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Wang X, Hao Y, Yin Y, Hou Y, Han N, Liu Y, Li Z, Wei Y, Ma K, Gu J, Ma Y, Qi H, Jia Z. Lianhua Qingke Preserves Mucociliary Clearance in Rat with Acute Exacerbation of Chronic Obstructive Pulmonary Disease by Maintaining Ciliated Cells Proportion and Protecting Structural Integrity and Beat Function of Cilia. Int J Chron Obstruct Pulmon Dis 2024; 19:403-418. [PMID: 38343495 PMCID: PMC10859105 DOI: 10.2147/copd.s436323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
Purpose Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is a sudden worsening of symptoms in patients with Chronic Obstructive Pulmonary Disease (COPD), such as cough, increased sputum volume, and sputum purulence. COPD and AECOPD are characterized by damage to cilia and increased mucus secretion. Mucociliary clearance (MCC) functions as part of the primary innate system of the lung to remove harmful particles and pathogens together with airway mucus and is therefore crucial for patients with COPD. Methods AECOPD was induced by cigarette smoke exposure (80 cigarettes/day, 5 days/week for 12 weeks) and lipopolysaccharide (LPS) instillation (200 μg, on days 1, 14, and 84). Rats administered Lianhua Qingke (LHQK) (0.367, 0.732, and 1.465 g/kg/d) or Eucalyptol, Limonene, and Pinene Enteric Soft Capsules (ELP, 0.3 g/kg/d) intragastrically. Pulmonary pathology, Muc5ac+ goblet cell and β-tubulin IV+ ciliated cells, and mRNA levels of forkhead box J1 (Foxj1) and multiciliate differentiation and DNA synthesis associated cell cycle protein (MCIDAS) were assessed by hematoxylin and eosin staining, immunofluorescence staining, and RT-qPCR, respectively. Ciliary morphology and ultrastructure were examined through scanning electron microscopy and transmission electron microscopy. Ciliary beat frequency (CBF) was recorded using a high-speed camera. Results Compared to the model group, LHQK treatment groups showed a reduction in inflammatory cell infiltration, significantly reduced goblet cell and increased ciliated cell proportion. LHQK significantly upregulated mRNA levels of MCIDAS and Foxj1, indicating promoted ciliated cell differentiation. LHQK protected ciliary structure and maintained ciliary function via increasing the ciliary length and density, reducing ciliary ultrastructure damage, and ameliorating random ciliary oscillations, consequently enhancing CBF. Conclusion LHQK enhances the MCC capability of ciliated cells in rat with AECOPD by preserving the structural integrity and beating function of cilia, indicating its therapeutic potential on promoting sputum expulsion in patients with AECOPD.
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Affiliation(s)
- Xiaoqi Wang
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, 050090, People’s Republic of China
- Hebei Yiling Pharmaceutical Research Institute, Shijiazhuang, 050035, People’s Republic of China
| | - Yuanjie Hao
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
| | - Yujie Yin
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, Hebei, 050035, People’s Republic of China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, People’s Republic of China
| | - Yunlong Hou
- Hebei Yiling Pharmaceutical Research Institute, Shijiazhuang, 050035, People’s Republic of China
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, Hebei, 050035, People’s Republic of China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, People’s Republic of China
| | - Ningxin Han
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
| | - Yi Liu
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
| | - Zhen Li
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
| | - Yaru Wei
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, 050090, People’s Republic of China
| | - Kun Ma
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, 050090, People’s Republic of China
| | - Jiaojiao Gu
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, 050090, People’s Republic of China
| | - Yan Ma
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, 050090, People’s Republic of China
| | - Hui Qi
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, Hebei, 050035, People’s Republic of China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, People’s Republic of China
| | - Zhenhua Jia
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, 050090, People’s Republic of China
- Hebei Academy of Integrated Traditional Chinese and Western Medicine, Shijiazhuang, Hebei, 050035, People’s Republic of China
- National Key Laboratory for Innovation and Transformation of Luobing Theory, Shijiazhuang, 050035, People’s Republic of China
- Department of Respiratory, Affiliated Yiling Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050091, People’s Republic of China
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Kim DY, Sub YJ, Kim HY, Cho KJ, Choi WI, Choi YJ, Lee MG, Hildebrandt F, Gee HY. LRRC6 regulates biogenesis of motile cilia by aiding FOXJ1 translocation into the nucleus. Cell Commun Signal 2023; 21:142. [PMID: 37328841 PMCID: PMC10273532 DOI: 10.1186/s12964-023-01135-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/22/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND LRRC6 is an assembly factor for dynein arms in the cytoplasm of motile ciliated cells, and when mutated, dynein arm components remained in the cytoplasm. Here, we demonstrate the role of LRRC6 in the active nuclear translocation of FOXJ1, a master regulator for cilia-associated gene transcription. METHODS We generated Lrrc6 knockout (KO) mice, and we investigated the role of LRRC6 on ciliopathy development by using proteomic, transcriptomic, and immunofluorescence analysis. Experiments on mouse basal cell organoids confirmed the biological relevance of our findings. RESULTS The absence of LRRC6 in multi-ciliated cells hinders the assembly of ODA and IDA components of cilia; in this study, we showed that the overall expression of proteins related to cilia decreased as well. Expression of cilia-related transcripts, specifically ODA and IDA components, dynein axonemal assembly factors, radial spokes, and central apparatus was lower in Lrrc6 KO mice than in wild-type mice. We demonstrated that FOXJ1 was present in the cytoplasm and translocated into the nucleus when LRRC6 was expressed and that this process was blocked by INI-43, an importin α inhibitor. CONCLUSIONS Taken together, these results hinted at the LRRC6 transcriptional regulation of cilia-related genes via the nuclear translocation of FOXJ1. Video Abstract.
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Affiliation(s)
- Dong Yun Kim
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Yu Jin Sub
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hye-Youn Kim
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyeong Jee Cho
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Won Il Choi
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Yo Jun Choi
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Min Goo Lee
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Friedhelm Hildebrandt
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
| | - Heon Yung Gee
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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Pfaar O, Beule AG, Jobst D, Kraft K, Stammer H, Röschmann-Doose KIL, Wittig T, Stuck BA. Phytomedicine ELOM-080 in Acute Viral Rhinosinusitis: A Randomized, Placebo-Controlled, Blinded Clinical Trial. Laryngoscope 2022. [PMID: 36222438 DOI: 10.1002/lary.30418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/28/2022] [Accepted: 08/30/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND ELOM-080 is a phytomedicine approved for the treatment of acute and chronic inflammatory diseases of the respiratory tract, sinusitis, and bronchitis in particular. This prospective, randomized, placebo-controlled, double-blind clinical trial was conducted to assess efficacy and safety of ELOM-080 in the treatment of acute viral rhinosinusitis (AVRS). METHODS Patients with AVRS received oral treatment (4 × 1 capsule per day) with either ELOM-080 or matching placebo. Primary endpoints were the change in major symptom score (MSS) after 7 and 14 days of treatment assessed by the investigator (MSSINV ). Secondary endpoints were changes in MSS assessed by the patients (MSSPAT ), olfactory function (12-item Sniffin' Sticks), 20-Item Sino-Nasal Outcome Test (SNOT-20 GAV; German adapted version), influence of treatment on viral load, and safety. RESULTS Four hundred and sixty-three patients were randomized. At day 4, subjective burden of disease (MSS) was significantly ameliorated compared to placebo (p = 0.012). During the first treatment week MSS scores improved about 1 day earlier, and 3 days earlier in the second week. Effect with ELOM-080 on mean MSSINV was statistically significantly superior to placebo at visit 3 (p = 0.016) and visit 4 (p = 0.014). In chemosensory testing identification scores improved comparably in both treatments. The improvement of the SNOT-20 GAV was more pronounced in ELOM-080 patients. Treatment with ELOM-080 indicated a potential for decreasing viral load. Both treatments were well tolerated. CONCLUSION ELOM-080 improves the burden of AVRS significantly in comparison to placebo, remission of symptoms occurred 3 days earlier. The results confirm the efficacy and safety of ELOM-080 for treatment of AVRS. LEVEL OF EVIDENCE 1 Laryngoscope, 2022.
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Affiliation(s)
- Oliver Pfaar
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Achim G Beule
- Department of Otolaryngology University Hospital Muenster, Muenster, Germany and Department of Otolaryngology, Head and Neck Cancer, University Clinic Greifswald, Greifswald, Germany
| | - Detmar Jobst
- Institute for Pharmacology and Toxicology, University of Bonn, Bonn and University of Witten-Herdecke, Herdecke, Germany
| | - Karin Kraft
- Chair of Naturopathic Medicine, University Medicine Rostock, Rostock, Germany
| | - Holger Stammer
- PHARMALOG Institut für klinische Forschung GmbH, Ismaning, Germany
| | | | - Thomas Wittig
- G. Pohl-Boskamp GmbH & Co. KG, Hohenlockstedt, Germany
| | - Boris A Stuck
- Section of Rhinology and Allergy, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
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Dreher M, Grohè C, Hartmann NU, Kanzler S, Kraft K, Sarrazin C, Doll M, Spiesshöfer J, Steiner S, Wöhrle J, Seeger J, Röschmann-Doose K, Thomsen J, Wittig T, Marx N, Eisenmann S. Efficacy and Safety of ELOM-080 as Add-On Therapy in COVID-19 Patients with Acute Respiratory Insufficiency: Exploratory Data from the Prospective Placebo-Controlled COVARI Trial. Adv Ther 2022; 39:3011-3018. [PMID: 35419650 PMCID: PMC9007397 DOI: 10.1007/s12325-022-02135-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/16/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Enhancement of mucociliary clearance (MCC) might be a potential target in treating COVID-19. The phytomedicine ELOM-080 is an MCC enhancer that is used to treat inflammatory respiratory diseases. PATIENTS/METHODS This randomised, double-blind exploratory study (EudraCT number 2020-003779-17) evaluated 14 days' add-on therapy with ELOM-080 versus placebo in patients with COVID-19 hospitalised with acute respiratory insufficiency. RESULTS The trial was terminated early after enrolment of 47 patients as a result of poor recruitment. Twelve patients discontinued prematurely, leaving 35 in the per-protocol set (PPS). Treatment with ELOM-080 had no significant effect on overall clinical status versus placebo (p = 0.49). However, compared with the placebo group, patients treated with ELOM-080 had less dyspnoea in the second week of hospitalisation (p = 0.0035), required less supplemental oxygen (p = 0.0229), and were more often without dyspnoea when climbing stairs at home (p < 0.0001). CONCLUSION These exploratory data suggest the potential for ELOM-080 to improve respiratory status during and after hospitalisation in patients with COVID-19.
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Affiliation(s)
- Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Christian Grohè
- Department of Respiratory Diseases, Evangelische Lungenklinik Berlin Buch, Berlin, Germany
| | - Niels-Ulrik Hartmann
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Stephan Kanzler
- Second Department of Medicine, Schweinfurt Hospital, Schweinfurt, Germany
| | - Karin Kraft
- Chair of Naturopathic Medicine, University Medicine Rostock, Rostock, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine and Liver Center, St. Josefs-Hospital Wiesbaden and Viral Hepatitis Research Group, Goethe-University Hospital Frankfurt, Frankfurt, Germany
| | - Michael Doll
- Department of Internal Medicine and Liver Center, St. Josefs-Hospital Wiesbaden and Viral Hepatitis Research Group, Goethe-University Hospital Frankfurt, Frankfurt, Germany
| | - Jens Spiesshöfer
- Department of Pneumology and Intensive Care Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Stephan Steiner
- Pneumology and Intensive Care, St. Vincenz Hospital, Limburg, Germany
| | - Jochen Wöhrle
- Department of Cardiology, Angiology, Pneumology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany
| | - Julia Seeger
- Department of Cardiology, Angiology, Pneumology and Intensive Care, Medical Campus Lake Constance, Friedrichshafen, Germany
| | | | - Jörn Thomsen
- G. Pohl-Boskamp GmbH & Co. KG, Hohenlockstedt, Germany
| | - Thomas Wittig
- G. Pohl-Boskamp GmbH & Co. KG, Hohenlockstedt, Germany
| | - Nikolaus Marx
- Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Stephan Eisenmann
- Section on Pneumology, Department of Internal Medicine I, University Hospital Halle, Halle (Saale), Germany
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Abstract
BACKGROUND As with other inflammatory diseases, the (dry) cough in COVID-19 patients indicates that mucociliary clearance (MCC) is at least at risk, if not overloaded, damaged or largely inoperable. Coughing is an important secondary mechanism that only takes over bronchial cleansing as a replacement if the MCC has failed. METHOD The review article describes the physiology and pathophysiology of MCC and its possible role in the pathogenesis of COVID-19. RESULTS AND CONCLUSIONS Human and animal studies as well as autopsy reports indicate that MCC could also be important for the COVID-19 pathogenesis. In primary care, MCC plays a major role in inflammatory respiratory diseases. In Germany, drugs for self-medication are approved for treatment and, due to the high quality of studies, are also recommended in the respective guidelines. A symptomatic approach to stabilize the airway barrier would also be conceivable in the early outpatient phase of COVID-19.
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Affiliation(s)
- Thomas Wittig
- Leiter Medizin & Klinische Forschung G. Pohl-Boskamp GmbH & Co KG, Arzt für Allgemeinmedizin, Kieler Straße 11, 25551, Hohenlockstedt, Germany.
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Wang Z, Liang W, Ma C, Wang J, Gao X, Wei L. Macrophages Inhibit Ciliary Protein Levels by Secreting BMP-2 Leading to Airway Epithelial Remodeling Under Cigarette Smoke Exposure. Front Mol Biosci 2021; 8:663987. [PMID: 33981724 PMCID: PMC8107431 DOI: 10.3389/fmolb.2021.663987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/29/2021] [Indexed: 11/22/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high morbidity and mortality worldwide. So far, smoking is still its leading cause. The characteristics of COPD are emphysema and airway remodeling, as well as chronic inflammation, which were predominated by macrophages. Some studies have reported that macrophages were involved in emphysema and chronic inflammation, but whether there is a link between airway remodeling and macrophages remains unclear. In this study, we found that both acute and chronic cigarette smoke exposure led to an increase of macrophages in the lung and a decrease of ciliated cells in the airway epithelium of a mouse model. The results of in vitro experiments showed that the ciliary protein (β-tubulin-IV) levels of BEAS-2B cells could be inhibited when co-cultured with human macrophage line THP-1, and the inhibitory effect was augmented with the stimulation of cigarette smoke extract (CSE). Based on the results of transcriptome sequencing, we focused on the protein, bone morphogenetic protein-2 (BMP-2), secreted by the macrophage, which might mediate this inhibitory effect. Further studies confirmed that BMP-2 protein inhibited β-tubulin-IV protein levels of BEAS-2B cells under the stimulation of CSE. Coincidentally, this inhibitory effect could be nearly blocked by the BMP receptor inhibitor, LDN, or could be interfered with BMP-2 siRNA. This study suggests that activation and infiltration of macrophages in the lung induced by smoke exposure lead to a high expression of BMP-2, which in turn inhibits the ciliary protein levels of the bronchial epithelial cells, contributing to the remodeling of airway epithelium, and aggravates the development of COPD.
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Affiliation(s)
- Zhigang Wang
- Department of Immunology, Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China.,Department of Intensive Care Unit, Hebei General Hospital, Shijiazhuang, China
| | - Wenzhang Liang
- Department of Immunology, Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Cuiqing Ma
- Department of Immunology, Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Jiachao Wang
- Department of Immunology, Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Xue Gao
- Department of Immunology, Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Lin Wei
- Department of Immunology, Key Laboratory of Immune Mechanism and Intervention on Serious Disease in Hebei Province, Hebei Medical University, Shijiazhuang, China
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Li J, Ye Z. The Potential Role and Regulatory Mechanisms of MUC5AC in Chronic Obstructive Pulmonary Disease. Molecules 2020; 25:molecules25194437. [PMID: 32992527 PMCID: PMC7582261 DOI: 10.3390/molecules25194437] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality globally. Studies show that airway mucus hypersecretion strongly compromises lung function, leading to frequent hospitalization and mortality, highlighting an urgent need for effective COPD treatments. MUC5AC is known to contribute to severe muco-obstructive lung diseases, worsening COPD pathogenesis. Various pathways are implicated in the aberrant MUC5AC production and secretion MUC5AC. These include signaling pathways associated with mucus-secreting cell differentiation [nuclear factor-κB (NF-κB)and IL-13-STAT6- SAM pointed domain containing E26 transformation-specific transcription factor (SPDEF), as well as epithelial sodium channel (ENaC) and cystic fibrosis transmembrane conductance regulator (CFTR)], and signaling pathways related to mucus transport and excretion-ciliary beat frequency (CBF). Various inhibitors of mucus hypersecretion are in clinical use but have had limited benefits against COPD. Thus, novel therapies targeting airway mucus hypersecretion should be developed for effective management of muco-obstructive lung disease. Here, we systematically review the mechanisms and pathogenesis of airway mucus hypersecretion, with emphasis on multi-target and multi-link intervention strategies for the elucidation of novel inhibitors of airway mucus hypersecretion.
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Affiliation(s)
- Jingyuan Li
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;
| | - Zuguang Ye
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
- Correspondence: ; Tel./Fax: +86-10-8425-2805
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Liu L, Li S, Wu Y, Wang X, Huang D, Pei C, Wang F, Wang Z. Effect of myrtol on chronic bronchitis or chronic obstructive pulmonary disease: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20692. [PMID: 32664065 PMCID: PMC7360323 DOI: 10.1097/md.0000000000020692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/15/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The key to the management of chronic obstructive (CB) and chronic obstructive pulmonary disease (COPD) is to control symptoms of the disease and to prevent deterioration in the health of affected patients. Myrtol has been proved to be effective in treating the symptoms of patients with CB and COPD and preventing the deterioration in their health. However, there has been no systematic review of the efficacy and safety of myrtol in the treatment of CB or COPD. The purpose of this study is going to evaluate the effects of myrtol on the management of CB or COPD based on randomized controlled trials. METHODS Electronic literature and other ongoing studies will be searched before November 31, 2019. Randomized controlled trials that report the use of myrtol in the treatment of CB or COPD (in the absence and presence of concurrent treatments) will be selected for inclusion regardless of language. Primary outcomes will include cumulative numbers of exacerbation events and the number of days of disability including days in bed, days off work due to breathing complications, and days on which the participant was unable to undertake normal activities due to breathing complications. Study selection, data extraction, and deviation the derivation risk assessment will be carried out by 2 independent investigators. Meta-analysis will be carried out by the RevMan5.3 software. RESULTS The study will provide summary results for estimating the efficacy and safety of myrtol for future treatments of CB or COPD. CONCLUSIONS This systematic review will determine if myrtol is an effective and a safe intervention on the symptoms and the prevention of exacerbation of CB or COPD. ETHICS AND DISSEMINATION Ethical approval will not be required for this study because no identifying patient data will be used. The review will be published as an article or a conference presentation in a peer-reviewed journal. REGISTRATION OSF registration number: DOI 10.17605/OSF.IO/PXRBV.
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Affiliation(s)
- Liyun Liu
- School of basic medical sciences, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai avenue, Wenjiang district
| | - Shuiqin Li
- Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, Sichuan Province, People's Republic of China
| | - Yongcan Wu
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road
| | - Xiaomin Wang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road
| | - Demei Huang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road
| | - Caixia Pei
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road
| | - Fei Wang
- Department of Geriatrics, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road
| | - Zhenxing Wang
- Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road
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Wu Y, Wang X, Huang D, Pei C, Li S, Wang Z. Gelomyrtol for acute or chronic sinusitis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20611. [PMID: 32502036 PMCID: PMC7306384 DOI: 10.1097/md.0000000000020611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sinusitis is a common condition worldwide, significantly affecting the quality of life of patients. Due to the limitations of conventional medicines, such as serious side effects and low efficacies, Gelomyrtol may be a promising treatment for sinusitis. As no related systematic review has been published, the purpose of this study will be to evaluate the safety and efficacy of Gelomyrtol for acute or chronic sinusitis. METHODS PubMed, EMBASE, the Cochrane Library, the Web of Science, the Chinese National Knowledge Infrastructure Database, the Chinese Biomedical Literature Database, the Wan Fang Database, and the Chongqing VIP Chinese Science, and Technology Periodical Database will be searched from their commencement until July 2020. Randomized controlled trials of Gelomyrtol for acute or chronic sinusitis will be selected in any language. Primary outcomes will include the Sino-Nasal Outcome Test-22 (SNOT-22) score, quality of life score as measured by SF-36, and the change in computed tomography (CT) score. Study selection, data extraction, and deviation risk assessment will be carried out by 2 investigators independently. RevMan V.5.3 software will be used to analyze the study data. RESULTS The study will provide high-quality evidence for estimating the efficacy and safety of Gelomyrtol in the treatment of acute or chronic sinusitis. CONCLUSIONS This systematic review will explore whether Gelomyrtol is an effective and safe intervention in the treatment of acute or chronic sinusitis. ETHICS AND DISSEMINATION As no patient data will be used in this study, ethical approval will not be required. The review will be published as an article or a conference presentation in a peer-reviewed journal. REGISTRATION OSF registration number: DOI 10.17605/OSF.IO/MTEU2.
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Affiliation(s)
| | | | | | | | - Shuiqin Li
- Department of Gastroenterology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, People's Republic of China
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Peng Y, Guan WJ, Zhu ZC, Tan KS, Chen Z, Hong HY, Zi XX, Andiappan AK, Shi L, Yang QT, Wang DY, Qiu QH. Microarray Assay Reveals Ciliary Abnormalities of the Allergic Nasal Mucosa. Am J Rhinol Allergy 2019; 34:50-58. [PMID: 31450948 DOI: 10.1177/1945892419871795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Gene expression patterns (particularly, cilia-associated genes) of nasal mucosa, the first-line defense system, in allergic rhinitis (AR) are not well understood. Objective We sought to screen for AR-associated genes in inferior turbinate (IT) from patients with AR, and to validate the expression of common cilia-related genes and ciliary shedding. Methods Prime View™ Human Gene Expression Array, which consisted of more than 530 000 probes covering more than 36 000 transcripts and variants, was employed to compare individual gene expression of ITs from control subjects (n = 11) and patients with AR (n = 19). Gene ontology (GO) analysis was performed with Cytoscape software. Eight of the common cilia-related genes were validated with quantitative polymerase chain reaction. We applied a semiquantitative scoring system for immunofluorescence assay to demonstrate ciliary shedding in 5 areas per paraffin section, with individual sections being scored between 0 (normal ciliary distribution) and 1 (ciliary shedding). Results Compared with control subjects, 160 (38 upregulated and 122 downregulated) genes were differentially expressed for at least 2 folds (all P < .05) in AR. Seven GO categories were significantly enriched, 4 of which were related to cilium assembly and motility. Quantitative polymerase chain reaction validated the predicted direction of change for common cilia-related gene expression. The ciliary distribution score was significantly higher (more prominent ciliary shedding) in AR than in controls ( P < .05). Conclusion The significant aberrant cilia-related gene expression, revealed by microarray assays, might be the critical driver of AR where ciliary shedding is prominent.
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Affiliation(s)
- Yang Peng
- Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Zhen-Chao Zhu
- Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Kai Sen Tan
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Zhuo Chen
- Department of Otolaryngology Head & Neck Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Hai-Yu Hong
- Department of Otolaryngology-Head and Neck Surgery, The 5th Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Xiao-Xue Zi
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,Department of Otolaryngology, The Second Hospital of Shandong University, Jinan, China
| | - Anand Kumar Andiappan
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore, Singapore
| | - Li Shi
- Department of Otolaryngology, The Second Hospital of Shandong University, Jinan, China
| | - Qin-Tai Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - De-Yun Wang
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Qian-Hui Qiu
- Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Department of Otolaryngology Head & Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Peng Y, Guan WJ, Tan KS, Zhu Z, Chen Z, Hong H, Wang Z, Tian T, Zi X, Ong YK, Thong M, Shi L, Yang Q, Qiu Q, Wang DY. Aberrant localization of FOXJ1 correlates with the disease severity and comorbidities in patients with nasal polyps. Allergy Asthma Clin Immunol 2018; 14:71. [PMID: 30459817 PMCID: PMC6234688 DOI: 10.1186/s13223-018-0296-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/28/2018] [Indexed: 12/13/2022] Open
Abstract
Background Upper airway inflammatory diseases are associated with abnormal expression of nasal epithelial forkhead-box J1 (FOXJ1) which regulates motile cilia formation. We sought to investigate whether aberrant FOXJ1 localizations correlate with the disease severity and the co-existence of allergic rhinitis (AR) or asthma in patients with nasal polyps (NPs). Methods We elucidated localization patterns of FOXJ1 by performing immunofluorescence assays in nasal specimens and cytospin samples from controls and patients with NPs. We also assayed mRNA expression levels of FOXJ1 by using quantitative real-time polymerase chain reaction. Four localization patterns [normal (N), intermediate (I), mislocalization (M), and absence (A)] were defined. A semi-quantitative scoring system was applied for demonstrating FOXJ1 localization in five areas per paraffin section, with individual sections being scored between 0 and 2. Results FOXJ1 localization score was significantly higher in samples from NPs than in controls (P < 0.001). Elevated FOXJ1 localization scores and down-regulation of FOXJ1 mRNA levels were observed in NPs with co-existing AR or asthma (all P < 0.05). Moreover, FOXJ1 localization scores positively correlated with Lund–Mackay score (r = 0.362, P = 0.007). Of primary cytospin samples, the mean percentage of patients with FOXJ1 localization patterns N, I, M and A was 15.0%, 3.3%, 53.3% and 28.3% in NPs, and 82.5%, 5.0%, 5.0% and 7.5% in controls, respectively (P < 0.001). Conclusions Aberrant localization of FOXJ1 correlates with the severity and co-existence of AR or asthma in patients with NPs, and might be a novel target for assessment and intervention in NPs. Electronic supplementary material The online version of this article (10.1186/s13223-018-0296-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yang Peng
- 1Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong China.,2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,3State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Wei-Jie Guan
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,3State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Kai Sen Tan
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Zhenchao Zhu
- 1Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong China.,4Department of Otolaryngology Head & Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China
| | - Zhuo Chen
- 5Department of Otolaryngology Head & Neck Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan China
| | - Haiyu Hong
- 6Department of Otolaryngology-Head and Neck Surgery, The 5th Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong China
| | - Zhaoni Wang
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,7Department of Pediatrics, The 3rd Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong China
| | - Tengfei Tian
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,8Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi China
| | - Xiaoxue Zi
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,9Department of Otolaryngology, The Second Hospital, Shandong University, Jinan, China
| | - Yew Kwang Ong
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Mark Thong
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Li Shi
- 9Department of Otolaryngology, The Second Hospital, Shandong University, Jinan, China
| | - Qintai Yang
- 10Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong China
| | - Qianhui Qiu
- 1Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong China.,4Department of Otolaryngology Head & Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong China.,12Department of Otolaryngology Head and Neck Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282 Guangdong China
| | - De-Yun Wang
- 2Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore.,3State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.,11Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228 Singapore
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Motile Ciliary Disorders in Chronic Airway Inflammatory Diseases: Critical Target for Interventions. Curr Allergy Asthma Rep 2018; 18:48. [PMID: 30046922 DOI: 10.1007/s11882-018-0802-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW Impaired mucociliary clearance has been implicated in chronic upper and lower airway inflammatory diseases (i.e., allergic and non-allergic rhinitis, chronic rhinosinusitis with or without nasal polyps and asthma). How motile ciliary disorders (impaired ciliogenesis, ciliary beating and ultrastructural defects) are implicated in chronic airway inflammatory diseases is not fully understood. Elaboration of the role of motile ciliary disorders may serve as therapeutic targets for improving mucociliary clearance, thereby complementing contemporary disease management. RECENT FINDINGS We have summarized the manifestations of motile ciliary disorders and addressed the underlying associations with chronic airway inflammatory diseases. A panel of established and novel diagnostic tests and therapeutic interventions are outlined. Physicians should be vigilant in screening for motile ciliary disorders, particularly in patients with co-existing upper and lower airway inflammatory diseases. Proper assessment and treatment of motile ciliary disorders may have added value to the management and prevention of chronic airway inflammatory diseases.
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Gottschlich S, Röschmann K, Candler H. Phytomedicines in Acute Rhinosinusitis: A Prospective, Non-interventional Parallel-Group Trial. Adv Ther 2018; 35:1023-1034. [DOI: 10.1007/s12325-018-0736-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Indexed: 12/13/2022]
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14
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Peng Y, Chen Z, Guan WJ, Zhu Z, Tan KS, Hong H, Zi X, Zeng J, Li Y, Ong YK, Thong M, Shi L, Yang Q, Qiu Q, Wang DY. Downregulation and Aberrant Localization of Forkhead Box J1 in Allergic Nasal Mucosa. Int Arch Allergy Immunol 2018; 176:115-123. [PMID: 29635245 DOI: 10.1159/000488014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 02/12/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Forkhead box J1 (FOXJ1) plays pivotal roles in motile cilia formation. However, it remains unclear whether abnormal expression or localization of FOXJ1 in nasal mucosa tissues is associated with allergic rhinitis (AR), in which impaired mucociliary clearance is implicated. OBJECTIVE We sought to investigate the expression and localization of FOXJ1 in inferior turbinate from patients with AR and controls. METHODS We assayed mRNA levels of FOXJ1, DNAI1, DNALI1, and DNAH9 by using whole-genome expression array and quantitative real-time polymerase chain reaction. We elucidated the localization of FOXJ1 by using immunofluorescence assays in paraffin sections and primary single cells. Four patterns of FOXJ1 localization (normal, N; intermediate, I; mislocalization, M; absence, A) were defined. We developed a semiquantitative scoring system to elucidate their localization in 5 areas per paraffin section, with individual sections being assigned a score between 0 and 2. RESULTS The mRNA levels of FOXJ1, DNAI1, DNALI1, and DNAH9 were significantly reduced in patients with AR compared with controls (all p < 0.05). The median (1st and 3rd quartile) of the FOXJ1 score was 0.4 (0.0 and 0.85) in patients with AR, and 0.2 (0.0 and 0.4) in controls (p < 0.05). For primary cytospin samples, the mean percentages of FOXJ1 localization patterns N, I, M, and A were 46.7, 10.0, 30.0, and 26.7% in patients with AR, and 82.5, 5.0, 5.0, and 7.5% in controls, respectively (p < 0.05). CONCLUSION Downregulation and aberrant localization of FOXJ1 may be crucial characteristics of the allergic nasal mucosa.
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Affiliation(s)
- Yang Peng
- Department of Otolaryngology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.,Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Zhuo Chen
- Department of Otolaryngology - Head and Neck Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhenchao Zhu
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kai Sen Tan
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Haiyu Hong
- Department of Otolaryngology - Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Xiaoxue Zi
- Department of Otolaryngology, The Second Hospital of Shandong University, Jinan, China
| | - Jie Zeng
- Department of Otolaryngology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yixuan Li
- Department of Otolaryngology, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yew Kwang Ong
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Mark Thong
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
| | - Li Shi
- Department of Otolaryngology, The Second Hospital of Shandong University, Jinan, China
| | - Qintai Yang
- Department of Otorhinolaryngology - Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qianhui Qiu
- Department of Otolaryngology Head and Neck Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - De-Yun Wang
- Department of Otolaryngology, National University of Singapore, National University Health System, Singapore, Singapore
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Han JK. Editorial. Int Forum Allergy Rhinol 2017; 7:219-220. [PMID: 28297554 DOI: 10.1002/alr.21930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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