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Ye WD, Wang HM, Xu ZJ, Liang DS, Huang AR, Xu ZW, Hu XG, Jin YM. MCC950 Ameliorates Acute Exogenous Lipoid Pneumonia Induced by Sewing Machine Oil in Rats via the NF-κB/NLRP3 Inflammasome Pathway. In Vivo 2023; 37:2533-2542. [PMID: 37905651 PMCID: PMC10621416 DOI: 10.21873/invivo.13361] [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: 06/22/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Acute exogenous lipoid pneumonia (AELP) is a rare disorder caused by intake of lipid formulations and is often underdiagnosed. Meanwhile, the mechanism of AELP is still underlying. MCC950, was previously found to significantly suppress the release of inflammatory cytokines IL-18 and IL-1β. However, the effect of MCC950 on AELP induced by sewing machine oil has not been reported. MATERIALS AND METHODS The NLRP3, NF-[Formula: see text]B p65, caspase-1 and IL-1β expression in lung tissues were compared between a rat model of AELP and control rats using western blotting and real-time quantitative assay. Moreover, haematoxylin and eosin (H&E) staining was performed to elucidate the mechanisms by which MCC950 ameliorates sewing machine oil-induced AELP in vivo. RESULTS MCC950 reduced the expression of NF-[Formula: see text]B p65 in the lung samples of the treatment group and further down-regulated the NLRP3 and caspase-1 levels while inhibited the production of IL-1β. Besides, decreases in inflammatory cell infiltration in the lung were shown using H&E staining. CONCLUSION MCC950 ameliorates sewing machine oil-induced acute exogenous lipoid pneumonia in rats through inhibition of the NF-[Formula: see text]B/NLRP3 inflammasome pathway.
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Affiliation(s)
- Wan-Ding Ye
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Hua-Min Wang
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Zi-Jin Xu
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, P.R. China
| | - Dong-Shi Liang
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Ai-Rong Huang
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Zhi-Wei Xu
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Xiao-Guang Hu
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China
| | - Yi-Mei Jin
- Department of Pediatrics, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China;
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Wang H, Lu S, Li H, Wang Y. Mycobacterium infection secondary to exogenous lipoid pneumonia caused by nasal drops: a case report and literature review. BMC Pulm Med 2023; 23:47. [PMID: 36721116 PMCID: PMC9887914 DOI: 10.1186/s12890-022-02265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/24/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Exogenous lipoid pneumonia (ELP) is a rare disease and its diagnosis is often mistaken or delayed. Secondary infection with rapidly growing non-tuberculous mycobacteria is a rare complication of lipoid pneumonia. CASE PRESENTATION A 38-year-old man presented with fever, cough, sputum, chest tightness, and shortness of breath. He had a 2-year history of allergic rhinitis and used liquid paraffin-containing menthol nasal drops daily. A chest CT scan showed multiple patchy ground glass opacities with blurred borders in both lungs, which were located in the inner pulmonary field and distributed along the bronchi. His ambient air PO2 was 63 mmHg. The patient was diagnosed with ELP by CT-guided lung biopsy. The nasal drops were discontinued, and systemic glucocorticoids were administered. During treatment, the pulmonary lesions deteriorated, and bronchoalveolar lavage was performed during bronchoscopy. Additionally, Mycobacterium abscessus was detected in the lavage fluid. Upon detection of a secondary M. abscessus infection, glucocorticoids were gradually discontinued, and anti-M. abscessus treatment was implemented. The patient's symptoms rapidly ameliorated. After 11 months of anti-M. abscessus treatment, a repeat CT scan showed clear regression of the lung lesions. CONCLUSION Routine microbiological examination of samples, including sputum or alveolar lavage fluid, is necessary for patients with diagnosed or suspected ELP.
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Affiliation(s)
- Huihong Wang
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China ,grid.469636.8Department of Respiratory Diseases, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, 317000 Zhejiang Province China
| | - Shan Lu
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China
| | - Hequan Li
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China
| | - Yuehong Wang
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003 China
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Shang L, Gu X, Du S, Wang Y, Cao B, Wang C. The efficacy and safety of therapeutic lung lavage for exogenous lipoid pneumonia: A systematic review. CLINICAL RESPIRATORY JOURNAL 2021; 15:134-146. [PMID: 32940399 DOI: 10.1111/crj.13273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 08/11/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES Exogenous lipoid pneumonia (ELP) is a lung inflammatory disease with low prevalence and has the feature of external lipid substances presented in the alveoli. Therapeutic lung lavage (segmental bronchoalveolar lavage and whole lung lavage) has been gradually recognized as an important therapy for the disease. There was no comprehensive summary on its efficacy and safety. METHODS We searched PubMed, Embase, Cochrane Library, CNKI, Wanfang Database, clinicaltrials.gov, and the references of included studies. After study selection, data extraction and quality assessment, we performed a qualitative description of current data. RESULTS We included 90 ELP patients from 25 case reports and 8 case series studies. Eighty-four (93.3%) patients received segmental bronchoalveolar lavage and six (6.7%) patients received whole lung lavage. Eighty-seven (96.7%) patients got clinical improvement after lavages, while three (3.3%) patients had no improvement and eventually died. The follow-up status was reported in 29 patients, of whom 24 patients remained well without any use of drugs and 4 patients remained well with some periods of corticosteroids. One patient endured recurrence. The radiological change was reported in 72 patients, of whom 41 (56.9%) patients had full resolution until the last follow-up. Two studies reported acute pulmonary edema and transient hypoxemia during lavages. CONCLUSIONS Therapeutic lung lavage might be an effective and safe therapy with long-term benefits for ELP. Current studies were all case reports and case series with relatively high risk of bias. Prospective controlled studies are needed to explore the actual efficacy, safety, individualized indications, and optimized treatment procedures of therapeutic lung lavage for ELP.
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Affiliation(s)
- Lianhan Shang
- Beijing University of Chinese Medicine, Beijing, China.,Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoying Gu
- Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Sisi Du
- Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Yimin Wang
- Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Department of Respiratory Medicine, Capital Medical University, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Department of Respiratory Medicine, Capital Medical University, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, Center for Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Davidson KR, Ha DM, Schwarz MI, Chan ED. Bronchoalveolar lavage as a diagnostic procedure: a review of known cellular and molecular findings in various lung diseases. J Thorac Dis 2020; 12:4991-5019. [PMID: 33145073 PMCID: PMC7578496 DOI: 10.21037/jtd-20-651] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Bronchoalveolar lavage (BAL) is a commonly used procedure in the evaluation of lung disease as it allows for sampling of the lower respiratory tract. In many circumstances, BAL differential cell counts have been reported to be typical of specific lung disorders. In addition, more specific diagnostic tests including molecular assays such as polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay, special cytopathologic stains, or particular microscopic findings have been described as part of BAL fluid analysis. This review focuses on common cellular and molecular findings of BAL in a wide range of lung diseases. Since the performance of the first lung irrigation in 1927, BAL has become a common and important diagnostic tool. While some pulmonary disorders have a highly characteristic signature of BAL findings, BAL results alone often lack specificity and require interpretation along with other clinical and radiographic details. Development of new diagnostic assays is certain to reinforce the utility of BAL in the future. Our review of the BAL literature is intended to serve as a resource to assist clinicians in the care of patients with lung disorders.
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Affiliation(s)
- Kevin R Davidson
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Duc M Ha
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Marvin I Schwarz
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Edward D Chan
- Division of Pulmonary Sciences & Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA.,National Jewish Health, Denver, Colorado, USA
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Nasogastric Intubation as Health and Safety Risk in Equine Practice-A Questionnaire. J Equine Vet Sci 2020; 88:102951. [PMID: 32303319 DOI: 10.1016/j.jevs.2020.102951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 11/23/2022]
Abstract
Placing a nasogastric tube can be a life-saving act for a horse but is considered an occupational hazard for veterinarians. An online questionnaire was performed to assess and specify potential risks. 123 equine veterinarians completed the survey, and the majority admitted using the mouth to handle the end of the nasogastric tube (sucking or blowing air) and having accidentally swallowed or aspirated stomach content or medications. This can potentially lead to aspiration pneumonia or pneumonitis. Mineral oil seems to be especially dangerous as aspiration may be asymptomatic at the beginning and lipoid pneumonitis may develop. Furthermore, 60% of responders would also handle the tube with their mouth if the horse was presented with fever and diarrhea or reflux formation, which might be affected by Salmonella sp. or Clostridium difficile producing toxins. The fact that nasogastric tubes are rarely being disinfected increases the risk of infection. 50% of veterinarians would use their mouth to suck or blow air into the tube during nasogastric intubation, even if the patient was presented with suspected poisoning. Rodenticide zinc phosphide is particularly dangerous as its breakdown product is a highly toxic gas. Inhalation leads to serious symptoms in humans, including pulmonary edema and neurological signs. Alternatives to mouth use (lavage, big syringe, or suction pump) when passing a tube should be considered, especially if a patient is presented with duodenitis-proximal jejunitis, diarrhea, or suspected poisoning. Awareness needs to be raised among veterinarians that nasogastric intubation is an extremely hazardous occupational practice.
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Guo M, Liu J, Jiang B. Exogenous lipid pneumonia in old people caused by aspiration: Two case reports and literature review. Respir Med Case Rep 2019; 27:100850. [PMID: 31193250 PMCID: PMC6522775 DOI: 10.1016/j.rmcr.2019.100850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 01/15/2023] Open
Abstract
Background Exogenous lipoid pneumonia is a rare entity, the diagnosis is often missed or delayed. Objective To investigate the clinical characteristics of exogenous lipid pneumonia in elderly patients, improve the efficiency of early diagnosis and treatment of this disease. Methods Retrospectively analyzed the clinical information and imaging data of these 2 exogenous lipid pneumonia patients, reviewed related literature. Results Both of the 2 patients were over 60 with a history of gastrointestinal diseases. The clinical presentation is nonspecific. Chest CT showed many different manifestations. Histopathology analysis revealed the accumulation of lipid carrying macrophages, vacuolar cells and inflammation. A literature review indicated that 25 previous cases of exogenous lipid pneumonia were caused by aspiration. The most common site of the lesion was located in right lung, while mineral oil was the most common substances. We sought to discuss the patient's treatment and the corresponding outcomes. Conclusion The diagnosis of lipid pneumonia's mainly depends on medical history and histopathological morphology. The standard treatment for exogenous lipid pneumonia was composed of antibiotics, steroid, bronchoscopic lavage and a regular follow-up.
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Affiliation(s)
- Maoqing Guo
- Department of Respiratory Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People's Republic of China
| | - Jianguo Liu
- Department of Critical Care Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People's Republic of China
| | - Bo Jiang
- Department of Respiratory Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People's Republic of China
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