Association of non-obstructive dyspnoea with all-cause mortality and incident chronic obstructive pulmonary disease: a systematic literature review and meta-analysis

BACKGROUND

Controversy exists regarding the association between non-obstructive dyspnoea and the future development of chronic obstructive pulmonary disease (COPD) and mortality. Therefore, we aimed to evaluate the association of non-obstructive dyspnoea with mortality and incident COPD in adults.

METHODS

We searched PubMed, Embase, and Web of Science to identify studies published from inception to 13 May 2023. Eligibility screening, data extraction, and quality assessment of the retrieved articles were conducted independently by two reviewers. Studies were included if they were original articles comparing incident COPD and all-cause mortality between individuals with normal lung function with and without dyspnoea. The primary outcomes were incident COPD and all-cause mortality. The secondary outcome was respiratory disease-related mortality. We used the random-effects model to calculate pooled estimates and corresponding 95% confidence interval (CI). Heterogeneity was determined using the I² statistic.

RESULTS

Of 6486 studies, 8 studies involving 100 758 individuals fulfilled the inclusion and exclusion criteria and were included in the study. Compared with individuals without non-obstructive dyspnoea, individuals with non-obstructive dyspnoea had an increased risk of incident COPD (relative risk: 1.41, 95% CI: 1.08 to 1.83), and moderate heterogeneity was found (p=0.079, I2=52.2%). Individuals with non-obstructive dyspnoea had a higher risk of all-cause mortality (hazard ratio: 1.21, 95% CI: 1.14 to 1.28, I2=0.0%) and respiratory disease-related mortality (hazard ratio: 1.52, 95% CI: 1.14 to 2.02, I2=0.0%) than those without.

CONCLUSIONS

Individuals with non-obstructive dyspnoea are at a higher risk of incident COPD and all-cause mortality than individuals without dyspnoea. Further research should investigate whether these high-risk adults may benefit from risk management and early therapeutic intervention.

PROSPERO REGISTRATION NUMBER

CRD42023395192.

Simultaneous Capture of CO2 Boosting Its Electroreduction in the Micropores of a Metal-organic Framework

Integration of CO2 capture capability from simulated flue gas and electrochemical CO2 reduction reaction (eCO2 RR) active sites into a catalyst is a promising cost-effective strategy for carbon neutrality, but is of great difficulty. Herein, combining the mixed gas breakthrough experiments and eCO2 RR tests, we showed that an Ag12 cluster-based metal-organic framework (1-NH2 , aka Ag12 bpy-NH2 ), simultaneously possessing CO2 capture sites as "CO2 relays" and eCO2 RR active sites, can not only utilize its micropores to efficiently capture CO2 from simulated flue gas (CO2  : N2 =15 : 85, at 298 K), but also catalyze eCO2 RR of the adsorbed CO2 into CO with an ultra-high CO2 conversion of 60 %. More importantly, its eCO2 RR performance (a Faradaic efficiency (CO) of 96 % with a commercial current density of 120 mA cm-2 at a very low cell voltage of -2.3 V for 300 hours and the full-cell energy conversion efficiency of 56 %) under simulated flue gas atmosphere is close to that under 100 % CO2 atmosphere, and higher than those of all reported catalysts at higher potentials under 100 % CO2 atmosphere. This work bridges the gap between CO2 enrichment/capture and eCO2 RR.

Self-Accelerating Effect in a Covalent-Organic Framework with Imidazole Groups Boosts Electroreduction of CO2 to CO

Solvent effect plays an important role in catalytic reaction, but there is little research and attention on it in electrochemical CO2 reduction reaction (eCO2 RR). Herein, we report a stable covalent-organic framework (denoted as PcNi-im) with imidazole groups as a new electrocatalyst for eCO2 RR to CO. Interestingly, compared with neutral conditions, PcNi-im not only showed high Faraday efficiency of CO product (≈100 %) under acidic conditions (pH ≈ 1), but also the partial current density was increased from 258 to 320 mA cm-2 . No obvious degradation was observed over 10 hours of continuous operation at the current density of 250 mA cm-2 . The mechanism study shows that the imidazole group on the framework can be protonated to form an imidazole cation in acidic media, hence reducing the surface work function and charge density of the active metal center. As a result, CO poisoning effect is weakened and the key intermediate *COOH is also stabilized, thus accelerating the catalytic reaction rate.

Zoledronic acid and thymosin α1 elicit antitumor immunity against prostate cancer by enhancing tumor inflammation and cytotoxic T cells

BACKGROUND

Advanced or metastatic prostate cancer (PCa) is still an incurable malignancy with high lethality and a poor prognosis. Despite the remarkable success of immunotherapy against many types of cancer, most patients with PCa receive minimal benefit from current immunotherapeutic strategies, because PCa is an immune cold tumor with scarce T-cell infiltration in the tumor microenvironment. The aim of this study was to develop an effective immunotherapeutic approach for immune cold PCa tumors.

METHODS

The therapeutic efficacy of androgen deprivation therapy (ADT) and zoledronic acid (ZA) plus thymosin α1 (Tα1) therapy was analyzed retrospectively in patients with advanced or metastatic PCa. The effects and mechanisms by which ZA and Tα1 regulated the immune functions of PCa cells and immune cells were evaluated by a PCa allograft mouse model, flow cytometric analysis, immunohistochemical and immunofluorescence staining assays, and PCR, ELISA, and Western blot analyses.

RESULTS

In this study, clinical retrospective analysis revealed that ADT combined with ZA plus Tα1 improved the therapeutic outcomes of patients with PCa, which might be associated with an enhanced frequency of T cells. ZA and Tα1 treatment synergistically inhibited the growth of androgen-independent PCa allograft tumors, with increased infiltration of tumor-specific cytotoxic CD8+ T cells and enhanced tumor inflammation. Functionally, ZA and Tα1 treatment relieved immunosuppression in PCa cells, stimulated pro-inflammatory macrophages, and enhanced the cytotoxic function of T cells. Mechanistically, ZA plus Tα1 therapy blocked the MyD88/NF-κB pathway in PCa cells but activated this signaling in macrophages and T cells, altering the tumor immune landscape to suppress PCa progression.

CONCLUSIONS

These findings uncover a previously undefined role for ZA and Tα1 in inhibiting the disease progression of immune cold PCa tumors by enhancing antitumor immunity and pave the way for the application of ZA plus Tα1 therapy as an immunotherapeutic strategy for treating patients with immunologically unresponsive PCa.