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Tao L, Lu X, Fu Z, Tian Y, Liu X, Li J, Zhao P. Tong Sai granules improves AECOPD via regulation of MAPK-SIRT1-NF-κB pathway and cellular senescence alleviation. JOURNAL OF ETHNOPHARMACOLOGY 2023; 314:116622. [PMID: 37210015 DOI: 10.1016/j.jep.2023.116622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/22/2023] [Accepted: 05/08/2023] [Indexed: 05/22/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tong Sai granules (TSG) a traditional Chinese medicine, are used to treat acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Cellular senescence is considered the mechanism underlying AECOPD progression. AIM OF THE STUDY This study aimed to investigate the therapeutic mechanisms of TSG in an AECOPD rat model (established using cigarette smoke exposure and bacterial infection) and focused on the inhibition of cellular senescence in vivo and in vitro. MATERIALS AND METHODS Histological changes and levels of inflammatory cytokines, matrix metalloproteinases (MMPs), p53, and p21 were determined. A cellular senescence model was established by challenging airway epithelial cells with cigarette smoke extract (CSE) and lipopolysaccharide (LPS). Quantitative PCR, western blotting, and immunofluorescence were used to measure mRNA and protein levels. Additionally, UPLC-Q-Extractive-Orbitrap MS analysis, network analysis, and transcriptomics were used to analyze the potential compounds and molecular mechanisms of TSG. RESULTS The results showed that oral administration of TSG significantly reduced the severity of AECOPD in rats by ameliorating lung function decline and pathological injuries and increasing the levels of C-reactive protein and serum amyloid A, two well-known proinflammatory mediators of the acute phase response. Oral TSG administration also decreased the expression levels of proinflammatory cytokines (e.g., IL-6, IL-1β, and TNF-α), MMPs (e.g., MMP-2 and MMP-9), critical regulators of senescence such as p21 and p53, and the apoptotic marker γH2AX, all of which are factors in cellular senescence in lung tissue. TSG4 was isolated from TSGs using macroporous resin and found to significantly suppress cellular senescence in CSE/LPS-induced bronchial epithelial cells. Furthermore, 26 of 56 compounds identified in TSG4 were used to predict 882 potential targets. Additionally, 317 differentially expressed genes (DEGs) were detected in CSE/LPS-treated bronchial epithelial cells. Network analysis of the 882 targets and 317 DEGs revealed that TSG4 regulated multiple pathways, among which the mitogen-activated protein kinase-sirtuin 1-nuclear factor kappa B (MAPK-SIRT1-NF-κB) pathway is important in terms of antisenescent mechanisms. Moreover, in CSE/LPS-induced bronchial epithelial cells, p-p38, p-ERK1/2, p-JNK, and p-p65 levels were increased and SIRT1 levels were decreased after TSG4 treatment. Additionally, oral TSG administration decreased p-p38 and p-p65 levels and increased SIRT1 levels in the lung tissues of AECOPD model rats. CONCLUSION Collectively, these results indicate that TSGs ameliorate AECOPD by regulating the MAPK-SIRT1-NF-κB signaling pathway and subsequently suppressing cellular senescence.
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Affiliation(s)
- Liuying Tao
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China.
| | - Xiaofan Lu
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China
| | - Zijian Fu
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China
| | - Yange Tian
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China; Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China
| | - Xinguang Liu
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China; Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China
| | - Jiansheng Li
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China; Department of Respiratory Diseases, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, 450000, China
| | - Peng Zhao
- Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China; Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province & Education Ministry of PR China, China; Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, Henan, 450046, China.
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Miravitlles M, Kawayama T, Dreher M. LABA/LAMA as First-Line Therapy for COPD: A Summary of the Evidence and Guideline Recommendations. J Clin Med 2022; 11:jcm11226623. [PMID: 36431099 PMCID: PMC9692772 DOI: 10.3390/jcm11226623] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022] Open
Abstract
Inhaled bronchodilators (alone or in combination) are the cornerstone of treatment for symptomatic patients with COPD, either as initial/first-line treatment or for second-line/treatment escalation in patients who experience persistent symptoms or exacerbations on monotherapy. The Global Initiative for Chronic Obstructive Lung Disease 2022 report recommends initial pharmacological treatment with a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA) as monotherapy for most patients, or dual bronchodilator therapy (LABA/LAMA) in patients with more severe symptoms, regardless of exacerbation history. The recommendations for LABA/LAMA are broader in the American Thoracic Society treatment guidelines, which strongly recommend LABA/LAMA combination therapy over LAMA or LABA monotherapy in patients with COPD and dyspnea or exercise intolerance. However, despite consistent guideline recommendations, real-world prescribing data indicate that LAMA and/or LABA without an inhaled corticosteroid are not the most widely prescribed therapies in COPD. This article reviews global and regional/national guideline recommendations for the use of LABA/LAMA in COPD, examines the evidence for the effectiveness and safety of LABA/LAMA versus other therapies and offers a practical guide for clinicians to help ensure appropriate use of LABA/LAMA therapy.
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Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d′Hebron, Vall d’Hebron Research Institute (VHIR), Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Correspondence: ; Tel.: +34-(93)-274-6157
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Michael Dreher
- Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, 52074 Aachen, Germany
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Zhao X, Wu Y. Correlations of Silent Information Regulator of Transcription 1 (SIRT1) Expression, Inflammatory Factors, and Oxidative Stress with Pulmonary Function in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD). Med Sci Monit 2021; 27:e929046. [PMID: 33762567 PMCID: PMC8008970 DOI: 10.12659/msm.929046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to investigate the correlations of silent information regulator of transcription 1 (SIRT1) expression, inflammatory factors, and oxidative stress with pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Material/Methods Bronchoalveolar lavage fluid (BALF) was collected from 188 patients with COPD (83 in stable phase and 105 in acute exacerbation phase) and 56 healthy controls. Subsequently, the SIRT1 expression levels, the IL-6 and IL-8 levels (the representatives of inflammatory factors), and the MDA and SOD levels (indicative of oxidative stress) were detected via enzyme-linked immunosorbent assay. Correlations of SIRT1 expression, inflammatory factors, and oxidative stress with pulmonary function parameters [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) and FEV1] were measured via Spearman’s correlation analysis. Results The levels of inflammatory factors and oxidative stress were elevated and SIRT1 expression remarkably declined in patients with AECOPD compared with those in healthy controls and stable COPD patients (P<0.05). Spearman’s correlation analysis revealed that SIRT1 expression, interleukin (IL)-6, and IL-8 were strongly associated with pulmonary function parameters (FEV1/FVC and FEV1) in patients with AECOPD (P<0.001), while no such obvious correlation was observed in stable COPD patients. Conclusions Oxidative stress and expression levels of inflammatory factors are evidently elevated and SIRT1 expression declines in patients with AECOPD. Moreover, SIRT1 expression is positively associated with pulmonary function parameters, while IL-6 and IL-8 exhibit negative correlations with pulmonary function parameters.
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Affiliation(s)
- Xin Zhao
- Department of Integrated Chinese and Western Medicine, Tianjin First Central Hospital, Tianjin, China (mainland)
| | - Yueqin Wu
- Department of Integrated Chinese and Western Medicine, Tianjin First Central Hospital, Tianjin, China (mainland)
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Machida K, Kawayama T, Kinoshita M, Ichinose M, Tsuda T, Takata S, Koto H, Yoshida M, Ashihara Y, Kawashima M, Suna H, Inoue H. Imidafenacin, An Orally Active Muscarinic Receptor Antagonist, Improves Pulmonary Function In Patients With Chronic Obstructive Pulmonary Disease: A Multicenter, Randomized, Double-Blind, Placebo-Controlled 3×3 Crossover Phase II Trial. Int J Chron Obstruct Pulmon Dis 2019; 14:2175-2184. [PMID: 31571853 PMCID: PMC6757323 DOI: 10.2147/copd.s223002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/05/2019] [Indexed: 02/01/2023] Open
Abstract
Background Although long-acting muscarinic receptor antagonists are central to the management of chronic obstructive pulmonary disease (COPD), inhaled medicines may have technical difficulty in some patients and adherence barriers. Methods A multicenter, randomized, double-blind, placebo-controlled 3×3 crossover Phase II trial was performed to evaluate the efficacy and safety of oral administration of the antimuscarinic agent imidafenacin in patients with COPD. Twenty-seven male COPD patients with % forced expiratory volume in 1 s (FEV1) ≥30% and <80% predicted were randomized to single oral dose of imidafenacin 0.1 mg, imidafenacin 0.2 mg, or placebo. Results Maximum change in FEV1 with both doses of imidafenacin significantly improved from baseline to 24 hrs after administration when compared with a placebo. Area under the curve in FEV1 during 24 hrs after administration with 0.2 mg, but not 0.1 mg dose, was significantly improved when compared with a placebo, and the improvement was significantly based on dose-dependent manners. Plasma imidafenacin level was positively correlated with change in FEV1. All subjects with both doses of imidafenacin completed without moderate nor severe adverse events. Conclusion A single oral dose of imidafenacin 0.1 mg or imidafenacin 0.2 mg may contribute to the improvement of pulmonary function with excellent safety and tolerability in patients with COPD. Trial registration JapicCTI-121760 (Japan Pharmaceutical Information Center – Clinical Trials Information [JapicCTI]; http://www.clinicaltrials.jp/user/cteSearch_e.jsp).
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Affiliation(s)
- Kentaro Machida
- Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
| | - Tomotaka Kawayama
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume 830-0011, Japan
| | | | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University, Graduate School of Medicine, Sendai 980-8574, Japan
| | - Tohru Tsuda
- Kirigaoka Tsuda Hospital, Kitakyushu 802-0052 Japan
| | - Shohei Takata
- Division of Respiratory Medicine, National Hospital Organization Fukuoka-Higashi Medical Center, Koga 811-3195, Japan
| | - Hiroshi Koto
- Division of Respiratory Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan
| | - Makoto Yoshida
- Division of Respiratory Medicine, National Hospital Organization Fukuoka Hospital, Fukuoka 811-1394, Japan
| | - Yoshinori Ashihara
- Division of Respiratory Medicine, Oita Nakamura Hospital, Oita 870-0022, Japan
| | | | - Hideaki Suna
- ONO Pharmaceutical Co. Ltd., Osaka 541-8564, Japan
| | - Hiromasa Inoue
- Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
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Aparici M, Carcasona C, Ramos I, Montero JL, Otal R, Ortiz JL, Cortijo J, Puig C, Vilella D, De Alba J, Doe C, Gavaldà A, Miralpeix M. Pharmacological Profile of AZD8871 (LAS191351), a Novel Inhaled Dual M 3 Receptor Antagonist/ β 2-Adrenoceptor Agonist Molecule with Long-Lasting Effects and Favorable Safety Profile. J Pharmacol Exp Ther 2019; 370:127-136. [PMID: 31085697 DOI: 10.1124/jpet.118.255620] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/08/2019] [Indexed: 12/12/2022] Open
Abstract
AZD8871 is a novel muscarinic antagonist and β 2-adrenoceptor agonist in development for chronic obstructive pulmonary disease. This study describes the pharmacological profile of AZD8871 in in vitro and in vivo assays. AZD8871 is potent at the human M3 receptor (pIC50 in binding assays: 9.5) and shows kinetic selectivity for the M3 (half-life: 4.97 hours) over the M2 receptor (half-life: 0.46 hour). It is selective for the β 2-adrenoceptor over the β 1 and β 3 subtypes (3- and 6-fold, respectively) and shows dual antimuscarinic and β 2-adrenoceptor functional activity in isolated guinea pig tissue (pIC50 in electrically stimulated trachea: 8.6; pEC50 in spontaneous tone isolated trachea: 8.8, respectively), which are sustained over time. AZD8871 exhibits a higher muscarinic component than batefenterol in human bronchi, with a shift in potency under propranolol blockade of 2- and 6-fold, respectively, together with a persisting relaxation (5.3% recovery at 8 hours). Nebulized AZD8871 prevents acetylcholine-induced bronchoconstriction in both guinea pig and dog with minimal effects on salivation and heart rate at doses with bronchoprotective activity. Moreover, AZD8871 shows long-lasting effects in dog, with a bronchoprotective half-life longer than 24 hours. In conclusion, these studies demonstrate that AZD8871 is a dual-acting molecule with a high muscarinic component and a long residence time at the M3 receptor; moreover, its preclinical profile in animal models suggests a once-daily dosing in humans and a favorable safety profile. Thus, AZD8871 has the potential to be a next generation of inhaled bronchodilators in respiratory diseases.
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Affiliation(s)
- Mònica Aparici
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Carla Carcasona
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Israel Ramos
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - José Luís Montero
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Raquel Otal
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - José Luís Ortiz
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Julio Cortijo
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Carlos Puig
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Dolors Vilella
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Jorge De Alba
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Chris Doe
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Amadeu Gavaldà
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
| | - Montserrat Miralpeix
- Almirall, Research & Development Center, Sant Feliu de Llobregat, Barcelona, Spain (M.A., C.C., I.R., J.L.M., R.O., C.P., D.V., J.D.A., C.D., A.G., M.M.); and Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain (J.L.O., J.C.)
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SIRT1 Activity in Peripheral Blood Mononuclear Cells Correlates with Altered Lung Function in Patients with Chronic Obstructive Pulmonary Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:9391261. [PMID: 29861836 PMCID: PMC5971245 DOI: 10.1155/2018/9391261] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/17/2018] [Accepted: 03/25/2018] [Indexed: 11/25/2022]
Abstract
Background Oxidative stress is a recognized pathogenic mechanism in chronic obstructive pulmonary disease (COPD). Expression of the NAD+-dependent deacetylase Sirtuin 1 (SIRT1), an antiaging molecule with a key role in oxidative stress response, has been described as decreased in the lung of COPD patients. No studies so far investigated whether systemic SIRT1 activity was associated to decreased lung function in this disease. Methods We measured SIRT1 protein expression and activity in peripheral blood mononuclear cells (PBMCs) and total oxidative status (TOS), total antioxidant capacity (TEAC), and oxidative stress index (TOS/TEAC) in the plasma of 25 COPD patients, 20 healthy nonsmokers (HnS), and 20 healthy smokers (HS). Results The activity of SIRT1 was significantly lower in COPD patients compared to both control groups while protein expression decreased progressively (HnS > HS > COPD). TOS levels were significantly lower in HnS than in smoke-associated subjects (COPD and HS), while TEAC levels were progressively lower according (HnS > HS > COPD). In COPD patients, SIRT1 activity, but not protein levels, correlated significantly with both lung function parameters (FEV1/FVC and FEV1) and TEAC. Conclusions These findings suggest loss of SIRT1-driven antioxidant activity as relevant in COPD pathogenesis and identify SIRT1 activity as a potential convenient biomarker for identification of mild/moderate, stable COPD.
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Li JX, Fu WP, Zhang J, Zhang XH, Sun C, Dai LM, Zhong L, Yu L, Zhang YP. A functional SNP upstream of the ADRB2 gene is associated with COPD. Int J Chron Obstruct Pulmon Dis 2018; 13:917-925. [PMID: 29588580 PMCID: PMC5859892 DOI: 10.2147/copd.s151153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Previous studies have suggested that β2-adrenergic receptor (ADRB2) is associated with COPD. However, the role of genetic polymorphisms in ADRB2 on COPD has not been evaluated yet. Methods In this study, SNaPshot genotyping, luciferase assay, chromatin immunoprecipitation and real-time polymerase chain reaction were adopted to investigate the association between ADRB2 genetic polymorphisms and COPD, comprehensively. Results One single nucleotide polymorphism (rs12654778), located upstream of ADRB2, showed a significant association with COPD by the logistic regression analysis after adjusting for age, sex and smoking history (p=0.04) in 200 COPD patients and 222 controls from southwest Chinese population. Furthermore, the luciferase assay indicated that rs12654778-A allele reduced the relative promoter activity by ~26% compared with rs12654778-G allele (p=0.0034). The chromatin immunoprecipitation analysis demonstrated that rs12654778 modulated the binding affinity of transcription factor neurofibromin 1. In addition, a significantly reduced expression of ADRB2 in COPD patients was observed, compared with normal controls (p=0.017). Conclusion Our findings suggest a previously unknown mechanism linking allele-specific effects of rs12654778 on ADRB2 expression to COPD onset, for the first time.
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MESH Headings
- Adult
- Aged
- Binding Sites
- Case-Control Studies
- Cell Line
- Chi-Square Distribution
- China
- Female
- Forced Expiratory Volume
- Gene Frequency
- Genetic Association Studies
- Genetic Predisposition to Disease
- Humans
- Logistic Models
- Lung/metabolism
- Lung/physiopathology
- Male
- Middle Aged
- Neurofibromin 1/metabolism
- Odds Ratio
- Phenotype
- Polymorphism, Single Nucleotide
- Promoter Regions, Genetic
- Pulmonary Disease, Chronic Obstructive/diagnosis
- Pulmonary Disease, Chronic Obstructive/genetics
- Pulmonary Disease, Chronic Obstructive/metabolism
- Pulmonary Disease, Chronic Obstructive/physiopathology
- Receptors, Adrenergic, beta-2/genetics
- Receptors, Adrenergic, beta-2/metabolism
- Risk Factors
- Vital Capacity
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Affiliation(s)
- Jin-Xiu Li
- State Key Laboratory for Conservation and Utilization of Bio-Resource in Yunnan
- Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, School of Life Sciences, Yunnan University
| | - Wei-Ping Fu
- Department of Respiratory Critical Care Medicine
| | - Jing Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming
| | - Xiao-Hua Zhang
- State Key Laboratory for Conservation and Utilization of Bio-Resource in Yunnan
- Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, School of Life Sciences, Yunnan University
| | - Chang Sun
- State Key Laboratory for Conservation and Utilization of Bio-Resource in Yunnan
- College of Life Sciences
| | - Lu-Ming Dai
- Department of Respiratory Critical Care Medicine
| | - Li Zhong
- State Key Laboratory for Conservation and Utilization of Bio-Resource in Yunnan
- College of Life Sciences
- Provincial Demonstration Center for Experimental Biology Education, Shaanxi Normal University, Xi’an
| | - Li Yu
- State Key Laboratory for Conservation and Utilization of Bio-Resource in Yunnan
- Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, School of Life Sciences, Yunnan University
| | - Ya-Ping Zhang
- State Key Laboratory for Conservation and Utilization of Bio-Resource in Yunnan
- State Key Laboratory of Genetic Resources and Evolution, and Yunnan Laboratory of Molecular Biology of Domestic Animals, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
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Aparici M, Carcasona C, Ramos I, Montero JL, Ortiz JL, Cortijo J, Puig C, Vilella D, Doe C, Gavaldà A, Miralpeix M. Pharmacological preclinical characterization of LAS190792, a novel inhaled bifunctional muscarinic receptor antagonist /β 2 -adrenoceptor agonist (MABA) molecule. Pulm Pharmacol Ther 2017; 46:1-10. [DOI: 10.1016/j.pupt.2017.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/02/2017] [Accepted: 07/15/2017] [Indexed: 01/29/2023]
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Tian C, Wang JY, Wang ML, Jiang B, Zhang LL, Liu F. Morphine versus methylprednisolone or aminophylline for relieving dyspnea in patients with advanced cancer in China: a retrospective study. SPRINGERPLUS 2016; 5:1945. [PMID: 27917339 PMCID: PMC5102996 DOI: 10.1186/s40064-016-3651-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022]
Abstract
Context Dyspnea is one of the most common and distressing symptoms that occurs in terminal cancer patients. However, there are no existing treatment guidelines for this condition in China. Objective This single-center, retrospective, observational study aimed to compare the efficacy of using morphine, methylprednisolone, or aminophylline to relieve the symptom of breathlessness in patients with advanced malignant tumors and to investigate the safety of these regimens during the treatment of dyspnea. Methods Between August 2011 and January 2015 we retrospectively reviewed the medical records of 343 terminally ill cancer patients with dyspnea who received morphine, methylprednisolone, or aminophylline. The therapeutic effect of each treatment by means of visual analogue scale (VAS) scores was assessed and compared. Statistical methods included Chi square and analysis of variance tests. Differences were considered significant when P < 0.05. Results VAS scores after treatment were (16.82 ± 10.89), (25.72 ± 15.03), and (31.95 ± 16.00) points in the morphine, methylprednisolone, and aminophylline group, respectively. These differences were found to be significantly different (P < 0.05). The effectiveness ratings were 86.44, 62.16, and 49.12%, respectively (P < 0.05). Conclusions We found that morphine subcutaneous injection for advanced cancer patients with dyspnea was safe and typically more effective than methylprednisolone or aminophylline. Therefore, morphine treatment could significantly improve the quality of life in terminal cancer patients with short life expectancies who are experiencing shortness of breath.
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Affiliation(s)
- Cong Tian
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Jiong-Yi Wang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Mei-Ling Wang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Bin Jiang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Lu-Lu Zhang
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
| | - Feng Liu
- Department of Medical Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, 201900 China
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10
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Gea J, Casadevall C, Pascual S, Orozco-Levi M, Barreiro E. Clinical management of chronic obstructive pulmonary disease patients with muscle dysfunction. J Thorac Dis 2016; 8:3379-3400. [PMID: 28066619 DOI: 10.21037/jtd.2016.11.105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Muscle dysfunction is frequently observed in chronic obstructive pulmonary disease (COPD) patients, contributing to their exercise limitation and a worsening prognosis. The main factor leading to limb muscle dysfunction is deconditioning, whereas respiratory muscle dysfunction is mostly the result of pulmonary hyperinflation. However, both limb and respiratory muscles are also influenced by other negative factors, including smoking, systemic inflammation, nutritional abnormalities, exacerbations and some drugs. Limb muscle weakness is generally diagnosed through voluntary isometric maneuvers such as handgrip or quadriceps muscle contraction (dynamometry); while respiratory muscle loss of strength is usually recognized through a decrease in maximal static pressures measured at the mouth. Both types of measurements have validated reference values. Respiratory muscle strength can also be evaluated determining esophageal, gastric and transdiaphragmatic maximal pressures although there is a lack of widely accepted reference equations. Non-volitional maneuvers, obtained through electrical or magnetic stimulation, can be employed in patients unable to cooperate. Muscle endurance can also be assessed, generally using repeated submaximal maneuvers until exhaustion, but no validated reference values are available yet. The treatment of muscle dysfunction is multidimensional and includes improvement in lifestyle habits (smoking abstinence, healthy diet and a good level of physical activity, preferably outside), nutritional measures (diet supplements and occasionally, anabolic drugs), and different modalities of general and muscle training.
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Affiliation(s)
- Joaquim Gea
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Carme Casadevall
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Sergi Pascual
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Mauricio Orozco-Levi
- Department of Respiratory, Cardiovascular Foundation from Colombia Floridablanca, Santander, Colombia, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Esther Barreiro
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
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11
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López-Campos JL, Abad Arranz M, Calero Acuña C, Romero Valero F, Ayerbe García R, Hidalgo Molina A, Aguilar Perez-Grovas RI, García Gil F, Casas Maldonado F, Caballero Ballesteros L, Sánchez Palop M, Pérez-Tejero D, Segado A, Calvo Bonachera J, Hernández Sierra B, Doménech A, Arroyo Varela M, González Vargas F, Cruz Rueda JJ. Determinants for changing the treatment of COPD: a regression analysis from a clinical audit. Int J Chron Obstruct Pulmon Dis 2016; 11:1171-8. [PMID: 27330285 PMCID: PMC4898035 DOI: 10.2147/copd.s103614] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction This study is an analysis of a pilot COPD clinical audit that evaluated adherence to guidelines for patients with COPD in a stable disease phase during a routine visit in specialized secondary care outpatient clinics in order to identify the variables associated with the decision to step-up or step-down pharmacological treatment. Methods This study was a pilot clinical audit performed at hospital outpatient respiratory clinics in the region of Andalusia, Spain (eight provinces with over eight million inhabitants), in which 20% of centers in the area (catchment population 3,143,086 inhabitants) were invited to participate. Treatment changes were evaluated in terms of the number of prescribed medications and were classified as step-up, step-down, or no change. Three backward stepwise binominal multivariate logistic regression analyses were conducted to evaluate variables associated with stepping up, stepping down, and inhaled corticosteroids discontinuation. Results The present analysis evaluated 565 clinical records (91%) of the complete audit. Of those records, 366 (64.8%) cases saw no change in pharmacological treatment, while 99 patients (17.5%) had an increase in the number of drugs, 55 (9.7%) had a decrease in the number of drugs, and 45 (8.0%) noted a change to other medication for a similar therapeutic scheme. Exacerbations were the main factor in stepping up treatment, as were the symptoms themselves. In contrast, rather than symptoms, doctors used forced expiratory volume in 1 second and previous treatment with long-term antibiotics or inhaled corticosteroids as the key determinants to stepping down treatment. Conclusion The majority of doctors did not change the prescription. When changes were made, a number of related factors were noted. Future trials must evaluate whether these therapeutic changes impact clinically relevant outcomes at follow-up.
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Affiliation(s)
- Jose Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - María Abad Arranz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Carmen Calero Acuña
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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12
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Ferreira AJ, Reis A, Marçal N, Pinto P, Bárbara C. COPD: A stepwise or a hit hard approach? REVISTA PORTUGUESA DE PNEUMOLOGIA 2016; 22:214-21. [PMID: 26935750 DOI: 10.1016/j.rppnen.2015.12.012] [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: 08/22/2015] [Revised: 11/28/2015] [Accepted: 12/27/2015] [Indexed: 10/22/2022] Open
Abstract
Current guidelines differ slightly on the recommendations for treatment of Chronic Obstructive Pulmonary Disease (COPD) patients, and although there are some undisputed recommendations, there is still debate regarding the management of COPD. One of the hindrances to deciding which therapeutic approach to choose is late diagnosis or misdiagnosis of COPD. After a proper diagnosis is achieved and severity assessed, the choice between a stepwise or "hit hard" approach has to be made. For GOLD A patients the stepwise approach is recommended, whilst for B, C and D patients this remains debatable. Moreover, in patients for whom inhaled corticosteroids (ICS) are recommended, a step-up or "hit hard" approach with triple therapy will depend on the patient's characteristics and, for patients who are being over-treated with ICS, ICS withdrawal should be performed, in order to optimize therapy and reduce excessive medications. This paper discusses and proposes stepwise, "hit hard", step-up and ICS withdrawal therapeutic approaches for COPD patients based on their GOLD group. We conclude that all approaches have benefits, and only a careful patient selection will determine which approach is better, and which patients will benefit the most from each approach.
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Affiliation(s)
- A J Ferreira
- Pulmonology Department, Centro Hospitalar Universitário de Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal
| | - A Reis
- Pulmonology Department, Centro Hospitalar Tondela-Viseu, EPE, Portugal
| | - N Marçal
- Pulmonology Department, Hospital de Vila Franca de Xira, Portugal
| | - P Pinto
- Chest Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Portugal
| | - C Bárbara
- Chest Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal; Environmental Health Institute (ISAMB), Faculty of Medicine, University of Lisbon, Portugal.
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13
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Sirtuin 1 and aging theory for chronic obstructive pulmonary disease. Anal Cell Pathol (Amst) 2015; 2015:897327. [PMID: 26236580 PMCID: PMC4506835 DOI: 10.1155/2015/897327] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/15/2015] [Accepted: 06/17/2015] [Indexed: 02/07/2023] Open
Abstract
Chronic Obstructive Pulmonary disease (COPD) is an inflammatory syndrome that represents an increasing health problem, especially in the elderly population. Drug therapies are symptomatic and inadequate to contrast disease progression and mortality. Thus, there is an urgent need to clarify the molecular mechanisms responsible for this condition in order to identify new biomarkers and therapeutic targets. Processes including oxidant/antioxidant, protease/antiprotease, and proliferative/antiproliferative balance and control of inflammatory response become dysfunctional during aging as well as in COPD. Recently it was suggested that Sirtuin 1 (SIRT1), an antiaging molecule involved in the response to oxidative stress and chronic inflammation, is implicated in both development and progression of COPD. The present review focuses on the involvement of SIRT1 in the regulation of redox state, inflammation, and premature senescence, all crucial characteristics of COPD phenotypes. Recent evidence corroborating the statement of the “aging theory for COPD” was also discussed.
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López-Campos JL, Abad-Arranz M, Calero-Acuña C. Double or Dual Bronchodilation: Defining the Correct Term. Arch Bronconeumol 2015; 51:661. [PMID: 25910546 DOI: 10.1016/j.arbres.2015.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 02/20/2015] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
Affiliation(s)
- José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Sevilla, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España.
| | - María Abad-Arranz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Sevilla, España
| | - Carmen Calero-Acuña
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Sevilla, España; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
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