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Hartung BF, Mueller RS, Gauss J, Weitzer T, Boehm TMSA, Palić J, Schulz B. Reactions to environmental allergens in cats with feline lower airway disease. Front Vet Sci 2023; 10:1267496. [PMID: 38130436 PMCID: PMC10734688 DOI: 10.3389/fvets.2023.1267496] [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: 07/26/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives Aeroallergens have been discussed as potential triggers for feline asthma (FA), which can be induced experimentally by allergen sensitization. To date, only few studies have investigated reactions to environmental allergens in cats with naturally occurring feline lower airway disease (FLAD). The aim of the study was to compare results of intradermal testing (IDT) and serum allergen-specific immunoglobulin E-(IgE) testing (SAT) in cats with FLAD, and to investigate possible associations with allergen exposure. Material and methods Eight cats with eosinophilic airway inflammation (EI), ten cats with mixed inflammation (MI), six with neutrophilic inflammation (NI), and 24 healthy cats (HC) were included. Cats diagnosed with FLAD were assigned to the different inflammatory groups based on bronchoalveolar lavage fluid (BLAF) cytology. SAT was performed in all cats; IDT was only carried out in cats with FLAD. Information about the cats' environment and potential allergen exposure was obtained using an owner questionnaire. Results In comparison to 83% of HC with positive reactions on SAT only 52% of cats with FLAD had positive responses (p = 0.051). Significantly more positive reactions per cat were detected on IDT than on SAT (p = 0.001). No significant difference was found for positive reactions per cat on SAT when compared between HC, NI, EI, and MI (p = 0.377). Only "slight" agreement was found for most allergens when reactions obtained in both tests in cats with FLAD were compared, except for "moderate" agreement for English plantain (k = 0.504) and Alternaria alternata (k = 0.488). Overall, no clear association between the cats' environment and allergen reactions were detected. Conclusions and clinical importance Interpretation of allergy test results in cats with FLAD should be done in the context of clinical signs and individual factors.
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Affiliation(s)
- Birte F. Hartung
- LMU Small Animal Clinic, Ludwig Maximilian University of Munich, Munich, Germany
| | - Ralf S. Mueller
- LMU Small Animal Clinic, Ludwig Maximilian University of Munich, Munich, Germany
| | - Jana Gauss
- Statistical Consulting Unit StaBLab, Department of Statistics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Tamara Weitzer
- LMU Small Animal Clinic, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Jelena Palić
- Vet Med Labor GmbH Division of IDEXX Laboratories, Kornwestheim, Germany
| | - Bianka Schulz
- LMU Small Animal Clinic, Ludwig Maximilian University of Munich, Munich, Germany
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Hashimoto K, Maeda H, Iwasa H, Kyozuka H, Maeda R, Kume Y, Ono T, Chishiki M, Sato A, Ogata Y, Murata T, Fujimori K, Shinoki K, Nishigori H, Yasumura S, Hosoya M. Tobacco Exposure During Pregnancy and Infections in Infants up to 1 Year of Age: The Japan Environment and Children's Study. J Epidemiol 2023; 33:489-497. [PMID: 35400710 PMCID: PMC10483106 DOI: 10.2188/jea.je20210405] [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: 09/17/2021] [Accepted: 03/23/2022] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Tobacco exposure during pregnancy is associated with several adverse outcomes in infants. We investigated the association between tobacco exposure during pregnancy (both active and second-hand) and various infections in infants up to 1 year. METHODS This prospective cohort study used a fixed dataset (jecs-an-20180131) from the Japan Environment and Children's Study of registered births in Japan during 2011-2014 that included 104,065 fetal records from enrolled pregnant women. Based on the participants' responses to the questionnaire on smoking status, mothers were first divided into "never smoked," "quit smoking," and "current smoker" groups and then into "no second-hand smoking (SHS)" and "SHS" groups. Infectious diseases included central nervous system infection, otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastroenteritis (GI), and urinary tract infection. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis and adjusted for maternal, socioeconomic, and postnatal confounding factors. RESULTS Among the 73,205 newborns enrolled, multivariable analysis revealed that the aOR of LRTI and GI was 1.20 (95% CI, 1.07-1.33) and 1.18 (95% CI, 1.04-1.35), respectively, for the "current smoker with/without SHS" group compared with the "never smoked without SHS" group. "Quit smoking without SHS" was not associated with the risk of LRTI. SHS was associated with an increased risk of OM, URTI, LRTI, and GI, especially with LRTI and GI. CONCLUSION Exposure to tobacco smoke during pregnancy was associated with an increased risk of OM, URTI, LRTI, and GI in infants during their first year of life.
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Affiliation(s)
- Koichi Hashimoto
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hajime Maeda
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hajime Iwasa
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hyo Kyozuka
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Ryo Maeda
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yohei Kume
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Ono
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akiko Sato
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
| | - Yuka Ogata
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
| | - Tsuyoshi Murata
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Keiya Fujimori
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kosei Shinoki
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
| | - Hidekazu Nishigori
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - the Japan Environment and Children’s Study (JECS) Group
- Fukushima Regional Center for the Japan Environmental and Children’s Study, Fukushima, Japan
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Obstetrics and Gynecology, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
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Ainsworth J, Sewell P, Eggert S, Morris K, Pillai S. Fungal Infections Are Not Associated with Increased Mortality in COVID-19 Patients Admitted to Intensive Care Unit (ICU). Crit Care Res Pract 2023; 2023:4037915. [PMID: 37720488 PMCID: PMC10505078 DOI: 10.1155/2023/4037915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/09/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Fungal infection is a cause of increased morbidity and mortality in intensive care patients. Critically unwell patients are at increased risk of developing invasive fungal infections. COVID-19 patients in the intensive care unit (ICU) may be at a particularly high risk. The primary aim of this study was to establish the incidence of secondary fungal infections in patients admitted to the ICU with COVID-19. Secondary aims were to investigate factors that may contribute to an increased risk of fungal infections and to calculate the mortality between fungal and nonfungal groups. Methods We undertook a retrospective observational study in a tertiary ICU in Wales, United Kingdom. 174 patients admitted with COVID-19 infection from March 2020 until May 2021 were included. Data were collected through a retrospective review of patient's clinical notes and microbiology investigation results obtained from the online clinical portal. Results 81/174 (47%) COVID-19 patients developed fungal infections, 93% of which were Candida species, including Candida albicans (88%), and 6% had an Aspergillus infection. Age and smoking history did not appear to be contributing factors. The nonfungal group had a significantly higher body mass index (33 ± 8 vs. 31 ± 7, p=0.01). The ICU length of stay (23 (1-116) vs. 8 (1-60), p < 0.001), hospital length of stay (30 (3-183) vs. 15 (1-174) ± 7, p < 0.001), steroid days (10 (1-116) vs. 4 (0-28), p=0.02), and ventilation days (18 (0-120) vs. 2 (0-55), p < 0.001) were significantly higher in the fungal group. The mortality rate in both groups was similar (51% vs. 52%). The Kaplan-Meier survival analysis showed that the fungal group survived more than the nonfungal group (log rank (Mantel-Cox), p < 0.001). Conclusion Secondary fungal infections are common in COVID-19 patients admitted to the ICU. Longer treatment with corticosteroids, increased length of hospital and ICU stay, and greater length of mechanical ventilation significantly increase the risk of fungal infections. Fungal infection, however, was not associated with an increase in mortality.
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Affiliation(s)
- James Ainsworth
- Ed Major Intensive Care Unit, Morriston Hospital, Swansea, UK
| | - Peter Sewell
- Ed Major Intensive Care Unit, Morriston Hospital, Swansea, UK
| | - Sabine Eggert
- Ed Major Intensive Care Unit, Morriston Hospital, Swansea, UK
| | | | - Suresh Pillai
- Ed Major Intensive Care Unit, Morriston Hospital, Swansea, UK
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Sharma G, Pund S, Govindan R, Nissa MU, Biswas D, Middha S, Ganguly K, Anand MP, Banerjee R, Srivastava S. A Proteomics Investigation of Cigarette Smoke Exposed Wistar Rats Revealed Improved Anti-Inflammatory Effects of the Cysteamine Nanoemulsions Delivered via Inhalation. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2023; 27:338-360. [PMID: 37581495 DOI: 10.1089/omi.2023.0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Cigarette smoking is the major cause of chronic inflammatory diseases such as chronic obstructive pulmonary disease (COPD). It is paramount to develop pharmacological interventions and delivery strategies against the cigarette smoke (CS) associated oxidative stress in COPD. This study in Wistar rats examined cysteamine in nanoemulsions to counteract the CS distressed microenvironment. In vivo, 28 days of CS and 15 days of cysteamine nanoemulsions treatment starting on 29th day consisting of oral and inhalation routes were established in Wistar rats. In addition, we conducted inflammatory and epithelial-to-mesenchymal transition (EMT) studies in vitro in human bronchial epithelial cell lines (BEAS2B) using 5% CS extract. Inflammatory and anti-inflammatory markers, such as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-1β, IL-8, IL-10, and IL-13, have been quantified in bronchoalveolar lavage fluid (BALF) to evaluate the effects of the cysteamine nanoemulsions in normalizing the diseased condition. Histopathological analysis of the alveoli and the trachea showed the distorted, lung parenchyma and ciliated epithelial barrier, respectively. To obtain mechanistic insights into the CS COPD rat model, "shotgun" proteomics of the lung tissues have been carried out using high-resolution mass spectrometry wherein genes such as ABI1, PPP3CA, PSMA2, FBLN5, ACTG1, CSNK2A1, and ECM1 exhibited significant differences across all the groups. Pathway analysis showed autophagy, signaling by receptor tyrosine kinase, cytokine signaling in immune system, extracellular matrix organization, and hemostasis, as the major contributing pathways across all the studied groups. This work offers new preclinical findings on how cysteamine taken orally or inhaled can combat CS-induced oxidative stress.
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Affiliation(s)
- Gautam Sharma
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Swati Pund
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
- Biobay, Ahmedabad, India
| | - Rajkumar Govindan
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
- Department of Biomedical Engineering, Hajim School of Engineering & Applied Sciences, University of Rochester, Rochester, New York, USA
| | - Mehar Un Nissa
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Deeptarup Biswas
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Sanniya Middha
- Department of Biochemistry, Panjab University, Chandigarh, India
| | - Koustav Ganguly
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Rinti Banerjee
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
| | - Sanjeeva Srivastava
- Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai, India
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Moyers SA, Hartwell M, Chiaf A, Greiner B, Oliver JA, Croff JM. Associations of Combustible Cigarette, Electronic Cigarette, and Dual Use With COVID Infection and Severity in the U.S.: A Cross-sectional Analysis of the 2021 National Health Information Survey. Tob Use Insights 2023; 16:1179173X231179675. [PMID: 37324057 PMCID: PMC10262671 DOI: 10.1177/1179173x231179675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Given the potential respiratory health risks, the association of COVID infection and the use of combustible cigarettes, electronic nicotine delivery systems (ENDS), and concurrent dual use is a priority for public health. Many published reports have not accounted for known covarying factors. This study sought to calculate adjusted odds ratios for self-reported COVID infection and disease severity as a function of smoking and ENDS use, while accounting for factors known to influence COVID infection and disease severity (i.e., age, sex, race and ethnicity, socioeconomic status and educational attainment, rural or urban environment, self-reported diabetes, COPD, coronary heart disease, and obesity status). Data from the 2021 U.S. National Health Interview Survey, a cross-sectional questionnaire design, were used to calculate both unadjusted and adjusted odds ratios for self-reported COVID infection and severity of symptoms. Results indicate that combustible cigarette use is associated with a lower likelihood of self-reported COVID infection relative to non-use of tobacco products (AOR = .64; 95% CI [.55, .74]), whereas ENDS use is associated with a higher likelihood of self-reported COVID infection (AOR = 1.30; 95% CI [1.04, 1.63]). There was no significant difference in COVID infection among dual users (ENDS and combustible use) when compared with non-users. Adjusting for covarying factors did not substantially change the results. There were no significant differences in COVID disease severity between those of varying smoking status. Future research should examine the relationship between smoking status and COVID infection and disease severity utilizing longitudinal study designs and non-self-report measures of smoking status (e.g., the biomarker cotinine), COVID infection (e.g., positive tests), and disease severity (e.g., hospitalizations, ventilator assistance, mortality, and ongoing symptoms of long COVID).
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Affiliation(s)
- Susette A Moyers
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Ashleigh Chiaf
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Benjamin Greiner
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie M Croff
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Siamwala JH, Mossman JA, Schorl C, Borgas D, Sakhatskyy P, Rand DM, Lu Q, Rounds S. Strain-dependent lung transcriptomic differences in cigarette smoke and LPS models of lung injury in mice. Physiol Genomics 2023; 55:259-274. [PMID: 37184227 PMCID: PMC10259868 DOI: 10.1152/physiolgenomics.00152.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023] Open
Abstract
Cigarette smoking increases the risk of acute respiratory distress syndrome (ARDS; Calfee CS, Matthay MA, Eisner MD, Benowitz N, Call M, Pittet J-F, Cohen MJ. Am J Respir Crit Care Med 183: 1660-1665, 2011; Calfee CS, Matthay MA, Kangelaris KN, Siew ED, Janz DR, Bernard GR, May AK, Jacob P, Havel C, Benowitz NL, Ware LB. Crit Care Med 43: 1790-1797, 2015; Toy P, Gajic O, Bacchetti P, Looney MR, Gropper MA, Hubmayr R, Lowell CA, Norris PJ, Murphy EL, Weiskopf RB, Wilson G, Koenigsberg M, Lee D, Schuller R, Wu P, Grimes B, Gandhi MJ, Winters JL, Mair D, Hirschler N, Sanchez Rosen R, Matthay MA, TRALI Study Group. Blood 119: 1757-1767, 2012) and causes emphysema. However, it is not known why some individuals develop disease, whereas others do not. We found that smoke-exposed AKR mice were more susceptible to lipopolysaccharides (LPS)-induced acute lung injury (ALI) than C57BL/6 mice (Sakhatskyy P, Wang Z, Borgas D, Lomas-Neira J, Chen Y, Ayala A, Rounds S, Lu Q. Am J Physiol Lung Cell Mol Physiol 312: L56-L67, 2017); thus, we investigated strain-dependent lung transcriptomic responses to cigarette smoke (CS). Eight-week-old male AKR and C57BL/6 mice were exposed to 3 wk of room air (RA) or cigarette smoke (CS) for 6 h/day, 4 days/wk, followed by intratracheal instillation of LPS or normal saline (NS) and microarray analysis of lung homogenate gene expression. Other groups of AKR and C57 mice were exposed to RA or CS for 6 wk, followed by evaluation of static lung compliance and tissue elastance, morphometric evaluation for emphysema, or microarray analysis of lung gene expression. Transcriptomic analyses of lung homogenates show distinct strain-dependent lung transcriptional responses to CS and LPS, with AKR mice having larger numbers of genes affected than similarly treated C57 mice, congruent with strain differences in physiologic and inflammatory parameters previously observed in LPS-induced ALI after CS priming. These results suggest that genetic differences may underlie differing susceptibility of smokers to ARDS and emphysema. Strain-based differences in gene transcription contribute to CS and LPS-induced lung injury. There may be a genetic basis for smoking-related lung injury. Clinicians should consider cigarette smoke exposure as a risk factor for ALI and ARDS.NEW & NOTEWORTHY We demonstrate that transcriptomes expressed in lung homogenates also differ between the mouse strains and after acute (3 wk) exposure of animals to cigarette smoke (CS) and/or to lipopolysaccharide. Mouse strains also differed in physiologic, pathologic, and transcriptomic, responses to more prolonged (6 wk) exposure to CS. These data support a genetic basis for enhanced susceptibility to acute and chronic lung injury among humans who smoke cigarettes.
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Affiliation(s)
- Jamila H Siamwala
- Vascular Research Laboratory, Veterans Affairs Providence Health Care System, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - Jim A Mossman
- Department of Ecology, Evolution, and Organismal Biology, Brown University, Providence, Rhode Island, United States
| | - Christoph Schorl
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, Providence, Rhode Island, United States
| | - Diana Borgas
- Vascular Research Laboratory, Veterans Affairs Providence Health Care System, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - Pavlo Sakhatskyy
- Vascular Research Laboratory, Veterans Affairs Providence Health Care System, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - David M Rand
- Department of Ecology, Evolution, and Organismal Biology, Brown University, Providence, Rhode Island, United States
| | - Qing Lu
- Vascular Research Laboratory, Veterans Affairs Providence Health Care System, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - Sharon Rounds
- Vascular Research Laboratory, Veterans Affairs Providence Health Care System, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
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Lyu H, Warren R, Gao S, Klinkhammer K, Yuan T, Zhang JS, Brownfield D, Li X, De Langhe SP. Niche-mediated repair of airways is directed in an occupant-dependent manner. Cell Rep 2022; 41:111863. [PMID: 36543133 DOI: 10.1016/j.celrep.2022.111863] [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: 03/02/2022] [Revised: 10/03/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
In injured airways of the adult lung, epithelial progenitors are called upon to repair by nearby mesenchymal cells via signals transmitted through the niche. Currently, it is unclear whether repair is coordinated by the mesenchymal cells that maintain the niche or by the airway epithelial cells that occupy it. Here, we show that the spatiotemporal expression of Fgf10 by the niche is primarily orchestrated by the niche's epithelial occupants-both those that reside prior to, and following, injury. During homeostasis, differentiated airway epithelial cells secrete Sonic hedgehog (Shh) to inhibit Fgf10 expression by Gli1+ peribronchial mesenchymal cells in the niche. After injury, remaining epithelial cells produce Wnt7b to induce Fgf10 expression in airway smooth muscle cells in the niche. We find that this reliance on a common activator of airway epithelial stem cells also allows for the recruitment of remote stem cell populations when local populations have been exhausted.
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Affiliation(s)
- Handeng Lyu
- School of Pharmaceutical Sciences, and The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China; Department of Medicine, Division of Pulmonary and Critical Medicine, Mayo Clinic, Rochester, MN 55905, USA; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue S., Birmingham, AL 35294-2182, USA
| | - Rachel Warren
- Department of Medicine, Division of Pulmonary and Critical Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Shan Gao
- Department of Medicine, Division of Pulmonary and Critical Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Kylie Klinkhammer
- Department of Medicine, Division of Pulmonary and Critical Medicine, Mayo Clinic, Rochester, MN 55905, USA; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue S., Birmingham, AL 35294-2182, USA
| | - Tingting Yuan
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue S., Birmingham, AL 35294-2182, USA
| | - Jin-San Zhang
- School of Pharmaceutical Sciences, and The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Douglas Brownfield
- Department of Medicine, Division of Pulmonary and Critical Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Xiaokun Li
- School of Pharmaceutical Sciences, and The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
| | - Stijn P De Langhe
- Department of Medicine, Division of Pulmonary and Critical Medicine, Mayo Clinic, Rochester, MN 55905, USA; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue S., Birmingham, AL 35294-2182, USA.
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8
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Hill S. Commentary: Tobacco and COVID-19: avoiding the error of distraction. Int J Epidemiol 2022; 51:1073-1075. [PMID: 35522734 DOI: 10.1093/ije/dyac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/21/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sarah Hill
- Sydney School of Public Health, University of Sydney, Sydney, Australia
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
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Gill AS, Meeks H, Curtin K, Alt JA. Tobacco Use Increases the Adjusted Risk of Revision Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis. Am J Rhinol Allergy 2022; 36:727-732. [PMID: 35698747 DOI: 10.1177/19458924221105926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Large epidemiologic studies have suggested that a history of tobacco use may be associated with an increased risk of developing chronic rhinosinusitis (CRS). The impact of tobacco use on revision rates of endoscopic sinus surgery (ESS), however, remains limited. OBJECTIVE This study seeks to define the independent risk of tobacco use (active or prior) on revision rates of ESS among a large cohort of patients with CRS. METHODS A state population database was queried for patients age ≥18 years with CRS who underwent at least one ESS between 1996 and 2018. Demographic characteristics, history of ESS, and tobacco use status were compared across patients with CRS, using t tests for continuous variables and χ2 tests for categorical variables. Unadjusted and adjusted logistic regression models were used to understand the impact of tobacco status on revision surgery. RESULTS The final analysis included 34 350 patients (29 916 CRS with no revision surgery and 4434 CRS with revision surgery). Unadjusted regression analysis demonstrated an increased odds of undergoing revision ESS (OR 1.12, 95% CI: 1.00-1.25, P = .05) among males with a history of tobacco use and CRS. Adjusted regression analysis demonstrated that the risk of revision ESS among CRS patients with a history of asthma and tobacco use was 1.72-fold, while the risk among CRS patients who were tobacco users without asthma was 1.11-fold. CONCLUSION History of tobacco use is an independent risk factor for revision ESS among patients with CRS.
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Affiliation(s)
- Amarbir S Gill
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Huong Meeks
- Pedigree and Population Resource, 20270Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Karen Curtin
- Pedigree and Population Resource, 20270Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Internal Medicine, 14434University of Utah, Salt Lake City, Utah
| | - Jeremiah A Alt
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah
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Mahmud A, Salisu AD, Kolo ES, Hasheem MG, Bello‐Muhammad N, Tukur AR, Nuhu YJ, Jalo RI. Impact of smoking on nasal mucociliary clearance time in Kano metropolis, Nigeria. World J Otorhinolaryngol Head Neck Surg 2022; 9:53-58. [PMID: 37006746 PMCID: PMC10050968 DOI: 10.1002/wjo2.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Mucociliary clearance is an important defense mechanism in human upper and lower respiratory airways. Impairment of this process by certain conditions such as cigarette smoking can predispose to chronic infection and neoplasm of the nose and paranasal sinuses. Methods This was a cross-sectional study conducted in Kano metropolis, Nigeria. Eligible adults were enrolled, a saccharine test was conducted, and the nasal mucociliary clearance time was assessed. Analysis of the result was carried out using Statistical Product and Service Solutions version 23.0. Results There were 225 participants categorized into 75 active smokers (33.3%), 74 passive smokers (32.9%), and 76 nonsmokers (33.8%, living in a smoking-free zone). The age range of the participants was between 18 and 50 years, with a mean age of (31.2 ± 5.6) years. All participants were males. There were 139 (61.8%) of Hausa-Fulani ethnic group, 24 (10.7%) Yoruba, 18 (8.0%) Igbo, and 44 (19.5%) other ethnic groups. Findings in this study showed that the average mucociliary clearance time among active smokers was prolonged ([15.25 ± 6.20] min) compared to passive ([11.41 ± 4.25] min) and nonsmokers ([9.17 ± 2.76] min) respectively, with a statistical significance (F = 33.59, P < 0.001). Binary logistic regression revealed that the number of cigarettes smoked per day was an independent predictor of prolonged mucociliary clearance time (P = 0.008, odds ratio = 0.44, 95% confidence interval = 0.24-0.80). Conclusion Active cigarette smoking is associated with prolonged nasal mucociliary clearance time. The number of cigarette sticks smoked per day was found to be an independent predictor of prolonged mucociliary clearance time.
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Affiliation(s)
- Ahmad Mahmud
- Department of ENT Federal Medical Centre Yola Yola Nigeria
- Department of ENT Aminu Kano Teaching Hospital Kano Nigeria
| | - Abubakar D. Salisu
- Department of ENT, Aminu Kano Teaching Hospital Bayero University Kano Kano Nigeria
| | - Emmanuel S. Kolo
- Department of ENT, Aminu Kano Teaching Hospital Bayero University Kano Kano Nigeria
| | - Muhammad G. Hasheem
- Department of ENT, Aminu Kano Teaching Hospital Bayero University Kano Kano Nigeria
| | | | - Ahmad R. Tukur
- Department of ENT, Aminu Kano Teaching Hospital Bayero University Kano Kano Nigeria
| | - Yasir J. Nuhu
- Department of ENT, Aminu Kano Teaching Hospital Bayero University Kano Kano Nigeria
| | - Rabiu I. Jalo
- Department of ENT, Aminu Kano Teaching Hospital Bayero University Kano Kano Nigeria
- Department of Community Medicine Aminu Kano Teaching Hospital/Bayero University Kano Kano Nigeria
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11
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Jackson SE, Brown J, Shahab L, Steptoe A, Fancourt D. COVID-19, smoking and inequalities: a study of 53 002 adults in the UK. Tob Control 2021; 30:e111-e121. [PMID: 32826387 PMCID: PMC7445100 DOI: 10.1136/tobaccocontrol-2020-055933] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study aimed to examine associations between smoking and COVID-19 relevant outcomes, taking into account the influence of inequalities and adjusting for potential confounding variables. METHODS Cross-sectional data were used from an online study of adults in the UK (n=53 002). Main outcome measures were confirmed and suspected COVID-19, worry about catching or becoming seriously ill from COVID-19 and adherence to protective behaviours. Covariates included age, sex, ethnicity, education (post-16 qualifications: yes/no), key worker status and comorbid health conditions. RESULTS Compared with never smokers (0.26% (95% CI 0.21% to 0.33%)), prevalence of confirmed COVID-19 was higher among current (0.56% (0.41% to 0.75%)) but not ex-smokers (0.19% (0.13% to 0.28%)). Associations were similar before (current: OR=2.14 (1.49-3.08); ex-smokers: OR=0.73 (0.47-1.14)) and after (current: OR=1.79 (1.22-2.62); ex-smokers: OR=0.85 (0.54-1.33)) adjustment. For current smokers, this was moderated by socio-economic position, with higher rates only seen in those without post-16 qualifications (OR=3.53 (2.04-6.10)). After including suspected cases, prevalence was higher among current smokers (11.2% (10.6% to 11.9%), OR=1.11 (1.03-1.20)) and ex-smokers (10.9% (10.4% to 11.5%), OR=1.07 (1.01-1.15)) than never smokers (10.2% (9.9% to 10.6%)), but remained higher only among ex-smokers after adjustment (OR=1.21 (1.13-1.29)). Current and ex-smokers had higher odds than never smokers of reporting significant stress about becoming seriously ill from COVID-19 (current: OR=1.34 (1.27-1.43); ex-smokers: OR=1.22 (1.16-1.28)). Adherence to recommendations to prevent spread of COVID-19 was high (96.3% (96.1% to 96.4%)), but lower among current than never smokers (OR=0.70 (0.62-0.78)). CONCLUSIONS In a population sample, current smoking was independently associated with self-reported confirmed COVID-19 infection. There were socio-economic disparities, with the association only apparent among those without post-16 qualifications. Smokers reported lower adherence to guidelines despite being more worried than non-smokers about catching or becoming seriously ill from COVID-19.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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12
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Zhang H, Miao J, Su M, Liu BY, Liu Z. Effect of fermented milk on upper respiratory tract infection in adults who lived in the haze area of Northern China: a randomized clinical trial. PHARMACEUTICAL BIOLOGY 2021; 59:647-652. [PMID: 34062085 PMCID: PMC8172217 DOI: 10.1080/13880209.2021.1929344] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/09/2021] [Accepted: 05/09/2021] [Indexed: 06/12/2023]
Abstract
CONTEXT Upper respiratory tract infection (URTI) is the most common illness in humans. Fermented milk containing probiotics can mitigate URTI symptoms. OBJECTIVE This study tests the effect of fermented milk (Qingrun), a yogurt supplemented with Bifidobacterium animalis subsp. lactis Bl-04, on adults with URTIs who live in a haze-covered area in a randomized clinical trial. MATERIALS AND METHODS A total of 136 subjects were enrolled in the study at the baseline and randomized to consume either control yogurt or Qingrun yogurt (250 g) once daily for 12 weeks. The duration and severity of URTI were evaluated by the Wisconsin Upper Respiratory Symptom Survey-24. Blood and faecal samples were collected at the baseline and post-intervention, to determine the changes of immune biomarkers. RESULTS Qingrun yogurt significantly reduced the incidence of the common cold (OR, 0.38; 95% CI, 0.17-0.81; p = 0.013) and influenza-like illness (OR, 0.32; 95% CI, 0.11-0.97; p = 0.045). Compared to the control yogurt, Qingrun yogurt significantly reduced the duration (1.23 ± 2.73 vs. 4.78 ± 5.09 d) and severity score (3.58 ± 7.12 vs. 11.37 ± 11.73) of URTI. In addition, the post-intervention levels of interferon-γ (139.49 ± 59.49 vs. 113.45 ± 65.12 pg/mL) and secretory immunoglobulin A (529.19 ± 91.70 vs. 388.88 ± 53.83 mg/dL) significantly increased in the Qingrun group, compared with those in the control group. CONCLUSIONS Qingrun yogurt showed a protective effect against URTI in adults, suggesting that the use of yogurt with probiotics could be a promising dietary supplement for mitigating URTI.
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Affiliation(s)
- Hong Zhang
- Department of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Junli Miao
- Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, China
| | - Miya Su
- Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, China
| | - Bryan Y. Liu
- College of Biotechnology, East China University of Science and Technology, Shanghai, China
| | - Zhenmin Liu
- Dairy Research Institute, Bright Dairy & Food Co., Ltd, Shanghai, China
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13
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Ozcifci G, Aydin T, Atli Z, Balkan II, Tabak F, Oztas M, Ozguler Y, Ugurlu S, Hatemi G, Melikoglu M, Fresko I, Hamuryudan V, Seyahi E. The incidence, clinical characteristics, and outcome of COVID-19 in a prospectively followed cohort of patients with Behçet's syndrome. Rheumatol Int 2021; 42:101-113. [PMID: 34825278 PMCID: PMC8614218 DOI: 10.1007/s00296-021-05056-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/13/2021] [Indexed: 12/28/2022]
Abstract
Initial case series of small number of patients at the beginning of the pandemic reported a rather guarded prognosis for Behçet’s syndrome (BS) patients infected with SARS-CoV-2. In this prospective study, we describe the incidence, clinical characteristics, disease course, management, and outcome in a large cohort of BS patients with laboratory-confirmed infection of SARS-CoV-2. We defined a cohort of 1047 registered BS patients who were aged between 16 and 60 years and seen routinely before the pandemic at the multidisciplinary outpatient clinic. We followed prospectively this cohort from beginning of April 2020 until the end of April 2021. During 13 months of follow-up, of the 1047 (599 M/448 F) patients, 592 (56.5%) were tested for SARS-CoV-2 PCR at least once and 215 (20.5%; 95% CI 0.18–0.23) were tested positive. We observed 2 peaks which took place in December 2020 and April 2021. Of the 215 PCR positive patients, complete information was available in 214. Of these 214, 14 (6.5%) were asymptomatic for COVID-19. In the remaining, the most common symptoms were anosmia, fatigue, fever, arthralgia, and headache. A total of 40 (18.7%) had lung involvement, 25 (11.7%) were hospitalized, 1 was admitted to the intensive care unit while none died. Favipiravir was the most prescribed drug (74.3%), followed by colchicine (40.2%), and hydroxychloroquine (20.1%) in the treatment of COVID-19. After COVID-19, 5 patients (2.3%) were given supplemental O2 and 31 (14.5%) antiaggregant or anticoagulants. During COVID-19, of the 214 PCR positive patients, 116 (54.2%) decreased the dose of their immunosuppressives or stopped taking completely; 36 (16.8%) experienced a BS flare which was mostly oral ulcers (10.3%). None of the patients reported a thrombotic event. A total of 93 (43.5%) patients reported BS flares after a median 45 days of COVID-19 infection and this was found to be significantly associated with immunosuppressive drug discontinuation. Multiple regression analysis adjusted for age and gender indicated that smoking and using interferon-alpha decreased the likelihood of getting COVID-19. The incidence and severity of COVID-19 did not differ between those who were using colchicine or not. The cumulative incidence of COVID-19 in this prospectively followed cohort of BS patients was almost two folds of that estimated for the general population living in Istanbul, Turkey, however, the clinical outcome of COVID-19 was not severe and there was no mortality. The protective effect of smoking and interferon deserves further investigation. On the other hand, colchicine did not have any positive or negative effect against COVID-19. Significant number of patients flared after COVID-19, however, this was significantly associated with immunosuppressive discontinuation during the infection. Contrary to our previous observations, COVID-19 did not seem to exacerbate thrombotic events during or after the infection.
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Affiliation(s)
- Guzin Ozcifci
- Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tahacan Aydin
- Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Zeynep Atli
- Department of Accounting and Taxation, Sinop University, Sinop, Turkey
| | - Ilker Inanc Balkan
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mert Oztas
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Yesim Ozguler
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Serdal Ugurlu
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Gulen Hatemi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Melike Melikoglu
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Izzet Fresko
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Vedat Hamuryudan
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey
| | - Emire Seyahi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey.
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14
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McRobbie H, Kwan B. Tobacco use disorder and the lungs. Addiction 2021; 116:2559-2571. [PMID: 33140508 DOI: 10.1111/add.15309] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/17/2020] [Accepted: 10/23/2020] [Indexed: 12/22/2022]
Abstract
This narrative review provides a summary of the impact of tobacco smoking on the respiratory system and the benefits of smoking cessation. Tobacco smoking is one of the leading preventable causes of death world-wide and a major risk factor for lung cancer and chronic obstructive pulmonary disease. Smoking is also associated with an increased risk of respiratory infections and appears to be related to poorer outcomes among those with COVID-19. Non-smokers with second-hand smoke exposure also experience significant adverse respiratory effects. Smoking imposes enormous health- and non-health-related costs to societies. The benefits of smoking cessation, in both prevention and management of respiratory disease, have been known for decades and, to this day, cessation support remains one of the most important cost-effective interventions that health professionals can provide to people who smoke. Cessation at any age confers substantial health benefits, even in smokers with established morbidities. As other treatments for chronic respiratory disease advance and survival rates increase, smoking cessation treatment will become even more relevant. While smoking cessation interventions are available, the offer of these by clinicians and uptake by patients remain limited.
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Affiliation(s)
- Hayden McRobbie
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.,Lakes District Health Board, Rotorua, New Zealand
| | - Benjamin Kwan
- Department of Respiratory and Sleep Medicine, Sutherland Hospital, Sydney, Australia.,St George and Sutherland Clinical School, University of New South Wales, Sydney, Australia
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15
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Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: a living rapid evidence review with Bayesian meta-analyses (version 7). Addiction 2021; 116:1319-1368. [PMID: 33007104 PMCID: PMC7590402 DOI: 10.1111/add.15276] [Citation(s) in RCA: 229] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/08/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]
Abstract
AIMS To estimate the association of smoking status with rates of (i) infection, (ii) hospitalization, (iii) disease severity and (iv) mortality from SARS-CoV-2/COVID-19 disease. DESIGN Living rapid review of observational and experimental studies with random-effects hierarchical Bayesian meta-analyses. Published articles and pre-prints were identified via MEDLINE and medRxiv. SETTING Community or hospital, no restrictions on location. PARTICIPANTS Adults who received a SARS-CoV-2 test or a COVID-19 diagnosis. MEASUREMENTS Outcomes were SARS-CoV-2 infection, hospitalization, disease severity and mortality stratified by smoking status. Study quality was assessed (i.e. 'good', 'fair' and 'poor'). FINDINGS Version 7 (searches up to 25 August 2020) included 233 studies with 32 'good' and 'fair' quality studies included in meta-analyses. Fifty-seven studies (24.5%) reported current, former and never smoking status. Recorded smoking prevalence among people with COVID-19 was generally lower than national prevalence. Current compared with never smokers were at reduced risk of SARS-CoV-2 infection [relative risk (RR) = 0.74, 95% credible interval (CrI) = 0.58-0.93, τ = 0.41]. Data for former smokers were inconclusive (RR = 1.05, 95% CrI = 0.95-1.17, τ = 0.17), but favoured there being no important association (21% probability of RR ≥ 1.1). Former compared with never smokers were at somewhat increased risk of hospitalization (RR = 1.20, CrI = 1.03-1.44, τ = 0.17), greater disease severity (RR = 1.52, CrI = 1.13-2.07, τ = 0.29) and mortality (RR = 1.39, 95% CrI = 1.09-1.87, τ = 0.27). Data for current smokers were inconclusive (RR = 1.06, CrI = 0.82-1.35, τ = 0.27; RR = 1.25, CrI = 0.85-1.93, τ = 0.34; RR = 1.22, 95% CrI = 0.78-1.94, τ = 0.49, respectively), but favoured there being no important associations with hospitalization and mortality (35% and 70% probability of RR ≥ 1.1, respectively) and a small but important association with disease severity (79% probability of RR ≥ 1.1). CONCLUSIONS Compared with never smokers, current smokers appear to be at reduced risk of SARS-CoV-2 infection, while former smokers appear to be at increased risk of hospitalization, increased disease severity and mortality from COVID-19. However, it is uncertain whether these associations are causal.
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Affiliation(s)
- David Simons
- Centre for Emerging, Endemic and Exotic DiseasesRoyal Veterinary CollegeLondonUK
| | - Lion Shahab
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Jamie Brown
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
| | - Olga Perski
- Department of Behavioural Science and HealthUniversity College LondonLondonUK
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16
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Guttenberg MA, Vose AT, Tighe RM. Role of Innate Immune System in Environmental Lung Diseases. Curr Allergy Asthma Rep 2021; 21:34. [PMID: 33970346 PMCID: PMC8311569 DOI: 10.1007/s11882-021-01011-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 01/07/2023]
Abstract
The lung mucosa functions as a principal barrier between the body and inhaled environmental irritants and pathogens. Precise and targeted surveillance mechanisms are required at this lung-environment interface to maintain homeostasis and preserve gas exchange. This is performed by the innate immune system, a germline-encoded system that regulates initial responses to foreign irritants and pathogens. Environmental pollutants, such as particulate matter (PM), ozone (O3), and other products of combustion (NO2, SO3, etc.), both stimulate and disrupt the function of the innate immune system of the lung, leading to the potential for pathologic consequences. PURPOSE OF REVIEW: The purpose of this review is to explore recent discoveries and investigations into the role of the innate immune system in responding to environmental exposures. This focuses on mechanisms by which the normal function of the innate immune system is modified by environmental agents leading to disruptions in respiratory function. RECENT FINDINGS: This is a narrative review of mechanisms of pulmonary innate immunity and the impact of environmental exposures on these responses. Recent findings highlighted in this review are categorized by specific components of innate immunity including epithelial function, macrophages, pattern recognition receptors, and the microbiome. Overall, the review supports broad impacts of environmental exposures to alterations to normal innate immune functions and has important implications for incidence and exacerbations of lung disease. The innate immune system plays a critical role in maintaining pulmonary homeostasis in response to inhaled air pollutants. As many of these agents are unable to be mitigated, understanding their mechanistic impact is critical to develop future interventions to limit their pathologic consequences.
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Affiliation(s)
| | | | - Robert M. Tighe
- Department of Medicine, Duke University, Durham, NC,Corresponding Author: Robert M Tighe, MD, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Box 2969, Durham, North Carolina 27710, Telephone: 919-684-4894, Fax: 919-684-5266,
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17
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Samadizadeh S, Masoudi M, Rastegar M, Salimi V, Shahbaz MB, Tahamtan A. COVID-19: Why does disease severity vary among individuals? Respir Med 2021; 180:106356. [PMID: 33713961 PMCID: PMC7934673 DOI: 10.1016/j.rmed.2021.106356] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/25/2021] [Accepted: 02/28/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the current pandemic, coronavirus disease 2019 (COVID-19). While all people are susceptible to the SARS-CoV-2 infection, the nature and severity of the disease vary significantly among individuals and populations. Importantly, reported disease burdens and case fatality rates differ considerably from country to country. There are, however, still uncertainties about the severity of the disease among individuals or the reason behind a more severe disease in some cases. There is a strong possibility that the severity of this disease depends on a complicated interaction between the host, virus, and environment, which leads to different clinical outcomes. The objective of this article is to point out the essential influential factors related to the host, virus, and environment affecting the clinical outcome of COVID-19.
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Affiliation(s)
- Saeed Samadizadeh
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Maha Masoudi
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mostafa Rastegar
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Vahid Salimi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Bataghva Shahbaz
- Roberts Research Institute and School of Biomedical Engineering, Western University, London, Canada
| | - Alireza Tahamtan
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran; Department of Microbiology, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
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18
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Olloquequi J. COVID-19 Susceptibility in chronic obstructive pulmonary disease. Eur J Clin Invest 2020; 50:e13382. [PMID: 32780415 PMCID: PMC7435530 DOI: 10.1111/eci.13382] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023]
Abstract
In barely nine months, the pandemic known as COVID-19 has spread over 200 countries, affecting more than 22 million people and causing over than 786 000 deaths. Elderly people and patients with previous comorbidities such as hypertension and diabetes are at an increased risk to suffer a poor prognosis after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although the same could be expected from patients with chronic obstructive pulmonary disease (COPD), current epidemiological data are conflicting. This could lead to a reduction of precautionary measures in these patients, in the context of a particularly complex global health crisis. Most COPD patients have a long history of smoking or exposure to other harmful particles or gases, capable of impairing pulmonary defences even years after the absence of exposure. Moreover, COPD is characterized by an ongoing immune dysfunction, which affects both pulmonary and systemic cellular and molecular inflammatory mediators. Consequently, increased susceptibility to viral respiratory infections have been reported in COPD, often worsened by bacterial co-infections and leading to serious clinical outcomes. The present paper is an up-to-date review that discusses the available research regarding the implications of coronavirus infection in COPD. Although validation in large studies is still needed, COPD likely increases SARS-CoV-2 susceptibility and increases COVID-19 severity. Hence, specific mechanisms to monitor and assess COPD patients should be addressed in the current pandemic.
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Affiliation(s)
- Jordi Olloquequi
- Laboratory of Cellular and Molecular Pathology, Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Talca, Chile
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19
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Silverman DA, Lin C, Tamaki A, Puram SV, Carrau RL, Seim NB, Eskander A, Rocco JW, Old MO, Kang SY. Respiratory and pulmonary complications in head and neck cancer patients: Evidence-based review for the COVID-19 era. Head Neck 2020; 42:1218-1226. [PMID: 32343013 PMCID: PMC7267530 DOI: 10.1002/hed.26217] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Pulmonary complications and infections frequently affect patients with head and neck squamous cell carcinoma (HNSCC). Common characteristics can predispose these patients to the development of severe respiratory illness, which may be particularly relevant during the 2019 coronavirus disease (COVID-19) pandemic. METHODS A scoping review was performed to assess the impact of pulmonary comorbidities and adverse respiratory outcomes in HNSCC patients. RESULTS Advanced age, history of tobacco and alcohol abuse, and cardiopulmonary comorbidities are significant risk factors for the development of adverse respiratory outcomes. Treatment toxicities from radiation or chemoradiation therapy significantly increase these risks. CONCLUSION Respiratory complications are a frequent cause of morbidity and mortality among HNSCC patients, and the COVID-19 pandemic may disproportionately affect this population. Interventions designed to decrease smoking and alcohol use, improve oral hygiene, and aggressively manage medical comorbidities are important to the long-term management and health of these patients.
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Affiliation(s)
- Dustin A Silverman
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Chen Lin
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Akina Tamaki
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery and Department of Genetics, Washington University School of Medicine, Ear, Nose & Throat Center, St. Louis, Missouri, USA
| | - Ricardo L Carrau
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Nolan B Seim
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, USA
| | - James W Rocco
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Matthew O Old
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Stephen Y Kang
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
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Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review. ACTA ACUST UNITED AC 2020. [DOI: 10.32388/ujr2aw.2] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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21
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da Silva Araújo NP, de Matos NA, Leticia Antunes Mota S, Farias de Souza AB, Dantas Cangussú S, Cunha Alvim de Menezes R, Silva Bezerra F. Quercetin Attenuates Acute Lung Injury Caused by Cigarette Smoke Both In Vitro and In Vivo. COPD 2020; 17:205-214. [PMID: 32237913 DOI: 10.1080/15412555.2020.1749253] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cigarette smoke is highly toxic and is a major risk factor for airway inflammation, oxidative stress, and decline in lung function-the starting points for chronic obstructive pulmonary disease. Quercetin is a potent dietary antioxidant that displays anti-inflammatory activities. The goal of this study was to evaluate the effects of quercetin on reducing the redox imbalance and inflammation induced by short-term cigarette smoke exposure. In vitro, 25 and 50 μM quercetin attenuated the effects of cigarette smoke extract (increased generation of reactive oxygen species and nitric oxide) on J774A.1 cells (macrophages). We further examined the effects of quercetin in vivo. Male C57Bl/6 mice that received 10 mg/kg/day of quercetin via orogastric gavage before exposure to five days of cigarette smoke demonstrated reduced levels of leukocyte, oxidative stress, histological pattern changes of pulmonary parenchyma, and lung function alterations compared to the group that did not receive quercetin. These results suggest that quercetin may be an effective adjuvant for treating the effects of cigarette smoke exposure.
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Affiliation(s)
- Natália Pereira da Silva Araújo
- Laboratory of Experimental Pathophysiology, Department of Biological Sciences and Center of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Natália Alves de Matos
- Laboratory of Experimental Pathophysiology, Department of Biological Sciences and Center of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Suianne Leticia Antunes Mota
- Laboratory of Parasitic Diseases, School of Medicine, Department of Biological Sciences and NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Ana Beatriz Farias de Souza
- Laboratory of Experimental Pathophysiology, Department of Biological Sciences and Center of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Sílvia Dantas Cangussú
- Laboratory of Experimental Pathophysiology, Department of Biological Sciences and Center of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Rodrigo Cunha Alvim de Menezes
- Laboratory of Cardiovascular Physiology, Department of Biological Sciences and Center of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Frank Silva Bezerra
- Laboratory of Experimental Pathophysiology, Department of Biological Sciences and Center of Research in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
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22
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Simons D, Brown J, Shahab L, Perski O. Smoking and COVID-19: Rapid evidence review for the Royal College of Physicians, London (UK). ACTA ACUST UNITED AC 2020. [DOI: 10.32388/vgjcun] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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23
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Sampath A, Weerasekera M, Dilhari A, Gunasekara C, Bulugahapitiya U, Fernando N, Samaranayake L. Type 2 diabetes mellitus and oral Candida colonization: Analysis of risk factors in a Sri Lankan cohort. Acta Odontol Scand 2019; 77:508-516. [PMID: 31145647 DOI: 10.1080/00016357.2019.1607547] [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: 10/26/2022]
Abstract
Aims: Oral candidiasis is a major oral manifestation of uncontrolled diabetes mellitus, and a number of cofactors are associated with the pathogenesis of this infection. Here, we describe the prevalence of oral Candida in a Sri Lankan cohort of type 2 diabetes mellitus and risk factors that predispose them to this common fungal infection. Methods: A case-control study was conducted in 250 diabetics with type 2 diabetes and 81 nondiabetic controls. Clinical and demographic data were collected using an interviewer administered questionnaire, and patient records. Oral rinse samples were collected to determine the candidal carriage, and the resultant yeast growth was quantified and speciated using multiplex-PCR and phenotypic analyses. Chi-square test (χ2 test) and Fisher exact test were used for the determination of the significant relationships between risk factors and oral candidiasis. Results: The oral prevalence of Candida species among both groups was similar (81%) although a significantly higher proportion of diabetics (32.8%) yielded >2000 CFU/mL of yeasts compared with only 12.3% of the healthy controls (p < .05). Significant associations were noted between oral candidal carriage amongst diabetics, and (i) denture wearing, (ii) female gender and (iii) cigarette smoking (all, p < .05). Amongst both groups, C.albicans was the most common Candida species isolated followed by C. parapsilosis, C. tropicalis and C. glabrata. Conclusions: The oral infestation of Candida in our Sri Lankan cohort of diabetics is significantly higher than their healthy counterparts, and co-carriage of multiple yeast species is a common finding in the study population. As there are no previous such reports of the latter phenomenon particularly from the Asian region it is noteworthy, mainly in view of the recent data on the emergence of drug-resistant yeast species the world over.
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Affiliation(s)
- Asanga Sampath
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Manjula Weerasekera
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Ayomi Dilhari
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Chinthika Gunasekara
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - Neluka Fernando
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Fujino N, Brand OJ, Morgan DJ, Fujimori T, Grabiec AM, Jagger CP, Maciewicz RA, Yamada M, Itakura K, Sugiura H, Ichinose M, Hussell T. Sensing of apoptotic cells through Axl causes lung basal cell proliferation in inflammatory diseases. J Exp Med 2019; 216:2184-2201. [PMID: 31289116 PMCID: PMC6719415 DOI: 10.1084/jem.20171978] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/18/2019] [Accepted: 06/14/2019] [Indexed: 12/16/2022] Open
Abstract
Epithelial cell proliferation, division, and differentiation are critical for barrier repair following inflammation, but the initial trigger for this process is unknown. Here we define that sensing of apoptotic cells by the TAM receptor tyrosine kinase Axl is a critical indicator for tracheal basal cell expansion, cell cycle reentry, and symmetrical cell division. Furthermore, once the pool of tracheal basal cells has expanded, silencing of Axl is required for their differentiation. Genetic depletion of Axl triggers asymmetrical cell division, leading to epithelial differentiation and ciliated cell regeneration. This discovery has implications for conditions associated with epithelial barrier dysfunction, basal cell hyperplasia, and continued turnover of dying cells in patients with chronic inflammatory pulmonary diseases.
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Affiliation(s)
- Naoya Fujino
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Oliver J Brand
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, the University of Manchester, Manchester, UK
| | - David J Morgan
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, the University of Manchester, Manchester, UK
| | - Toshifumi Fujimori
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
| | - Aleksander M Grabiec
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
- Department of Microbiology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Kraków, Poland
| | - Christopher P Jagger
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, the University of Manchester, Manchester, UK
| | - Rose A Maciewicz
- Respiratory, Inflammation, and Autoimmunity Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Gothenburg, Sweden
- Institute of Infection, Immunity, and Inflammation, University of Glasgow, Glasgow, UK
| | - Mitsuhiro Yamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Koji Itakura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tracy Hussell
- Manchester Collaborative Centre for Inflammation Research, the University of Manchester, Manchester, UK
- Lydia Becker Institute of Immunology and Inflammation, the University of Manchester, Manchester, UK
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Lawrence H, Hunter A, Murray R, Lim WS, McKeever T. Cigarette smoking and the occurrence of influenza - Systematic review. J Infect 2019; 79:401-406. [PMID: 31465780 DOI: 10.1016/j.jinf.2019.08.014] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The association of current smoking with influenza infection is not widely recognised. The aim of this systematic review was to summarise published evidence and quantify the risk of influenza infection in tobacco smokers compared to non-smokers. METHODS We systematically searched MEDLINE, EMBASE, CINAHL, LILACS and Web of Science, from inception to 7 November 2017, to identify relevant randomised control trials, cohort and case-control studies. Study quality was assessed using the Newcastle-Ottawa Scale. We included studies defining influenza as a clinical syndrome and those using confirmatory microbiological tests. Pooled odds ratios (ORs) were estimated by using random effects model. RESULTS The mean quality score across the nine included studies (n = 40,685 participants) was 5.4 of 9 (SD 1.07). Current smokers were over 5 times more likely to develop laboratory-confirmed influenza than non-smokers (pooled OR 5.69 (95% CI 2.79-11.60), 3 studies). For studies reporting the occurrence of an influenza-like illness (ILI), current smokers were 34% more likely to develop ILI than non-smokers (pooled OR 1.34 (95% CI 1.13-1.59), 6 studies). CONCLUSION Current smokers have an increased risk of developing influenza compared to non-smokers. The association was strongest in studies examining cases with laboratory confirmed influenza.
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Affiliation(s)
- H Lawrence
- Nottingham University Hospitals NHS Trust, Clinical Sciences Building, Hucknall Road, Nottingham NG5 1 PB, UK; Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK.
| | - A Hunter
- Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - R Murray
- Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK
| | - W S Lim
- Nottingham University Hospitals NHS Trust, Clinical Sciences Building, Hucknall Road, Nottingham NG5 1 PB, UK; Nottingham Biomedical Research Centre NIHR, UK
| | - T McKeever
- Department of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies (UKCTAS), School of Medicine, Clinical Sciences Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK; Nottingham Biomedical Research Centre NIHR, UK
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Cigarette smoke exposure redirects Staphylococcus aureus to a virulence profile associated with persistent infection. Sci Rep 2019; 9:10798. [PMID: 31346202 PMCID: PMC6658544 DOI: 10.1038/s41598-019-47258-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/07/2019] [Indexed: 01/09/2023] Open
Abstract
Tobacco smoking represents the leading preventable cause of death worldwide. Smoking is a recognised risk factor for several pathologies and is detrimental to host immune surveillance and defence. However, the impact of smoking on microbial residents of the nasopharyngeal cavity, in contact with cigarette smoke (CS), is lacking. Staphylococcus aureus is a major human pathogen that colonises the human nasopharynx and causes a wide range of infections. We investigated the impact of CS on specific virulence phenotypes important in S aureus pathogenesis. We observed strain-dependent differences following exposure to CS, namely growth inhibition, augmented biofilm formation, increased invasion of, and persistence within, bronchial alveolar epithelial cells. Additionally, we confirm the critical role of a functional accessory gene regulator (Agr) system in mediating increased biofilm development and host cell invasion and persistence following CS exposure. Furthermore, CS exposure resulted in reduced toxin production. Importantly, exposure of S aureus to CS accelerated the frequency of mutations and resulted in a significant increase in gentamicin-resistant small colony variant (SCV) formation. Mutational analysis revealed that CS induced SCVs emerge via the SOS response DNA mutagenic repair system. Taken together, our results suggest that CS redirects certain S aureus strains to a virulence profile associated with persistence.
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Application of Inflammatory Markers in Induced Sputum in Stable Chronic Obstructive Pulmonary Disease Patients with Positive Bronchodilation Tests. Curr Med Sci 2019; 39:560-567. [PMID: 31346991 DOI: 10.1007/s11596-019-2074-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/21/2019] [Indexed: 01/02/2023]
Abstract
Positive bronchodilation (BD) tests can be noticed in some stable chronic obstructive pulmonary disease (COPD) patients. The characteristics of airway inflammation in this entity remain unclear. Our study aimed to identify the characteristics of airway inflammation in stable COPD patients with positive BD tests. The airway inflammation was assessed in 88 patients with stable COPD using the examination of induced sputum in the aftermath of lung function and BD tests. Cellular counts and the levels of molecular markers including eosinophil cationic protein (ECP), myeloperoxidase (MPO), interleukin-5 (IL-5), and IL-8 were assayed by Wright's stain, Immuno-CAP system, and ELISA, RT-PCR. Among the 88 patients with stable COPD, 20 (22.7%) showed positive BD tests. The values of eosinophils (4.7%±3.4%) and ECP (90.1±41.6 ng/mL) in induced sputum in stable COPD patients with positive BD tests were markedly elevated as compared with those in stable COPD patients with negative BD tests or in healthy controls (all P>0.05), but significantly lower than those in asthmatic patients (all P<0.01). The IL-5 in sputum supernatant was significantly decreased in stable COPD patients with positive BD tests as compared with the patients with asthma (12.5±7.8 vs. 48.2±26.0 ng/mL;.P<0.01). However, healthy controls exhibited similar concentrations of IL-5 in induced sputum with patients with stable COPD, whether with positive or negative BD tests (all P>0.05). Moreover, the values of neutrophils (61.8%±15.1%), MPO (574.0±111.8 ng/mL), and IL-8 (32.6±13.4 ng/mL) in induced sputum in stable COPD patients with positive BD tests were significantly higher than those in asthmatics or normal controls (all P<0.01). However, the values of the above inflammatory markers in induced sputum were similar among stable COPD patients with positive or negative BD tests (all P>0.05). The stable COPD patients with positive BD tests may present not only eosinophilic airway inflammation but also neutrophilic airway inflammation.
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Baskaran V, Murray RL, Hunter A, Lim WS, McKeever TM. Effect of tobacco smoking on the risk of developing community acquired pneumonia: A systematic review and meta-analysis. PLoS One 2019; 14:e0220204. [PMID: 31318967 PMCID: PMC6638981 DOI: 10.1371/journal.pone.0220204] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/10/2019] [Indexed: 01/19/2023] Open
Abstract
AIM To summarise and quantify the effect of tobacco smoking on the risk of developing community acquired pneumonia (CAP) in adults. METHODS We systematically searched MEDLINE, Embase, CINAHL, PsychINFO and Web of Science, from inception to October 2017, to identify case-control and cohort studies and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. The review protocol was registered with the PROSPERO database (CRD42018093943). Study quality was assessed by the Newcastle-Ottawa Scale. Pooled odds ratios (ORs) or hazard ratios (HRs) were estimated using a random-effects model. RESULTS Of 647 studies identified, 27 studies were included (n = 460,592 participants) in the systematic review. Most of the included studies were of moderate quality with a median score of six (IQR 6-7). Meta-analysis showed that current smokers (pooled OR 2.17, 95% CI 1.70-2.76, n = 13 studies; pooled HR 1.52, 95% CI 1.13-2.04, n = 7 studies) and ex-smokers (pooled OR 1.49, 95% CI 1.26-1.75, n = 8 studies; pooled HR 1.18, 95% CI 0.91-1.52, n = 6 studies) were more likely to develop CAP compared to never smokers. Although the association between passive smoking and risk of CAP in adults of all ages was not statistically significant (pooled OR 1.13, 95% CI 0.94-1.36, n = 5 studies), passive smoking in adults aged ≥65 years was associated with a 64% increased risk of CAP (pooled OR 1.64; 95% CI 1.17-2.30, n = 2 studies). Dose-response analyses of data from five studies revealed a significant trend; current smokers who smoked higher amount of tobacco had a higher risk of CAP. CONCLUSION Tobacco smoke exposure is significantly associated with the development of CAP in current smokers and ex-smokers. Adults aged > 65 years who are passive smokers are also at higher risk of CAP. For current smokers, a significant dose-response relationship is evident.
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Affiliation(s)
- Vadsala Baskaran
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Rachael L. Murray
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Abby Hunter
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Wei Shen Lim
- Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Tricia M. McKeever
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
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30
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Carr TF, Zeki AA, Kraft M. Eosinophilic and Noneosinophilic Asthma. Am J Respir Crit Care Med 2019; 197:22-37. [PMID: 28910134 DOI: 10.1164/rccm.201611-2232pp] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Tara F Carr
- 1 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona; and
| | - Amir A Zeki
- 2 Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of California Davis School of Medicine, Davis, California
| | - Monica Kraft
- 1 Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona; and
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Kumar S, Sharma SK, Kaushik G, Avti PK, Pandey SK, Sarma P, Medhi B, Khanduja KL. Therapeutic potential of arachidonyl trifluromethyl ketone, a cytosolic phospholipaseA 2 IVA specific inhibitor, in cigarette smoke condensate-induced pathological conditions in alveolar type I & II epithelial cells. Toxicol In Vitro 2019; 54:215-223. [PMID: 30253184 DOI: 10.1016/j.tiv.2018.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/07/2018] [Accepted: 09/19/2018] [Indexed: 11/18/2022]
Abstract
Cigarette smoke is responsible for multiple disorders and causes almost 10 million annual deaths globally but underlying mechanisms are still underexplored. Continuous exposure of Cigarette smoke condensate (CSC) leads to cytosolic phospholipase A2 (cPLA2) mediated high free radicals where cPLA2s seems to play crucial role in generated various patho-physiological conditions such as chronic inflammation, oxidative stress and cancer. In this view, we assessed the therapeutic potential of arachidonyl trifluromethyl ketone (ATK), a cPLA2 inhibitor, via pharmacological inhibition of most expressible CSC-induced cPLA2 group IVA in type-I and type-II alveolar epithelial cells. The In Vitro inhibitory effect of ATK on CSC-induced PLA2 activity and its cellular role were assessed in terms of cell viability, fluorescein diacetate (FDA) dye uptake assay for membrane integrity, reactive oxygen species (ROS)/reactive nitrogen species (RNS) levels and pro apoptotic as well as anti apoptosis markers via flow cytometry, along with extracellular signal-regulated kinases (ERK) levels using enzyme-linked immunosorbent assay (ELISA). The experimental findings demonstrated that ATK acts as potent inhibitor of cPLA2 activity and shown its effectiveness as therapeutic agent by significantly mimicking CSC-induced levels of free radicals, primary apoptosis, ratio of pro-apoptotic/apoptotic proteins and levels of ERK whereas protected cells from loss of cell viability and membrane integrity. Thus, this study is an important step towards the opening up of avenues for the applicability of the cPLA2 isoform specific inhibitors such as ATK for pre-clinical and clinical studies and could be beneficial during smoking-induced lung pathological conditions.
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Affiliation(s)
- Subodh Kumar
- Department of Biophysics, PGIMER, Chandigarh 160012, India.
| | - Sanjeev Kumar Sharma
- Department of Biophysics, PGIMER, Chandigarh 160012, India; Rajiv Gandhi Cancer Institute & Research Centre (RGCIRC), Rohini, New Delhi 110085, India
| | - Gaurav Kaushik
- Department of Biophysics, PGIMER, Chandigarh 160012, India; Surgery, School of Medicine, KU Medical Center (KUMC), Kansas City KS-66160, USA
| | | | - Satish Kumar Pandey
- Central Scientific Instruments Organisation (CSIO), Chandigarh 160030, India
| | - Phulen Sarma
- Present address: Department of Pharmacology, PGIMER, Chandigarh 160012, India
| | - Bikash Medhi
- Present address: Department of Pharmacology, PGIMER, Chandigarh 160012, India
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Zhu J, Lian L, Qin H, Wang WJ, Ren R, Xu MD, Chen K, Duan W, Gong FR, Tao M, Zhi Q, Wu MY, Li W. Prognostic evaluation of patients with resectable lung cancer using systemic inflammatory response parameters. Oncol Lett 2018; 17:2244-2256. [PMID: 30675290 PMCID: PMC6341870 DOI: 10.3892/ol.2018.9858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 09/04/2018] [Indexed: 12/12/2022] Open
Abstract
Lung cancer is one of the leading causes of cancer-associated mortality. C-reactive protein (CRP), albumin (ALB), globulin (GLB), lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been identified as general parameters for systemic inflammatory response (SIR). Furthermore, these parameters are also associated with tumor development and metastasis. The present study aimed to investigate the predictive values of these SIR parameters in patients with resectable lung cancer. In total, 101 patients with resectable lung cancer were recruited in the present study. The patients were divided into two groups according to the median value of pre-treatment CRP, ALB, GLB, LDH, NLR or PLR values. The post-/pre-treatment ratios were defined as the ratio of pre-treatment blood parameter values and the corresponding values obtained following therapy. A ratio of ≤1.1 indicated that the values were not increased, while a ratio of >1.1 suggested that the values were increased following treatment. Patients with lower pre-treatment ALB levels had poorer overall survival (OS) rates, whereas GLB, LDH, CRP, NLR or PLR levels were not associated with outcomes. Whole course treatment (surgery combined with adjuvant chemotherapy) significantly increased the value of ALB, but decreased the value of NLR, whereas it had no effect on the values of LDH, CRP or PLR. Post-/pre-treatment LDH and PLR were associated with outcomes. Post-/pre-treatment ALB, GLB, CRP and NLR were not associated with outcomes. Multivariate analysis revealed that a low pre-treatment ALB level and increased post-/pre-treatment PLR were independent risk factors affecting OS. The receiver operating characteristic curve analysis demonstrated that an ALB value of 47.850 g/l was considered to be the optimal cut-off value for prognosis; the sensitivity was 28.8% and specificity was 95.9%. It was suggested that the pre-treatment ALB and post-/pre-treatment PLR may be potential prognostic factors in resectable lung cancer.
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Affiliation(s)
- Jie Zhu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Lian Lian
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.,Department of Oncology, Suzhou Xiangcheng People's Hospital, Suzhou, Jiangsu 215000, P.R. China
| | - Hualong Qin
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Wen-Jie Wang
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.,Department of Radio-Oncology, Nanjing Medical University Affiliated Suzhou Hospital, Suzhou, Jiangsu 215001, P.R. China
| | - Rui Ren
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.,Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Meng-Dan Xu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Kai Chen
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Weiming Duan
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Fei-Ran Gong
- Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Min Tao
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.,PREMED Key Laboratory for Precision Medicine, Soochow University, Suzhou, Jiangsu 215021, P.R. China
| | - Qiaoming Zhi
- Department of Radio-Oncology, Nanjing Medical University Affiliated Suzhou Hospital, Suzhou, Jiangsu 215001, P.R. China
| | - Meng-Yao Wu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Wei Li
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.,PREMED Key Laboratory for Precision Medicine, Soochow University, Suzhou, Jiangsu 215021, P.R. China.,Comprehensive Cancer Center, Suzhou Xiangcheng People's Hospital, Suzhou, Jiangsu 215000, P.R. China
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Nakao M, Muramatsu H, Arakawa S, Sakai Y, Suzuki Y, Fujita K, Sato H. Immunonutritional status and pulmonary cavitation in patients with tuberculosis: A revisit with an assessment of neutrophil/lymphocyte ratio. Respir Investig 2018; 57:60-66. [PMID: 30528689 DOI: 10.1016/j.resinv.2018.08.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/06/2018] [Accepted: 08/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several reports have described the importance of immunological and nutritional factors in the morbidity and/or mortality of patients with tuberculosis. The aim of this study was to evaluate the association between pulmonary cavitation and immunonutritional status, assessed by parameters such as neutrophil/lymphocyte ratio (NLR) and prognostic nutritional index (PNI), in patients with pulmonary tuberculosis. METHODS We retrospectively analyzed the data of 137 patients with culture-positive active pulmonary tuberculosis without bacterial pneumonia diagnosed at Kainan Hospital between April 2008 and March 2016. The associations between the levels of serum albumin, lymphocytes, NLR, PNI, platelet to lymphocyte ratio (PLR), and body mass index (BMI) and pulmonary cavitation were evaluated in the patients. RESULTS A total of 83 men and 63 women (median age, 75 years; range, 16-94 years) were included in the study. Sixty-six patients had smoking history; 55 patients had respiratory symptoms, while 44 patients did not have any symptoms. Patient׳s delay, defined as medical examination performed over 60 days after the onset of symptoms was observed in 25 patients. Univariate analysis showed that high NLR (≥ 5), high PLR (≥200), low serum albumin (<3 g/dL), high neutrophil count (≥6000/mm3), and low lymphocyte count (<1000/mm3) were associated with pulmonary cavitation. Multivariate analysis showed that high NLR and low serum albumin were associated with pulmonary cavitation. CONCLUSION Malnutrition and increased severity of inflammation may be associated with pulmonary cavitation in patients with tuberculosis. Further studies are warranted to confirm the findings of the present study.
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Affiliation(s)
- Makoto Nakao
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan.
| | - Hideki Muramatsu
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Sosuke Arakawa
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Yusuke Sakai
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Yuto Suzuki
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Kohei Fujita
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
| | - Hidefumi Sato
- Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, 396 Minamihonndenn, Maegasu-cho, Yatomi City, Aichi Prefecture 498-8502, Japan
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Kim SH, Lee JS. The association of smoking and hypertension according to cotinine-verified smoking status in 25,150 Korean adults. Clin Exp Hypertens 2018; 41:401-408. [DOI: 10.1080/10641963.2018.1489548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sung Hoon Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Alroumi F, Abdul Azim A, Kergo R, Lei Y, Dargin J. The impact of smoking on patient outcomes in severe sepsis and septic shock. J Intensive Care 2018; 6:42. [PMID: 30065844 PMCID: PMC6064183 DOI: 10.1186/s40560-018-0312-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/18/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To assess, in the setting of severe sepsis and septic shock, whether current smokers have worse outcomes compared to non-smokers. METHODS This is a retrospective analysis of immunocompetent adult patients with severe sepsis and septic shock at a tertiary medical center. The primary outcome was the effect of active smoking on hospital mortality. Chi-square test and logistic regression were used to assess categorical outcomes. Wilcoxon rank-sum was utilized to test the differences in continuous outcomes among the varied smoking histories. Multivariable logistic regression was used to evaluate the association of smoking and mortality, need for vasopressors, mechanical ventilation, and ICU admission. RESULTS Of the 1437 charts reviewed, 562 patients were included. Current smokers accounted for 19% (107/562) of patients, while 81% (455/562) were non-smokers. The median hospital length of stay in survivors was significantly longer in current smokers versus non-smokers (8 vs 7 days, p = 0.03). There was a trend towards a higher mortality among current smokers, but this failed to meet statistical significance (OR 1.81, 95% CI 0.92-3.54, p = 0.08). On multivariable analysis, current smoking was associated with the need for mechanical ventilation (OR 2.38, 95% CI 1.06-5.34, p = 0.04), but that association was not observed with the need for vasopressors (OR 2.10, 95% CI 1.01-4.36, p = 0.58) nor ICU admission (OR 0.93, 95% CI 0.41-2.13, p = 0.86). CONCLUSIONS In patients with severe sepsis or septic shock, current smoking was associated with a longer hospital stay, the need for mechanical ventilation, and trended towards a higher mortality. Larger multicenter prospective case-control studies are needed to confirm these findings.
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Affiliation(s)
- Fahad Alroumi
- Department of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA USA
- Tufts University School of Medicine, Boston, MA USA
| | - Ahmed Abdul Azim
- Department of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA USA
- Tufts University School of Medicine, Boston, MA USA
| | - Rachel Kergo
- Department of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA USA
| | - Yuxiu Lei
- Department of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA USA
- Tufts University School of Medicine, Boston, MA USA
| | - James Dargin
- Department of Pulmonary and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA USA
- Tufts University School of Medicine, Boston, MA USA
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Strzelak A, Ratajczak A, Adamiec A, Feleszko W. Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1033. [PMID: 29883409 PMCID: PMC5982072 DOI: 10.3390/ijerph15051033] [Citation(s) in RCA: 322] [Impact Index Per Article: 53.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 02/06/2023]
Abstract
Many studies have been undertaken to reveal how tobacco smoke skews immune responses contributing to the development of chronic obstructive pulmonary disease (COPD) and other lung diseases. Recently, environmental tobacco smoke (ETS) has been linked with asthma and allergic diseases in children. This review presents the most actual knowledge on exact molecular mechanisms responsible for the skewed inflammatory profile that aggravates inflammation, promotes infections, induces tissue damage, and may promote the development of allergy in individuals exposed to ETS. We demonstrate how the imbalance between oxidants and antioxidants resulting from exposure to tobacco smoke leads to oxidative stress, increased mucosal inflammation, and increased expression of inflammatory cytokines (such as interleukin (IL)-8, IL-6 and tumor necrosis factor α ([TNF]-α). Direct cellular effects of ETS on epithelial cells results in increased permeability, mucus overproduction, impaired mucociliary clearance, increased release of proinflammatory cytokines and chemokines, enhanced recruitment of macrophages and neutrophils and disturbed lymphocyte balance towards Th2. The plethora of presented phenomena fully justifies a restrictive policy aiming at limiting the domestic and public exposure to ETS.
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Affiliation(s)
- Agnieszka Strzelak
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
| | - Aleksandra Ratajczak
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
| | - Aleksander Adamiec
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
| | - Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, Zwirki i Wigury 61, 02-091 Warszawa, Poland.
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Gobba NAEK, Hussein Ali A, El Sharawy DE, Hussein MA. The potential hazardous effect of exposure to iron dust in Egyptian smoking and nonsmoking welders. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 73:189-202. [PMID: 28375782 DOI: 10.1080/19338244.2017.1314930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/28/2017] [Indexed: 06/07/2023]
Abstract
Exposure to iron dust and welding fumes is widespread and may increase the risk of lung inflammation. The aim of this study was to identify associations between exposure to iron/welding fumes and the levels of inflammatory parameters and allergic mediators among 120 Egyptian men. Forty nonsmoking and 40 smoking Egyptian welders as well as 40 healthy volunteers who were never exposed to welding fumes and were nonsmoking were enrolled in the study. Peak expiratory flow rates (PEFR) assessed at the end of the shift of work on working days revealed an impairment in lung function, with the smoking workers showing the worse results, followed by nonsmoking workers, as compared to healthy volunteers. Moreover, the results of the present study showed a significant increase in serum iron and immunoglobulin E, as well as plasma thiobarbaturic acid reactive substances, C-reactive protein, tumor necrosis factor-alpha, haptoglobin, interleukin-2, interleukin-6 and interleukin-23 histamine, lactate dehydrogenase isoenzyme-3, and calcitonin. In addition, the results revealed significant decrease in plasma α-1-antitrypsin and serum transferrin, as well as blood activities of antioxidant enzymes: catalase, superoxide dismutase, glutathione peroxidase, and glutathione reductase (as compared with control group). However, there was a nonsignificant change in arginase and α-L-fucosidase in smoking and nonsmoking welders exposed to iron dust and welding fumes. In conclusion, occupational exposure to iron dust and welding fumes increases lung inflammation risk among Egyptian blacksmith workers, a condition that worsens with smoking.
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Affiliation(s)
- Naglaa Abd El Khalik Gobba
- a Department of Pharmacology and Toxicology, College of Pharmacy , Misr University for Science and Technology (MUST) , 6th of October City , Egypt
| | - Abdelmaksoud Hussein Ali
- b Department of Biochemistry, Faculty of Veterinary Medicine , Benha University , Qalioubeya , Egypt
| | - Dalia E El Sharawy
- c Department of Chest Diseases, Faculty of Medicine , Tanta University , Cairo , Egypt
| | - Mohammed Abdalla Hussein
- d Department of Biochemistry, Faculty of Applied Medical Sciences , October 6 University , 6th of October City , Egypt
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Pourostadi M, Rashedi J, Mahdavi Poor B, Samadi Kafil H, Hariri-Akbari M, Asgharzadeh M. Frequency of Smear-Negative Tuberculosis in Northwest Iran. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:269-275. [PMID: 29892144 PMCID: PMC5993903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Microscopic smear examination is the most common test in tuberculosis (TB) detection. It is, however, not strong enough to identify TB in the majority of afflicted individuals; thus, a significant number of TB patients are smear negative and capable of transmitting the infection. The aim of this study was to evaluate the rate of smear-negative TB in northwest Iran. METHODS In this cross-sectional study, 329 TB-confirmed patients were evaluated through culture up to March 1, 2015, in northwest Iran. The demographic and clinical features of the smear-negative and smear-positive TB patients were compared. The χ2 test was used to compare the frequency of the variables. All the statistical analyses were conducted using SPSS, version 16 (Chicago, IL, USA). RESULTS Seventy-five cases were smear negative and 254 were smear positive. Smokers, asthmatics, and extra-pulmonary TB patients were primarily among the smear-negative cases. The rate of mortality was also relatively higher among the smear-negative TB patients. CONCLUSION Totally, 22.8% of the TB cases in northwest Iran were smear negative, with a relatively higher rate of mortality than those with positive smears. A delay in these patients' return to TB diagnosis and treatment centers increases the chance of transmission to others. This is a very sensitive issue in centers where there is no equipment for TB cultivation. Thus, it is essential to equip centers without TB cultivation facilities and to use appropriate diagnostic techniques in centers with those facilities to help rapidly detect smear-negative cases.
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Affiliation(s)
- Mahya Pourostadi
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Jalil Rashedi
- Department of Laboratory Science, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran;
,Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Behroz Mahdavi Poor
- Department of Laboratory Science, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran;
,Department of Medical Parasitology, School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran;
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Maral Hariri-Akbari
- Adjunct Lecturer, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran;
| | - Mohammad Asgharzadeh
- Biotechnology Research Center and Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran;
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De Rose V, Molloy K, Gohy S, Pilette C, Greene CM. Airway Epithelium Dysfunction in Cystic Fibrosis and COPD. Mediators Inflamm 2018; 2018:1309746. [PMID: 29849481 PMCID: PMC5911336 DOI: 10.1155/2018/1309746] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/15/2018] [Accepted: 02/01/2018] [Indexed: 12/22/2022] Open
Abstract
Cystic fibrosis is a genetic disease caused by mutations in the CFTR gene, whereas chronic obstructive pulmonary disease (COPD) is mainly caused by environmental factors (mostly cigarette smoking) on a genetically susceptible background. Although the etiology and pathogenesis of these diseases are different, both are associated with progressive airflow obstruction, airway neutrophilic inflammation, and recurrent exacerbations, suggesting common mechanisms. The airway epithelium plays a crucial role in maintaining normal airway functions. Major molecular and morphologic changes occur in the airway epithelium in both CF and COPD, and growing evidence suggests that airway epithelial dysfunction is involved in disease initiation and progression in both diseases. Structural and functional abnormalities in both airway and alveolar epithelium have a relevant impact on alteration of host defences, immune/inflammatory response, and the repair process leading to progressive lung damage and impaired lung function. In this review, we address the evidence for a critical role of dysfunctional airway epithelial cells in chronic airway inflammation and remodelling in CF and COPD, highlighting the common mechanisms involved in the epithelial dysfunction as well as the similarities and differences of the two diseases.
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Affiliation(s)
- Virginia De Rose
- Department of Clinical and Biological Sciences, University of Torino, A.O.U. S. Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Torino, Italy
| | - Kevin Molloy
- Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Dublin, Ireland
| | - Sophie Gohy
- Institute of Experimental and Clinical Research, Pole of Pneumology, ENT and Dermatology, Université Catholique de Louvain (UCL), Brussels, Belgium
- Department of Pneumology, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Charles Pilette
- Institute of Experimental and Clinical Research, Pole of Pneumology, ENT and Dermatology, Université Catholique de Louvain (UCL), Brussels, Belgium
- Department of Pneumology, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Catherine M. Greene
- Lung Biology Group, Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Dublin, Ireland
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López-Hernández Y, Rivas-Santiago CE, López JA, Mendoza-Almanza G, Hernandez-Pando R. Tuberculosis and cigarette smoke exposure: An update of in vitro and in vivo studies. Exp Lung Res 2018; 44:113-126. [PMID: 29565741 DOI: 10.1080/01902148.2018.1444824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tuberculosis (TB) has been declared the first cause of death by an infectious agent. Annually, 10.4 million people suffer active TB. Most infected individuals live in low-income countries, where social and economic conditions enhance the dissemination and progression of the disease. These countries have a high percentage of smokers. Thousands of studies have linked cigarette smoke (CS) with increased risk of many diseases, such as cancer and lung diseases. Numerous in vitro studies have been conducted to evaluate the general and specific toxic effects of CS in lung immune function. Smoke exposure increases the risk of TB development three-fold. However, until now, only few animal studies have been performed to analyze the association between smoke and TB. In the present work, we review in vitro and in vivo studies whose aim was to analyze the molecular basis of TB susceptibility caused by exposure to CS.
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Affiliation(s)
- Y López-Hernández
- a CONACyT, Unidad Academica de Ciencias Biologicas , Universidad Autónoma de Zacatecas , Zacatecas , Mexico
| | - C E Rivas-Santiago
- a CONACyT, Unidad Academica de Ciencias Biologicas , Universidad Autónoma de Zacatecas , Zacatecas , Mexico
| | - J A López
- b Laboratorio de MicroRNAs, Unidad Academica de Ciencias Biologicas , Universidad Autónoma de Zacatecas , Zacatecas , Mexico
| | - G Mendoza-Almanza
- a CONACyT, Unidad Academica de Ciencias Biologicas , Universidad Autónoma de Zacatecas , Zacatecas , Mexico
| | - R Hernandez-Pando
- c Departamento de Patologia, Unidad de Patologia Experimental , Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran , Mexico
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Affiliation(s)
- Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Turner RD, Chiu C, Churchyard GJ, Esmail H, Lewinsohn DM, Gandhi NR, Fennelly KP. Tuberculosis Infectiousness and Host Susceptibility. J Infect Dis 2017; 216:S636-S643. [PMID: 29112746 PMCID: PMC5853924 DOI: 10.1093/infdis/jix361] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The transmission of tuberculosis is complex. Necessary factors include a source case with respiratory disease that has developed sufficiently for Mycobacterium tuberculosis to be present in the airways. Viable bacilli must then be released as an aerosol via the respiratory tract of the source case. This is presumed to occur predominantly by coughing but may also happen by other means. Airborne bacilli must be capable of surviving in the external environment before inhalation into a new potential host-steps influenced by ambient conditions and crowding and by M. tuberculosis itself. Innate and adaptive host defenses will then influence whether new infection results; a process that is difficult to study owing to a paucity of animal models and an inability to measure infection directly. This review offers an overview of these steps and highlights the many gaps in knowledge that remain.
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Affiliation(s)
| | - Christopher Chiu
- Section of Infectious Diseases & Immunity, Imperial College London, United Kingdom
| | - Gavin J Churchyard
- Aurum Institute and
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Hanif Esmail
- Radcliffe Department of Medicine, University of Oxford, United Kingdom
- Wellcome Center for Infectious Diseases Research in Africa, University of Cape Town, South Africa
| | - David M Lewinsohn
- Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland
| | - Neel R Gandhi
- School of Medicine and Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kevin P Fennelly
- Pulmonary Clinical Medicine Section, Cardiovascular Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
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The making of a miscreant: tobacco smoke and the creation of pathogen-rich biofilms. NPJ Biofilms Microbiomes 2017; 3:26. [PMID: 29081982 PMCID: PMC5655325 DOI: 10.1038/s41522-017-0033-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/29/2017] [Accepted: 09/25/2017] [Indexed: 02/03/2023] Open
Abstract
We have previously reported that oral biofilms in clinically healthy smokers are pathogen-rich, and that this enrichment occurs within 24 h of biofilm formation. The present investigation aimed to identify a mechanism by which smoking creates this altered community structure. By combining in vitro microbial–mucosal interface models of commensal (consisting of Streptococcus oralis, Streptococcus sanguis, Streptococcus mitis, Actinomyces naeslundii, Neisseria mucosa and Veillonella parvula) and pathogen-rich (comprising S.oralis, S.sanguis, S.mitis, A.naeslundii, N.mucosa and V.parvula, Fusobacterium nucleatum, Porphyromonas gingivalis, Filifactor alocis, Dialister pneumosintes, Selenonomas sputigena, Selenominas noxia, Catonella morbi, Parvimonas micra and Tannerella forsythia) communities with metatranscriptomics, targeted proteomics and fluorescent microscopy, we demonstrate that smoke exposure significantly downregulates essential metabolic functions within commensal biofilms, while significantly increasing expression of virulence genes, notably lipopolysaccharide (LPS), flagella and capsule synthesis. By contrast, in pathogen-rich biofilms several metabolic pathways were over-expressed in response to smoke exposure. Under smoke-rich conditions, epithelial cells mounted an early and amplified pro-inflammatory and oxidative stress response to these virulence-enhanced commensal biofilms, and a muted early response to pathogen-rich biofilms. Commensal biofilms also demonstrated early and widespread cell death. Similar results were observed when smoke-free epithelial cells were challenged with smoke-conditioned biofilms, but not vice versa. In conclusion, our data suggest that smoke-induced transcriptional shifts in commensal biofilms triggers a florid pro-inflammatory response, leading to early commensal death, which may preclude niche saturation by these beneficial organisms. The cytokine-rich, pro-oxidant, anaerobic environment sustains inflammophilic bacteria, and, in the absence of commensal antagonism, may promote the creation of pathogen-rich biofilms in smokers. Tobacco smoke inhibits the metabolism of beneficial bacteria in biofilms, while activating specific genes in pathogenic bacteria. This suggests a mechanism to explain how smoking quickly leads to the formation of damaging biofilms in the mouth and respiratory tract. Purnima Kumar and colleagues at Ohio State University, USA studied the effect of tobacco smoke on cultured biofilms used to model those that form on mucous membranes. They detected specific and varied changes in the activity of genes, proteins and metabolism that allowed pathogenic bacteria to displace beneficial “commensal” bacteria. The research suggests the transition toward pathogen-rich biofilms may contribute to the health effects of smoking by causing increased inflammation of mucous membranes and the production of damaging oxidant chemicals. Further research should investigate the chemical constituents of smoke responsible for these effects.
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Volckaert T, Yuan T, Chao CM, Bell H, Sitaula A, Szimmtenings L, El Agha E, Chanda D, Majka S, Bellusci S, Thannickal VJ, Fässler R, De Langhe SP. Fgf10-Hippo Epithelial-Mesenchymal Crosstalk Maintains and Recruits Lung Basal Stem Cells. Dev Cell 2017; 43:48-59.e5. [PMID: 29017029 DOI: 10.1016/j.devcel.2017.09.003] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/20/2017] [Accepted: 09/08/2017] [Indexed: 11/25/2022]
Abstract
The lung harbors its basal stem/progenitor cells (BSCs) in the protected environment of the cartilaginous airways. After major lung injuries, BSCs are activated and recruited to sites of injury. Here, we show that during homeostasis, BSCs in cartilaginous airways maintain their stem cell state by downregulating the Hippo pathway (resulting in increased nuclear Yap), which generates a localized Fgf10-expressing stromal niche; in contrast, differentiated epithelial cells in non-cartilaginous airways maintain quiescence by activating the Hippo pathway and inhibiting Fgf10 expression in airway smooth muscle cells (ASMCs). However, upon injury, surviving differentiated epithelial cells spread to maintain barrier function and recruit integrin-linked kinase to adhesion sites, which leads to Merlin degradation, downregulation of the Hippo pathway, nuclear Yap translocation, and expression and secretion of Wnt7b. Epithelial-derived Wnt7b, then in turn, induces Fgf10 expression in ASMCs, which extends the BSC niche to promote regeneration.
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Affiliation(s)
- Thomas Volckaert
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, CO 80206, USA; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue South, Birmingham, AL 35294-2182, USA
| | - Tingting Yuan
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, CO 80206, USA; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue South, Birmingham, AL 35294-2182, USA
| | - Cho-Ming Chao
- German Center for Lung Research, Excellence Cluster Cardio-Pulmonary System, Universities of Giessen and Marburg Lung Center, 35392 Giessen, Germany
| | - Harold Bell
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, CO 80206, USA
| | - Alina Sitaula
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, CO 80206, USA
| | - Luisa Szimmtenings
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue South, Birmingham, AL 35294-2182, USA
| | - Elie El Agha
- German Center for Lung Research, Excellence Cluster Cardio-Pulmonary System, Universities of Giessen and Marburg Lung Center, 35392 Giessen, Germany
| | - Diptiman Chanda
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue South, Birmingham, AL 35294-2182, USA
| | - Susan Majka
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine or Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Saverio Bellusci
- German Center for Lung Research, Excellence Cluster Cardio-Pulmonary System, Universities of Giessen and Marburg Lung Center, 35392 Giessen, Germany
| | - Victor J Thannickal
- Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue South, Birmingham, AL 35294-2182, USA
| | - Reinhard Fässler
- Department of Molecular Medicine, Max Planck Institute of Biochemistry, 82152 Martinsried, Germany
| | - Stijn P De Langhe
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, CO 80206, USA; Department of Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, THT 422, 1720 2nd Avenue South, Birmingham, AL 35294-2182, USA; Department of Cellular and Developmental Biology, School of Medicine, University of Colorado Denver, Aurora, CO 80045, USA.
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Ponce-Gallegos MA, Ramírez-Venegas A, Falfán-Valencia R. Th17 profile in COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2017; 12:1857-1865. [PMID: 28694696 PMCID: PMC5491572 DOI: 10.2147/copd.s136592] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
COPD is characterized by an ongoing inflammatory process of the airways that leads to obstruction or limitation of airflow. It is mainly associated with exposure to cigarette smoke. In addition, it is considered, at present, a serious public health problem, ranking fourth in mortality worldwide. Many cells participate in the pathophysiology of COPD, the most important are neutrophils, macrophages and CD4+ and CD8+ T cells. Neutrophil migration to the inflammation area could be mediated largely by cytokines related to CD4+ Th17 lymphocytes, because it has been shown that IL-17A, IL-17F and IL-22 act as inducers for CXCL8, CXCL1, CXCL5, G-CSF, and GM-CSF secretion by epithelial cells of the airways. The aims of these molecules are differentiation, proliferation and recruitment of neutrophils. Furthermore, it is believed that CD4+ lymphocytes Th17 may be involved in protection against pathogens for which Th1 and Th2 are not prepared to fight. In COPD exacerbations, there is an increased cellularity in the lung region and respiratory tract. Therefore, the increase in the number of neutrophils and macrophages in the airways and the increase in proinflammatory cytokines are directly related to the severity of exacerbations and that is the importance of the functions of Th17 profile in this entity.
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Affiliation(s)
- Marco Antonio Ponce-Gallegos
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.,Medicine Academic Unit, Universidad Autónoma de Nayarit. Tepic, Nayarit, Mexico.,Interinstitutional Program for Strengthening Research and the Postgraduate in the Pacific (Dolphin), Tepic, Nayarit, México
| | - Alejandra Ramírez-Venegas
- Tobacco Smoking and COPD Research Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Ramcés Falfán-Valencia
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
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Aufderheide M, Ito S, Ishikawa S, Emura M. Metaplastic phenotype in human primary bronchiolar epithelial cells after repeated exposure to native mainstream smoke at the air-liquid interface. EXPERIMENTAL AND TOXICOLOGIC PATHOLOGY : OFFICIAL JOURNAL OF THE GESELLSCHAFT FUR TOXIKOLOGISCHE PATHOLOGIE 2017; 69:307-315. [PMID: 28254108 DOI: 10.1016/j.etp.2017.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/22/2016] [Accepted: 01/31/2017] [Indexed: 12/31/2022]
Abstract
3D constructs composed of primary normal differentiated human bronchiolar epithelial (NHBE) cells as mono- or co-culture in combination with normal human lung fibroblasts were exposed repeatedly at the air-liquid interface with non-lethal concentrations of mainstream cigarette smoke (4 cigarettes a day, 5days/week, 13 times repetition in total) to build up a permanent burden on the cells. Samples were taken after 4, 8 and 13 times of repeated smoke exposure and the cultures were analyzed by histopathological methods In comparison with the clean air exposure (process control) and incubator control cells the cigarette smoke exposed cultures showed a reduction of cilia bearing as well as mucus producing cells. In both mono- as well as co-cultures, hyperplasia was induced showing different histological cell types (undifferentiated secretory and squamous cell types). At the end of the exposure phase, we observed the development of non-hyperplastic areas strongly positive to CK13 antibody, commonly seen in squamous cells as a marker for non-cornified squamous epithelium, thus suggesting a transition of the normal bronchial epithelial cells towards metaplastic cells. The control cultures (clean air exposed and incubator cells) showed no comparable phenotypic changes. In conclusion, our in vitro model presents a valuable tool to study the induction of metaplastic alterations after exposure to airborne material.
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Affiliation(s)
| | - Shigeaki Ito
- Japan Tobacco Inc., 6-2, Umegaoka, Aobaku, Yokohama, Kanagawa, 227-8512, Japan
| | - Shinkichi Ishikawa
- Japan Tobacco Inc., 6-2, Umegaoka, Aobaku, Yokohama, Kanagawa, 227-8512, Japan
| | - Makito Emura
- Cultex Laboratories GmbH, Feodor-Lynen-Str. 21, 30625, Hannover, Germany
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Wang B, Huo W, Lu Q, Li Z, Liu Y, Zhao D, Li Z. Passive smoking and influenza-like illness in housewives: A perspective of gene susceptibility. CHEMOSPHERE 2017; 176:67-73. [PMID: 28259080 DOI: 10.1016/j.chemosphere.2017.02.085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 02/07/2017] [Accepted: 02/14/2017] [Indexed: 06/06/2023]
Abstract
Relation between influenza-like illness (ILI) and passive smoking remains a debate of subject. We aimed to determine an association of passive smoking with ILI risk of housewives in North China, and the modification effects of gene polymorphisms related to the metabolisms of smoking pollutants. We included 379 housewives for a cross-sectional study in Shanxi Province, China, including 118 with ILI frequency of "≥1 times per year" as the case group and 261 with ILI frequency of "<1 time per year" in the past 10 years as the control group. We collected their information on frequencies of passive smoking and ILI by questionnaires, as well as their single nucleotide polymorphisms (SNPs) of genes related to Phase I and Phase II metabolisms of smoking pollutants. Our results revealed a significant Spearman correlation between frequencies of ILI and passive smoking (r = 0.406, p < 0.001). Frequency of passive smoking was associated with an increased risk of ILI with adjusted OR [6.75 (95% confidence interval: 3.98-11.4)]. Dose-response association between the passive smoking and ILI risk was observed with or without adjusting for confounders. Mutant types of rs1041983 (N-acetyltransferase 2 gene, NAT2) had a synergetic effect with passive smoking on ILI frequency, while mutant types of rs1695 (glutathione S-transferase P1 gene, GSTP1) had an antagonistic effect. Overall, our study results supported the hypothesis that passive smoking was positively associated with ILI frequency in housewives and this effect was modified by gene polymorphisms of Phase II metabolism genes (NAT2 and GSTP1).
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Affiliation(s)
- Bin Wang
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, School of Public Health, Peking University, Beijing, 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Wenhua Huo
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, School of Public Health, Peking University, Beijing, 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Qun Lu
- Reproductive Medical Center, Peking University People's Hospital, Beijing, 100044, China
| | - Zhenjiang Li
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, School of Public Health, Peking University, Beijing, 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Yingying Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, School of Public Health, Peking University, Beijing, 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Dan Zhao
- Beijing MedNet Research Center, Zi Zhu Yuan RD, SuiteA-2104, Haidian District, Beijing, 100044, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, School of Public Health, Peking University, Beijing, 100191, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.
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Feldman C, Anderson R, Rossouw T. HIV-related pneumococcal disease prevention in adults. Expert Rev Respir Med 2017; 11:181-199. [PMID: 28228053 DOI: 10.1080/17476348.2017.1289841] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION HIV-infected persons are particularly susceptible to the development of severe pneumococcal disease, even in the setting of combination antiretroviral therapy (cART), due to slow, incomplete recovery of anti-pneumococcal host defenses. This risk is increased by avoidable aspects of lifestyle, particularly smoking, which intensify immunosuppression. Clearly, more effective preventive measures are needed to counter this threat. Areas covered: This is a detailed review of the published literature focusing on currently available strategies for prevention of pneumococcal infection in HIV-infected patients, including cotrimoxazole prophylaxis, cART, pneumococcal vaccination, and smoking cessation strategies. This is preceded by a consideration of the epidemiology, clinical presentation, risk factors, and outcome of pneumococcal disease. Expert commentary: Cotrimoxazole prophylaxis has been shown to reduce morbidity and mortality in HIV-infected patients, although there is inconsistent data on the preventive efficacy against pneumococcal infections. Some recent studies have documented unchanged incidences of IPD in adult patients in the cART era. With regard to pneumococcal vaccination, routine acceptance of the efficacy of the PCV13/PPV23 sequential administration prime-boost strategy awaits the outcome of clinical trials in those with HIV infection. Smoking cessation, and discontinuation of excessive alcohol consumption and intravenous drug abuse, are priority strategies to prevent severe pneumococcal infection.
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Affiliation(s)
- Charles Feldman
- a Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences , University of the Witwatersrand Medical School , Johannesburg , South Africa
| | - Ronald Anderson
- b Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa
| | - Theresa Rossouw
- b Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences , University of Pretoria , Pretoria , South Africa
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Joshua V, Chatzidionisyou K, Catrina AI. Role of the lung in individuals at risk of rheumatoid arthritis. Best Pract Res Clin Rheumatol 2017; 31:31-41. [DOI: 10.1016/j.berh.2017.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/31/2017] [Accepted: 06/12/2017] [Indexed: 10/18/2022]
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González Álvarez DA, López Cortés LF, Cordero E. Impact of HIV on the severity of influenza. Expert Rev Respir Med 2016; 10:463-472. [PMID: 26918376 DOI: 10.1586/17476348.2016.1157474] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite current antiretroviral therapy, HIV/AIDS is one of the most prelevant problems in healthcare worldwide. Similarly, influenza viruses are causes of epidemics outbreaks. HIV-infected patients are considered a high risk group for severe influenza infection, although several recent observational studies suggest that not all HIV-infected patients are equally susceptible to complications and that these patients should be stratified by their immunodeficiency status and other factors (such as smoking or comorbidities). Here, we have compiled the most recent data on the impact that HIV has on influenza infection.
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Affiliation(s)
| | | | - Elisa Cordero
- a Infectious Diseases Unit , University Hospital Virgen del Rocío , Sevilla , Spain
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