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Huang JTJ, Cant E, Keir HR, Barton AK, Kuzmanova E, Shuttleworth M, Pollock J, Finch S, Polverino E, Bottier M, Dicker AJ, Shoemark A, Chalmers JD. Endotyping Chronic Obstructive Pulmonary Disease, Bronchiectasis, and the "Chronic Obstructive Pulmonary Disease-Bronchiectasis Association". Am J Respir Crit Care Med 2022; 206:417-426. [PMID: 35436182 DOI: 10.1164/rccm.202108-1943oc] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Bronchiectasis and chronic obstructive pulmonary disease (COPD) are two disease entities with overlapped clinical features, and codiagnosis frequently occurs (termed the "COPD-bronchiectasis association"). Objectives: To investigate the sputum microbiome and proteome in patients with bronchiectasis, COPD, and the COPD-bronchiectasis association with the aim of identifying endotypes that may inform treatment. Methods: Sputum microbiome and protein profiling were carried out using 16S rRNA amplicon sequencing and a label-free proteomics workflow, respectively, in a cohort comprising patients with COPD (n = 43), bronchiectasis (n = 30), and the COPD-bronchiectasis association (n = 48). Results were validated in an independent cohort of 91 patients (n = 28-31 each group) using targeted measurements of inflammatory markers, mucins, and bacterial culture. Measurements and Main Results: Principal component analysis of sputum microbiome and protein profiles showed a partial separation between the COPD and the "COPD-bronchiectasis association" group. Further analyses revealed that patients with the "COPD-bronchiectasis association" had a higher abundance of proteobacteria, higher expression of mucin-5AC and proteins from the "neutrophil degranulation" pathway compared to those with COPD. In contrast, patients with COPD had an elevated expression of mucin-5B and several peptidase inhibitors, higher abundance of common commensal taxa, and a greater microbiome diversity. The profiles of "COPD-bronchiectasis association" and bronchiectasis groups were largely overlapping. Five endotypes were proposed with differential inflammatory, mucin, and microbiological features. The key features related to the "COPD-bronchiectasis association" were validated in an independent cohort. Conclusions: Neutrophilic inflammation, differential mucin expression, and Gram-negative infection are dominant traits in patients with the "COPD-bronchiectasis association."
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Affiliation(s)
| | - Erin Cant
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | - Holly R Keir
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | | | | | - Morven Shuttleworth
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | - Jennifer Pollock
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | - Simon Finch
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | - Eva Polverino
- Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Mathieu Bottier
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | | | - Amelia Shoemark
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; and
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2
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Hunt BC, Stanford D, Xu X, Li J, Gaggar A, Rowe SM, Raju SV, Swords WE. Haemophilus influenzae persists in biofilm communities in a smoke-exposed ferret model of COPD. ERJ Open Res 2020; 6:00200-2020. [PMID: 32802827 PMCID: PMC7418822 DOI: 10.1183/23120541.00200-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/18/2020] [Indexed: 12/01/2022] Open
Abstract
Rationale Non-typeable Haemophilus influenzae (NTHi) is a common inhabitant of the human nasopharynx and upper airways that can cause opportunistic infections of the airway mucosa including bronchopulmonary infections in patients with chronic obstructive pulmonary disease (COPD). It is clear that opportunistic infections contribute significantly to inflammatory exacerbations of COPD; however, there remains much to be learned regarding specific host and microbial determinants of persistence and/or clearance in this context. Methods In this study, we used a recently described ferret model for COPD, in which animals undergo chronic long-term exposure to cigarette smoke, to define host–pathogen interactions during COPD-related NTHi infections. Results NTHi bacteria colonised the lungs of smoke-exposed animals to a greater extent than controls, and elicited acute host inflammation and neutrophilic influx and activation, along with a significant increase in airway resistance and a decrease in inspiratory capacity consistent with inflammatory exacerbation; notably, these findings were not observed in air-exposed control animals. NTHi bacteria persisted within multicellular biofilm communities within the airway lumen, as evidenced by immunofluorescent detection of bacterial aggregates encased within a sialylated matrix as is typical of NTHi biofilms and differential bacterial gene expression consistent with the biofilm mode of growth. Conclusions Based on these results, we conclude that acute infection with NTHi initiates inflammatory exacerbation of COPD disease. The data also support the widely held hypothesis that NTHi bacteria persist within multicellular biofilm communities in the lungs of patients with COPD. Infection of smoke-exposed ferrets with COPD results in mucus obstruction and respiratory symptoms as in patients, and the bacteria are in a distinct mode of growth consistent with biofilmshttps://bit.ly/3euXpbQ
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Affiliation(s)
- Benjamin C Hunt
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.,Gregory Fleming James Center for Cystic Fibrosis Research, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Denise Stanford
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Xin Xu
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Jindong Li
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Amit Gaggar
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.,Gregory Fleming James Center for Cystic Fibrosis Research, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Steven M Rowe
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.,Gregory Fleming James Center for Cystic Fibrosis Research, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - S Vamsee Raju
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.,Gregory Fleming James Center for Cystic Fibrosis Research, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - W Edward Swords
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.,Gregory Fleming James Center for Cystic Fibrosis Research, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
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3
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Rao DM, Phan DT, Choo MJ, Weaver MR, Oberley-Deegan RE, Bowler RP, Gally F. Impact of fatty acid binding protein 5-deficiency on COPD exacerbations and cigarette smoke-induced inflammatory response to bacterial infection. Clin Transl Med 2019; 8:7. [PMID: 30877402 PMCID: PMC6420539 DOI: 10.1186/s40169-019-0227-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/09/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although cigarette smoking (CS) is by far the most important risk factor of chronic obstructive pulmonary disease (COPD), repeated and sustained infections are clearly linked to disease pathogenesis and are responsible for acute inflammatory flares (i.e. COPD exacerbations). We have previously identified Fatty Acid Binding Protein 5 (FABP5) as an important anti-inflammatory protein in primary airway epithelial cells. RESULTS In this study we found decreased FABP5 mRNA and protein levels in peripheral blood mononuclear cells (PBMCs) of COPD patients, especially among those who reported episodes of COPD exacerbations. Using wildtype (WT) and FABP5-/- mice, we examined the effects of FABP5 on CS and infection-induced inflammatory responses. Similarly to what we saw in airway epithelial cells, infection increased FABP5 expression while CS decreased FABP5 expression in mouse lung tissues. CS-exposed and P. aeruginosa-infected FABP5-/- mice had significantly increased inflammation as shown by increased lung histopathological score, cell infiltration and inflammatory cytokine levels. Restoration of FABP5 in alveolar macrophages using a lentiviral approach attenuated the CS- and bacteria-induced pulmonary inflammation. And finally, while P. aeruginosa infection increased PPARγ activity, CS or FABP5 knockdown greatly reduced PPARγ activity. CONCLUSIONS These findings support a model in which CS-induced FABP5 inhibition contributes to increased inflammation in COPD exacerbations. It is interesting to speculate that the increased inflammation is a result of decreased PPARγ activity.
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Affiliation(s)
- Deviyani M. Rao
- Department of Biomedical Research, National Jewish Health, 1400 Jackson St., Room K827, Denver, CO 80206 USA
| | - Della T. Phan
- Department of Biomedical Research, National Jewish Health, 1400 Jackson St., Room K827, Denver, CO 80206 USA
| | - Michelle J. Choo
- Department of Biomedical Research, National Jewish Health, 1400 Jackson St., Room K827, Denver, CO 80206 USA
| | - Michael R. Weaver
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206 USA
| | - Rebecca E. Oberley-Deegan
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, BCC 6.12.392, 985870 Nebraska Medical Center, Omaha, NE 68198-5870 USA
| | - Russell P. Bowler
- Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206 USA
| | - Fabienne Gally
- Department of Biomedical Research, National Jewish Health, 1400 Jackson St., Room K827, Denver, CO 80206 USA
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4
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Feng C, Huang H, Huang S, Zhai YZ, Dong J, Chen L, Huang Z, Zhou X, Li B, Wang LL, Chen W, Lv FQ, Li TS. Identification of potential key genes associated with severe pneumonia using mRNA-seq. Exp Ther Med 2018; 16:758-766. [PMID: 30112034 PMCID: PMC6090384 DOI: 10.3892/etm.2018.6262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 04/11/2017] [Indexed: 01/24/2023] Open
Abstract
This study aimed to identify the potential key genes associated with severe pneumonia using mRNA-seq. Nine peripheral blood samples from patients with severe pneumonia alone (SP group, n=3) and severe pneumonia accompanied with chronic obstructive pulmonary disease (COPD; CSP group, n=3), as well as volunteers without pneumonia (control group, n=3) underwent mRNA-seq. Based on the sequencing data, differentially expressed genes (DEGs) were identified by Limma package. Following the pathway enrichment analysis of DEGs, the genes that were differentially expressed in the SP and CSP groups were selected for pathway enrichment analysis and coexpression analysis. In addition, potential genes related to pneumonia were identified based on the information in the Comparative Toxicogenomics Database. In total, 645 and 528 DEGs were identified in the SP and CSP groups, respectively, compared with the normal controls. Among these DEGs, 88 upregulated genes and 80 downregulated genes were common between the two groups. The functions of the common DEGs were similar to those of the DEGs in the SP group. In the coexpression network, the commonly downregulated genes (including ND1, ND3, ND4L, and ND6) and the commonly upregulated genes (including TSPY6P and CDY10P) exhibited a higher degree. In addition, 131 DEGs (including ND1, ND3, ND6, MIR449A and TAS2R43) were predicted to be potential pneumonia-related genes. In conclusion, the present study demonstrated that the common DEGs may be associated with the progression of severe pneumonia.
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Affiliation(s)
- Cong Feng
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - He Huang
- Department of Critical Care Medicine, General Hospital of Jinan Command, Jinan, Shandong 250031, P.R. China
| | - Sai Huang
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China.,Department of Hematology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Yong-Zhi Zhai
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Jing Dong
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Li Chen
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Zhi Huang
- Department of Electrical and Computer Engineering, Purdue University, Indianapolis, IN 46202, USA
| | - Xuan Zhou
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Bei Li
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Li-Li Wang
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Wei Chen
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Fa-Qin Lv
- Department of Ultrasound, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Tan-Shi Li
- Department of Emergency, Chinese PLA General Hospital, Beijing 100853, P.R. China
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5
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Liu H. Assessment of anti-reflux treatment on pulmonary ventilation function and inflammatory cytokines in patients with stable chronic obstructive pulmonary disease combined with gastroesophageal reflux. Exp Ther Med 2018; 15:5528-5536. [PMID: 29844808 DOI: 10.3892/etm.2018.6077] [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: 10/09/2017] [Accepted: 03/16/2018] [Indexed: 12/31/2022] Open
Abstract
Compelling evidence has demonstrated that systemic inflammation among patients with stable chronic obstructive pulmonary disease (COPD) is linked with increased levels of inflammatory cytokines. The aim of the present study was to investigate the effects associated with anti-reflux treatment on pulmonary ventilation function and inflammatory cytokines in patients with stable COPD and gastroesophageal reflux (GER). One hundred and thirty-six stable COPD and GER patients were recruited for the study and randomly designated into the routine treatment and the anti GER groups. Six months prior to and after treatment, pulmonary ventilation function, 6-min walk distance (6MWD) and times of acute exacerbation of COPD (AECOPD) were recorded. The levels of inflammatory cytokines IL-13, IL-18, transforming growth factor-β1 (TGF-βl) and tumor necrosis factor-α (TNF-α) in the sputum were detected by ELISA. BODE indexes, including body mass index, obstruction, dyspnea and exercise, were analyzed in order to evaluate patient prognoses. In comparison with the routine treatment group, patients in the anti-GER group displayed improved pulmonary ventilation function, increased 6MWD as well as decreases in AECOPD, levels of IL-13, IL-18, TGF-βl and TNF-α in the sputum and BODE index 6 months after treatment. The results obtained suggested a correlation between the BODE indexes after treatment and the course of disease as well as the frequency of exacerbation. The key findings of the study suggested that conventional treatment combined with anti-reflux treatment could effectively improve pulmonary ventilation function, while acting to decrease the levels of inflammatory cytokines and improve the prognosis of patients with stable COPD along with GER.
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Affiliation(s)
- Hang Liu
- Department of Respiratory Medicine, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region 530022, P.R. China
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6
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de la Fuente-Núñez C, Silva ON, Lu TK, Franco OL. Antimicrobial peptides: Role in human disease and potential as immunotherapies. Pharmacol Ther 2017; 178:132-140. [DOI: 10.1016/j.pharmthera.2017.04.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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7
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Rodríguez-Arce I, Martí S, Euba B, Fernández-Calvet A, Moleres J, López-López N, Barberán M, Ramos-Vivas J, Tubau F, Losa C, Ardanuy C, Leiva J, Yuste JE, Garmendia J. Inactivation of the Thymidylate Synthase thyA in Non-typeable Haemophilus influenzae Modulates Antibiotic Resistance and Has a Strong Impact on Its Interplay with the Host Airways. Front Cell Infect Microbiol 2017; 7:266. [PMID: 28676846 PMCID: PMC5476696 DOI: 10.3389/fcimb.2017.00266] [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: 12/01/2016] [Accepted: 06/02/2017] [Indexed: 12/29/2022] Open
Abstract
Antibacterial treatment with cotrimoxazol (TxS), a combination of trimethoprim and sulfamethoxazole, generates resistance by, among others, acquisition of thymidine auxotrophy associated with mutations in the thymidylate synthase gene thyA, which can modify the biology of infection. The opportunistic pathogen non-typeable Haemophilus influenzae (NTHi) is frequently encountered in the lower airways of chronic obstructive pulmonary disease (COPD) patients, and associated with acute exacerbation of COPD symptoms. Increasing resistance of NTHi to TxS limits its suitability as initial antibacterial against COPD exacerbation, although its relationship with thymidine auxotrophy is unknown. In this study, the analysis of 2,542 NTHi isolates recovered at Bellvitge University Hospital (Spain) in the period 2010–2014 revealed 119 strains forming slow-growing colonies on the thymidine low concentration medium Mueller Hinton Fastidious, including one strain isolated from a COPD patient undergoing TxS therapy that was a reversible thymidine auxotroph. To assess the impact of thymidine auxotrophy in the NTHi-host interplay during respiratory infection, thyA mutants were generated in both the clinical isolate NTHi375 and the reference strain RdKW20. Inactivation of the thyA gene increased TxS resistance, but also promoted morphological changes consistent with elongation and impaired bacterial division, which altered H. influenzae self-aggregation, phosphorylcholine level, C3b deposition, and airway epithelial infection patterns. Availability of external thymidine contributed to overcome such auxotrophy and TxS effect, potentially facilitated by the nucleoside transporter nupC. Although, thyA inactivation resulted in bacterial attenuation in a lung infection mouse model, it also rendered a lower clearance upon a TxS challenge in vivo. Thus, our results show that thymidine auxotrophy modulates both the NTHi host airway interplay and antibiotic resistance, which should be considered at the clinical setting for the consequences of TxS administration.
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Affiliation(s)
- Irene Rodríguez-Arce
- Instituto de Agrobiotecnología, Consejo Superior de Investigaciones Científicas-Universidad Pública Navarra-GobiernoNavarra, Spain
| | - Sara Martí
- Centro de Investigación Biomédica en Red de Enfermedades RespiratoriasMadrid, Spain.,Departamento Microbiología, Hospital Universitari Bellvitge, University of Barcelona, Institut d'Investigació Biomédica de BellvitgeBarcelona, Spain
| | - Begoña Euba
- Instituto de Agrobiotecnología, Consejo Superior de Investigaciones Científicas-Universidad Pública Navarra-GobiernoNavarra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades RespiratoriasMadrid, Spain
| | - Ariadna Fernández-Calvet
- Instituto de Agrobiotecnología, Consejo Superior de Investigaciones Científicas-Universidad Pública Navarra-GobiernoNavarra, Spain
| | - Javier Moleres
- Instituto de Agrobiotecnología, Consejo Superior de Investigaciones Científicas-Universidad Pública Navarra-GobiernoNavarra, Spain
| | - Nahikari López-López
- Instituto de Agrobiotecnología, Consejo Superior de Investigaciones Científicas-Universidad Pública Navarra-GobiernoNavarra, Spain
| | | | - José Ramos-Vivas
- Servicio Microbiología, Hospital Universitario Marqués de Valdecilla and Instituto de Investigación Marqués de ValdecillaSantander, Spain.,Red Española de Investigación en Patología Infecciosa, Instituto de Salud Carlos IIIMadrid, Spain
| | - Fe Tubau
- Centro de Investigación Biomédica en Red de Enfermedades RespiratoriasMadrid, Spain.,Departamento Microbiología, Hospital Universitari Bellvitge, University of Barcelona, Institut d'Investigació Biomédica de BellvitgeBarcelona, Spain
| | - Carmen Losa
- Servicio de Microbiología, Clínica Universidad de NavarraNavarra, Spain
| | - Carmen Ardanuy
- Centro de Investigación Biomédica en Red de Enfermedades RespiratoriasMadrid, Spain.,Departamento Microbiología, Hospital Universitari Bellvitge, University of Barcelona, Institut d'Investigació Biomédica de BellvitgeBarcelona, Spain
| | - José Leiva
- Servicio de Microbiología, Clínica Universidad de NavarraNavarra, Spain
| | - José E Yuste
- Centro de Investigación Biomédica en Red de Enfermedades RespiratoriasMadrid, Spain.,Centro Nacional de Microbiología, Instituto de Salud Carlos IIIMadrid, Spain
| | - Junkal Garmendia
- Instituto de Agrobiotecnología, Consejo Superior de Investigaciones Científicas-Universidad Pública Navarra-GobiernoNavarra, Spain.,Centro de Investigación Biomédica en Red de Enfermedades RespiratoriasMadrid, Spain
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8
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Hennawy MG, Elhosseiny NM, Sultan H, Abdelfattah W, Akl Y, Sabry NA, Attia AS. The effect of α 1-antitrypsin deficiency combined with increased bacterial loads on chronic obstructive pulmonary disease pharmacotherapy: A prospective, parallel, controlled pilot study. J Adv Res 2016; 7:1019-1028. [PMID: 27857848 PMCID: PMC5106446 DOI: 10.1016/j.jare.2016.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 02/03/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is caused by α1-antitrypsin deficiency (AATD) genetic susceptibility and exacerbated by infection. The current pilot study aimed at studying the combined effect of AATD and bacterial loads on the efficacy of COPD conventional pharmacotherapy. Fifty-nine subjects (29 controls and 30 COPD patients) were tested for genetic AATD and respiratory function. The bacterial loads were determined to the patients’ group who were then given a long acting beta-agonist and corticosteroid inhaler for 6 months. Nineteen percent of the studied group were Pi∗MZ (heterozygote deficiency variant), Pi∗S (5%) (milder deficiency variant), Pi∗ZZ (10%) (the most common deficiency variant), and Pi∗Mmalton (2%) (very rare deficiency variant). The patients’ sputum contained from 0 to 8 × 108 CFU/mL pathogenic bacteria. The forced vital capacity (FVC6) values of the AAT non-deficient group significantly improved after 3 and 6 months. Patients lacking AATD and pathogenic bacteria showed significant improvement in forced expiratory volume (FEV1), FEV1/FVC6, FVC6, and 6 min walk distance (6MWD) after 6 months. However, patients with AATD and pathogenic bacteria showed only significant improvement in FEV1 and FEV1/FVC6. The findings of this pilot study highlight for the first time the role of the combined AATD and pathogenic bacterial loads on the efficacy of COPD treatment.
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Affiliation(s)
- Marwa G Hennawy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Noha M Elhosseiny
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Hussein Sultan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Wael Abdelfattah
- Department of Chest Diseases and Allergy, Faculty of Medicine, Ain Shams University, Cairo 11539, Egypt
| | - Yousry Akl
- Department of Chest Diseases and Allergy, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Nirmeen A Sabry
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
| | - Ahmed S Attia
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
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9
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Abstract
Chronic obstructive pulmonary disease (COPD) patients are at a high risk of developing cardiovascular diseases. Airflow limitation is a predictor of future risks of hypertension and cardiovascular events. COPD is now understood as a systemic inflammatory disease, with the focus on inflammation of the lungs. An association between inflammation and sympathetic overactivity has also been reported. In this article, we review the association between chronic lung disease and the risks of hypertension, cardiovascular morbidity, the underlying mechanisms, and the therapeutic approach to hypertension and cardiovascular diseases in patients with lung diseases.
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Affiliation(s)
| | | | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
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10
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Molina L, Udaondo Z, Duque E, Fernández M, Molina-Santiago C, Roca A, Porcel M, de la Torre J, Segura A, Plesiat P, Jeannot K, Ramos JL. Antibiotic resistance determinants in a Pseudomonas putida strain isolated from a hospital. PLoS One 2014; 9:e81604. [PMID: 24465371 PMCID: PMC3894933 DOI: 10.1371/journal.pone.0081604] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 10/15/2013] [Indexed: 12/31/2022] Open
Abstract
Environmental microbes harbor an enormous pool of antibiotic and biocide resistance genes that can impact the resistance profiles of animal and human pathogens via horizontal gene transfer. Pseudomonas putida strains are ubiquitous in soil and water but have been seldom isolated from humans. We have established a collection of P. putida strains isolated from in-patients in different hospitals in France. One of the isolated strains (HB3267) kills insects and is resistant to the majority of the antibiotics used in laboratories and hospitals, including aminoglycosides, ß-lactams, cationic peptides, chromoprotein enediyne antibiotics, dihydrofolate reductase inhibitors, fluoroquinolones and quinolones, glycopeptide antibiotics, macrolides, polyketides and sulfonamides. Similar to other P. putida clinical isolates the strain was sensitive to amikacin. To shed light on the broad pattern of antibiotic resistance, which is rarely found in clinical isolates of this species, the genome of this strain was sequenced and analysed. The study revealed that the determinants of multiple resistance are both chromosomally-borne as well as located on the pPC9 plasmid. Further analysis indicated that pPC9 has recruited antibiotic and biocide resistance genes from environmental microorganisms as well as from opportunistic and true human pathogens. The pPC9 plasmid is not self-transmissible, but can be mobilized by other bacterial plasmids making it capable of spreading antibiotic resistant determinants to new hosts.
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Affiliation(s)
- Lázaro Molina
- Laboratorio de Investigación y Control Agroalimentario, Universidad de Huelva, Huelva, Spain
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
- Centro de Investigación en Química Sostenible, Universidad de Huelva, Huelva, Spain
| | - Zulema Udaondo
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Estrella Duque
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | | | - Carlos Molina-Santiago
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Amalia Roca
- Bio-Iliberis Research and Development, Peligros-Granada, Spain
| | - Mario Porcel
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Jesús de la Torre
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Ana Segura
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
| | - Patrick Plesiat
- Centre Hospitalier Régional Universitaire - Hôpital Jean Minjoz, Besançon, France
| | - Katy Jeannot
- Centre Hospitalier Régional Universitaire - Hôpital Jean Minjoz, Besançon, France
| | - Juan-Luis Ramos
- Estación Experimental del Zaidín, Consejo Superior de Investigaciones Científicas, Granada, Spain
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Klaile E, Klassert TE, Scheffrahn I, Müller MM, Heinrich A, Heyl KA, Dienemann H, Grünewald C, Bals R, Singer BB, Slevogt H. Carcinoembryonic antigen (CEA)-related cell adhesion molecules are co-expressed in the human lung and their expression can be modulated in bronchial epithelial cells by non-typable Haemophilus influenzae, Moraxella catarrhalis, TLR3, and type I and II interferons. Respir Res 2013; 14:85. [PMID: 23941132 PMCID: PMC3765474 DOI: 10.1186/1465-9921-14-85] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 08/10/2013] [Indexed: 11/18/2022] Open
Abstract
Background The carcinoembryonic antigen (CEA)-related cell adhesion molecules CEACAM1 (BGP, CD66a), CEACAM5 (CEA, CD66e) and CEACAM6 (NCA, CD66c) are expressed in human lung. They play a role in innate and adaptive immunity and are targets for various bacterial and viral adhesins. Two pathogens that colonize the normally sterile lower respiratory tract in patients with chronic obstructive pulmonary disease (COPD) are non-typable Haemophilus influenzae (NTHI) and Moraxella catarrhalis. Both pathogens bind to CEACAMs and elicit a variety of cellular reactions, including bacterial internalization, cell adhesion and apoptosis. Methods To analyze the (co-) expression of CEACAM1, CEACAM5 and CEACAM6 in different lung tissues with respect to COPD, smoking status and granulocyte infiltration, immunohistochemically stained paraffin sections of 19 donors were studied. To address short-term effects of cigarette smoke and acute inflammation, transcriptional regulation of CEACAM5, CEACAM6 and different CEACAM1 isoforms by cigarette smoke extract, interferons, Toll-like receptor agonists, and bacteria was tested in normal human bronchial epithelial (NHBE) cells by quantitative PCR. Corresponding CEACAM protein levels were determined by flow cytometry. Results Immunohistochemical analysis of lung sections showed the most frequent and intense staining for CEACAM1, CEACAM5 and CEACAM6 in bronchial and alveolar epithelium, but revealed no significant differences in connection with COPD, smoking status and granulocyte infiltration. In NHBE cells, mRNA expression of CEACAM1 isoforms CEACAM1-4L, CEACAM1-4S, CEACAM1-3L and CEACAM1-3S were up-regulated by interferons alpha, beta and gamma, as well as the TLR3 agonist polyinosinic:polycytidylic acid (poly I:C). Interferon-gamma also increased CEACAM5 expression. These results were confirmed on protein level by FACS analysis. Importantly, also NTHI and M. catarrhalis increased CEACAM1 mRNA levels. This effect was independent of the ability to bind to CEACAM1. The expression of CEACAM6 was not affected by any treatment or bacterial infection. Conclusions While we did not find a direct correlation between CEACAM1 expression and COPD, the COPD-associated bacteria NTHi and M. catarrhalis were able to increase the expression of their own receptor on host cells. Further, the data suggest a role for CEACAM1 and CEACAM5 in the phenomenon of increased host susceptibility to bacterial infection upon viral challenge in the human respiratory tract.
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Affiliation(s)
- Esther Klaile
- Septomics, Research Centre of the Friedrich-Schiller-University Jena, the Jena University Hospital and the Leibniz-Institute for Natural Products Research and Infection Biology - Hans Knöll Institute, Albert-Einstein-Strasse 10, 07745 Jena, Germany
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Gally F, Chu HW, Bowler RP. Cigarette smoke decreases airway epithelial FABP5 expression and promotes Pseudomonas aeruginosa infection. PLoS One 2013; 8:e51784. [PMID: 23349676 PMCID: PMC3551956 DOI: 10.1371/journal.pone.0051784] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 11/06/2012] [Indexed: 12/21/2022] Open
Abstract
Cigarette smoking is the primary cause of Chronic Obstructive Pulmonary Disease (COPD), which is characterized by chronic inflammation of the airways and destruction of lung parenchyma. Repeated and sustained bacterial infections are clearly linked to disease pathogenesis (e.g., exacerbations) and a huge burden on health care costs. The airway epithelium constitutes the first line of host defense against infection and our previous study indicated that Fatty Acid Binding Protein 5 (FABP5) is down regulated in airway epithelial cells of smokers with COPD as compared to smokers without COPD. We hypothesized that cigarette smoke (CS) exposure down regulates FABP5, thus, contributing to a more sustained inflammation in response to bacterial infection. In this report, we show that FABP5 is increased following bacterial infection but decreased following CS exposure of primary normal human bronchial epithelial (NHBE) cells. The goal of this study was to address FABP5 function by knocking down or overexpressing FABP5 in primary NHBE cells exposed to CS. Our data indicate that FABP5 down regulation results in increased P. aeruginosa bacterial load and inflammatory cytokine levels (e.g., IL-8) and decreased expression of the anti-bacterial peptide, β defensin-2. On the contrary, FABP5 overexpression exerts a protective function in airway epithelial cells against P. aeruginosa infection by limiting the production of IL-8 and increasing the expression of β defensin-2. Our study indicates that FABP5 exerts immunomodulatory functions in the airway epithelium against CS exposure and subsequent bacterial infection through its modulation of the nuclear receptor peroxisome proliferator-activated receptor (PPAR)-γ activity. These findings support the development of FABP5/PPAR-γ-targeted therapeutic approach to prevent airway inflammation by restoring antimicrobial immunity during COPD exacerbations.
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Affiliation(s)
- Fabienne Gally
- Pulmonary Division, Department of Medicine, National Jewish Health, Denver, Colorado, United States of America
| | - Hong Wei Chu
- Pulmonary Division, Department of Medicine, National Jewish Health, Denver, Colorado, United States of America
| | - Russell P. Bowler
- Pulmonary Division, Department of Medicine, National Jewish Health, Denver, Colorado, United States of America
- * E-mail:
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García-Sanz MT, Pol-Balado C, Abellás C, Cánive-Gómez JC, Antón-Sanmartin D, González-Barcala FJ. Factors associated with hospital admission in patients reaching the emergency department with COPD exacerbation. Multidiscip Respir Med 2012; 7:6. [PMID: 22958396 PMCID: PMC3436640 DOI: 10.1186/2049-6958-7-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 06/19/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the frequency of COPD exacerbations in our Emergency Department, as well as the hospitalization-related factors. METHODS Prospective observational study conducted in the Emergency Department of Salnés County Hospital among patients admitted for COPD exacerbation. Admission predictors were determined by multivariate analysis. RESULTS There were 409 exacerbations in 239 patients (79% male, mean age 75). 57% of exacerbations required hospitalization. Hospitalization-related factors were impaired oxygenation (p < 0.001), presence of neutrophilia (p < 0.01) and prescription of antibiotics in the Emergency Department (p < 0.05). CONCLUSIONS COPD exacerbation accounts for over 1% of all visits to our Emergency Department. 57% of them required hospitalization. Impaired oxygenation, greater neutrophilia and prescription of antibiotics in the Emergency Department were associated with greater probability of admission.
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Affiliation(s)
- Maria Teresa García-Sanz
- Emergency Department, Salnés County Hospital, Ande-Rubiáns s/n, Vilagarcía de Arousa, Pontevedra, Spain
| | - Carlos Pol-Balado
- Emergency Department, Salnés County Hospital, Ande-Rubiáns s/n, Vilagarcía de Arousa, Pontevedra, Spain
| | - Concepción Abellás
- Emergency Department, Salnés County Hospital, Ande-Rubiáns s/n, Vilagarcía de Arousa, Pontevedra, Spain
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Drago L, Mattina R, Legnani D, Romano CL, Vianello E, Ricci C, De Vecchi E. Modulation of biofilm of strains isolated from patients with chronic obstructive pulmonary disease by levofloxacin, moxifloxacin, ciprofloxacin, amoxicillin/clavulanic acid and ceftriaxone. Int J Immunopathol Pharmacol 2012; 24:1027-35. [PMID: 22230408 DOI: 10.1177/039463201102400420] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The ability of levofloxacin, moxifloxacin, ciprofloxacin, amoxicillin/clavulanic acid and ceftriaxone to interfere on biofilm produced by Pseudomonas aeruginosa, Haemophilus influenzae and Streptococcus pneumoniae isolated from patients with chronic obstructive pulmonary disease was evaluated. The effects of antibiotics were evaluated on formation of biofilm (at 1/2, 1/4 and 1/8 X MIC) and on preformed biofilm (at epithelial lining fluid peak concentrations) by means of a spectrophotometric method. Levofloxacin was the most active compound followed by ciprofloxacin, moxifloxacin and amoxicillin/clavulanic acid and ceftriaxone. Levofloxacin may contribute to clear the reservoir of pathogens involved in chronic obstructive pulmonary disease, thus leading to decreased occurrence of acute exacerbations.
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Affiliation(s)
- L Drago
- Laboratory of Clinical Chemistry and Microbiology, IRCCS Galeazzi Institute, Milan, Italy.
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Current world literature. Curr Opin Pulm Med 2011; 17:126-30. [PMID: 21285709 DOI: 10.1097/mcp.0b013e3283440e26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Antoniou T, Gomes T, Mamdani MM, Juurlink DN. Ciprofloxacin-induced theophylline toxicity: a population-based study. Eur J Clin Pharmacol 2011; 67:521-6. [PMID: 21234553 DOI: 10.1007/s00228-010-0985-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE Ciprofloxacin can inhibit the cytochrome P450-mediated metabolism of theophylline, but the clinical relevance of this drug interaction is uncertain. We studied the risk of theophylline toxicity associated with the co-prescription of ciprofloxacin and theophylline. METHODS This was a population-based, nested case-control study of a cohort of Ontario residents aged 66 years of age or older treated with theophylline between April 1, 1992 and March 31, 2009. Within this group, case patients were those hospitalized with theophylline toxicity. For each case, 50 age- and sex-matched control patients were identified from the same cohort. The odds ratio (OR) for the association between hospitalization for theophylline toxicity and receipt of ciprofloxacin in the 14 days preceding hospitalization was determined. RESULTS Among the 77,251 elderly patients receiving therapy with theophylline, 180 eligible case patients hospitalized for theophylline toxicity and 9000 matched controls were identified. Following multivariable adjustment, a nearly twofold increase in the risk of theophylline toxicity following the receipt of ciprofloxacin was observed [adjusted OR 1.86, 95% confidence interval (CI) 1.18-2.93]. In contrast, there was no increased risk of theophylline toxicity within a group of patients receiving neutral comparator antibiotics (levofloxacin, trimethoprim-sulfamethoxazole or cefuroxime) (adjusted OR 0.78; 95% CI 0.38-1.62). CONCLUSION Treatment with ciprofloxacin is associated with a significant increase in the risk of theophylline toxicity. When clinically appropriate, alternate antibiotics should be considered for elderly patients receiving theophylline.
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&NA;. Acute exacerbations of chronic obstructive pulmonary disease in elderly patients often require treatment with antibacterials. DRUGS & THERAPY PERSPECTIVES 2010. [DOI: 10.2165/11205250-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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