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Hartman DJ. Applications of Artificial Intelligence in Lung Pathology. Surg Pathol Clin 2024; 17:321-328. [PMID: 38692814 DOI: 10.1016/j.path.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Artificial intelligence/machine learning tools are being created for use in pathology. Some examples related to lung pathology include acid-fast stain evaluation, programmed death ligand-1 (PDL-1) interpretation, evaluating histologic patterns of non-small-cell lung carcinoma, evaluating histologic features in mesothelioma associated with adverse outcomes, predicting response to anti-PDL-1 therapy from hematoxylin and eosin-stained slides, evaluation of tumor microenvironment, evaluating patterns of interstitial lung disease, nondestructive methods for tissue evaluation, and others. There are still some frameworks (regulatory, workflow, and payment) that need to be established for these tools to be integrated into pathology.
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Affiliation(s)
- Douglas J Hartman
- University of Pittsburgh Medical Center, 200 Lothrop Street C-620, Pittsburgh, PA 15213, USA.
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Pollenus E, Prenen F, Possemiers H, Knoops S, Mitera T, Lamote J, De Visscher A, Vandermosten L, Pham TT, Matthys P, Van den Steen PE. Aspecific binding of anti-NK1.1 antibodies on myeloid cells in an experimental model for malaria-associated acute respiratory distress syndrome. Malar J 2024; 23:110. [PMID: 38637828 PMCID: PMC11025177 DOI: 10.1186/s12936-024-04944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/12/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Conventional natural killer (cNK) cells play an important role in the innate immune response by directly killing infected and malignant cells and by producing pro- and anti-inflammatory cytokines. Studies on their role in malaria and its complications have resulted in conflicting results. METHODS Using the commonly used anti-NK1.1 depletion antibodies (PK136) in an in-house optimized experimental model for malaria-associated acute respiratory distress syndrome (MA-ARDS), the role of cNK cells was investigated. Moreover, flow cytometry was performed to characterize different NK cell populations. RESULTS While cNK cells were found to be dispensable in the development of MA-ARDS, the appearance of a NK1.1+ cell population was observed in the lungs upon infection despite depletion with anti-NK1.1. Detailed characterization of the unknown population revealed that this population consisted of a mixture of monocytes and macrophages that bind the anti-NK1.1 antibody in an aspecific way. This aspecific binding may occur via Fcγ receptors, such as FcγR4. In contrast, in vivo depletion using anti-NK1.1 antibodies was proved to be specific for cNK cells. CONCLUSION cNK cells are dispensable in the development of experimental MA-ARDS. Moreover, careful flow cytometric analysis, with a critical mindset in relation to potential aspecific binding despite the use of commercially available Fc blocking reagents, is critical to avoid misinterpretation of the results.
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Affiliation(s)
- Emilie Pollenus
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Fran Prenen
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Hendrik Possemiers
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Sofie Knoops
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Tania Mitera
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Jochen Lamote
- Laboratory for Molecular Cancer Biology, Department of Oncology, VIB, KU Leuven, Leuven, Belgium
| | - Amber De Visscher
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Leen Vandermosten
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Thao-Thy Pham
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
- Currently at Clinical Immunology Unit, Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Patrick Matthys
- Laboratory of Immunobiology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Philippe E Van den Steen
- Laboratory of Immunoparasitology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
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Amin F, Memarzia A, Kazemi Rad H, Kazerani HR, Ghasemi SZ, Boskabady MH. Inhaled paraquat-induced lung injury in rat, improved by the extract of Zataria multiflora boiss and PPARγ agonist, pioglitazone. Leg Med (Tokyo) 2024; 67:102335. [PMID: 37951808 DOI: 10.1016/j.legalmed.2023.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023]
Abstract
The effects of a PPAR-γ agonist, pioglitazone and Zataria multiflora (Z. multiflora) on inhaled paraquat (PQ)-induced lung oxidative stress, inflammation, pathological changes and tracheal responsiveness were examined. The study was carried out in control rats exposed to normal aerosol of saline, PQl and PQh groups exposed to aerosols of 27 and 54 mg/m3 PQ, groups exposed to high PQ concentration (PQh) and treated with 200 and 800 mg/kg/day Z. multiflora, 5 and 10 mg/kg/day pioglitazone, low doses of Z. multiflora + pioglitazone, and 0.03 mg/kg/day dexamethasone. Increased tracheal responsiveness, transforming growth factor beta (TGF-ß) and lung pathological changes due to PQh were significantly improved by high doses of Z. multiflora and pioglitazone, dexamethasone and extract + pioglitazone, (p < 0.05 to p < 0.001). In group treated with low doses of the extract + pioglitazone, the improvements of most measured variables were significantly higher than the low dose of two agents alone (p < 0.05 to p < 0.001). Z. multiflora improved lung injury induced by inhaled PQ similar to dexamethasone and pioglitazone which could be mediated by PPAR-γ receptor.
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Affiliation(s)
- Fatemeh Amin
- Department of Physiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Arghavan Memarzia
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Kazemi Rad
- Department of Physiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Hamid Reza Kazerani
- Department of Physiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Seyedeh Zahra Ghasemi
- Department of Physiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Suresh V, Behera P, Parida D, Mohapatra AP, Das SK, Kumari S, Avula K, Mohapatra A, Syed GH, Senapati S. Therapeutic role of N-acetyl cysteine (NAC) for the treatment and/or management of SARS-CoV-2-induced lung damage in hamster model. Eur J Pharmacol 2023; 938:175392. [PMID: 36400163 PMCID: PMC9663386 DOI: 10.1016/j.ejphar.2022.175392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/17/2022]
Abstract
Oxidative stress by reactive oxygen species (ROS) has been hypothesized to be the major mediator of SARS-CoV-2-induced pathogenesis. During infection, the redox homeostasis of cells is altered as a consequence of virus-induced cellular stress and inflammation. In such scenario, high levels of ROS bring about the production of pro-inflammatory molecules like IL-6, IL-1β, etc. that are believed to be the mediators of severe COVID-19 pathology. Based on the known antioxidant, anti-inflammatory, mucolytic and antiviral properties of NAC, it has been hypothesized that NAC will have beneficial effects in COVID-19 patients. In the current study efforts have been made to evaluate the protective effect of NAC in combination with remdesivir against SARS-CoV-2 induced lung damage in the hamster model. The SARS-CoV-2 infected animals were administered with high (500 mg/kg/day) and low (150 mg/kg/day) doses of NAC intraperitoneally with and without remdesivir. Lung viral load, pathology score and expression of inflammatory molecules were checked by using standard techniques. The findings of this study show that high doses of NAC alone can significantly suppress the SARS-CoV-2 mediated severe lung damage (2 fold), but on the contrary, it fails to restrict viral load. Moreover, high doses of NAC with and without remdesivir significantly suppressed the expression of pro-inflammatory genes including IL-6 (4.16 fold), IL-1β (1.96 fold), and TNF-α (5.55 fold) in lung tissues. Together, results of this study may guide future preclinical and clinical attempts to evaluate the efficacy of different doses and routes of NAC administration with or without other drugs against SARS-CoV-2 infection.
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Affiliation(s)
- Voddu Suresh
- Institute of Life Sciences, Bhubaneswar, Odisha, India; Regional Centre for Biotechnology, Faridabad, Haryana, India
| | - Padmanava Behera
- Institute of Life Sciences, Bhubaneswar, Odisha, India; Department of Microbiology, SOA University, Bhubaneswar, Odisha, India
| | - Deepti Parida
- Institute of Life Sciences, Bhubaneswar, Odisha, India; Regional Centre for Biotechnology, Faridabad, Haryana, India
| | - Amlan Priyadarshee Mohapatra
- Institute of Life Sciences, Bhubaneswar, Odisha, India; Regional Centre for Biotechnology, Faridabad, Haryana, India
| | | | - Sneha Kumari
- Institute of Life Sciences, Bhubaneswar, Odisha, India
| | - Kiran Avula
- Institute of Life Sciences, Bhubaneswar, Odisha, India; Regional Centre for Biotechnology, Faridabad, Haryana, India
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Yuan L, Zhu H, Chen P, Zhou M, Ma J, Liu X, Wu K, Chen R, Liu Q, Yu H, Li L, Wang J, Zhang Y, Ge S, Yuan Q, Tang Q, Cheng T, Guan Y, Xia N. Infection, pathology and interferon treatment of the SARS-CoV-2 Omicron BA.1 variant in juvenile, adult and aged Syrian hamsters. Cell Mol Immunol 2022; 19:1392-9. [PMID: 36258005 DOI: 10.1038/s41423-022-00923-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
Abstract
The new predominant circulating SARS-CoV-2 variant, Omicron, can robustly escape current vaccines and neutralizing antibodies. Although Omicron has been reported to have milder replication and disease manifestations than some earlier variants, its pathogenicity in different age groups has not been well elucidated. Here, we report that the SARS-CoV-2 Omicron BA.1 sublineage causes elevated infection and lung pathogenesis in juvenile and aged hamsters, with more body weight loss, respiratory tract viral burden, and lung injury in these hamsters than in adult hamsters. Juvenile hamsters show a reduced interferon response against Omicron BA.1 infection, whereas aged hamsters show excessive proinflammatory cytokine expression, delayed viral clearance, and aggravated lung injury. Early inhaled IFN-α2b treatment suppresses Omicron BA.1 infection and lung pathogenesis in juvenile and adult hamsters. Overall, the data suggest that the diverse patterns of the innate immune response affect the disease outcomes of Omicron BA.1 infection in different age groups.
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Gagiannis D, Umathum VG, Bloch W, Rother C, Stahl M, Witte HM, Djudjaj S, Boor P, Steinestel K. Antemortem vs Postmortem Histopathologic and Ultrastructural Findings in Paired Transbronchial Biopsy Specimens and Lung Autopsy Samples From Three Patients With Confirmed SARS-CoV-2. Am J Clin Pathol 2022; 157:54-63. [PMID: 34463314 PMCID: PMC8499854 DOI: 10.1093/ajcp/aqab087] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives Respiratory failure is the major cause of death in coronavirus disease 2019 (COVID-19). Autopsy-based reports describe diffuse alveolar damage (DAD), organizing pneumonia, and fibrotic change, but data on early pathologic changes and during progression of the disease are rare. Methods We prospectively enrolled three patients with COVID-19 and performed full clinical evaluation, including high-resolution computed tomography. We took transbronchial biopsy (TBB) specimens at different time points and autopsy tissue samples for histopathologic and ultrastructural evaluation after the patients’ death. Results Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed by reverse transcription polymerase chain reaction and/or fluorescence in situ hybridization in all TBBs. Lung histology showed reactive pneumocytes and capillary congestion in one patient who died shortly after hospital admission with detectable virus in one of two lung autopsy samples. SARS-CoV-2 was detected in two of two autopsy samples from another patient with a fulminant course and very short latency between biopsy and autopsy, showing widespread organizing DAD. In a third patient with a prolonged course, autopsy samples showed extensive fibrosis without detectable virus. Conclusions We report the course of COVID-19 in paired biopsy specimens and autopsies, illustrating vascular, organizing, and fibrotic patterns of COVID-19–induced lung injury. Our results suggest an early spread of SARS-CoV-2 from the upper airways to the lung periphery with diminishing viral load during disease.
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Affiliation(s)
| | | | - Wilhelm Bloch
- Department of Hematology and Oncology, Bundeswehrkrankenhaus Ulm, Ulm, Germany
| | - Conn Rother
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
| | | | - Hanno Maximilian Witte
- Institute of Pathology and Molecular Pathology, Ulm, Germany
- Department of Molecular and Cellular Sport Medicine, German Sport University Cologne, Cologne, Germany
- Department of Hematology and Oncology, University Hospital Schleswig-Holstein Campus Luebeck, Luebeck, Germany
| | - Sonja Djudjaj
- Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany
| | - Peter Boor
- Institute of Pathology, RWTH Aachen University Hospital, Aachen, Germany
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Raj NSS, Kodiatte TA, Vimala LR, Gnanamuthu BR. Giant cystic pulmonary hamartoma-images. Indian J Thorac Cardiovasc Surg 2022; 38:99-101. [PMID: 34898886 PMCID: PMC8630139 DOI: 10.1007/s12055-021-01239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 01/03/2023] Open
Abstract
Hamartoma is the commonest benign tumor of the lung. They usually present as an asymptomatic solitary solid nodule of varying size, located peripherally in the lung parenchyma and picked up incidentally in a chest X-ray. Rarely, they may be intra-bronchial in location. A giant cystic variant of hamartoma is very rare, with only a few cases reported in literature so far. It may be misdiagnosed as any other cystic disease of the lung and thus get mismanaged. We herewith present the images of a patient with a giant cystic pulmonary hamartoma who presented with respiratory distress.
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Affiliation(s)
- Nikhil Solomon Sundara Raj
- grid.11586.3b0000 0004 1767 8969Department of Critical Care Medicine, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Thomas Alex Kodiatte
- grid.11586.3b0000 0004 1767 8969Department of Pathology, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Leena Robinson Vimala
- grid.11586.3b0000 0004 1767 8969Department of Radiology, The Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Birla Roy Gnanamuthu
- grid.11586.3b0000 0004 1767 8969Department of CTVS, The Christian Medical College, Vellore, Tamil Nadu 632004 India
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Ferrera L, Cappiello F, Loffredo MR, Puglisi E, Casciaro B, Botta B, Galietta LJV, Mori M, Mangoni ML. Esc peptides as novel potentiators of defective cystic fibrosis transmembrane conductance regulator: an unprecedented property of antimicrobial peptides. Cell Mol Life Sci 2021. [PMID: 34971429 DOI: 10.1007/s00018-021-04030-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 12/17/2022]
Abstract
Mutations in the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) protein lead to persistent lung bacterial infections, mainly due to Pseudomonas aeruginosa, causing loss of respiratory function and finally death of people affected by CF. Unfortunately, even in the era of CFTR modulation therapies, management of pulmonary infections in CF remains highly challenging especially for patients with advanced stages of lung disease. Recently, we identified antimicrobial peptides (AMPs), namely Esc peptides, with potent antipseudomonal activity. In this study, by means of electrophysiological techniques and computational studies we discovered their ability to increase the CFTR-controlled ion currents, by direct interaction with the F508del-CFTR mutant. Remarkably, this property was not explored previously with any AMPs or peptides in general. More interestingly, in contrast with clinically used CFTR modulators, Esc peptides would give particular benefit to CF patients by combining their capability to eradicate lung infections and to act as promoters of airway wound repair with their ability to ameliorate the activity of the channel with conductance defects. Overall, our findings not only highlighted Esc peptides as the first characterized AMPs with a novel property, that is the potentiator activity of CFTR, but also paved the avenue to investigate the functions of AMPs and/or other peptide molecules, for a new up-and-coming pharmacological approach to address CF lung disease.
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Dawson RE, Jenkins BJ, Saad MI. IL-6 family cytokines in respiratory health and disease. Cytokine 2021; 143:155520. [PMID: 33875334 DOI: 10.1016/j.cyto.2021.155520] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023]
Abstract
Chronic lung diseases including asthma, chronic obstructive pulmonary disease (COPD) and lung fibrosis represent a major burden on healthcare systems with limited effective therapeutic options. Developing effective treatments for these debilitating diseases requires an understanding of how alterations at the molecular level affect lung macroscopic architecture. A common theme among these lung disorders is the presence of an underlying dysregulated immune system which can lead to sustained chronic inflammation. In this respect, several inflammatory cytokines have been implicated in the pathogenesis of lung diseases, thus leading to the notion that cytokines are attractive therapeutic targets for these disorders. In this review, we discuss and highlight the recent breakthroughs that have enhanced our understanding of the role of the interleukin (IL)-6 family of cytokines in lung homeostasis and chronic diseases including asthma, COPD, lung fibrosis and lung cancer.
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Affiliation(s)
- Ruby E Dawson
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia; Department of Molecular and Translational Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Brendan J Jenkins
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia; Department of Molecular and Translational Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Mohamed I Saad
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia; Department of Molecular and Translational Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
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Mauad T, Duarte-Neto AN, da Silva LFF, de Oliveira EP, de Brito JM, do Nascimento ECT, de Almeida Monteiro RA, Ferreira JC, de Carvalho CRR, do Nascimento Saldiva PH, Dolhnikoff M. Tracking the time course of pathological patterns of lung injury in severe COVID-19. Respir Res 2021; 22:32. [PMID: 33514373 PMCID: PMC7844838 DOI: 10.1186/s12931-021-01628-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/18/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Pulmonary involvement in COVID-19 is characterized pathologically by diffuse alveolar damage (DAD) and thrombosis, leading to the clinical picture of Acute Respiratory Distress Syndrome. The direct action of SARS-CoV-2 in lung cells and the dysregulated immuno-coagulative pathways activated in ARDS influence pulmonary involvement in severe COVID, that might be modulated by disease duration and individual factors. In this study we assessed the proportions of different lung pathology patterns in severe COVID-19 patients along the disease evolution and individual characteristics. METHODS We analysed lung tissue from 41 COVID-19 patients that died in the period March-June 2020 and were submitted to a minimally invasive autopsy. Eight pulmonary regions were sampled. Pulmonary pathologists analysed the H&E stained slides, performing semiquantitative scores on the following parameters: exudative, intermediate or advanced DAD, bronchopneumonia, alveolar haemorrhage, infarct (%), arteriolar (number) or capillary thrombosis (yes/no). Histopathological data were correlated with demographic-clinical variables and periods of symptoms-hospital stay. RESULTS Patient´s age varied from 22 to 88 years (18f/23 m), with hospital admission varying from 0 to 40 days. All patients had different proportions of DAD in their biopsies. Ninety percent of the patients presented pulmonary microthrombosis. The proportion of exudative DAD was higher in the period 0-8 days of hospital admission till death, whereas advanced DAD was higher after 17 days of hospital admission. In the group of patients that died within eight days of hospital admission, elderly patients had less proportion of the exudative pattern and increased proportions of the intermediate patterns. Obese patients had lower proportion of advanced DAD pattern in their biopsies, and lower than patients with overweight. Clustering analysis showed that patterns of vascular lesions (microthrombosis, infarction) clustered together, but not the other patterns. The vascular pattern was not influenced by demographic or clinical parameters, including time of disease progression. CONCLUSION Patients with severe COVID-19 present different proportions of DAD patterns over time, with advanced DAD being more prevalent after 17 days, which seems to be influenced by age and weight. Vascular involvement is present in a large proportion of patients, occurs early in disease progression, and does not change over time.
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Affiliation(s)
- Thais Mauad
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil.
| | - Amaro Nunes Duarte-Neto
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil
| | - Luiz Fernando Ferraz da Silva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil.,Serviço de Verificação de Óbitos da Capital, Universidade de São Paulo, São Paulo, Brazil
| | - Ellen Pierre de Oliveira
- Departamento de Cardiopneumologia, Instituto Do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jose Mara de Brito
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil
| | - Ellen Caroline Toledo do Nascimento
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil
| | - Renata Aparecida de Almeida Monteiro
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil
| | - Juliana Carvalho Ferreira
- Departamento de Cardiopneumologia, Instituto Do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Paulo Hilário do Nascimento Saldiva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil
| | - Marisa Dolhnikoff
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, sala 1155, Cerqueira Cesar, São Paulo, Brazil
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Mukhopadhyay S, Mehrad M, Dammert P, Arrossi AV, Sarda R, Brenner DS, Maldonado F, Choi H, Ghobrial M. Lung Biopsy Findings in Severe Pulmonary Illness Associated With E-Cigarette Use (Vaping). Am J Clin Pathol 2020; 153:30-39. [PMID: 31621873 DOI: 10.1093/ajcp/aqz182] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this report is to describe the lung biopsy findings in vaping-associated pulmonary illness. METHODS Lung biopsies from eight patients with vaping-associated pulmonary illness were reviewed. RESULTS The biopsies were from eight men (aged 19-61 years) with respiratory symptoms following e-cigarette use (vaping). Workup for infection was negative in all cases, and there was no evidence for other etiologies. Imaging showed diffuse bilateral ground-glass opacities in all patients. Most recovered with corticosteroid therapy, while one died. Lung biopsies (seven transbronchial, one surgical) showed acute lung injury, including organizing pneumonia and/or diffuse alveolar damage. Common features were fibroblast plugs, hyaline membranes, fibrinous exudates, type 2 pneumocyte hyperplasia, and interstitial organization. Some cases featured a sparse interstitial chronic inflammatory infiltrate. Although macrophages were present within the airspaces in all cases, this feature was not prominent, and findings typical of exogenous lipoid pneumonia were absent. CONCLUSIONS The histopathology of acute pulmonary illness related to e-cigarette use (vaping) is characterized by acute lung injury patterns, supporting the contention that vaping can cause severe lung damage.
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Affiliation(s)
| | - Mitra Mehrad
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Pedro Dammert
- Kent Pulmonary Associates, Dover, DE
- Bayhealth Medical Center, Dover, DE
| | | | | | | | - Fabien Maldonado
- Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Humberto Choi
- Respiratory Institute, Cleveland Clinic, Cleveland, OH
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Pham TT, Punsawad C, Glaharn S, De Meyer SF, Viriyavejakul P, Van den Steen PE. Release of endothelial activation markers in lungs of patients with malaria-associated acute respiratory distress syndrome. Malar J 2019; 18:395. [PMID: 31796023 PMCID: PMC6891978 DOI: 10.1186/s12936-019-3040-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/26/2019] [Indexed: 11/17/2022] Open
Abstract
Background Malaria-associated acute respiratory distress syndrome (MA-ARDS) is an understudied complication of malaria and is characterized by pulmonary inflammation and disruption of the alveolar-capillary membrane. Its pathogenesis remains poorly understood. Since endothelial activation plays an important role in other malarial complications, the expression of two endothelial activation markers, von Willebrand factor (VWF) and angiopoietin-2 (ANG-2), was investigated in the lungs of patients with MA-ARDS. Methods Post-mortem lung sections of Plasmodium falciparum-infected patients without alveolar oedema (NA), P. falciparum-infected patients with alveolar oedema (MA-ARDS), and uninfected people who died accidentally with no pathological changes to the lungs (CON) were immunohistochemically stained for VWF and ANG-2, and were evaluated with semi-quantitative analysis. Results Alveolar oedematous VWF and ANG-2 and intravascular VWF staining were significantly increased in patients with MA-ARDS versus infected and uninfected control groups. The levels of VWF in the alveolar septa and endothelial lining of large blood vessels of patients with MA-ARDS was significantly decreased compared to controls. ANG-2 expression was increased in the alveolar septa of malaria patients without alveolar oedema versus control patients, while ANG-2+ leukocytes were increased in the alveoli in both infected patient groups. Conclusions This study documents a high level of VWF and ANG-2, two endothelial activation markers in the oedematous alveoli of post-mortem lung sections of Thai patients with MA-ARDS. Decreased detection of VWF in the endothelial lining of blood vessels, in parallel with an increased presence of intravascular VWF staining suggests marked endothelial activation and Weibel–Palade body release in the lungs of patients with MA-ARDS.
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Affiliation(s)
- Thao-Thy Pham
- Laboratory of Immunoparasitology, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, University of Leuven, Leuven, Belgium
| | - Chuchard Punsawad
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Supattra Glaharn
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Simon F De Meyer
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Parnpen Viriyavejakul
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Philippe E Van den Steen
- Laboratory of Immunoparasitology, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, University of Leuven, Leuven, Belgium.
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Shakeri F, Eftekhar N, Roshan NM, Rezaee R, Moghimi A, Boskabady MH. Rosmarinic acid affects immunological and inflammatory mediator levels and restores lung pathological features in asthmatic rats. Allergol Immunopathol (Madr) 2019; 47:16-23. [PMID: 29983238 DOI: 10.1016/j.aller.2018.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/31/2018] [Accepted: 04/06/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND The effects of rosmarinic acid (RA) on immunological and inflammatory mediator levels in bronchoalveolar lavage fluid (BALF) as well as lung pathological changes in asthmatic rats were investigated. METHODS The levels of IFN-γ, IL-4, IFN-γ/IL-4 ratio, IgE, PLA2, and total protein (TP) in BALF and pathological changes in the lung were evaluated in control group (C), asthma group (sensitized to ovalbumin) (A), asthma groups treated with RA and dexamethasone. RESULTS Compared to the control group, asthmatic rats showed increased levels of IL-4, IgE, PLA2, and TP as well as all pathological scores with decreased levels of IFN-γ and IFN-γ/IL-4 ratio (P<0.05 to P<0.001). The levels of IL-4, IgE, PLA2, and TP significantly reduced in groups treated with all concentrations of RA compared to asthma group (P<0.001 for all cases). IFN-γ was significantly decreased in groups treated with two lower concentrations of RA but IFN-γ/IL-4 ratio was increased in groups treated with two higher concentrations of RA compared to asthma group (P<0.05 to P<0.001). Treatment with all doses of RA led to significant improvement in pathological scores in asthmatic animals (P<0.05 to P<0.001). Most measured parameters were also significantly improved in dexamethasone-treated animals (P<0.01 to P<0.001) but IFN-γ/IL-4 ratio and the scores of interstitial fibrosis, bleeding and epithelial damage did not change in this group. CONCLUSION The results indicated a preventive effect for RA on immunological and inflammatory mediators as well as lung pathological changes in asthmatic rats which were comparable or even more potent than that of dexamethasone.
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Affiliation(s)
- F Shakeri
- Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - N Eftekhar
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Iran
| | - N Mohammadian Roshan
- Department of Pathology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R Rezaee
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Moghimi
- Department of Biology, Faculty of Science, Ferdowsi University of Mashhad, Iran
| | - M H Boskabady
- Neurogeneeic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Zhang K, Li C, Luo YS, Wen L, Yuan S, Wang D, Ho-Yin Wong B, Zhao X, Chiu MC, Ye ZW, Sun Z, Zhao H, Zhang X, Hu M, Yang D, Shuai H, Wang Y, He J, Bose ME, Henrickson KJ, Huang JD, Zheng B, Chu H, Zhou J. Establishment of a lethal aged mouse model of human respiratory syncytial virus infection. Antiviral Res 2018; 161:125-133. [PMID: 30503888 DOI: 10.1016/j.antiviral.2018.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 01/08/2023]
Abstract
Human respiratory syncytial virus (HRSV) infection is a significant cause of morbidity and mortality, particularly among the children and the elderly. Despite extensive efforts, there is currently no formally approved vaccine and effective antiviral options against HRSV infection are limited. The development of vaccines and antiviral strategies for HRSV was partly hampered by the lack of an efficient lethal mouse model to evaluate the efficacy of the candidate vaccines or antivirals. In this study, we established a lethal HRSV mouse model by consecutively passaging a clinical HRSV isolate, GZ08-0. GZ08-18 was isolated from mouse bronchioalveolar lavage fluids at the 50th passage of GZ08-0. Importantly, all GZ08-18-inoculated mice succumbed to the infection by day 7 post infection, whereas all GZ08-0-inoculated mice recovered from the infection. Subsequent investigations demonstrated that GZ08-18 replicated to a higher titer in mouse lungs, induced more prominent lung pathology, and resulted in higher expression levels of a number of key pro-inflammatory cytokines including IFN-γ, MIP-1α, and TNF-α in comparison to that of GZ08-0. The cyclophosphamide pretreatment rendered the mice more susceptible to a lethal outcome with less rounds of virus inoculation. Full genome sequencing revealed 17 mutations in GZ08-18, some of which might account for the dramatically increased pathogenicity over GZ08-0. In addition, by using ribavirin as a positive control, we demonstrated the potential application of this lethal mouse model as a tool in HRSV investigations. Overall, we have successfully established a practical lethal mouse model for HRSV with a mouse-adapted virus, which may facilitate future in vivo studies on the evaluation of candidate vaccines and drugs against HRSV.
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Affiliation(s)
- Ke Zhang
- Department of Microbiology, The University of Hong Kong, Hong Kong, China; Department of Parasitology, Basic Medical College, Guizhou Medical University, Guiyang, China; The Key and Characteristic Laboratory of Modern Pathogen Biology, Guizhou Medical University, Guiyang, China
| | - Cun Li
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Yu-Si Luo
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Lei Wen
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Shuofeng Yuan
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Dong Wang
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Bosco Ho-Yin Wong
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Xiaoyu Zhao
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Man Chun Chiu
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Zi-Wei Ye
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Zehua Sun
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Hanjun Zhao
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Xiaomin Zhang
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Meng Hu
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Dong Yang
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Huiping Shuai
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Yixin Wang
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Jie He
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael E Bose
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kelly J Henrickson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jian-Dong Huang
- School of Biomedical Sciences, The University of Hong Kong, Hong Kong, China
| | - Bojian Zheng
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Hin Chu
- Department of Microbiology, The University of Hong Kong, Hong Kong, China; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.
| | - Jie Zhou
- Department of Microbiology, The University of Hong Kong, Hong Kong, China; State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong, China; Research Centre of Infection and Immunology, The University of Hong Kong, Hong Kong, China.
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Kondratieva TK, Kapina MA, Rubakova EI, Kondratieva EV, Nikonenko BV, Majorov KB, Dyatlov AV, Linge IA, Apt AS. A new model for chronic and reactivation tuberculosis: Infection with genetically attenuated Mycobacterium tuberculosis in mice with polar susceptibility. Tuberculosis (Edinb) 2018; 113:130-8. [PMID: 30514495 DOI: 10.1016/j.tube.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/01/2018] [Accepted: 10/07/2018] [Indexed: 12/30/2022]
Abstract
TB infection in mice develops relatively rapidly which interferes with experimental dissection of immune responses and lung pathology features that differ between genetically susceptible and resistant hosts. Earlier we have shown that the M. tuberculosis strain lacking four of five Rpf genes (ΔACDE) is seriously attenuated for growth in vivo. Using this strain, we assessed key parameters of lung pathology, immune and inflammatory responses in chronic and reactivation TB infections in highly susceptible I/St and more resistant B6 mice. ΔACDE mycobacteria progressively multiplied only in I/St lungs, whilst in B6 lung CFU counts decreased with time. Condensed TB foci apeared in B6 lungs at week 4 of infection, whilst in I/St their formation was delayed. At the late phase of infection, in I/St lungs TB foci fused resulting in extensive pneumonia, whereas in B6 lungs pathology was limited to condensed foci. Macrophage and neutrophil populations characteristically differed between I/St and B6 mice at early and late stages of infection: more neutrophils accumulated in I/St and more macrophages in B6 lungs. The expression level of chemokine genes involved in neutrophil influx was higher in I/St compared to B6 lungs. B6 lung cells produced more IFN-γ, IL-6 and IL-11 at the early and late phases of infection. Overall, using a new mouse model of slow TB progression, we demonstrate two important features of ineffective infection control underlined by shifts in lung inflammation: delay in early granuloma formation and fusion of granulomas resulting in consolidated pneumonia late in the infectious course.
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Van de Louw A, Lewis AM, Yang Z. Autopsy findings in patients with acute myeloid leukemia and non-Hodgkin lymphoma in the modern era: a focus on lung pathology and acute respiratory failure. Ann Hematol 2018; 98:119-129. [PMID: 30218164 DOI: 10.1007/s00277-018-3494-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 09/09/2018] [Indexed: 12/21/2022]
Abstract
We aimed to report autopsy findings in patients with acute myeloid leukemia (AML) and non-Hodgkin lymphoma (NHL) in the modern era, and also to focus on lung pathology in the subgroup of patients with acute respiratory failure (ARF) of unknown etiology, which is associated with especially high mortality rates. Charts and autopsy reports of 107 patients (59 AML and 48 NHL) autopsied between 2003 and 2018 were reviewed. More than 50% of patients had missed major diagnoses found at autopsy with 95% of lungs displaying abnormal findings. Malignant infiltration in at least one organ was observed in about 70% of patients with either no complete remission or relapse at the time of death (n = 92) versus 20% in patients without signs of active malignancy (n = 15) (p = 0.001). In patients with ARF of unknown etiology (n = 59), the proportion of malignant lung infiltration was 27% and equilibrated with bacterial pneumonias (29%), fungal pneumonias represented 8%, and isolated alveolar damage or pulmonary edema were the only findings in 32% of patients. Overall, 85% of patients with ARF of unknown etiology had either relapsed or not achieved remission at time of death and 80% of patients with malignant lung infiltration had ARF of unknown etiology. Ninety percent of malignant infiltration and fungal infections were observed in patients with no complete remission or relapse. Autopsy remains valuable in AML and NHL patients; besides infections, malignant infiltration is a significant contributor to ARF of unknown etiology and is rarely diagnosed ante mortem.
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Affiliation(s)
- Andry Van de Louw
- Division of Pulmonary and Critical Care Medicine, Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
| | - Allyson M Lewis
- Department of Pathology, Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
| | - Zhaohai Yang
- Department of Pathology, Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA
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Shakeri F, Roshan NM, Kaveh M, Eftekhar N, Boskabady MH. Curcumin affects tracheal responsiveness and lung pathology in asthmatic rats. Pharmacol Rep 2018; 70:981-7. [PMID: 32002955 DOI: 10.1016/j.pharep.2018.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/16/2018] [Accepted: 04/20/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Curcumin has shown various pharmacological effects such as anti-inflammatory activities. In this study, the effects of curcumin on tracheal responsiveness and lung pathological features were evaluated in a rat model of asthma. METHODS Tracheal responsiveness and lung pathological features were evaluated in control rats (C), ovalbumin (OVA)-sensitized rats (as an animal model of asthma; A), A rats treated with curcumin (Cu, 0.15, 0.30, and 0.60 mg/ml) and dexamethasone (D, 1.25 μg/ml), (n = 8 in curcumin-treated groups and n = 6 in other groups). Curcumin and dexamethasone were added to animals' drinking water during the sensitization period. RESULTS Asthmatic group showed increased lung pathological score and tracheal responsiveness to methacholine and OVA compared to control group (p < 0.01 to p < 0.001). Pathological features including interstitial inflammation, interstitial fibrosis, bleeding, and emphysema as well as tracheal responsiveness to methacholine and OVA, were significantly decreased in treated groups with dexamethasone and all concentrations of curcumin compared to group A (p < 0.05 to p < 0.001). Epithelial damage was also significantly decreased in treated groups with the two higher concentrations of curcumin (p < 0.05 to p < 0.001). CONCLUSION Curcumin showed preventive effects on tracheal responsiveness and lung pathological features in asthmatic rats.
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Abstract
Following its initial description over a century ago, pulmonary arterial hypertension (PAH) continues to challenge researchers committed to understanding its pathobiology and finding a cure. The last two decades have seen major developments in our understanding of the genetics and molecular basis of PAH that drive cells within the pulmonary vascular wall to produce obstructive vascular lesions; presently, the field of PAH research has taken numerous approaches to dissect the complex amalgam of genetic, molecular and inflammatory pathways that interact to initiate and drive disease progression. In this review, we discuss the current understanding of PAH pathology and the role that genetic factors and environmental influences share in the development of vascular lesions and abnormal cell function. We also discuss how animal models can assist in elucidating gene function and the study of novel therapeutics, while at the same time addressing the limitations of the most commonly used rodent models. Novel experimental approaches based on application of next generation sequencing, bioinformatics and epigenetics research are also discussed as these are now being actively used to facilitate the discovery of novel gene mutations and mechanisms that regulate gene expression in PAH. Finally, we touch on recent discoveries concerning the role of inflammation and immunity in PAH pathobiology and how they are being targeted with immunomodulatory agents. We conclude that the field of PAH research is actively expanding and the major challenge in the coming years is to develop a unified theory that incorporates genetic and mechanistic data to address viable areas for disease modifying drugs that can target key processes that regulate the evolution of vascular pathology of PAH.
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Kaczyńska K, Zając D, Wojciechowski P, Kogut E, Szereda-Przestaszewska M. Neuropeptides and breathing in health and disease. Pulm Pharmacol Ther 2017; 48:217-224. [PMID: 29223509 DOI: 10.1016/j.pupt.2017.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 12/18/2022]
Abstract
Regulatory neuropeptides control and regulate breathing in physiological and pathophysiological conditions. While they have been identified in the neurons of major respiratory areas, they can be active not only at the central level, but also at the periphery via chemoreceptors, vagal afferents, or locally within lungs and airways. Some neuropeptides, such as leptin or substance P, are respiratory stimulants; others, such as neurotensin, produce variable effects on respiration depending on the site of application. Some neuropeptides have been implicated in pathological states, such as obstructive sleep apnea or asthma. This article provides a concise review of the possible role and functions of several selected neuropeptides in the process of breathing in health and disease and in lung pathologies.
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Affiliation(s)
- Katarzyna Kaczyńska
- Laboratory of Respiration Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland.
| | - Dominika Zając
- Laboratory of Respiration Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Piotr Wojciechowski
- Laboratory of Respiration Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Ewelina Kogut
- Laboratory of Respiration Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
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Teng F, Felix KM, Bradley CP, Naskar D, Ma H, Raslan WA, Wu HJJ. The impact of age and gut microbiota on Th17 and Tfh cells in K/BxN autoimmune arthritis. Arthritis Res Ther 2017; 19:188. [PMID: 28810929 PMCID: PMC5558662 DOI: 10.1186/s13075-017-1398-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/27/2017] [Indexed: 02/08/2023] Open
Abstract
Background Age is an important risk factor for rheumatoid arthritis (RA), which often develops in middle age. However, how age-associated changes in immunity impact RA is poorly understood. Gut microbiota are known to be involved in the pathogenesis of RA, but the effects of microbiota in older subjects remain mostly unknown. Methods We used segmented filamentous bacteria (SFB), a gut commensal species with immunomodulatory effects, and K/BxN mice, a T cell receptor (TCR) transgenic model, to study the effect of age and microbiota on autoimmune arthritis. Comparing young and middle-aged K/BxN T cells of the same TCR specificity allows us to study T cells with an age focus eliminating a key variable: TCR repertoire alteration with age. In addition to joints, we also studied pathological changes in the lung, an important extra-articular RA manifestation. We used flow cytometry to evaluate T follicular helper (Tfh) and T helper 17 (Th17) cells, as they both contribute to autoantibody production, a key disease index in both RA and K/BxN arthritis. Results Middle-aged K/BxN mice had aggravated arthritis and pathological changes in the lung compared to young mice. Middle-aged mice displayed a strong accumulation of Tfh but not Th17 cells, and had defective Th17 differentiation and low expression of interleukin-23, a critical cytokine for Th17 maintenance. Although a soaring Tfh cell population accompanied by robust germinal center B cell responses were found in middle-aged mice, there was decreased cycling of Tfh cells, and SFB only induced the non-Tfh cells to upregulate Bcl-6, the Tfh master transcription factor, in the young but not the middle-aged group. Finally, the accumulated Tfh cells in middle-aged mice had an effector phenotype (CD62LloCD44hi). Conclusion Age-dependent Tfh cell accumulation may play a crucial role in the increased autoimmune disease phenotype in middle-age. SFB, a potent stimulus for inducing Tfh differentiation, fails to promote Tfh differentiation in middle-aged K/BxN mice, suggesting that most of the middle-aged Tfh cells with an effector phenotype are Tfh effector memory cells induced at an earlier age. Our results also indicate that exposure to immunomodulatory commensals may allow the young host to develop an overactive immune system reminiscent of that found in the middle-aged host.
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Affiliation(s)
- Fei Teng
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA
| | - Krysta M Felix
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA
| | - C Pierce Bradley
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA
| | - Debdut Naskar
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA
| | - Heqing Ma
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA
| | - Walid A Raslan
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA
| | - Hsin-Jung Joyce Wu
- Department of Immunobiology, University of Arizona, Tucson, AZ, 85719, USA. .,Arizona Arthritis Center, College of Medicine, University of Arizona, Tucson, AZ, 85719, USA.
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Hon C, O'Hara CJ, Litle VR. Endotracheal hamartoma case report: Two contrasting clinical presentations of a rare entity. Int J Surg Case Rep 2017; 38:98-101. [PMID: 28755616 PMCID: PMC5537398 DOI: 10.1016/j.ijscr.2017.07.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 07/12/2017] [Accepted: 07/15/2017] [Indexed: 11/30/2022] Open
Abstract
Hamartomas are benign tumors that are rarely localized to the trachea. Symptoms often gradual, mimicking those of chronic obstructive pulmonary disease. Successful management of Endotracheal Hamartomas is feasible using a bronchoscopic approach. Etiology of endotracheal hamartomas is unknown. Early suspicion in patients with obstructive pulmonary symptoms can prevent easily avoidable fatal complications.
Introduction The majority of tracheal tumors in adults are malignant. The finding of a benign tumor in the trachea is uncommon and endotracheal hamartomas are rare. Presentation of case We report two cases presenting within six months at our institution. The first patient is a 67 year-old man who was found to have an asymptomatic endotracheal hamartoma on chest imaging for aortic valve replacement. The second patient is a 46 year-old man with an extensive continued tobacco use disorder and a known endotracheal lesion identified 8 years prior to intervention. Both patients were treated surgically and recovered without complications. Discussion Identification of these lesions and timely management are necessary because without intervention, they can lead to fatal complications. Most symptoms of tracheal hamartoma result from mechanical obstruction with the earliest presenting symptom being dyspnea, but as evident in these two cases, they can have different presentations. Conclusion We have found that endotracheal hamartoma has a tendency to present in Caucasian, male patients with a comorbidity of respiratory disease and variable smoking history, but it can also present in asymptomatic patients with no significant smoking history.
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Affiliation(s)
- Curtis Hon
- Boston University School of Medicine, 72 East Concord St, Boston, MA, 02118, United States
| | - Carl J O'Hara
- Department of Pathology, Boston University School of Medicine, 72 East Concord St, Boston, MA, 02118, United States
| | - Virginia R Litle
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, 72 East Concord St, Boston, MA, 02118, United States.
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Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a progressive disorder that makes the breathing difficult and is characterized by pathological conditions ranging from chronic inflammation to tissue proteolysis. With regard to ethical issues related to the studies on patients with COPD, the use of animal models of COPD is inevitable. Animal models improve our knowledge about the basic mechanisms underlying COPD physiology, pathophysiology and treatment. Although these models are only able to mimic some of the features of the disease, they are valuable for further investigation of mechanisms involved in human COPD. METHODS We searched the literature available in Google Scholar, PubMed and ScienceDirect databases for English articles published until November 2015. For this purpose, we used 5 keywords for COPD, 3 for animal models, 4 for exposure methods, 3 for pathophysiological changes and 3 for biomarkers. One hundred and fifty-one studies were considered eligible for inclusion in this review. RESULTS According to the reviewed articles, animal models of COPD are mainly induced in mice, guinea pigs and rats. In most of the studies, this model was induced by exposure to cigarette smoke (CS), intra-tracheal lipopolysaccharide (LPS) and intranasal elastase. There were variations in time course and dose of inducers used in different studies. The main measured parameters were lung pathological data and lung inflammation (both inflammatory cells and inflammatory mediators) in most of the studies and tracheal responsiveness (TR) in only few studies. CONCLUSION The present review provides various methods used for induction of animal models of COPD, different animals used (mainly mice, guinea pigs and rats) and measured parameters. The information provided in this review is valuable for choosing appropriate animal, method of induction and selecting parameters to be measured in studies concerning COPD.
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Affiliation(s)
- Vahideh Ghorani
- Pharmaceutical Research Centre and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Neurogenic Inflammation Research Centre and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564 Iran
| | - Mohammad Reza Khazdair
- Pharmaceutical Research Centre and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Kianmeher
- Neurogenic Inflammation Research Centre and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564 Iran
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Shepelkova G, Evstifeev V, Kondratieva T, Bocharova I, Averbakh M, Apt A. Local targeting NF-κB in the lung tissue of TB-infected mice diminishes the level of pathology. Tuberculosis (Edinb) 2017; 103:92-96. [PMID: 28237038 DOI: 10.1016/j.tube.2016.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
Abstract
Mice of the genetically TB-susceptible strain I/St were infected with ∼100 CFU of Mycobacterium tuberculosis strain H37Rv, and after week 3 post-infection treated by inhalations of the NBD peptide selectively blocking NF-κB activation pathway. This therapy resulted in a pronounced attenuation of lung pathology and down-regulation of the expression of several genes encoding major inflammatory molecules, but did not diminish the level of mycobacterial multiplication in the lungs.
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Affiliation(s)
- Galena Shepelkova
- Department of Immunology, Central Institute for Tuberculosis, Moscow, Russia
| | - Vladimir Evstifeev
- Department of Immunology, Central Institute for Tuberculosis, Moscow, Russia
| | - Tatiana Kondratieva
- Department of Immunology, Central Institute for Tuberculosis, Moscow, Russia
| | - Irina Bocharova
- Department of Immunology, Central Institute for Tuberculosis, Moscow, Russia
| | - Mikhail Averbakh
- Department of Immunology, Central Institute for Tuberculosis, Moscow, Russia
| | - Alexander Apt
- Department of Immunology, Central Institute for Tuberculosis, Moscow, Russia; Department of Immunology, School of Biology, Moscow State University, Russia.
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Noguchi S, Shinohara N, Ito T, Ohtsu A, Ravaud A, Jerusalem G, Ohno N, Gallo J, Bouillaud E, Fan J, Nonomura N. Relationship between Pulmonary Adverse Events and Everolimus Exposure in Japanese and Non-Japanese Patients: A Meta-Analysis of Oncology Trials. Oncology 2017; 92:243-254. [PMID: 28219073 DOI: 10.1159/000457904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 01/13/2017] [Indexed: 11/19/2022]
Abstract
AIMS This meta-analysis explores the relationship between the everolimus minimum (Cmin) and maximum (Cmax) exposure and the risk for pulmonary adverse events (AEs) in Japanese versus non-Japanese patients. METHODS Patient-level data from patients treated with daily everolimus in advanced solid tumor trials were evaluated using a Cox regression model, stratified by cancer type or treatment arm, with log-transformed time-averaged Cmin or Cmax as a time-varying covariate. Kaplan-Meier analysis was used to evaluate the relationship between pulmonary AEs and pharmacokinetic parameters. RESULTS Thirty studies were identified. In the Cmin population (n = 1,962), all-grade pulmonary AE incidence was significantly higher in Japanese versus non-Japanese patients (19.9 vs. 9.4%). Pharmacokinetic parameters were similar between Japanese and non-Japanese patients. A 2-fold increase in everolimus Cmin significantly increased the risk for the first any-grade pulmonary AE in Japanese (risk ratio: 1.824; 95% CI: 1.141-2.918) and non-Japanese patients (risk ratio: 1.406; 95% CI: 1.156-1.710). CONCLUSIONS The risk for pulmonary AEs is related to everolimus exposure. Local monitoring and reporting differences might account for the significantly higher reported incidence of low-grade everolimus-associated pulmonary AEs in Japanese versus non-Japanese patients. Patients should be carefully monitored for early signs of pulmonary AEs, and appropriate medical management should be implemented.
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Affiliation(s)
- Shinzaburo Noguchi
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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Shiono S, Yanagawa N. Spread through air spaces is a predictive factor of recurrence and a prognostic factor in stage I lung adenocarcinoma. Interact Cardiovasc Thorac Surg 2016; 23:567-72. [PMID: 27354463 DOI: 10.1093/icvts/ivw211] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/25/2016] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Spread through air spaces (STAS) is considered a prognosticator related to local recurrence. We assessed the prognostic impact of spread through air spaces and local recurrence in stage I lung adenocarcinoma. METHODS From July 2004 to November 2014, 877 lung cancer patients underwent surgery, of whom 318 with pathological stage I adenocarcinoma were reviewed. We investigated the characteristics of spread through air spaces and analysed the relationship between spread through air spaces and prognosis. RESULTS The median follow-up was 30 months. Of the 318 patients, 47 (14.8%) had spread through air spaces. The patients with spread through air spaces were associated with male sex (P < 0.001), smoking (P < 0.001), solid nodules (P < 0.001), stage IB disease (P = 0.006), epidermal growth factor receptor mutation negativity (P < 0.001), and lymphovascular (P < 0.001) and pleural invasion (P = 0.001). Among the preoperative findings, spread through air spaces was significantly related to solid nodules on computed tomography. Local recurrence occurred in 11 of 47 (23.4%) cases with spread through air spaces and 10 of 271 (3.7%) cases without spread through air spaces (P < 0.01). Univariate analysis showed that the overall 5-year survival rates were 62.7 and 91.1% in cases with and without spread through air spaces, respectively (P < 0.01), and the recurrence-free 5-year survival rates were 54.4 and 87.8% in cases with and without spread through air spaces, respectively (P < 0.01). Multivariate analysis confirmed spread through air spaces as a significant prognosticator for overall survival and a predictive factor for recurrence after surgery. CONCLUSIONS Among stage I lung adenocarcinoma patients, spread through air spaces was found frequently in the invasive cases and was closely related to poor prognosis and recurrence.
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Affiliation(s)
- Satoshi Shiono
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Naoki Yanagawa
- Department of Pathology, Yamagata Prefectural Central Hospital, Yamagata, Japan
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Ichiki Y, Kawasaki J, Hamatsu T, Suehiro T, Tanaka F, Hisaoka M, Sugimachi K. A primary cellular fibrohistiocytoma of the lung: Report of a case. Int J Surg Case Rep 2016; 24:150-2. [PMID: 27262347 DOI: 10.1016/j.ijscr.2016.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 05/05/2016] [Indexed: 11/21/2022] Open
Abstract
We experienced a rare patient with a primary cellular fibrohistiocytoma (CFH). Our search of literature only revealed one case of a primary CFH of the lung. It is essential to perform resection with an adequate margin with close clinical follow-up.
Introduction Cellular fibrohistiocytoma (CFH) is a type of fibrohistiocytic tumor that commonly occurs in the dermis and superficial subcutis. The designation is used for lesions that show increased cellularity with a fascicular growth pattern and frequent extension. Our search of literature only revealed one case of a primary CFH of the lung. We experienced a rare patient with a primary CFH of the lung. Presentation of case We herein present a rare case of a 77-year-old female patient without a cutaneous lesion, who underwent resection for what was considered to be a primary CFH of the lung. There has been no recurrence including a cutaneous lesion in a year after surgery. Discussion CFH is considered to be benign, but rare cases showing multiple recurrences and involving metastasis to the lymph nodes and internal organs have been reported. At present, it is not possible to predict this aggressive biological behavior based on the tumor histology. Conclusion It is essential to perform resection with an adequate margin with close clinical follow-up.
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Qiao L, Zhang Y, Chai F, Tan Y, Huo C, Pan Z. Chimeric virus-like particles containing a conserved region of the G protein in combination with a single peptide of the M2 protein confer protection against respiratory syncytial virus infection. Antiviral Res 2016; 131:131-40. [PMID: 27154395 DOI: 10.1016/j.antiviral.2016.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/28/2016] [Accepted: 05/02/2016] [Indexed: 01/08/2023]
Abstract
To investigate the feasibility and efficacy of a virus-like particle (VLP) vaccine composed of the conserved antigenic epitopes of respiratory syncytial virus (RSV), the chimeric RSV VLPs HBcΔ-tG and HBcΔ-tG/M282-90 were generated based on the truncated hepatitis B virus core protein (HBcΔ). HBcΔ-tG consisted of HBcΔ, the conserved region (aa 144-204) of the RSV G protein. HBcΔ-tG was combined with a single peptide (aa 82-90) of the M2 protein to generate HBcΔ-tG/M282-90. Immunization of mice with the HBcΔ-tG or HBcΔ-tG/M282-90 VLPs elicited RSV-specific IgG and neutralizing antibody production and conferred protection against RSV infection. Compared with HBcΔ-tG, HBcΔ-tG/M282-90 induced decreased Th2 cytokine production (IL-4 and IL-5), increased Th1 cytokine response (IFN-γ, TNF-α, and IL-2), and increased ratios of IgG2a/IgG1 antibodies, thereby relieving pulmonary pathology upon subsequent RSV infection. Our results demonstrated that chimeric HBcΔ-tG/M282-90 VLPs represented an effective RSV subunit vaccine candidate.
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Affiliation(s)
- Lei Qiao
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Yuan Zhang
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Feng Chai
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Yiluo Tan
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Chunling Huo
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China
| | - Zishu Pan
- State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan 430072, China.
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Jin M, Lee YH, Kim B, Yoon YC, Wi JH. Solitary Atypical Adenomatous Hyperplasia in a 12-Year-Old Girl. Korean J Thorac Cardiovasc Surg 2016; 49:141-4. [PMID: 27065090 PMCID: PMC4825920 DOI: 10.5090/kjtcs.2016.49.2.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/02/2015] [Accepted: 11/03/2015] [Indexed: 11/26/2022]
Abstract
Atypical adenomatous hyperplasia is a premalignant lesion reflecting a focal proliferation of atypical cells. These lesions are usually observed as incidental findings in lungs that have been resected due to other conditions, such as lung cancer. We report the youngest case of atypical adenomatous hyperplasia on record in a 12-year-old girl. In this patient, the lesion was found in association with pneumothorax.
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Affiliation(s)
- Moran Jin
- Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine
| | - Yang-Haeng Lee
- Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine
| | - Bomi Kim
- Department of Pathology, Inje University Busan Paik Hospital, Inje University College of Medicine
| | - Young Chul Yoon
- Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine
| | - Jin Hong Wi
- Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine
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Mohammadian M, Boskabady MH, Kashani IR, Jahromi GP, Omidi A, Nejad AK, Khamse S, Sadeghipour HR. Effect of bone marrow derived mesenchymal stem cells on lung pathology and inflammation in ovalbumin-induced asthma in mouse. Iran J Basic Med Sci 2016; 19:55-63. [PMID: 27096065 PMCID: PMC4823617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Bone marrow-derived mesenchymal stem cells (BMSCs) have attracted significant interest to treat asthma and its complication. In this study, the effects of BMSCs on lung pathology and inflammation in an ovalbumin-induced asthma model in mouse were examined. MATERIALS AND METHODS BALB/c mice were divided into three groups: control group (animals were not sensitized), asthma group (animals were sensitized by ovalbumin), asthma+BMSC group (animals were sensitized by ovalbumin and treated with BMSCs). BMSCs were isolated and characterized and then labeled with Bromodeoxyuridine (BrdU). After that the cells transferred into asthmatic mice. Histopathological changes of the airways, BMSCs migration and total and differential white blood cell (WBC) count in bronchoalveolar lavage (BAL) fluid were evaluated. RESULTS A large number of BrdU-BMSCs were found in the lungs of mice treated with BMSCs. The histopathological changes, BAL total WBC counts and the percentage of neutrophils and eosinophils were increased in asthma group compared to the control group. Treatment with BMSCs significantly decreased airway pathological indices, inflammatory cell infiltration, and also goblet cell hyperplasia. CONCLUSION The results of this study revealed that BMSCs therapy significantly suppressed the lung pathology and inflammation in the ovalbumin induced asthma model in mouse.
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Affiliation(s)
- Maryam Mohammadian
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Boskabady
- Neurogenic Inflammation Research Center and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Iraj Ragerdi Kashani
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Gila Pirzad Jahromi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amene Omidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Kavian Nejad
- Department of Emergency Medical Services, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safoura Khamse
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Sadeghipour
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Hamid Reza Sadeghipour. Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Tel/Fax: +98-2166419484;
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Deutsch G, Muralidhar A, Le E, Borbon IA, Erickson RP. Extensive macrophage accumulation in young and old Niemann-Pick C1 model mice involves the alternative, M2, activation pathway and inhibition of macrophage apoptosis. Gene 2015; 578:242-50. [PMID: 26707209 DOI: 10.1016/j.gene.2015.12.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 12/18/2022]
Abstract
We have studied the pathophysiology of lung disease which occurs in two mouse models of Niemann-Pick C1 disease. We utilized Npc1(-/-) mice transgenic for normal gene expression in glia or neurons and glia at ages several fold the usual and a mouse model of the juvenile form of NPC1, a point mutation, at one age to confirm some findings. Lung weights, as per cent of body weight, increase much more than liver and spleen weights. Although pulmonary function parameters only vary for hysteresis between young and older Npc1(-/-) mice, they are markedly different than those found in normal control mice. Cholesterol accumulation continued in the older mice but sphingosine-1-phosphate was not increased. Bronchoalveolar lavage (BAL) showed a massive increase (26×) in the number of macrophages. Histologic examination from the older, transgenic Npc1(-/-) mice showed small foci of alveolar proteinosis and evidence of hemorrhage, as well as dense macrophage accumulation. A large subset of macrophages was immunopositive for Fizz1 or arginase-1, markers of the alternative activation pathway, while no Fizz1 or arginase-1 positive macrophages were found in wild-type mice. The percentage of marker positive macrophages was relatively stable at 5-10% at various ages and within the 2 transgenic models. Phosphohistone H3 and Ki67 showed low levels of proliferation of these macrophages. Apoptosis was prominent within lung capillary endothelial cells, but limited within macrophages. Thus, activation of the alternative pathway is involved in Niemann-Pick C1 associated pulmonary macrophage accumulation, with low proliferation of these cells balanced by low levels of apoptosis.
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Affiliation(s)
- Gail Deutsch
- Dept. of Pathology, Seattle Children's Hospital, Seattle, WA 98105-0371, United States
| | - Akshay Muralidhar
- Dept. of Pediatrics, Univ. of AZ Health Sci. Ctr., Tucson, AZ 85724-5073, United States
| | - Ellen Le
- Dept. of Pediatrics, Univ. of AZ Health Sci. Ctr., Tucson, AZ 85724-5073, United States
| | - Ivan A Borbon
- Dept. of Pediatrics, Univ. of AZ Health Sci. Ctr., Tucson, AZ 85724-5073, United States
| | - Robert P Erickson
- Dept. of Pediatrics, Univ. of AZ Health Sci. Ctr., Tucson, AZ 85724-5073, United States; Dept. of Molecular and Cellular Biology, Univ. of AZ, Tucson, AZ 85721, United States.
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Gallo K, Brickman A, Warren WH, Gattuso P, Seder CW. Unresectable Middle Mediastinal Biphasic Pulmonary Blastoma. Anticancer Res 2015; 35:6325-6327. [PMID: 26504071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a case of a young male who presented with an unresectable, centrally-located classic biphasic pulmonary blastoma (CBPB) involving his bilateral mainstem bronchi and esophagus and a synchronous right testicular seminoma. CBPB is a rare and aggressive tumor that most commonly presents as a solitary mass in the periphery of the lung. Surgical resection is the preferred treatment for CBPB, as chemotherapy and radiation have demonstrated limited effectiveness. In the current case, four cycles of cisplatin, ifosfamide, and etoposide with concurrent radiotherapy resulted in a favorable response at three months. Currently he optimal treatment for unresectable pulmonary blastomas remains undefined.
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Affiliation(s)
- Kelsey Gallo
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, U.S.A
| | - Arlen Brickman
- Department of Pathology, Rush University Medical Center, Chicago, IL, U.S.A
| | - William H Warren
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, U.S.A
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, Chicago, IL, U.S.A
| | - Christopher W Seder
- Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, U.S.A.
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Jolissaint JS, Kilbourne SK, LaFortune K, Patel M, Lau CL. Benign metastasizing leiomyomatosis (BML): A rare cause of cavitary and cystic pulmonary nodules. Respir Med Case Rep 2015; 16:122-4. [PMID: 26744676 PMCID: PMC4681982 DOI: 10.1016/j.rmcr.2015.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 09/17/2015] [Indexed: 12/16/2022] Open
Abstract
Benign metastasizing leiomyomatosis (BML) is a rare cause of pulmonary lesions found in reproductive age women who have undergone a hysterectomy for uterine leiomyoma. Given the relative rarity of the disease, the management of these lesions varies from surgical (oopherectomy) or medical antiestrogen hormonal therapy to clinical observation and survelliance. The disease generally presents asymptomatically with multiple, well-defined pulmonary nodules discovered incidentally on imaging. We report an atypical presentation of a 46-year-old woman with incidentally found bilateral pulmonary cavitating nodules and cysts, concerning for lymphangioleiomyomatosis (LAM), who was ultimately diagnosed with BML.
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Key Words
- BAL, Bronchoalveolar lavage
- BML, Benign metastasizing leiomyomatosis
- Benign metastasizing leiomyomatosis (BML)
- Benign or congenital lesions
- CTPA, Computed tomography pulmonary angiogram
- ER, Estrogen receptor
- GnRH, Gonadotropin-releasing hormone
- HMB-45, Human melanoma black-45
- LAM, Lymphangioleiomyomatosis
- Lung histology
- Lung pathology
- Lymphangioleiomyomatosis (LAM)
- POD, Post-operative day
- PR, Progesterone receptor
- SMA, Smooth muscle actin
- VATS, Video-assisted thoracoscopic surgery
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Affiliation(s)
- Joshua S Jolissaint
- University of Virginia School of Medicine, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA, 22903, USA
| | - Sarah K Kilbourne
- University of Virginia, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA, 22903, USA
| | - Kristen LaFortune
- University of Virginia, Department of Pathology, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA, 22903, USA
| | - Manojkumar Patel
- University of Virginia, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA, 22903, USA
| | - Christine L Lau
- University of Virginia, Department of Surgery, University of Virginia Health System, 1215 Lee Street, Charlottesville, VA, 22903, USA
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Alexander GR, Biccard B. A retrospective review comparing treatment outcomes of adjuvant lung resection for drug-resistant tuberculosis in patients with and without human immunodeficiency virus co-infection. Eur J Cardiothorac Surg 2015; 49:823-8. [PMID: 26142471 DOI: 10.1093/ejcts/ezv228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/28/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This review was undertaken to compare treatment outcomes in human immunodeficiency virus (HIV) negative versus HIV-positive patients following adjuvant lung resection for drug-resistant tuberculosis (DR-TB) in patients deemed feasible for surgery. Despite appropriate medical therapy, mortality remains extremely high and cure rates poor in patients with DR-TB and HIV co-infection. Therefore, adjuvant lung resection may warrant a more prominent role in the treatment of these patients. METHODS A retrospective review of all case records from 1 January 2012 to 31 March 2013 of all patients admitted to the Department of Cardiothoracic Surgery King Dinuzulu Hospital with DR-TB and treated with adjuvant lung resection was undertaken. Prior to surgery, all patients were treated for at least 3 months with appropriate drug therapy for DR-TB. This was continued for the recommended period following lung resection. RESULTS Fourteen patients with extensively drug-resistant tuberculosis (XDR-TB) were deemed suitable for lung resection. Of these patients, 10 patients were HIV-positive and 4 were HIV-negative. In the XDR-TB/HIV-positive group, 7 patients were cured, 2 converted and 2 patients developed a post-pneumonectomy broncho-pleural fistula. One patient was lost to follow-up. In the XDR-TB/HIV-negative group, 1 patient was cured, 3 converted and 1 patient developed a post-thoracotomy superficial wound infection. There was no in-hospital mortality in both groups. Thirty-six patients with multi-drug-resistant tuberculosis (MDR-TB) were deemed suitable for lung resection. Of these patients, 19 were HIV-positive and 17 HIV-negative. In the MDR-TB/HIV-positive group, 12 patients were cured and 6 converted. One patient developed a post-thoracotomy superficial wound infection and another patient who developed a post-pneumonectomy empyema thoracis was also regarded as a treatment failure. In the MDR-TB/HIV-negative group, 15 patients were cured, 2 converted and 1 patient developed a post-pneumonectomy lower respiratory tract infection which necessitated a short period of mechanical ventilation. There was no in-hospital mortality in both groups. CONCLUSIONS Lung resection for DR-TB may be safely undertaken in selected patients who are HIV-positive with cure rates equivalent to that of HIV-negative patients. More importantly, these patients also have significantly higher cure rates than those patients treated with medical therapy alone.
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Affiliation(s)
| | - Bruce Biccard
- King Dinuzulu Hospital, Durban, South Africa Department of Anaesthesiology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
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Roncati L, Pusiol T, Piscioli F, Scialpi M, Barbolini G, Maiorana A. Pneumothorax-associated fibroblastic lesion in combination with localized pleural angiomatosis: A possible cause of juvenile spontaneous hemopneumothorax. Pathol Res Pract 2015; 211:481-4. [PMID: 25749626 DOI: 10.1016/j.prp.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/22/2015] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
Abstract
Spontaneous hemopneumothorax is an uncommon but potentially life-threatening condition, with a potential for a rapid ventilatory collapse and a large collection of hidden blood loss into the pleural cavity. Here, we report the first case in the literature on pneumothorax-associated fibroblastic lesion in combination with localized pleural angiomatosis in a 19-year-old Caucasian male, resulting in massive spontaneous hemopneumothorax and hypovolemic shock. Our findings support a causal link between this condition and pneumothorax. The possible superimposed hemothorax is explainable by the pleural involvement of large angiomatous vessels, prone to rupture.
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Affiliation(s)
- Luca Roncati
- Department of Diagnostic and Clinical Medicine and of Public Health, Section of Pathology, University of Modena and Reggio Emilia, Modena, MO, Italy.
| | - Teresa Pusiol
- Provincial Health Care Services, Institute of Pathology, Santa Maria del Carmine Hospital, Rovereto, TN, Italy
| | - Francesco Piscioli
- Provincial Health Care Services, Institute of Pathology, Santa Maria del Carmine Hospital, Rovereto, TN, Italy
| | - Michele Scialpi
- Department of Surgical and Biomedical Sciences, Section of Radiology, University of Perugia, Perugia, PG, Italy
| | - Giuseppe Barbolini
- Department of Diagnostic and Clinical Medicine and of Public Health, Section of Pathology, University of Modena and Reggio Emilia, Modena, MO, Italy
| | - Antonio Maiorana
- Department of Diagnostic and Clinical Medicine and of Public Health, Section of Pathology, University of Modena and Reggio Emilia, Modena, MO, Italy
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Holbrook BC, Hayward SL, Blevins LK, Kock N, Aycock T, Parks GD, Alexander-Miller MA. Nonhuman primate infants have an impaired respiratory but not systemic IgG antibody response following influenza virus infection. Virology 2014; 476:124-133. [PMID: 25543963 DOI: 10.1016/j.virol.2014.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/06/2014] [Accepted: 12/03/2014] [Indexed: 10/24/2022]
Abstract
Respiratory infection of young infants results in increased morbidity and mortality compared to infection of adults. In spite of the significance of this health issue, our understanding of the immune response elicited in infants especially in the respiratory tract is highly limited. We developed a nonhuman primate model to probe the virus-specific antibody response in infants following infection with influenza virus. Infection of infants resulted in more pulmonary damage and higher viral loads compared to adults. While the systemic IgG antibody response was similar in infant and adult animals, the response in the upper respiratory tract of the infant was compromised. This lower response was associated with an increased prevalence of Treg cells and low levels of BALT. These data suggest a defect in the ability to produce effective virus-specific antibody responses at the local infection site is a contributor to increased pulmonary damage in the at-risk infant population.
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Affiliation(s)
- Beth C Holbrook
- Department of Microbiology and Immunology, Wake Forest School of Medicine, United States
| | - Sarah L Hayward
- Department of Microbiology and Immunology, Wake Forest School of Medicine, United States
| | - Lance K Blevins
- Department of Microbiology and Immunology, Wake Forest School of Medicine, United States
| | - Nancy Kock
- Department of Pathology, Wake Forest School of Medicine, United States
| | - Tyler Aycock
- Animal Resources Program, Wake Forest School of Medicine, United States
| | - Griffith D Parks
- Department of Microbiology and Immunology, Wake Forest School of Medicine, United States
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Lee S, Quan FS, Kwon Y, Sakamoto K, Kang SM, Compans RW, Moore ML. Additive protection induced by mixed virus-like particles presenting respiratory syncytial virus fusion or attachment glycoproteins. Antiviral Res 2014; 111:129-35. [PMID: 25239522 DOI: 10.1016/j.antiviral.2014.09.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/03/2014] [Accepted: 09/08/2014] [Indexed: 01/13/2023]
Abstract
Respiratory syncytial virus (RSV) is the most important pathogen for lower respiratory tract illness in infants and a high priority for vaccine development. We previously reported that RSV virus-like particles (VLPs) expressing either the fusion (F) or attachment (G) glycoprotein could confer protection against RSV challenge in BALB/c mice. Here, we tested the hypothesis that RSV VLP vaccine efficacy can be enhanced by mixing RSV VLP F and RSV VLP G, and we analyzed host responses to these RSV VLPs. Mice were immunized with VLP F, VLP G, or VLP F+VLP G. Lung viral loads in BALB/c mice following RSV strain A2-line19F challenge were lower in mice vaccinated with RSV VLP F+VLP G compared to VLP F- or VLP G-vaccinated mice. Vaccination with VLP F or VLP F+VLP G induced similar levels of neutralizing antibodies. The enhanced protection against RSV challenge induced by vaccination with RSV VLP F+VLP G correlated with CD8 T cells producing T helper type 1 cytokines. VLP G vaccination alone followed by challenge resulted in immunopathology similar to formalin-inactivated RSV vaccination and RSV challenge. Taken together, mixed VLP F+VLP G provided a high level of protection against RSV without vaccine-induced immunopathology, but VLP G vaccination enhanced disease when used alone.
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Sakurai H, Asamura H, Miyaoka E, Yoshino I, Fujii Y, Nakanishi Y, Eguchi K, Mori M, Sawabata N, Okumura M, Yokoi K. Differences in the prognosis of resected lung adenocarcinoma according to the histological subtype: a retrospective analysis of Japanese lung cancer registry data. Eur J Cardiothorac Surg 2013; 45:100-7. [PMID: 23729748 DOI: 10.1093/ejcts/ezt284] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study intended to assess the clinicopathological features of the histological subtypes of adenocarcinoma of the lung in a large registry population. METHODS The Japanese Joint Committee of Lung Cancer Registry performed a nationwide retrospective registry study on the prognosis and clinicopathological profiles of 11 663 patients who underwent resection for primary lung neoplasm in 2004. The registry data of 7921 (62.5%) patients with adenocarcinoma were analysed regarding the prognosis and clinicopathological features according to the histological subtype of adenocarcinoma. The histological subtypes were defined according to the 1999 World Health Organization classification (third edition), where bronchioloalveolar carcinoma (BAC) is defined as adenocarcinoma with a pure bronchioloalveolar growth pattern without invasion. RESULTS The distribution of the histological subtype was acinar in 471 patients (7.5%), papillary in 2004 (32.2%), BAC in 1385 (22.3%), solid adenocarcinoma with mucin in 103 (1.7%) and adenocarcinoma with mixed subtypes (AMS) in 2257 (36.3%). The 5-year overall survival rates according to histological subtype were 63.4% for acinar, 72.9% for papillary, 90.3% for BAC, 54.4% for solid adenocarcinoma with mucin and 73.7% for AMS. While the survival rate in patients with BAC was significantly better than those for the other histological subtypes, acinar and solid adenocarcinoma with mucin had significantly worse prognoses than the other histological subtypes. The histological subtype was an independent predictor of survival in a multivariate analysis (P < 0.001). Regarding BAC, the pathological stage included not only Stage IA/IB (n = 1275; 92.1%), but also Stage II-IV (n = 110; 7.9%). One hundred twenty-five patients (9.0%) with BAC had recurrence, including both local and distant recurrence. CONCLUSIONS The histological subtype in adenocarcinoma significantly correlated with the prognosis. In BACs with recurrence or pathological stage II-IV, these tumours might have been classified as invasive adenocarcinoma rather than as BAC. The need for the rigorous pathological evaluation of adenocarcinomas that are considered to be a preinvasive or minimally invasive tumour should be addressed in the new lung adenocarcinoma classification to be proposed by the International Association for the Study of Lung Cancer, the American Thoracic Society and the European Respiratory Society.
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Affiliation(s)
- Hiroyuki Sakurai
- Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
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