Altering cough reflex sensitivity with aerosolized capsaicin paired with behavioral cough suppression: a proof-of-concept study

Sensorimotor Cough Dysfunction in Cerebellar Ataxias

Cerebellar ataxias are neurological conditions with a high prevalence of aspiration pneumonia and dysphagia. Recent research shows that sensorimotor cough dysfunction is associated with airway invasion and dysphagia in other neurological conditions and may increase the risk of pneumonia. Therefore, this study aimed to characterize sensorimotor cough function and its relationship with ataxia severity. Thirty-seven participants with cerebellar ataxia completed voluntary and/or reflex cough testing. Ataxia severity was assessed using the Scale for the Assessment and Rating of Ataxia (SARA). Linear multilevel models revealed voluntary cough peak expiratory flow rate (PEFR) estimates of 2.61 L/s and cough expired volume (CEV) estimates of 0.52 L. Reflex PEFR (1.82 L/s) and CEV (0.34 L) estimates were lower than voluntary PEFR and CEV estimates. Variability was higher for reflex PEFR (15.74% coefficient of variation [CoV]) than voluntary PEFR (12.13% CoV). 46% of participants generated at least two, two-cough responses following presentations of reflex cough stimuli. There was a small inverse relationship between ataxia severity and voluntary PEFR (β = -0.05, 95% CI: -0.09 - -0.01 L) and ataxia severity and voluntary CEV (β = -0.01, 95% CI: -0.02 - -0.004 L/s). Relationships between reflex cough motor outcomes (PEFR β = 0.03, 95% CI: -0.007-0.07 L/s; CEV β = 0.007, 95% CI: -0.004-0.02 L) and ataxia severity were not statistically robust. Results indicate that voluntary and reflex cough sensorimotor dysfunction is present in cerebellar ataxias and that increased severity of ataxia symptoms may impact voluntary cough function.

Characterization of Ethyl Butyrate-Induced Cough Before and After Breath Control Techniques in Healthy Adults

PURPOSE

Methods for cough elicitation frequently involve aerosolized tussive agents. Here, we sought to determine whether healthy individuals demonstrate a quantifiable cough response after inhaling a volatile ester and if breath control techniques modify this chemically induced cough response.

METHOD

Sixty adult male and female participants inhaled prepared liquid dilutions of ethyl butyrate dissolved in paraffin oil at 20%, 40%, and 60% v/v concentrations in triplicate, with presentation order randomized. We delivered stimuli through a face mask connected to an olfactometer and respiratory pneumotachograph. Participants rated sensations of their urge to cough and pleasantness of the odor while cough airflow was measured. Following baseline testing, participants were randomized to implement pursed-lip breathing or slow-paced breathing after inhaling ethyl butyrate to determine the effects of breath control on cough measures.

RESULTS

Inhaled ethyl butyrate elicited cough in 70% of participants. Higher concentrations of ethyl butyrate resulted in significantly greater sensation of the urge to cough, F(2, 80) = 10.72, p < .001, and significantly more generated coughs, F(2, 63) = 13.14, p < .001. Compared to baseline, participants rated significantly decreased urge to cough during breath control techniques, F(1, 40) = 11.01, p = .0019. No significant changes were observed in the number of generated coughs between baseline and breath control techniques, F(1, 31) = 7.23, p = .01.

CONCLUSIONS

Airborne ethyl butyrate is a tussigenic agent in humans. Our findings provide opportunities for future research directions in normal and disordered cough responses to volatile compounds.

L22 ribosomal protein is involved in dynamin-related protein 1-mediated gastric carcinoma progression

Mitochondrial fission depends on dynamin-related protein 1 (Drp1) guanosine triphosphatase activity. Although there is some association between Drp1 and gastric cancer, the detailed mechanism remains largely unknown. In this study, the elevation of Drp1 was observed in human gastric carcinoma specimens including gastric mixed adenocarcinoma tissues, gastric intestinal-type adenocarcinoma tissues, and human gastric cancer cells compared to normal control, but not in diffuse gastric adenocarcinoma tissues. Gastric cancer patients with high Drp1 harbored advanced pathological stages and poor progression-free survival probability compared to those with low Drp1. Mdivi-1-mediated inactivation of Drp1 robustly inhibited cell viability and tumor growth but conversely induced cell apoptotic events in vitro and in vivo. Based on the Encyclopedia of RNA Interactomes Starbase, L22 ribosomal protein (RPL22) was recognized as the potential downstream oncogene of Drp1. Clinically, the significant correlation of Drp1 and RPL22 was also verified. Mechanistically, Drp1 inactivation did not affect the accumulation of RPL22 in gastric carcinoma. However, the intracellular distribution of RPL22 had an endonuclear location in Drp1-inactivated tumors. Of note, Drp1 inactivation notably reduced the expression of cytoplasmic RPL22 and increased its nuclear level in gastric cancer cells. Collectively, Drp1 had high levels in human gastric carcinoma specimens and could serve as a potential diagnostic and prognostic biomarker in gastric carcinoma. The Drp1 inactivation-mediated anti-proliferative and pro-apoptosis effects on gastric cancer were possibly associated with nuclear import of RPL22. This knowledge may provide new therapeutic tools for treating gastric carcinoma via targeting mitochondria-related ribosome pathway.

Evaluation methods and influencing factors of cough sensitivity

Increased cough sensitivity is an important mechanism of chronic cough, and the evaluation of cough sensitivity helps understand the mechanism of cough and explore better methods to reduce cough. Evaluation methods may be direct or indirect. Direct methods include mechanical stimulation and chemical stimulation, and indirect methods include laryngeal reflex test, questionnaires, and brain functional magnetic resonance imaging (fMRI). Chemical stimulation is the most common method, while the capsaicin cough challenge test is proven and widely used. In this article, we will compare evaluation methods and explore influencing factors of cough sensitivity.

Expression and methylation status of BTG2, PPP1CA, and PEG3 genes in colon adenocarcinoma cell lines: promising treatment targets

Aim

This study investigated the association between methylation status and expression levels of BTG2, PPP1CA, and PEG3 genes in colon cancer.

Background

Aberrant DNA methylation is one of the most important epigenetic modifications in the development of cancer. Evidence indicates that hypermethylation of various tumor suppressor genes could be a potential mechanism of colon tumorigenesis.

Methods

The expression levels of BTG2, PPP1CA, and PEG3 genes were evaluated in HT-29/219, HCT116, SW48, SW742, SW480, and LS180 cell lines using quantitative Real-Time PCR. The methylation status of BTG2 and PPP1CA was determined by methylation-specific PCR (MSP) method, and the methylation pattern of PEG3 was evaluated by bisulfite sequencing PCR (BSP). To investigate the effect of methylation on the expression of these genes, all colon cancer cell lines were treated by 5-Azacitidine (5-Aza) and/or Trichostatin A (TSA).

Results

The expression levels of BTG2, PPP1CA, and PEG3 were highly heterogeneous and quantitatively correlated to their promoter methylation status in the studied colon cancer cell lines. Treatment by 5-Aza and/or TSA increased the expression of the above-named genes in colon cancer cell lines.

Conclusion

Overall, it seems that BTG2, PPP1CA, and PEG3 act as tumor suppressor genes in colon cancer, and methylation is a potential mechanism for their loss of expression. Therefore, these genes may be considered as suitable targets for demethylation approaches and, eventually, colon cancer treatment. Combined treatment by 5-Aza and TSA may be a promising therapeutic strategy for colon cancer treatment. Further studies may contribute to confirm these results.

Decision making on vestibular schwannoma treatment: predictions based on machine-learning analysis

Decision making on the treatment of vestibular schwannoma (VS) is mainly based on the symptoms, tumor size, patient's preference, and experience of the medical team. Here we provide objective tools to support the decision process by answering two questions: can a single checkup predict the need of active treatment?, and which attributes of VS development are important in decision making on active treatment? Using a machine-learning analysis of medical records of 93 patients, the objectives were addressed using two classification tasks: a time-independent case-based reasoning (CBR), where each medical record was treated as independent, and a personalized dynamic analysis (PDA), during which we analyzed the individual development of each patient's state in time. Using the CBR method we found that Koos classification of tumor size, speech reception threshold, and pure tone audiometry, collectively predict the need for active treatment with approximately 90% accuracy; in the PDA task, only the increase of Koos classification and VS size were sufficient. Our results indicate that VS treatment may be reliably predicted using only a small set of basic parameters, even without the knowledge of individual development, which may help to simplify VS treatment strategies, reduce the number of examinations, and increase cause effectiveness.

Analysis of Nuclear Encoded Mitochondrial Gene Networks in Cervical Cancer

BACKGROUND

Cervical cancer (CC) is one of the most common female cancers in many developing and underdeveloped countries. High incidence, late presentation, and mortality suggested the need for molecular markers. Mitochondrial defects due to abnormal expression of nuclear-encoded mitochondrial genes (NEMG) have been reported during cancer progression. Nevertheless, the application of NEMG for the prognosis of CC is still elusive. Herein, we aimed to investigate the associations between NEMG and CC prognosis.

MATERIALS AND METHODS

The differentially expressed genes (DEG) in the TCGA-CESC dataset and NEMGs were retrieved from TACCO and Mitocarta2.0 databases, respectively. The impact of methylation on NEMG expression were predicted using DNMIVD and UALCAN tools. HCMDB tool was used to predict genes having metastatic potential. The prognostic models were constructed using DNMIVD, TACCO, GEPIA2, and SurvExpress. The functional enrichment analysis (FEA) was performed using clusterProfiler. The protein-protein interaction network (PPIN) was constructed to identify the hub genes (HG) using String and CytoHubba tools. Independent validation of the HG was performed using Oncomine and Human Protein Atlas databases. The druggable genes were predicted using DGIdb.

RESULTS

Among the 52 differentially expressed NEMG, 15 were regulated by DNA methylation. The expression level of 16, 10, and 7 has the potential for CC staging, prediction of metastasis, and prognosis. Moreover, 1 driver gene and 16 druggable genes were also identified. The FEA identified the enrichment of cancer-related pathways, including AMPK and carbon metabolism in cancer. The combined expression of 10 HG has been shown to affect patient survival.

CONCLUSION

Our findings suggest that the abnormal expression of NEMGs may play a critical role in CC development and progression. The genes identified in our study may serve as a prognostic indicator and therapeutic target in CC.
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Liquiritin, a novel inhibitor of TRPV1 and TRPA1, protects against LPS-induced acute lung injury

TRPV1 and TRPA1 are cation channels that play key roles in inflammatory signaling pathways. They are co-expressed on airway C-fibers, where they exert synergistic effects on causing inflammation and cough. Licorice, the root of Glycyrrhiza uralensis, has been widely used in China as an anti-inflammatory and anti-coughing herb. To learn if TRPV1 and TRPA1 might be key targets of the anti-inflammatory and antitussive effects of licorice, we examined liquiritin, the main flavonoid compound and active ingredient of licorice, on agonist-evoked TRPV1 and TRPA1 activation. Liquiritin inhibited capsaicin- and allyl isothiocyanate-evoked TRPV1 and TRPA1 whole-cell currents, respectively, with a similar potency and maximal inhibition. In a mouse acute lung injury (ALI) model induced by the bacterial endotoxin lipopolysaccharide, which involves both TRPV1 and TRPA1, an oral gavage of liquiritin prevented tissue damage and suppressed inflammation and the activation of NF-κB signaling pathway in the lung tissue. Liquiritin also suppressed LPS-induced increase in TRPV1 and TRPA1 protein expression in the lung tissue, as well as TRPV1 and TRPA1 mRNA levels in cells contained in mouse bronchoalveolar lavage fluid. In cultured THP-1 monocytes, liguiritin, or TRPV1 and TRPA1 antagonists capsazepine and HC030031, respectively, diminished not only cytokine-induced upregulation of NF-κB function but also TRPV1 and TRPA1 expression at both protein and mRNA levels. We conclude that the anti-inflammatory and antitussive effects of liquiritin are mediated by the dual inhibition of TRPV1 and TRPA1 channels, which are upregulated in nonneuronal cells through the NF-κB pathway during airway inflammation via a positive feedback mechanism.

Assessment of Occupational Health Hazards Due to Particulate Matter Originated from Spices

Spices have been known for their various health activities; however, they also possess the allergic potential for the respiratory system and the skin as they are fine particulate matter. Persons involved in spice agriculture and food industries are at greater risk since they are exposed to a considerable amount of combustible dust, which may be the cause of fire and explosion and adversely affect the health. These workers may experience allergy, long-term and short-term respiratory issues including occupational asthma, dermatitis, etc. Some spices induce T cell-based inflammatory reaction upon contact recognition of the antigen. Antigen Presenting Cells (APC) on binding to the causative metabolite results in activation of macrophages by allergen cytokine interleukin (IL)-12 and tumor necrosis factor-beta (TNF). Cross-reactivity for protein allergens is another factor which seems to be a significant trigger for the stimulation of allergic reactions. Thus, it was imperative to perform a systematic review along with bioinformatics based representation of some evident allergens has been done to identify the overall conservation of epitopes. In the present manuscript, we have covered a multifold approach, i.e., to categorize the spice particles based on a clear understanding about nature, origin, mechanisms; to assess metabolic reactions of the particles after exposure as well as knowledge on the conditions of exposure along with associated potential health effects. Another aim of this study is to provide some suggestions to prevent and to control the exposure up to some extent.