1
|
Qiu W, He H, Fan L, Feng X, Li M, Dong C, Li Z, Liu W, Liang R, Zhang Y, Zhang Y, Gu P, Wang B, Chen W. Ambient temperature exposure causes lung function impairment: The evidence from Controlled Temperature Study in Healthy Subjects (CTSHS). Int J Hyg Environ Health 2023; 252:114214. [PMID: 37392524 DOI: 10.1016/j.ijheh.2023.114214] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/14/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND The effect of non-optimal ambient temperatures (low and high temperatures) on lung function and the underlying mechanisms remains unclear. METHODS Forty-three (20 males, 23 females) healthy non-obese volunteers with an average of 23.9 years participated in the controlled temperature study. All volunteers underwent three temperature exposures in a sequence (moderate [18 °C], low [6 °C], and high [30 °C] temperatures) lasting 12 h with air pollutants controlled. lung function parameters (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and peak expiratory flow [PEF]) were determined in each exposure. Blood and urine samples were collected after each exposure and assayed for inflammatory markers [C-reactive protein (CRP), procalcitonin (PCT), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR)] and oxidative damage markers [protein carbonylation (PCO), 4-hydroxy-2-nominal-mercapturic acid (HNE-MA), 8-iso-prostaglandin-F2α (8-isoPGF2α), and 8-hydroxy-2-deoxyguanosine (8-OHdG)]. Mixed-effects models were constructed to assess the changes of the above indexes under low or high temperatures relative to moderate temperature, and then the repeated measures correlation analyses were performed. RESULTS Compared with moderate temperature, a 2.20% and 2.59% net decrease in FVC, FEV1, and a 5.68% net increase for PEF were observed under low-temperature exposure, while a 1.59% net decrease in FVC and a 7.29% net increase in PEF under high-temperature exposure were found (all P < 0.05). In addition, low temperature elevated inflammatory markers (PCT, PLR, and NLR) and oxidative damage markers (8-isoPGF2α, 8-OHdG), and high temperature elevated HNE-MA. Repeated measures correlation analyses revealed that PCT (r = -0.33) and NLR (r = -0.31) were negatively correlated with FVC and HNE-MA (r = -0.35) and 8-OHdG (r = -0.31) were negatively correlated with the FEV1 under low-temperature exposure (all P < 0.05). CONCLUSION Non-optimal ambient temperatures exposure alters lung function, inflammation, and oxidative damage. Inflammation and oxidative damage might be involved in low temperature-related lung function reduction.
Collapse
Affiliation(s)
- Weihong Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China; Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Heng He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Lieyang Fan
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Xiaobing Feng
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Minjing Li
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Chaoqian Dong
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Zhenzhen Li
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Wei Liu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Ruyi Liang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yingdie Zhang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Yongfang Zhang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Pei Gu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
| |
Collapse
|
2
|
Morasert T, Kriengwattanakul O, Kulalert P. Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis. Int J Chron Obstruct Pulmon Dis 2022; 17:2229-2239. [PMID: 36124296 PMCID: PMC9482436 DOI: 10.2147/copd.s373595] [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: 05/11/2022] [Accepted: 08/28/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to assess whether the short-term use of macrolide antibiotics during hospitalization can reduce in-hospital all-cause mortality compared to non-macrolide treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A propensity score (PS) matching analysis was performed using retrospective data from the admission records of AECOPD patients in the medical general ward and medical intensive care unit of a tertiary care center between October 2015 and September 2018. The multivariable Cox proportional hazard model was performed to eliminate residual confounding after the PS analysis. Results The mortality rate was 11.1% of 1528 admissions in the PS matching cohort. Approximately 70% of patients had respiratory failure requiring intubation on initial admission, and 34% had pneumonia. Macrolide treatment significantly reduced in-hospital mortality among AECOPD patients (adjusted hazard ratio, 0.55; 95% confidence interval 0.32–0.96; P=0.034). Clarithromycin was the most commonly prescribed macrolide (80%). Conclusion Macrolide antibiotics reduced in-hospital mortality in hospitalized AECOPD patients. The combination of antimicrobial and immunomodulatory effects of macrolide treatment could play an essential role.
Collapse
Affiliation(s)
- Thotsaporn Morasert
- Pulmonary and Critical Care Medicine, Department of Internal Medicine, Suratthani Hospital, Surat Thani, 84000, Thailand
| | | | - Prapasri Kulalert
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| |
Collapse
|
3
|
Dawood A, Algharib SA, Zhao G, Zhu T, Qi M, Delai K, Hao Z, Marawan MA, Shirani I, Guo A. Mycoplasmas as Host Pantropic and Specific Pathogens: Clinical Implications, Gene Transfer, Virulence Factors, and Future Perspectives. Front Cell Infect Microbiol 2022; 12:855731. [PMID: 35646746 PMCID: PMC9137434 DOI: 10.3389/fcimb.2022.855731] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/04/2022] [Indexed: 12/28/2022] Open
Abstract
Mycoplasmas as economically important and pantropic pathogens can cause similar clinical diseases in different hosts by eluding host defense and establishing their niches despite their limited metabolic capacities. Besides, enormous undiscovered virulence has a fundamental role in the pathogenesis of pathogenic mycoplasmas. On the other hand, they are host-specific pathogens with some highly pathogenic members that can colonize a vast number of habitats. Reshuffling mycoplasmas genetic information and evolving rapidly is a way to avoid their host's immune system. However, currently, only a few control measures exist against some mycoplasmosis which are far from satisfaction. This review aimed to provide an updated insight into the state of mycoplasmas as pathogens by summarizing and analyzing the comprehensive progress, current challenge, and future perspectives of mycoplasmas. It covers clinical implications of mycoplasmas in humans and domestic and wild animals, virulence-related factors, the process of gene transfer and its crucial prospects, the current application and future perspectives of nanotechnology for diagnosing and curing mycoplasmosis, Mycoplasma vaccination, and protective immunity. Several questions remain unanswered and are recommended to pay close attention to. The findings would be helpful to develop new strategies for basic and applied research on mycoplasmas and facilitate the control of mycoplasmosis for humans and various species of animals.
Collapse
Affiliation(s)
- Ali Dawood
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
- Hubei Hongshan Laboratory, Wuhan, China
| | - Samah Attia Algharib
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, HZAU, Wuhan, China
- Department of Clinical Pathology, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Gang Zhao
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Tingting Zhu
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Mingpu Qi
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Kong Delai
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhiyu Hao
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| | - Marawan A. Marawan
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- Infectious Diseases, Faculty of Veterinary Medicine, Benha University, Toukh, Egypt
| | - Ihsanullah Shirani
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- Para-Clinic Department, Faculty of Veterinary Medicine, Jalalabad, Afghanistan
| | - Aizhen Guo
- The State Key Laboratory of Agricultural Microbiology, (HZAU), Wuhan, China
- College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
- Hubei Hongshan Laboratory, Wuhan, China
- Hubei International Scientific and Technological Cooperation Base of Veterinary Epidemiology, Huazhong Agricultural University, Wuhan, China
| |
Collapse
|
4
|
Ye YP, Zhao H, Kang T, Zhao LH, Li N, Chen J, Peng XX. Optimal cut-off value of serum procalcitonin in predicting bacterial infection induced acute exacerbation in chronic obstructive pulmonary disease: A prospective observational study. Chron Respir Dis 2022; 19:14799731221108516. [PMID: 35830291 PMCID: PMC9284202 DOI: 10.1177/14799731221108516] [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] [Indexed: 11/15/2022] Open
Abstract
Objective To explore the optimal cut-off value of serum procalcitonin (PCT) level in
predicting bacterial infection in hospitalized patients with acute
exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 204 hospitalized patients with AECOPD were enrolled in this study. Their
diagnoses and treatments followed routine protocols in Fu-Xing Hospital
affiliated to Capital Medical University, Beijing, China. Extra blood
samples were taken for serum PCT level testing and the results were blinded
to the treating physicians. On discharge, clinical data were collected and
the treating physicians made comprehensive analyses to determine whether the
AECOPD were triggered by respiratory tract bacterial infection or
non-bacterial causes according to the “new diagnostic criteria” defined in
this study. In the AECOPD patients with bacterial infection, treating
physicians decided whether they had bacterial pneumonia based on imaging
studies. Receiver operating characteristic curve (ROC) was used to analyze
the accuracy of serum PCT level in predicting bacterial infection. Results In the 173 AECOPD patients who did not have pneumonia, 115 had evidences of
bacterial infection while 58 did not. The median PCT levels were 0.1(0.08,
0.18) ng/ml and 0.07 (0.05, 0.08) ng/ml for each group, which were
statistically different. The proposed optimal cut-off value of serum PCT
level in predicting bacterial infection was 0.08 ng/mL according to this
study, with a sensitivity of 81%, specificity of 67% and area under the ROC
curve (AUC) of 0.794. There were 31 AECOPD patients diagnosed with
pneumonia, their median PCT level was 0.23 ng/mL. Conclusions The serum PCT levels slightly increased in the majority of hospitalized
patients with AECOPD compared with reference range. When PCT level was
≥0.08 ng/mL, AECOPD was more likely to be caused by bacterial infection. A
significantly elevated PCT levels may indicate combination of AECOPD and
bacterial pneumonia.
Collapse
Affiliation(s)
- Yan-Ping Ye
- Department of Respiratory Medicine, Fu-Xing Hospital, 12517Capital Medical University, Beijing, China
| | - Hang Zhao
- Department of Respiratory Medicine, Fu-Xing Hospital, 12517Capital Medical University, Beijing, China
| | - Tao Kang
- Department of Laboratory Medicine, Fu-Xing Hospital, 12517Capital Medical University, Beijing, China
| | - Li-Hua Zhao
- Department of Respiratory Medicine, Fu-Xing Hospital, 12517Capital Medical University, Beijing, China
| | - Ning Li
- Department of Respiratory Medicine, Fu-Xing Hospital, 12517Capital Medical University, Beijing, China
| | - Jing Chen
- Department of Respiratory Medicine, Fu-Xing Hospital, 12517Capital Medical University, Beijing, China
| | - Xiao-Xia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, 12517Capital Medical University, National Center for Children's Health, Beijing, China
| |
Collapse
|
5
|
Lin SH, He YP, Lian JJ, Chu CK. Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin's adjunct role. Libyan J Med 2021; 16:1961382. [PMID: 34357857 PMCID: PMC8354150 DOI: 10.1080/19932820.2021.1961382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
How to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explore the clinical significance of taking the change rate of procalcitonin (PCT) as identifying the timing of weaning on the mechanical ventilation for the patients of AECOPD followed by ARF as a complication. There were altogether 140 patients of AECOPD complicated with ARF, who were randomly selected and divided into a study group and a control group respectively. A change rate of serum PCT level exceeding 50% was taken as the switch point selection of tracheal intubation removal for the patients of the study group, while the ‘pulmonary infection control (PIC) window’ was done for those in the control group. With CRP, IL-6, TNF-a, PaCO2, PaO2, and Lac having been detected before and after treatment to them all, clinical indexes were obtained and compared between these two groups. The CRP, TNF-a, and IL-6 levels of the patients in the study group after treatment (p < 0.05) were lower than those in the control group. There was no significant difference in PaCO2, PaO2, and Lac between these two groups before and after treatment (p > 0.05). Even so, some other indexes available for the study group of patients were found to be lower than those for the control group (p < 0.05) in the following aspects: duration of invasive ventilation support, total time of mechanical ventilation support, incidence rate of ventilator-associated pneumonia, 48-hour reintubation rate, incidence rate of upper gastrointestinal bleeding, hospitalization time of critical respiratory illness, total hospitalization time, RICU treatment cost, total treatment cost, and mortality. It is preferable to take the change rate of PCT level exceeding 50% as the switch point of weaning time in sequential mechanical ventilation rather than the PIC window.
Abbreviations AECOPD: acute exacerbation of chronic obstructive pulmonary disease; ARF: acute respiratory failure; PCT: procalcitonin; PaO2: the oxygen partial pressure; PaCO2: the partial pressure of carbon dioxide; TNF-a: serum tumor necrosis factor-a; IL-6: interleukin-6; CRP: serum C-reactive protein; PIC window: pulmonary infection control window; RICU: respiration and intensive care unit
Collapse
Affiliation(s)
- Shao-Hua Lin
- Department of Infectious Diseases, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Ying-Ping He
- Department of Human Resources, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Jun-Jie Lian
- Department of Respiratory and Critical Care Medicine, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Cun-Kun Chu
- Library Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, P.R.China
| |
Collapse
|