1
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Ozoh OB, Dede SK, Ekete OA, Ojo OO, Dania MG. Risk factors for chronic obstructive pulmonary disease (COPD) in a tertiary health institution in Lagos, Nigeria. Ghana Med J 2023; 57:175-182. [PMID: 38957678 PMCID: PMC11216736 DOI: 10.4314/gmj.v57i3.3] [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] [Indexed: 07/04/2024] Open
Abstract
Objective To describe the clinical characteristics and identifiable risk factors for Chronic Obstructive Pulmonary Disease (COPD) in a real-world clinical setting. Design Cross-sectional study among patients with COPD. Setting The Respiratory clinic of the Lagos University Teaching Hospital. Participants Consecutive patients with spirometry confirmed COPD on follow-up for ≥3 months. There were 79 participants. Intervention None. Main outcome measure COPD risk factors, disease severity, comorbidities, and the severity of airflow limitation. Results The mean age of the participants was 63.3± 12.4 years, and 47 (59.5) were male. There was a high symptom burden (73.4% had COPD assessment test (CAT) score >10), 33 (41.8%) and 4 (5.1%) had GOLD 3 and GOLD 4 airflow limitation, respectively. Risk factors were identified for 96.2% of the participants: history of asthma in 37 (46.8%), tobacco smoking 22 (27.8%), occupational exposure 15 (19%), biomass exposure 5 (6.6%), post-tuberculosis 3 (3.8%), old age (3.8%), and prematurity 1 (1.3%). Fifty-nine (74.7%) had Asthma COPD Overlap (ACO). There were no significant associations between the risk factors and disease severity. Participants with ACO had lower lung function and a high frequency of allergic rhinitis. Conclusion Asthma was the most commonly identifiable risk factor for COPD, underscoring asthma risk reduction and management optimisation as priorities toward COPD burden mitigation. Future studies need to validate these findings and identify the predominant COPD phenotypes in our setting. Funding None declared.
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Affiliation(s)
- Obianuju B Ozoh
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Sandra K Dede
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ogochukwu A Ekete
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwafemi O Ojo
- Department of Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria
| | - Michelle G Dania
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
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2
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Abohalaka R. Bronchial epithelial and airway smooth muscle cell interactions in health and disease. Heliyon 2023; 9:e19976. [PMID: 37809717 PMCID: PMC10559680 DOI: 10.1016/j.heliyon.2023.e19976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Chronic pulmonary diseases such as asthma, COPD, and Idiopathic pulmonary fibrosis are significant causes of mortality and morbidity worldwide. Currently, there is no radical treatment for many chronic pulmonary diseases, and the treatment options focus on relieving the symptoms and improving lung function. Therefore, efficient therapeutic agents are highly needed. Bronchial epithelial cells and airway smooth muscle cells and their crosstalk play a significant role in the pathogenesis of these diseases. Thus, targeting the interactions of these two cell types could open the door to a new generation of effective therapeutic options. However, the studies on how these two cell types interact and how their crosstalk adds up to respiratory diseases are not well established. With the rise of modern research tools and technology, such as lab-on-a-chip, organoids, co-culture techniques, and advanced immunofluorescence imaging, a substantial degree of evidence about these cell interactions emerged. Hence, this contribution aims to summarize the growing evidence of bronchial epithelial cells and airway smooth muscle cells crosstalk under normal and pathophysiological conditions. The review first discusses the impact of airway smooth muscle cells on the epithelium in inflammatory settings. Later, it examines the role of airway smooth muscle cells in the early development of bronchial epithelial cells and their recovery after injury. Then, it deliberates the effects of both healthy and stressed epithelial cells on airway smooth muscle cells, taking into account three themes; contraction, migration, and proliferation.
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Affiliation(s)
- Reshed Abohalaka
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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3
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Stolz D, Matera MG, Rogliani P, van den Berge M, Papakonstantinou E, Gosens R, Singh D, Hanania N, Cazzola M, Maitland-van der Zee AH, Fregonese L, Mathioudakis AG, Vestbo J, Rukhadze M, Page CP. Current and future developments in the pharmacology of asthma and COPD: ERS seminar, Naples 2022. Breathe (Sheff) 2023; 19:220267. [PMID: 37377851 PMCID: PMC10292790 DOI: 10.1183/20734735.0267-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/28/2023] [Indexed: 06/29/2023] Open
Abstract
Pharmacological management of airway obstructive diseases is a fast-evolving field. Several advances in unravelling disease mechanisms as well as intracellular and molecular pathways of drug action have been accomplished. While the clinical translation and implementation of in vitro results to the bedside remains challenging, advances in comprehending the mechanisms of respiratory medication are expected to assist clinicians and scientists in identifying meaningful read-outs and designing clinical studies. This European Respiratory Society Research Seminar, held in Naples, Italy, 5-6 May 2022, focused on current and future developments of the drugs used to treat asthma and COPD; on mechanisms of drug action, steroid resistance, comorbidities and drug interactions; on prognostic and therapeutic biomarkers; on developing novel drug targets based on tissue remodelling and regeneration; and on pharmacogenomics and emerging biosimilars. Related European Medicines Agency regulations are also discussed, as well as the seminar's position on the above aspects.
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Affiliation(s)
- Daiana Stolz
- Clinic of Pulmonary Medicine, Department of Internal Medicine, Medical Center University of Freiburg, Freiburg, Germany
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital of Basel, Basel, Switzerland
| | - Maria Gabriella Matera
- Unit of Pharmacology, Department of Experimental Medicine, School of Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Paola Rogliani
- Unit of Respiratory Medicine, Department Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Maarten van den Berge
- Groningen Research Institute for Asthma and COPD, and Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Eleni Papakonstantinou
- Clinic of Pulmonary Medicine, Department of Internal Medicine, Medical Center University of Freiburg, Freiburg, Germany
- Clinic of Respiratory Medicine and Pulmonary Cell Research, University Hospital of Basel, Basel, Switzerland
| | - Reinoud Gosens
- Groningen Research Institute for Asthma and COPD, and Department of Molecular Pharmacology, Groningen Research Institute of Pharmacy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dave Singh
- Medicines Evaluation Unit, Manchester University NHS Foundation Trust, University of Manchester, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - Nicola Hanania
- Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | | | | | - Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK
| | - Maia Rukhadze
- Center of Allergy and Immunology, Teaching University Geomedi LLC, Tbilisi, Georgia
| | - Clive P. Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
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4
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Ghosh S. Computed tomography findings in bronchial asthma: quantification of air trapping and correlation with pulmonary function tests. Acta Radiol 2022; 64:1418-1421. [PMID: 36317289 DOI: 10.1177/02841851221135233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background High-resolution computed tomography (HRCT) scans can help identify subsets of asthma patients who show rapid decline in lung function. Purpose To evaluate high-resolution computed tomography (HRCT) findings in adult patients with asthma, obtain quantitative measurements of air trapping on expiratory scans, and correlate the findings with pulmonary function tests (PFTs). Material and Methods Thirty adults with asthma with persistent-mild, persistent-moderate, and persistent-severe categories as per standard clinical guidelines were evaluated with inspiratory and expiratory HRCT for various imaging features of bronchial asthma. Expiratory HRCT scan were used to quantify degree of air-trapping, and their values quantified as “pixel index,” using a special “density' mask” software. Complete spirometry and body plethysmography were performed on each patient within 0–2 days of HRCT scans. HRCT findings were correlated with the clinical severity groups and the CT pixel indices (PI) were correlated with the PFT results using correlation coefficients and linear regression analysis. Results The inspiratory CT findings did not correlate with increase in disease severity. Expiratory scans accurately quantified areas of air trapping. CT-PI correlated well with PFT values indicative of airway obstruction and airflow limitation, which helped differentiate patients with asthma with increasing severity from those with milder forms of the disease. Conclusion Expiratory thin-section CT is a useful objective method to quantify air-trapping in people with asthma. The air-trapping score measured in “pixel indices” correlates well with PFT results and can successfully identify patients with severe asthma. Further studies are needed to confirm if this parameter can serve as a potential marker for airway remodeling and declining lung function.
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Affiliation(s)
- Subha Ghosh
- Thoracic Imaging, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
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5
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Ehrhardt B, El-Merhie N, Kovacevic D, Schramm J, Bossen J, Roeder T, Krauss-Etschmann S. Airway remodeling: The Drosophila model permits a purely epithelial perspective. FRONTIERS IN ALLERGY 2022; 3:876673. [PMID: 36187164 PMCID: PMC9520053 DOI: 10.3389/falgy.2022.876673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Airway remodeling is an umbrella term for structural changes in the conducting airways that occur in chronic inflammatory lung diseases such as asthma or chronic obstructive pulmonary disease (COPD). The pathobiology of remodeling involves multiple mesenchymal and lymphoid cell types and finally leads to a variety of hardly reversible changes such as hyperplasia of goblet cells, thickening of the reticular basement membrane, deposition of collagen, peribronchial fibrosis, angiogenesis and hyperplasia of bronchial smooth muscle cells. In order to develop solutions for prevention or innovative therapies, these complex processes must be understood in detail which requires their deconstruction into individual building blocks. In the present manuscript we therefore focus on the role of the airway epithelium and introduce Drosophila melanogaster as a model. The simple architecture of the flies’ airways as well as the lack of adaptive immunity allows to focus exclusively on the importance of the epithelium for the remodeling processes. We will review and discuss genetic and environmentally induced changes in epithelial structures and molecular responses and propose an integrated framework of research for the future.
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Affiliation(s)
- Birte Ehrhardt
- Division of Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Natalia El-Merhie
- Division of Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Draginja Kovacevic
- Division of Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Juliana Schramm
- Division of Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
| | - Judith Bossen
- Division of Molecular Physiology, Institute of Zoology, Christian-Albrechts University Kiel, Kiel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Kiel, Germany
| | - Thomas Roeder
- Division of Molecular Physiology, Institute of Zoology, Christian-Albrechts University Kiel, Kiel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Kiel, Germany
| | - Susanne Krauss-Etschmann
- Division of Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Borstel, Germany
- Institute of Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
- Correspondence: Susanne Krauss-Etschmann
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6
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Niedbalski PJ, Choi J, Hall CS, Castro M. Imaging in Asthma Management. Semin Respir Crit Care Med 2022; 43:613-626. [PMID: 35211923 DOI: 10.1055/s-0042-1743289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Asthma is a heterogeneous disease characterized by chronic airway inflammation that affects more than 300 million people worldwide. Clinically, asthma has a widely variable presentation and is defined based on a history of respiratory symptoms alongside airflow limitation. Imaging is not needed to confirm a diagnosis of asthma, and thus the use of imaging in asthma has historically been limited to excluding alternative diagnoses. However, significant advances continue to be made in novel imaging methodologies, which have been increasingly used to better understand respiratory impairment in asthma. As a disease primarily impacting the airways, asthma is best understood by imaging methods with the ability to elucidate airway impairment. Techniques such as computed tomography, magnetic resonance imaging with gaseous contrast agents, and positron emission tomography enable assessment of the small airways. Others, such as optical coherence tomography and endobronchial ultrasound enable high-resolution imaging of the large airways accessible to bronchoscopy. These imaging techniques are providing new insights in the pathophysiology and treatments of asthma and are poised to impact the clinical management of asthma.
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Affiliation(s)
- Peter J Niedbalski
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Jiwoong Choi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Chase S Hall
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Mario Castro
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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7
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Cao X, Lin L, Sood A, Ma Q, Zhang X, Liu Y, Liu H, Li Y, Wang T, Tang J, Jiang M, Zhang R, Yu S, Yu Z, Zheng Y, Han W, Leng S. Small Airway Wall Thickening Assessed by Computerized Tomography Is Associated With Low Lung Function in Chinese Carbon Black Packers. Toxicol Sci 2021; 178:26-35. [PMID: 32818265 DOI: 10.1093/toxsci/kfaa134] [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] [Indexed: 01/26/2023] Open
Abstract
Nanoscale carbon black as virtually pure elemental carbon can deposit deep in the lungs and cause pulmonary injury. Airway remodeling assessed using computed tomography (CT) correlates well with spirometry in patients with obstructive lung diseases. Structural airway changes caused by carbon black exposure remain unknown. Wall and lumen areas of sixth and ninth generations of airways in 4 lobes were quantified using end-inhalation CT scans in 58 current carbon black packers (CBPs) and 95 non-CBPs. Carbon content in airway macrophage (CCAM) in sputum was quantified to assess the dose-response. Environmental monitoring and CCAM showed a much higher level of elemental carbon exposure in CBPs, which was associated with higher wall area and lower lumen area with no change in total airway area for either airway generation. This suggested small airway wall thickening is a major feature of airway remodeling in CBPs. When compared with wall or lumen areas, wall area percent (WA%) was not affected by subject characteristics or lobar location and had greater measurement reproducibility. The effect of carbon black exposure status on WA% did not differ by lobes. CCAM was associated with WA% in a dose-dependent manner. CBPs had lower FEV1 (forced expiratory volume in 1 s) than non-CBPs and mediation analysis identified that a large portion (41-72%) of the FEV1 reduction associated with carbon black exposure could be explained by WA%. Small airway wall thickening as a major imaging change detected by CT may underlie the pathology of lung function impairment caused by carbon black exposure.
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Affiliation(s)
- Xue Cao
- Department of Occupational and Environmental Health, School of Public Health
| | - Li Lin
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao 266021, China
| | - Akshay Sood
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131
| | - Qianli Ma
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao 266021, China
| | - Xiangyun Zhang
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environment and Resources, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China
| | - Yuansheng Liu
- Department of Occupational and Environmental Health, School of Public Health
| | - Hong Liu
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao 266021, China
| | - Yanting Li
- Department of Occupational and Environmental Health, School of Public Health
| | - Tao Wang
- Department of Occupational and Environmental Health, School of Public Health
| | - Jinglong Tang
- Department of Occupational and Environmental Health, School of Public Health
| | - Menghui Jiang
- Department of Occupational and Environmental Health, School of Public Health
| | - Rong Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang 050017, China
| | - Shanfa Yu
- Henan Institute of Occupational Medicine, Zhengzhou, Henan 450052, China
| | - Zhiqiang Yu
- State Key Laboratory of Organic Geochemistry, Guangdong Key Laboratory of Environment and Resources, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640, China
| | - Yuxin Zheng
- Department of Occupational and Environmental Health, School of Public Health
| | - Wei Han
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao 266021, China
| | - Shuguang Leng
- Department of Occupational and Environmental Health, School of Public Health.,Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131.,Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico 87131
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8
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Allam VSRR, Chellappan DK, Jha NK, Shastri MD, Gupta G, Shukla SD, Singh SK, Sunkara K, Chitranshi N, Gupta V, Wich PR, MacLoughlin R, Oliver BGG, Wernersson S, Pejler G, Dua K. Treatment of chronic airway diseases using nutraceuticals: Mechanistic insight. Crit Rev Food Sci Nutr 2021; 62:7576-7590. [PMID: 33977840 DOI: 10.1080/10408398.2021.1915744] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Respiratory diseases, both acute and chronic, are reported to be the leading cause of morbidity and mortality, affecting millions of people globally, leading to high socio-economic burden for the society in the recent decades. Chronic inflammation and decline in lung function are the common symptoms of respiratory diseases. The current treatment strategies revolve around using appropriate anti-inflammatory agents and bronchodilators. A range of anti-inflammatory agents and bronchodilators are currently available in the market; however, the usage of such medications is limited due to the potential for various adverse effects. To cope with this issue, researchers have been exploring various novel, alternative therapeutic strategies that are safe and effective to treat respiratory diseases. Several studies have been reported on the possible links between food and food-derived products in combating various chronic inflammatory diseases. Nutraceuticals are examples of such food-derived products which are gaining much interest in terms of its usage for the well-being and better human health. As a consequence, intensive research is currently aimed at identifying novel nutraceuticals, and there is an emerging notion that nutraceuticals can have a positive impact in various respiratory diseases. In this review, we discuss the efficacy of nutraceuticals in altering the various cellular and molecular mechanisms involved in mitigating the symptoms of respiratory diseases.
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Affiliation(s)
- Venkata Sita Rama Raju Allam
- Department of Medical Biochemistry and Microbiology, Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, Uttar Pradesh, India
| | - Madhur D Shastri
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura, Jaipur, India
| | - Shakti D Shukla
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute (HMRI), University of Newcastle, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Sachin K Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Krishna Sunkara
- Emergency Clinical Management, Intensive Care Unit, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Nitin Chitranshi
- Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Vivek Gupta
- Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Peter R Wich
- School of Chemical Engineering, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Nanomedicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ronan MacLoughlin
- Aerogen, IDA Business Park, Dangan, Galway, Ireland.,School of Pharmacy & Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.,School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Brian Gregory George Oliver
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Sara Wernersson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Gunnar Pejler
- Department of Medical Biochemistry and Microbiology, Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden.,Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, Australia
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9
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Liu H, Li J, Ma Q, Tang J, Jiang M, Cao X, Lin L, Kong N, Yu S, Sood A, Zheng Y, Leng S, Han W. Chronic exposure to diesel exhaust may cause small airway wall thickening without lumen narrowing: a quantitative computerized tomography study in Chinese diesel engine testers. Part Fibre Toxicol 2021; 18:14. [PMID: 33766066 PMCID: PMC7992811 DOI: 10.1186/s12989-021-00406-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/12/2021] [Indexed: 01/23/2023] Open
Abstract
Background Diesel exhaust (DE) is a major source of ultrafine particulate matters (PM) in ambient air and contaminates many occupational settings. Airway remodeling assessed using computerized tomography (CT) correlates well with spirometry in patients with obstructive lung diseases. Structural changes of small airways caused by chronic DE exposure is unknown. Wall and lumen areas of 6th and 9th generations of four candidate airways were quantified using end-inhalation CT scans in 78 diesel engine testers (DET) and 76 non-DETs. Carbon content in airway macrophage (CCAM) in sputum was quantified to assess the dose-response relationship. Results Environmental monitoring and CCAM showed a much higher PM exposure in DETs, which was associated with higher wall area and wall area percent for 6th generation of airways. However, no reduction in lumen area was identified. No study subjects met spirometry diagnosis of airway obstruction. This suggested that small airway wall thickening without lumen narrowing may be an early feature of airway remodeling in DETs. The effect of DE exposure status on wall area percent did not differ by lobes or smoking status. Although the trend test was of borderline significance between categorized CCAM and wall area percent, subjects in the highest CCAM category has a 14% increase in wall area percent for the 6th generation of airways compared to subjects in the lowest category. The impact of DE exposure on FEV1 can be partially explained by the wall area percent with mediation effect size equal to 20%, Pperm = 0.028). Conclusions Small airway wall thickening without lumen narrowing may be an early image feature detected by CT and underlie the pathology of lung injury in DETs. The pattern of changes in small airway dimensions, i.e., thicker airway wall without lumen narrowing caused by occupational DE exposure was different to that (i.e., thicker airway wall with lumen narrowing) seen in our previous study of workers exposed to nano-scale carbon black aerosol, suggesting constituents other than carbon cores may contribute to such differences. Our study provides some imaging indications of the understanding of the pulmonary toxicity of combustion derived airborne particulate matters in humans. Supplementary Information The online version contains supplementary material available at 10.1186/s12989-021-00406-1.
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Affiliation(s)
- Hong Liu
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, 266021, China
| | - Jianyu Li
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Qianli Ma
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, 266021, China
| | - Jinglong Tang
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Menghui Jiang
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Xue Cao
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Li Lin
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, 266021, China
| | - Nan Kong
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China
| | - Shanfa Yu
- Henan Institute of Occupational Medicine, Zhengzhou, Henan, China
| | - Akshay Sood
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Yuxin Zheng
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China.
| | - Shuguang Leng
- Department of Occupational and Environmental Health, School of Public Health, Qingdao University, Qingdao, 266021, Shandong, China. .,Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, 87131, USA. .,Cancer Control and Population Sciences, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, 87131, USA.
| | - Wei Han
- Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, 266021, China.
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10
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Ferraro V, Andrinopoulou ER, Sijbring AMM, Haarman EG, Tiddens HAWM, Pijnenburg MWH. Airway-artery quantitative assessment on chest computed tomography in paediatric primary ciliary dyskinesia. ERJ Open Res 2020; 6:00210-2019. [PMID: 32964004 PMCID: PMC7487358 DOI: 10.1183/23120541.00210-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 05/26/2020] [Indexed: 11/24/2022] Open
Abstract
Chest computed tomography (CT) is the gold standard for detecting structural abnormalities in patients with primary ciliary dyskinesia (PCD) such as bronchiectasis, bronchial wall thickening and mucus plugging. There are no studies on quantitative assessment of airway and artery abnormalities in children with PCD. The objectives of the present study were to quantify airway and artery dimensions on chest CT in a cohort of children with PCD and compare these with control children to analyse the influence of covariates on airway and artery dimensions. Chest CTs of 13 children with PCD (14 CT scans) and 12 control children were collected retrospectively. The bronchial tree was segmented semi-automatically and reconstructed in a three-dimensional view. All visible airway–artery (AA) pairs were measured perpendicular to the airway centre line, annotating per branch inner and outer airway and adjacent artery diameter and computing inner airway diameter/artery ratio (AinA ratio), outer airway diameter/artery ratio (AoutA ratio), wall thickness (WT), WT/outer airway diameter ratio (Awt ratio) and WT/artery ratio. In the children with PCD (38.5% male, mean age 13.5 years, range 9.8–15.3) 1526 AA pairs were measured versus 1516 in controls (58.3% male, mean age 13.5 years, range 8–14.8). AinA ratio and AoutA ratio were significantly higher in children with PCD than in control children (both p<0.001). Awt ratio was significantly higher in control children than in children with PCD (p<0.001). Our study showed that in children with PCD airways are more dilated than in controls and do not show airway wall thickening. Chest CT is the gold standard for detecting structural abnormalities in patients with PCD, and this study is the first on quantitative assessment of airway and artery abnormalities in children with PCDhttps://bit.ly/2XZYWjU
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Affiliation(s)
- Valentina Ferraro
- Unit of Pediatric Allergy and Respiratory Medicine, Dept of Women's and Children's Health, University of Padua, Padua, Italy.,Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Anna Marthe Margaretha Sijbring
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Eric G Haarman
- Dept of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands
| | - Harm A W M Tiddens
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Dept of Radiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marielle W H Pijnenburg
- Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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11
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Karimi-Sales E, Alipour MR, Naderi R, Hosseinzadeh E, Ghiasi R. Protective Effect of Trans-chalcone Against High-Fat Diet-Induced Pulmonary Inflammation Is Associated with Changes in miR-146a And pro-Inflammatory Cytokines Expression in Male Rats. Inflammation 2020; 42:2048-2055. [PMID: 31473901 DOI: 10.1007/s10753-019-01067-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
High-fat diet (HFD) increases the risk of non-communicable inflammatory diseases including pulmonary disorders. Trans-chalcone is a chalcone with antioxidant and anti-inflammatory effects. This study aimed to explore the effect of this natural compound and molecular mechanism of its effect on HFD-induced pulmonary inflammation. Twenty-eight male Wistar rats were randomly divided into four main groups (n = 7 per each group): control, receiving 10% tween 80; Chal, receiving trans-chalcone, HFD, receiving a high-fat emulsion and 10% tween 80; HFD + Chal, receiving a high-fat emulsion and trans-chalcone. After 6 weeks, the lungs were dissected, and the expression levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and miR-146a were determined using real-time PCR. Moreover, histological analysis was done by hematoxylin and eosin staining. Significant elevations in TNF-α, IL-1β, IL-6, and miR-146a expression levels (P < 0.001) were observed within the lungs of HFD-fed rats compared with the control. However, oral administration of trans-chalcone reduced TNF-α, IL-1β, IL-6 (P < 0.001), and miR-146a (P < 0.05) expression levels and also improved HFD-induced histological abnormalities. These findings indicate that trans-chalcone ameliorates lung inflammatory response and structural alterations. It seems that this beneficial effect is associated with the down-regulation of pro-inflammatory cytokines and miR-146a.
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Affiliation(s)
- Elham Karimi-Sales
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Alipour
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roya Naderi
- Department of Physiology, Urmia Faculty of Medical Science, Nephrology and Kidney Transplant Research Center, Urmia University of Medical Science, Urmia, Iran
| | - Elham Hosseinzadeh
- Department of Medical Genetic, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rafigheh Ghiasi
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. .,Department of Physiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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12
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Matsumura K, Kurachi T, Ishikawa S, Kitamura N, Ito S. Regional differences in airway susceptibility to cigarette smoke: An investigational case study of epithelial function and gene alterations in in vitroairway epithelial three-dimensional cultures. TOXICOLOGY RESEARCH AND APPLICATION 2020. [DOI: 10.1177/2397847320911629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cigarette smoke (CS) is a risk factor contributing to lung remodeling in chronic obstructive pulmonary disease (COPD). COPD is a heterogeneous disease because many factors contribute in varying degrees to the resulting airflow limitations in different regions of the respiratory tract. This heterogeneity makes it difficult to understand mechanisms behind COPD development. In the current study, we investigate the regional heterogeneity of the acute response to CS exposure between large and small airways using in vitro three-dimensional (3D) cultures. We used two in vitro 3D human airway epithelial tissues from large and small airway epithelial cells, namely, MucilAir™ and SmallAir™, respectively, which were derived from the same single healthy donor to eliminate donor differences. Impaired epithelial functions and altered gene expression were observed in SmallAir™ exposed to CS at the lower dose and earlier period following the last exposure compared with MucilAir™. In addition, severe damage in SmallAir™ was retained for a longer duration than MucilAir™. Transcriptomic analysis showed that although well-known CS-inducible biological processes (i.e. inflammation, cell fate, and metabolism) were disturbed with consistent activity in both tissues exposed to CS, we elucidated distinctively regulated genes in only MucilAir™ and SmallAir™, which were mostly related to catalytic and transporter activities. Our findings suggest that CS exposure elicited epithelial dysfunction through almost the same perturbed pathways in both airways; however, they expressed different genes related to metabolic and transporter activities in response to CS exposure which may contribute to cytotoxic heterogeneity to the response to CS in the respiratory tract.
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Affiliation(s)
- Kazushi Matsumura
- Scientific Product Assessment Center, R&D Group, Japan Tobacco Inc., Yokohama, Kanagawa, Japan
| | - Takeshi Kurachi
- Scientific Product Assessment Center, R&D Group, Japan Tobacco Inc., Yokohama, Kanagawa, Japan
| | - Shinkichi Ishikawa
- Scientific Product Assessment Center, R&D Group, Japan Tobacco Inc., Yokohama, Kanagawa, Japan
| | - Nobumasa Kitamura
- Scientific Product Assessment Center, R&D Group, Japan Tobacco Inc., Yokohama, Kanagawa, Japan
| | - Shigeaki Ito
- Scientific Product Assessment Center, R&D Group, Japan Tobacco Inc., Yokohama, Kanagawa, Japan
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13
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Vanfleteren LE, Ojanguren I, Nolan CM, Franssen FM, Andrianopoulos V, Grgic A, van Dijk M, Slebos DJ, Daines L, Kocks JW, Kahn N. European Respiratory Society International Congress, Paris, 2018: highlights from the Clinical Assembly. ERJ Open Res 2019; 5:00176-2018. [PMID: 30775373 PMCID: PMC6368995 DOI: 10.1183/23120541.00176-2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/13/2018] [Indexed: 01/14/2023] Open
Abstract
This article contains highlights and a selection of the scientific advances from the European Respiratory Society's Clinical Assembly (Assembly 1 and its five respective groups) that were presented at the 2018 European Respiratory Society International Congress in Paris, France. The most relevant topics from each of the groups will be discussed, covering a wide range of areas including clinical problems, rehabilitation and chronic care, thoracic imaging, interventional pulmonology, and general practice and primary care. The newest research, actual data and highlight sessions will be discussed.
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Affiliation(s)
- Lowie E.G.W. Vanfleteren
- COPD Center, Sahlgrenska University Hospital and Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Iñigo Ojanguren
- Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Claire M. Nolan
- Harefield Pulmonary Rehabilitation and Muscle Research Laboratory, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | - Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Aleksandar Grgic
- Dept of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany
| | - Marlies van Dijk
- Dept of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dirk Jan Slebos
- Dept of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Luke Daines
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Janwillem W.H. Kocks
- General Practitioners Research Institute, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands
| | - Nicolas Kahn
- Dept of Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany
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14
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Dunican EM. Seeing the forest for the trees: fractal dimensions measure COPD airway remodeling. J Clin Invest 2018; 128:5203-5205. [PMID: 30371506 DOI: 10.1172/jci124776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is extremely heterogenous in its effects on airway remodeling. Parsing the complex and interrelated morphologic changes and understanding their contribution to disease severity has posed a significant challenge to the field. In the current issue of the JCI, Bodduluri et al. measured the complex effects of COPD on the airway tree using airway fractal dimension (AFD) on computerized tomography in a large cohort of smokers with and without COPD. They found that lower AFD was independently associated with disease severity and mortality in COPD. This work highlights AFD as a noninvasive approach to analyze complex changes in airway geometry.
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Ye X, Hong W, Hao B, Peng G, Huang L, Zhao Z, Zhou Y, Zheng M, Li C, Liang C, Yi E, Pu J, Li B, Ran P. PM2.5 promotes human bronchial smooth muscle cell migration via the sonic hedgehog signaling pathway. Respir Res 2018; 19:37. [PMID: 29499705 PMCID: PMC5833105 DOI: 10.1186/s12931-017-0702-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/14/2017] [Indexed: 12/12/2022] Open
Abstract
Background The contribution of airway remodeling in chronic obstructive pulmonary disease (COPD) has been well documented, with airway smooth muscle cell proliferation and migration playing a role in the remodeling process. Here, we aimed to verify the effects of fine particulate matter (PM2.5) on human bronchial smooth muscle cell (HBSMC) migration and to explore the underlying signaling pathways. Methods HBSMC apoptosis, proliferation and migration were measured using flow cytometry, cell counting and transwell migration assays, respectively. The role of the hedgehog pathway in cell migration was assessed by western blotting to measure the expression of Sonic hedgehog (Shh), Gli1 and Snail. Furthermore, siRNA was used to knock down Gli1 or Snail expression. Results PM2.5 induced HBSMC apoptosis in a dose-dependent manner, although certain concentrations of PM2.5 did not induce HBSMC proliferation or apoptosis. Interestingly, cell migration was stimulated by PM2.5 doses far below those that induced apoptosis. Additional experiments revealed that these PM2.5 doses enhanced the expression of Shh, Gli1 and Snail in HBSMCs. Furthermore, PM2.5-induced cell migration and protein expression were enhanced by recombinant Shh and attenuated by cyclopamine. Similar results were obtained by knocking down Gli1 or Snail. Conclusions These findings suggest that PM2.5, which may exert its effects through the Shh signaling pathway, is necessary for the migration of HBSMCs. These data define a novel role for PM2.5 in airway remodeling in COPD. Electronic supplementary material The online version of this article (10.1186/s12931-017-0702-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiuqin Ye
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Xiamen Humanity Hospital, Xiamen, Fujian, China
| | - Wei Hong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Binwei Hao
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Gongyong Peng
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lingmei Huang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Respiratory Department of the First Hospital of Yueyang City, Yueyang, Hunan, China
| | - Zhuxiang Zhao
- The First Affiliated Municipal Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mengning Zheng
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chenglong Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunxiao Liang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Erkang Yi
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jinding Pu
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Bing Li
- GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Pixin Ran
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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16
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Lee G, Bak SH, Lee HY. CT Radiomics in Thoracic Oncology: Technique and Clinical Applications. Nucl Med Mol Imaging 2017; 52:91-98. [PMID: 29662557 DOI: 10.1007/s13139-017-0506-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 11/02/2017] [Accepted: 11/16/2017] [Indexed: 11/26/2022] Open
Abstract
Precision medicine offers better treatment options and improved survival for cancer patients based on individual variability. As the success of precision medicine depends on robust biomarkers, the requirement for improved imaging biomarkers that reflect tumor biology has grown exponentially. Radiomics, the field of study in which high-throughput data are generated and large amounts of advanced quantitative features are extracted from medical images, has shown great potential as a source of quantitative biomarkers in the field of oncology. Radiomics provides quantitative information about the morphology, texture, and intratumoral heterogeneity of the tumor itself as well as features related to pulmonary function. Hence, radiomics data can be used to build descriptive and predictive clinical models that relate imaging characteristics to tumor biology phenotypes. In this review, we describe the workflow of CT radiomics, types of CT radiomics, and its clinical application in thoracic oncology.
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Affiliation(s)
- Geewon Lee
- 1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul, 06351 South Korea
- Department of Radiology and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - So Hyeon Bak
- 1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul, 06351 South Korea
- 3Department of Radiology, Kangwon National University Hospital, Chuncheon, South Korea
| | - Ho Yun Lee
- 1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-gu, Seoul, 06351 South Korea
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17
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Abstract
INTRODUCTION The prevalence and awareness of bronchiectasis not related to cystic fibrosis (CF) is increasing and it is now recognized as a major cause of respiratory morbidity, mortality and healthcare utilization worldwide. The need to elucidate the early origins of bronchiectasis is increasingly appreciated and has been identified as an important research priority. Current treatments for pediatric bronchiectasis are limited to antimicrobials, airway clearance techniques and vaccination. Several new drugs targeting airway inflammation are currently in development. Areas covered: Current management of pediatric bronchiectasis, including discussion on therapeutics, non-pharmacological interventions and preventative and surveillance strategies are covered in this review. We describe selected adult and pediatric data on bronchiectasis treatments and briefly discuss emerging therapeutics in the field. Expert commentary: Despite the burden of disease, the number of studies evaluating potential treatments for bronchiectasis in children is extremely low and substantially disproportionate to that for CF. Research into the interactions between early life respiratory tract infections and the developing immune system in children is likely to reveal risk factors for bronchiectasis development and inform future preventative and therapeutic strategies. Tailoring interventions to childhood bronchiectasis is imperative to halt the disease in its origins and improve adult outcomes.
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Affiliation(s)
- Danielle F Wurzel
- a The Royal Children's Hospital , Parkville , Australia.,b Murdoch Childrens Research Institute , Parkville , Australia
| | - Anne B Chang
- c Lady Cilento Children's Hospital , Queensland University of Technology , Brisbane , Australia.,d Menzies School of Health Research , Charles Darwin University , Darwin , Australia
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18
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Quantitative CT characterization of pediatric lung development using routine clinical imaging. Pediatr Radiol 2016; 46:1804-1812. [PMID: 27576458 PMCID: PMC5116406 DOI: 10.1007/s00247-016-3686-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/09/2016] [Accepted: 08/12/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The use of quantitative CT analysis in children is limited by lack of normal values of lung parenchymal attenuation. These characteristics are important because normal lung development yields significant parenchymal attenuation changes as children age. OBJECTIVE To perform quantitative characterization of normal pediatric lung parenchymal X-ray CT attenuation under routine clinical conditions in order to establish a baseline comparison to that seen in pathological lung conditions. MATERIALS AND METHODS We conducted a retrospective query of normal CT chest examinations in children ages 0-7 years from 2004 to 2014 using standard clinical protocol. During these examinations semi-automated lung parenchymal segmentation was performed to measure lung volume and mean lung attenuation. RESULTS We analyzed 42 CT examinations in 39 children, ages 3 days to 83 months (mean ± standard deviation [SD] = 42 ± 27 months). Lung volume ranged 0.10-1.72 liters (L). Mean lung attenuation was much higher in children younger than 12 months, with values as high as -380 Hounsfield units (HU) in neonates (lung volume 0.10 L). Lung volume decreased to approximately -650 HU by age 2 years (lung volume 0.47 L), with subsequently slower exponential decrease toward a relatively constant value of -860 HU as age and lung volume increased. CONCLUSION Normal lung parenchymal X-ray CT attenuation decreases with increasing lung volume and age; lung attenuation decreases rapidly in the first 2 years of age and more slowly thereafter. This change in normal lung attenuation should be taken into account as quantitative CT methods are translated to pediatric pulmonary imaging.
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19
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Kuo W, Andrinopoulou ER, Perez-Rovira A, Ozturk H, de Bruijne M, Tiddens HAWM. Objective airway artery dimensions compared to CT scoring methods assessing structural cystic fibrosis lung disease. J Cyst Fibros 2016; 16:116-123. [PMID: 27343002 DOI: 10.1016/j.jcf.2016.05.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
Background CF-CT and PRAGMA-CF are commonly used scoring methods to quantify the severity of bronchiectasis (BE) and airway wall thickening (AWT) on chest CTs of children with cystic fibrosis (CF). We aimed to validate CF-CT and PRAGMA-CF sub-scores for BE and AWT against quantitative airway–artery (AA) dimensions. Methods This is a retrospective study with 23 spirometer guided inspiratory chest CTs (11 CF, 12 controls; age range 6 to 16 years old) included. AA-, and AWTA-ratios of all visible AA pairs were computed by dividing diameters of the outer airway and wall (outer-inner airway) by the accompanying artery diameter, respectively. BE, AWT and total airway disease (TAD) were scored using CF-CT (% max score) and PRAGMA-CF (% extent). Correlations were computed using Spearman rank. Akaike information criterion (AIC) from the mixed-effects models were used to investigate whether CF-CT or PRAGMA-CF was a better predictor for AA-, and AWTA-ratios (lower AIC equals a better fitted model). Results 4861 AA pairs were measured in total. Correlations between CF-CT and PRAGMA-CF: BE (r = 0.93, P < 0.001); AWT (r = 0.62, P < 0.001); TAD (r = 0.88, P < 0.001). PRAGMA-CF TAD sub-score had lowest AIC in the mixed-model predicting AA-ratio. CF-CT AWT and PRAGMA-CF TAD sub-score had equal low AIC in the mixed-model predicting AWTA-ratio. Conclusion PRAGMA-CF TAD sub-score was more precise predicting BE. CF-CT AWT and PRAGMA-CF TAD sub-scores predicted AWT equally well. CF-CT and PRAGMA-CF were both sensitive methods to score BE and AWT in children with CF lung disease, with PRAGMA-CT TAD sub-score being most accurate in predicting AA dimensions.
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Affiliation(s)
- Wieying Kuo
- Dept. of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Dept. of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Adria Perez-Rovira
- Dept. of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Biomedical Imaging Group Rotterdam, Dept. of Medical Informatics and Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Hadiye Ozturk
- Dept. of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marleen de Bruijne
- Biomedical Imaging Group Rotterdam, Dept. of Medical Informatics and Radiology, Erasmus MC, Rotterdam, The Netherlands; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Harm A W M Tiddens
- Dept. of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands; Dept. of Radiology, Erasmus MC, Rotterdam, The Netherlands.
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20
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Bahloul M, Chtara K, Gargouri R, Majdoub A, Chaari A, Bouaziz M. Failure of noninvasive ventilation in adult patients with acute asthma exacerbation. J Thorac Dis 2016; 8:744-7. [PMID: 27162642 DOI: 10.21037/jtd.2016.03.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mabrouk Bahloul
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Kamilia Chtara
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Rahma Gargouri
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Ali Majdoub
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Anis Chaari
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
| | - Mounir Bouaziz
- 1 Service de Réanimation médicale, CHU Habib Bourguiba, 3029 Sfax, Tunisie ; 2 Hospital Tahar Sfar de Mahdia, Service Anesthésie Réanimation Chirurgicale, Mahdia, Tunisie
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21
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Suwatanapongched T, Thongprasert C, Lertpongpiroon S, Muntham D, Kiatboonsri S. Expiratory air trapping during asthma exacerbation: Relationships with clinical indices and proximal airway morphology. Eur J Radiol 2015; 84:2671-8. [DOI: 10.1016/j.ejrad.2015.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/21/2015] [Accepted: 09/08/2015] [Indexed: 12/22/2022]
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22
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Organ L, Bacci B, Koumoundouros E, Barcham G, Milne M, Kimpton W, Samuel C, Snibson K. Structural and functional correlations in a large animal model of bleomycin-induced pulmonary fibrosis. BMC Pulm Med 2015; 15:81. [PMID: 26227819 PMCID: PMC4521476 DOI: 10.1186/s12890-015-0071-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/06/2015] [Indexed: 11/10/2022] Open
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a severe and progressive respiratory disease with poor prognosis. Despite the positive outcomes from recent clinical trials, there is still no cure for this disease. Pre-clinical animal models are currently largely limited to small animals which have a number of shortcomings. We have previously shown that fibrosis is induced in isolated sheep lung segments 14 days after bleomycin treatment. This study aimed to determine whether bleomycin-induced fibrosis and associated functional changes persisted over a seven-week period. Methods Two separate lung segments in nine sheep received two challenges two weeks apart of either, 3U bleomycin (BLM), or saline (control). Lung function in these segments was assessed by a wedged-bronchoscope procedure after bleomycin treatment. Lung tissue, and an ex vivo CT analysis were used to assess for the persistence of inflammation, fibrosis and collagen content in this model. Results Fibrotic changes persisted up to seven weeks in bleomycin-treated isolated lung segments (Pathology scores: bleomycin12.27 ± 0.07 vs. saline 4.90 ± 1.18, n = 9, p = 0.0003). Localization of bleomycin-induced injury and increased tissue density was confirmed by CT analysis (mean densitometric CT value: bleomycin −698 ± 2.95 Hounsfield units vs. saline −898 ± 2.5 Hounsfield units, p = 0.02). Masson’s trichrome staining revealed increased connective tissue in bleomycin segments, compared to controls (% blue staining/total field area: 8.5 ± 0.8 vs. 2.1 ± 0.2 %, n = 9, p < 0.0001). bleomycin-treated segments were significantly less compliant from baseline at 7 weeks post treatment compared to control-treated segments (2.05 ± 0.88 vs. 4.97 ± 0.79 mL/cmH20, n = 9, p = 0.002). There was also a direct negative correlation between pathology scores and segmental compliance. Conclusions We show that there is a correlation between fibrosis and correspondingly poor lung function which persist for up to seven weeks after bleomycin treatment in this large animal model of pulmonary fibrosis.
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Affiliation(s)
- Louise Organ
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Parkville, VIC, Australia.
| | - Barbara Bacci
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Werribee, VIC, Australia.
| | - Emmanuel Koumoundouros
- Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, VIC, Australia.
| | - Garry Barcham
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Parkville, VIC, Australia.
| | - Marjorie Milne
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Werribee, VIC, Australia.
| | - Wayne Kimpton
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Parkville, VIC, Australia.
| | - Chrishan Samuel
- Department of Pharmacology, Monash University, Clayton, VIC, Australia.
| | - Ken Snibson
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Parkville, VIC, Australia.
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23
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Andersson-Sjöland A, Hallgren O, Rolandsson S, Weitoft M, Tykesson E, Larsson-Callerfelt AK, Rydell-Törmänen K, Bjermer L, Malmström A, Karlsson JC, Westergren-Thorsson G. Versican in inflammation and tissue remodeling: the impact on lung disorders. Glycobiology 2014; 25:243-51. [PMID: 25371494 PMCID: PMC4310351 DOI: 10.1093/glycob/cwu120] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Versican is a proteoglycan that has many different roles in tissue homeostasis and inflammation. The biochemical structure comprises four different types of the core protein with attached glycosaminoglycans (GAGs) that can be sulfated to various extents and has the capacity to regulate differentiation of different cell types, migration, cell adhesion, proliferation, tissue stabilization and inflammation. Versican's regulatory properties are of importance during both homeostasis and changes that lead to disease progression. The GAGs that are attached to the core protein are of the chondroitin sulfate/dermatan sulfate type and are known to be important in inflammation through interactions with cytokines and growth factors. For a more complex understanding of versican, it is of importance to study the tissue niche, where the wound healing process in both healthy and diseased conditions take place. In previous studies, our group has identified changes in the amount of the multifaceted versican in chronic lung disorders such as asthma, chronic obstructive pulmonary disease, and bronchiolitis obliterans syndrome, which could be a result of pathologic, transforming growth factor β driven, on-going remodeling processes. Reversely, the context of versican in its niche is of great importance since versican has been reported to have a beneficial role in other contexts, e.g. emphysema. Here we explore the vast mechanisms of versican in healthy lung and in lung disorders.
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Affiliation(s)
| | - Oskar Hallgren
- Lung Biology Lung Medicine and Allergology, Skåne University Hospital, Lund University, Lund 221 84, Sweden
| | | | | | - Emil Tykesson
- Lung Biology Matrix Biology, Department of Experimental Medical Sciences, BMC D12, Lund University, Lund 221 84, Sweden
| | | | | | - Leif Bjermer
- Lung Medicine and Allergology, Skåne University Hospital, Lund University, Lund 221 84, Sweden
| | - Anders Malmström
- Lung Medicine and Allergology, Skåne University Hospital, Lund University, Lund 221 84, Sweden
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24
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Gu S, Leader J, Zheng B, Chen Q, Sciurba F, Kminski N, Gur D, Pu J. Direct assessment of lung function in COPD using CT densitometric measures. Physiol Meas 2014; 35:833-45. [PMID: 24710855 DOI: 10.1088/0967-3334/35/5/833] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
To investigate whether lung function in patients with chronic obstructive pulmonary disease (COPD) can be directly predicted using CT densitometric measures and assess the underlying prediction errors as compared with the traditional spirometry-based measures. A total of 600 CT examinations were collected from a COPD study. In addition to the entire lung volume, the extent of emphysema depicted in each CT examination was quantified using density mask analysis (densitometry). The partial least square regression was used for constructing the prediction model, where a repeated random split-sample validation was employed. For each split, we randomly selected 400 CT exams for training (regression) purpose and the remaining 200 exams for assessing performance in prediction of lung function (e.g., FEV1 and FEV1/FVC) and disease severity. The absolute and percentage errors as well as their standard deviations were computed. The averaged percentage errors in prediction of FEV1, FEV1/FVC%, TLC, RV/TLC% and DLco% predicted were 33%, 17%, 9%, 18% and 23%, respectively. When classifying the exams in terms of disease severity grades using the CT measures, 37% of the subjects were correctly classified with no error and 83% of the exams were either correctly classified or classified into immediate neighboring categories. The linear weighted kappa and quadratic weighted kappa were 0.54 (moderate agreement) and 0.72 (substantial agreement), respectively. Despite the existence of certain prediction errors in quantitative assessment of lung function, the CT densitometric measures could be used to relatively reliably classify disease severity grade of COPD patients in terms of GOLD.
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Affiliation(s)
- Suicheng Gu
- Imaging Research Center, Department of Radiology, University of Pittsburgh, PA, USA
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