[The concept of risk factors in assessing the impact of smoking on an exacerbation of chronic obstructive pulmonary disease]

Effect of lentivirus-mediated CFTR overexpression on oxidative stress injury and inflammatory response in the lung tissue of COPD mouse model

We aimed to investigate the regulatory mechanism of lentivirus-mediated overexpression of cystic fibrosis transmembrane conductance regulator (CFTR) in oxidative stress injury and inflammatory response in the lung tissue of mouse model of chronic obstructive pulmonary disease (COPD). COPD mouse model induced by cigarette smoke was established and normal mice were used as control. The mice were assigned into a normal group (control), a model group (untreated), an oe-CFTR group (injection of lentivirus overexpressing CFTR), and an oe-NC group (negative control, injection of lentivirus expressing irrelevant sequences). Compared with the oe-NC group, the oe-CFTR group had higher CFTR expression and a better recovery of pulmonary function. CFTR overexpression could inhibit the pulmonary endothelial cell apoptosis, reduce the levels of glutathione (GSH), reactive oxygen species (ROS), and malondialdehyde (MDA) and increase the values of superoxide dismutase (SOD), GSH peroxidase (GSH-Px), and total antioxidant capacity (T-AOC). The overexpression also led to reductions in the white blood cell (WBC) count in alveolus pulmonis, the concentrations of C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor-α, and the protein expressions of NF-κB p65, ERK, JNK, p-EPK, and p-JNK related to MAPK/NF-κB p65 signaling pathway. In conclusion, CFTR overexpression can protect lung tissues from injuries caused by oxidative stress and inflammatory response in COPD mouse model. The mechanism behind this may be related to the suppression of MAPK/NF-κB p65 signaling pathway.

Assessment of the clinical efficacy of telemonitoring and distant counseling in patients with uncontrolled hypertension

The aim of the study was to investigate the mathematical correlation of the clinical efficacy of blood pressure telemonitoring and distant counseling (BPTM) in patients in uncontrolled hypertension (HTN). Telehealth tools are widely used in HTN management. However clinical efficacy of such interventions assessed mainly in groups investigated without its populational and attributable impact. Materials and methods. The total of 240 patients were included, then randomized in 2:1 manner to BPTM group (n=160, median age 47 y.o.) and control group (n=80, median age 49 y.o). The user - friendly and secure telehealth software was provided with mobile application (patients) and desktop (doctors) platforms which allowed storage and analysis of self-BP monitoring data and remote consultations. A three - month surveillance was designed with mandatory baseline and final face - to - face visits with the assessment of office systolic BP (oSBP). Mathematical evaluation was based on target SBP rates achieved in comparator groups and included the absolute efficacies (AE), the attributable efficacy (AtE), the relative efficacy (RE) and the population attributable efficacy (PAtE). Results. BPTM group characterized by larger decrease in SBP level compared with controls (-16.8±2.9 mm Hg versus -7.9±3.9 mm Hg; p

Methodology for determining the correlation of the clinical efficacy of therapy with the addition of a drug (for example, anti-asthma therapy in children)

Introduction: In the recent years, much attention has been paid to the use of leukotriene receptor antagonists (LTRA) in the treatment of bronchial asthma (BA). It has been even proposed to use them as alternatives to hormone therapy. Yet, there are studies demonstrating the advantage of montelukast as similar to placebo. The objective was to create a methodology for determining the correlation of the clinical efficacy of therapy with the addition of a drug (on example, clinical efficacy of montelukast in an anti-asthmatic therapy in pediatric patients).

Materials and methods: The data on prescribed regimens was retrospectively extracted from the inpatient records of 608 BA patients admitted to hospital in 2014–2015. Mathematical evaluation was based on the risk factor concept.

Results and discussion: The absolute efficacies (AEs) was estimated to be 91.85% (95% CI 90.15–93.55%) in the exposed group; the attributable efficacy (AtE) was found to be 17.00% (95% CI 10.91–23.09%); the relative efficacy (RE) was found to be 1.23 (95% CI 0.21–2.24); and the population attributable efficacy (PAtE) was found to be 7.55% (95% CI 2.49–12.61%).

Conclusions: The AtE, RE, and PAtE were statistically significant. The RE was found to be 1.23. However, the lower limit of its 95% CI (0.21–2.24) was less than 1, indicating that the increase in clinical efficacy was not found to be statistically significant. In the studied sample positive outcome rates were 91.85% (95% CI 90.15–93.55%) in the exposed group and 74.85% (95% CI 72.49–77.21%) in the comparator group. He presented methodology for determining the correlation of the clinical efficacy of the pharmacotherapy regimen with the addition of a drug can be successfully applied in the future.

[Plasma low-molecular-weight DNA in patients with chronic obstructive pulmonary disease]

AIM

To determine plasma extracellular low-molecular-weight DNA (elmwDNA) as an indicator of apoptosis in patients with chronic obstructive pulmonary disease (COPD) in remission versus healthy donors, patients with chronic non-obstructive bronchitis (CNOB), and their first-degree relatives (FDRs).

SUBJECTS AND METHODS

The investigation recruited 110 participants, including 17 healthy donors, 31 patients with COPD, and 20 patients with CNOB in remission, 19 healthy FDRs of patients with COPD, and 23 healthy FDRs of those with SNOB. The plasma levels of elmwDNA were determined in the study participants. Nucleic acids were isolated by phenol/chloroform extraction, precipitated with ethanol, and treated with RNase; elmwDNA was analyzed by electrophoresis.

RESULTS

In patients with COPD, the mean level of elmwDNA was 7.8±2.0 ng/ml, which was 3.9 and 3.0 times statistically significantly lower than that in healthy donors and patients with SNOB, respectively; while the level of elmwDNA in the latter did not differ statistically significantly from that in healthy donors. In both the blood relatives of patients with COPD and FDRs of those with SNOB, the mean level of elmwDNA was not significantly different from that in healthy donors. The content of elmwDNA tended to increase in COPD patients aged 60-80 years as compared to those aged 45-59 years; that in both age groups was, however, significantly lower than in healthy donors of the same age.

CONCLUSION

The level of elmwDNA in plasma and, accordingly, apoptosis in the lung are reduced in patients with COPD in remission, whereas that is unchanged in those with SNOB. In patients with COPD, blood elmwDNA release is unrelated to heredity and varies little with age. The determination of elmwDNA is recommended for use in patients with COPD to assess apoptosis.