Structure-function relationship in COPD revisited: an in vivo microscopy view

BACKGROUND

Fibred confocal fluorescence microscopy (FCFM) is a novel technology that allows the in vivo assessment and quantification during bronchoscopy of the bronchial wall elastic fibre pattern, alveolar and vessel diameters and thickness of the elastic fibre in the alveolar wall.

AIMS

To relate these structural characteristics with lung function parameters in healthy subjects, smokers with normal spirometry and patients with chronic obstructive pulmonary disease (COPD).

METHODS

We performed FCFM in 20 never smokers, 20 smokers with normal spirometry and 23 patients with COPD who required bronchoscopy for clinical reasons. The bronchial wall elastic fibre pattern was classified as lamellar, loose and mixed pattern, and later confirmed pathologically. Airspace dimensions and extra-alveolar vessel diameters were measured. Lung function measurements and pulmonary CT scans were obtained in all participants.

RESULTS

Patients with COPD were characterised by a significantly higher prevalence of loose fibre bronchial deposition pattern and larger alveolar diameter which correlated inversely with several lung function parameters (forced expiratory volume in 1 s (FEV1) , FEV1/forced vital capacity ratio, maximum expiratory flow, carbon monoxide transfer factor and carbon monoxide transfer coefficient; p<0.05). Increased alveolar macrophages were demonstrated in active smokers with or without COPD.

CONCLUSIONS

This is the first FCFM study to describe in vivo microscopic changes in the airways and alveoli of patients with COPD that are related to lung function impairment. These findings open the possibility of assessing the in vivo effects of therapeutic interventions for COPD in future studies.

Complete and repeatable inactivation of HIV-1 viral particles in suspension using a photo-labeled non-nucleoside reverse transcriptase inhibitor

A method is described for achieving repeatable, complete inactivation of HIV, based on photo-inactivation of HIV reverse transcriptase (RT) with a non-nucleoside reverse transcriptase inhibitor (NNRTI), photoactive 4-[[4-[(4-azido-2,6-dimethylphenyl) amino]-2-pyrimidinyl]amino]benzonitrile (PA-DAPYa). These results show that PA-DAPYa inactivated completely a suspension of cell-free HIV-1 viral particles in a dose and time-dependent manner. Using an ELISA assay for p24, it is demonstrated that a 500nM concentration of PA-DAPYa is able to inactivate 500 TCID50 of HIV viral particles in suspension when irradiated with non-microbicidal wavelength UV light for 30min. No active p24 was detected on days 7, 14, and 21 days after culturing the inactivated HIV in peripheral blood mononuclear cells (PBMCs). Several batches of large quantities of HIV viral particles were demonstrated to be inactivated completely and repeatedly by this method. Therefore, a reliable method has been developed to inactivate HIV viral particles in a reproducible manner using an optimal concentration of PA-DAPYa and duration of UV exposure time of the treated particles. The inactivation of viral particles in suspension allows for large-scale production of an injectable formulation of inactivated HIV viral particles for vaccine development which should preserve the conformational and antigenic integrity of viral surface proteins.

Charge radius isotope shift across the N=126 shell gap

We revisit the problem of the kink in the charge radius shift of neutron-rich even isotopes near the N=126 shell closure. We show that the ability of a Skyrme force to reproduce the isotope shift is determined by the occupation of the neutron 1i(11/2) orbital beyond N=126 and the corresponding change it causes to deeply-bound protons orbitals with a principal quantum number of 1. Given the observed position of the single-particle energies, one must either ensure occupation is allowed through correlations, or not demand that the single-particle energies agree with experimental values at the mean-field level.

Pesticide residue levels in green beans cultivated in Souss Masa valley (Morocco) after multiple applications of bifenthrin and λ-cyhalothrin

Dissipation of bifenthrin and λ-cyhalothrin pyrethroid insecticides, under environmental conditions, was evaluated on green beans grown in experimental greenhouses (Souss Massa valley, Morocco). Pesticide residues were determined by gas chromatography with micro electron-capture detector (GC-μECD) after dichloromethane extraction and cleanup on florisil phase cartridges. In the case of field experiments, a random block scheme was employed. Each block contained 25 plants in a single row and tests were carried out in triplicates applying pesticides at the recommended doses by the manufacturers. Fruit samples were periodically taken until the end of the preharvest interval (p.i.). The results obtained showed that the p.i of bifenthrin in green bean were 4 days in the winter and 3.5 days in the spring, whereas that for λ-cyhalothrin 8 days was found in the winter and 7.5 days in the spring. Consequently, it is possible to consider the European Union maximum residue limit (EU MRL) values compatible with the proper agricultural practices used for growing green bean in the plastic greenhouse of Souss Massa valley in South Morocco. Bifenthrin had a degradation of first-order kinetics, whereas that of levels for λ-cyhalothrin residue can not be interpreted by the use of a first order model.

Low-dose theophylline enhances the anti-inflammatory effects of steroids during exacerbations of COPD

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is characterised by an abnormal inflammatory response mainly to cigarette smoke that flares up during exacerbations of the disease (ECOPD). Reduced activity of histone deacetylases (HDAC) contributes to enhanced inflammation in stable COPD. It was hypothesised that HDAC activity is further reduced during ECOPD and that theophylline, an HDAC activator, potentiates the anti-inflammatory effect of steroids in these patients. A study was performed to investigate HDAC activity during ECOPD and the effects of theophylline on the anti-inflammatory effects of steroids in a randomised single-blind controlled study.

METHODS

35 patients hospitalised with ECOPD and treated according to international guidelines (including systemic steroids) were randomised to receive or not to receive low-dose oral theophylline (100 mg twice daily). Before treatment and 3 months after discharge, HDAC and nuclear factor-kappaB (NF-kappaB) activity in sputum macrophages, the concentration of nitric oxide in exhaled air (eNO) and total antioxidant status (TAS), tumour necrosis factor alpha (TNFalpha), interleukin (IL)-6 and IL8 levels in sputum supernatants were measured.

RESULTS

Patients receiving standard therapy showed decreased NF-kappaB activity, eNO concentration and sputum levels of TNFalpha, IL6 and IL8, as well as increased TAS during recovery of ECOPD, but HDAC activity did not change. The addition of low-dose theophylline increased HDAC activity and further reduced IL8 and TNFalpha concentrations.

CONCLUSIONS

During ECOPD, low-dose theophylline increases HDAC activity and improves the anti-inflammatory effects of steroids.

TRIAL REGISTRATION NUMBER

NCT00671151.

Supercritical fluid extraction as an on-line clean-up technique for rapid amperometric screening and alternative liquid chromatography for confirmation of paraquat and diquat in olive oil samples

A rapid and simple method for the direct screening of paraquat (PQ) and diquat (DQ) in olive oil samples is proposed. The sample screening method involves supercritical fluid extraction (SFE) (clean-up followed by the extraction of the analytes) followed by continuous flow electrochemical detection. Those samples for which the total concentration is close to or above the threshold limit established by the Columbian Society for Social Protection (0.05 microg g(-1)) are subsequently analyzed by liquid chromatography (LC) with diode array detection (DAD). This confirmation method allows the determination of PQ and DQ in the range between 0.04 and 1.0 microg g(-1), with average relative standard deviations lower than 3.5%, and 0.003 and 0.002 microg g(-1) detection limits for PQ and DQ, respectively. The proposed arrangement opens up interesting prospects for the direct determination of polar pesticides in complex samples with a good throughput and a high level of automation.

Method of determination of nitrosamines in sausages by CO2 supercritical fluid extraction (SFE) and micellar electrokinetic chromatography (MEKC)

In this paper, the use of supercritical fluid extraction (SFE) and micellar electrokinetic capillary chromatography (MEKC) is proposed for the complete analysis of volatile nitrosamines in sausages. The extraction fluid used was CO2 and variables such as density, temperature of thimbles, extraction time, modifier, fluid flow, and kind of traps were investigated. Several experiments were carried out to obtain the most favorable conditions for analysis of volatile nitrosamines in sausages. The recoveries ranged from 21 to 82% for the five nitrosamines studied. The optimal condition of extraction was 0.2 g of sample fortified with 10 mg/kg, using dynamic extraction during 20 min and with adsorbent Florisil in the trap. The solvent selected for the elution of the analytes was methanol.

Subcellular distribution of theEntamoeba histolytica140 kDa FN-binding molecule during host-parasite interaction

Entamoeba histolyticatrophozoites recovered from the host-parasite interface during abscess development obtain different stimuli compared with long-term cultured cells. In order to have a better understanding about the mechanisms in which the 140 kDa fibronectin (FN)-binding molecule (EhFNR) is involved during the invasive process, we decided to compare the regulation process of this molecule among long-term cultured trophozoites, FN-stimulated trophozoites, and trophozoites recently recovered from a liver abscess. A cDNA clone (5A) containing a fragment of theEhFNR that shows identity to the C-terminal region of the intermediate galactose lectin subunit Igl, was selected with a mAb (3C10). Identity ofEhFNR with Igl was confirmed by immunoprecipitation with 3C10 and EH3015 (against the Gal/GalNAc intermediate subunit) mAbs. The 3C10 mAb was used as a tool to explore the modulation of the amoebic receptor (EhFNR). Our results showed specific regulation of theEhFNR in FN-interacted amoebas, as well as in trophozoites recovered at different stages of abscess development. This regulation involved mobilization of the receptor molecule from internal vesicles to the plasma membrane. Therefore, we suggest that in the host-parasite interface, theEhFNR (Igl) plays an important role in the adhesion process during abscess development.

The Premature Infants in Need of Transfusion (PINT) study: a randomized, controlled trial of a restrictive (low) versus liberal (high) transfusion threshold for extremely low birth weight infants

OBJECTIVE

To determine whether extremely low birth weight infants (ELBW) transfused at lower hemoglobin thresholds versus higher thresholds have different rates of survival or morbidity at discharge.

STUDY DESIGN

Infants weighing <1000 g birth weight were randomly assigned within 48 hours of birth to a transfusion algorithm of either low or high hemoglobin transfusion thresholds. The composite primary outcome was death before home discharge or survival with any of either severe retinopathy, bronchopulmonary dysplasia, or brain injury on cranial ultrasound. Morbidity outcomes were assessed, blinded to allocation.

RESULTS

Four hundred fifty-one infants were randomly assigned to low (n = 223) or high (n = 228) hemoglobin thresholds. Groups were similar, with mean birth weight of 770 g and gestational age of 26 weeks. Fewer infants received one or more transfusions in the low threshold group (89% low versus 95% high, P = .037). Rates of the primary outcome were 74.0% in the low threshold group and 69.7% in the high (P = .25; risk difference, 2.7%; 95% CI -3.7% to 9.2%). There were no statistically significant differences between groups in any secondary outcome.

CONCLUSIONS

In extremely low birth weight infants, maintaining a higher hemoglobin level results in more infants receiving transfusions but confers little evidence of benefit.

Aromatase inhibitor (AI)-associated arthralgia (A) and bone pain (BP): Frequency and characterization in clinical practice

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Background: Prior studies of AI have identified A and/or BP as side effects. Reported incidences have varied from 4% (IMPACT) to 35.6% (ATAC). In order to determine the frequency of A or BP in clinical practice, we reviewed a consecutive series of patients (PTs) receiving AI in community cancer centers. Methods: The charts of consecutive PTs receiving AI were reviewed, and PTs were interviewed regarding the occurrence of A or BP (ABP), severity, whether ABP was worse than before AI therapy, preexisting co-morbidities, type of therapy for ABP, and pain characterization. Results: 56 PTs were receiving AI. The type of AI used was anastrazole in 44 PTs, letrozole in 10 PTs, and exemestane in 2 PTs. The age range was 45 to 89 years. All PTs had breast cancer. The duration AI usage was 1 to 44 mo. Worsening of ABP compared to pretreatment ABP was reported in 34 PTs (61%). In 11 Pts (20%), severity was sufficient and control poor enough to result in discontinuation of AI at a median of 2 mo of AI therapy. The median severity of ABP, when present, was 7.5 on a 10 point pain scale. The character of the ABP was continuous in 20 (59%) and intermittent in 14 (41%), affected central/axial bones in 20 (36%), and peripheral bones in 35 (64%). Coexisting conditions possibly contributing to worsening of ABP occurred in 36%, consisting of degenerative joint disease 10, fibromyalgia 1, osteoporosis 4, and degenerative disc disease 1. Therapy associated with amelioration of symptoms included acetaminophen in 26%, NSAIDs in 45%, mild opiates in 11%, strong opiates in 5%, and glucosamine in 13%. The occurrence of ABP was not associated with age (68% in PTs less than 60 versus 57% in PTs over 60). The occurrence of ABP was not associated with duration of use of AI (50% of 16 Pts on AI for 3–6 mo, 75% for 7–12 mo, and 56% for over 12 mo). Conclusions: The occurrence of AI associated ABP is higher in a non-clinical trial population of PTs than reported in most clinical trials. This side effect is severe enough to cause discontinuation of needed AI therapy in 20%. Further studies are warranted to determine the mechanism of AI associated ABP, and optimal therapy. It is reasonable to consider glucosamine as well as standard analgesics in controlling this syndrome.

No significant financial relationships to disclose.

Frequency analysis of air and skin temperature in neonates in servo-controlled incubators

OBJECTIVE

To test a new system designed for digital recording of skin and air temperature, thereby allowing analysis of cyclic changes in temperature in neonates in servo-controlled incubators.

METHODS

Analysis of cyclic changes of serial skin and air temperature in asymptomatic infants in servo-controlled incubators adjusting heat output to the patient's temperature.

RESULTS

In nine asymptomatic neonates ranging from 25 to 40 weeks of gestational age, analysis showed peaks of coherence (squared correlation) between skin and air temperature measurements at periods ranging between 1.5 and 3 h.

CONCLUSION

We have established a new system to study cyclic changes in skin and air temperature in neonates in servo-controlled incubators. The analysis of this pilot study suggests that the most important changes in skin and air temperature in asymptomatic neonates occur at a periodicity of 1.5 to 3 h, which is similar to that previously described for neonatal temperature. Additional data are required to determine whether this new system may be useful in neonatal care.