swift
- Spirit Health, Leicester, United Kingdom
| | | | | | - Alex Woodward
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Sudip Ghosh
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
- Department of Allied Health Sciences, De Montford University, Leicester, United Kingdom
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17
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Drigot ZG, Clark SE. Insights into the role of the respiratory tract microbiome in defense against bacterial pneumonia. Curr Opin Microbiol 2024; 77:102428. [PMID: 38277901 PMCID: PMC10922932 DOI: 10.1016/j.mib.2024.102428] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/28/2024]
Abstract
The respiratory tract microbiome (RTM) is a microbial ecosystem inhabiting different niches throughout the airway. A critical role for the RTM in dictating lung infection outcomes is underlined by recent efforts to identify community members benefiting respiratory tract health. Obligate anaerobes common in the oropharynx and lung such as Prevotella and Veillonella are associated with improved pneumonia outcomes and activate several immune defense pathways in the lower airway. Colonizers of the nasal cavity, including Corynebacterium and Dolosigranulum, directly impact the growth and virulence of lung pathogens, aligning with robust clinical correlations between their upper airway abundance and reduced respiratory tract infection risk. Here, we highlight recent work identifying respiratory tract bacteria that promote airway health and resilience against disease, with a focus on lung infections and the underlying mechanisms driving RTM-protective benefits.
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Affiliation(s)
- Zoe G Drigot
- University of Colorado School of Medicine, Department of Otolaryngology, Aurora, CO 80045, USA
| | - Sarah E Clark
- University of Colorado School of Medicine, Department of Otolaryngology, Aurora, CO 80045, USA.
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18
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Antia M, Ezejiofor AN, Orish CN, Cirovic A, Cirovic A, Orisakwe OE. Selenium and zinc supplementation mitigates metals-(loids) mixture- mediated cardiopulmonary toxicity via attenuation of antioxidant, anti-inflammatory and antiapoptotic mechanisms in female Sprague Dawley rats. Toxicol Res (Camb) 2024; 13:tfad119. [PMID: 38179003 PMCID: PMC10762678 DOI: 10.1093/toxres/tfad119] [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: 08/28/2023] [Revised: 11/01/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
This study evaluated the cardiopulmonary protective effects of essential elements (Zn and Se) against heavy metals mixture (HMM) exposure. Twenty five female Sprague Dawley albino rats, divided in to five groups: controls were orally treated only with distilled water; next, group 2 was exposed to HMM with the following concentrations: 20 mg/kg of Pb body weight, 0.40 mg/kg of Hg, 0.56 mg/kg of Mn, and 35 mg/kg of Al. Groups 3, 4 and 5 were exposed to HMM and co-treated with zinc chloride (ZnCl2; 0.80 mg/kg), sodium selenite (Na2SeO3;1.50 mg/kg) and both zinc chloride and sodium selenite, respectively. The experiment lasted for 60 days. Afterwards animals were sacrificed, and we conduced biochemical and histopathological examination of the heart and lungs. HMM only exposed animals had an increased levels of malondialdehyde (MDA) and nitric oxide (NO), increased IL-6 and TNF-α, attenuated SOD, GPx, CAT and GSH and caspase 3 in the heart and lungs. HMM affected NF-kB and Nrf2 in the heart muscle with histomorphological alterations. Zn and Se attenuated adverse effects of HMM exposure. Essential element supplementation ameliorated heavy metal cardiopulmonary intoxication in rats.
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Affiliation(s)
- Mfoniso Antia
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, East West Road, Choba, Port Harcourt, Rivers State, Choba 5323, Nigeria
| | - Anthonet N Ezejiofor
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, East West Road, Choba, Port Harcourt, Rivers State, Choba 5323, Nigeria
| | - Chinna N Orish
- Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, University of Port Harcourt, PMB, East West Road, Choba, Port Harcourt, Rivers State, Choba 5323, Nigeria
| | - Ana Cirovic
- Faculty of Medicine, The Institute of Anatomy, University of Belgrade, East West Road, Choba, Port Harcourt, Rivers State Belgrade, Serbia
| | - Aleksandar Cirovic
- Faculty of Medicine, The Institute of Anatomy, University of Belgrade, East West Road, Choba, Port Harcourt, Rivers State Belgrade, Serbia
| | - Orish E Orisakwe
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, East West Road, Choba, Port Harcourt, Rivers State, Choba 5323, Nigeria
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Maakestad R. On creation, pneumothorax, death, and the breath of God. Anat Sci Educ 2024. [PMID: 38273458 DOI: 10.1002/ase.2381] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/04/2023] [Accepted: 01/01/2024] [Indexed: 01/27/2024]
Affiliation(s)
- Robbie Maakestad
- Literature, Journalism, Writing, and Languages Department, Point Loma Nazarene University, San Diego, California, USA
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Alhajery MA. Rheumatoid Arthritis With Multiple Lung Nodules: A Case Report. Cureus 2024; 16:e52350. [PMID: 38361708 PMCID: PMC10867547 DOI: 10.7759/cureus.52350] [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: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Rheumatoid arthritis (RA) is an inflammatory multisystemic disease characterized by erosive arthritis with many extra-articular manifestations. Pleuropulmonary manifestations are frequently seen in patients with RA. Risk factors include male gender, severe erosive arthritis, high titers of rheumatoid factor, subcutaneous nodules, smoking, genetic predisposition, and the presence of other extra-articular manifestations of RA. We report a patient known to have RA presenting with multiple lung nodules. A 35-year-old female patient, known to have seropositive RA, was diagnosed 10 years ago. She was on oral corticosteroids (OCS) 5 mg daily, Upadacitinib 15 mg daily, and methotrexate (MTX) 20 mg weekly. The patient was referred for pulmonary medicine evaluation because of the finding of multiple lung nodules on chest imaging. A routine chest X-ray conducted as a part of the general evaluation showed a nodular opacity in the right lower lobe. Subsequently, a high-resolution CT (HRCT) scan of the chest was carried out and showed multiple pulmonary nodules. At the time of evaluation, she had no active respiratory symptoms with no signs of respiratory distress. As she was an active smoker, the decision was to proceed with a CT-guided biopsy besides full clinical, hematological, biochemical, and microbiological evaluations. The histopathological findings suggested a rheumatoid nodule with no evidence of malignant or infectious causes. No specific therapy was added at the time being, and the patient was monitored with regular follow-ups. Differentiation of rheumatoid lung nodules from other causes, such as malignancy and infectious causes, is essential. A biopsy with histopathological evaluation is a must in those with a high likelihood of malignancy, such as smokers. In addition to that, comprehensive clinical, hematological, microbiological, and radiological evaluations are required. Rheumatoid lung nodules are usually asymptomatic, with no specific therapy needed apart from the general management of RA with glucocorticoid, immunosuppressive, and biologic therapies.
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Affiliation(s)
- Mohammad A Alhajery
- Department of Internal Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
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21
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Zarubin EA, Kogan EA, Zharkov NV, Avdalyan AM, Procenko DN. [Exosomes' role in intercellular interactions in different variants of lung injury in fatal cases of COVID-19]. Arkh Patol 2024; 86:22-29. [PMID: 38591903 DOI: 10.17116/patol20248602122] [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] [Indexed: 04/10/2024]
Abstract
BACKGROUND Extracellular vesicles are surrounded by a phospholipid bilayer, carrying various active biomolecules and participating in many physiological and pathological processes, including infectious ones. OBJECTIVE To research the role of exosomes in intercellular interactions in the pathogenesis of various types of lung damage in fatal cases of COVID-19. MATERIAL AND METHODS We conducted a clinical and morphological analysis of 118 fatal cases caused by coronavirus infection in Moscow. We selected 32 cases with morphological signs of various types of lung lesions for immunohistochemical reaction (IHC) with antibodies against tetraspanin proteins (CD63, CD81), which are involved in the assembly of exosomes, as well as with antibodies against viral proteins: nucleocapsid and spike protein. We determined the main producing cells of extracellular vesicles and cells containing viral proteins, carried out their comparison and quantitative analysis. RESULTS IHC reaction with antibodies against CD63 showed cytoplasmic granular uniform and subapical staining of cells, as well as granular extracellular staining. We determined similar staining using antibodies against viral proteins. Extracellular vesicles were found in the same cells as viral proteins. The main producing cells of vesicles and cells containing viral proteins were found to be macrophages, type II pneumocytes, and endothelial cells. CONCLUSION Taking into account the results of the literature, the localization of viral proteins and extracellular vesicles in the same cells indicates the key role of vesicles in the pathogenesis of various forms of lung damage by the SARS-CoV-2 virus, in the dissemination of the pathogen in the organism, which leads to interaction with the adaptive immune system and the formation of immunity.
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Affiliation(s)
- E A Zarubin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia
| | - E A Kogan
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - N V Zharkov
- Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia
| | - A M Avdalyan
- Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia
| | - D N Procenko
- Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia
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22
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Nasyrov RA, Galichina VA, Timchenko VN, Krasnogorskaya OL, Chepelev AS, Fedotova EP, Sidorova NA, Agafonnikova AA, Anichkov NM. [Lung pathology in children with a long-term novel coronavirus infection COVID-19]. Arkh Patol 2024; 86:36-43. [PMID: 38319270 DOI: 10.17116/patol20248601136] [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] [Indexed: 02/07/2024]
Abstract
New coronavirus infection is registered less frequently in children than in adults. Among all patients with COVID-19, the share of children is 8.6%. Clinical practice shows that in children, COVID-19 can be severe and even fatal. Articles have been published reflecting the clinical manifestations of Long Covid in children, while data on pathomorphological examination of the lungs during long-term COVID-19 in children are not available in the literature. On the basis of the Department of Pathological Anatomy with a course of Forensic Medicine and the Pathological-Anatomical Department of the Clinic of St. Petersburg State Pediatric Medical University, an analysis of medical documentation was carried out, autopsy materials were selected from 3 observations of the death of children from COVID-19. The selection criterion was the duration of the disease. A histological examination using standard methods and IHC analysis using antibodies to the nucleocapsid of SARS-Cov-2, CD95, CD31 were carried out on the lung tissue of 3 children aged 2 months to 2 years who died from a new coronavirus infection. Microscopically, all three patients showed microvessels damage, their thrombosis, angiogenesis, as well as signs of diffuse alveolar damage The combination of expression of the SARS-CoV-2 nucleocapsid and the apoptosis marker on the vascular endothelium of the MCR is of interest. CONCLUSION The data obtained indicate infection with coronavirus and death of endothelial cells due to apoptosis. Endothelial damage in the microvessels of the lungs is the initiating factor in the development of capillary-alveolar block, tissue hypoxia, and disseminated intravascular coagulation syndrome, leading in some cases to respiratory/multiple organ failure and death.
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Affiliation(s)
- R A Nasyrov
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - V A Galichina
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - V N Timchenko
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - O L Krasnogorskaya
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - A S Chepelev
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - E P Fedotova
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - N A Sidorova
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - A A Agafonnikova
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
| | - N M Anichkov
- St. Petersburg State Pediatric Medical University, Saint Petersburg, Russia
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23
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Wierzbicka A, Semik-Gurgul E, Świątkiewicz M, Szmatoła T, Steg A, Oczkowicz M. Changes in DNA Methylation and mRNA Expression in Lung Tissue after Long-Term Supplementation with an Increased Dose of Cholecalciferol. Int J Mol Sci 2023; 25:464. [PMID: 38203636 PMCID: PMC10778667 DOI: 10.3390/ijms25010464] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
Maintaining an appropriate concentration of vitamin D is essential for the proper functioning of the body, regardless of age. Nowadays, there are more and more indications that vitamin D supplementation at higher than standard doses may show protective and therapeutic effects. Our study identified differences in the body's response to long-term supplementation with cholecalciferol at an increased dose. Two groups of pigs were used in the experiment. The first group received a standard dose of cholecalciferol (grower, 2000 IU/kg feed, and finisher, 1500 IU/kg feed), and the second group received an increased dose (grower, 3000 IU/kg feed, and finisher, 2500 IU/kg feed). After slaughter, lung samples were collected and used for RRBS and mRNA sequencing. Analysis of the methylation results showed that 2349 CpG sites had significantly altered methylation patterns and 1116 (47.51%) identified DMSs (Differentially Methylated Sites) were related to genes and their regulatory sites. The mRNA sequencing results showed a significant change in the expression of 195 genes. The integrated analysis identified eleven genes with DNA methylation and mRNA expression differences between the analyzed groups. The results of this study suggested that an increased vitamin D intake may be helpful for the prevention of lung cancer and pulmonary fibrosis. These actions may stem from the influence of vitamin D on the expression of genes associated with collagen production, such as SHMT1, UGT1A6, and ITIH2.The anti-cancer properties of vitamin D are also supported by changes in KLHL3 and TTPA gene expression.
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Affiliation(s)
- Alicja Wierzbicka
- Department of Animal Molecular Biology, National Research Institute of Animal Production, ul. Krakowska 1, 32-083 Balice, Poland; (A.W.); (E.S.-G.); (T.S.); (A.S.)
| | - Ewelina Semik-Gurgul
- Department of Animal Molecular Biology, National Research Institute of Animal Production, ul. Krakowska 1, 32-083 Balice, Poland; (A.W.); (E.S.-G.); (T.S.); (A.S.)
| | - Małgorzata Świątkiewicz
- Department of Animal Nutrition and Feed Science, National Research Institute of Animal Production, ul. Krakowska 1, 32-083 Balice, Poland;
| | - Tomasz Szmatoła
- Department of Animal Molecular Biology, National Research Institute of Animal Production, ul. Krakowska 1, 32-083 Balice, Poland; (A.W.); (E.S.-G.); (T.S.); (A.S.)
- Center for Experimental and Innovative Medicine, The University of Agriculture in Kraków, Rędzina 1c, 30-248 Kraków, Poland
| | - Anna Steg
- Department of Animal Molecular Biology, National Research Institute of Animal Production, ul. Krakowska 1, 32-083 Balice, Poland; (A.W.); (E.S.-G.); (T.S.); (A.S.)
| | - Maria Oczkowicz
- Department of Animal Molecular Biology, National Research Institute of Animal Production, ul. Krakowska 1, 32-083 Balice, Poland; (A.W.); (E.S.-G.); (T.S.); (A.S.)
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24
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Visani de Luna LA, Loret T, He Y, Legnani M, Lin H, Galibert AM, Fordham A, Holme S, Del Rio Castillo AE, Bonaccorso F, Bianco A, Flahaut E, Kostarelos K, Bussy C. Pulmonary Toxicity of Boron Nitride Nanomaterials Is Aspect Ratio Dependent. ACS Nano 2023; 17:24919-24935. [PMID: 38051272 PMCID: PMC10753895 DOI: 10.1021/acsnano.3c06599] [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] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 12/07/2023]
Abstract
Boron nitride (BN) nanomaterials have drawn a lot of interest in the material science community. However, extensive research is still needed to thoroughly analyze their safety profiles. Herein, we investigated the pulmonary impact and clearance of two-dimensional hexagonal boron nitride (h-BN) nanosheets and boron nitride nanotubes (BNNTs) in mice. Animals were exposed by single oropharyngeal aspiration to h-BN or BNNTs. On days 1, 7, and 28, bronchoalveolar lavage (BAL) fluids and lungs were collected. On one hand, adverse effects on lungs were evaluated using various approaches (e.g., immune response, histopathology, tissue remodeling, and genotoxicity). On the other hand, material deposition and clearance from the lungs were assessed. Two-dimensional h-BN did not cause any significant immune response or lung damage, although the presence of materials was confirmed by Raman spectroscopy. In addition, the low aspect ratio h-BN nanosheets were internalized rapidly by phagocytic cells present in alveoli, resulting in efficient clearance from the lungs. In contrast, high aspect ratio BNNTs caused a strong and long-lasting inflammatory response, characterized by sustained inflammation up to 28 days after exposure and the activation of both innate and adaptive immunity. Moreover, the presence of granulomatous structures and an indication of ongoing fibrosis as well as DNA damage in the lung parenchyma were evidenced with these materials. Concurrently, BNNTs were identified in lung sections for up to 28 days, suggesting long-term biopersistence, as previously demonstrated for other high aspect ratio nanomaterials with poor lung clearance such as multiwalled carbon nanotubes (MWCNTs). Overall, we reveal the safer toxicological profile of BN-based two-dimensional nanosheets in comparison to their nanotube counterparts. We also report strong similarities between BNNTs and MWCNTs in lung response, emphasizing their high aspect ratio as a major driver of their toxicity.
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Affiliation(s)
- Luis Augusto Visani de Luna
- Nanomedicine
Lab, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science
Centre, Manchester M13 9PT, U.K.
- National
Graphene Institute, The University of Manchester, Manchester, M13 9PL, U.K.
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, The University of Manchester,
Manchester Academic Health Science Centre, Manchester M13 9PT, U.K.
| | - Thomas Loret
- Nanomedicine
Lab, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science
Centre, Manchester M13 9PT, U.K.
- National
Graphene Institute, The University of Manchester, Manchester, M13 9PL, U.K.
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, The University of Manchester,
Manchester Academic Health Science Centre, Manchester M13 9PT, U.K.
| | - Yilin He
- CNRS,
Immunology, Immunopathology and Therapeutic Chemistry, UPR 3572, University
of Strasbourg, ISIS, 67000 Strasbourg, France
| | - Morgan Legnani
- CIRIMAT,
Université Toulouse 3 Paul Sabatier, Toulouse INP, CNRS, Université
de Toulouse, 118 Route de Narbonne, 31062 Toulouse cedex 9, France
| | - Hazel Lin
- CNRS,
Immunology, Immunopathology and Therapeutic Chemistry, UPR 3572, University
of Strasbourg, ISIS, 67000 Strasbourg, France
| | - Anne Marie Galibert
- CIRIMAT,
Université Toulouse 3 Paul Sabatier, Toulouse INP, CNRS, Université
de Toulouse, 118 Route de Narbonne, 31062 Toulouse cedex 9, France
| | - Alexander Fordham
- Nanomedicine
Lab, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science
Centre, Manchester M13 9PT, U.K.
- National
Graphene Institute, The University of Manchester, Manchester, M13 9PL, U.K.
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, The University of Manchester,
Manchester Academic Health Science Centre, Manchester M13 9PT, U.K.
| | - Sonja Holme
- Nanomedicine
Lab, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science
Centre, Manchester M13 9PT, U.K.
- National
Graphene Institute, The University of Manchester, Manchester, M13 9PL, U.K.
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, The University of Manchester,
Manchester Academic Health Science Centre, Manchester M13 9PT, U.K.
| | | | - Francesco Bonaccorso
- BeDimensional
S.p.A., Lungo Torrente
Secca 30r, 16163 Genoa, Italy
- Istituto
Italiano di Tecnologia, Graphene Laboratories, Via Morego 30, 16163 Genoa, Italy
| | - Alberto Bianco
- CNRS,
Immunology, Immunopathology and Therapeutic Chemistry, UPR 3572, University
of Strasbourg, ISIS, 67000 Strasbourg, France
| | - Emmanuel Flahaut
- CIRIMAT,
Université Toulouse 3 Paul Sabatier, Toulouse INP, CNRS, Université
de Toulouse, 118 Route de Narbonne, 31062 Toulouse cedex 9, France
| | - Kostas Kostarelos
- Nanomedicine
Lab, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science
Centre, Manchester M13 9PT, U.K.
- National
Graphene Institute, The University of Manchester, Manchester, M13 9PL, U.K.
- Catalan
Institute of Nanoscience and Nanotechnology (ICN2), CSIC and BIST,, Campus UAB, Bellaterra, 08193 Barcelona, Spain
| | - Cyrill Bussy
- Nanomedicine
Lab, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science
Centre, Manchester M13 9PT, U.K.
- National
Graphene Institute, The University of Manchester, Manchester, M13 9PL, U.K.
- Lydia
Becker Institute of Immunology and Inflammation, Faculty of Biology,
Medicine and Health, The University of Manchester,
Manchester Academic Health Science Centre, Manchester M13 9PT, U.K.
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25
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Zayou L, Prakash S, Dhanushkodi NR, Quadiri A, Ibraim IC, Singer M, Salem A, Shaik AM, Suzer B, Chilukuri A, Tran J, Nguyen PC, Sun M, Hormi-Carver KK, Belmouden A, Vahed H, Gil D, Ulmer JB, BenMohamed L. A multi-epitope/CXCL11 prime/pull coronavirus mucosal vaccine boosts the frequency and the function of lung-resident memory CD4 + and CD8 + T cells and enhanced protection against COVID-19-like symptoms and death caused by SARS-CoV-2 infection. J Virol 2023; 97:e0109623. [PMID: 38038432 PMCID: PMC10734477 DOI: 10.1128/jvi.01096-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/20/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023] Open
Abstract
IMPORTANCE Although the current rate of SARS-CoV-2 infections has decreased significantly, COVID-19 still ranks very high as a cause of death worldwide. As of October 2023, the weekly mortality rate is still at 600 deaths in the United States alone, which surpasses even the worst mortality rates recorded for influenza. Thus, the long-term outlook of COVID-19 is still a serious concern outlining the need for the next-generation vaccine. This study found that a prime/pull coronavirus vaccine strategy increased the frequency of functional SARS-CoV-2-specific CD4+ and CD8+ memory T cells in the lungs of SARS-CoV-2-infected triple transgenic HLA-DR*0101/HLA-A*0201/hACE2 mouse model, thereby resulting in low viral titer and reduced COVID-19-like symptoms.
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Affiliation(s)
- Latifa Zayou
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
- Laboratory of Cell Biology and Molecular Genetics, Faculty of Sciences, Ibn Zohr University, Agadir, Morocco
| | - Swayam Prakash
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Nisha Rajeswari Dhanushkodi
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Afshana Quadiri
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Izabela Coimbra Ibraim
- High containment facility, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Mahmoud Singer
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Amirah Salem
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Amin Mohammed Shaik
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Berfin Suzer
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Amruth Chilukuri
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Jennifer Tran
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Pauline Chau Nguyen
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Miyo Sun
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Kathy K. Hormi-Carver
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Ahmed Belmouden
- Laboratory of Cell Biology and Molecular Genetics, Faculty of Sciences, Ibn Zohr University, Agadir, Morocco
| | - Hawa Vahed
- Department of Vaccines and Immunotherapies, TechImmune, LLC, University Lab Partners, Irvine, California, USA
| | - Daniel Gil
- Department of Vaccines and Immunotherapies, TechImmune, LLC, University Lab Partners, Irvine, California, USA
| | - Jeffrey B. Ulmer
- Department of Vaccines and Immunotherapies, TechImmune, LLC, University Lab Partners, Irvine, California, USA
| | - Lbachir BenMohamed
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, California, USA
- Department of Vaccines and Immunotherapies, TechImmune, LLC, University Lab Partners, Irvine, California, USA
- Department of Molecular Biology and Biochemistry, University of California Irvine, Irvine, California, USA
- Institute for Immunology, School of Medicine, University of California Irvine, Irvine, California, USA
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26
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Lee AR, Park H, Yoo A, Kim S, Sunwoo L, Yoo S. Risk Prediction of Emergency Department Visits in Patients With Lung Cancer Using Machine Learning: Retrospective Observational Study. JMIR Med Inform 2023; 11:e53058. [PMID: 38055320 PMCID: PMC10733827 DOI: 10.2196/53058] [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: 09/24/2023] [Revised: 10/31/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Patients with lung cancer are among the most frequent visitors to emergency departments due to cancer-related problems, and the prognosis for those who seek emergency care is dismal. Given that patients with lung cancer frequently visit health care facilities for treatment or follow-up, the ability to predict emergency department visits based on clinical information gleaned from their routine visits would enhance hospital resource utilization and patient outcomes. OBJECTIVE This study proposed a machine learning-based prediction model to identify risk factors for emergency department visits by patients with lung cancer. METHODS This was a retrospective observational study of patients with lung cancer diagnosed at Seoul National University Bundang Hospital, a tertiary general hospital in South Korea, between January 2010 and December 2017. The primary outcome was an emergency department visit within 30 days of an outpatient visit. This study developed a machine learning-based prediction model using a common data model. In addition, the importance of features that influenced the decision-making of the model output was analyzed to identify significant clinical factors. RESULTS The model with the best performance demonstrated an area under the receiver operating characteristic curve of 0.73 in its ability to predict the attendance of patients with lung cancer in emergency departments. The frequency of recent visits to the emergency department and several laboratory test results that are typically collected during cancer treatment follow-up visits were revealed as influencing factors for the model output. CONCLUSIONS This study developed a machine learning-based risk prediction model using a common data model and identified influencing factors for emergency department visits by patients with lung cancer. The predictive model contributes to the efficiency of resource utilization and health care service quality by facilitating the identification and early intervention of high-risk patients. This study demonstrated the possibility of collaborative research among different institutions using the common data model for precision medicine in lung cancer.
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Affiliation(s)
- Ah Ra Lee
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Hojoon Park
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Aram Yoo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Seok Kim
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Business, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
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27
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Reichard A, Wanner N, Farha S, Asosingh K. Hematopoietic stem cells and extramedullary hematopoiesis in the lungs. Cytometry A 2023; 103:967-977. [PMID: 37807901 PMCID: PMC10841540 DOI: 10.1002/cyto.a.24804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/13/2023] [Revised: 08/02/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023]
Abstract
Hematopoietic stem cells are key players in hematopoiesis as the body maintains a physiologic steady state, and the signaling pathways and control mechanisms of these dynamic cells are implicated in processes from inflammation to cancer. Although the bone marrow is commonly regarded as the site of hematopoiesis and hematopoietic stem cell residence, these cells also circulate in the blood and reside in extramedullary tissues, including the lungs. Flow cytometry is an invaluable tool in evaluating hematopoietic stem cells, revealing their phenotypes and relative abundances in both healthy and diseased states. This review outlines current protocols and cell markers used in flow cytometric analysis of hematopoietic stem and progenitor cell populations. Specific niches within the bone marrow are discussed, as are metabolic processes that contribute to stem cell self-renewal and differentiation, as well as the role of hematopoietic stem cells outside of the bone marrow at physiologic steady state. Finally, pulmonary extramedullary hematopoiesis and its associated disease states are outlined. Hematopoiesis in the lungs is a new and emerging concept, and discovering ways in which the study of lung-resident hematopoietic stem cells can be translated from murine models to patients will impact clinical treatment.
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Affiliation(s)
- Andrew Reichard
- Department of Inflammation and Immunity, Lerner Research Institute, The Cleveland Clinic, Cleveland, OH, USA
| | - Nicholas Wanner
- Department of Inflammation and Immunity, Lerner Research Institute, The Cleveland Clinic, Cleveland, OH, USA
| | - Samar Farha
- Department of Inflammation and Immunity, Lerner Research Institute, The Cleveland Clinic, Cleveland, OH, USA
- Respiratory Institute, The Cleveland Clinic, Cleveland, OH, USA
| | - Kewal Asosingh
- Department of Inflammation and Immunity, Lerner Research Institute, The Cleveland Clinic, Cleveland, OH, USA
- Flow Cytometry Shared Laboratory Resource, Lerner Research Institute, The Cleveland Clinic, Cleveland, OH, USA
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28
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Lamb T, Kaur G, Rahman I. Tobacco-Derived and Tobacco-Free Nicotine cause differential inflammatory cell influx and MMP9 in mouse lung. Res Sq 2023:rs.3.rs-3650978. [PMID: 38077054 PMCID: PMC10705704 DOI: 10.21203/rs.3.rs-3650978/v1] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Electronic nicotine delivery systems (ENDS) or electronic cigarettes (e-cigarettes) have propylene glycol (PG) and vegetable glycerin (VG) as humectants, flavoring chemicals, and nicotine. Nicotine naturally occurs in two isomers R- and S-nicotine, with both tobacco-derived nicotine (TDN) composed of S-nicotine and synthetic nicotine (TFN) composed of a racemic mixture of R- and S-nicotine. Currently there is limited knowledge of the potential differences in the toxicity of TFN vs TDN. We hypothesized that exposure of TFN salts to C57BL/6J mice will result in a differential response in inflammation and lung protease and antiprotease imbalance compared to TDN salts exposed mice. We studied the toxicological impact of these isomers by exposing mice to air, PG/VG, PG/VG with TFN salts, or PG/VG with TDN salts by nose-only exposure and measured the cytokine levels in BALF and lung homogenate along with MMP protein abundance in the lungs of exposed mice. Exposure to the humectants, PG/VG, used in e-cigarettes alone was able to increase cytokine levels-IL-6, KC, and MCP-1 in BALF and KC levels in lung homogenate. Further, it showed differential responses on exposure to PG/VG with TDN salts and PG/VG with TFN salts since PG/VG with TDN salts did not alter the cytokine levels in lung homogenate while PG/VG with TFN salts resulted in an increase in KC levels. PG/VG with TDN salts increased the levels of MMP9 protein abundance in female exposed mice, while PG/VG with TFN salts did not alter MMP9 levels in female mice. The metabolism of nicotine or the clearance of cotinine from TFN may differ from the metabolism of nicotine or the clearance of cotinine from TDN. Thus exposure of humectants alone to induce an inflammatory response while PG/VG with TFN salts and PG/VG with TDN salts may differentially alter inflammatory responses and lung proteases in acute exposures. These data suggest the harmful effects of synthetic/natural nicotine and PG/VG and potential toxicological risk for users.
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29
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Nasyrov RA, Ivanov DO, Krasnogorskaya OL, Timchenko VN, Fedotova EP, Chepelev AS, Galichina VA, Sidorova NA, Anichkov NM. COVID-19 in Children: Molecular Profile and Pathological Features. Int J Mol Sci 2023; 24:16750. [PMID: 38069078 PMCID: PMC10706827 DOI: 10.3390/ijms242316750] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Although the World Health Organization has declared the end of the COVID-19 pandemic, doctors continue to register new cases of the disease among both adults and children. Unfortunately, the course of COVID-19 in children can have a severe form, with death being a potential outcome. The absence of published works discussing the pathological morphology of COVID-19 in children prevents the objective analysis of the disease's pathogenesis, including among the adult population. In this vein, the objective of our study is to identify the morphological features of the lungs' involvement and evaluate virus-host interactions in the case of COVID-19 in patients at a pediatric medical practice. We present the results of the study of the lungs of three children who died due to COVID-19, highlighting the predominant involvement of their respiratory organs at different stages of the disease (5, 21, and 50 days). This article presents data obtained from histopathological and immunohistochemical investigations, taking into account the results of clinical and laboratory indicators and intravital and postmortem SARS-CoV-2 PCR investigations. The common finding of all of the examined COVID-19 cases is the involvement of the endothelium in microcirculation vessels, which are considered to be a primary target of various pathogenic influencing factors. We also discuss both the significance of apoptosis as a result of virus-host interactions and the most likely cause of endothelium cell destruction. The results of this study could be useful for the development of endothelium-protective therapy to prevent the progression of disseminated intravascular coagulation syndrome.
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Affiliation(s)
- Ruslan A. Nasyrov
- The Prof. D.D. Lohov Department of Pathological Anatomy with Course of Forensic Medicine, Saint Petersburg State Pediatric Medical University Ministry of Public Health Care of the Russian Federation, St. Litovskaya, 2, 194100 St. Petersburg, Russia; (D.O.I.); (O.L.K.); (V.N.T.); (E.P.F.); (A.S.C.); (V.A.G.); (N.A.S.); (N.M.A.)
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Althobiani MA, Ranjan Y, Jacob J, Orini M, Dobson RJB, Porter JC, Hurst JR, Folarin AA. Evaluating a Remote Monitoring Program for Respiratory Diseases: Prospective Observational Study. JMIR Form Res 2023; 7:e51507. [PMID: 37999935 DOI: 10.2196/51507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/07/2023] [Revised: 09/23/2023] [Accepted: 10/20/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Patients with chronic respiratory diseases and those in the postdischarge period following hospitalization because of COVID-19 are particularly vulnerable, and little is known about the changes in their symptoms and physiological parameters. Continuous remote monitoring of physiological parameters and symptom changes offers the potential for timely intervention, improved patient outcomes, and reduced health care costs. OBJECTIVE This study investigated whether a real-time multimodal program using commercially available wearable technology, home-based Bluetooth-enabled spirometers, finger pulse oximeters, and smartphone apps is feasible and acceptable for patients with chronic respiratory diseases, as well as the value of low-burden, long-term passive data collection. METHODS In a 3-arm prospective observational cohort feasibility study, we recruited 60 patients from the Royal Free Hospital and University College Hospital. These patients had been diagnosed with interstitial lung disease, chronic obstructive pulmonary disease, or post-COVID-19 condition (n=20 per group) and were followed for 180 days. This study used a comprehensive remote monitoring system designed to provide real-time and relevant data for both patients and clinicians. Data were collected using REDCap (Research Electronic Data Capture; Vanderbilt University) periodic surveys, Remote Assessment of Disease and Relapses-base active app questionnaires, wearables, finger pulse oximeters, smartphone apps, and Bluetooth home-based spirometry. The feasibility of remote monitoring was measured through adherence to the protocol, engagement during the follow-up period, retention rate, acceptability, and data integrity. RESULTS Lowest-burden passive data collection methods, via wearables, demonstrated superior adherence, engagement, and retention compared with active data collection methods, with an average wearable use of 18.66 (SD 4.69) hours daily (77.8% of the day), 123.91 (SD 33.73) hours weekly (72.6% of the week), and 463.82 (SD 156.70) hours monthly (64.4% of the month). Highest-burden spirometry tasks and high-burden active app tasks had the lowest adherence, engagement, and retention, followed by low-burden questionnaires. Spirometry and active questionnaires had the lowest retention at 0.5 survival probability, indicating that they were the most burdensome. Adherence to and quality of home spirometry were analyzed; of the 7200 sessions requested, 4248 (59%) were performed. Of these, 90.3% (3836/4248) were of acceptable quality according to American Thoracic Society grading. Inclusion of protocol holidays improved retention measures. The technologies used were generally well received. CONCLUSIONS Our findings provide evidence supporting the feasibility and acceptability of remote monitoring for capturing both subjective and objective data from various sources for respiratory diseases. The high engagement level observed with passively collected data suggests the potential of wearables for long-term, user-friendly remote monitoring in respiratory disease management. The unique piloting of certain features such as protocol holidays, alert notifications for missing data, and flexible support from the study team provides a reference for future studies in this field. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/28873.
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Affiliation(s)
- Malik A Althobiani
- Respiratory Medicine, University College London, London, United Kingdom
- Interstitial Lung Disease Service, University College London Hospital, London, United Kingdom
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Yatharth Ranjan
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Joseph Jacob
- Respiratory Medicine, University College London, London, United Kingdom
- Satsuma Lab, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Michele Orini
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Richard James Butler Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health and Care Research, Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- National Institute for Health and Care Research, Biomedical Research Centre at University College London Hospitals, National Institute for Health Foundation Trust, London, United Kingdom
| | - Joanna C Porter
- Respiratory Medicine, University College London, London, United Kingdom
- Interstitial Lung Disease Service, University College London Hospital, London, United Kingdom
| | - John R Hurst
- Respiratory Medicine, University College London, London, United Kingdom
| | - Amos A Folarin
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health and Care Research, Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- National Institute for Health and Care Research, Biomedical Research Centre at University College London Hospitals, National Institute for Health Foundation Trust, London, United Kingdom
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Badaoui M, Chanson M. Intercellular Communication in Airway Epithelial Cell Regeneration: Potential Roles of Connexins and Pannexins. Int J Mol Sci 2023; 24:16160. [PMID: 38003349 PMCID: PMC10671439 DOI: 10.3390/ijms242216160] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/19/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Connexins and pannexins are transmembrane proteins that can form direct (gap junctions) or indirect (connexons, pannexons) intercellular communication channels. By propagating ions, metabolites, sugars, nucleotides, miRNAs, and/or second messengers, they participate in a variety of physiological functions, such as tissue homeostasis and host defense. There is solid evidence supporting a role for intercellular signaling in various pulmonary inflammatory diseases where alteration of connexin/pannexin channel functional expression occurs, thus leading to abnormal intercellular communication pathways and contributing to pathophysiological aspects, such as innate immune defense and remodeling. The integrity of the airway epithelium, which is the first line of defense against invading microbes, is established and maintained by a repair mechanism that involves processes such as proliferation, migration, and differentiation. Here, we briefly summarize current knowledge on the contribution of connexins and pannexins to necessary processes of tissue repair and speculate on their possible involvement in the shaping of the airway epithelium integrity.
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Affiliation(s)
| | - Marc Chanson
- Department of Cell Physiology & Metabolism, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland;
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Kubra KT, Barabutis N. Ceapin-A7 potentiates lipopolysaccharide-induced endothelial injury. J Biochem Mol Toxicol 2023; 37:e23460. [PMID: 37431958 PMCID: PMC10782819 DOI: 10.1002/jbt.23460] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/14/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023]
Abstract
Barrier dysfunction is the hallmark of severe lung injury, including acute respiratory distress syndrome. Efficient medical countermeasures to counteract endothelial hyperpermeability do not exist, hence the mortality rates of disorders related to barrier abnormalities are unacceptable high. The unfolded protein response is a highly conserved mechanism, which aims to support the cells against endoplasmic reticulum stress, and ATF6 is a protein sensor that triggers its activation. In the current study, we investigate the effects of ATF6 suppression in LPS-induced endothelial inflammation. Our observations suggest that Ceapin-A7, which is an ATF6 suppressor, potentiates LPS-induced STAT3 and JAK2 activation. Hence ATF6 activation may serve as a new therapeutic possibility toward diseases related to barrier dysfunction.
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Affiliation(s)
- Khadeja-Tul Kubra
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana Monroe, Monroe, Louisiana 71201, USA
| | - Nektarios Barabutis
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana Monroe, Monroe, Louisiana 71201, USA
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Alexander KM, Davis SN, Butts CC, Morgan J, Croft LK, Lee YLL, Kinnard CM, Polite NM, Mbaka MI, Williams AY, Barrington RA, Audia JP, Simmons JD. Defining Pathogen and Susceptibility Patterns for Early Versus Late Ventilator Associated Pneumonia in Trauma Patients to Guide Empiric Treatment Decisions. Am Surg 2023; 89:4536-4541. [PMID: 35979859 DOI: 10.1177/00031348221121539] [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] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Studies have demonstrated that trauma patients with early-ventilator associated pneumonia (early-VAP, < 7 days) have decreased risk of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa infections. We hypothesize that routinely using broad-spectrum antibiotics is unnecessary to treat trauma patients with the diagnosis of early-VAP. METHODS This retrospective cohort study included adult trauma patients with the diagnosis of VAP. The primary outcome was the presence of MRSA and/or P. aeruginosa in patients with early- and late-VAP. Secondary outcomes included the bacterial susceptibility of pathogens to methicillin, ampicillin/sulbactam, ceftriaxone, piperacillin/tazobactam, and cefepime. Intensive care unit (ICU) and hospital length of stay (LOS), ventilator-free days, and in-hospital mortality were also collected. RESULTS 164 patients met inclusion criteria, and 208 organisms (n = 90 early vs n = 118 late) were identified by respiratory culture. The incidence of MRSA and P. aeruginosa in early-VAP was 7.7% (7/90) and 5.6% (5/90), respectively. The susceptibility of bacteria causing early-VAP to ampicillin/sulbactam and ceftriaxone was 73.3% (66/90) and 83.3% (75/90), respectively. Ventilator-free days at 30 days was similar between groups (P = .649). Patients with late-VAP spent more time in the ICU (P = .040); however, in-hospital mortality was higher in the early-VAP group (P = .012). CONCLUSIONS Ampicillin/sulbactam or ceftriaxone monotherapy did not provide reliable broad-spectrum coverage for early-VAP in our cohort. These findings highlight the importance of each institution performing a similar analysis to ensure adequate initial treatment of VAP.
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Affiliation(s)
| | - S Noelle Davis
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - C Caleb Butts
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - John Morgan
- School of Medicine, The University of South Alabama, Mobile, AL, USA
| | - Leah K Croft
- Department of Pharmacy, USA Health University Hospital, Mobile, AL, USA
| | - Yann-Leei L Lee
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | | | - Nathan M Polite
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | - Maryann I Mbaka
- Department of Surgery, University of South Alabama, Mobile, AL, USA
| | | | - Robert A Barrington
- Department of Microbiology and Immunology, Univeristy of South Alabama, Mobile, AL, USA
| | - Jonathon P Audia
- Department of Microbiology and Immunology, Univeristy of South Alabama, Mobile, AL, USA
- Center for Lung Biology, University of South Alabama, Mobile, AL, USA
| | - Jon D Simmons
- Department of Surgery, University of South Alabama, Mobile, AL, USA
- Department of Pharmacology, The University of South Alabama, Mobile, AL, USA
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Puhm F, Laroche A, Boilard E. Diversity of Megakaryocytes. Arterioscler Thromb Vasc Biol 2023; 43:2088-2098. [PMID: 37675634 DOI: 10.1161/atvbaha.123.318782] [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: 05/17/2023] [Accepted: 08/14/2023] [Indexed: 09/08/2023]
Abstract
Megakaryocytes are commonly known as large, polyploid, bone marrow resident cells that contribute to hemostasis through the production of platelets. Soon after their discovery in the 19th century, megakaryocytes were described in tissue locations other than the bone marrow, specifically in the lungs and the blood circulation. However, the localization of megakaryocytes in the lungs and the contribution of lung megakaryocytes to the general platelet pool has only recently been appreciated. Moreover, the conception of megakaryocytes as uniform cells with the sole purpose of platelet production has been challenged. Here, we review the literature on megakaryocyte cell identity and location with a special focus on recent observations of megakaryocyte subpopulations identified by transcriptomic analyses.
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Affiliation(s)
- Florian Puhm
- Department of Infectious Diseases and Immunity, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval, Canada (F.P., A.L., E.B.)
- Centre de Recherche ARThrite, Faculté de Médecine de l'Université Laval, Québec, Canada (F.P., A.L., E.B.)
| | - Audrée Laroche
- Department of Infectious Diseases and Immunity, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval, Canada (F.P., A.L., E.B.)
- Centre de Recherche ARThrite, Faculté de Médecine de l'Université Laval, Québec, Canada (F.P., A.L., E.B.)
| | - Eric Boilard
- Department of Infectious Diseases and Immunity, Centre de Recherche du Centre Hospitalier Universitaire de Québec - Université Laval, Canada (F.P., A.L., E.B.)
- Centre de Recherche ARThrite, Faculté de Médecine de l'Université Laval, Québec, Canada (F.P., A.L., E.B.)
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Misplon JA, Lo CY, Crabbs TA, Price GE, Epstein SL. Adenoviral-vectored universal influenza vaccines administered intranasally reduce lung inflammatory responses upon viral challenge 15 months post-vaccination. J Virol 2023; 97:e0067423. [PMID: 37830821 PMCID: PMC10617573 DOI: 10.1128/jvi.00674-23] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023] Open
Abstract
IMPORTANCE Vaccines targeting highly conserved proteins can protect broadly against diverse viral strains. When a vaccine is administered to the respiratory tract, protection against disease is especially powerful. However, it is important to establish that this approach is safe. When vaccinated animals later encounter viruses, does reactivation of powerful local immunity, including T cell responses, damage the lungs? This study investigates the safety of mucosal vaccination of the respiratory tract. Non-replicating adenoviral vaccine vectors expressing conserved influenza virus proteins were given intranasally. This vaccine-induced protection persists for at least 15 months. Vaccination did not exacerbate inflammatory responses or tissue damage upon influenza virus infection. Instead, vaccination with nucleoprotein reduced cytokine responses and histopathology, while neutrophil and T cell responses resolved earlier. The results are promising for safe vaccination at the site of infection and thus have implications for the control of influenza and other respiratory viruses.
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Affiliation(s)
- Julia A. Misplon
- Division of Cellular and Gene Therapies, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Chia-Yun Lo
- Division of Cellular and Gene Therapies, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Torrie A. Crabbs
- Experimental Pathology Laboratories, Inc., Durham, North Carolina, USA
| | - Graeme E. Price
- Division of Cellular and Gene Therapies, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Suzanne L. Epstein
- Division of Cellular and Gene Therapies, Office of Tissues and Advanced Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
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Viganò M, Beretta M, Lepore M, Abete R, Benatti SV, Grassini MV, Camagni S, Chiodini G, Vargiu S, Vittori C, Iachini M, Terzi A, Neri F, Pinelli D, Casotti V, Di Marco F, Ruggenenti P, Rizzi M, Colledan M, Fagiuoli S. Vaccination Recommendations in Solid Organ Transplant Adult Candidates and Recipients. Vaccines (Basel) 2023; 11:1611. [PMID: 37897013 PMCID: PMC10611006 DOI: 10.3390/vaccines11101611] [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: 07/21/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Prevention of infections is crucial in solid organ transplant (SOT) candidates and recipients. These patients are exposed to an increased infectious risk due to previous organ insufficiency and to pharmacologic immunosuppression. Besides infectious-related morbidity and mortality, this vulnerable group of patients is also exposed to the risk of acute decompensation and organ rejection or failure in the pre- and post-transplant period, respectively, since antimicrobial treatments are less effective than in the immunocompetent patients. Vaccination represents a major preventive measure against specific infectious risks in this population but as responses to vaccines are reduced, especially in the early post-transplant period or after treatment for rejection, an optimal vaccination status should be obtained prior to transplantation whenever possible. This review reports the currently available data on the indications and protocols of vaccination in SOT adult candidates and recipients.
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Affiliation(s)
- Mauro Viganò
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (S.F.)
| | - Marta Beretta
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
| | - Marta Lepore
- Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.L.); (P.R.)
| | - Raffaele Abete
- Cardiology Division, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (C.V.)
| | - Simone Vasilij Benatti
- Infectious Diseases Unit, ASST Papa Giovanni XXII, 24127 Bergamo, Italy; (S.V.B.); (M.R.)
| | - Maria Vittoria Grassini
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (S.F.)
- Section of Gastroenterology & Hepatology, Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90128 Palermo, Italy
| | - Stefania Camagni
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Greta Chiodini
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
| | - Simone Vargiu
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
| | - Claudia Vittori
- Cardiology Division, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (C.V.)
| | - Marco Iachini
- Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.L.); (P.R.)
| | - Amedeo Terzi
- Cardiothoracic Department, ASST Papa Giovanni XXII, 24127 Bergamo, Italy;
| | - Flavia Neri
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Domenico Pinelli
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Valeria Casotti
- Pediatric Hepatology, Gastroenterology and Transplantation Unit, ASST Papa Giovanni XXII, 24127 Bergamo, Italy;
| | - Fabiano Di Marco
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
- Department of Health Sciences, University of Milan, 20158 Milan, Italy
| | - Piero Ruggenenti
- Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.L.); (P.R.)
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases “Aldo e Cele Daccò”, Institute of Pharmacologic Research “Mario Negri IRCCS”, Ranica, 24020 Bergamo, Italy
| | - Marco Rizzi
- Infectious Diseases Unit, ASST Papa Giovanni XXII, 24127 Bergamo, Italy; (S.V.B.); (M.R.)
| | - Michele Colledan
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Stefano Fagiuoli
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (S.F.)
- Department of Medicine, University of Milan Bicocca, 20126 Milan, Italy
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White AD, Tran AC, Sibley L, Sarfas C, Morrison AL, Lawrence S, Dennis M, Clark S, Zadi S, Lanni F, Rayner E, Copland A, Hart P, Diogo GR, Paul MJ, Kim M, Gleeson F, Salguero FJ, Singh M, Stehr M, Cutting SM, Basile JI, Rottenberg ME, Williams A, Sharpe SA, Reljic R. Spore-FP1 tuberculosis mucosal vaccine candidate is highly protective in guinea pigs but fails to improve on BCG-conferred protection in non-human primates. Front Immunol 2023; 14:1246826. [PMID: 37881438 PMCID: PMC10594996 DOI: 10.3389/fimmu.2023.1246826] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023] Open
Abstract
Tuberculosis remains a major health threat globally and a more effective vaccine than the current Bacillus Calmette Guerin (BCG) is required, either to replace or boost it. The Spore-FP1 mucosal vaccine candidate is based on the fusion protein of Ag85B-Acr-HBHA/heparin-binding domain, adsorbed on the surface of inactivated Bacillus subtilis spores. The candidate conferred significant protection against Mycobacterium. tuberculosis challenge in naïve guinea pigs and markedly improved protection in the lungs and spleens of animals primed with BCG. We then immunized rhesus macaques with BCG intradermally, and subsequently boosted with one intradermal and one aerosol dose of Spore-FP1, prior to challenge with low dose aerosolized M. tuberculosis Erdman strain. Following vaccination, animals did not show any adverse reactions and displayed higher antigen specific cellular and antibody immune responses compared to BCG alone but this did not translate into significant improvement in disease pathology or bacterial burden in the organs.
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Affiliation(s)
- Andrew D. White
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Andy C. Tran
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Laura Sibley
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Charlotte Sarfas
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Alexandra L. Morrison
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Steve Lawrence
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Mike Dennis
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Simon Clark
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Sirine Zadi
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Faye Lanni
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Emma Rayner
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Alastair Copland
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Peter Hart
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Gil Reynolds Diogo
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Matthew J. Paul
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Miyoung Kim
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Fergus Gleeson
- Department of Oncology, The Churchill Hospital, Oxford, United Kingdom
| | - Francisco J. Salguero
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | | | | | - Simon M. Cutting
- School of Biological Sciences, Royal Holloway University of London, Surrey, United Kingdom
- Sporegen Ltd , London Bioscience Innovation Centre, London, United Kingdom
| | - Juan I. Basile
- Department of Microbiology, Tumour and Cell Biology and Centre for Tuberculosis Research, Karolinska Institute, Stockholm, Sweden
| | - Martin E. Rottenberg
- Department of Microbiology, Tumour and Cell Biology and Centre for Tuberculosis Research, Karolinska Institute, Stockholm, Sweden
| | - Ann Williams
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Sally A. Sharpe
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Rajko Reljic
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
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Kosyreva AM, Miroshnichenko EA, Tsvetkov IS, Lokhonina AV, Sentyabreva AV, Dzhalilova DS, Fatkhudinov TK, Makarova OV. Morphofunctional Characteristics of Lung Macrophages in Rats with Acute Respiratory Distress Syndrome. Bull Exp Biol Med 2023; 175:822-827. [PMID: 37979023 DOI: 10.1007/s10517-023-05954-4] [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: 04/24/2023] [Indexed: 11/19/2023]
Abstract
A comprehensive morphofunctional study of the lungs and alveolar macrophages was carried out in Sprague-Dawley rats with acute respiratory distress syndrome (n=10) induced by intratracheal administration of E. coli LPS 0111:B4 in a dose of 15 mg/kg. On the first day after LPS administration, bronchopneumonia was observed in the lungs, the number of macrophages of the bone marrow origin and the number of M1 macrophages with the proinflammatory phenotype in the bronchoalveolar lavage increased, the expression of proinflammatory cytokines increased and the expression of anti-inflammatory cytokines decreased, which was accompanied by an increase in LPS and C-reactive protein in the blood serum. The revealed changes correspond to the development of acute respiratory distress syndrome in humans, and the decrease in the number of macrophages in the lungs and their predominant polarization to the M1-proinflammatory phenotype substantiate the use of cell therapy with reprogrammed M2 macrophages.
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Affiliation(s)
- A M Kosyreva
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia.
| | - E A Miroshnichenko
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
| | - I S Tsvetkov
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
| | - A V Lokhonina
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
| | - A V Sentyabreva
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
| | - D Sh Dzhalilova
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
| | - T Kh Fatkhudinov
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
| | - O V Makarova
- A. P. Avtsyn Research Institute of Human Morphology, B. V. Pet-rovsky Russian Research Center of Surgery, Moscow, Russia
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Romanova OL, Blagonravov ML, Torshin VI, Dzhuvalyakov PG, Ershov AV, Kislov MA, Magulaev AM. The Effect of the Toxic Dose of Baclofen on Selected Parameters of the Cardiovascular and Respiratory Systems. Bull Exp Biol Med 2023; 175:777-780. [PMID: 37979027 DOI: 10.1007/s10517-023-05945-5] [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: 04/06/2023] [Indexed: 11/19/2023]
Abstract
The effect of the toxic dose of the muscle relaxant baclofen on the parameters of the cardiovascular and respiratory systems was studied in adult male Wistar rats (n=20). Systolic and diastolic BP, HR, and respiratory rate were measured; histological changes in the lungs 3, 4.5, and 24 h after drug administration. Baclofen was administered orally in a sublethal toxic dose of 85 mg/kg under anesthesia. Cardiac activity was analyzed using RSM physiological indicators monitoring system with MouseMonitor S (Indus Instruments) software. Histological examination was performed by light microscopy. Baclofen significantly decreased the respiratory rate and increased HR and BP. Histological examination of the lungs revealed a complex of general pathological processes, such as local circulatory disorders (venular and capillary fullness, sludge), leukocyte infiltration of the interalveolar septa and their thickening due to edema. These findings can be used to estimate the time elapsed after baclofen treatment.
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Affiliation(s)
- O L Romanova
- Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.
- A. P. Avtsyn Research Institute of Human Morphology, A. P. Petrovsky Russian Research Center of Surgery, Moscow, Russia.
| | - M L Blagonravov
- Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - V I Torshin
- Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - P G Dzhuvalyakov
- A. P. Avtsyn Research Institute of Human Morphology, A. P. Petrovsky Russian Research Center of Surgery, Moscow, Russia
| | - A V Ershov
- Federal Research Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - M A Kislov
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - A M Magulaev
- I. M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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Bakakos A, Sotiropoulou Z, Vontetsianos A, Zaneli S, Papaioannou AI, Bakakos P. Epidemiology and Immunopathogenesis of Virus Associated Asthma Exacerbations. J Asthma Allergy 2023; 16:1025-1040. [PMID: 37791040 PMCID: PMC10543746 DOI: 10.2147/jaa.s277455] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/16/2023] [Indexed: 10/05/2023] Open
Abstract
Asthma is a common airway disease, affecting millions of people worldwide. Although most asthma patients experience mild symptoms, it is characterized by variable airflow limitation, which can occasionally become life threatening in the case of a severe exacerbation. The commonest triggers of asthma exacerbations in both children and adults are viral infections. In this review article, we will try to investigate the most common viruses triggering asthma exacerbations and their role in asthma immunopathogenesis, since viral infections in young adults are thought to trigger the development of asthma either right away after the infection or at a later stage of their life. The commonest viral pathogens associated with asthma include the respiratory syncytial virus, rhinoviruses, influenza and parainfluenza virus, metapneumovirus and coronaviruses. All these viruses exploit different molecular pathways to infiltrate the host. Asthmatics are more prone to severe viral infections due to their unique inflammatory response, which is mostly characterized by T2 cytokines. Unlike the normal T1 high response to viral infection, asthmatics with T2 high inflammation are less potent in containing a viral infection. Inhaled and/or systematic corticosteroids and bronchodilators remain the cornerstone of asthma exacerbation treatment, and although many targeted therapies which block molecules that viruses use to infect the host have been used in a laboratory level, none has been yet approved for clinical use. Nevertheless, further understanding of the unique pathway that each virus follows to infect an individual may be crucial in the development of targeted therapies for the commonest viral pathogens to effectively prevent asthma exacerbations. Finally, biologic therapies resulted in a complete change of scenery in the treatment of severe asthma, especially with a T2 high phenotype. All available data suggest that monoclonal antibodies are safe and able to drastically reduce the rate of viral asthma exacerbations.
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Affiliation(s)
- Agamemnon Bakakos
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Zoi Sotiropoulou
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Angelos Vontetsianos
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Stavroula Zaneli
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Andriana I Papaioannou
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
| | - Petros Bakakos
- 1st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, 11527, Greece
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Yadav S. Disseminated Tuberculosis of the Lungs, Pleura, Mediastinal Lymph Nodes, and Pericardium: A Rare Case Report. Cureus 2023; 15:e45562. [PMID: 37868442 PMCID: PMC10586713 DOI: 10.7759/cureus.45562] [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: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Tuberculosis is mainly known to affect the lungs, but it can manifest at various extrapulmonary sites. Disseminated tuberculosis is a relatively rare clinical condition, and cases with no history of the disease are sparse. A case of an 18-year-old Indian male is presented. He came with complaints of chest pain, coughing with expectoration, and loss of appetite. The diagnostic workup led to a definite diagnosis of disseminated tuberculosis with involvement of the lungs, pleura, mediastinal lymph nodes, and pericardium. He was initiated on a fixed-dose anti-tubercular treatment per the national guidelines.
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Affiliation(s)
- Sankalp Yadav
- Medicine, Shri Madan Lal Khurana Chest Clinic, Moti Nagar, New Delhi, IND
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Heath O, Pandithan D, Pitt J, Savva E, Raiti L, Bracken J, Vandeleur M, Delatycki MB, Yaplito‐Lee J, Hardikar W, Halligan R. Interstitial lung disease and pancreatic exocrine insufficiency in CADDS: Phenotypic expansion and literature review. JIMD Rep 2023; 64:337-345. [PMID: 37701323 PMCID: PMC10494507 DOI: 10.1002/jmd2.12390] [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: 07/02/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 09/14/2023] Open
Abstract
Contiguous ABCD1/ DXS1357E deletion syndrome (CADDS) is a rare deletion syndrome involving two contiguous genes on Xq28, ABCD1 and BCAP31 (formerly known as DXS1357E). Only nine individuals with this diagnosis have been reported in the medical literature to date. Intragenic loss-of-function variants in BCAP31 cause the deafness, dystonia, and cerebral hypomyelination syndrome (DDCH). Isolated pathogenic intragenic variants in ABCD1 are associated with the most common peroxisomal disorder, X-linked adrenoleukodystrophy (X-ALD), a single transporter deficiency, which in its more severe cerebral form is characterised by childhood-onset neurodegeneration and high levels of very-long-chain fatty acids (VLCFA). While increased VLCFA levels also feature in CADDS, the few patients described to date all presented as neonates with a severe phenotype. Here we report a tenth individual with CADDS, a male infant with dysmorphic facial features who was diagnosed through ultra-rapid whole genome sequencing (WGS) in the setting of persistent cholestatic liver disease, sensorineural hearing loss, hypotonia and growth failure and developmental delay. Biochemical studies showed elevated VLCFA and mildly reduced plasmalogens. He died at 7 months having developed pancreatic exocrine deficiency and interstitial lung disease, two features we propose to be possible extensions to the CADDS phenotype. We also review the genetic, phenotypic, and biochemical features in previously reported individuals with CADDS.
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Affiliation(s)
- Oliver Heath
- Department of Metabolic MedicineThe Royal Children's HospitalMelbourneAustralia
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneAustralia
| | - Dinusha Pandithan
- Department of Metabolic MedicineThe Royal Children's HospitalMelbourneAustralia
| | - James Pitt
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneAustralia
| | - Elena Savva
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneAustralia
| | - Laura Raiti
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneAustralia
| | - Jenny Bracken
- Department of RadiologyThe Royal Children's HospitalMelbourneAustralia
| | - Moya Vandeleur
- Department of Respiratory MedicineThe Royal Children's HospitalMelbourneAustralia
| | - Martin B. Delatycki
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneAustralia
| | - Joy Yaplito‐Lee
- Department of Metabolic MedicineThe Royal Children's HospitalMelbourneAustralia
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneAustralia
| | - Winita Hardikar
- Department of GastroenterologyThe Royal Children's HospitalMelbourneAustralia
| | - Rebecca Halligan
- Department of Metabolic MedicineThe Royal Children's HospitalMelbourneAustralia
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Hirsh JD, Burt JN, Panchal RM, Endler GT, Devalla RN, Mitchell ME, Villalobos MA. Saddle Pulmonary Embolus and Simultaneous Common Carotid and Subclavian Artery Emboli. Am Surg 2023; 89:3908-3910. [PMID: 37171974 DOI: 10.1177/00031348231175103] [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] [Indexed: 05/14/2023]
Abstract
A patent foramen ovale (PFO) is present in 27-35% of the population. Right to left cardiac shunts predispose patients to arterial emboli in the presence of venous thromboembolisms. Paradoxical embolus should be suspected in patients with deep venous thrombosis (DVT) and arterial emboli. A 45-year-old man with hypercoagulability and history of DVT presented with a week-long history of chest pain, shortness of breath, and left arm numbness. Imaging showed a saddle pulmonary embolus (PE) and emboli involving the aortic arch, left common carotid, and left subclavian artery. The patient proceeded with an endovascular thrombectomy of the pulmonary artery, followed by open thrombectomy. Echocardiogram confirmed a right to left intra-cardiac shunt consistent with a PFO. Paradoxical emboli are rare manifestations of venous thromboemboli in patients with right to left intra-cardiac shunts. Patients should be evaluated for these to help prevent further manifestations.
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Affiliation(s)
- Joshua D Hirsh
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jeremy N Burt
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ramola M Panchal
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Graham T Endler
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Raviteja N Devalla
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Marc E Mitchell
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
| | - Miguel A Villalobos
- Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
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Bgatova NP, Savchenko SV, Lamanov AN, Ergazina MZ, Adilova MT, Letyagin AY. Ultrastructural Reorganization of Endotheliocytes of Pulmonary Blood Capillaries in COVID-19. Bull Exp Biol Med 2023; 175:667-672. [PMID: 37861904 DOI: 10.1007/s10517-023-05923-x] [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: 02/21/2023] [Indexed: 10/21/2023]
Abstract
The ultrastructural organization endotheliocytes of pulmonary blood capillaries in COVID-19 was studied on autopsy material using electron microscopy. Swelling of the cytoplasm and mitochondria with destruction of the cristae, dilation of the Golgi complex cisternae, a decrease in the volume density of the luminal and basal caveolae and free transport vesicles, an increase of the rough endoplasmic reticulum, as well as the presence of elements of coronavirus replication (reticulovesicular structures, zippered endoplasmic reticulum, electron-dense particles in the Golgi cisternae, and vacuoles with viral particles) were revealed. Further studies of the intracellular mechanisms used by the virus to replicate could help to develop antiviral drugs for the treatment of the new coronavirus infection.
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Affiliation(s)
- N P Bgatova
- Research Institute of Clinical and Experimental Lymphology - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia.
| | - S V Savchenko
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - A N Lamanov
- Novosibirsk State Medical University, Ministry of Health of the Russian Federation, Novosibirsk, Russia
| | - M Zh Ergazina
- S. D. Asfendiyarov Kazakhstan National Medical University, Almaty, Republic of Kazakhstan
| | - M T Adilova
- S. D. Asfendiyarov Kazakhstan National Medical University, Almaty, Republic of Kazakhstan
| | - A Yu Letyagin
- Research Institute of Clinical and Experimental Lymphology - Branch of Federal Research Center Institute of Cytology and Genetics, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
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Almuzaini AS, Algeffari M, Alsohaibani A, Almutlaq LY, Alwehaibi R, Almuzaini RA, Mahmood SE. Awareness of Chronic Obstructive Pulmonary Disease and Its Risk Factors Among the Adult Population of the Qassim Region, Saudi Arabia. Cureus 2023; 15:e44743. [PMID: 37809115 PMCID: PMC10555947 DOI: 10.7759/cureus.44743] [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: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Epidemiological studies are crucial in appraising the occurrence of chronic obstructive pulmonary disease (COPD) in a specific region, establishing benchmarks, and devising effective preventive measures. It is against this background that the study aims to evaluate adult awareness of COPD and its risk factors among adults in the Qassim Region, Saudi Arabia. METHOD This observational cross-sectional study was conducted in the Qassim Region and involved consenting adults who voluntarily participated. Between 20 May and 4 June 2023, a self-administered online survey was distributed through social media platforms, utilizing an anonymous, self-explanatory questionnaire to evaluate participants' awareness of COPD. RESULTS In our study, a total of 1,306 participants were enrolled, of which 27.6% (n=360) reported having ever heard of COPD. Among all respondents, 21.3% (n=278) stated that they study or work in medical-related fields, and out of them, 60.4% (n=168) had prior awareness of COPD. Upon excluding participants associated with medical-related fields, the overall awareness level decreased to 18.7%. The majority of respondents fell within the age range of 18 to 29 years, of whom 34.5% had ever heard of COPD. Regarding smoking habits, the majority were cigarette smokers (38.4%), and of all cigarette smokers, 22.4% had heard of COPD. The second highest proportion of smokers (35.8%) were electronic smokers, and among them, 24.1% were aware of COPD. The lowest proportion of smokers (25.8%) were shisha smokers, with 25.6% of them having heard of COPD. Among the 1,306 respondents, only 27.5% (n=360) had ever heard of COPD. When asked about the organ affected by COPD, 81% (n=292) of those who were aware of the condition correctly responded that it affects the lungs. On the other hand, 8.9% (n=32) incorrectly selected "heart" as the affected organ, while 2.5% (n=9) chose "I don't know," and none selected "throat." CONCLUSION The Qassim Region in Saudi Arabia exhibits a reduced level of COPD awareness among the general population. It is imperative to urgently address this situation and enhance awareness for improved COPD diagnosis and treatment. Considering the region's high prevalence of COPD and associated risk factors, it becomes vital to strengthen educational curricula and integrate COPD awareness into public forums and awareness campaigns. Moreover, conducting additional national research would be instrumental in assisting policymakers in developing effective preventive and therapeutic strategies.
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Affiliation(s)
- Ahmed S Almuzaini
- Department of Family and Community Medicine, Qassim University, Buraydah, SAU
| | - Mutab Algeffari
- Department of Family and Community Medicine, Qassim University, Buraydah, SAU
| | - Asma Alsohaibani
- Department of Family and Community Medicine, Qassim University, Buraydah, SAU
| | - Latifah Y Almutlaq
- Department of Family and Community Medicine, Qassim University, Buraydah, SAU
| | - Raghad Alwehaibi
- Department of Family and Community Medicine, Qassim University, Buraydah, SAU
| | - Reema A Almuzaini
- Department of Family and Community Medicine, Qassim University, Buraydah, SAU
| | - Syed E Mahmood
- Department of Family and Community Medicine, King Khalid University, Abha, SAU
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Plantzas I, Tousia A, Vlachodimitropoulos D, Piagkou M, Goutas N, Tsakotos G, Triantafyllou G, Plantzas E, Sakelliadis E. The Anaphylactoid Syndrome of Pregnancy: Two Autopsy Cases. Cureus 2023; 15:e45145. [PMID: 37842488 PMCID: PMC10570657 DOI: 10.7759/cureus.45145] [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: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
The anaphylactoid syndrome of pregnancy (ASP) is a rare emergency with significant mortality and morbidity, in which the amniotic fluid and fetal cells enter the maternal circulation leading to respiratory failure, altered mental status, hypotension, and disseminated intravascular coagulation. The term ASP was recently introduced to replace the term amniotic fluid embolism since the clinical manifestations of the entity were more similar to a septic or anaphylactic shock rather than that of an embolic event. Two autopsy cases are described, regarding a 35-year-old gravida 2 para 1 and a 34-year-old gravida 1 para 0, where the cause of death was determined to be ASP.
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Affiliation(s)
- Ioannis Plantzas
- Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, GRC
| | - Athina Tousia
- Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Maria Piagkou
- Anatomy, National and Kapodistrian University of Athens, Athens, GRC
| | - Nikolaos Goutas
- Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, GRC
| | - George Tsakotos
- Anatomy, National and Kapodistrian University of Athens, Athens, GRC
| | | | - Evangelos Plantzas
- Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, GRC
| | - Emmanouil Sakelliadis
- Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, GRC
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Alberro-Brage A, Kryvenko V, Malainou C, Günther S, Morty RE, Seeger W, Herold S, Samakovlis C, Vadász I. Influenza virus decreases albumin uptake and megalin expression in alveolar epithelial cells. Front Immunol 2023; 14:1260973. [PMID: 37727782 PMCID: PMC10505651 DOI: 10.3389/fimmu.2023.1260973] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 09/21/2023] Open
Abstract
Introduction Acute respiratory distress syndrome (ARDS) is a common complication of influenza virus (IV) infection. During ARDS, alveolar protein concentrations often reach 40-90% of plasma levels, causing severe impairment of gas exchange and promoting deleterious alveolar remodeling. Protein clearance from the alveolar space is at least in part facilitated by the multi-ligand receptor megalin through clathrin-mediated endocytosis. Methods To investigate whether IV infection impairs alveolar protein clearance, we examined albumin uptake and megalin expression in MLE-12 cells and alveolar epithelial cells (AEC) from murine precision-cut lung slices (PCLS) and in vivo, under IV infection conditions by flow cytometry and western blot. Transcriptional levels from AEC and broncho-alveolar lavage (BAL) cells were analyzed in an in-vivo mouse model by RNAseq. Results IV significantly downregulated albumin uptake, independently of activation of the TGF-β1/GSK3β axis that has been previously implicated in the regulation of megalin function. Decreased plasma membrane abundance, total protein levels, and mRNA expression of megalin were associated with this phenotype. In IV-infected mice, we identified a significant upregulation of matrix metalloproteinase (MMP)-14 in BAL fluid cells. Furthermore, the inhibition of this protease partially recovered total megalin levels and albumin uptake. Discussion Our results suggest that the previously described MMP-driven shedding mechanisms are potentially involved in downregulation of megalin cell surface abundance and clearance of excess alveolar protein. As lower alveolar edema protein concentrations are associated with better outcomes in respiratory failure, our findings highlight the therapeutic potential of a timely MMP inhibition in the treatment of IV-induced ARDS.
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Affiliation(s)
- Andrés Alberro-Brage
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
| | - Vitalii Kryvenko
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
| | - Christina Malainou
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
| | - Stefan Günther
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Rory E. Morty
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
- Department of Translational Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - Werner Seeger
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Susanne Herold
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
| | - Christos Samakovlis
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
- Science for Life Laboratory, Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - István Vadász
- Department of Internal Medicine, Justus Liebig University, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
- German Center for Lung Research (DZL), Giessen, Germany
- The Cardio-Pulmonary Institute (CPI), Giessen, Germany
- Institute for Lung Health (ILH), Giessen, Germany
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Campos-Carraro C, Turck P, de Lima-Seolin BG, Teixeira RB, Zimmer A, Araujo ASDR, Belló-Klein A. Copaiba oil improves pulmonary nitric oxide bioavailability in monocrotaline-treated rats. Can J Physiol Pharmacol 2023; 101:447-454. [PMID: 37581356 DOI: 10.1139/cjpp-2023-0028] [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] [Indexed: 08/16/2023]
Abstract
Oxidative stress is involved in increased pulmonary vascular resistance (PVR) and right ventricular (RV) hypertrophy, characteristics of pulmonary arterial hypertension (PAH). Copaiba oil, an antioxidant compound, could attenuate PAH damage. This study's aim was to determine the effects of copaiba oil on lung oxidative stress, PVR, and mean pulmonary arterial pressure (mPAP) in the monocrotaline (MCT) model of PAH. Male Wistar rats (170 g, n = 7/group) were divided into four groups: control, MCT, copaiba oil, and MCT + copaiba oil (MCT-O). PAH was induced by MCT (60 mg/kg i.p.) and, after 1 week, the treatment with copaiba oil (400 mg/kg/day gavage) was started for 14 days. Echocardiographic and hemodynamic measurements were performed. RV was collected for morphometric evaluations and lungs and the pulmonary artery were used for biochemical analysis. Copaiba oil significantly reduced RV hypertrophy, PVR, mPAP, and antioxidant enzyme activities in the MCT-O group. Moreover, increased nitric oxide synthase and decreased NADPH oxidase activities were observed in the MCT-O group. In conclusion, copaiba oil was able to improve the balance between nitric oxide and reactive oxygen species in lungs and the pulmonary artery and to reduce PVR, which could explain a decrease in RV hypertrophy in this PAH model.
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Affiliation(s)
| | - Patrick Turck
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Alexsandra Zimmer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Adriane Belló-Klein
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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da Silva PHS, Lopes CEB, Stallmach LB, Ferreira LDO, Pimentel PAB, Giuliano A, Freitas PMC, Horta RDS. Comparison of Different Pneumorrhaphy Methods after Partial Pulmonary Lobectomy in Dogs. Animals (Basel) 2023; 13:2732. [PMID: 37684995 PMCID: PMC10486489 DOI: 10.3390/ani13172732] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Pulmonary loborraphy can be performed using manual sutures and staples, although other methods, such as tissue adhesives, are also cited in the veterinary literature. Although the surgery is well tolerated in the canine species, failure in pulmonary aerostasis is still a reality since all the methods described so far eventually lead to air leakage after the use of the partial lobectomy technique in the lungs. Within this context, the aim of this research was to compare the effectiveness of different hermetic sealing methods after partial lobectomy of the right caudal lung lobe (RCLL) in dogs. 30 cadavers models were divided in 6 groups: G1-cobbler suture associated with simple continuous; G2-overlapping continuous suture associated with simple continuous suture; G3-Ford interlocking suture; G4-Stapling device; G5-Tissue glue (cyanoacrylate). After performing the sealing techniques, the lungs were submerged in water and inflated with oxygen at positive ventilatory pressures at physiological (up to 14.7 mmHg, which is equivalent to up to 20 cmH2O) and supraphysiological levels (above 14.7 mmHg) to evaluate the performance of the sealing methods. At physiological ventilatory pressure levels, there was no difference between groups. Sealing with surgical glue was superior to interlocking sutures and stapling devices at supraphysiological levels of ventilatory pressure.
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Affiliation(s)
- Paloma Helena Sanches da Silva
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Carlos Eduardo Bastos Lopes
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Larissa Bueno Stallmach
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Lucas de Oliveira Ferreira
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Pedro Antônio Bronhara Pimentel
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Antonio Giuliano
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine, City University of Hong Kong, Kowloon, Hong Kong, China
| | - Patrícia Maria Coletto Freitas
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
| | - Rodrigo dos Santos Horta
- Department of Veterinary Medicine and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (P.H.S.d.S.); (C.E.B.L.); (L.B.S.); (L.d.O.F.); (P.A.B.P.); (P.M.C.F.)
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Sécher T, Heuzé-Vourc'h N. Barriers for orally inhaled therapeutic antibodies. Expert Opin Drug Deliv 2023; 20:1071-1084. [PMID: 37609943 DOI: 10.1080/17425247.2023.2249821] [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: 05/12/2023] [Revised: 07/17/2023] [Accepted: 08/16/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Respiratory diseases represent a worldwide health issue. The recent Sars-CoV-2 pandemic, the burden of lung cancer, and inflammatory respiratory diseases urged the development of innovative therapeutic solutions. In this context, therapeutic antibodies (Abs) offer a tremendous opportunity to benefit patients with respiratory diseases. Delivering Ab through the airways has been demonstrated to be relevant to improve their therapeutic index. However, few inhaled Abs are on the market. AREAS COVERED This review describes the different barriers that may alter the fate of inhaled therapeutic Abs in the lungs at steady state. It addresses both physical and biological barriers and discusses the importance of taking into consideration the pathological changes occurring during respiratory disease, which may reinforce these barriers. EXPERT OPINION The pulmonary route remains rare for delivering therapeutic Abs, with few approved inhaled molecules, despite promising evidence. Efforts must focus on the intertwined barriers associated with lung diseases to develop appropriate Ab-formulation-device combo, ensuring optimal Ab deposition in the respiratory tract. Finally, randomized controlled clinical trials should be carried out to establish inhaled Ab therapy as prominent against respiratory diseases.
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Affiliation(s)
- Thomas Sécher
- INSERM, Centre d'Etude des Pathologies Respiratoires, Tours, France
- Université de Tours, Tours, France
| | - Nathalie Heuzé-Vourc'h
- INSERM, Centre d'Etude des Pathologies Respiratoires, Tours, France
- Université de Tours, Tours, France
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