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Smoking shifts human small airway epithelium club cells toward a lesser differentiated population. NPJ Genom Med 2021; 6:73. [PMID: 34497273 PMCID: PMC8426481 DOI: 10.1038/s41525-021-00237-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/03/2021] [Indexed: 02/07/2023] Open
Abstract
The club cell, a small airway epithelial (SAE) cell, plays a central role in human lung host defense. We hypothesized that subpopulations of club cells with distinct functions may exist. The SAE of healthy nonsmokers and healthy cigarette smokers were evaluated by single-cell RNA sequencing, and unsupervised clustering revealed subpopulations of SCGCB1A1+KRT5loMUC5AC- club cells. Club cell heterogeneity was supported by evaluations of SAE tissue sections, brushed SAE cells, and in vitro air-liquid interface cultures. Three subpopulations included: (1) progenitor; (2) proliferating; and (3) effector club cells. The progenitor club cell population expressed high levels of mitochondrial, ribosomal proteins, and KRT5 relative to other club cell populations and included a differentiation branch point leading to mucous cell production. The small proliferating population expressed high levels of cyclins and proliferation markers. The effector club cell cluster expressed genes related to host defense, xenobiotic metabolism, and barrier functions associated with club cell function. Comparison of smokers vs. nonsmokers demonstrated that smoking limited the extent of differentiation of all three subclusters and altered SAM pointed domain-containing Ets transcription factor (SPDEF)-regulated transcription in the effector cell population leading to a change in the location of the branch point for mucous cell production, a potential explanation for the concomitant reduction in effector club cells and increase in mucous cells in smokers. These observations provide insights into both the makeup of human SAE club cell subpopulations and the smoking-induced changes in club cell biology.
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Cazzola M, Page C. An inhaled “bifunctional” dual PDE3/4 inhibitor provides additional short-term improvements in lung function compared to existing classes of bronchodilator: implications for future treatment of COPD. Eur Respir J 2018; 52:52/5/1801675. [DOI: 10.1183/13993003.01675-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 09/07/2018] [Indexed: 11/05/2022]
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Chronic obstructive pulmonary disease in the long-term care setting: current practices, challenges, and unmet needs. Curr Opin Pulm Med 2018; 23 Suppl 1:S1-S28. [PMID: 28990958 DOI: 10.1097/mcp.0000000000000416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
: Chronic obstructive pulmonary disease (COPD) is a prevalent and disabling disorder in the United States, especially affecting older individuals, women, and those with a history of smoking. Studies show that COPD may be underrepresented, underdiagnosed, and undertreated in elderly patients residing in long-term care (LTC) facilities. The quality of care for LTC residents with COPD is heterogeneous in regard to both the facility and the patient. For LTC facilities, care should be driven by staff education, interstaff communication, and interfacility communication. From the perspective of the LTC patient, choice of medication and device should be based on appropriate diagnosis, comorbidities, ability to perform treatment, and patient preferences. Nebulization is currently underutilized in LTC settings, although it would benefit older patients with low peak inspiratory flow, cognitive impairment, and/or physical impairment, which may preclude them from using other inhalation devices. Authors developed a COPD treatment algorithm that focuses on three primary patient aspects to consider when deciding on respiratory device in patients in LTC facilities: inspiratory flow, hand dexterity and coordination, and cognitive capacity.
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Fernandes FLA, Cukier A, Camelier AA, Fritscher CC, da Costa CH, Pereira EDB, Godoy I, Cançado JED, Romaldini JG, Chatkin JM, Jardim JR, Rabahi MF, de Nucci MCNM, Sales MDPU, Castellano MVCDO, Aidé MA, Teixeira PJZ, Maciel R, Corrêa RDA, Stirbulov R, Athanazio RA, Russo R, Minamoto ST, Lundgren FLC. Recommendations for the pharmacological treatment of COPD: questions and answers. J Bras Pneumol 2017; 43:290-301. [PMID: 29365005 PMCID: PMC5687967 DOI: 10.1590/s1806-37562017000000153] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/04/2017] [Indexed: 11/22/2022] Open
Abstract
The treatment of COPD has become increasingly effective. Measures that range from behavioral changes, reduction in exposure to risk factors, education about the disease and its course, rehabilitation, oxygen therapy, management of comorbidities, and surgical and pharmacological treatments to end-of-life care allow health professionals to provide a personalized and effective therapy. The pharmacological treatment of COPD is one of the cornerstones of COPD management, and there have been many advances in this area in recent years. Given the greater availability of drugs and therapeutic combinations, it has become increasingly challenging to know the indications for, limitations of, and potential risks and benefits of each treatment modality. In order to critically evaluate recent evidence and systematize the major questions regarding the pharmacological treatment of COPD, 24 specialists from all over Brazil gathered to develop the present recommendations. A visual guide was developed for the classification and treatment of COPD, both of which were adapted to fit the situation in Brazil. Ten questions were selected on the basis of their relevance in clinical practice. They address the classification, definitions, treatment, and evidence available for each drug or drug combination. Each question was answered by two specialists, and then the answers were consolidated in two phases: review and consensus by all participants. The questions answered are practical questions and help select from among the many options the best treatment for each patient and his/her peculiarities.
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Affiliation(s)
- Frederico Leon Arrabal Fernandes
- . Divisão de Pneumologia, Instituto do Coração - InCor − Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Alberto Cukier
- . Divisão de Pneumologia, Instituto do Coração - InCor − Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Aquiles Assunção Camelier
- . Universidade do Estado da Bahia - UNEB - Salvador (BA) Brasil
- . Escola Bahiana de Medicina e Saúde Pública, Salvador (BA) Brasil
| | - Carlos Cezar Fritscher
- . Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul − PUCRS− Porto Alegre (RS)Brasil
| | | | | | - Irma Godoy
- . Departamento de Medicina Interna, Área de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
| | | | - José Gustavo Romaldini
- . Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo,São Paulo (SP) Brasil
| | - Jose Miguel Chatkin
- . Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul − PUCRS− Porto Alegre (RS)Brasil
| | - José Roberto Jardim
- . Faculdade de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo (SP) Brasil
| | | | | | | | | | - Miguel Abidon Aidé
- . Faculdade de Medicina, Universidade Federal Fluminense, Niterói (RJ) Brasil
| | - Paulo José Zimermann Teixeira
- . Departamento de Clínica Médica, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS) Brasil
- . Universidade FEEVALE, Campus II, Novo Hamburgo (RS) Brasil
| | - Renato Maciel
- . Disciplina de Pneumologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte (MG) Brasil
| | - Ricardo de Amorim Corrêa
- . Faculdade de Medicina, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | - Roberto Stirbulov
- . Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo,São Paulo (SP) Brasil
| | - Rodrigo Abensur Athanazio
- . Divisão de Pneumologia, Instituto do Coração - InCor − Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rodrigo Russo
- . Departamento de Medicina, Universidade Federal de São João Del Rei - UFSJ − São João Del Rei (MG) Brasil
| | - Suzana Tanni Minamoto
- . Departamento de Medicina Interna, Área de Pneumologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP - Botucatu (SP) Brasil
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Hosseini B, Berthon BS, Wark P, Wood LG. Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis. Nutrients 2017; 9:nu9040341. [PMID: 28353635 PMCID: PMC5409680 DOI: 10.3390/nu9040341] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/09/2017] [Accepted: 03/24/2017] [Indexed: 12/25/2022] Open
Abstract
Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies. The present review aimed to summarize the evidence for the association between fruit and vegetable intake, risk of asthma/wheeze and immune responses. Databases including PubMed, Cochrane, CINAHL and EMBASE were searched up to June 2016. Studies that investigated the effects of fruit and vegetable intake on risk of asthma/wheeze and immune responses were considered eligible (n = 58). Studies used cross-sectional (n = 30), cohort (n = 13), case-control (n = 8) and experimental (n = 7) designs. Most of the studies (n = 30) reported beneficial associations of fruit and vegetable consumption with risk of asthma and/or respiratory function, while eight studies found no significant relationship. Some studies (n = 20) reported mixed results, as they found a negative association between fruit only or vegetable only, and asthma. In addition, the meta-analyses in both adults and children showed inverse associations between fruit intake and risk of prevalent wheeze and asthma severity (p < 0.05). Likewise, vegetable intake was negatively associated with risk of prevalent asthma (p < 0.05). Seven studies examined immune responses in relation to fruit and vegetable intake in asthma, with n = 6 showing a protective effect against either systemic or airway inflammation. Fruit and vegetable consumption appears to be protective against asthma.
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Affiliation(s)
- Banafshe Hosseini
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia.
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
| | - Bronwyn S Berthon
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia.
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
| | - Peter Wark
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia.
- Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle NSW 2308, Australia.
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