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Azzellino G, Ginaldi L, De Martinis M. Precision medicine in COPD: A possible contribution of vitamin D? Eur J Intern Med 2024:S0953-6205(24)00315-7. [PMID: 39043530 DOI: 10.1016/j.ejim.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024]
Affiliation(s)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy; Long-Term Care Unit, "Maria SS. dello Splendore" Hospital, Giulianova, AUSL 04 Teramo, Italy; UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
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Rahi MS, Mudgal M, Asokar BK, Yella PR, Gunasekaran K. Management of Refractory Chronic Obstructive Pulmonary Disease: A Review. Life (Basel) 2024; 14:542. [PMID: 38792564 PMCID: PMC11122447 DOI: 10.3390/life14050542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/07/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common condition with an estimated prevalence of 12% in adults over the age of 30 years worldwide. COPD is a leading cause of morbidity and mortality globally, with a substantial economic and social burden. There are an estimated 3 million deaths annually due to COPD. However, most of the patients with COPD respond to routine interventions like bronchodilator therapy, assessing supplemental oxygen needs, smoking cessation, vaccinations, and pulmonary rehabilitation. There is a significant number of patients who unfortunately progress to have persistent symptoms despite these interventions. Refractory COPD is not yet formally defined. Patients with severe persistent symptoms or exacerbations despite appropriate care can be considered to have refractory COPD. Managing refractory COPD needs a multidimensional approach. In this review article, we will discuss essential interventions like ensuring adequate inhaler techniques, exploring the need for non-invasive ventilatory support, use of chronic antibiotics and phosphodiesterase inhibitors to advanced therapies like bronchoscopic lung volume reduction surgery, and the upcoming role of anti-IL5 agents in managing patients with refractory COPD. We will also discuss non-pharmacologic interventions like psycho-social support and nutritional support. We will conclude by discussing the palliative care aspect of managing patients with refractory COPD. Through this review article, we aim to better the approach to managing patients with refractory COPD and discuss new upcoming therapies.
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Affiliation(s)
- Mandeep Singh Rahi
- Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Lawrence and Memorial Hospital, New London, CT 06320, USA
| | - Mayuri Mudgal
- Department of Internal Medicine, Camden Clark Medical Center, Parkersburg, WV 26101, USA;
| | - Bharat Kumar Asokar
- Division of Medical Sciences, The Tamilnadu Dr. MGR University, Chennai 600032, Tamilnadu, India;
| | | | - Kulothungan Gunasekaran
- Division of Pulmonary Diseases and Critical Care Medicine, Yuma Regional Medical Center, Yuma, AZ 85364, USA;
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He PY, Wu MY, Zheng LY, Duan Y, Fan Q, Zhu XM, Yao YM. Interleukin-33/serum stimulation-2 pathway: Regulatory mechanisms and emerging implications in immune and inflammatory diseases. Cytokine Growth Factor Rev 2024; 76:112-126. [PMID: 38155038 DOI: 10.1016/j.cytogfr.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
Interleukin (IL)- 33, a nuclear factor and pleiotropic cytokine of the IL-1 family, is gaining attention owing to its important role in chronic inflammatory and autoimmune diseases. This review extends our knowledge of the effects exerted by IL-33 on target cells by binding to its specific receptor serum stimulation-2 (ST2). Depending on the tissue context, IL-33 performs multiple functions encompassing host defence, immune response, initiation and amplification of inflammation, tissue repair, and homeostasis. The levels and activity of IL-33 in the body are controlled by complex IL-33-targeting regulatory pathways. The unique temporal and spatial expression patterns of IL-33 are associated with host homeostasis and the development of immune and inflammatory disorders. Therefore, understanding the origin, function, and processes of IL-33 under various conditions is crucial. This review summarises the regulatory mechanisms underlying the IL-33/ST2 signalling axis and its potential role and clinical significance in immune and inflammatory diseases, and discusses the current complex and conflicting findings related to IL-33 in host responses.
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Affiliation(s)
- Peng-Yi He
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China; School of Medicine, Nankai University, Tianjin 300071, China
| | - Meng-Yao Wu
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
| | - Li-Yu Zheng
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
| | - Yu Duan
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
| | - Qi Fan
- Emergency Medicine Center, First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China
| | - Xiao-Mei Zhu
- Tissue Repair and Regeneration Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100048, China.
| | - Yong-Ming Yao
- Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing 100853, China; School of Medicine, Nankai University, Tianjin 300071, China.
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Kersul AL, Cosio BG. Biologics in COPD. OPEN RESPIRATORY ARCHIVES 2024; 6:100306. [PMID: 38486675 PMCID: PMC10937225 DOI: 10.1016/j.opresp.2024.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Ana L. Kersul
- Servicio de Neumología, Hospital de Manacor, Manacor, Baleares, Spain
| | - Borja G. Cosio
- Unidad de Vía Aérea Compleja, Servicio de Neumología, Hospital Universitario Son Espases-IdISBa y CIBERES, Palma de Mallorca, Baleares, Spain
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Gueçamburu M, Zysman M. [Biologic agents in COPD management]. Rev Mal Respir 2024; 41:127-138. [PMID: 38129268 DOI: 10.1016/j.rmr.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a frequently occurring disease entailing high morbidity and mortality, and relevant therapeutic resources are limited. As is the case with asthma, the current trend consists in the phenotyping of COPD patients so as to develop personalized medicine tailored to a given individual's inflammatory profile. The aim of this review is to summarize the role of biologic agents in the management of COPD, taking into consideration not only COPD pathophysiology, but also the previously published studies and the relatively encouraging prospects for the future.
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Affiliation(s)
- M Gueçamburu
- Service des maladies respiratoires, CHU de Bordeaux, Centre François-Magendie, hôpital Haut-Lévêque, hôpital Haut Lévèque, avenue de Magellan, 33604 Pessac, France.
| | - M Zysman
- Service des maladies respiratoires, CHU de Bordeaux, Centre François-Magendie, hôpital Haut-Lévêque, hôpital Haut Lévèque, avenue de Magellan, 33604 Pessac, France; U1045, CIC 1401, Univ-Bordeaux, Centre de Recherche cardio-thoracique de Bordeaux, 33604 Pessac, France
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Zhou L, Jian T, Wan Y, Huang R, Fang H, Wang Y, Liang C, Ding X, Chen J. Luteolin Alleviates Oxidative Stress in Chronic Obstructive Pulmonary Disease Induced by Cigarette Smoke via Modulation of the TRPV1 and CYP2A13/NRF2 Signaling Pathways. Int J Mol Sci 2023; 25:369. [PMID: 38203542 PMCID: PMC10779282 DOI: 10.3390/ijms25010369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The current study aims to investigate the therapeutic potential of luteolin (Lut), a naturally occurring flavonoid found in various medicinal plants, for treating chronic obstructive pulmonary disease (COPD) through both in vitro and in vivo studies. The results demonstrated that Lut increased body weight, reduced lung tissue swelling and lung damage indices, mitigated systemic oxidative stress levels, and decreased alveolar fusion in cigarette smoke (CS)- and lipopolysaccharide (LPS)-induced COPD mice. Additionally, Lut was observed to downregulate the expression of the TRPV1 and CYP2A13 proteins while upregulating SIRT6 and NRF2 protein expression in CS + LPS-induced COPD mice and cigarette smoke extract (CSE)-treated A549 cells. The concentrations of total reactive oxygen species (ROS) and mitochondrial ROS in A549 cells induced by CSE significantly increased. Moreover, CSE caused a notable elevation of intracellular Ca2+ levels in A549 cells. Importantly, Lut exhibited inhibitory effects on the inward flow of Ca2+ and attenuated the overproduction of mitochondrial and intracellular ROS in A549 cells treated with CSE. In conclusion, Lut demonstrated a protective role in alleviating oxidative stress and inflammation in CS + LPS-induced COPD mice and CSE-treated A549 cells by regulating TRPV1/SIRT6 and CYP2A13/NRF2 signaling pathways.
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Affiliation(s)
- Lina Zhou
- Jiangsu Key Laboratory for the Research and Utilization of Plant Resources, Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing 210014, China; (L.Z.); (T.J.); (C.L.)
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China; (Y.W.); (R.H.); (H.F.); (Y.W.)
| | - Tunyu Jian
- Jiangsu Key Laboratory for the Research and Utilization of Plant Resources, Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing 210014, China; (L.Z.); (T.J.); (C.L.)
| | - Yan Wan
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China; (Y.W.); (R.H.); (H.F.); (Y.W.)
| | - Rizhong Huang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China; (Y.W.); (R.H.); (H.F.); (Y.W.)
| | - Hailing Fang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China; (Y.W.); (R.H.); (H.F.); (Y.W.)
| | - Yiwei Wang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China; (Y.W.); (R.H.); (H.F.); (Y.W.)
| | - Chengyuan Liang
- Jiangsu Key Laboratory for the Research and Utilization of Plant Resources, Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing 210014, China; (L.Z.); (T.J.); (C.L.)
| | - Xiaoqin Ding
- Jiangsu Key Laboratory for the Research and Utilization of Plant Resources, Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing 210014, China; (L.Z.); (T.J.); (C.L.)
| | - Jian Chen
- Jiangsu Key Laboratory for the Research and Utilization of Plant Resources, Institute of Botany, Jiangsu Province and Chinese Academy of Sciences, Nanjing 210014, China; (L.Z.); (T.J.); (C.L.)
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, China; (Y.W.); (R.H.); (H.F.); (Y.W.)
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