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McCool H, Evans A, Vinan Vega M, Nugent K. Prolonged cough and dyspnea following a single episode of intense silica exposure. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2024; 78:501-506. [PMID: 38095547 DOI: 10.1080/19338244.2023.2293939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 02/08/2024]
Abstract
Long term exposure to silica at worksites can cause silicosis. This typically has two radiographic forms, simple silicosis and complicated or conglomerate silicosis. Patients with acute silicosis have rapid progression of disease with fulminant respiratory failure over months rather than years. The patient described in this case report had a one-time 4 to 5-h exposure to silica and sand dust at work when his mask malfunctioned. He developed cough and shortness of breath. During his initial clinic visit he had significant cough. His chest examination was clear without crackles or wheezes. His pulmonary function tests were within normal limits. His chest x-ray was clear. Both symptoms, especially the cough, persisted over the next 6+ months even after treatment with oral corticosteroids and inhaled corticosteroids and long-acting beta agonists. Consequently, this patient developed severe cough following a one-time exposure to silica particulates. Laboratory studies have demonstrated that silica exposure can cause reactive oxygen species which potentially could have activated transient receptor potential vanilloid 1 channels in the afferent sensory nerves in his bronchial epithelium. This could cause sustained cough for more than 6 months. His symptoms improved but did not resolve with corticosteroid treatment. Therefore, this case demonstrates that acute silica exposure can cause sustained airway symptoms in healthy workers.
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Affiliation(s)
- Hannah McCool
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Abbie Evans
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Myrian Vinan Vega
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Terada S, Matsumoto H, Nishi K, Kogo M, Nomura N, Tashima N, Morimoto C, Sunadome H, Nagasaki T, Oguma T, Nakatsuka Y, Murase K, Kawaguchi T, Tabara Y, Sonomura K, Matsuda F, Chin K, Hirai T. Association of lower plasma citric acid with prolonged cough: the Nagahama study. Sci Rep 2023; 13:13921. [PMID: 37626075 PMCID: PMC10457296 DOI: 10.1038/s41598-023-40878-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Little is known about the association of prolonged cough, a common and troublesome symptom, with metabolic pathways. We aimed to clarify this association using data from the Nagahama cohort, a prospective study of participants from the general population. Self-report questionnaires on prolonged cough were collected at baseline and 5-year follow-up assessments. Blood tests at follow-up were used for gas chromatography-mass spectrometry-based metabolomics. The association between metabolites and prolonged cough was examined using the partial least squares discriminant analysis and multiple regression analysis. Among the 7432 participants, 632 had newly developed prolonged cough at follow-up, which was defined as "new-onset prolonged cough". Low plasma citric acid was significantly associated with new-onset prolonged cough, even after the adjustment of confounding factors including the presence of asthma, upper airway cough syndrome (UACS), and gastroesophageal reflux disease (GERD). A similar association was observed for isocitric acid, 3-hydroxybutyric acid, and 3-hydroxyisobutyric acid. The analysis of these four metabolites revealed that citric acid had the strongest association with new-onset prolonged cough. This significant association remained even when the analysis was confined to participants with UACS or GERD at baseline or follow-up, and these associations were also observed in participants (n = 976) who had prolonged cough at follow-up regardless of baseline status. In conclusion, low blood citric acid may be associated with prolonged cough.
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Affiliation(s)
- Satoru Terada
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hisako Matsumoto
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
- Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osakasayama City, Osaka, Japan.
| | - Kenta Nishi
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mariko Kogo
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Natsuko Nomura
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Noriyuki Tashima
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Chie Morimoto
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hironobu Sunadome
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadao Nagasaki
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tsuyoshi Oguma
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshinari Nakatsuka
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Kazuhiro Sonomura
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Technology Research Laboratory, Life Science Research Center, Shimadzu Corporation, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Chin
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University of Medicine, Tokyo, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Qaraaty M, Bahrami M, Azimi SA, Hashem-Dabaghian F, Saberi S, Abbas Zaidi SM, Sahebkar A, Enayati A. Lavender ( Lavandula angustifolia) syrup as an adjunct to standard care in patients with mild to moderate COVID-19: An open-label, randomized, controlled clinical trial. AVICENNA JOURNAL OF PHYTOMEDICINE 2023; 13:400-411. [PMID: 37663382 PMCID: PMC10474914 DOI: 10.22038/ajp.2022.21606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/06/2022] [Indexed: 09/05/2023]
Abstract
Objective ongoing COVID-19 pandemic has been associated with clinical signs characterized by fever, fatigue and cough. Our study aimed to assess the efficacy of a Persian medicine formulation, lavender syrup, as an add-on to standard care in patients with mild to moderate COVID-19. Materials and Methods In this clinical trial which was conducted in Gorgan (Iran), 84 male and female COVID-19 outpatients were randomly allocated to either lavender syrup receiving 9 ml/twice/day for 21 days with standard conventional care or control groups. The primary objectives were to assess the improvement of clinical symptoms, while the secondary objectives were treatment satisfaction and anxiety levels which were evaluated once a week for 3 weeks. Results Out of 84 participants, 81 were analyzed (41 in the add-on group). The comparison between groups for cough severity and anosmia showed a higher reduction in the lavender group. The effect size was 0.6 for cough relief. Other symptoms and the Hamilton total score decreased in both groups with no statistically significant differences between the groups. The lavender group showed greater patients' satisfaction score. Conclusion Adjunctive therapy with lavender syrup could reduce cough and improve the quality of life in patients with COVID-19 patients.
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Affiliation(s)
- Marzieh Qaraaty
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Department of Persian Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Persian Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohsen Bahrami
- Academic Center for Education Culture and Research, Tehran, Iran
| | - Sadegh-Ali Azimi
- Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fataneh Hashem-Dabaghian
- Department of Traditional Medicine, Institute for Studies in Medical History, Persian and Complementary Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Safoora Saberi
- Gonbad-E-Kavoos Health Center, Golestan University of Medical Sciences, Gonbad-E-Kavoos, Iran
| | | | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ayesheh Enayati
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Mu G, Xiang Q, Zhang Z, Liu C, Zhang H, Liu Z, Pang X, Jiang J, Xie Q, Zhou S, Wang Z, Hu K, Wang Z, Jiang S, Qin X, Cui Y. PNPT1 and PCGF3 variants associated with angiotensin-converting enzyme inhibitor-induced cough: a nested case–control genome-wide study. Pharmacogenomics 2020; 21:601-614. [PMID: 32397904 DOI: 10.2217/pgs-2019-0167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Aim: We aimed to identify genetic variants associated with ACE inhibitor (ACEI)-induced cough. Materials & methods: A nested case–control study was performed among hypertensive Chinese patients receiving enalapril-only therapy. Whole-exome sequencing and genome-wide association analysis were performed. Results: We identified that PNPT1 rs13015243 (odds ratio [OR]: 0.47; 95% CI: 0.34–0.66; p = 7.45 × 10-6), PNPT1 rs13009649 (OR: 0.48; 95% CI: 0.35–0.67; p = 9.96 × 10-6) and PCGF3 rs1044147 (OR: 2.67; 95% CI: 1.71–4.17; p = 9.91 × 10-6) were significantly associated with ACEI-induced cough. Nearly genome-wide significant associations in previously reported candidate risk genes CLASP1, ACE, CES1, CPN1, XPNPEP1, PDE11A or SLC38A were detected in our dataset. Conclusion: Our results suggest that ACEI-induced cough is associated with noncoding SNPs of PNPT1 and PCGF3, all of which are independent of the bradykinin pathway. Study registration: NCT03259399.
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Affiliation(s)
- Guangyan Mu
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Qian Xiang
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Zhuo Zhang
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Chengzhang Liu
- Research Center, Shenzhen Evergreen Medical Institute, Shenzhen, 518057, China
| | - Hanxu Zhang
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Zhiyan Liu
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Xiaocong Pang
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Jie Jiang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Qiufen Xie
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Shuang Zhou
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Zining Wang
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Kun Hu
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Zhe Wang
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
| | - Shanqun Jiang
- School of Life Science, Anhui University, Hefei, 230601, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, 100034, China
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Koskela HO, Nurmi HM, Purokivi MK. Cough-provocation tests with hypertonic aerosols. ERJ Open Res 2020; 6:00338-2019. [PMID: 32337214 PMCID: PMC7167210 DOI: 10.1183/23120541.00338-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/23/2020] [Indexed: 12/19/2022] Open
Abstract
Recent advances in cough research suggest a more widespread use of cough-provocation tests to demonstrate the hypersensitivity of the cough reflex arc. Cough-provocation tests with capsaicin or acidic aerosols have been used for decades in scientific studies. Several factors have hindered their use in everyday clinical work: i.e. lack of standardisation, the need for special equipment and the limited clinical importance of the response. Cough-provocation tests with hypertonic aerosols (CPTHAs) involve provocations with hypertonic saline, hypertonic histamine, mannitol and hyperpnoea. They probably act via different mechanisms than capsaicin and acidic aerosols. They are safe and well tolerated and the response is repeatable. CPTHAs can assess not only the sensitivity of the cough reflex arc but also the tendency of the airway smooth muscles to constrict (airway hyper-responsiveness). They can differentiate between subjects with asthma or chronic cough and healthy subjects. The responsiveness to CPTHAs correlates with the cough-related quality of life among asthmatic subjects. Furthermore, the responsiveness to them decreases during treatment of chronic cough. A severe response to CPTHAs may indicate poor long-term prognosis in chronic cough. The mannitol test has been stringently standardised, is easy to administer with simple equipment, and has regulatory approval for the assessment of airway hyper-responsiveness. Manual counting of coughs during a mannitol challenge would allow the measurement of the function of the cough reflex arc as a part of clinical routine. Cough-provocation tests with hypertonic aerosols offer the possibility to measure the function of the cough reflex arc even in everyday clinical workhttp://bit.ly/2RTOfMI
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Affiliation(s)
- Heikki O Koskela
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hanna M Nurmi
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Minna K Purokivi
- Unit for Medicine and Clinical Research, Pulmonary Division, Kuopio University Hospital, Kuopio, Finland
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Shanks J, de Morais SDB, Gao L, Zucker IH, Wang HJ. TRPV1 (Transient Receptor Potential Vanilloid 1) Cardiac Spinal Afferents Contribute to Hypertension in Spontaneous Hypertensive Rat. Hypertension 2019; 74:910-920. [PMID: 31422690 DOI: 10.1161/hypertensionaha.119.13285] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypertension is associated with increased sympathetic activity. A component of this sympathoexcitation may be driven by increased signaling from sensory endings from the heart to the autonomic control areas in the brain. This pathway mediates the so-called cardiac sympathetic afferent reflex, which is also activated by coronary ischemia or other nociceptive stimuli in the heart. The cardiac sympathetic afferent reflex has been shown to be enhanced in the heart failure state and in renal hypertension. However, little is known about its role in the development or progression of hypertension or the phenotype of the sensory endings involved. To investigate this, we used the selective afferent neurotoxin, resiniferatoxin (RTX) to chronically abolish the cardiac sympathetic afferent reflex in 2 models of hypertension; the spontaneous hypertensive rats (SHRs) and AngII (angiotensin II) infusion (240 ng/kg per min). Blood pressure (BP) was measured in conscious animals for 2 to 8 weeks post-RTX. Epidural application of RTX to the T1-T4 spinal segments prevented the further BP increase in 8-week-old SHR and lowered BP in 16-week-old SHR. RTX did not affect BP in Wistar-Kyoto normotensive rats nor in AngII-infused rats. Epicardial application of RTX (50 µg/mL) in 4-week-old SHR prevented the BP increase whereas this treatment does not lower BP in 16-week-old SHR. When RTX was administered into the L2-L5 spinal segments of 16-week-old SHR, no change in BP was observed. These findings indicate that signaling via thoracic afferent nerve fibers may contribute to the hypertension phenotype in the SHR but not in the Ang II infusion model of hypertension.
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Affiliation(s)
- Julia Shanks
- From the Department of Cellular and Integrative Physiology (J.S., S.D.B.d., L.G., I.H.Z., H.-J.W.), University of Nebraska Medical Center, Omaha, NE
| | - Sharon D B de Morais
- From the Department of Cellular and Integrative Physiology (J.S., S.D.B.d., L.G., I.H.Z., H.-J.W.), University of Nebraska Medical Center, Omaha, NE
| | - Lie Gao
- From the Department of Cellular and Integrative Physiology (J.S., S.D.B.d., L.G., I.H.Z., H.-J.W.), University of Nebraska Medical Center, Omaha, NE
| | - Irving H Zucker
- From the Department of Cellular and Integrative Physiology (J.S., S.D.B.d., L.G., I.H.Z., H.-J.W.), University of Nebraska Medical Center, Omaha, NE
| | - Han-Jun Wang
- From the Department of Cellular and Integrative Physiology (J.S., S.D.B.d., L.G., I.H.Z., H.-J.W.), University of Nebraska Medical Center, Omaha, NE.,Department of Anesthesiology (H.-J.W.), University of Nebraska Medical Center, Omaha, NE
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7
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Impaired innate immune gene profiling in airway smooth muscle cells from chronic cough patients. Biosci Rep 2017; 37:BSR20171090. [PMID: 28842514 PMCID: PMC5686396 DOI: 10.1042/bsr20171090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/17/2017] [Accepted: 08/21/2017] [Indexed: 01/13/2023] Open
Abstract
Chronic cough is associated with airway inflammation and remodelling. Abnormal airway smooth muscle cell (ASMC) function may underlie mechanisms of chronic cough. Our objective was to examine the transcriptome and focused secretome of ASMCs from chronic cough patients and healthy non-cough volunteers. ASMC gene expression profiling was performed at baseline and/or after stimulation with polyinosinic:polycytidylic acid (poly(I:C)) to mimic viral infection. Supernatants were collected for multiplex analysis. Our results showed no significant differentially expressed genes (DEGs, false discovery rate (FDR) <0.05) between chronic cough and healthy non-cough ASMCs at baseline. Poly(I:C) stimulation resulted in 212 DEGs (>1.5 fold-change, FDR <0.05) in ASMCs from chronic cough patients compared with 1674 DEGs in healthy non-cough volunteers. The top up-regulated genes included chemokine (C–X–C motif) ligand (CXCL) 11 (CXCL11), CXCL10, chemokine (C–C motif) ligand (CCL) 5 (CCL5) and interferon-induced protein 44 like (IFI44L) corresponding with inflammation and innate immune response pathways. ASMCs from cough subjects had enhanced activation of viral response pathways in response to poly(I:C) compared with healthy non-cough subjects, reduced activation of pathways involved in chronic inflammation and equivalent activation of neuroregulatory genes. The poly(I:C)-induced release of inflammatory mediators, including CXCL8, interleukin (IL)-6 and CXCL1, from ASMCs from cough patients was significantly impaired compared with healthy non-cough subjects. Addition of fluticasone propionate (FP) to poly(I:C)-treated ASMCs resulted in greater gene expression changes in healthy non-cough ASMCs. FP had a differential effect on poly(I:C)-induced mediator release between chronic cough and healthy non-cough volunteers. In conclusion, altered innate immune and inflammatory gene profiles within ASMCs, rather than infiltrating cells or nerves, may drive the cough response following respiratory viral infection.
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Robinson RK, Birrell MA, Adcock JJ, Wortley MA, Dubuis ED, Chen S, McGilvery CM, Hu S, Shaffer MSP, Bonvini SJ, Maher SA, Mudway IS, Porter AE, Carlsten C, Tetley TD, Belvisi MG. Mechanistic link between diesel exhaust particles and respiratory reflexes. J Allergy Clin Immunol 2017; 141:1074-1084.e9. [PMID: 28532657 PMCID: PMC5840514 DOI: 10.1016/j.jaci.2017.04.038] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 04/14/2017] [Accepted: 04/26/2017] [Indexed: 02/09/2023]
Abstract
Background Diesel exhaust particles (DEPs) are a major component of particulate matter in Europe's largest cities, and epidemiologic evidence links exposure with respiratory symptoms and asthma exacerbations. Respiratory reflexes are responsible for symptoms and are regulated by vagal afferent nerves, which innervate the airway. It is not known how DEP exposure activates airway afferents to elicit symptoms, such as cough and bronchospasm. Objective We sought to identify the mechanisms involved in activation of airway sensory afferents by DEPs. Methods In this study we use in vitro and in vivo electrophysiologic techniques, including a unique model that assesses depolarization (a marker of sensory nerve activation) of human vagus. Results We demonstrate a direct interaction between DEP and airway C-fiber afferents. In anesthetized guinea pigs intratracheal administration of DEPs activated airway C-fibers. The organic extract (DEP-OE) and not the cleaned particles evoked depolarization of guinea pig and human vagus, and this was inhibited by a transient receptor potential ankyrin-1 antagonist and the antioxidant N-acetyl cysteine. Polycyclic aromatic hydrocarbons, major constituents of DEPs, were implicated in this process through activation of the aryl hydrocarbon receptor and subsequent mitochondrial reactive oxygen species production, which is known to activate transient receptor potential ankyrin-1 on nociceptive C-fibers. Conclusions This study provides the first mechanistic insights into how exposure to urban air pollution leads to activation of guinea pig and human sensory nerves, which are responsible for respiratory symptoms. Mechanistic information will enable the development of appropriate therapeutic interventions and mitigation strategies for those susceptible subjects who are most at risk.
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Affiliation(s)
- Ryan K Robinson
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Mark A Birrell
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - John J Adcock
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Michael A Wortley
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Eric D Dubuis
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Shu Chen
- Department of Materials and London Centre for Nanotechnology, Imperial College London, London, United Kingdom
| | - Catriona M McGilvery
- Department of Materials and London Centre for Nanotechnology, Imperial College London, London, United Kingdom
| | - Sheng Hu
- Department of Chemistry and London Centre for Nanotechnology, Imperial College London, London, United Kingdom
| | - Milo S P Shaffer
- Department of Materials and London Centre for Nanotechnology, Imperial College London, London, United Kingdom; Department of Chemistry and London Centre for Nanotechnology, Imperial College London, London, United Kingdom
| | - Sara J Bonvini
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Sarah A Maher
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Ian S Mudway
- MRC-PHE Centre for Environment and Health, King's College London, London, United Kingdom; NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, London, United Kingdom
| | - Alexandra E Porter
- Department of Materials and London Centre for Nanotechnology, Imperial College London, London, United Kingdom; NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, London, United Kingdom
| | - Chris Carlsten
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Teresa D Tetley
- NIHR Health Protection Research Unit in Health Impact of Environmental Hazards, London, United Kingdom; Lung Cell Biology, Airways Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom.
| | - Maria G Belvisi
- Respiratory Pharmacology Group, Airway Disease, National Heart & Lung Institute, Imperial College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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Chung KF. Advances in mechanisms and management of chronic cough: The Ninth London International Cough Symposium 2016. Pulm Pharmacol Ther 2017; 47:2-8. [PMID: 28216388 DOI: 10.1016/j.pupt.2017.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/12/2017] [Indexed: 12/30/2022]
Abstract
At the Ninth London International Cough Symposium held in June 2016, advances in chronic cough were presented. Chronic cough has been labelled as a cough hypersensitivity syndrome (CHS) with neuroinflammatory mechanisms likely to be the underlying mechanisms. The concept is that there is a stage of peripheral sensitisation induced by inflammatory factors setting up the scene for a central component that can be visualised by functional magnetic resonance imaging. There has also been progress in assessing CHS patients in the clinic in terms of measuring cough, with an increasing interest in assessing different types of cough associated with respiratory diseases such as asthma, COPD, bronchiectasis and pulmonary fibrosis. There is an emerging area of new antitussives in the form of neuromodulators. These advances have been paralleled by improvements in the management of patients with chronic cough. However, more work is needed but the future looks promising.
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Affiliation(s)
- Kian Fan Chung
- National Heart & Lung Institute, Imperial College London, UK; Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK.
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10
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Schwingshackl A. The role of stretch-activated ion channels in acute respiratory distress syndrome: finally a new target? Am J Physiol Lung Cell Mol Physiol 2016; 311:L639-52. [PMID: 27521425 DOI: 10.1152/ajplung.00458.2015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 08/05/2016] [Indexed: 02/06/2023] Open
Abstract
Mechanical ventilation (MV) and oxygen therapy (hyperoxia; HO) comprise the cornerstones of life-saving interventions for patients with acute respiratory distress syndrome (ARDS). Unfortunately, the side effects of MV and HO include exacerbation of lung injury by barotrauma, volutrauma, and propagation of lung inflammation. Despite significant improvements in ventilator technologies and a heightened awareness of oxygen toxicity, besides low tidal volume ventilation few if any medical interventions have improved ARDS outcomes over the past two decades. We are lacking a comprehensive understanding of mechanotransduction processes in the healthy lung and know little about the interactions between simultaneously activated stretch-, HO-, and cytokine-induced signaling cascades in ARDS. Nevertheless, as we are unraveling these mechanisms we are gathering increasing evidence for the importance of stretch-activated ion channels (SACs) in the activation of lung-resident and inflammatory cells. In addition to the discovery of new SAC families in the lung, e.g., two-pore domain potassium channels, we are increasingly assigning mechanosensing properties to already known Na(+), Ca(2+), K(+), and Cl(-) channels. Better insights into the mechanotransduction mechanisms of SACs will improve our understanding of the pathways leading to ventilator-induced lung injury and lead to much needed novel therapeutic approaches against ARDS by specifically targeting SACs. This review 1) summarizes the reasons why the time has come to seriously consider SACs as new therapeutic targets against ARDS, 2) critically analyzes the physiological and experimental factors that currently limit our knowledge about SACs, and 3) outlines the most important questions future research studies need to address.
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