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Tornyi I, Horváth I. Role of Complement Components in Asthma: A Systematic Review. J Clin Med 2024; 13:3044. [PMID: 38892755 PMCID: PMC11172655 DOI: 10.3390/jcm13113044] [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: 04/02/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Asthma is a chronic inflammatory airway disease characterized by recurrent symptoms in response to a wide range of external stimuli, including allergens, viral infections, and air pollution together with internal host-derived danger signals. The disease is traditionally associated with adaptive immune responses; recent research emphasizes the critical role of innate immunity in its pathogenesis. The complement system, activated as part of the defense mechanisms, plays a crucial role in bridging innate to adaptive immunity. While experimental models demonstrate complement cascade activation in asthma, human studies remain limited. Methods: This systematic review summarizes existing literature on the complement system in asthma patients, gathering data from PubMed, Web of Science, Scopus, and Google Scholar. The protocol was registered in the OSF. Results: Out of 482 initially identified articles, only 24 met the eligibility criteria, revealing disparities in sample origin, methodologies, and populations. Despite observed heterogeneity, a consistent result was found in the elevation of complement regulatory proteins, such as complement Factor H, in samples from patients with asthma compared to those from healthy subjects. Conclusions: The increased level of regulatory proteins, such as Factor H and I highlight that these may influence asthma pathophysiology. The role of complement factors as potential biomarkers of asthma activity and severity needs further evaluation.
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Affiliation(s)
- Ilona Tornyi
- Department of Pulmonology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Ildikó Horváth
- Department of Pulmonology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
- National Koranyi Institute of Pulmonology, 1121 Budapest, Hungary
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Roe T, Silveira S, Luo Z, Osborne EL, Senthil Murugan G, Grocott MPW, Postle AD, Dushianthan A. Particles in Exhaled Air (PExA): Clinical Uses and Future Implications. Diagnostics (Basel) 2024; 14:972. [PMID: 38786270 PMCID: PMC11119244 DOI: 10.3390/diagnostics14100972] [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: 03/30/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Access to distal airway samples to assess respiratory diseases is not straightforward and requires invasive procedures such as bronchoscopy and bronchoalveolar lavage. The particles in exhaled air (PExA) device provides a non-invasive means of assessing small airways; it captures distal airway particles (PEx) sized around 0.5-7 μm and contains particles of respiratory tract lining fluid (RTLF) that originate during airway closure and opening. The PExA device can count particles and measure particle mass according to their size. The PEx particles can be analysed for metabolites on various analytical platforms to quantitatively measure targeted and untargeted lung specific markers of inflammation. As such, the measurement of distal airway components may help to evaluate acute and chronic inflammatory conditions such as asthma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, and more recently, acute viral infections such as COVID-19. PExA may provide an alternative to traditional methods of airway sampling, such as induced sputum, tracheal aspirate, or bronchoalveolar lavage. The measurement of specific biomarkers of airway inflammation obtained directly from the RTLF by PExA enables a more accurate and comprehensive understanding of pathophysiological changes at the molecular level in patients with acute and chronic lung diseases.
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Affiliation(s)
- Thomas Roe
- General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Siona Silveira
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Zixing Luo
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Optoelectronics Research Centre, University of Southampton, Southampton SO17 1BJ, UK
| | - Eleanor L Osborne
- Optoelectronics Research Centre, University of Southampton, Southampton SO17 1BJ, UK
| | | | - Michael P W Grocott
- General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Anthony D Postle
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Ahilanandan Dushianthan
- General Intensive Care Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
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Fricke-Galindo I, García-Carmona S, Alanis-Ponce J, Pérez-Rubio G, Ramírez-Venegas A, Montiel-Lopez F, Robles-Hernández R, Hernández-Zenteno RDJ, Valencia-Pérez Rea D, Bautista-Becerril B, Ramírez-Díaz ME, Cruz-Vicente F, Martínez-Gómez MDL, Sansores R, Falfán-Valencia R. sRAGE levels are decreased in plasma and sputum of COPD secondary to biomass-burning smoke and tobacco smoking: Differences according to the rs3134940 AGER variant. Heliyon 2024; 10:e28675. [PMID: 38571598 PMCID: PMC10988041 DOI: 10.1016/j.heliyon.2024.e28675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/12/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
The receptor for advanced glycation end products (RAGE) and its gene (AGER) have been related to lung injury and inflammatory diseases, including chronic obstructive pulmonary disease (COPD). We aimed to evaluate the association of rs2071288, rs3134940, rs184003, and rs2070600 AGER single-nucleotide variants and the soluble-RAGE plasma and sputum levels with COPD secondary to biomass-burning smoke (BBS) and tobacco smoking. Four groups, including 2189 subjects, were analyzed: COPD secondary to BBS exposure (COPD-BBS, n = 342), BBS-exposed subjects without COPD (BBES, n = 774), tobacco smoking-induced COPD (COPD-TS, n = 434), and smokers without COPD (SWOC, n = 639). Allelic discrimination assays determined the AGER variants. The sRAGE was quantified in plasma (n = 240) and induced-sputum (n = 72) samples from a subgroup of patients using the ELISA technique. In addition, a meta-analysis was performed for the association of rs2070600 with COPD susceptibility. None of the studied genetic variants were found to be associated with COPD-BBS or COPD-TS. A marginal association was observed for the rs3134940 with COPD-BBS (p = 0.066). The results from the meta-analysis, including six case-control studies (n = 4149 subjects), showed a lack of association of rs2070600 with COPD susceptibility (p = 0.681), probably due to interethnic differences. The sRAGE plasma levels were lower in COPD-BBS compared to BBS and in COPD-TS compared to SWOC. The sRAGE levels were also lower in sputum samples from COPD-BBS than BBES. Subjects with rs3134940-TC genotypes exhibit lower sRAGE plasma levels than TT subjects, mainly from the COPD-BBS and SWOC groups. The AGER variants were not associated with COPD-BBS nor COPD-TS, but the sRAGE plasma and sputum levels are related to both COPD-BBS and COPD-TS and are influenced by the rs3134940 variant.
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Affiliation(s)
- Ingrid Fricke-Galindo
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
| | - Salvador García-Carmona
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
| | - Jesús Alanis-Ponce
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
| | - Gloria Pérez-Rubio
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
| | - Alejandra Ramírez-Venegas
- Tobacco Smoking and COPD Research Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, 14080, Mexico
| | - Francisco Montiel-Lopez
- Tobacco Smoking and COPD Research Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, 14080, Mexico
| | - Robinson Robles-Hernández
- Tobacco Smoking and COPD Research Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, 14080, Mexico
| | - Rafael de Jesús Hernández-Zenteno
- Tobacco Smoking and COPD Research Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, 14080, Mexico
| | - Daniela Valencia-Pérez Rea
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
| | - Brandon Bautista-Becerril
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
| | - María Elena Ramírez-Díaz
- Coordinación de Vigilancia Epidemiológica, Jurisdicción 06 Sierra, Tlacolula de Matamoros Oaxaca, Servicios de Salud de Oaxaca, Oaxaca, 70400, Mexico
| | - Filiberto Cruz-Vicente
- Internal Medicine Department, Hospital Civil Aurelio Valdivieso, Servicios de Salud de Oaxaca, Oaxaca, 68050, Mexico
| | | | - Raúl Sansores
- Clínica de Enfermedades Respiratorias, Fundación Médica Sur, Mexico City, 14080, Mexico
| | - Ramcés Falfán-Valencia
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, 14080, Mexico
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Wen SWC, Borg M, Timm S, Hansen TF, Hilberg O, Andersen RF. Methylated Cell-Free Tumor DNA in Sputum as a Tool for Diagnosing Lung Cancer-A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:506. [PMID: 38339257 PMCID: PMC10854681 DOI: 10.3390/cancers16030506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide. Early diagnosis is pivotal for the prognosis. There is a notable overlap between lung cancer and chronic bronchitis, and the potential use of methylated tumor DNA in sputum as a biomarker for lung cancer detection is appealing. This systematic review and meta-analysis followed the PRISMA 2020 statement. A comprehensive search was conducted in Embase, Medline, Web of Science, and the Cochrane Library, using these search strings: Lung cancer, sputum, and methylated tumor DNA. A total of 15 studies met the eligibility criteria. Studies predominantly utilized a case-control design, with sensitivity ranging from 10 to 93% and specificity from 8 to 100%. A meta-analysis of all genes across studies resulted in a summary sensitivity of 54.3% (95% CI 49.4-59.2%) and specificity of 79.7% (95% CI 75.0-83.7%). Notably, two less explored genes (TAC1, SOX17) demonstrated sensitivity levels surpassing 85%. The study's findings highlight substantial variations in the sensitivity and specificity of methylated tumor DNA in sputum for lung cancer detection. Challenges in reproducibility could stem from differences in tumor site, sample acquisition, extraction methods, and methylation measurement techniques. This meta-analysis provides a foundation for prioritizing high-performing genes, calling for a standardization and refinement of methodologies before potential application in clinical trials.
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Affiliation(s)
- Sara Witting Christensen Wen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Morten Borg
- Department of Medicine, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark;
| | - Signe Timm
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Torben Frøstrup Hansen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Ole Hilberg
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
- Department of Medicine, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark;
| | - Rikke Fredslund Andersen
- Department of Biochemistry and Immunology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark
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Goncalves B, Eze UA. Sputum induction and its diagnostic applications in inflammatory airway disorders: a review. FRONTIERS IN ALLERGY 2023; 4:1282782. [PMID: 37901763 PMCID: PMC10600502 DOI: 10.3389/falgy.2023.1282782] [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: 08/24/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Sputum induction is a technique that covers the induction and the subsequent processing of the expectorate primarily for the analysis of cells and different inflammatory biomarkers present in the airways to further understand the pathophysiology of different inflammatory respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD) as well as the diagnosis of lung diseases such as lung cancer, tuberculosis, and Pneumocystis jirovecii pneumonia. It is a non-invasive, safe, cost-effective, and reliable technique reported to exhibit a high success rate. However, due to being technically demanding and time-consuming and having the need of employing trained staff, this technique is only used in restricted research centres and in limited centres of clinical use. When the sputum is collected after induction, the primary goal is to obtain a differential cell count and evaluate the molecular biomarkers of airway inflammation such as eosinophil cationic protein, eosinophil-derived neurotoxin, major basic protein, tryptase, cytokine production [e.g., interleukin (IL)-5], albumin, and fibrinogen. In addition, cytospins from the processed sputum are used for immunocytochemical staining of cellular products such as EG-2 reactive protein, granulocyte-macrophage colony-stimulating factor, tumour necrosis factor alpha, and IL-8 that play significant roles in understanding the pathophysiology of inflammatory airway diseases. Nowadays, this technique can be further used by performing an additional analysis such as flow cytometry and in situ hybridisation on the sputum supernatant to investigate more the immune response and pathophysiological process of such various respiratory diseases. In addition, the application of sputum fluid phase to assess the biomarkers could be used more routinely in pathological laboratories for diagnosing lung cancer, COPD, and asthma as well as for monitoring lung cancer progression and asthma and COPD treatment, allowing for early detection and a better treatment provided by the clinicians.
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Affiliation(s)
- Beatriz Goncalves
- NIHR Leicester Biomedical Research Centre, Department of Respiratory Sciences, Glenfield Hospital, Leicester, United Kingdom
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Ukpai A. Eze
- Leicester School of Allied Health Sciences, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
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Mosbech CH, Godtfredsen NS, Ulrik CS, Westergaard CG. Biomarker-guided withdrawal of inhaled corticosteroids in asthma patients with a non-T2 inflammatory phenotype - a randomized controlled trial study protocol. BMC Pulm Med 2023; 23:372. [PMID: 37794472 PMCID: PMC10552380 DOI: 10.1186/s12890-023-02679-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Non-T2 asthma is characterized by the absence of elevated type 2 inflammatory biomarkers such as blood-eosinophils, total and allergen-specific Immunoglobulin E and Fractional exhaled Nitric Oxide (FeNO). According to guidelines, inhaled corticosteroids (ICS) are the cornerstone of asthma management. However, ICS treatment is associated with a risk of local side effects, including hoarseness and thrush, and long-term high-dose therapy may cause systemic adverse effects. Furthermore, whereas treatment with ICS is highly effective in T2 asthma, studies have shown a markedly reduced ICS efficacy in patients with a lower degree of T2 inflammation, thus posing a clinical challenge in this subgroup of patients. Hence, owing to the ICS dosage step-up approach in current clinical guidelines, patients with low T2 biomarkers are at risk of being exposed to high doses of ICS, and by that at risk of side effects. Thus, an ICS-treatment regime guided by biomarkers that reflects the inflammatory phenotype is warranted in order to reduce the corticosteroid burden in patients with non-T2 asthma. This study combines a panel of non-T2 inflammatory markers (low periostin, low blood-eosinophils, and low FeNO), to determine if this group of patients can maintain asthma control during ICS withdrawal. METHODS This is an ongoing prospective multicenter open-label randomized, controlled trial aiming to assess if ICS can be safely tapered in patients with non-T2 asthma. The patients are randomized 1:1 to either standard of care or an ICS tapering regimen (n = 55 in each group) where the initial ICS dose is reduced by 50% for 8 weeks followed by total ICS removal. The primary endpoint is change in asthma control questionnaire (ACQ) from baseline to post-tapered ICS. The secondary endpoints are time from baseline to drop-out caused by loss of asthma control, changes in serum-periostin, blood-eosinophils, FeNO, Forced Expiratory Volume in 1 s (FEV1) and in sputum-eosinophils. DISCUSSION This study aims to provide data on ICS tapering in non-T2 asthma patients and to contribute to a more individualized and corticosteroid-sparing treatment regime in this group of patients. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03141424. Registration date: May 5th, 2017.
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Affiliation(s)
| | - Nina Skavlan Godtfredsen
- Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Kettegaard Allé 30, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Kettegaard Allé 30, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark
| | - Christian Grabow Westergaard
- Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Kettegaard Allé 30, Hvidovre, Denmark
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Eggenkemper L, Schlegtendal A, Maier C, Lücke T, Brinkmann F, Beckmann B, Tsikas D, Koerner-Rettberg C. Impaired Nitric Oxide Synthetase Activity in Primary Ciliary Dyskinesia-Data-Driven Hypothesis. J Clin Med 2023; 12:6010. [PMID: 37762950 PMCID: PMC10531778 DOI: 10.3390/jcm12186010] [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: 07/27/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Low nasal nitric oxide (nNO) is a typical feature of Primary Ciliary Dyskinesia (PCD). nNO is part of the PCD diagnostic algorithm due to its discriminative power against other lung diseases, such as cystic fibrosis (CF). However, the underlying pathomechanisms are elusive. To better understand NO dysregulation in PCD, the L-arginine/NO (Arg/NO) pathway in patients with PCD (pwPCD) and CF (pwCF) and in healthy control (HC) subjects was investigated. In a prospective, controlled study, we measured in 24 pwPCD, 25 age-matched pwCF, and 14 HC the concentrations of the NO precursors Arg and homoarginine (hArg), the arginase metabolite ornithine (Orn), the NO inhibitor asymmetric dimethylarginine (ADMA), and the major NO metabolites (nitrate, nitrite) in sputum, plasma, and urine using validated methods. In comparison to HC, the sputum contents (in µmol/mg) of L-Arg (PCD 18.43 vs. CF 329.46 vs. HC 9.86, p < 0.001) and of ADMA (PCD 0.055 vs. CF 0.015 vs. HC 0.010, p < 0.001) were higher. In contrast, the sputum contents (in µmol/mg) of nitrate and nitrite were lower in PCD compared to HC (nitrite 4.54 vs. 9.26, p = 0.023; nitrate 12.86 vs. 40.33, p = 0.008), but higher in CF (nitrite 16.28, p < 0.001; nitrate 56.83, p = 0.002). The metabolite concentrations in urine and plasma were similar in all groups. The results of our study indicate that PCD, unlike CF, is associated with impaired NO synthesis in the lung, presumably due to mechano-chemical uncoupling.
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Affiliation(s)
- Lisa Eggenkemper
- University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (A.S.); (C.M.); (T.L.); (F.B.); (C.K.-R.)
- Department of Internal Medicine and Gastroenterology, Christophorus-Kliniken Coesfeld, Teaching Hospital of University Münster, 48653 Coesfeld, Germany
| | - Anne Schlegtendal
- University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (A.S.); (C.M.); (T.L.); (F.B.); (C.K.-R.)
| | - Christoph Maier
- University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (A.S.); (C.M.); (T.L.); (F.B.); (C.K.-R.)
| | - Thomas Lücke
- University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (A.S.); (C.M.); (T.L.); (F.B.); (C.K.-R.)
| | - Folke Brinkmann
- University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (A.S.); (C.M.); (T.L.); (F.B.); (C.K.-R.)
- Section for Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, 23538 Lübeck, Germany
| | - Bibiana Beckmann
- Core Unit Proteomics, Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (B.B.); (D.T.)
| | - Dimitrios Tsikas
- Core Unit Proteomics, Institute of Toxicology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; (B.B.); (D.T.)
| | - Cordula Koerner-Rettberg
- University Children’s Hospital, Ruhr-University Bochum, 44791 Bochum, Germany; (A.S.); (C.M.); (T.L.); (F.B.); (C.K.-R.)
- Department of Pediatrics, Marien-Hospital Wesel, Teaching Hospital of University of Münster, 46483 Wesel, Germany
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Goossens J, Jonckheere AC, Seys SF, Dilissen E, Decaesteker T, Goossens C, Peers K, Vanbelle V, Stappers J, Aertgeerts S, De Wilde B, Leus J, Verelst S, Raes M, Dupont L, Bullens DM. Activation of epithelial and inflammatory pathways in adolescent elite athletes exposed to intense exercise and air pollution. Thorax 2023; 78:775-783. [PMID: 36927754 PMCID: PMC10359548 DOI: 10.1136/thorax-2022-219651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/07/2023] [Indexed: 03/18/2023]
Abstract
RATIONALE Participation in high-intensity exercise in early life might act as stressor to the airway barrier. OBJECTIVES To investigate the effect of intense exercise and associated exposure to air pollution on the airway barrier in adolescent elite athletes compared with healthy controls and to study exercise-induced bronchoconstriction (EIB) in this population. METHODS Early-career elite athletes attending 'Flemish-Elite-Sports-Schools' (12-18 years) of 4 different sport disciplines (n=90) and control subjects (n=25) were recruited. Presence of EIB was tested by the eucapnic voluntary hyperventilation (EVH) test. Markers at mRNA and protein level; RNA-sequencing; carbon load in airway macrophages were studied on induced sputum samples. RESULTS 444 genes were differentially expressed in sputum from athletes compared with controls, which were related to inflammation and epithelial cell damage and sputum samples of athletes contained significantly more carbon loaded airway macrophages compared with controls (24%, 95% CI 20% to 36%, p<0.0004). Athletes had significantly higher substance P (13.3 pg/mL, 95% CI 2.0 to 19.2) and calprotectin (1237 ng/mL, 95% CI 531 to 2490) levels as well as IL-6, IL-8 and TNF-α mRNA levels compared with controls (p<0.05). The incidence of EIB in athletes was 9%. The maximal fall in forced expiratory volume in 1 s (%) after EVH test in athletes was significantly associated with prior PM10 and PM2.5 exposure. CONCLUSION Early-career elite athletes showed increased markers of air pollution exposure, epithelial damage and airway inflammation compared with controls. Acute exposure to increased air pollution PM10 levels was linked to increased airway hyper-reactivity. TRIAL REGISTRATION NUMBER NCT03587675.
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Affiliation(s)
- Janne Goossens
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Anne-Charlotte Jonckheere
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Sven F Seys
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Ellen Dilissen
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Tatjana Decaesteker
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Camille Goossens
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Koen Peers
- Sport Medical Advice Centre, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Sven Aertgeerts
- Academic Centre for General Practitioners, Catholic University, Leuven, Belgium
| | | | - Jasmine Leus
- Pediatric Allergy, AZ Maria Middelares, Sint-Niklaas, Belgium
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
| | - Sophie Verelst
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
- Pediatrics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - Marc Raes
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
- Pediatrics, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium
| | - Lieven Dupont
- Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven, Belgium
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Dominique M Bullens
- Allergy and Clinical Immunology Research Group, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
- Clinical Division of Paediatrics, Katholieke Universiteit, Leuven, Flanders, Belgium
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Perez MF, Yurieva M, Poddutoori S, Mortensen EM, Crotty Alexander LE, Williams A. Transcriptomic responses in the blood and sputum of cigarette smokers compared to e-cigarette vapers. Respir Res 2023; 24:134. [PMID: 37208747 PMCID: PMC10196320 DOI: 10.1186/s12931-023-02438-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
RATIONALE Electronic (e)-cigarettes are popular among youth and cigarette smokers attempting to quit. Studies to date have focused on the utility of e-cigarettes as a smoking cessation tool, but the biological effects are largely unknown. OBJECTIVES To identify transcriptomic differences in the blood and sputum of e-cigarette users compared to conventional cigarettes smokers and healthy controls and describe biological pathways affected by these tobacco products. METHODS Cross-sectional analysis of whole blood and sputum RNA-sequencing data from 8 smokers, 9 e-cigarette users (e-cigs) and 4 controls. Weighted gene co-network analysis (WGCNA) identified gene module associations. Ingenuity Pathway Analysis (IPA) identified canonical pathways associated with tobacco products. MAIN RESULTS In blood, a three-group comparison showed 16 differentially expressed genes (DEGs); pair-wise comparison showed 7 DEGs between e-cigs and controls, 35 DEGs between smokers and controls, and 13 DEGs between smokers and e-cigs. In sputum, 438 DEGs were in the three-group comparison. In pair-wise comparisons, there were 2 DEGs between e-cigs and controls, 270 DEGs between smokers and controls, and 468 DEGs between smokers and e-cigs. Only 2 genes in the smokers vs. control comparison overlapped between blood and sputum. Most gene modules identified through WGCNA associated with tobacco product exposures also were associated with cotinine and exhaled CO levels. IPA showed more canonical pathways altered by conventional cigarette smoking than by e-cigarette use. CONCLUSION Cigarette smoking and e-cigarette use led to transcriptomic changes in both blood and sputum. However, conventional cigarettes induced much stronger transcriptomic responses in both compartments.
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Affiliation(s)
- Mario F Perez
- Department of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Marina Yurieva
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | - Eric M Mortensen
- Department of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Laura E Crotty Alexander
- Division of Pulmonary Critical Care, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Adam Williams
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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10
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Houlder EL, Costain AH, Nambuya I, Brown SL, Koopman JPR, Langenberg MCC, Janse JJ, Hoogerwerf MA, Ridley AJL, Forde-Thomas JE, Colombo SAP, Winkel BMF, Galdon AA, Hoffmann KF, Cook PC, Roestenberg M, Mpairwe H, MacDonald AS. Pulmonary inflammation promoted by type-2 dendritic cells is a feature of human and murine schistosomiasis. Nat Commun 2023; 14:1863. [PMID: 37012228 PMCID: PMC10070318 DOI: 10.1038/s41467-023-37502-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/17/2023] [Indexed: 04/05/2023] Open
Abstract
Schistosomiasis is a parasitic disease affecting over 200 million people in multiple organs, including the lungs. Despite this, there is little understanding of pulmonary immune responses during schistosomiasis. Here, we show type-2 dominated lung immune responses in both patent (egg producing) and pre-patent (larval lung migration) murine Schistosoma mansoni (S. mansoni) infection. Human pre-patent S. mansoni infection pulmonary (sputum) samples revealed a mixed type-1/type-2 inflammatory cytokine profile, whilst a case-control study showed no significant pulmonary cytokine changes in endemic patent infection. However, schistosomiasis induced expansion of pulmonary type-2 conventional dendritic cells (cDC2s) in human and murine hosts, at both infection stages. Further, cDC2s were required for type-2 pulmonary inflammation in murine pre-patent or patent infection. These data elevate our fundamental understanding of pulmonary immune responses during schistosomiasis, which may be important for future vaccine design, as well as for understanding links between schistosomiasis and other lung diseases.
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Affiliation(s)
- E L Houlder
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - A H Costain
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - I Nambuya
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - S L Brown
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - J P R Koopman
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - M C C Langenberg
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - J J Janse
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - M A Hoogerwerf
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - A J L Ridley
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - J E Forde-Thomas
- Department of Life Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - S A P Colombo
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - B M F Winkel
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - A A Galdon
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - K F Hoffmann
- Department of Life Sciences, Aberystwyth University, Aberystwyth, SY23 3DA, UK
| | - P C Cook
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - M Roestenberg
- Leiden University Center for Infectious Diseases (LU-CID), Leiden University Medical Centre, Leiden, Netherlands
| | - H Mpairwe
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - A S MacDonald
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK.
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11
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Hickman E, Smyth T, Cobos-Uribe C, Immormino R, Rebuli ME, Moran T, Alexis NE, Jaspers I. Expanded characterization of in vitro polarized M0, M1, and M2 human monocyte-derived macrophages: Bioenergetic and secreted mediator profiles. PLoS One 2023; 18:e0279037. [PMID: 36862675 PMCID: PMC9980743 DOI: 10.1371/journal.pone.0279037] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/28/2022] [Indexed: 03/03/2023] Open
Abstract
Respiratory macrophage subpopulations exhibit unique phenotypes depending on their location within the respiratory tract, posing a challenge to in vitro macrophage model systems. Soluble mediator secretion, surface marker expression, gene signatures, and phagocytosis are among the characteristics that are typically independently measured to phenotype these cells. Bioenergetics is emerging as a key central regulator of macrophage function and phenotype but is often not included in the characterization of human monocyte-derived macrophage (hMDM) models. The objective of this study was to expand the phenotype characterization of naïve hMDMs, and their M1 and M2 subsets by measuring cellular bioenergetic outcomes and including an expanded cytokine profile. Known markers of M0, M1 and M2 phenotypes were also measured and integrated into the phenotype characterization. Peripheral blood monocytes from healthy volunteers were differentiated into hMDM and polarized with either IFN-γ + LPS (M1) or IL-4 (M2). As expected, our M0, M1, and M2 hMDMs exhibited cell surface marker, phagocytosis, and gene expression profiles indicative of their different phenotypes. M2 hMDMs however were uniquely characterized and different from M1 hMDMs by being preferentially dependent on oxidativte phosphorylation for their ATP generation and by secreting a distinct cluster of soluble mediators (MCP4, MDC, and TARC). In contrast, M1 hMDMs secreted prototypic pro-inflammatory cytokines (MCP1, eotaxin, eotaxin-3, IL12p70, IL-1α, IL15, TNF-β, IL-6, TNF-α, IL12p40, IL-13, and IL-2), but demonstrated a relatively constitutively heightened bioenergetic state, and relied on glycolysis for ATP generation. These data are similar to the bioenergetic profiles we previously observed in vivo in sputum (M1) and BAL (M2)-derived macrophages in healthy volunteers, supporting the notion that polarized hMDMs can provide an acceptable in vitro model to study specific human respiratory macrophage subtypes.
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Affiliation(s)
- Elise Hickman
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Timothy Smyth
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Catalina Cobos-Uribe
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Robert Immormino
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Meghan E. Rebuli
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Timothy Moran
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Neil E. Alexis
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Ilona Jaspers
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Curriculum in Toxicology & Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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12
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Cottin S, Doyen V, Pilette C. Upper airway disease diagnosis as a predictive biomarker of therapeutic response to biologics in severe asthma. Front Med (Lausanne) 2023; 10:1129300. [PMID: 37035303 PMCID: PMC10073432 DOI: 10.3389/fmed.2023.1129300] [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: 12/21/2022] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Asthma is a heterogeneous disease sharing airway instability but with different biology, risk factors, and response-to-therapy patterns. Biologics have revolutionized the one-size-fits-to-all approach to personalized medicine in severe asthma (SA), which relies on the identification of biomarkers that define distinct endotypes. Thus, blood eosinophils and, to some extent, exhaled nitric oxide (FeNO) can predict the response to approved anti-type 2 (T2) biologics (anti-IgE, anti-IL-5, and anti-IL-4R alpha), whereas age at onset and comorbidities such as anxiety/depression, obesity, reflux, and upper airway disease (UAD) also influence therapeutic responses in SA. In this article, focusing on the predictive value of biomarkers for the therapeutic response to biologics in SA, we first summarize the level of prediction achieved by T2 biomarkers (blood eosinophils, FeNO) and then review whether data support the predictive value of upper airway diagnosis on such outcomes. Post hoc analysis of most studies with T2 biologics suggests that chronic rhinosinusitis with nasal polyps (CRSwNP) and, to a lower extent, allergic rhinitis may help in predicting clinical response. Considering that T2 biologics are now also approved for the treatment of severe CRSwNP, diagnosis of upper airway disease is a key step in determining eligibility for such therapy.
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Affiliation(s)
- Sophie Cottin
- Department of Pulmonary Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Virginie Doyen
- Department of Pulmonary Medicine, Centre Hospitalier Universitaire UCL Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Charles Pilette
- Department of Pulmonary Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Pole of Pulmonology, ENT and Dermatology, Institute of Experimental and Cliniqal Research, Université catholique de Louvain, Brussels, Belgium
- *Correspondence: Charles Pilette
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13
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Boldi MO, Denis-Lessard J, Neziri R, Brouillet R, von-Garnier C, Chavez V, Mazza-Stalder J, Jaton K, Greub G, Opota O. Performance of microbiological tests for tuberculosis diagnostic according to the type of respiratory specimen: A 10-year retrospective study. Front Cell Infect Microbiol 2023; 13:1131241. [PMID: 36936773 PMCID: PMC10017756 DOI: 10.3389/fcimb.2023.1131241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023] Open
Abstract
Background The microbial diagnosis of tuberculosis (TB) remains challenging and relies on multiple microbiological tests performed on different clinical specimens. Polymerase chain reactions (PCRs), introduced in the last decades has had a significant impact on the diagnosis of TB. However, questions remain about the use of PCRs in combination with conventional tests for TB, namely microscopy and culture. We aimed to determine the performance of microscopy, culture and PCR for the diagnosis of pulmonary tuberculosis according to the type of clinical specimen in order to improve the diagnostic yield and to avoid unnecessary, time and labor-intensive tests. Methods We conducted a retrospective study (2008-2018) on analysis (34'429 specimens, 14'358 patients) performed in our diagnostic laboratory located in the Lausanne University Hospital to compare the performance of microbiological tests on sputum, induced sputum, bronchial aspirate and bronchoalveolar lavage (BAL). We analysed the performance using a classical "per specimen" approach and a "per patient" approach for paired specimens collected from the same patient. Results The overall sensitivities of microscopy, PCR and culture were 0.523 (0.489, 0.557), 0.798 (0.755, 0.836) and 0.988 (0.978, 0.994) and the specificity were 0.994 (0.993, 0.995), 1 (0.999, 1) and 1 (1, 1). Microscopy displayed no significant differences in sensitivity according to the type of sample. The sensitivities of PCR for sputum, induced sputum, bronchial aspirate and BAL were, 0.821 (0.762, 0.871), 0.643 (0.480, 0.784), 0.837 (0.748, 0.904) and 0.759 (0.624, 0.865) respectively and the sensitivity of culture were, 0.993 (0.981, 0.998), 0.980 (0.931, 0.998), 0.965 (0.919, 0.988), and 1 (0.961, 1) respectively. Pairwise comparison of specimens collected from the same patient reported a significantly higher sensitivity of PCR on bronchial aspirate over BAL (p < 0.001) and sputum (p < 0.05) and a significantly higher sensitivity of culture on bronchial aspirate over BAL (p < 0.0001). Conclusions PCR displayed a higher sensitivity and specificity than microscopy for all respiratory specimens, a rational for a smear-independent PCR-based approach to initiate tuberculosis microbial diagnostic. The diagnosis yield of bronchial aspirate was higher than BAL. Therefore, PCR should be systematically performed also on bronchial aspirates when available.
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Affiliation(s)
- Marc-Olivier Boldi
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Justin Denis-Lessard
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Rina Neziri
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - René Brouillet
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
| | - Christophe von-Garnier
- Division of Pulmonology, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Valérie Chavez
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Jesica Mazza-Stalder
- Division of Pulmonology, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Katia Jaton
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
- Infectious Diseases Service, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
| | - Onya Opota
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
- *Correspondence: Onya Opota,
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14
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Chen M, Xu K, He Y, Jin J, Mao R, Gao L, Zhang Y, Wang G, Gao P, Xie M, Liu C, Chen Z. CC16 as an Inflammatory Biomarker in Induced Sputum Reflects Chronic Obstructive Pulmonary Disease (COPD) Severity. Int J Chron Obstruct Pulmon Dis 2023; 18:705-717. [PMID: 37139166 PMCID: PMC10150740 DOI: 10.2147/copd.s400999] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/06/2023] [Indexed: 05/05/2023] Open
Abstract
Purpose The progression of an abnormal inflammatory response plays a crucial role in the lung function decline of chronic obstructive pulmonary disease (COPD) patients. Compared to serum biomarkers, inflammatory biomarkers in induced sputum would be a more reliable reflection of inflammatory processes in the airways. Patients and Methods A total of 102 COPD participants were divided into a mild-to-moderate group (FEV1%pred≥ 50%, n=57) and a severe-to-very-severe group (FEV1%pred<50%, n=45). We measured a series of inflammatory biomarkers in induced sputum and analyzed their association with lung function and SGRQ in COPD patients. To evaluate the relationship between inflammatory biomarkers and the inflammatory phenotype, we also analyzed the correlation between biomarkers and airway eosinophilic phenotype. Results We found increased mRNA levels of MMP9, LTB4R, and A1AR and decreased levels of CC16 mRNA in induced sputum in the severe-to-very-severe group. After adjustment for age, sex and other biomarkers, CC16 mRNA expression was positively associated with FEV1%pred (r=0.516, p=0.004) and negatively correlated with SGRQ scores (r=-0.3538, p=0.043). As previously known, decreased CC16 was related to the migration and aggregation of eosinophils in airway. It was also found that CC16 had a moderate negative correlation with the eosinophilic inflammation in airway (r=-0.363, p=0.045) in our COPD patients. Conclusion Low CC16 mRNA expression levels in induced sputum were associated with low FEV1%pred and a high SGRQ score in COPD patients. Sputum CC16 as a potential biomarker for predicting COPD severity in clinical practice might attribute to the involvement of CC16 in airway eosinophilic inflammation.
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Affiliation(s)
- Mengjie Chen
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Kan Xu
- Geriatric Department of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Yuting He
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Jianjun Jin
- Research Center of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Ruolin Mao
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Lei Gao
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
| | - Yi Zhang
- Air Liquide Holding Co., Ltd, Shanghai, People’s Republic of China
| | - Gang Wang
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Peng Gao
- Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, People’s Republic of China
| | - Min Xie
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical 10 College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Chunfang Liu
- Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China
- Chunfang Liu, Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wlmq Road, Shanghai, People’s Republic of China, Email
| | - Zhihong Chen
- Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China
- Correspondence: Zhihong Chen, Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, No. 180 Fenglin Road, Shanghai, People’s Republic of China, Tel +86-21-64041990-2445, Fax +86-21-64187165, Email
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15
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Using induced sputum method in clinical practice in patients with bronchial asthma. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.5-2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This article presents an overview of modern statements of the induced sputum method; detailed description of the methods and protocols for taking sputum in adults and children, methods for processing the obtained substance. The paper describes in detail the features of the cellular composition of induced sputum in healthy individuals and in patients with bronchial asthma, emphasizes the importance of the eosinophilia level as a prognostic and diagnostic criterion of asthma and also determines the functions of other induced sputum cells such as neutrophils, macrophages, basophils. The article is illustrated with photographs of sputum microscopy. In addition to sputum cytology, we give accent to the possibility of using other research methods such as an identification of viral and bacterial pathogens, genomics, proteomics, lipidomics, metabolomics, determination of the concentration of various mediators in the sputum supernatant. The paper presents the ideas on biochemical inflammatory markers and remodelling of the respiratory tract in asthma, which can be determined in sputum (C3a anaphylatoxin, clusterin, periostin, eosinophil-derived neurotoxin, folliculin). In addition, we summarize the information on inflammatory phenotypes of bronchial asthma, emphasize their variability and modification depending on the period of the disease, prescribed treatment, intercurrent respiratory infections, and smoking. The article also presents detailed characteristics of eosinophilic, neutrophilic, mixed and small granulocyte phenotypes of bronchial asthma, and describes the most frequent correlations of phenotypes with the severity and course of the disease, with lung function parameters and other indicators. The paper gives an account of the possibilities of using the induced sputum method for a comprehensive assessment of the course, asthma controllability and the effectiveness of drug therapy, as well as for a personalized selection of an antiinflammatory drug considering the inflammatory phenotype.
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16
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Ghimire JJ, Jat KR, Sankar J, Lodha R, Iyer VK, Gautam H, Sood S, Kabra SK. Azithromycin for Poorly Controlled Asthma in Children: A Randomized Controlled Trial. Chest 2022; 161:1456-1464. [PMID: 35202621 DOI: 10.1016/j.chest.2022.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Azithromycin has immunomodulatory actions, and its beneficial effects have been demonstrated in asthmatic adults. Data on children are limited. RESEARCH QUESTION Does the addition of oral azithromycin to standard therapy in children with poorly controlled asthma improve asthma control compared with standard treatment alone? STUDY DESIGN AND METHODS This open-label randomized controlled trial included children (5-15 years of age) with poorly controlled asthma defined by Asthma Control Test (ACT) and Childhood Asthma Control Test (CACT) score of ≤ 19. They were randomized to receive azithromycin (10 mg/kg) three times weekly for 3 months along with standard treatment or standard treatment alone. The primary outcome was the ACT and CACT scores at 3 months. Secondary outcomes were asthma control according to Global Initiative for Asthma (GINA) guidelines, the number of exacerbations, change in spirometry parameters, change in fractional exhaled nitric oxide (Feno) level, positive throat swab results, and side effects. RESULTS The trial included 120 children (89 boys; 60 in each group). The mean ± SD age was 9.9 ± 3 years. The baseline parameters were similar between the groups. Mean ± SD ACT and CACT scores (available for 115 children) at 3 months of intervention were 21.71 ± 2.17 vs 18.33 ± 2.19 (P < .001) in the azithromycin and control groups, respectively. The numbers of children with well-controlled asthma according to GINA guidelines were 41 of 56 vs 10 of 56 in the azithromycin and control groups, respectively (P < .001). The median number of exacerbations requiring emergency visit and steroid use were fewer in the azithromycin group: 0 (interquartile range [IQR], 3) vs 1 [IQR, 6]; P < .001). No difference was found in Feno level, spirometry parameters, positive throat swab results, and adverse effects between the groups. INTERPRETATION The use of azithromycin in children with poorly controlled asthma resulted in improved asthma control and reduced exacerbations. TRIAL REGISTRY Clinical Trials Registry - India; No.: CTRI/2019/06/019727; URL: www.ctri.nic.in.
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Affiliation(s)
- Jagat Jeevan Ghimire
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, New Delhi, India
| | - Kana Ram Jat
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, New Delhi, India.
| | - Jhuma Sankar
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, New Delhi, India
| | - Rakesh Lodha
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, New Delhi, India
| | - Venkat K Iyer
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Hitender Gautam
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sood
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - S K Kabra
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, New Delhi, India
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17
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Waagsbø B, Buset EM, Longva JÅ, Bjerke M, Bakkene B, Ertesvåg AS, Holmen H, Nikodojevic M, Tran TT, Christensen A, Nilsen E, Damås JK, Heggelund L. Diagnostic stewardship aiming at expectorated or induced sputum promotes microbial diagnosis in community-acquired pneumonia. BMC Infect Dis 2022; 22:203. [PMID: 35236305 PMCID: PMC8889388 DOI: 10.1186/s12879-022-07199-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/16/2022] [Indexed: 12/16/2022] Open
Abstract
Purpose Studies on aetiology of community-acquired pneumonia (CAP) vary in terms of microbial sampling methods, anatomical locations, and laboratory analyses, since no gold standard exists. In this large, multicentre, retrospective, regional study from Norway, our primary objective was to report the results of a strategic diagnostic stewardship intervention, targeting diagnostic yield from lower respiratory tract sampling. The secondary objective was to report hospitalized CAP aetiology and the diagnostic yield of various anatomical sampling locations.
Methods Medical records from cases diagnosed with hospitalized CAP were collected retrospectively from March throughout May for three consecutive years at six hospitals. Between year one and two, we launched a diagnostic stewardship intervention at the emergency room level for the university teaching hospital only. The intervention was multifaceted aiming at upscaling specimen collection and enhancing collection techniques. Year one at the interventional hospital and every year at the five other emergency hospitals were used for comparison.
Results Of the 1280 included cases of hospitalized CAP, a microbiological diagnosis was established for 29.1% among 1128 blood cultures and 1444 respiratory tract specimens. Blood cultures were positive for a pathogenic respiratory tract microbe in 4.9% of samples, whereas upper and lower respiratory tract samples overall provided a probable microbiological diagnosis in 21.3% and 47.5%, respectively. Expectorated or induced sputum overall provided aetiology in 51.7% of the samples. At the interventional hospital, the number of expectorated or induced sputum samples were significantly increased, and diagnostic yield from expectorated or induced sputum was significantly enhanced from 41.2 to 62.0% after the intervention (p = 0.049). There was an over-representation of samples from the interventional hospital during the study period. Non-typeable Haemophilus influenza and Streptococcus pneumoniae accounted for 25.3% and 24.7% of microbiologically confirmed cases, respectively. Conclusion Expectorated or induced sputum outperformed other sampling methods in providing a reliable microbiological diagnosis for hospitalized CAP. A diagnostic stewardship intervention significantly improved diagnostic yield of lower respiratory tract sampling.
Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07199-4.
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Affiliation(s)
- Bjørn Waagsbø
- Regional Centre for Disease Control in Central Norway Regional Health Authority, St. Olavs Hospital Trondheim University Hospital, Trondheim, Norway.
| | | | - Jørn-Åge Longva
- Department of Medicine, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Merete Bjerke
- Central Norway Hospital Pharmacy Trust, Ålesund, Norway
| | | | | | - Hanne Holmen
- Central Norway Hospital Pharmacy Trust, Trondheim, Norway
| | | | - To Thy Tran
- Central Norway Hospital Pharmacy Trust, Trondheim, Norway
| | - Andreas Christensen
- Department of Microbiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Einar Nilsen
- Department of Microbiology, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Jan Kristian Damås
- Department of Infectious Diseases, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Centre of Molecular Inflammation Research, NTNU, Trondheim, Norway
| | - Lars Heggelund
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
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18
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Methods of Sputum and Mucus Assessment for Muco-Obstructive Lung Diseases in 2022: Time to “Unplug” from Our Daily Routine! Cells 2022; 11:cells11050812. [PMID: 35269434 PMCID: PMC8909676 DOI: 10.3390/cells11050812] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 01/27/2023] Open
Abstract
Obstructive lung diseases, such as chronic obstructive pulmonary disease, asthma, or non-cystic fibrosis bronchiectasis, share some major pathophysiological features: small airway involvement, dysregulation of adaptive and innate pulmonary immune homeostasis, mucus hyperproduction, and/or hyperconcentration. Mucus regulation is particularly valuable from a therapeutic perspective given it contributes to airflow obstruction, symptom intensity, disease severity, and to some extent, disease prognosis in these diseases. It is therefore crucial to understand the mucus constitution of our patients, its behavior in a stable state and during exacerbation, and its regulatory mechanisms. These are all elements representing potential therapeutic targets, especially in the era of biologics. Here, we first briefly discuss the composition and characteristics of sputum. We focus on mucus and mucins, and then elaborate on the different sample collection procedures and how their quality is ensured. We then give an overview of the different direct analytical techniques available in both clinical routine and more experimental settings, giving their advantages and limitations. We also report on indirect mucus assessment procedures (questionnaires, high-resolution computed tomography scanning of the chest, lung function tests). Finally, we consider ways of integrating these techniques with current and future therapeutic options. Cystic fibrosis will not be discussed given its monogenic nature.
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19
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Obling N, Backer V, Hurst JR, Bodtger U. Nasal and systemic inflammation in Chronic Obstructive Pulmonary Disease (COPD). Respir Med 2022; 195:106774. [DOI: 10.1016/j.rmed.2022.106774] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/06/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
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20
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Yin G, Wu X, Wu Y, Li H, Gao L, Zhu X, Jiang Y, Wang W, Shen Y, He Y, Chen C, Niu Y, Zhang Y, Mao R, Zeng Y, Kan H, Chen Z, Chen R. Evaluating carbon content in airway macrophages as a biomarker of personal exposure to fine particulate matter and its acute respiratory effects. CHEMOSPHERE 2021; 283:131179. [PMID: 34146873 DOI: 10.1016/j.chemosphere.2021.131179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/04/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
It remains unclear whether carbon content in airway macrophages (AM) can predict personal short-term exposure to fine particulate matter (PM2.5) air pollution and its respiratory health effects. We aimed to evaluate the pathway from personal PM2.5 exposure to adverse respiratory outcomes through AM carbon content. We designed a longitudinal panel study with 3 scheduled follow-ups among 113 non-smoking patients of chronic obstructive pulmonary disease in Shanghai, China, from April 2017 to January 2019. We quantified AM carbon content from induced sputum by image analysis, tested lung function and measured sputum levels of 4 pro-inflammatory cytokines and 2 anti-inflammatory cytokines. We applied the "meet in the middle" approach incorporating linear mixed-effect models to evaluate the associations from external PM2.5 exposure to respiratory outcomes through AM carbon content. Our results indicated that personal exposure to PM2.5 within 24 h was significantly associated with decreased forced expiratory volume in 1s and anti-inflammatory cytokines, as well as increased macrophages and pro-inflammatory cytokines. These changes were accompanied by increased areas of AM carbon and higher percentage of AM area occupied by carbon, both of which were associated with increased levels of pro-inflammatory cytokines and decreased levels of anti-inflammatory cytokines. Exposure to ambient black carbon and organic carbon in PM2.5 within 2 days was significantly associated with increased AM carbon area and percentage of AM area occupied by carbon. Our findings reinforced the causality in respiratory health effects of PM2.5 in which increased AM carbon content might serve as a valid exposure biomarker.
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Affiliation(s)
- Guanjin Yin
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Xiaodan Wu
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Yihan Wu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Hongjin Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Lei Gao
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yanling Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yu He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Chen Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yi Zhang
- Air Liquide (China) Holding Co., Ltd., Shanghai, 200233, China
| | - Ruolin Mao
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Yuzhen Zeng
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Zhihong Chen
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
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21
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Lucchetti D, Santini G, Perelli L, Ricciardi-Tenore C, Colella F, Mores N, Macis G, Bush A, Sgambato A, Montuschi P. Detection and characterisation of extracellular vesicles in exhaled breath condensate and sputum of COPD and severe asthma patients. Eur Respir J 2021; 58:13993003.03024-2020. [PMID: 33795323 DOI: 10.1183/13993003.03024-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 03/22/2021] [Indexed: 12/31/2022]
Affiliation(s)
- Donatella Lucchetti
- Dept of Translational Medicine and Surgery, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy.,These authors contributed equally to this study
| | - Giuseppe Santini
- Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy.,These authors contributed equally to this study
| | - Luigi Perelli
- Dept of Translational Medicine and Surgery, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy.,These authors contributed equally to this study
| | - Claudio Ricciardi-Tenore
- Dept of Translational Medicine and Surgery, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Filomena Colella
- Dept of Translational Medicine and Surgery, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Nadia Mores
- Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Giuseppe Macis
- Imaging Diagnostics, University Hospital Agostino Gemelli Foundation IRCCS, Rome, Italy
| | - Andrew Bush
- Dept of Paediatrics, Imperial College London, London, UK
| | - Alessandro Sgambato
- Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), Rionero in Vulture, Italy.,These authors share senior authorship of this article
| | - Paolo Montuschi
- Pharmacology, Faculty of Medicine, Catholic University of the Sacred Heart, Rome, Italy.,These authors share senior authorship of this article
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22
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Campisi M, Liviero F, Maestrelli P, Guarnieri G, Pavanello S. DNA Methylation-Based Age Prediction and Telomere Length Reveal an Accelerated Aging in Induced Sputum Cells Compared to Blood Leukocytes: A Pilot Study in COPD Patients. Front Med (Lausanne) 2021; 8:690312. [PMID: 34368190 PMCID: PMC8342924 DOI: 10.3389/fmed.2021.690312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/08/2021] [Indexed: 11/13/2022] Open
Abstract
Aging is the predominant risk factor for most degenerative diseases, including chronic obstructive pulmonary disease (COPD). This process is however very heterogeneous. Defining the biological aging of individual tissues may contribute to better assess this risky process. In this study, we examined the biological age of induced sputum (IS) cells, and peripheral blood leukocytes in the same subject, and compared these to assess whether biological aging of blood leukocytes mirrors that of IS cells. Biological aging was assessed in 18 COPD patients (72.4 ± 7.7 years; 50% males). We explored mitotic and non-mitotic aging pathways, using telomere length (TL) and DNA methylation-based age prediction (DNAmAge) and age acceleration (AgeAcc) (i.e., difference between DNAmAge and chronological age). Data on demographics, life style and occupational exposure, lung function, and clinical and blood parameters were collected. DNAmAge (67.4 ± 5.80 vs. 61.6 ± 5.40 years; p = 0.0003), AgeAcc (-4.5 ± 5.02 vs. -10.8 ± 3.50 years; p = 0.0003), and TL attrition (1.05 ± 0.35 vs. 1.48 ± 0.21 T/S; p = 0.0341) are higher in IS cells than in blood leukocytes in the same patients. Blood leukocytes DNAmAge (r = 0.927245; p = 0.0026) and AgeAcc (r = 0.916445; p = 0.0037), but not TL, highly correlate with that of IS cells. Multiple regression analysis shows that both blood leukocytes DNAmAge and AgeAcc decrease (i.e., younger) in patients with FEV1% enhancement (p = 0.0254 and p = 0.0296) and combined inhaled corticosteroid (ICS) therapy (p = 0.0494 and p = 0.0553). In conclusion, new findings from our work reveal a differential aging in the context of COPD, by a direct quantitative comparison of cell aging in the airway with that in the more accessible peripheral blood leukocytes, providing additional knowledge which could offer a potential translation into the disease management.
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Affiliation(s)
- Manuela Campisi
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Filippo Liviero
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Piero Maestrelli
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Gabriella Guarnieri
- Respiratory Pathophysiology Unit, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Sofia Pavanello
- Occupational Medicine, Department of Cardiac, Thoracic, and Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
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23
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Obling N, Backer V, Hurst JR, Bodtger U. Upper airway symptoms associate with the eosinophilic phenotype of COPD. ERJ Open Res 2021; 7:00184-2021. [PMID: 34350281 PMCID: PMC8326684 DOI: 10.1183/23120541.00184-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/08/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND There is growing evidence that upper airway symptoms coexist with lower airway symptoms in COPD. Still, the prevalence and impact of upper airway disease on the nature and course of COPD remain unclear. We aimed to describe this in a cross-sectional study. METHODS We examined a cohort of COPD patients with pulmonary function tests, induced sputum, blood eosinophils, atopy tests and computed tomography (CT) of the paranasal sinuses. Lower airway symptoms were assessed using the COPD Assessment Test (CAT), and upper airway symptoms were assessed using the nasal subdomain of the 22-item Sino Nasal Outcome Test (SNOT22nasal). We recruited patients from five sites in Denmark and Sweden. We excluded patients with a history of asthma. FINDINGS In total, 180 patients (female 55%, age 67±8 years, forced expiratory volume in 1 s (FEV1 %) 52.4±16.6, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage: A: 18%, B: 54%, C: 3%, D: 25%) were included in the study. Seventy-four patients (41%) reported high upper airway symptoms (UAS, defined as SNOT22nasal≥6) with a median score of 10 (IQR 8-13). Patients with high UAS reported higher CAT scores (17.4±7.5 versus 14.9±6.6, p<0.05) and displayed higher fractions of eosinophils in blood (median 3.0% (IQR 1.6-4.2%) versus 2.3% (IQR 1.4-3.1%), p<0.05) and in induced sputum (median 1.8% (IQR 0.3-7.1%) versus median 0.5% (IQR 0-1.7%), p<0.05). No differences in atopy, CT findings or exacerbation rates were observed. CONCLUSION COPD patients with upper airway disease showed increased evidence of eosinophilic disease and increased lower airway symptom burden.
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Affiliation(s)
- Nicolai Obling
- Dept of Respiratory Medicine, Zealand University Hospital, Næstved, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Vibeke Backer
- Center for Physical Activity Research, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
- Dept of ENT, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - John R. Hurst
- UCL Respiratory, University College London, London, UK
| | - Uffe Bodtger
- Dept of Respiratory Medicine, Zealand University Hospital, Næstved, Denmark
- Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Zealand University Hospital, Roskilde, Denmark
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24
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Lung macrophages drive mucus production and steroid-resistant inflammation in chronic bronchitis. Respir Res 2021; 22:172. [PMID: 34098956 PMCID: PMC8186034 DOI: 10.1186/s12931-021-01762-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/27/2021] [Indexed: 11/10/2022] Open
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) frequently suffer from chronic bronchitis (CB) and display steroid-resistant inflammation with increased sputum neutrophils and macrophages. Recently, a causal link between mucus hyper-concentration and disease progression of CB has been suggested. Methods In this study, we have evaluated the steroid sensitivity of purified, patient-derived sputum and alveolar macrophages and used a novel mechanistic cross-talk assay to examine how macrophages and bronchial epithelial cells cross-talk to regulate MUC5B production. Results We demonstrate that sputum plug macrophages isolated from COPD patients with chronic bronchitis (COPD/CB) are chronically activated and only partially respond to ex vivo corticosteroid treatment compared to alveolar macrophages isolated from lung resections. Further, we show that pseudo-stratified bronchial epithelial cells grown in air–liquid-interface are inert to direct bacterial lipopolysaccharide stimulation and that macrophages are able to relay this signal and activate the CREB/AP-1 transcription factor complex and subsequent MUC5B expression in epithelial cells through a soluble mediator. Using recombinant protein and neutralizing antibodies, we identified a key role for TNFα in this cross-talk. Conclusions For the first time, we describe ex vivo pharmacology in purified human sputum macrophages isolated from chronic bronchitis COPD patients and identify a possible basis for the steroid resistance frequently seen in this population. Our data pinpoint a critical role for chronically activated sputum macrophages in perpetuating TNFα-dependent signals driving mucus hyper-production. Targeting the chronically activated mucus plug macrophage phenotype and interfering with aberrant macrophage-epithelial cross-talk may provide a novel strategy to resolve chronic inflammatory lung disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01762-4.
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25
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Cane J, Tregidgo L, Thulborn S, Finch D, Bafadhel M. Antimicrobial Peptides SLPI and Beta Defensin-1 in Sputum are Negatively Correlated with FEV 1. Int J Chron Obstruct Pulmon Dis 2021; 16:1437-1447. [PMID: 34093009 PMCID: PMC8170372 DOI: 10.2147/copd.s301622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) and asthma have heterogeneous inflammation with inhaled corticosteroids (ICS) as a mainstay of treatment. There is increased prevalence of non-typeable Haemophilus influenzae (NTHi) persistence in airways of patients with neutrophilic airway inflammation, potentially due to suppressed host defence after corticosteroid treatment. Antimicrobial peptides (AMPs) have antimicrobial activity against pathogens and immunomodulatory effects. We investigated whether AMPs associate with NTHi presence in COPD and asthma, and whether ICS alter this. Methods Secretory leukocyte protease inhibitor (SLPI), osteopontin, elafin and beta defensin-1 were measured in sputum supernatants from healthy donors (n=9), asthmatics (n=21) and patients with COPD (n=14). Elafin and beta defensin-1 were measured in a primary human bronchial epithelial cells (HBECs) from healthy and COPD donors infected with NTHi and pre-treated with fluticasone propionate (FP) and budesonide (BUD). Internalised NTHi was quantified by qPCR. Results Sputum SLPI was negatively correlated with FEV1 (p<0.001, r=-0.610), FEV1% predicted (p<0.001, r=-0.583) and FEV1/FVC (p=0.001, r=-0.528). Sputum beta defensin-1 was negatively associated with FEV1 (p<0.001***r=-0.594). SLPI and beta defensin-1 levels in sputum were higher in the healthy controls and COPD group compared to the asthma group (p=0.001 and p=0.014) and (p<0.001 and p=0.007, respectively). ICS use was associated with higher sputum osteopontin compared to those with no ICS use. NTHi infection of COPD HBECs produced higher levels of beta defensin-1 compared to healthy donors (mean (SD) release: 45.1pg/mL (7.3) vs 21.2pg/mL (7.3) respectively, p=0.014). Elafin release from HBECs from COPD donors did not change following NTHi infection; however, elafin from healthy donors was significantly reduced (%mean reduction: 23.7%, 95% confidence intervals (CI) of reduction: 5.3-38.4%, p<0.01). Conclusion Sputum SLPI and beta defensin-1 may be markers to identify those patients with declining lung function. ICS use was associated with higher sputum osteopontin compared to those with no ICS use.
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Affiliation(s)
- Jennifer Cane
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Laura Tregidgo
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Samantha Thulborn
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | | | - Mona Bafadhel
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
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26
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Celejewska-Wójcik N, Kania A, Górka K, Nastałek P, Wójcik K, Gielicz A, Mastalerz L, Sanak M, Sładek K. Eicosanoids and Eosinophilic Inflammation of Airways in Stable COPD. Int J Chron Obstruct Pulmon Dis 2021; 16:1415-1424. [PMID: 34079245 PMCID: PMC8164670 DOI: 10.2147/copd.s298678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose Lipid mediators, particularly eicosanoids, are associated with airway inflammation, especially with the eosinophilic influx. This study aimed to measure lipid mediators and cells in induced sputum, that could possibly reflect the inflammatory process in the bronchial tree of COPD subjects. Patients and Methods Eighty patients diagnosed with COPD and 37 healthy controls participated in the study. Induced sputum samples were ascertained for differential cell count and induced sputum supernatant concentrations of selected eicosanoids by the means of gas chromatography/mass spectrometry and high-performance liquid chromatography/tandem mass spectrometry. Results Increased sputum eosinophilia was associated with higher concentrations of selected proinflammatory eicosanoids. In COPD subjects prostaglandin D2 and 11-dehydro-thromboxane B2 correlated negatively with airway obstruction measured by FEV1 and FEV1/FVC values. COPD subjects with disease exacerbations during past 12 months had significantly higher concentrations of prostaglandin D2, 12-oxo-eicosatetraenoic acid and 5-oxo-eicosatetraenoic acid. Conclusion Stable COPD is often associated with eosinophil influx in the lower airways and elevated concentrations of eicosanoids that is reflected by some disease characteristics.
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Affiliation(s)
- Natalia Celejewska-Wójcik
- Department of Pulmonology, 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksander Kania
- Department of Pulmonology, 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Karolina Górka
- Department of Pulmonology, 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Nastałek
- Department of Pulmonology, 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Wójcik
- 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Gielicz
- Department of Molecular Biology and Clinical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Lucyna Mastalerz
- Department of Pulmonology, 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Sanak
- Department of Molecular Biology and Clinical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Sładek
- Department of Pulmonology, 2nd Department of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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27
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Kyosei Y, Yamura S, Namba M, Yoshimura T, Watabe S, Ito E. Antigen tests for COVID-19. Biophys Physicobiol 2021; 18:28-39. [PMID: 33954080 PMCID: PMC8049777 DOI: 10.2142/biophysico.bppb-v18.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 12/20/2022] Open
Abstract
PCR diagnosis has been considered as the gold standard for coronavirus disease 2019 (COVID-19) and other many diseases. However, there are many problems in using PCR, such as non-specific (i.e., false-positive) and false-negative amplifications, the limits of a target sample volume, deactivation of the enzymes used, complicated techniques, difficulty in designing probe sequences, and the expense. We, thus, need an alternative to PCR, for example an ultrasensitive antigen test. In the present review, we summarize the following three topics. (1) The problems of PCR are outlined. (2) The antigen tests are surveyed in the literature that was published in 2020, and their pros and cons are discussed for commercially available antigen tests. (3) Our own antigen test on the basis of an ultrasensitive enzyme-linked immunosorbent assay (ELISA) is introduced. Finally, we discuss the possibility that our antigen test by an ultrasensitive ELISA technique will become the gold standard for diagnosis of COVID-19 and other diseases.
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Affiliation(s)
- Yuta Kyosei
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan
| | - Sou Yamura
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan
| | - Mayuri Namba
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan
| | - Teruki Yoshimura
- School of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Ishikari, Hokkaido 061-0293, Japan
| | - Satoshi Watabe
- Waseda Research Institute for Science and Engineering, Waseda University, Shinjuku, Tokyo 169-8555, Japan
| | - Etsuro Ito
- Department of Biology, Waseda University, Shinjuku, Tokyo 162-8480, Japan.,Waseda Research Institute for Science and Engineering, Waseda University, Shinjuku, Tokyo 169-8555, Japan.,Graduate Institute of Medicine, Kaohsiung Medical University, Sanmin, Kaohsiung 80756, Taiwan
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Fennelly M, Keane J, Dolan L, Plant BJ, O'Connor DJ, Sodeau JR, Prentice MB. Containment of procedure-associated aerosols by an extractor tent: effect on nebulized drug particle dispersal. J Hosp Infect 2021; 110:108-113. [PMID: 33484782 PMCID: PMC7817412 DOI: 10.1016/j.jhin.2021.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 02/07/2023]
Abstract
Background Several medical procedures involving the respiratory tract are considered as ‘aerosol-generating procedures’. Aerosols from these procedures may be inhaled by bystanders, and there are consequent concerns regarding the transmission of infection or, specific to nebulized therapy, secondary drug exposure. Aim To assess the efficacy of a proprietary high-efficiency-particulate-air-filtering extractor tent on reducing the aerosol dispersal of nebulized bronchodilator drugs. Methods The study was conducted in an unoccupied outpatient room at St. James's Hospital, Dublin, Ireland. A novel real-time, fluorescent particle counter, the Wideband Integrated Bioaerosol Sensor (WIBS), monitored room air continuously for 3 h. Baseline airborne particle count and count during nebulization of bronchodilator drug solutions were recorded. Findings Nebulization within the tent prevented any increase over background level. Nebulization directly into room air resulted in mean fluorescent particle counts of 4.75 x 105/m3 and 4.21 x 105/m3 for Ventolin and Ipramol, respectively, representing more than 400-fold increases over mean background level. More than 99.3% of drug particles were <2 μm in diameter and therefore small enough to enter the lower respiratory tract. Conclusion The extractor tent was completely effective for the prevention of airborne spread of drug particles of respirable size from nebulized therapy. This suggests that extractor tents of this type would be efficacious for the prevention of airborne infection from aerosol-generating procedures during the COVID-19 pandemic.
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Affiliation(s)
- M Fennelly
- Environmental Research Institute, University College Cork, Cork, Ireland; Department of Pathology, University College Cork, Cork, Ireland.
| | - J Keane
- Respiratory Assessment Unit, St. James's Hospital, Dublin, Ireland
| | - L Dolan
- Respiratory Assessment Unit, St. James's Hospital, Dublin, Ireland
| | - B J Plant
- Adult Cystic Fibrosis Centre, Cork University Hospital, Cork, Ireland
| | - D J O'Connor
- School of Chemical and Pharmaceutical Sciences, Technological University Dublin, Dublin, Ireland
| | - J R Sodeau
- Environmental Research Institute, University College Cork, Cork, Ireland
| | - M B Prentice
- Department of Pathology, University College Cork, Cork, Ireland; APC Microbiome Institute, University College Cork, Cork, Ireland.
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29
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Jayamohan H, Lambert CJ, Sant HJ, Jafek A, Patel D, Feng H, Beeman M, Mahmood T, Nze U, Gale BK. SARS-CoV-2 pandemic: a review of molecular diagnostic tools including sample collection and commercial response with associated advantages and limitations. Anal Bioanal Chem 2021; 413:49-71. [PMID: 33073312 PMCID: PMC7568947 DOI: 10.1007/s00216-020-02958-1] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/03/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
The unprecedented global pandemic known as SARS-CoV-2 has exercised to its limits nearly all aspects of modern viral diagnostics. In doing so, it has illuminated both the advantages and limitations of current technologies. Tremendous effort has been put forth to expand our capacity to diagnose this deadly virus. In this work, we put forth key observations in the functionality of current methods for SARS-CoV-2 diagnostic testing. These methods include nucleic acid amplification-, CRISPR-, sequencing-, antigen-, and antibody-based detection methods. Additionally, we include analysis of equally critical aspects of COVID-19 diagnostics, including sample collection and preparation, testing models, and commercial response. We emphasize the integrated nature of assays, wherein issues in sample collection and preparation could impact the overall performance in a clinical setting.
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Affiliation(s)
- Harikrishnan Jayamohan
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Christopher J Lambert
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Himanshu J Sant
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Alexander Jafek
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Dhruv Patel
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Haidong Feng
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Michael Beeman
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Tawsif Mahmood
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Ugochukwu Nze
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
| | - Bruce K Gale
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, 84112, USA
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30
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Messous S, Elargoubi A, Pillet S, Rajoharison A, Hoffmann J, Trabelsi I, Grissa MH, Boukef R, Beltaief K, Mastouri M, Paranhos-Baccalà G, Nouira S, Pozzetto B. Bacterial and Viral Infection in Patients Hospitalized for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Implication for Antimicrobial Management and Clinical Outcome. COPD 2020; 18:53-61. [PMID: 33353408 DOI: 10.1080/15412555.2020.1854210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) exhibit frequent acute exacerbations (AE). The objectives of this study were first to evaluate the prevalence of pathogens associated to these episodes by combining conventional bacteriology and multiplex viral and bacterial PCR assays in sputum specimens, and second to determine whether C-reactive protein (CRP) value and clinical outcome could be influenced by the type of microbial agent(s) recovered from these samples. A cohort of 84 Tunisian patients hospitalized at the emergency room for AECOPD was investigated prospectively for the semi-quantitative detection of bacteria by conventional culture (the threshold of positivity was of 107 CFU/ml) and for the detection of viral genome and DNA of atypical bacteria by quantitative PCR using two commercial multiplex respiratory kits (Seegene and Fast-track). The two kits exhibited very similar performances although the Seegene assay was a bit more sensitive. A large number and variety of pathogens were recovered from the sputum samples of these 84 patients, including 15 conventional bacteria, one Chlamydia pneumoniae and 63 respiratory viruses, the most prevalent being rhinoviruses (n = 33) and influenza viruses (n = 13). From complete results available for 74 patients, the presence of bacteria was significantly associated with risk of recurrence at 6 and 12 months post-infection. The combination of these different markers appears useful for delineating correctly the antimicrobial treatment and for initiating a long-term surveillance in those patients with high risk of recurrent exacerbation episodes. A prospective study is required for confirming the benefits of this strategy aimed at improving the stewardship of antibiotics.
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Affiliation(s)
- Salma Messous
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Aida Elargoubi
- Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Sylvie Pillet
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, and GIMAP group (EA 3064), Faculty of Medicine de Saint-Etienne, University of Lyon, Lyon, France
| | - Alain Rajoharison
- Laboratory of Emerging Pathogens, Mérieux Foundation, CIRI, Inserm U1111, Lyon, France
| | - Jonathan Hoffmann
- Laboratory of Emerging Pathogens, Mérieux Foundation, CIRI, Inserm U1111, Lyon, France
| | - Imen Trabelsi
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia
| | - Mohamed Habib Grissa
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Riadh Boukef
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Sahloul University Hospital, Sousse, Tunisia
| | - Kaouther Beltaief
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Maha Mastouri
- Microbiology Laboratory, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | | | - Semir Nouira
- Research Laboratory (LR12SP18), University of Monastir, Monastir, Tunisia.,Department of Emergency, Fattouma Bourguiba University Hospital of Monastir, Monastir, Tunisia
| | - Bruno Pozzetto
- Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, and GIMAP group (EA 3064), Faculty of Medicine de Saint-Etienne, University of Lyon, Lyon, France
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31
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Mycroft K, Krenke R, Górska K. Eosinophils in COPD-Current Concepts and Clinical Implications. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2020; 8:2565-2574. [PMID: 32251737 DOI: 10.1016/j.jaip.2020.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/03/2020] [Accepted: 03/08/2020] [Indexed: 01/20/2023]
Abstract
In recent years, heterogeneity in chronic obstructive pulmonary disease (COPD) inflammatory patterns has been recognized as a basis for more precise treatment interventions because current therapies have limited effectiveness. Eosinophilic airway inflammation in COPD has become a subject of research interest as a potential treatment target for inhaled corticosteroid therapy. However, the role of eosinophils in COPD is still unclear, and it is unknown why only some patients with COPD develop eosinophilic airway inflammation. Induced sputum analysis is the most common method of assessing the type of airway inflammation. Accessibility to sputum induction, however, is limited in clinical practice, and blood eosinophils have been proposed to serve as a surrogate marker and treatment guide. Blood eosinophil count has been shown to poorly predict sputum eosinophilia, and, moreover, it seems to be fairly unstable and affected by various factors. Nevertheless, in several trials, blood eosinophil count appeared to predict good response to inhaled corticosteroids However, biologics targeting eosinophils do not appear to be effective in COPD. In this review, we briefly summarize the current knowledge on eosinophils in COPD pathogenesis. Then, we discuss the use of blood eosinophil count in COPD in relation to the recent Global Initiative for Chronic Obstructive Pulmonary Disease recommendations, their ability to predict sputum eosinophilia, and their potential role in guiding treatment.
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Affiliation(s)
- Katarzyna Mycroft
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Rafal Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
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32
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Prevalence of HIV infection and bacteriologically confirmed tuberculosis among individuals found at bars in Kampala slums, Uganda. Sci Rep 2020; 10:13438. [PMID: 32778729 PMCID: PMC7417543 DOI: 10.1038/s41598-020-70472-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022] Open
Abstract
Individuals found at bars in slums have several risk factors for HIV and tuberculosis (TB). To determine the prevalence of HIV and TB among individuals found at bars in slums of Kampala, Uganda, we enrolled adults found at bars that provided written informed consent. Individuals with alcohol intoxication were excluded. We performed HIV testing using immunochromatographic antibody tests (Alere Determine HIV-1/2 and Chembio HIV 1/2 STAT-PAK). TB was confirmed using the Xpert MTB/RIF Ultra assay, performed on single spot sputum samples. We enrolled 272 participants from 42 bars in 5 slums. The prevalence of HIV and TB was 11.4% (95% CI 8.1–15.8) and 15 (95% CI 6–39) per 1,000 population respectively. Predictors of HIV were female sex (aOR 5.87, 95% CI 2.05–16.83), current cigarette smoking (aOR 3.23, 95% CI 1.02–10.26), history of TB treatment (aOR 10.19, 95% CI 3.17–32.82) and CAGE scores of 2–3 (aOR 3.90, 95% CI 1.11–13.70) and 4 (aOR 4.77, 95% CI 1.07–21.35). The prevalence of HIV and TB was twice and four times the national averages respectively. These findings highlight the need for concurrent programmatic screening for both HIV and TB among high risk populations in slums.
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33
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Mohd Isa KN, Hashim Z, Jalaludin J, Lung Than LT, Hashim JH. The Effects of Indoor Pollutants Exposure on Allergy and Lung Inflammation: An Activation State of Neutrophils and Eosinophils in Sputum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5413. [PMID: 32731346 PMCID: PMC7432088 DOI: 10.3390/ijerph17155413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND To explore the inflammation phenotypes following indoor pollutants exposure based on marker expression on eosinophils and neutrophils with the application of chemometric analysis approaches. METHODS A cross-sectional study was undertaken among secondary school students in eight suburban and urban schools in the district of Hulu Langat, Selangor, Malaysia. The survey was completed by 96 students at the age of 14 by using the International Study of Asthma and Allergies in Children (ISAAC) and European Community Respiratory Health Survey (ECRHS) questionnaires. The fractional exhaled nitric oxide (FeNO) was measured, and an allergic skin prick test and sputum induction were performed for all students. Induced sputum samples were analysed for the expression of CD11b, CD35, CD63, and CD66b on eosinophils and neutrophils by flow cytometry. The particulate matter (PM2.5 and PM10), NO2, CO2, and formaldehyde were measured inside the classrooms. RESULTS Chemometric and regression results have clustered the expression of CD63 with PM2.5, CD11b with NO2, CD66b with FeNO levels, and CO2 with eosinophils, with the prediction accuracy of the models being 71.88%, 76.04%, and 76.04%, respectively. Meanwhile, for neutrophils, the CD63 and CD66b clustering with PM2.5 and CD11b with FeNO levels showed a model prediction accuracy of 72.92% and 71.88%, respectively. CONCLUSION The findings indicated that the exposure to PM2.5 and NO2 was likely associated with the degranulation of eosinophils and neutrophils, following the activation mechanisms that led to the inflammatory reactions.
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Affiliation(s)
- Khairul Nizam Mohd Isa
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (J.J.)
- Environmental Health Research Cluster (EHRc), Environmental Healthcare Section, Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang 43000, Selangor, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (J.J.)
| | - Juliana Jalaludin
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia; (K.N.M.I.); (J.J.)
| | - Leslie Thian Lung Than
- Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang 43400, Selangor, Malaysia;
| | - Jamal Hisham Hashim
- IIGH United Nations University, UKM Medical Centre, Cheras 56000, Kuala Lumpur, Malaysia;
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34
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Abdel-Aziz MI, Brinkman P, Vijverberg SJH, Neerincx AH, Riley JH, Bates S, Hashimoto S, Kermani NZ, Chung KF, Djukanovic R, Dahlén SE, Adcock IM, Howarth PH, Sterk PJ, Kraneveld AD, Maitland-van der Zee AH. Sputum microbiome profiles identify severe asthma phenotypes of relative stability at 12 to 18 months. J Allergy Clin Immunol 2020; 147:123-134. [PMID: 32353491 DOI: 10.1016/j.jaci.2020.04.018] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Asthma is a heterogeneous disease characterized by distinct phenotypes with associated microbial dysbiosis. OBJECTIVES Our aim was to identify severe asthma phenotypes based on sputum microbiome profiles and assess their stability after 12 to 18 months. A further aim was to evaluate clusters' robustness after inclusion of an independent cohort of patients with mild-to-moderate asthma. METHODS In this longitudinal multicenter cohort study, sputum samples were collected for microbiome profiling from a subset of the Unbiased Biomarkers in Prediction of Respiratory Disease Outcomes adult patient cohort at baseline and after 12 to 18 months of follow-up. Unsupervised hierarchical clustering was performed by using the Bray-Curtis β-diversity measure of microbial profiles. For internal validation, partitioning around medoids, consensus cluster distribution, bootstrapping, and topological data analysis were applied. Follow-up samples were studied to evaluate within-patient clustering stability in patients with severe asthma. Cluster robustness was evaluated by using an independent cohort of patients with mild-to-moderate asthma. RESULTS Data were available for 100 subjects with severe asthma (median age 55 years; 42% males). Two microbiome-driven clusters were identified; they were characterized by differences in asthma onset, smoking status, residential locations, percentage of blood and/or sputum neutrophils and macrophages, lung spirometry results, and concurrent asthma medications (all P values < .05). The cluster 2 patients displayed a commensal-deficient bacterial profile that was associated with worse asthma outcomes than those of the cluster 1 patients. Longitudinal clusters revealed high relative stability after 12 to 18 months in those with severe asthma. Further inclusion of an independent cohort of 24 patients with mild-to-moderate asthma was consistent with the clustering assignments. CONCLUSION Unbiased microbiome-driven clustering revealed 2 distinct robust phenotypes of severe asthma that exhibited relative overtime stability. This suggests that the sputum microbiome may serve as a biomarker for better characterizing asthma phenotypes.
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Affiliation(s)
- Mahmoud I Abdel-Aziz
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut, Egypt
| | - Paul Brinkman
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Susanne J H Vijverberg
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anne H Neerincx
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - John H Riley
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, United Kingdom
| | - Stewart Bates
- Respiratory Therapeutic Unit, GlaxoSmithKline, Stockley Park, United Kingdom
| | - Simone Hashimoto
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Pediatric Respiratory Medicine, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, and Royal Brompton and Harefield NHS Trust, London, United Kingdom
| | - Ratko Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences and Human Development and Health, University of Southampton, Southampton, United Kingdom
| | - Sven-Erik Dahlén
- Centre for Allergy Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ian M Adcock
- National Heart and Lung Institute, Imperial College London, and Royal Brompton and Harefield NHS Trust, London, United Kingdom
| | - Peter H Howarth
- NIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences and Human Development and Health, University of Southampton, Southampton, United Kingdom
| | - Peter J Sterk
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Aletta D Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands; Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Anke H Maitland-van der Zee
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Department of Pediatric Respiratory Medicine, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands.
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35
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Carpagnano GE, Scioscia G, Lacedonia D, Stornelli SR, Irene Quarato CM, Soccio P, Resta O, Foschino Barbaro MP. Treatment response according to small airways disease status: The effects of high-strength extrafine pMDI beclomethasone dipropionate/formoterol fumarate in fixed dose combination in moderate uncontrolled asthmatic patients. Pulm Pharmacol Ther 2019; 60:101879. [PMID: 31866498 DOI: 10.1016/j.pupt.2019.101879] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Inflammation in small airways is particularly clinically active in severe asthma but they still continue to be ignored as considered silent. Recently, the Atlantis study reports small airways involvement in 91% of the asthma population. Therefore in the era of phenotype driven therapy, the aim of this study was to verify if high-strength extrafine ICS/LABA in fixed dose increases clinical efficacy in moderate asthmatic patients with small airways dysfunction and it could be proposed as phenotype driven therapy. METHODS In this prospective, non-interventional, real-life pilot study we enrolled 37 consecutive patients with moderate asthma who were uncontrolled despite GINA step 3 treatment. All subjects at enrollment were divided in two groups according to the presence of small airways dysfunction:1) small airways phenotype (SAP) group: smokers (≥10 packs/die), ex-smokers (>20 packs/year) with air trapping (FVC <80% - VR >100% - FEF 25-75%<60%); 2) non-small airways phenotype (NSAP) group: non-smokers, without air trapping (FVC ≥80% - VR ≤ 100% - FEF 25-75%≥60%). We later proceeded in both groups with a step up in therapy with high-strength extrafine pMDI beclomethasone dipropionate/formoterol fumarate (BDP/FF) (200/6 μg) in fixed dose to achieve a better control and followed patients for 6 months. RESULTS Treatment with extrafine BDP/FF(200/6 μg) in SAP group showed a more significant improvement of FEF25-75%, FVC, RV, and a reduction of alveolar inflammatory markers such as FENO350 and alveolar exhaled pH compared with NSAP patients. CONCLUSIONS Our preliminary results support the use of high-strength extrafine pMDI BDP/FF (200/6 μg) as phenotype driven treatment directed to small airways dysfunction demonstrating an increase of clinical efficacy in moderate asthmatics with SAP.
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Affiliation(s)
- Giovanna E Carpagnano
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy.
| | - Giulia Scioscia
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Donato Lacedonia
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Silvia Romana Stornelli
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Carla Maria Irene Quarato
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Piera Soccio
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - Onofrio Resta
- Institute of Respiratory Diseases, University of Bari, Italy
| | - Maria Pia Foschino Barbaro
- Institute of Respiratory Diseases, Department of Medical and Surgical Sciences, University of Foggia, Italy
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36
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Atanasova KR, Reznikov LR. Strategies for measuring airway mucus and mucins. Respir Res 2019; 20:261. [PMID: 31752894 PMCID: PMC6873701 DOI: 10.1186/s12931-019-1239-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/11/2019] [Indexed: 12/17/2022] Open
Abstract
Mucus secretion and mucociliary transport are essential defense mechanisms of the airways. Deviations in mucus composition and secretion can impede mucociliary transport and elicit airway obstruction. As such, mucus abnormalities are hallmark features of many respiratory diseases, including asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD). Studying mucus composition and its physical properties has therefore been of significant interest both clinically and scientifically. Yet, measuring mucus production, output, composition and transport presents several challenges. Here we summarize and discuss the advantages and limitations of several techniques from five broadly characterized strategies used to measure mucus secretion, composition and mucociliary transport, with an emphasis on the gel-forming mucins. Further, we summarize advances in the field, as well as suggest potential areas of improvement moving forward.
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Affiliation(s)
- Kalina R Atanasova
- Department of Physiological Sciences, University of Florida, 1333 Center Drive, PO Box 100144, Gainesville, FL, 32610, USA
| | - Leah R Reznikov
- Department of Physiological Sciences, University of Florida, 1333 Center Drive, PO Box 100144, Gainesville, FL, 32610, USA.
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37
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Allen KJ, Tennant KV, Franklin SH. Effect of inclusion or exclusion of epithelial cells in equine respiratory cytology analysis. Vet J 2019; 254:105405. [PMID: 31836172 DOI: 10.1016/j.tvjl.2019.105405] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 11/25/2022]
Abstract
Published studies vary as to whether epithelial cells are included in differential counts for tracheal wash (TW) and bronchoalveolar lavage (BAL) cytology in horses. The aim of this study was to determine whether inclusion or exclusion of epithelial cells affects interpretation of airway cytology. Using criteria of >20% TW neutrophils, >10% BAL neutrophils and/or >5% BAL mast cells to indicate airway inflammation, there was a change in categorisation from 'normal' to 'abnormal' in 21%, 4% and 8% horses, respectively, when epithelial cells were excluded from differential counts. It is recommended that future equine respiratory research studies explicitly state whether epithelial cells are included or excluded in differential counts. A consensus on epithelial cell inclusion during cytology reporting is required.
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Affiliation(s)
- K J Allen
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK.
| | - K V Tennant
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK
| | - S H Franklin
- Equine Health and Performance Centre, School of Animal and Veterinary Science, University of Adelaide, Roseworthy, South Australia 5371, Australia
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38
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Proboszcz M, Mycroft K, Paplinska-Goryca M, Górska K, Nejman-Gryz P, Jankowski P, Zak N, Krenke R. Relationship between Blood and Induced Sputum Eosinophils, Bronchial Hyperresponsiveness and Reversibility of Airway Obstruction in Mild-to-Moderate Chronic Obstructive Pulmonary Disease. COPD 2019; 16:354-361. [PMID: 31631716 DOI: 10.1080/15412555.2019.1675150] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Blood eosinophilia has been proposed as a surrogate marker for airway eosinophilia and as a predictor of treatment response in chronic obstructive pulmonary disease (COPD). The aim of the study was to assess the relationship between blood and sputum eosinophils and to investigate the association between blood and sputum eosinophil count and clinical features of mild-to-moderate COPD. We performed a retrospective analysis of blood and sputum eosinophil count, as well as demographic and lung function data in a cohort of 90 stable, steroid-naive (Global Initiative for Chronic Obstructive Lung Disease 1 or 2) COPD patients and 20 control subjects. Blood and sputum eosinophil count did not correlate both in patients with COPD (r = -0.04 p = 0.705) and in controls (r = 0.05, p = 0.838). Sputum eosinophilia (≥3%) was present in 40% of COPD patients. The median blood eosinophil count in patients with COPD was 180 (interquartile range 90-270)/μL; patients with low blood eosinophils (<180/μL) did not differ from those with high blood eosinophils (≥180/μL) in terms of forced expiratory volume in 1 second, bronchial reversibility or hyperresponsiveness. This was also the case when COPD patients with and without sputum eosinophilia were compared. At the same time, positive bronchial reversibility and positive bronchial hyperresponsiveness were observed in 2 (11%) COPD patients with high blood eosinophils and in 1 (5%) patient with sputum eosinophilia. There was a weak, albeit significant correlation (r = 0.22 p = 0.041) between blood eosinophil count and age in patients with COPD. Peripheral eosinophil count poorly reflects sputum eosinophils and lung function in stable steroid-naive mild-to-moderate COPD patients.
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Affiliation(s)
- Malgorzata Proboszcz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Mycroft
- Students' Research Group "Alveolus," Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Paplinska-Goryca
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Górska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Patrycja Nejman-Gryz
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Jankowski
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Zak
- Students' Research Group "Alveolus," Medical University of Warsaw, Warsaw, Poland
| | - Rafal Krenke
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
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Bedi P, Davidson DJ, McHugh BJ, Rossi AG, Hill AT. Blood Neutrophils Are Reprogrammed in Bronchiectasis. Am J Respir Crit Care Med 2019; 198:880-890. [PMID: 29733693 DOI: 10.1164/rccm.201712-2423oc] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
RATIONALE Excessive neutrophilic airway inflammation is the central feature of bronchiectasis, but little is known about neutrophils in bronchiectasis. OBJECTIVES To assess blood neutrophil phenotype in patients with bronchiectasis while stable and during exacerbations. METHODS In the clinically stable arm of this study, there were eight healthy volunteers, eight patients with mild bronchiectasis, and eight patients with severe bronchiectasis. In addition, six patients with severe bronchiectasis were compared with six patients with community-acquired pneumonia at the start and end of an exacerbation. We assessed neutrophils for spontaneous apoptosis, cell surface marker expression, degranulation, reactive oxygen species generation, phagocytosis, and killing of Pseudomonas aeruginosa (PAO1). In addition, blood neutrophil function was compared with airway neutrophil function in bronchiectasis. MEASUREMENTS AND MAIN RESULTS In stable bronchiectasis, compared with healthy volunteers, blood neutrophils had significantly prolonged viability, delayed apoptosis, increased CD62L shedding, upregulated CD11b expression, increased myeloperoxidase release, and impaired neutrophil phagocytosis and killing of PAO1. Bronchiectatic airway neutrophils had significantly lower bacterial phagocytosis and killing than their matched autologous blood neutrophils. Both blood and airway neutrophil phagocytosis and killing were impaired at the start of an exacerbation and improved following antibiotic treatment. In pneumonia, there was a significant improvement in phagocytosis and killing after treatment with antibiotics. During infections, there was no difference in phagocytosis, but there was significantly increased bacterial killing at the start and end of infection in pneumonia compared with bronchiectasis exacerbations. CONCLUSIONS In bronchiectasis stable state, peripheral blood neutrophils are reprogrammed and have prolonged survival. This impairs their functional ability of bacterial phagocytosis and killing, thereby perpetuating the vicious circle in bronchiectasis.
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Affiliation(s)
- Pallavi Bedi
- 1 MRC Centre for Inflammation Research at the University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom; and
| | - Donald J Davidson
- 1 MRC Centre for Inflammation Research at the University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom; and
| | - Brian J McHugh
- 1 MRC Centre for Inflammation Research at the University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom; and
| | - Adriano G Rossi
- 1 MRC Centre for Inflammation Research at the University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom; and
| | - Adam T Hill
- 1 MRC Centre for Inflammation Research at the University of Edinburgh, Queen's Medical Research Institute, Edinburgh, United Kingdom; and.,2 Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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Jonckheere AC, Seys S, Dilissen E, Schelpe AS, Van der Eycken S, Corthout S, Verhalle T, Goossens J, Vanbelle V, Aertgeerts S, Troosters T, Peers K, Dupont L, Bullens D. Early-onset airway damage in early-career elite athletes: A risk factor for exercise-induced bronchoconstriction. J Allergy Clin Immunol 2019; 144:1423-1425.e9. [PMID: 31356920 DOI: 10.1016/j.jaci.2019.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/21/2019] [Accepted: 07/19/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Anne-Charlotte Jonckheere
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Sven Seys
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Ellen Dilissen
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - An-Sofie Schelpe
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Sarah Van der Eycken
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Steffie Corthout
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Tulasi Verhalle
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | - Janne Goossens
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium
| | | | - Sven Aertgeerts
- KU Leuven, Academic Centre for General Practitioners, Leuven, Belgium
| | | | - Koen Peers
- UZ Leuven, Sport Medical Advice Centre, Leuven, Belgium
| | - Lieven Dupont
- KU Leuven, Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Pneumology, Leuven, Belgium; UZ Leuven, Clinical Division of Respiratory Medicine, Leuven, Belgium
| | - Dominique Bullens
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium; UZ Leuven, Clinical Division of Paediatrics, Leuven, Belgium.
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Mastalerz L, Tyrak KE, Ignacak M, Konduracka E, Mejza F, Ćmiel A, Buczek M, Kot A, Oleś K, Sanak M. Prostaglandin E 2 decrease in induced sputum of hypersensitive asthmatics during oral challenge with aspirin. Allergy 2019; 74:922-932. [PMID: 30446997 DOI: 10.1111/all.13671] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/01/2018] [Accepted: 11/05/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND A special regulatory role for prostaglandin E2 (PGE2 ) has been postulated in nonsteroidal anti-inflammatory drug (NSAID)-exacerbated respiratory disease (NERD). OBJECTIVE To investigate the effect of systemic aspirin (acetylsalicylic acid) administration on airway PGE2 biosynthesis in induced sputum supernatant (ISS) among subjects with NERD or aspirin-tolerant asthma with chronic rhinosinusitis with nasal polyposis (ATA-CRSwNP), as well as healthy controls (HC). METHODS Induced sputum (IS) was collected from patients with NERD (n = 26), ATA-CRSwNP (n = 17), and HC (n = 21) at baseline and after aspirin challenge. Sputum differential cell count and IS supernatant (ISS) levels of prostanoids, PGE2 , 8-iso-PGE2 , tetranor-PGE-M, 8-iso-PGF2 α, and leukotriene C4 , D4 , and E4 , were determined using mass spectrometry. Urinary excretion of LTE4 was measured by ELISA. RESULTS NERD subjects had elevated sputum eosinophilic count as compared to ATA-CRSwNP and HC (median NERD 9.1%, ATA-CRSwNP 2.1%, and HC 0.4%; P < 0.01). Baseline ISS levels of PGE2 were higher in asthmatics as compared to HC at baseline (NERD vs HC P = 0.04, ATA-CRSwNP vs HC P < 0.05). Post-challenge ISS levels of PGE2 compared to baseline significantly decreased in NERD and HC (P < 0.01 and P = 0.01), but not in ATA-CRSwNP. In NERD, a similar decrease in PGE2 as in HC resulted from 2.8 times lower dose of aspirin. CONCLUSION Aspirin-precipitated bronchoconstriction is associated with a decrease in airway PGE2 biosynthesis. These results support the mechanism of PGE2 biosynthesis inhibition as a trigger for bronchoconstriction in NERD.
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Affiliation(s)
- Lucyna Mastalerz
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Katarzyna E. Tyrak
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Maria Ignacak
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Ewa Konduracka
- Coronary and Heart Failure Department Jagiellonian University School of Medicine John Paul II Hospital Cracow Poland
| | - Filip Mejza
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Adam Ćmiel
- Department of Applied Mathematics AGH University of Science and Technology Cracow Poland
| | - Michał Buczek
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Adrianna Kot
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
| | - Krzysztof Oleś
- Department of Oncological and Reconstructive Surgery The Maria Sklodowska‐Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch Gliwice Poland
| | - Marek Sanak
- Department of Internal Medicine Jagiellonian University School of Medicine Cracow Poland
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Henderson AG, Anderson WH, Ceppe A, Coakley RD, Button B, Alexis NE, Peden DB, Lazarowski ER, Davis CW, Fuller F, Almond M, Qaqish B, Kesimer M, Boucher RC. Mucus Hydration in Subjects with Stable Chronic Bronchitis: A Comparison of Spontaneous and Induced Sputum. COPD 2019; 15:572-580. [PMID: 30712400 DOI: 10.1080/15412555.2019.1566892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Mucus hydration is important in mucus clearance and lung health. This study sought to test the relative utility of spontaneous sputum (SS) versus the reasonably noninvasive induced sputum (IS) samples for measurement of mucus hydration. SS and IS samples were collected over a 2-day study interval. Sputum was induced with escalating inhaled nebulized 3-5% hypertonic saline. Viscous portions of the samples ("plugs") were utilized for percent solids and total mucin analyses. Cytokines, nucleotides/nucleosides and cell differentials were measured in plugs diluted into 0.1% Sputolysin. Overall, 61.5% of chronic bronchitis (CB) subjects produced a SS sample and 95.2% an IS sample. Total expectorate sample weights were less for the SS (0.94 ± 0.98 g) than the IS (2.67 ± 2.33 g) samples. Percent solids for the SS samples (3.56% ± 1.95; n = 162) were significantly greater than the IS samples (3.08% ± 1.81; n = 121), p = 0.133. Total mucin concentrations also exhibited a dilution of the IS samples: SS = 4.15 ± 3.23 mg/ml (n = 62) versus IS= 3.34 ± 2.55 mg/ml (n = 71) (p = 0.371). Total mucins (combined SS and IS) but not percent solids, were inversely associated with FEV1 percent predicted (p = 0.052) and FEV1,/FVC % (p = 0.035). There were no significant differences between sample types in cytokine or differential cell counts. The probability of sample collections was less for SS than IS samples. Measurements of hydration revealed modest dilution of the IS samples compared to SS. Thus for measurements of mucus hydration, both SS and IS samples appear to be largely interchangeable.
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Affiliation(s)
- Ashley G Henderson
- a Pulmonary and Critical Care Medicine, Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Wayne H Anderson
- b Pulmonary and Critical Care Medicine, Department of Medicine and Marsico Lung Institute , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Agathe Ceppe
- a Pulmonary and Critical Care Medicine, Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Raymond D Coakley
- a Pulmonary and Critical Care Medicine, Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Brian Button
- c Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Neil E Alexis
- d Marsico Lung Institute, Center for Environmental Medicine, Asthma and Lung Biology , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - David B Peden
- d Marsico Lung Institute, Center for Environmental Medicine, Asthma and Lung Biology , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Eduardo R Lazarowski
- c Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - C W Davis
- c Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Fred Fuller
- e Division of Urology , NC Memorial Hospital, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Martha Almond
- a Pulmonary and Critical Care Medicine, Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Bahjat Qaqish
- f Department of Statistics , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Mehmet Kesimer
- c Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Richard C Boucher
- c Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
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43
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Sulaiman I, Wu BG, Li Y, Scott AS, Malecha P, Scaglione B, Wang J, Basavaraj A, Chung S, Bantis K, Carpenito J, Clemente JC, Shen N, Bessich J, Rafeq S, Michaud G, Donington J, Naidoo C, Theron G, Schattner G, Garofano S, Condos R, Kamelhar D, Addrizzo-Harris D, Segal LN. Evaluation of the airway microbiome in nontuberculous mycobacteria disease. Eur Respir J 2018; 52:13993003.00810-2018. [PMID: 30093571 DOI: 10.1183/13993003.00810-2018] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/29/2018] [Indexed: 01/15/2023]
Abstract
Aspiration is associated with nontuberculous mycobacterial (NTM) pulmonary disease and airway dysbiosis is associated with increased inflammation. We examined whether NTM disease was associated with a distinct airway microbiota and immune profile.297 oral wash and induced sputum samples were collected from 106 participants with respiratory symptoms and imaging abnormalities compatible with NTM. Lower airway samples were obtained in 20 participants undergoing bronchoscopy. 16S rRNA gene and nested mycobacteriome sequencing approaches characterised microbiota composition. In addition, inflammatory profiles of lower airway samples were examined.The prevalence of NTM+ cultures was 58%. Few changes were noted in microbiota characteristics or composition in oral wash and sputum samples among groups. Among NTM+ samples, 27% of the lower airway samples were enriched with Mycobacterium A mycobacteriome approach identified Mycobacterium in a greater percentage of samples, including some nonpathogenic strains. In NTM+ lower airway samples, taxa identified as oral commensals were associated with increased inflammatory biomarkers.The 16S rRNA gene sequencing approach is not sensitive in identifying NTM among airway samples that are culture-positive. However, associations between lower airway inflammation and microbiota signatures suggest a potential role for these microbes in the inflammatory process in NTM disease.
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Affiliation(s)
- Imran Sulaiman
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Benjamin G Wu
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Yonghua Li
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Adrienne S Scott
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Patrick Malecha
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Benjamin Scaglione
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Jing Wang
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Ashwin Basavaraj
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Samuel Chung
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Katrina Bantis
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Joseph Carpenito
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Jose C Clemente
- Dept of Genetics and Genomic Sciences and Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nan Shen
- Dept of Genetics and Genomic Sciences and Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jamie Bessich
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Samaan Rafeq
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Gaetene Michaud
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Jessica Donington
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Charissa Naidoo
- Medicine and Health Sciences, Stellenbosch University, DST/NRF of Excellence for Biomedical Tuberculosis Research and SA MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics Tygerberg, Cape Town, South Africa
| | - Grant Theron
- Medicine and Health Sciences, Stellenbosch University, DST/NRF of Excellence for Biomedical Tuberculosis Research and SA MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics Tygerberg, Cape Town, South Africa
| | - Gail Schattner
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Suzette Garofano
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Rany Condos
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - David Kamelhar
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Doreen Addrizzo-Harris
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA
| | - Leopoldo N Segal
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University School of Medicine, New York, NY, USA.,Dept of Medicine, New York University School of Medicine, New York, NY, USA
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Bar-Shai A, Shenhar-Tsarfaty S, Ahimor A, Ophir N, Rotem M, Alcalay Y, Fireman E. A novel combined score of biomarkers in sputum may be an indicator for lung cancer: A pilot study. Clin Chim Acta 2018; 487:139-144. [PMID: 30222960 DOI: 10.1016/j.cca.2018.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 08/22/2018] [Accepted: 09/13/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lung cancer is a leading cause of morbidity and mortality worldwide and there is an urgent need for sensitive, specific, and reliable biomarkers. METHODS The study population included 60 patients (31 with lung cancer and 29 with chronic obstructive pulmonary disease [COPD]) and thirty healthy individuals comprised the control group. Measurements of neutrophil, beclin-1, VEGF, ICAM, VCAM, and TNF-alpha levels in induced sputum were analyzed as possible biomarkers for lung cancer. RESULTS Neutrophil, beclin-1, VEGF, ICAM and TNF-alpha levels of lung cancer patients differed significantly compared to those of COPD patients and healthy controls. A novel combined-score was created which was found to increase the likelihood to belong to the cancer group by 70% (odds-ratio 1.70 CI = 1.310-2.224,p < 0.001). CONCLUSION Biomarkers of autophagy, angiogenesis and inflammation in lung-cancer patients are significantly different from controls, and combination of these markers may be an indicator for lung cancer.
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Affiliation(s)
- Amir Bar-Shai
- Division of Pulmonary Medicine, Barzilai Medical Center, Faculty of Health Sciences, Ben-Gurion University, Ashkelon, Israel; Laboratory of Pulmonary Diseases, Laboratory National Service for ILD, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Shani Shenhar-Tsarfaty
- Laboratory of Pulmonary Diseases, Laboratory National Service for ILD, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Ahimor
- Division of Pulmonary Medicine, Barzilai Medical Center, Faculty of Health Sciences, Ben-Gurion University, Ashkelon, Israel
| | - Noa Ophir
- Laboratory of Pulmonary Diseases, Laboratory National Service for ILD, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Rotem
- Division of Pulmonary Medicine, Barzilai Medical Center, Faculty of Health Sciences, Ben-Gurion University, Ashkelon, Israel
| | - Yifat Alcalay
- Laboratory of Pulmonary Diseases, Laboratory National Service for ILD, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elizabeth Fireman
- Laboratory of Pulmonary Diseases, Laboratory National Service for ILD, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Neville DM, Fogg C, Brown TP, Jones TL, Lanning E, Bassett P, Chauhan AJ. Using the Inflammacheck Device to Measure the Level of Exhaled Breath Condensate Hydrogen Peroxide in Patients With Asthma and Chronic Obstructive Pulmonary Disease (The EXHALE Pilot Study): Protocol for a Cross-Sectional Feasibility Study. JMIR Res Protoc 2018; 7:e25. [PMID: 29382628 PMCID: PMC5811652 DOI: 10.2196/resprot.8768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/24/2017] [Accepted: 11/24/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Asthma and Chronic Obstructive Pulmonary Disease (COPD) are common conditions that affect over 5 million people in the United Kingdom. These groups of patients suffer significantly from breathlessness and recurrent exacerbations that can be difficult to diagnose and go untreated. A common feature of COPD and asthma is airway inflammation that increases before and during exacerbations. Current methods of assessing airway inflammation can be invasive, difficult to perform, and are often inaccurate. In contrast, measurement of exhaled breath condensate (EBC) hydrogen peroxide (H2O2) is performed during normal tidal breathing and is known to reflect the level of global inflammation in the airways. There is a need for novel tools to diagnose asthma and COPD earlier and to detect increased airway inflammation that precedes an exacerbation. OBJECTIVE The aim of this study was to explore the use of a new handheld device (called Inflammacheck) in measuring H2O2 levels in EBC. We will study whether it can measure EBC H2O2 levels consistently and whether it can be used to differentiate asthma and COPD from healthy controls. METHODS We will perform a cross-sectional, feasibility, pilot study of EBC H2O2 levels, as measured by Inflammacheck, and other markers of disease severity and symptom control in patients with asthma and COPD and volunteers with no history of lung disease. Participants will be asked to provide an exhaled breath sample for measurement of their EBC H2O2 using Inflammacheck. The result will be correlated with disease stage, spirometry, fractional exhaled nitric oxide (FeNO), and symptom control scores. RESULTS This study's recruitment is ongoing; it is anticipated that the results will be available in 2018. CONCLUSIONS The EXhaled Hydrogen peroxide As a marker of Lung diseasE (EXHALE) pilot study will provide an evaluation of a new method of measuring EBC H2O2. It will assess the device's consistency and ability to distinguish airway inflammation in asthma and COPD compared with healthy controls.
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Affiliation(s)
- Daniel M Neville
- Department of Respiratory Research & Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Carole Fogg
- Department of Respiratory Research & Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Thomas P Brown
- Department of Respiratory Research & Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Thomas L Jones
- Department of Respiratory Research & Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | - Eleanor Lanning
- Department of Respiratory Research & Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
| | | | - Anoop J Chauhan
- Department of Respiratory Research & Innovation, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
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Szabó M, Sárosi V, Balikó Z, Bodó K, Farkas N, Berki T, Engelmann P. Deficiency of innate-like T lymphocytes in chronic obstructive pulmonary disease. Respir Res 2017; 18:197. [PMID: 29179729 PMCID: PMC5704534 DOI: 10.1186/s12931-017-0671-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/22/2017] [Indexed: 02/06/2023] Open
Abstract
Background Based on the phenotypic and functional characteristics unconventional T-lymphocytes such as invariant natural killer T (iNKT) cells and mucosal-associated invariant T (MAIT) cells link the innate and adaptive immune responses. Up to now data are scarce about their involvement in pulmonary disorders including chronic obstructive pulmonary disease (COPD). This study explores simultaneously the frequencies of iNKT and MAIT cells in the peripheral blood and sputum of stable and exacerbating COPD patients. Methods By means of multicolor flow cytometry frequencies of total iNKT and MAIT cells and their subsets were enumerated in peripheral blood and sputum samples of healthy controls, and COPD patients. In addition, gene expression of TCR for iNKT, MAIT cells, and CD1d, MR1 were assessed by qPCR in the study cohorts. Results Percentages of total iNKT and MAIT cells were dramatically dropped in blood, and reduced numbers of iNKT cells were observed in the sputum of COPD patients. Furthermore decreased DN and increased CD4+ iNKT subsets, while increased DN and decreased CD8+ MAIT subpopulations were measured in the blood of COPD patients. Reduced invariant TCR mRNA levels in COPD patients had confirmed these previous findings. The mRNA expression of CD1d and MR1 were increased in stable and exacerbating COPD patients; however both molecules were decreased upon antibiotic and systemic steroid treatments. Conclusions Our results support the notion that both invariant T-cell populations are affected in COPD. Further detailed analysis of invariant T cells could shed more light into the complex interactions of these lymphocyte groups in COPD pathogenesis. Electronic supplementary material The online version of this article (10.1186/s12931-017-0671-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mariann Szabó
- Division of Pulmonology, 1st Department of Internal Medicine, Clinical Center, University of Pécs, Rákóczi u. 2, Pécs, H-7623, Hungary.
| | - Veronika Sárosi
- Division of Pulmonology, 1st Department of Internal Medicine, Clinical Center, University of Pécs, Rákóczi u. 2, Pécs, H-7623, Hungary
| | - Zoltán Balikó
- Division of Pulmonology, 1st Department of Internal Medicine, Clinical Center, University of Pécs, Rákóczi u. 2, Pécs, H-7623, Hungary
| | - Kornélia Bodó
- Department of Immunology and Biotechnology, Clinical Center, University of Pécs, Szigeti u. 12, Pécs, H-7643, Hungary
| | - Nelli Farkas
- Department of Bioanalysis, Medical School, University of Pécs, Szigeti u. 12, Pécs, H-7643, Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology, Clinical Center, University of Pécs, Szigeti u. 12, Pécs, H-7643, Hungary
| | - Péter Engelmann
- Department of Immunology and Biotechnology, Clinical Center, University of Pécs, Szigeti u. 12, Pécs, H-7643, Hungary.
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McNerney R, Clark TG, Campino S, Rodrigues C, Dolinger D, Smith L, Cabibbe AM, Dheda K, Schito M. Removing the bottleneck in whole genome sequencing of Mycobacterium tuberculosis for rapid drug resistance analysis: a call to action. Int J Infect Dis 2017; 56:130-135. [PMID: 27986491 DOI: 10.1016/j.ijid.2016.11.422] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 11/15/2022] Open
Abstract
Whole genome sequencing (WGS) can provide a comprehensive analysis of Mycobacterium tuberculosis mutations that cause resistance to anti-tuberculosis drugs. With the deployment of bench-top sequencers and rapid analytical software, WGS is poised to become a useful tool to guide treatment. However, direct sequencing from clinical specimens to provide a full drug resistance profile remains a serious challenge. This article reviews current practices for extracting M. tuberculosis DNA and possible solutions for sampling sputum. Techniques under consideration include enzymatic digestion, physical disruption, chemical degradation, detergent solubilization, solvent extraction, ligand-coated magnetic beads, silica columns, and oligonucleotide pull-down baits. Selective amplification of genomic bacterial DNA in sputum prior to WGS may provide a solution, and differential lysis to reduce the levels of contaminating human DNA is also being explored. To remove this bottleneck and accelerate access to WGS for patients with suspected drug-resistant tuberculosis, it is suggested that a coordinated and collaborative approach be taken to more rapidly optimize, compare, and validate methodologies for sequencing from patient samples.
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Affiliation(s)
- Ruth McNerney
- Lung Infection and Immunity Unit, Department of Medicine, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
| | - Taane G Clark
- Faculty of Infectious and Tropical Diseases and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Susana Campino
- Faculty of Infectious and Tropical Diseases and Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Camilla Rodrigues
- Department of Microbiology, P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India
| | | | - Liezel Smith
- Lung Infection and Immunity Unit, Department of Medicine, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Andrea M Cabibbe
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Keertan Dheda
- Lung Infection and Immunity Unit, Department of Medicine, Division of Pulmonology and UCT Lung Institute, University of Cape Town, Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, South Africa
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48
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Kim MH, Kim MY, Lim KH, Yang MS, Song WJ, Lee J, Suh DI, Shin YS, Kwon JW, Kim SH, Kim SH, Lee BJ, Cho SH, Jung JW. KAAACI Standardization Committee report on the procedure and application of induced sputum examination. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.6.307] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Min-Hye Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Mi-Yeong Kim
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kyung-Hwan Lim
- Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea
| | - Min-Suk Yang
- Department of Internal Medicine, Seoul Metropolitan Government: Seoul National University Boramae Medical Center, Seoul, Korea
| | - Woo-Jung Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jeongmin Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo Seob Shin
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Jae-Woo Kwon
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Byung-Jae Lee
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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