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Poole JA, Zamora-Sifuentes JL, De Las Vecillas L, Quirce S. Respiratory Diseases Associated With Organic Dust Exposure. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1960-1971. [PMID: 38423290 PMCID: PMC11316665 DOI: 10.1016/j.jaip.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
Organic dusts are complex bioaerosol mixtures comprised of dust and par ticulate matter of organic origin. These include components from bacteria, fungi, pollen, and viruses to fragments of animals and plants commonplace to several environmental/occupational settings encompassing agriculture/farming, grain processing, waste/recycling, textile, cotton, woodworking, bird breeding, and more. Organic dust exposures are linked to development of chronic bronchitis, chronic obstructive pulmonary disease, asthma, asthma-like syndrome, byssinosis, hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. Risk factors of disease development include cumulative dust exposure, smoking, atopy, timing/duration, and nutritional factors. The immunopathogenesis predominantly involves Toll-like receptor signaling cascade, T-helper 1/T-helper 17 lymphocyte responses, neutrophil influx, and potentiation of manifestations associated with allergy. The true prevalence of airway disease directly attributed to organic dust, especially in a workplace setting, remains challenging. Diagnostic confirmation can be difficult and complicated by hesitancy from workers to seek medical care, driven by fears of potential labor-related consequence. Clinical respiratory and systemic presentations coupled with allergy testing, lung function patterns of obstructive versus restrictive disease, and radiological characteristics are typically utilized to delineate these various organic dust-associated respiratory diseases. Prevention, risk reduction, and management primarily focus on reducing exposure to the offending dust, managing symptoms, and preventing disease progression.
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Affiliation(s)
- Jill A Poole
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb.
| | - Jose L Zamora-Sifuentes
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb
| | | | - Santiago Quirce
- Department of Allergy, La Paz University of Hospital, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Lan D, Fermoyle CC, Troy LK, Knibbs LD, Corte TJ. The impact of air pollution on interstitial lung disease: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 10:1321038. [PMID: 38298511 PMCID: PMC10827982 DOI: 10.3389/fmed.2023.1321038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction There is a growing body of evidence suggesting a causal relationship between interstitial lung disease (ILD) and air pollution, both for the development of the disease, and driving disease progression. We aim to provide a comprehensive literature review of the association between air pollution, and ILD, including idiopathic pulmonary fibrosis (IPF). Methods We systematically searched from six online database. Two independent authors (DL and CF) selected studies and critically appraised the risk of bias using the Newcastle-Ottawa Scale (NOS). Findings are presented through a narrative synthesis and meta-analysis. Meta-analyses were performed exclusively when there was a minimum of three studies examining identical pollutant-health outcome pairs, all evaluating equivalent increments in pollutant concentration, using a random effects model. Results 24 observational studies conducted in 13 countries or regions were identified. Pollutants under investigation encompassed ozone (O3), nitrogen dioxide (NO2), Particulate matter with diameters of 10 micrometers or less (PM10) and 2.5 micrometers or less (PM2.5), sulfur dioxide (SO2), carbon monoxide (CO), nitric oxide (NO) and nitrogen oxides (NOx). We conducted meta-analyses to assess the estimated Risk Ratios (RRs) for acute exacerbations (AE)-IPF in relation to exposure to every 10 μg/m3 increment in air pollutant concentrations, including O3, NO2, PM10, and PM2.5. The meta-analysis revealed a significant association between the increased risk of AE-IPF in PM2.5, yielding RR 1.94 (95% CI 1.30-2.90; p = 0.001). Findings across all the included studies suggest that increased exposure to air pollutants may be linked to a range of health issues in individuals with ILDs. Conclusion A scarcity of available studies on the air pollutants and ILD relationship underscores the imperative for further comprehensive research in this domain. The available data suggest that reducing levels of PM2.5 in the atmosphere could potentially reduce AE frequency and severity in ILD patients.
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Affiliation(s)
- Doris Lan
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Caitlin C. Fermoyle
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Lauren K. Troy
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Luke D. Knibbs
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Public Health Unit, Public Health Research Analytics and Methods for Evidence (PHRAME), Sydney Local Health District, Camperdown, NSW, Australia
| | - Tamera J. Corte
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
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3
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Leavy OC, Goemans AF, Stockwell AD, Allen RJ, Guillen-Guio B, Hernandez-Beeftink T, Adegunsoye A, Booth HL, Cullinan P, Fahy WA, Fingerlin TE, Virk HS, Hall IP, Hart SP, Hill MR, Hirani N, Hubbard RB, Kaminski N, Ma SF, McAnulty RJ, Sheng XR, Millar AB, Molina-Molina M, Navaratnam V, Neighbors M, Parfrey H, Saini G, Sayers I, Strek ME, Tobin MD, Whyte MK, Zhang Y, Maher TM, Molyneaux PL, Oldham JM, Yaspan BL, Flores C, Martinez F, Reynolds CJ, Schwartz DA, Noth I, Jenkins RG, Wain LV. Genome-wide SNP-sex interaction analysis of susceptibility to idiopathic pulmonary fibrosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.12.24301204. [PMID: 38293162 PMCID: PMC10827242 DOI: 10.1101/2024.01.12.24301204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a chronic lung condition that is more prevalent in males than females. The reasons for this are not fully understood, with differing environmental exposures due to historically sex-biased occupations, or diagnostic bias, being possible explanations. To date, over 20 independent genetic variants have been identified to be associated with IPF susceptibility, but these have been discovered when combining males and females. Our aim was to test for the presence of sex-specific associations with IPF susceptibility and assess whether there is a need to consider sex-specific effects when evaluating genetic risk in clinical prediction models for IPF. Methods We performed genome-wide single nucleotide polymorphism (SNP)-by-sex interaction studies of IPF risk in six independent IPF case-control studies and combined them using inverse-variance weighted fixed effect meta-analysis. In total, 4,561 cases (1,280 females and 2,281 males) and 23,500 controls (8,360 females and 14,528 males) of European genetic ancestry were analysed. We used polygenic risk scores (PRS) to assess differences in genetic risk prediction between males and females. Findings Three independent genetic association signals were identified. All showed a consistent direction of effect across all individual IPF studies and an opposite direction of effect in IPF susceptibility between females and males. None had been previously identified in IPF susceptibility genome-wide association studies (GWAS). The predictive accuracy of the PRSs were similar between males and females, regardless of whether using combined or sex-specific GWAS results. Interpretation We prioritised three genetic variants whose effect on IPF risk may be modified by sex, however these require further study. We found no evidence that the predictive accuracy of common SNP-based PRSs varies significantly between males and females.
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Affiliation(s)
- Olivia C Leavy
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Anne F Goemans
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | | | - Richard J Allen
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Beatriz Guillen-Guio
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Tamara Hernandez-Beeftink
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | | | | | | | | | | | | | - Ian P Hall
- University of Nottingham, Nottingham, UK
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, UK
| | | | | | | | - Richard B Hubbard
- University of Nottingham, Nottingham, UK
- National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, UK
| | | | | | | | | | | | - Maria Molina-Molina
- Servei de Pneumologia, Laboratori de Pneumologia Experimental, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain
- Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Vidya Navaratnam
- Department of Respiratory Medicine, Sir Charles Gardiner Hospital, Perth, Australia
- Centre for Respiratory Research, University of Western Australia, Perth, Australia
| | | | - Helen Parfrey
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | | | - Ian Sayers
- Centre for Respiratory Research, NIHR Nottingham Biomedical Research Centre, School of Medicine, Biodiscovery Institute, University of Nottingham, Nottingham, UK
| | | | - Martin D Tobin
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | | | | | - Toby M Maher
- NIHR Imperial Biomedical Research Unit, National Heart and Lung Institute, Imperial College London, London, UK
- Division of Pulmonary and Critical Care Medicine, University of Southern California, Los Angeles, USA
| | - Philip L Molyneaux
- National Institute for Health Research Respiratory Clinical Research Facility, Royal Brompton Hospital, London, UK
- NIHR Imperial Biomedical Research Unit, National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - Carlos Flores
- Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnologico y de Energias Renovables, Santa Cruz de Tenerife, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | | | | | | | - Imre Noth
- University of Virginia, Virginia, USA
| | - R Gisli Jenkins
- NIHR Imperial Biomedical Research Unit, National Heart and Lung Institute, Imperial College London, London, UK
| | - Louise V Wain
- Department of Population Health Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
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Desai R, Katukuri N, Kanagala SG, Ghadge N, James A, Tajdin B, Nalla A, Vutukuru SD, Kotharu DM, Kadiyala A, Vyas A, Prajjwal P, Ogbu I. Examining prevalence and predictors of pulmonary hypertension in adults with idiopathic pulmonary fibrosis: a population-based analysis in the United States. J Med Life 2024; 17:35-40. [PMID: 38737661 PMCID: PMC11080510 DOI: 10.25122/jml-2023-0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/14/2023] [Indexed: 05/14/2024] Open
Abstract
Pulmonary hypertension (PH) often complicates idiopathic pulmonary fibrosis (IPF), a progressive parenchymal lung disease. We investigated predictors of PH in IPF hospitalizations in the United States. We identified IPF hospital- izations with or without PH using the National Inpatient Sample (2018) and relevant ICD-10-CM codes. We com- pared demographics, comorbidities, PH prevalence, and its multivariable predictors adjusted for confounders among patients with IPF. In 2018, 30,335 patients from 30,259,863 hospitalizations had IPF, of which 8,075 (26.6%) had PH. Black (41%), Hispanic (21.3%), and female (28.7%) patients had higher rates of PH compared to white patients (25%). The IPF-PH cohort was hospitalized more often in urban teaching (77.7% vs. 72.2%), Midwest, and West hospitals vs. non-PH cohort. Comorbidities including congestive heart failure (2.08 [1.81-2.39]), valvular disease (2.12 [1.74-2.58]), rheumatoid arthritis/collagen vascular disease (1.32 [1.08-1.61]) predicted higher odds of PH. The PH-IPF cohort was less often routinely discharged (35.4%) and more likely to be transferred to intermediate care facilities (22.6%) and home health care (27.1%) (P < 0.001). The PH-IPF group had higher rates of all-cause mortality (12.3% vs. 9.4%), cardiogenic shock (2.4% vs. 1%), dysrhythmia (37.6% vs. 29%), and cardiac arrest (2.7% vs. 1.5%) vs. non-PH cohort (all P < 0.001). Patients with PH-IPF also had longer hospital stays (9 vs. 8) and a higher median cost ($23,054 vs. $19,627, P < 0.001). Nearly 25% of IPF hospitalizations with PH were linked to higher mortality, extended stays, and costs, emphasizing the need to integrate demographic and comorbidity predictors into risk stratification for improved outcomes in patients with IPF-PH.
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Affiliation(s)
- Rupak Desai
- Independent Outcomes Researcher, Atlanta, GA, USA
| | | | - Sai Gautham Kanagala
- Department of Internal Medicine, New York Medical College, New York City Health Hospitals Metropolitan, NY, USA
| | | | - Alpha James
- Department of Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine
| | | | - Akhila Nalla
- Department of Internal Medicine, MNR Medical College, Telangana, India
| | | | | | - Avinash Kadiyala
- Department of Medicine, Deccan College of Medical Sciences, Hyderabad, Telangana, India
| | - Ankit Vyas
- Department of Internal Medicine, Baptist Hospitals of Southeast Texas Beaumont, TX, USA
| | - Priyadarshi Prajjwal
- Department of Internal Medicine, Bharati Vidyapeeth University Medical College, Pune, India
| | - Ikechukwu Ogbu
- Department of Internal Medicine, Mountainview Hospital Sunrise GME, Las Vegas, NV, USA
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5
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Lee MKH, Lim HK, Su C, Koh JYC, Setyawati MI, Ng KW, Hou HW, Tay CY. 3D Airway Epithelial-Fibroblast Biomimetic Microfluidic Platform to Unravel Engineered Nanoparticle-Induced Acute Stress Responses as Exposome Determinants. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:19223-19235. [PMID: 37933439 DOI: 10.1021/acs.est.3c03678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Insights into how biological systems respond to high- and low-dose acute environmental stressors are a fundamental aspect of exposome research. However, studying the impact of low-level environmental exposure in conventional in vitro settings is challenging. This study employed a three-dimensional (3D) biomimetic microfluidic lung-on-chip (μLOC) platform and RNA-sequencing to examine the effects of two model anthropogenic engineered nanoparticles (NPs): zinc oxide nanoparticles (Nano-ZnO) and copier center nanoparticles (Nano-CCP). The airway epithelium exposed to these NPs exhibited dose-dependent increases in cytotoxicity and barrier dysregulation (dominance of the external exposome). Interestingly, even nontoxic and low-level exposure (10 μg/mL) of the epithelium compartment to Nano-ZnO triggered chemotaxis of lung fibroblasts toward the epithelium. An increase in α smooth muscle actin (α-SMA) expression and contractile activity was also observed in these cells, indicating a bystander-like adaptive response (dominance of internal exposome). Further bioinformatics and network analysis showed that a low-dose Nano-ZnO significantly induced a robust transcriptomic response and upregulated several hub genes associated with the development of lung fibrosis. We propose that Nano-ZnO, even at a no observable effect level (NOEL) dose according to conventional standards, can function as a potent nanostressor to disrupt airway epithelium homeostasis. This leads to a cascade of profibrotic events in a cross-tissue compartment fashion. Our findings offer new insights into the early acute events of respiratory harm associated with environmental NPs exposure, paving the way for better exposomic understanding of this emerging class of anthropogenic nanopollutants.
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Affiliation(s)
- Melissa Kao Hui Lee
- School of Materials Science and Engineering, Nanyang Technological University, N4.1, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Hong Kit Lim
- School of Materials Science and Engineering, Nanyang Technological University, N4.1, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Chengxun Su
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Clinical Sciences Building Level 11, Singapore 308232, Singapore
| | - Jie Yan Cheryl Koh
- School of Materials Science and Engineering, Nanyang Technological University, N4.1, 50 Nanyang Avenue, Singapore 639798, Singapore
- Nanyang Environment & Water Research Institute, 1 CleanTech Loop, CleanTech One, Singapore 637141, Singapore
| | - Magdiel Inggrid Setyawati
- School of Materials Science and Engineering, Nanyang Technological University, N4.1, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Kee Woei Ng
- School of Materials Science and Engineering, Nanyang Technological University, N4.1, 50 Nanyang Avenue, Singapore 639798, Singapore
- Nanyang Environment & Water Research Institute, 1 CleanTech Loop, CleanTech One, Singapore 637141, Singapore
- Center for Sustainable Materials (SusMat), Nanyang Technological University, Singapore 637553, Singapore
| | - Han Wei Hou
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Clinical Sciences Building Level 11, Singapore 308232, Singapore
| | - Chor Yong Tay
- School of Materials Science and Engineering, Nanyang Technological University, N4.1, 50 Nanyang Avenue, Singapore 639798, Singapore
- Nanyang Environment & Water Research Institute, 1 CleanTech Loop, CleanTech One, Singapore 637141, Singapore
- Center for Sustainable Materials (SusMat), Nanyang Technological University, Singapore 637553, Singapore
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6
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Pillai M, Lafortune P, Dabo A, Yu H, Park SS, Taluru H, Ahmed H, Bobrow D, Sattar Z, Jundi B, Reece J, Ortega RR, Soto B, Yewedalsew S, Foronjy R, Wyman A, Geraghty P, Ohlmeyer M. Small-Molecule Activation of Protein Phosphatase 2A Counters Bleomycin-Induced Fibrosis in Mice. ACS Pharmacol Transl Sci 2023; 6:1659-1672. [PMID: 37974628 PMCID: PMC10644462 DOI: 10.1021/acsptsci.3c00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Indexed: 11/19/2023]
Abstract
The activity of protein phosphatase 2A (PP2A), a serine-threonine phosphatase, is reduced in the lung fibroblasts of idiopathic pulmonary fibrosis (IPF) patients. The objective of this study was to determine whether the reactivation of PP2A could reduce fibrosis and preserve the pulmonary function in a bleomycin (BLM) mouse model. Here, we present a new class of direct small-molecule PP2A activators, diarylmethyl-pyran-sulfonamide, exemplified by ATUX-1215. ATUX-1215 has improved metabolic stability and bioavailability compared to our previously described PP2A activators. Primary human lung fibroblasts were exposed to ATUX-1215 and an older generation PP2A activator in combination with TGFβ. ATUX-1215 treatment enhanced the PP2A activity, reduced the phosphorylation of ERK and JNK, and reduced the TGFβ-induced expression of ACTA2, FN1, COL1A1, and COL3A1. C57BL/6J mice were administered 5 mg/kg ATUX-1215 daily following intratracheal instillation of BLM. Three weeks later, forced oscillation and expiratory measurements were performed using the Scireq Flexivent System. ATUX-1215 prevented BLM-induced lung physiology changes, including the preservation of normal PV loop, compliance, tissue elastance, and forced vital capacity. PP2A activity was enhanced with ATUX-1215 and reduced collagen deposition within the lungs. ATUX-1215 also prevented the BLM induction of Acta2, Ccn2, and Fn1 gene expression. Treatment with ATUX-1215 reduced the phosphorylation of ERK, p38, JNK, and Akt and the secretion of IL-12p70, GM-CSF, and IL1α in BLM-treated animals. Delayed treatment with ATUX-1215 was also observed to slow the progression of lung fibrosis. In conclusion, our study indicates that the decrease in PP2A activity, which occurs in fibroblasts from the lungs of IPF subjects, could be restored with ATUX-1215 administration as an antifibrotic agent.
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Affiliation(s)
- Meshach Pillai
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Pascale Lafortune
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Abdoulaye Dabo
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Howard Yu
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Sangmi S. Park
- Department
of Cell Biology, The State University of
New York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Harsha Taluru
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Huma Ahmed
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Dylan Bobrow
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Zeeshan Sattar
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Bakr Jundi
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Joshua Reece
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Romy Rodriguez Ortega
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Brian Soto
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Selome Yewedalsew
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Robert Foronjy
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Anne Wyman
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
| | - Patrick Geraghty
- Department
of Medicine, The State University of New
York Downstate Health Sciences University, Brooklyn, New York 11203, United States
- Department
of Cell Biology, The State University of
New York Downstate Health Sciences University, Brooklyn, New York 11203, United States
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7
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Margallo Iribarnegaray J, Churruca Arróspide M, Matesanz López C, Pérez Rojo R. [Interstitial Lung Disease]. OPEN RESPIRATORY ARCHIVES 2023; 5:100248. [PMID: 37496878 PMCID: PMC10369608 DOI: 10.1016/j.opresp.2023.100248] [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: 07/28/2023] Open
Abstract
Diffuse interstitial lung diseases (ILD) are a heterogeneous group of respiratory disorders that are usually classified together because they have similar clinical, radiological, physiological or pathological manifestations. In the last decade there have been important scientific advances in the study of these entities, which has led to a better understanding of their pathophysiology and to the appearance of treatments that have brought about a paradigm shift in the disease. This document presents a series of questions and answers on ILD, with special emphasis on the most relevant changes in terms of pathophysiology, diagnosis, and treatment.
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Affiliation(s)
| | | | | | - Raquel Pérez Rojo
- Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
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8
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Steele MP, Peljto AL, Mathai SK, Humphries S, Bang TJ, Oh A, Teague S, Cicchetti G, Sigakis C, Kropski JA, Loyd JE, Blackwell TS, Brown KK, Schwarz MI, Warren RA, Powers J, Walts AD, Markin C, Fingerlin TE, Yang IV, Lynch DA, Lee JS, Schwartz DA. Incidence and Progression of Fibrotic Lung Disease in an At-Risk Cohort. Am J Respir Crit Care Med 2023; 207:587-593. [PMID: 36094461 PMCID: PMC10870916 DOI: 10.1164/rccm.202206-1075oc] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Relatives of patients with familial interstitial pneumonia (FIP) are at increased risk for pulmonary fibrosis and develop preclinical pulmonary fibrosis (PrePF). Objectives: We defined the incidence and progression of new-onset PrePF and its relationship to survival among first-degree relatives of families with FIP. Methods: This is a cohort study of family members with FIP who were initially screened with a health questionnaire and chest high-resolution computed tomography (HRCT) scan, and approximately 4 years later, the evaluation was repeated. A total of 493 asymptomatic first-degree relatives of patients with FIP were evaluated at baseline, and 296 (60%) of the original subjects participated in the subsequent evaluation. Measurements and Main Results: The median interval between HRCTs was 3.9 years (interquartile range, 3.5-4.4 yr). A total of 252 subjects who agreed to repeat evaluation were originally determined not to have PrePF at baseline; 16 developed PrePF. A conservative estimate of the annual incidence of PrePF is 1,023 per 100,000 person-years (95% confidence interval, 511-1,831 per 100,000 person-years). Of 44 subjects with PrePF at baseline, 38.4% subjects had worsening dyspnea compared with 15.4% of those without PrePF (P = 0.002). Usual interstitial pneumonia by HRCT (P < 0.0002) and baseline quantitative fibrosis score (P < 0.001) are also associated with worsening dyspnea. PrePF at the initial screen is associated with decreased survival (P < 0.001). Conclusions: The incidence of PrePF in this at-risk population is at least 100-fold higher than that reported for sporadic idiopathic pulmonary fibrosis (IPF). Although PrePF and IPF represent distinct entities, our study demonstrates that PrePF, like IPF, is progressive and associated with decreased survival.
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Affiliation(s)
| | | | - Susan K. Mathai
- Center for Advanced Heart and Lung Disease, Baylor University Medical Center at Dallas, Dallas, Texas
| | | | | | | | | | - Giuseppe Cicchetti
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Fondazione Policlinico University Gemelli, Rome, Italy
| | - Christopher Sigakis
- Department of Regional Radiology, Cleveland Clinic Imaging Institute, Cleveland, Ohio; and
| | | | - James E. Loyd
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | | | | | | | | | | | | | - Cheryl Markin
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Tasha E. Fingerlin
- Center for Genes, Environment, and Health, National Jewish Health, Denver, Colorado
| | | | | | | | - David A. Schwartz
- Department of Medicine
- Department of Microbiology and Immunology, University of Colorado School of Medicine, Aurora, Colorado
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9
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Double Lung Transplantation for Idiopathic Pulmonary Fibrosis in a Patient with a History of Liver Transplantation and Prolonged Journey for Disease-Specific Antifibrotic Therapy. Case Rep Pulmonol 2022; 2022:4054339. [PMID: 35996614 PMCID: PMC9392625 DOI: 10.1155/2022/4054339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is characterized by uncontrolled progressive lung fibrosis with a median survival of 3 to 5 years. Although currently available pharmacotherapy cannot cure the disease, antifibrotics including pirfenidone and nintedanib were shown to slow disease progression and improve survival in IPF. Nevertheless, there is a knowledge gap on the safety of antifibrotics in patients after liver transplantation receiving concomitant immunosuppressive therapy. This case report of a 68-year-old male patient with IPF illustrates how a complex medical history has led to diagnostic and therapeutic challenges considerably affecting clinical decisions and impacting the patient's journey. The increasing severity of lung function impairment due to the progressive natural history of IPF ultimately led to severe respiratory failure. Double lung transplantation (LTx) was performed as the only therapeutic option in end-stage disease with the potential to improve quality of life and survival. To the best of our knowledge, this is the first case report describing the feasibility and safety of antifibrotic therapy with pirfenidone for IPF in a 68-year-old patient with a history of liver transplantation receiving concomitant immunosuppressive therapy with tacrolimus who underwent successful double lung transplantation when alternative medical interventions had been exhausted.
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10
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Towards Treatable Traits for Pulmonary Fibrosis. J Pers Med 2022; 12:jpm12081275. [PMID: 36013224 PMCID: PMC9410230 DOI: 10.3390/jpm12081275] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/24/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Interstitial lung diseases (ILD) are a heterogeneous group of disorders, of which many have the potential to lead to progressive pulmonary fibrosis. A distinction is usually made between primarily inflammatory ILD and primarily fibrotic ILD. As recent studies show that anti-fibrotic drugs can be beneficial in patients with primarily inflammatory ILD that is characterized by progressive pulmonary fibrosis, treatment decisions have become more complicated. In this perspective, we propose that the ‘treatable trait’ concept, which is based on the recognition of relevant exposures, various treatable phenotypes (disease manifestations) or endotypes (shared molecular mechanisms) within a group of diseases, can be applied to progressive pulmonary fibrosis. These targets for medical intervention can be identified through validated biomarkers and are not necessarily related to specific diagnostic labels. Proposed treatable traits are: cigarette smoking, occupational, allergen or drug exposures, excessive (profibrotic) auto- or alloimmunity, progressive pulmonary fibrosis, pulmonary hypertension, obstructive sleep apnea, tuberculosis, exercise intolerance, exertional hypoxia, and anxiety and depression. There are also several potential traits that have not been associated with relevant outcomes or for which no effective treatment is available at present: air pollution, mechanical stress, viral infections, bacterial burden in the lungs, surfactant-related pulmonary fibrosis, telomere-related pulmonary fibrosis, the rs35705950 MUC5B promoter polymorphism, acute exacerbations, gastro-esophageal reflux, dyspnea, and nocturnal hypoxia. The ‘treatable traits’ concept can be applied in new clinical trials for patients with progressive pulmonary fibrosis and could be used for developing new treatment strategies.
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11
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Majewski S, Szewczyk K, Jerczyńska H, Miłkowska-Dymanowska J, Białas AJ, Gwadera Ł, Piotrowski WJ. Longitudinal and Comparative Measures of Serum Chitotriosidase and YKL-40 in Patients With Idiopathic Pulmonary Fibrosis. Front Immunol 2022; 13:760776. [PMID: 35222369 PMCID: PMC8866556 DOI: 10.3389/fimmu.2022.760776] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/24/2022] [Indexed: 12/14/2022] Open
Abstract
Background Although chitin is absent in humans, chitinases are present in healthy subjects and show dysregulated expression in a variety of diseases resulting from abnormal tissue injury and repair responses. It was shown that chitotriosidase (chitinase 1/CHIT1) and structurally-related chitinase 3-like 1 protein (CHI3L1/YKL-40) play important roles in the pathobiology of idiopathic pulmonary fibrosis (IPF), however little is known about their longitudinal serum levels and relationship to clinical measures in IPF. Methods The present study is the first to evaluate serial measurements of serum CHIT1 activity and YKL-40 concentrations in patients with IPF starting antifibrotic treatment and followed up for 24 months. In addition, baseline serum CHIT1 and YKL-40 were compared between patients with IPF and control subjects, and possible CHIT1 and YKL-40 relationships to longitudinal clinical assessments in IPF were explored. Results Baseline serum CHIT1 activity and YKL-40 concentrations were significantly elevated in patients with IPF compared to control subjects and showed similar discriminatory ability in distinguishing IPF from controls. No significant differences between the median serum CHIT1 activity and YKL-40 concentration measured over a study follow-up were noted. We found significantly elevated baseline serum CHIT1 activity in the progressors compared with the stables in the first year, while significantly increased baseline serum CHIT1 activity was noted in the stables compared to the progressors in the second year. Additionally, we observed a significant negative correlation between a change in serum YKL-40 concentration and a change in forced vital capacity (FVC) % predicted (% pred.) in the stables subgroup, whereas, a change in serum CHIT1 activity correlated negatively with a change in FVC% pred. in the progressors subgroup. Conclusions This explorative study findings add further evidence that CHIT1 and YKL-40 are upregulated in patients with IPF, and suggest that longitudinally stable serum CHIT1 activity and YKL-40 concentration levels may potentially be associated with the antifibrotic treatment response. In addition, our findings are supporting the possible role of CHIT1 and YKL-40 as candidate diagnostic and prognostic biomarkers in IPF. Further research is needed to validate present study findings.
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Affiliation(s)
| | - Karolina Szewczyk
- Department of Pathobiology of Respiratory Diseases, Medical University of Lodz, Lodz, Poland
| | - Hanna Jerczyńska
- Central Scientific Laboratory (CoreLab), Medical University of Lodz, Lodz, Poland
| | | | - Adam J Białas
- Department of Pathobiology of Respiratory Diseases, Medical University of Lodz, Lodz, Poland
| | - Łukasz Gwadera
- Department of Pneumology, Medical University of Lodz, Lodz, Poland
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12
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Shi W, Hao J, Wu Y, Liu C, Shimizu K, Li R, Zhang C. Protective effects of heterophyllin B against bleomycin-induced pulmonary fibrosis in mice via AMPK activation. Eur J Pharmacol 2022; 921:174825. [PMID: 35283110 DOI: 10.1016/j.ejphar.2022.174825] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/28/2022]
Abstract
Pulmonary fibrosis (PF) is a chronic interstitial lung disease with unknown etiology. In the present study, we evaluated the anti-fibrotic effects of heterophyllin B, a natural product from Radix Pseudostellariae having anti-inflammatory and tyrosinase inhibitory activities. In bleomycin (BLM)-induced PF mouse model, heterophyllin B treatments (5 or 20 mg/kg/d) significantly attenuated BLM-induced alveolar cavity collapse, inflammatory cell infiltration, alveolar wall thickening and collagen deposition. When compared to model group, heterophyllin B treatments also increased adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) phosphorylation levels by 359% (P < 0.001) and reduced the expression of stimulator of interferon genes (STING) by 73% (P < 0.001). Furthermore, co-administration of heterophyllin B with AMPK inhibitor dorsomorphin (Compound C) significantly blocked the improvement effects of heterophyllin B on BLM-damaged lung tissue, and also increased the protein expression of STING which was inhibited by heterophyllin B in fibrotic lungs (P < 0.001). It is known that alveolar epithelia and lung fibroblasts exert prominent roles in the fibrosis progression. In the present study we found that, in vitro, heterophyllin B significantly inhibited alveolar epithelial mesenchymal transition (EMT) and lung fibroblast transdifferentiation. We also found that the inhibition of heterophyllin B on lung fibroblast transdifferentiation and STING expression was reversed by Compound C. To summarize, heterophyllin B exhibited protective effects on BLM-induced lung fibrosis potentially by inhibiting TGF-Smad2/3 signalings and AMPK-mediated STING signalings.
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Affiliation(s)
- Wen Shi
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China
| | - Jiatong Hao
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China
| | - Yanliang Wu
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China
| | - Chang Liu
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China
| | - Kuniyoshi Shimizu
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China; Department of Forest and Forest Products Sciences, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka, 812-8581, Japan
| | - Renshi Li
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China.
| | - Chaofeng Zhang
- Sino-Jan Joint Lab of Natural Health Products Research, School of Traditional Chinese Medicines, China Pharmaceutical University, Nanjing, China.
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13
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Takehara K, Koga Y, Hachisu Y, Utsugi M, Sawada Y, Saito Y, Yoshimi S, Yatomi M, Shin Y, Wakamatsu I, Umetsu K, Kouno S, Nakagawa J, Sunaga N, Maeno T, Hisada T. Differential Discontinuation Profiles between Pirfenidone and Nintedanib in Patients with Idiopathic Pulmonary Fibrosis. Cells 2022; 11:cells11010143. [PMID: 35011705 PMCID: PMC8750555 DOI: 10.3390/cells11010143] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 12/18/2022] Open
Abstract
Antifibrotic agents have been widely used in patients with idiopathic pulmonary fibrosis (IPF). Long-term continuation of antifibrotic therapy is required for IPF treatment to prevent disease progression. However, antifibrotic treatment has considerable adverse events, and the continuation of treatment is uncertain in many cases. Therefore, we examined and compared the continuity of treatment between pirfenidone and nintedanib in patients with IPF. We retrospectively enrolled 261 consecutive IPF patients who received antifibrotic treatment from six core facilities in Gunma Prefecture from 2009 to 2018. Among them, 77 patients were excluded if the antifibrotic agent was switched or if the observation period was less than a year. In this study, 134 patients treated with pirfenidone and 50 treated with nintedanib were analyzed. There was no significant difference in patient background, discontinuation rate of antifibrotic treatment over time, and survival rate between the two groups. However, the discontinuation rate due to adverse events within one year of antifibrotic treatment was significantly higher in the nintedanib group than in the pirfenidone group (76% vs. 37%, p < 0.001). Furthermore, the discontinuation rate due to adverse events in nintedanib was higher than that of pirfenidone treatment throughout the observation period (70.6% vs. 31.2%, p = 0.016). The pirfenidone group tended to be discontinued due to acute exacerbation or transfer to another facility. The results of this study suggest that better management of adverse events with nintedanib leads to more continuous treatment that prevents disease progression and acute exacerbations, thus improving prognosis in patients with IPF.
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Affiliation(s)
- Kazutaka Takehara
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
- Department of Respiratory Medicine, Public Tomioka General Hospital, 2073-1, Tomioka 370-2393, Japan
| | - Yasuhiko Koga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
- Correspondence:
| | - Yoshimasa Hachisu
- Department of Respiratory Medicine, Maebashi Red Cross Hospital, 389-1, Asakura-machi, Maebashi 371-0811, Japan;
| | - Mitsuyoshi Utsugi
- Department of Respiratory Medicine, Kiryu Kosei General Hospital, 6-3, Orihime-machi, Kiryu 376-0024, Japan;
| | - Yuri Sawada
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
| | - Yasuyuki Saito
- Department of Respiratory Medicine, Isesaki Municipal Hospital, Tsunatorihonchou 12-1, Isesaki 372-0817, Japan;
| | - Seishi Yoshimi
- Department of Respiratory Medicine, Tone Central Hospital, 910-1, Numasu-machi, Numata 378-0012, Japan;
| | - Masakiyo Yatomi
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
| | - Yuki Shin
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
| | - Ikuo Wakamatsu
- Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, 36, Takamatsu-cho, Takasaki 370-0829, Japan; (I.W.); (J.N.)
| | - Kazue Umetsu
- Department of Respiratory Medicine, Fujioka General Hospital, 813-1, Nakakurisu, Fujioka 375-8503, Japan; (K.U.); (S.K.)
| | - Shunichi Kouno
- Department of Respiratory Medicine, Fujioka General Hospital, 813-1, Nakakurisu, Fujioka 375-8503, Japan; (K.U.); (S.K.)
| | - Junichi Nakagawa
- Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, 36, Takamatsu-cho, Takasaki 370-0829, Japan; (I.W.); (J.N.)
| | - Noriaki Sunaga
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
| | - Toshitaka Maeno
- Department of Respiratory Medicine, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi 371-8511, Japan; (K.T.); (Y.S.); (M.Y.); (Y.S.); (N.S.); (T.M.)
| | - Takeshi Hisada
- Graduate School of Health Sciences, Gunma University, 3-39-22, Showa-machi, Maebashi 371-8514, Japan;
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14
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Lacedonia D, Scioscia G, Soccio P, Conese M, Catucci L, Palladino GP, Simone F, Quarato CMI, Di Gioia S, Rana R, Sollitto F, Foschino-Barbaro MP. Downregulation of exosomal let-7d and miR-16 in idiopathic pulmonary fibrosis. BMC Pulm Med 2021; 21:188. [PMID: 34088304 PMCID: PMC8176704 DOI: 10.1186/s12890-021-01550-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/24/2021] [Indexed: 01/04/2023] Open
Abstract
Background Idiopathic Pulmonary Fibrosis (IPF) is a degenerative interstitial lung disease with both a poor prognosis and quality of life once the diagnosis is made. In the last decade many features of the disease have been investigated to better understand the pathological steps that lead to the onset of the disease and, moreover, different types of biomarkers have been tested to find valid diagnostic, prognostic and therapy response predictive ones. In the complexity of IPF, microRNA (miRNAs) biomarker investigation seems to be promising. Methods We analysed the expression of five exosomal miRNAs supposed to have a role in the pathogenesis of the disease from serum of a group of IPF patients (n = 61) and we compared it with the expression of the same miRNAs in a group of healthy controls (n = 15). Results In the current study what emerged is let-7d down-regulation and, unexpectedly, miR-16 significant down-regulation. Moreover, through a cross-sectional analysis, a clustering of the expression of miR-16, miR-21 and miR-26a was found. Conclusions These findings could help the individuation of previously unknown key players in the pathophysiology of IPF and, most interestingly, more specific targets for the development of effective medications. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01550-2.
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Affiliation(s)
- Donato Lacedonia
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy. .,Institute of Respiratory Diseases, Policlinico Riuniti of Foggia, 71122, Foggia, Italy.
| | - Giulia Scioscia
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy.,Institute of Respiratory Diseases, Policlinico Riuniti of Foggia, 71122, Foggia, Italy
| | - Piera Soccio
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy.,Institute of Respiratory Diseases, Policlinico Riuniti of Foggia, 71122, Foggia, Italy
| | - Massimo Conese
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy
| | - Lucia Catucci
- Department of Chemistry, University "Aldo Moro" of Bari, 70126, Bari, Italy
| | - Grazia P Palladino
- Medical Genetics, Department of Laboratory Diagnostics, Policlinico Riuniti of Foggia, 71122, Foggia, Italy
| | - Filomena Simone
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy
| | - Carla M I Quarato
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy
| | - Sante Di Gioia
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy
| | - Roberto Rana
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy
| | - Francesco Sollitto
- Institute of Thoracic Surgery, University of Foggia, 71122, Foggia, Italy
| | - Maria P Foschino-Barbaro
- Department of Medical and Surgical Sciences, University of Foggia, 71122, Foggia, Italy.,Institute of Respiratory Diseases, Policlinico Riuniti of Foggia, 71122, Foggia, Italy
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15
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Kiener M, Roldan N, Machahua C, Sengupta A, Geiser T, Guenat OT, Funke-Chambour M, Hobi N, Kruithof-de Julio M. Human-Based Advanced in vitro Approaches to Investigate Lung Fibrosis and Pulmonary Effects of COVID-19. Front Med (Lausanne) 2021; 8:644678. [PMID: 34026781 PMCID: PMC8139419 DOI: 10.3389/fmed.2021.644678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/01/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused considerable socio-economic burden, which fueled the development of treatment strategies and vaccines at an unprecedented speed. However, our knowledge on disease recovery is sparse and concerns about long-term pulmonary impairments are increasing. Causing a broad spectrum of symptoms, COVID-19 can manifest as acute respiratory distress syndrome (ARDS) in the most severely affected patients. Notably, pulmonary infection with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the causing agent of COVID-19, induces diffuse alveolar damage (DAD) followed by fibrotic remodeling and persistent reduced oxygenation in some patients. It is currently not known whether tissue scaring fully resolves or progresses to interstitial pulmonary fibrosis. The most aggressive form of pulmonary fibrosis is idiopathic pulmonary fibrosis (IPF). IPF is a fatal disease that progressively destroys alveolar architecture by uncontrolled fibroblast proliferation and the deposition of collagen and extracellular matrix (ECM) proteins. It is assumed that micro-injuries to the alveolar epithelium may be induced by inhalation of micro-particles, pathophysiological mechanical stress or viral infections, which can result in abnormal wound healing response. However, the exact underlying causes and molecular mechanisms of lung fibrosis are poorly understood due to the limited availability of clinically relevant models. Recently, the emergence of SARS-CoV-2 with the urgent need to investigate its pathogenesis and address drug options, has led to the broad application of in vivo and in vitro models to study lung diseases. In particular, advanced in vitro models including precision-cut lung slices (PCLS), lung organoids, 3D in vitro tissues and lung-on-chip (LOC) models have been successfully employed for drug screens. In order to gain a deeper understanding of SARS-CoV-2 infection and ultimately alveolar tissue regeneration, it will be crucial to optimize the available models for SARS-CoV-2 infection in multicellular systems that recapitulate tissue regeneration and fibrotic remodeling. Current evidence for SARS-CoV-2 mediated pulmonary fibrosis and a selection of classical and novel lung models will be discussed in this review.
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Affiliation(s)
- Mirjam Kiener
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Urology Research Laboratory, University of Bern, Bern, Switzerland
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Nuria Roldan
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Carlos Machahua
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Arunima Sengupta
- Organs-on-Chip Technologies, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
| | - Thomas Geiser
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olivier Thierry Guenat
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Organs-on-Chip Technologies, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland
- Department of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Manuela Funke-Chambour
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research DBMR, Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nina Hobi
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
| | - Marianna Kruithof-de Julio
- Department for BioMedical Research DBMR, Urology Research Laboratory, University of Bern, Bern, Switzerland
- Alveolix AG, Swiss Organs-on-Chip Innovation, Bern, Switzerland
- Organoid Core, Department for BioMedical Research, University of Bern, Bern, Switzerland
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16
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Forte G, Bocca B, Pisano A, Collu C, Farace C, Sabalic A, Senofonte M, Fois AG, Mazzarello VL, Pirina P, Madeddu R. The levels of trace elements in sputum as biomarkers for idiopathic pulmonary fibrosis. CHEMOSPHERE 2021; 271:129514. [PMID: 33434828 DOI: 10.1016/j.chemosphere.2020.129514] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a rare lung disease that quickly leads to death. This paper addressed the issue of whether the levels of trace elements in sputum samples are suitable biomarkers for IPF disease. The sputum Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn concentrations were measured by sector field inductively coupled plasma mass spectrometry in populations sampled in Sardinia Island (Italy) including 31 patients with IPF, 31 patients with other lung-related diseases and 30 age- and gender-matched healthy controls. Risk factors in the disease as gender, age, severity and duration of the disease were assessed. Results showed that IPF patients had significantly increased sputum levels of Cd, Cr, Cu and Pb respect to controls. In males, but not in females, sputum levels of Cd, Cr and Cu were significantly higher in IPF cases respect to controls. In addition, Cr and Pb were increased in male patients with IPF compared to male patients with other lung diseases. Regarding Zn, it was found higher with the more serious stage of disease. Moreover, the ratios Cu/Zn, Fe/Mn and Cu/Mn were significantly increased in IPF patients and in non-IPF patients than in control subjects. These data showed clear increases in the concentration of some trace elements in sputum from patients with IPF and patients with other lung-related diseases that may contribute to the injury. The non-invasiveness of the sputum analysis is beneficial for its use as biomarker of trace element status in diseased patients for both the researcher and the clinic.
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Affiliation(s)
- Giovanni Forte
- Department of Environment and Health, Italian National Institute for Health, Rome, Italy
| | - Beatrice Bocca
- Department of Environment and Health, Italian National Institute for Health, Rome, Italy.
| | - Andrea Pisano
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Claudia Collu
- Department of Clinical, Surgical & Experimental Sciences, University of Sassari, Sassari, Italy
| | - Cristiano Farace
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Angela Sabalic
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Marta Senofonte
- Department of Environment and Health, Italian National Institute for Health, Rome, Italy
| | | | | | - Pietro Pirina
- Department of Clinical, Surgical & Experimental Sciences, University of Sassari, Sassari, Italy
| | - Roberto Madeddu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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17
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Stufano A, Scardapane A, Foschino Barbaro MP, Soleo L, Corradi M, Lovreglio P. Clinical and radiological criteria for the differential diagnosis between asbestosis and idiopathic pulmonary fibrosis: Application in two cases. LA MEDICINA DEL LAVORO 2021; 112:115-122. [PMID: 33881005 PMCID: PMC8095333 DOI: 10.23749/mdl.v112i2.10473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/05/2020] [Indexed: 11/17/2022]
Abstract
Introduction: Idiopathic pulmonary fibrosis (IPF) and asbestosis are pulmonary interstitial diseases that may present overlapping clinical aspects in the full-blown phase of the disease. For both clinical entities the gold standard for diagnosis is histological examination, but its execution poses ethical problems, especially when performed for preventive or forensic purposes. Objective: To evaluate the application of internationally accepted clinical, anamnestic and radiological criteria for differential diagnosis between asbestosis and IPF, and to assess the ability to discriminate between the two diseases. Even if clinically similar, the two diseases present extremely different prognostic and therapeutic perspectives. Methods: Two clinical cases of IPF are reported, in which the differential diagnosis was made by studying occupational exposure to asbestos, the onset and progression of clinical symptoms, and the identification of specific radiological elements by means of chest High Resolution Computed Tomography (HRCT). Results: The diagnosis of IPF could be made on the basis of the absence of significant exposure to asbestos, the early onset and rapid progression of dyspnea and restrictive ventilatory defects, in association with a pulmonary radiological pattern characterized by peculiar elements such as honeycombing. Discussion: The diagnostic procedure adopted to make a differential diagnosis with asbestosis provides practical clinical elements facilitating the differentiation between the two forms of pulmonary fibrosis, a fundamental aspect of the activity of the occupational physician.
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Affiliation(s)
- Angela Stufano
- Interdisciplinary Department of Medicine - Section of Occupational Medicine, University of Bari Aldo Moro.
| | - Arnaldo Scardapane
- Interdisciplinary Department of Medicine - Section of Diagnostic Imaging, University of Bari Aldo Moro.
| | | | - Leonardo Soleo
- Interdisciplinary Department of Medicine - Section of Occupational Medicine, University of Bari Aldo Moro.
| | | | - Piero Lovreglio
- Interdisciplinary Department of Medicine - Section of Occupational Medicine, University of Bari Aldo Moro.
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Cao X, Li Y, Shi J, Tang H. The Potentially Therapeutic Role of EPAC in Curbing the Process of Idiopathic Pulmonary Fibrosis via Differential Cellular Pathways. J Inflamm Res 2021; 14:611-619. [PMID: 33679138 PMCID: PMC7926039 DOI: 10.2147/jir.s296382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/27/2021] [Indexed: 12/12/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrosis disease caused by genetic susceptibility (causative) and other indirect risk factors such as smoking, micro-aspiration and air pollution. Repeated damage of lung epithelial cells can cause fibroblast activation and excessive collagen will lead the scar formation and severe fibrosis. It has been decades since drugs for the treatment of IPF were developed, but clinical choices were limited. Exchange Protein directly Activated by cAMP (EPAC), as a newly emerging cAMP (adenosine 3ʹ,5ʹ-cyclic monophosphate) downstream molecule, plays a vital role in the cellular pathways of IPF such as inhibiting fibroblast proliferation, stress fiber formation and epithelium cell adhesion, so it may be a novel target for drug development and treatment for curbing IPF. Here, we hypothesize that EPAC may participate in the signaling pathways related to IPF in different cell types (fibroblasts; airway smooth muscle cells; vascular endothelial cells; lung epithelial cells; macrophages; mesenchymal stem cells; T cells), thereby playing a potentially therapeutic role in resisting the process of fibrosis. We summarize the current correlation between EPAC and IPF in these different cell types, and further insights into EPAC will help to optimize the pharmacological treatment for IPF.
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Affiliation(s)
- Xinwei Cao
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, 310058, People's Republic of China
| | - Yajun Li
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, 310058, People's Republic of China
| | - Jianrong Shi
- Department of Clinical Laboratory, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, 310003, People's Republic of China
| | - Huifang Tang
- Department of Pharmacology, School of Basic Medical Sciences, Zhejiang University, Hangzhou, 310058, People's Republic of China
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Characteristics and Prevalence of Domestic and Occupational Inhalational Exposures Across Interstitial Lung Diseases. Chest 2021; 160:209-218. [PMID: 33621598 DOI: 10.1016/j.chest.2021.02.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/28/2020] [Accepted: 02/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Inhalational exposures are increasingly recognized as contributing factors in interstitial lung disease (ILD). However, the characteristics of both exposures and exposed patients are not well understood. We hypothesized that domestic and occupational inhalational exposures would be common and associated with differences in demographics, clinical characteristics, and transplant-free survival in patients with all forms of ILD. RESEARCH QUESTION What is the prevalence of inhalational exposures across all ILD diagnoses, and are these exposures associated with differences in demographics, clinical characteristics, and transplant-free survival? STUDY DESIGN AND METHODS Patients from a tertiary ILD clinic underwent an interview designed to capture inhalational exposures including occupational, home, hobbies, and tobacco. Demographic and survival data were collected from the electronic medical record. Survival analysis was performed using Cox regression to compare exposed vs unexposed patients and adjusted for gender-age-physiology score and smoking. RESULTS One hundred and fifty-six patients seen between May and October 2018 were analyzed. Patients had a wide variety of multidisciplinary diagnoses, with a minority of patients with hypersensitivity pneumonitis (14%). One hundred and one patients (65%) had potentially relevant inhalational exposures. More men than women had a history of any exposure (82% vs 51%; P < .001), occupational exposure (66% vs 14%, P < .001), and multiple exposures (56% vs 26%, P < .001), respectively. White race was associated with bird and hobby exposure. Patients with any exposure had worse transplant-free survival (unadjusted hazard ratio, 2.58; 95% CI, 1.13-5.92; P = .025), but this was not statistically significant after adjustment (hazard ratio, 1.82; 95% CI, 0.77-4.27; P = .17). INTERPRETATION A standardized interview revealed most patients across all types of ILD had potentially relevant inhalational exposures. Exposures were markedly different based on demographics and were associated with worse transplant-free survival, but this survival difference was not significant after multivariable adjustment. Identification and avoidance of exposures represent actionable targets in ILD management.
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Air Pollution-An Overlooked Risk Factor for Idiopathic Pulmonary Fibrosis. J Clin Med 2020; 10:jcm10010077. [PMID: 33379260 PMCID: PMC7794751 DOI: 10.3390/jcm10010077] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/16/2020] [Accepted: 12/24/2020] [Indexed: 12/13/2022] Open
Abstract
Air pollution is a major environmental risk to health and a global public health concern. In 2016, according to the World Health Organization (WHO), ambient air pollution in cities and rural areas was estimated to cause 4.2 million premature deaths. It is estimated that around 91% of the world’s population lives in places where air pollution exceeds the limits recommended by the WHO. Sources of air pollution are multiple and context-specific. Air pollution exposures are established risk factors for development and adverse health outcomes in many respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), or lung cancer. However, possible associations between air pollution and idiopathic pulmonary fibrosis (IPF) have not been adequately studied and air pollution seems to be an underrecognized risk factor for IPF. This narrative review describes potential mechanisms triggered by ambient air pollution and their possible roles in the initiation of the pathogenic process and adverse health effects in IPF. Additionally, we summarize the most current research evidence from the clinical studies supporting links between air pollution and IPF.
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21
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Venosa A. Senescence in Pulmonary Fibrosis: Between Aging and Exposure. Front Med (Lausanne) 2020; 7:606462. [PMID: 33282895 PMCID: PMC7689159 DOI: 10.3389/fmed.2020.606462] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
To date, chronic pulmonary pathologies represent the third leading cause of death in the elderly population. Evidence-based projections suggest that >65 (years old) individuals will account for approximately a quarter of the world population before the turn of the century. Genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication, are described as the nine “hallmarks” that govern cellular fitness. Any deviation from the normal pattern initiates a complex cascade of events culminating to a disease state. This blueprint, originally employed to describe aberrant changes in cancer cells, can be also used to describe aging and fibrosis. Pulmonary fibrosis (PF) is the result of a progressive decline in injury resolution processes stemming from endogenous (physiological decline or somatic mutations) or exogenous stress. Environmental, dietary or occupational exposure accelerates the pathogenesis of a senescent phenotype based on (1) window of exposure; (2) dose, duration, recurrence; and (3) cells type being targeted. As the lung ages, the threshold to generate an irreversibly senescent phenotype is lowered. However, we do not have sufficient knowledge to make accurate predictions. In this review, we provide an assessment of the literature that interrogates lung epithelial, mesenchymal, and immune senescence at the intersection of aging, environmental exposure and pulmonary fibrosis.
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Affiliation(s)
- Alessandro Venosa
- Department of Pharmacology and Toxicology, University of Utah College of Pharmacy, Salt Lake City, UT, United States
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22
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Luzina IG, Lillehoj EP, Lockatell V, Hyun SW, Lugkey KN, Imamura A, Ishida H, Cairo CW, Atamas SP, Goldblum SE. Therapeutic Effect of Neuraminidase-1-Selective Inhibition in Mouse Models of Bleomycin-Induced Pulmonary Inflammation and Fibrosis. J Pharmacol Exp Ther 2020; 376:136-146. [PMID: 33139318 DOI: 10.1124/jpet.120.000223] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022] Open
Abstract
Pulmonary fibrosis remains a serious biomedical problem with no cure and an urgent need for better therapies. Neuraminidases (NEUs), including NEU1, have been recently implicated in the mechanism of pulmonary fibrosis by us and others. We now have tested the ability of a broad-spectrum neuraminidase inhibitor, 2,3-dehydro-2-deoxy-N-acetylneuraminic acid (DANA), to modulate the in vivo response to acute intratracheal bleomycin challenge as an experimental model of pulmonary fibrosis. A marked alleviation of bleomycin-induced body weight loss and notable declines in accumulation of pulmonary lymphocytes and collagen deposition were observed. Real-time polymerase chain reaction analyses of human and mouse lung tissues and primary human lung fibroblast cultures were also performed. A predominant expression and pronounced elevation in the levels of NEU1 mRNA were observed in patients with idiopathic pulmonary fibrosis and bleomycin-challenged mice compared with their corresponding controls, whereas NEU2, NEU3, and NEU4 were expressed at far lower levels. The levels of mRNA for the NEU1 chaperone, protective protein/cathepsin A (PPCA), were also elevated by bleomycin. Western blotting analyses demonstrated bleomycin-induced elevations in protein expression of both NEU1 and PPCA in mouse lungs. Two known selective NEU1 inhibitors, C9-pentyl-amide-DANA (C9-BA-DANA) and C5-hexanamido-C9-acetamido-DANA, dramatically reduced bleomycin-induced loss of body weight, accumulation of pulmonary lymphocytes, and deposition of collagen. Importantly, C9-BA-DANA was therapeutic in the chronic bleomycin exposure model with no toxic effects observed within the experimental timeframe. Moreover, in the acute bleomycin model, C9-BA-DANA attenuated NEU1-mediated desialylation and shedding of the mucin-1 ectodomain. These data indicate that NEU1-selective inhibition offers a potential therapeutic intervention for pulmonary fibrotic diseases. SIGNIFICANCE STATEMENT: Neuraminidase-1-selective therapeutic targeting in the acute and chronic bleomycin models of pulmonary fibrosis reverses pulmonary collagen deposition, accumulation of lymphocytes in the lungs, and the disease-associated loss of body weight-all without observable toxic effects. Such therapy is as efficacious as nonspecific inhibition of all neuraminidases in these models, thus indicating the central role of neuraminidase-1 as well as offering a potential innovative, specifically targeted, and safe approach to treating human patients with a severe malady: pulmonary fibrosis.
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Affiliation(s)
- Irina G Luzina
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Erik P Lillehoj
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Virginia Lockatell
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Sang W Hyun
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Katerina N Lugkey
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Akihiro Imamura
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Hideharu Ishida
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Christopher W Cairo
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Sergei P Atamas
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
| | - Simeon E Goldblum
- Departments of Medicine (I.G.L., V.L., S.W.H., K.N.L., S.P.A., S.E.G.) and Pediatrics (E.P.L.), University of Maryland School of Medicine, Baltimore, Maryland; Research Service, Baltimore VA Medical Center, Baltimore, Maryland (I.G.L., S.W.H., S.P.A., S.E.G.); Department of Applied Bioorganic Chemistry, Gifu University, Gifu, Japan (A.I., H.I.); and Department of Chemistry, University of Alberta, Edmonton, Alberta, Canada (C.W.C.)
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[Occupational medical pneumology - what's new?]. Dtsch Med Wochenschr 2020; 145:1174-1178. [PMID: 32791555 DOI: 10.1055/a-1090-5723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In case of obstructive, interstitial and malignant respiratory and lung diseases, occupational causes must always be searched for. The sensitivity and specificity of specific IgE determinations in the diagnosis of occupational asthma are only slightly above 70 %, even for high-molecular allergens. If the patient's medical history is positive, further diagnostics must be carried out, if necessary up to specific exposure testing in specialised institutions. New data show that the serial FeNO determination after working days compared to days off contains additional information that can lead to a positive diagnostic classification. In case of interstitial lung diseases, (avoidable) occupational triggers must be searched for - a new questionnaire provides practical assistance. Patients with lung carcinoma should also be investigated for occupational causes. Here too, questionnaires and tables are available in simple language. In future lung cancer caused by long-term exposure to passive smoke will be considered an occupational disease.
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24
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Casas M. Air pollution exposure and interstitial lung diseases: have we identified all the harmful environmental exposures? Thorax 2019; 74:1013-1014. [PMID: 31615927 DOI: 10.1136/thoraxjnl-2019-213805] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2019] [Indexed: 12/11/2022]
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