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Till S, Kaminsky DA. Utilizing data from the clinical pulmonary function laboratory to teach about respiratory physiology: illustrating airway-parenchymal interdependence. Adv Physiol Educ 2024; 48:279-283. [PMID: 38299212 DOI: 10.1152/advan.00149.2023] [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] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/04/2024] [Accepted: 01/30/2024] [Indexed: 02/02/2024]
Abstract
Here we demonstrate how data from the clinical pulmonary function lab can help students learn about the principle of airway-parenchymal interdependence. We examined the relationship between airway conductance (Gaw) and lung volume (thoracic gas volume, TGV) in 48 patients: 17 healthy; 20 with emphysema, expected to have reduced airway-parenchymal interdependence; and 11 with pulmonary fibrosis, expected to have increased airway-parenchymal interdependence. Our findings support these expectations, with the slope of Gaw vs. TGV being steeper among those with pulmonary fibrosis and flatter among those with emphysema, compared to the slope of the healthy group. This type of analytic approach, using real-world patient data readily available from any pulmonary function laboratory, can be used to explore other fundamental principles of respiratory physiology.NEW & NOTEWORTHY This report demonstrates how common data obtained from the clinical pulmonary function testing laboratory can be used to illustrate important principles of respiratory physiology. Here we show how the relationship between airway conductance and lung volume across different disease states reflects intrinsic differences in airway-parenchymal interdependence.
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Affiliation(s)
- Sean Till
- Department of Medicine, University of Vermont Larner College of Medicine, Burlington, Vermont, United States
| | - David A Kaminsky
- Pulmonary and Critical Care, University of Vermont Larner College of Medicine, Burlington, Vermont, United States
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Lund Håheim AL, Olsen I, Thelle DS, Rønningen KS. Comparative analysis of antibodies to four major periodontal bacteria in respiratory diseases: a cohort study. BMJ Open 2024; 14:e082116. [PMID: 38626983 PMCID: PMC11029457 DOI: 10.1136/bmjopen-2023-082116] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES To make a descriptive comparison of antibodies to four major periodontal bacteria and their relation to the respiratory diseases asthma and bronchitis/emphysema, and to cancer incidence. METHODS The serum of a random sample of men with no history of cancer incidence (n=621) was analysed by the ELISA method for antibody levels of four periodontal bacteria; the anaerobes of the so-called red complex Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD), and the facultative anaerobe Aggregatibacter actinomycetemcomitans (AA). The antibody readings were divided into quartiles and the distribution of cases of the relevant diseases as compared with the non-cases. Comparisons of the quartile distributions were by the Pearson χ2 test. Data and serum from the Oslo II study of Norwegian men from 2000 were used. The ELISA analyses were performed on thawed frozen serum. Cancer data from 17.5 years of follow-up were provided by the Norwegian Cancer Registry. RESULTS In all, 52 men had reported asthma and 23 men had bronchitis/emphysema at the health screening. Results on cancer incidence are given for all respiratory cancers, n=23, and bronchi and lung cancers separately, n=18. Stratified analyses were performed for the four endpoints showing significant association with low levels of TD antibodies for bronchitis; p=0.035. Both TF and TD were significant for low levels of antibodies among daily smokers; p=0.030 for TF and p<0.001 for TD in the analysis of the full study sample. For PG and AA, no such associations were observed. An association with respiratory cancers was not observed. CONCLUSION A low level of TD was associated with bronchitis/emphysema compared with the rest of the cohort. In the total study sample, low levels of antibodies to both TF and TD were associated with daily smoking.
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Affiliation(s)
| | - Ingar Olsen
- Institute of Oral Biology, University of Oslo, Oslo, Norway
| | - Dag S Thelle
- University of Oslo, Oslo, Norway
- Department of Community Medicine and Public Health, University of Gothenburg, Gothenburg, Sweden
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Fung NH, Nguyen QA, Owczarek C, Wilson N, Doomun NE, De Souza D, Quinn K, Selemidis S, McQualter J, Vlahos R, Wang H, Bozinovski S. Early-life house dust mite aeroallergen exposure augments cigarette smoke-induced myeloid inflammation and emphysema in mice. Respir Res 2024; 25:161. [PMID: 38614991 PMCID: PMC11016214 DOI: 10.1186/s12931-024-02774-6] [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: 11/29/2023] [Accepted: 03/14/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Longitudinal studies have identified childhood asthma as a risk factor for obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) where persistent airflow limitation can develop more aggressively. However, a causal link between childhood asthma and COPD/ACO remains to be established. Our study aimed to model the natural history of childhood asthma and COPD and to investigate the cellular/molecular mechanisms that drive disease progression. METHODS Allergic airways disease was established in three-week-old young C57BL/6 mice using house dust mite (HDM) extract. Mice were subsequently exposed to cigarette smoke (CS) and HDM for 8 weeks. Airspace enlargement (emphysema) was measured by the mean linear intercept method. Flow cytometry was utilised to phenotype lung immune cells. Bulk RNA-sequencing was performed on lung tissue. Volatile organic compounds (VOCs) in bronchoalveolar lavage-fluid were analysed to screen for disease-specific biomarkers. RESULTS Chronic CS exposure induced emphysema that was significantly augmented by HDM challenge. Increased emphysematous changes were associated with more abundant immune cell lung infiltration consisting of neutrophils, interstitial macrophages, eosinophils and lymphocytes. Transcriptomic analyses identified a gene signature where disease-specific changes induced by HDM or CS alone were conserved in the HDM-CS group, and further revealed an enrichment of Mmp12, Il33 and Il13, and gene expression consistent with greater expansion of alternatively activated macrophages. VOC analysis also identified four compounds increased by CS exposure that were paradoxically reduced in the HDM-CS group. CONCLUSIONS Early-life allergic airways disease worsened emphysematous lung pathology in CS-exposed mice and markedly alters the lung transcriptome.
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Affiliation(s)
- Nok Him Fung
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Quynh Anh Nguyen
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Catherine Owczarek
- Research and Development, CSL Limited, Bio21 Institute, Melbourne, Australia
| | - Nick Wilson
- Research and Development, CSL Limited, Bio21 Institute, Melbourne, Australia
| | - Nadeem Elahee Doomun
- Metabolomics Australia, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - David De Souza
- Metabolomics Australia, Bio21 Institute, University of Melbourne, Melbourne, Australia
| | - Kylie Quinn
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Stavros Selemidis
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Jonathan McQualter
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Ross Vlahos
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Hao Wang
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia.
| | - Steven Bozinovski
- Centre for Respiratory Science & Health, School of Health & Biomedical Sciences, RMIT University, Melbourne, Australia.
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Xu SL, Chen Z, Yang J, Fan ZQ, Liu T, Zhang XT, Zeng BQ, Xing XQ. [Effect of SHP-1 knockout in airway epithelial cells on emphysema phenotype in chronic obstructive pulmonary disease in mice]. Zhonghua Jie He He Hu Xi Za Zhi 2024; 47:339-345. [PMID: 38599809 DOI: 10.3760/cma.j.cn112147-20231114-00309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Objective: To construct and characterize conditional Src homology region 2 protein tyrosine phosphatase 1 (SHP-1) knockout mice in airway epithelial cells and to observe the effect of defective SHP-1 expression in airway epithelial cells on the emphysema phenotype in chronic obstructive pulmonary disease (COPD). Methods: To detect the expression of SHP-1 in the airway epithelium of COPD patients. CRISPR/Cas9 technology was used to construct SHP-1flox/flox transgenic mice, which were mated with airway epithelial Clara protein 10-cyclase recombinase and estrogen receptor fusion transgenic mice (CC10-CreER+/+), and after intraperitoneal injection of tamoxifen, airway epithelial SHP-1 knockout mice were obtained (SHP-1flox/floxCC10-CreER+/-, SHP-1Δ/Δ). Mouse tail and lung tissue DNA was extracted and PCR amplified to discriminate the genotype of the mice; the knockout effect of SHP-1 gene in airway epithelial cells was verified by qRT-PCR, Western blotting, and immunofluorescence. In addition, an emphysema mouse model was constructed using elastase to assess the severity of emphysema in each group of mice. Results: Airway epithelial SHP-1 was significantly downregulated in COPD patients. Genotyping confirmed that SHP-1Δ/Δ mice expressed CC10-CreER and SHP-1-flox. After tamoxifen induction, we demonstrated the absence of SHP-1 protein expression in airway epithelial cells of SHP-1Δ/Δ mice at the DNA, RNA, and protein levels, indicating that airway epithelial cell-specific SHP-1 knockout mice had been successfully constructed. In the emphysema animal model, SHP-1Δ/Δ mice had a more severe emphysema phenotype compared with the control group, which was manifested by disorganization of alveolar structure in lung tissue and rupture and fusion of alveolar walls to form pulmonary alveoli. Conclusions: The present study successfully established and characterized the SHP-1 knockout mouse model of airway epithelial cells, which provides a new experimental tool for the in-depth elucidation of the role of SHP-1 in the emphysema process of COPD and its mechanism.
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Affiliation(s)
- S L Xu
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming 650021, Yunnan, China
| | - Z Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China
| | - J Yang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Z Q Fan
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming 650021, Yunnan, China
| | - T Liu
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming 650021, Yunnan, China
| | - X T Zhang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming 650021, Yunnan, China
| | - B Q Zeng
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming 650021, Yunnan, China
| | - X Q Xing
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming 650021, Yunnan, China
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Huh JY, Jeong BH, Yoon HI, Kim H, Cho YJ, Kim C, Lee SJ, Kim HH, Ra SW, Lee YJ, Kim BK, Kim SK, Seo KH, Lee SW. Endobronchial valves for emphysema and persistent air-leak: 10-year experience in an Asian country. BMC Pulm Med 2024; 24:162. [PMID: 38570737 PMCID: PMC10988911 DOI: 10.1186/s12890-024-02982-2] [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: 12/12/2023] [Accepted: 03/26/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Endobronchial valve (EBV) therapy, a validated method for bronchoscopic lung volume reduction (BLVR) in severe emphysema, has been explored for persistent air-leak (PAL) management. However, its effectiveness and safety in the Asian population require further real-world evaluation. In this study, we assessed the outcomes of treatment with EBV within this demographic. METHODS We conducted a retrospective analysis of medical records from 11 Korean centers. For the emphysema cohort, inclusion criteria were patients diagnosed with emphysema who underwent bronchoscopy intended for BLVR. We assessed these patients for clinical outcomes of chronic obstructive pulmonary disease. All patients with PAL who underwent treatment with EBV were included. We identified the underlying causes of PAL and evaluated clinical outcomes after the procedure. RESULTS The severe emphysema cohort comprised 192 patients with an average age of 70.3 years, and 95.8% of them were men. Ultimately, 137 underwent treatment with EBV. Three months after the procedure, the BLVR group demonstrated a significant improvement in forced expiratory volume in 1 s (+160 mL vs. +30 mL; P = 0.009). Radiographic evidence of lung volume reduction 6 months after BLVR was significantly associated with improved survival (adjusted hazard ratio 0.020; 95% confidence interval 0.038-0.650; P = 0.010). Although pneumothorax was more common in the BLVR group (18.9% vs. 3.8%; P = 0.018), death was higher in the no-BLVR group (38.5% vs. 54.5%, P = 0.001), whereas other adverse events were comparable between the groups. Within the subset of 18 patients with PAL, the predominant causes of air-leak included spontaneous secondary pneumothorax (44.0%), parapneumonic effusion/empyema (22.2%), and post-lung resection surgery (16.7%). Following the treatment, the majority (77.8%) successfully had their chest tubes removed. Post-procedural complications were minimal, with two incidences of hemoptysis and one of empyema, all of which were effectively managed. CONCLUSIONS Treatment with EBV provides substantial clinical benefits in the management of emphysema and PAL in the Asian population, suggesting a favorable outcome for this therapeutic approach.
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Affiliation(s)
- Jin-Young Huh
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ho Il Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Jae Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Changhwan Kim
- Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, South Korea
- Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, South Korea
| | - Seung Jun Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - Hwan Hee Kim
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Seung Won Ra
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Ye Jin Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Beong Ki Kim
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Sung Kyoung Kim
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea
| | - Ki Hyun Seo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
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Sotoudeh-Paima S, Segars WP, Ghosh D, Luo S, Samei E, Abadi E. A systematic assessment and optimization of photon-counting CT for lung density quantifications. Med Phys 2024; 51:2893-2904. [PMID: 38368605 PMCID: PMC11055522 DOI: 10.1002/mp.16987] [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: 07/21/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Photon-counting computed tomography (PCCT) has recently emerged into clinical use; however, its optimum imaging protocols and added benefits remains unknown in terms of providing more accurate lung density quantification compared to energy-integrating computed tomography (EICT) scanners. PURPOSE To systematically assess the performance of a clinical PCCT scanner for lung density quantifications and compare it against EICT. METHODS This cross-sectional study involved a retrospective analysis of subjects scanned (August-December 2021) using a clinical PCCT system. The influence of altering reconstruction parameters was studied (reconstruction kernel, pixel size, slice thickness). A virtual CT dataset of anthropomorphic virtual subjects was acquired to demonstrate the correspondence of findings to clinical dataset, and to perform systematic imaging experiments, not possible using human subjects. The virtual subjects were imaged using a validated, scanner-specific CT simulator of a PCCT and two EICT (defined as EICT A and B) scanners. The images were evaluated using mean absolute error (MAE) of lung and emphysema density against their corresponding ground truth. RESULTS Clinical and virtual PCCT datasets showed similar trends, with sharper kernels and smaller voxel sizes increasing percentage of low-attenuation areas below -950 HU (LAA-950) by up to 15.7 ± 6.9% and 11.8 ± 5.5%, respectively. Under the conditions studied, higher doses, thinner slices, smaller pixel sizes, iterative reconstructions, and quantitative kernels with medium sharpness resulted in lower lung MAE values. While using these settings for PCCT, changes in the dose level (13 to 1.3 mGy), slice thickness (0.4 to 1.5 mm), pixel size (0.49 to 0.98 mm), reconstruction technique (70 keV-VMI to wFBP), and kernel (Qr48 to Qr60) increased lung MAE by 15.3 ± 2.0, 1.4 ± 0.6, 2.2 ± 0.3, 4.2 ± 0.8, and 9.1 ± 1.6 HU, respectively. At the optimum settings identified per scanner, PCCT images exhibited lower lung and emphysema MAE than those of EICT scanners (by 2.6 ± 1.0 and 9.6 ± 3.4 HU, compared to EICT A, and by 4.8 ± 0.8 and 7.4 ± 2.3 HU, compared to EICT B). The accuracy of lung density measurements was correlated with subjects' mean lung density (p < 0.05), measured by PCCT at optimum setting under the conditions studied. CONCLUSION Photon-counting CT demonstrated superior performance in density quantifications, with its influences of imaging parameters in line with energy-integrating CT scanners. The technology offers improvement in lung quantifications, thus demonstrating potential toward more objective assessment of respiratory conditions.
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Affiliation(s)
- Saman Sotoudeh-Paima
- Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University School of Medicine, Durham, USA
- Department of Electrical & Computer Engineering, Duke University, Durham, USA
| | - W. Paul Segars
- Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University School of Medicine, Durham, USA
- Medical Physics Graduate Program, Duke University, Durham, USA
- Department of Biomedical Engineering, Duke University, Durham, USA
| | - Dhrubajyoti Ghosh
- Department of Biostatistics and Bioinformatics, Duke University, Durham, USA
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, USA
| | - Ehsan Samei
- Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University School of Medicine, Durham, USA
- Department of Electrical & Computer Engineering, Duke University, Durham, USA
- Medical Physics Graduate Program, Duke University, Durham, USA
- Department of Biomedical Engineering, Duke University, Durham, USA
- Department of Physics, Duke University, Durham, USA
| | - Ehsan Abadi
- Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University School of Medicine, Durham, USA
- Department of Electrical & Computer Engineering, Duke University, Durham, USA
- Medical Physics Graduate Program, Duke University, Durham, USA
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Negasi ZH, Nommi N, Liu C, Tesfaigzi Y. Persistence of emphysema following cessation of cigarette smoke exposure requires a susceptibility factor. Am J Physiol Lung Cell Mol Physiol 2024; 326:L431-L439. [PMID: 38349118 DOI: 10.1152/ajplung.00342.2023] [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: 11/09/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/21/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is caused by cigarette smoke (CS) exposure but can often be progressive even in former smokers. Exposure of mice to CS for 22 wk causes emphysema, but whether emphysema persists after cessation of CS exposure is not clear. The purpose of this study was to determine whether emphysema persists in mice following a recovery period of 22 wk and whether a susceptibility factor, such as deficiency in the Bcl-2-interacting killer (Bik), is required for this persistence. Therefore, bik+/+ and bik-/- mice at 6-10 wk of age were exposed to 250 mg/m3 total particulate matter of CS or filtered air (FA) for 3 or 22 wk and were kept in FA for an additional 22 wk. Lungs were lavaged to quantify inflammatory cells, and sections were stained with hematoxylin and eosin to assess severity of emphysema. Exposure to CS for 3 wk increased the number of inflammatory cells in bik-/- mice compared with bik+/+ mice but not at 22 wk of exposure. At 22 wk of CS exposure, extent of emphysema was similar in bik+/+ and bik-/- mice. However, when mice were exposed to CS over the first 22 wk and were kept in FA for an additional 22 wk, emphysema remained similar in bik+/+ mice but was enhanced in bik-/- mice. These findings link increased inflammation with persistent emphysematous changes even after smoking cessation and demonstrate that a preexisting susceptibility condition is required to sustain enhanced emphysema that was initiated by long-term CS exposure.NEW & NOTEWORTHY Exposure of mice to cigarette smoke (CS) for 22 wk causes emphysema, but whether emphysema persists after an additional period of 6 mo after cessation of CS exposure has not been reported. In addition, the role of preexisting susceptibility in enhancing the persistence of CS-induced emphysema after exposure to CS has stopped has not been shown. The present study shows that a preexisting susceptibility must be present to enhance CS-induced emphysema after cessation of CS exposure.
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Affiliation(s)
- Zerihun Hailemariam Negasi
- Pulmonary Critical Care Medicine Division, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, United States
| | - Naomi Nommi
- Pulmonary Critical Care Medicine Division, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, United States
| | - Congjian Liu
- Pulmonary Critical Care Medicine Division, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, United States
| | - Yohannes Tesfaigzi
- Pulmonary Critical Care Medicine Division, Brigham and Women's Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts, United States
- Chronic Obstructive Pulmonary Disease Program, Lovelace Respiratory Research Institute, Albuquerque, New Mexico, United States
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Posthuma R, van der Molen MC, Hartman JE, Spruit MA, Slebos DJ, Vanfleteren LEGW, Vaes AW. Treatable traits in advanced emphysema patients eligible for bronchoscopic lung volume reduction with endobronchial valves. Respir Med 2024; 224:107558. [PMID: 38373596 DOI: 10.1016/j.rmed.2024.107558] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/17/2024] [Accepted: 02/04/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Patients with advanced emphysema eligible for bronchoscopic lung volume reduction (BLVR) using endobronchial valves (EBV) are characterized by severe static lung hyperinflation, which can be considered a treatable trait. Other treatable traits (TTs), which are assumed to be present in this highly selected patient group, have not been studied in detail nor how they may affect health-related quality of life (HRQL). AIMS We aimed to evaluate a spectrum of TTs in COPD patients eligible for EBV treatment and their association with HRQL. METHODS The SoLVE study (NCT03474471) was a prospective multicenter randomized controlled trial to examine the impact of pulmonary rehabilitation in COPD patients receiving EBV. The presence/absence of 16 TTs was based on pre-defined thresholds. HRQL was assessed with the St. George's Respiratory Questionnaire (SGRQ). Subjects were stratified into two groups, using the median split method, into higher or lower SGRQ total score. Logistic regression assessed the odds ratio (OR) of having a higher SGRQ total score per TT. RESULTS Ninety-seven subjects were included, the mean number of TTs per patient was 8.1 ± 2.5. Low physical activity (95%), poor exercise capacity (94%) and severe fatigue (75%) were the most prevalent TTs. The sum of TTs present in a subject was associated with the SGRQ total score (r = 0.53; p < 0.001). Severe fatigue, depression, and anxiety were predictors of having a higher SGRQ total score. CONCLUSIONS A high prevalence and co-occurrence of multiple TTs were identified in emphysema patients eligible for EBV. Patients with a higher number of TTs were more likely to have worse HRQL.
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Affiliation(s)
- Rein Posthuma
- Department of Research and Development, Ciro+, Horn, the Netherlands; NUTRIM, School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands.
| | - Marieke C van der Molen
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jorine E Hartman
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Ciro+, Horn, the Netherlands; NUTRIM, School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands
| | - Dirk-Jan Slebos
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Lowie E G W Vanfleteren
- COPD Center, Sahlgrenska University Medical Hospital and Institute of Medicine, Gothenburg University, Gothenburg, Sweden
| | - Anouk W Vaes
- Department of Research and Development, Ciro+, Horn, the Netherlands
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Jeong J, Nam YH, Sim DW, Kim BK, Lee Y, Shim JS, Lee SY, Yang MS, Kim MH, Kim SR, Choi S, Kim SH, Koh YI, Park HW. Relationship of computed tomography-based measurements with symptom perception and quality of life in patients with severe asthma. Respir Med 2024; 225:107598. [PMID: 38499273 DOI: 10.1016/j.rmed.2024.107598] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/06/2024] [Accepted: 03/09/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Symptom perception and quality of life (QOL) are important domains for properly managing severe asthma. This study aimed to assess the relationship between airway structural and parenchymal variables measured using chest computed tomography (CT) and subjective symptom perception and QOL in patients with severe asthma enrolled in the Korean Severe Asthma Registry. METHODS This study used CT-based objective measurements, including airway wall thickness (WT), hydraulic diameter, functional small airway disease (fSAD), and emphysematous lung (Emph), to assess their association with subjective symptom (cough, dyspnea, wheezing, and sputum) perception measured using the visual analog scale, and QOL measured by the Severe Asthma Questionnaire (SAQ). RESULTS A total of 94 patients with severe asthma were enrolled in this study. The WT and fSAD% were significantly positively associated with cough and dyspnea, respectively. For QOL, WT and Emph% showed significant negative associations with the SAQ. However, there was no significant association between lung function and symptom perception or between lung function and QOL. CONCLUSION Overall, WT, fSAD%, and Emph% measured using chest CT were associated with subjective symptom perception and QOL in patients with severe asthma. This study provides a basis for clarifying the clinical correlates of imaging-derived metrics and for understanding the mechanisms of respiratory symptom perception.
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Affiliation(s)
- Jinyoung Jeong
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Young-Hee Nam
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea
| | - Da Woon Sim
- Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Byung-Keun Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youngsoo Lee
- Department of Allergy and Clinical Immunology, Ajou University Hospital, Suwon, Republic of Korea
| | - Ji-Su Shim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min-Suk Yang
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Min-Hye Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - So Ri Kim
- Division of Respiratory Medicine and Allergy, Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sanghun Choi
- School of Mechanical Engineering, Kyungpook National University, Daegu, Republic of Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Young-Il Koh
- Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Heung-Woo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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10
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Cottin V. Combined pulmonary fibrosis and emphysema syndrome: the age of majority. Eur Respir J 2024; 63:2400353. [PMID: 38575167 DOI: 10.1183/13993003.00353-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Vincent Cottin
- Department of Respiratory Medicine, National Reference Centre for Rare Pulmonary Diseases, ERN-LUNG, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
- UMR 754, INRAE, Claude Bernard University Lyon 1, Lyon, France
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11
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Verleden SE, Hendriks JMH, Snoeckx A, Mai C, Mentens Y, Callebaut W, De Belie B, Van Schil PE, Verplancke V, Janssens A, Jacob J, Pakzad A, Conlon TM, Guvenc G, Yildirim AÖ, Pauwels P, Koljenovic S, Kwakkel-Van Erp JM, Lapperre TS. Small Airway Disease in Pre-Chronic Obstructive Pulmonary Disease with Emphysema: A Cross-Sectional Study. Am J Respir Crit Care Med 2024; 209:683-692. [PMID: 38055196 DOI: 10.1164/rccm.202301-0132oc] [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: 01/20/2023] [Accepted: 12/06/2023] [Indexed: 12/07/2023] Open
Abstract
Rationale: Small airway disease is an important pathophysiological feature of chronic obstructive pulmonary disease (COPD). Recently, "pre-COPD" has been put forward as a potential precursor stage of COPD that is defined by abnormal spirometry findings or significant emphysema on computed tomography (CT) in the absence of airflow obstruction. Objective: To determine the degree and nature of (small) airway disease in pre-COPD using microCT in a cohort of explant lobes/lungs. Methods: We collected whole lungs/lung lobes from patients with emphysematous pre-COPD (n = 10); Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I (n = 6), II (n = 6), and III/IV (n = 7) COPD; and controls (n = 10), which were analyzed using CT and microCT. The degree of emphysema and the number and morphology of small airways were compared between groups, and further correlations were investigated with physiologic measures. Airway and parenchymal pathology was also validated with histopathology. Measurements and Main Results: The numbers of transitional bronchioles and terminal bronchioles per milliliter of lung were significantly lower in pre-COPD and GOLD stages I, II, and III/IV COPD compared with controls. In addition, the number of alveolar attachments of the transitional bronchioles and terminal bronchioles was also lower in pre-COPD and all COPD groups compared with controls. We did not find any differences between the pre-COPD and COPD groups in CT or microCT measures. The percentage of emphysema on CT showed the strongest correlation with the number of small airways in the COPD groups. Histopathology showed an increase in the mean chord length and a decrease in alveolar surface density in pre-COPD and all GOLD COPD stages compared with controls. Conclusions: Lungs of patients with emphysematous pre-COPD already show fewer small airways and airway remodeling even in the absence of physiologic airway obstruction.
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Affiliation(s)
- Stijn E Verleden
- Division of Thoracic Surgery, Antwerp Surgical Training, Anatomy and Research Centre
- Department of Thoracic and Vascular Surgery
- Department of Pulmonology
| | - Jeroen M H Hendriks
- Division of Thoracic Surgery, Antwerp Surgical Training, Anatomy and Research Centre
- Department of Thoracic and Vascular Surgery
| | - Annemiek Snoeckx
- Department of Molecular Morphology Microscopy, Faculty of Medicine and Health Sciences
- Department of Radiology
| | | | - Yves Mentens
- Department of Pulmonology, General Hospital Herentals, Herentals, Belgium
| | - Wim Callebaut
- Department of Pulmonology, General Hospital Voorkempen, Malle, Belgium
| | - Bruno De Belie
- Department of Pulmonology, General Hospital, Rumst, Belgium
| | - Paul E Van Schil
- Division of Thoracic Surgery, Antwerp Surgical Training, Anatomy and Research Centre
- Department of Thoracic and Vascular Surgery
| | | | | | - Joseph Jacob
- Department of Radiology, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom
| | - Ashkan Pakzad
- Department of Radiology, University College London Hospitals National Health Service Foundation Trust, London, United Kingdom
| | - Thomas M Conlon
- Comprehensive Pneumology Center, Institute of Lung Health and Immunity, Helmholtz Munich, Munich, Germany; and
| | - Guney Guvenc
- Comprehensive Pneumology Center, Institute of Lung Health and Immunity, Helmholtz Munich, Munich, Germany; and
| | - Ali Önder Yildirim
- Comprehensive Pneumology Center, Institute of Lung Health and Immunity, Helmholtz Munich, Munich, Germany; and
- Institute of Experimental Pneumology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Patrick Pauwels
- Center for Oncologic Research, and
- Department of Pathology, University Hospital Antwerp, Edegem, Belgium
| | - Senada Koljenovic
- Center for Oncologic Research, and
- Department of Pathology, University Hospital Antwerp, Edegem, Belgium
| | - Johanna M Kwakkel-Van Erp
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Department of Pulmonology
| | - Thérèse S Lapperre
- Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Department of Pulmonology
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12
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Tanabe N. Increase Attention to Computed Tomography Findings of Emphysema without Airflow Limitation: Small Airway Disease Is Already There. Am J Respir Crit Care Med 2024; 209:619-621. [PMID: 38207095 PMCID: PMC10945056 DOI: 10.1164/rccm.202312-2245ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/10/2024] [Indexed: 01/13/2024] Open
Affiliation(s)
- Naoya Tanabe
- Department of Respiratory Medicine Kyoto University Kyoto, Japan
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13
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Teixeira EM, Ribeiro CO, Lopes AJ, de Melo PL. Respiratory Oscillometry and Functional Performance in Different COPD Phenotypes. Int J Chron Obstruct Pulmon Dis 2024; 19:667-682. [PMID: 38464561 PMCID: PMC10924760 DOI: 10.2147/copd.s446085] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) phenotypes may introduce different characteristics that need to be known to improve treatment. Respiratory oscillometry provides a detailed analysis and may offer insight into the pathophysiology of COPD. In this paper, we used this method to evaluate the differences in respiratory mechanics of COPD phenotypes. Patients and Methods This study investigated a sample of 83 volunteers, being divided into control group (CG = 20), emphysema (n = 23), CB (n = 20) and asthma-COPD overlap syndrome (ACOS, n = 20). These analyses were performed before and after bronchodilator (BD) use. Functional capacity was evaluated using the Glittre‑ADL test, handgrip strength and respiratory pressures. Results Initially it was observed that oscillometry provided a detailed description of the COPD phenotypes, which was consistent with the involved pathophysiology. A correlation between oscillometry and functional capacity was observed (r=-0.541; p = 0.0001), particularly in the emphysema phenotype (r = -0.496, p = 0.031). BD response was different among the studied phenotypes. This resulted in an accurate discrimination of ACOS from CB [area under the receiver operating curve (AUC) = 0.84] and emphysema (AUC = 0.82). Conclusion These results offer evidence that oscillatory indices may enhance the comprehension and identification of COPD phenotypes, thereby potentially improving the support provided to these patients.
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Affiliation(s)
- Elayne Moura Teixeira
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caroline Oliveira Ribeiro
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Agnaldo José Lopes
- Pulmonary Function Laboratory, Pedro Ernesto University Hospital, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Pulmonary Rehabilitation Laboratory, Augusto Motta University Center, Rio de Janeiro, Brazil
| | - Pedro Lopes de Melo
- Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Clinical and Experimental Research in Vascular Biology - Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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14
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Burkes RM, Zafar MA, Panos RJ. The role of chest computed tomography in the evaluation and management of chronic obstructive pulmonary disease. Curr Opin Pulm Med 2024; 30:129-135. [PMID: 38227648 DOI: 10.1097/mcp.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
PURPOSE OF REVIEW The purpose of this review is to compile recent data on the clinical associations of computed tomography (CT) scan findings in the literature and potential avenues for implementation into clinical practice. RECENT FINDINGS Airways dysanapsis, emphysema, chronic bronchitis, and pulmonary vascular metrics have all recently been associated with poor chronic obstructive pulmonary disease (COPD) outcomes when controlled for clinically relevant covariables, including risk of mortality in the case of emphysema and chronic bronchitis. Other authors suggest that CT scan may provide insight into both lung parenchymal damage and other clinically important comorbidities in COPD. SUMMARY CT scan findings in COPD relate to clinical outcomes. There is a continued need to develop processes to best implement the results of these studies into clinical practice.
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Affiliation(s)
- Robert M Burkes
- Cincinnati Veterans Affairs Medical Center
- University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, Ohio, USA
| | - Muhammad A Zafar
- University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, Ohio, USA
| | - Ralph J Panos
- Cincinnati Veterans Affairs Medical Center
- University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, Cincinnati, Ohio, USA
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15
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Rott C, Limen E, Kriegsmann K, Herth F, Brock JM. Analysis of body composition with bioelectrical impedance analysis in patients with severe COPD and pulmonary emphysema. Respir Med 2024; 223:107559. [PMID: 38350511 DOI: 10.1016/j.rmed.2024.107559] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/13/2024] [Accepted: 02/04/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) often suffer from cachexia and malnutrition. Less is known about body composition and nutritional behaviour in patients with advanced COPD and pulmonary emphysema. METHODS We performed a single-center prospective analysis of patients with COPD GOLD III/IV. Metabolic parameters, dietary and exercise behavior, lung function, exercise capacity and body composition by bioelectrical impedance analysis (BIA) were analyzed. Patients with severe emphysema (emphysema index [EI] >20%) were compared to patients with mild emphysema (EI ≤ 20%). RESULTS A total of 121 patients (45.5% female, mean age 64.8 ± 8.1 years, mean FEV1 31.0 ± 8.6%, mean RV 234.7 ± 50.6%) were analyzed, of whom 14.1% were underweight. Only 5% of the patients substituted protein and only about 1/3 performed regular exercise training. BIA showed an unfavourable body composition: body fat ↑, ECM/BCM-index ↑, phase angle ↓ (5.0 ± 0.9°), cell percentage ↓, FFMI (fat-free mass index) ↓. The 94 patients with severe emphysema (mean EI 36.6 ± 8.5%) had lower body-mass-index (22.8 ± 4.3 vs. 31.1 ± 5.8 kg/m2, p < 0.001), FFMI, body weight and body fat, but did not differ significantly in the quality of body composition (e.g. phase angle). Their lipid and glucose metabolism were even better than in mild emphysema patients. CONCLUSION The finding of significantly lower BMI but similar body composition and better metabolic status in severe emphysema patients needs further investigation. However, it should not distract from the necessity to implement dietary and exercise recommendations for advanced COPD patients.
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Affiliation(s)
- Christina Rott
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eldridge Limen
- Department for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | | | - Felix Herth
- Department for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - Judith Maria Brock
- Department for Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.
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16
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Fitzgerald M, Urriola N. Subcutaneous Emphysema Presenting as Bilateral Periorbital Angioedema. J Allergy Clin Immunol Pract 2024; 12:764-765. [PMID: 38127035 DOI: 10.1016/j.jaip.2023.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Michael Fitzgerald
- Department of Clinical Immunology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
| | - Nicolás Urriola
- Department of Clinical Immunology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Central Sydney Immunopathology Laboratory, Sydney, NSW, Australia; Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Institute for Academic Medicine, Sydney, NSW, Australia
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17
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Lipskaia L, Breau M, Cayrou C, Churikov D, Braud L, Jacquet J, Born E, Fouillade C, Curras-Alonso S, Bauwens S, Jourquin F, Fiore F, Castellano R, Josselin E, Sánchez-Ferrer C, Giovinazzo G, Lachaud C, Gilson E, Flores I, Londono-Vallejo A, Adnot S, Géli V. mTert induction in p21-positive cells counteracts capillary rarefaction and pulmonary emphysema. EMBO Rep 2024; 25:1650-1684. [PMID: 38424230 PMCID: PMC10933469 DOI: 10.1038/s44319-023-00041-1] [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: 10/06/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 03/02/2024] Open
Abstract
Lung diseases develop when telomeres shorten beyond a critical point. We constructed a mouse model in which the catalytic subunit of telomerase (mTert), or its catalytically inactive form (mTertCI), is expressed from the p21Cdkn1a locus. Expression of either TERT or TERTCI reduces global p21 levels in the lungs of aged mice, highlighting TERT non-canonical function. However, only TERT reduces accumulation of very short telomeres, oxidative damage, endothelial cell (ECs) senescence and senile emphysema in aged mice. Single-cell analysis of the lung reveals that p21 (and hence TERT) is expressed mainly in the capillary ECs. We report that a fraction of capillary ECs marked by CD34 and endowed with proliferative capacity declines drastically with age, and this is counteracted by TERT but not TERTCI. Consistently, only TERT counteracts decline of capillary density. Natural aging effects are confirmed using the experimental model of emphysema induced by VEGFR2 inhibition and chronic hypoxia. We conclude that catalytically active TERT prevents exhaustion of the putative CD34 + EC progenitors with age, thus protecting against capillary vessel loss and pulmonary emphysema.
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Affiliation(s)
- Larissa Lipskaia
- Institute for Lung Health, Justus Liebig University, Giessen, Germany
- INSERM U955 and Département de Physiologie, Hôpital Henri Mondor, FHU SENEC, AP-HP, 94010, Créteil, and Université Paris-Est Créteil (UPEC), Paris, France
| | - Marielle Breau
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Ligue Nationale Contre le Cancer (Equipe labellisée), Team Telomeres and Chromatin, Marseille, France
| | - Christelle Cayrou
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Ligue Nationale Contre le Cancer (Equipe labellisée), Team Telomeres and Chromatin, Marseille, France
| | - Dmitri Churikov
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Ligue Nationale Contre le Cancer (Equipe labellisée), Team Telomeres and Chromatin, Marseille, France
| | - Laura Braud
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Ligue Nationale Contre le Cancer (Equipe labellisée), Team Telomeres and Chromatin, Marseille, France
| | - Juliette Jacquet
- Institute for Lung Health, Justus Liebig University, Giessen, Germany
| | - Emmanuelle Born
- Institute for Lung Health, Justus Liebig University, Giessen, Germany
| | - Charles Fouillade
- Institut Curie, Inserm U1021, CNRS UMR 3347, University Paris-Saclay, PSL Research University, Orsay, France
| | - Sandra Curras-Alonso
- Institut Curie, PSL Research University, CNRS UMR3244, Sorbonne Université, Telomeres and Cancer, 75005, Paris, France
| | - Serge Bauwens
- Université Côte d'Azur, CNRS, Inserm, IRCAN, Faculty of Medicine, Nice, France
| | - Frederic Jourquin
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Ligue Nationale Contre le Cancer (Equipe labellisée), Team Telomeres and Chromatin, Marseille, France
| | - Frederic Fiore
- Centre d'Immunophénomique, Aix Marseille Université, INSERM, CNRS UMR, Marseille, France
| | - Rémy Castellano
- Marseille Cancer Research Centre (CRCM), TrGET Preclinical Platform, Institut Paoli-Calmettes, Inserm, CNRS, Aix Marseille Université, Marseille, France
| | - Emmanuelle Josselin
- Marseille Cancer Research Centre (CRCM), TrGET Preclinical Platform, Institut Paoli-Calmettes, Inserm, CNRS, Aix Marseille Université, Marseille, France
| | | | - Giovanna Giovinazzo
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, 28029, Madrid, Spain
| | - Christophe Lachaud
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Team DNA Interstrand Crosslink Lesions and Blood Disorders, Marseille, France
| | - Eric Gilson
- Université Côte d'Azur, CNRS, Inserm, IRCAN, Faculty of Medicine, Nice, France
| | - Ignacio Flores
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, 28029, Madrid, Spain
- Centro de Biologia Molecular Severo Ochoa, CSIC-UAM, Cantoblanco, Madrid, Spain
| | - Arturo Londono-Vallejo
- Institut Curie, PSL Research University, CNRS UMR3244, Sorbonne Université, Telomeres and Cancer, 75005, Paris, France
| | - Serge Adnot
- Institute for Lung Health, Justus Liebig University, Giessen, Germany.
- INSERM U955 and Département de Physiologie, Hôpital Henri Mondor, FHU SENEC, AP-HP, 94010, Créteil, and Université Paris-Est Créteil (UPEC), Paris, France.
| | - Vincent Géli
- Marseille Cancer Research Centre (CRCM), U1068 INSERM, UMR7258 CNRS, UM105 Aix-Marseille University, Institut Paoli-Calmettes, Ligue Nationale Contre le Cancer (Equipe labellisée), Team Telomeres and Chromatin, Marseille, France.
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18
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Wang JM, Bell AJ, Ram S, Labaki WW, Hoff BA, Murray S, Kazerooni EA, Galban S, Hatt CR, Han MK, Galban CJ. Topologic Parametric Response Mapping Identifies Tissue Subtypes Associated with Emphysema Progression. Acad Radiol 2024; 31:1148-1159. [PMID: 37661554 DOI: 10.1016/j.acra.2023.08.003] [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: 06/09/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 09/05/2023]
Abstract
RATIONALE AND OBJECTIVES Small airways disease (SAD) and emphysema are significant components of chronic obstructive pulmonary disease (COPD), a heterogenous disease where predicting progression is difficult. SAD, a principal cause of airflow obstruction in mild COPD, has been identified as a precursor to emphysema. Parametric Response Mapping (PRM) of chest computed tomography (CT) can help distinguish SAD from emphysema. Specifically, topologic PRM can define local patterns of both diseases to characterize how and in whom COPD progresses. We aimed to determine if distribution of CT-based PRM of functional SAD (fSAD) is associated with emphysema progression. MATERIALS AND METHODS We analyzed paired inspiratory-expiratory chest CT scans at baseline and 5-year follow up in 1495 COPDGene subjects using topological analyses of PRM classifications. By spatially aligning temporal scans, we mapped local emphysema at year five to baseline lobar PRM-derived topological readouts. K-means clustering was applied to all observations. Subjects were subtyped based on predominant PRM cluster assignments and assessed using non-parametric statistical tests to determine differences in PRM values, pulmonary function metrics, and clinical measures. RESULTS We identified distinct lobar imaging patterns and classified subjects into three radiologic subtypes: emphysema-dominant (ED), fSAD-dominant (FD), and fSAD-transition (FT: transition from healthy lung to fSAD). Relative to year five emphysema, FT showed rapid local emphysema progression (-57.5% ± 1.1) compared to FD (-49.9% ± 0.5) and ED (-33.1% ± 0.4). FT consisted primarily of at-risk subjects (roughly 60%) with normal spirometry. CONCLUSION The FT subtype of COPD may allow earlier identification of individuals without spirometrically-defined COPD at-risk for developing emphysema.
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Affiliation(s)
- Jennifer M Wang
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan (J.M.W., W.W.L., M.K.H.)
| | - Alexander J Bell
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.)
| | - Sundaresh Ram
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.); Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan (S.R.)
| | - Wassim W Labaki
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan (J.M.W., W.W.L., M.K.H.)
| | - Benjamin A Hoff
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.)
| | - Susan Murray
- School of Public Health, University of Michigan, Ann Arbor, Michigan (S.M.)
| | - Ella A Kazerooni
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.)
| | - Stefanie Galban
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.)
| | - Charles R Hatt
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.); Imbio, LLC, Minneapolis, Minnesota (C.R.H.)
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan (J.M.W., W.W.L., M.K.H.)
| | - Craig J Galban
- Department of Radiology, University of Michigan, Ann Arbor, Michigan (A.J.B., S.R., B.A.H., E.A.K., S.G., C.R.H., C.J.G.).
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Buttery SC, Lewis A, Alzetani A, Bolton CE, Curtis KJ, Dodd JW, Habib AM, Hussain A, Havelock T, Jordan S, Kallis C, Kemp SV, Kirk A, Lawson RA, Mahadeva R, Munavvar M, Naidu B, Rathinam S, Shackcloth M, Shah PL, Tenconi S, Hopkinson NS. Survival following lung volume reduction procedures: results from the UK Lung Volume Reduction (UKLVR) registry. BMJ Open Respir Res 2024; 11:e002092. [PMID: 38423954 PMCID: PMC10910650 DOI: 10.1136/bmjresp-2023-002092] [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: 09/25/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement can produce substantial benefits in appropriately selected people with emphysema. The UK Lung Volume Reduction (UKLVR) registry is a national multicentre observational study set up to support quality standards and assess outcomes from LVR procedures at specialist centres across the UK. METHODS Data were analysed for all patients undergoing an LVR procedure (LVRS/EBV) who were recruited into the study at participating centres between January 2017 and June 2022, including; disease severity and risk assessment, compliance with guidelines for selection, procedural complications and survival to February 2023. RESULTS Data on 541 patients from 14 participating centres were analysed. Baseline disease severity was similar in patients who had surgery n=244 (44.9%), or EBV placement n=219 (40.9%), for example, forced expiratory volume in 1 s (FEV1) 32.1 (12.1)% vs 31.2 (11.6)%. 89% of cases had discussion at a multidisciplinary meeting recorded. Median (IQR) length of stay postprocedure for LVRS and EBVs was 12 (13) vs 4 (4) days(p=0.01). Increasing age, male gender and lower FEV1%predicted were associated with mortality risk, but survival did not differ between the two procedures, with 50 (10.8%) deaths during follow-up in the LVRS group vs 45 (9.7%) following EBVs (adjusted HR 1.10 (95% CI 0.72 to 1.67) p=0.661) CONCLUSION: Based on data entered in the UKLVR registry, LVRS and EBV procedures for emphysema are being performed in people with similar disease severity and long-term survival is similar in both groups.
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Affiliation(s)
- S C Buttery
- National Heart and Lung Institute, Imperial College, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Lewis
- Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - A Alzetani
- University Hospital Southampton, Southampton, UK
| | - C E Bolton
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals Trust, City Hospital Campus, Nottingham, UK
| | - K J Curtis
- University Hospitals Bristol and Weston, Bristol, UK
| | - J W Dodd
- Academic Respiratory Unit, University of Bristol, Bristol, UK
- North Bristol Lung Centre, North Bristol NHS Trust, Bristol, UK
| | - A M Habib
- New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - A Hussain
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - T Havelock
- University Hospital Southampton, Southampton, UK
| | - S Jordan
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - C Kallis
- National Heart and Lung Institute, Imperial College, London, UK
| | - S V Kemp
- National Heart and Lung Institute, Imperial College, London, UK
- Nottingham University Hospitals Trust, City Hospital Campus, Nottingham, UK
| | - A Kirk
- Department of Thoracic Surgery, West of Scotland Regional Heart and Lung Centre, Golden Jubilee National Hospital, West Dunbartonshire, Scotland, UK
| | - R A Lawson
- Northern General Hospital, Sheffield, UK
| | | | - M Munavvar
- Lancashire Teaching Hospitals NHS Trust, Preston, UK
| | - B Naidu
- Heartlands Hospital, Birmingham Teaching Hospitals, Birmingham, UK
| | - S Rathinam
- Thoracic Surgery, Glenfield Hospital, Leicester, UK
| | - M Shackcloth
- Liverpool Heart and Chest Hospital, Liverpool, UK
| | - P L Shah
- National Heart and Lung Institute, Imperial College, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Tenconi
- Northern General Hospital, Sheffield, UK
| | - N S Hopkinson
- National Heart and Lung Institute, Imperial College, London, UK
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
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20
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Bell AJ, Pal R, Labaki WW, Hoff BA, Wang JM, Murray S, Kazerooni EA, Galban S, Lynch DA, Humphries SM, Martinez FJ, Hatt CR, Han MK, Ram S, Galban CJ. Local heterogeneity of normal lung parenchyma and small airways disease are associated with COPD severity and progression. Respir Res 2024; 25:106. [PMID: 38419014 PMCID: PMC10903150 DOI: 10.1186/s12931-024-02729-x] [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: 01/09/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Small airways disease (SAD) is a major cause of airflow obstruction in COPD patients and has been identified as a precursor to emphysema. Although the amount of SAD in the lungs can be quantified using our Parametric Response Mapping (PRM) approach, the full breadth of this readout as a measure of emphysema and COPD progression has yet to be explored. We evaluated topological features of PRM-derived normal parenchyma and SAD as surrogates of emphysema and predictors of spirometric decline. METHODS PRM metrics of normal lung (PRMNorm) and functional SAD (PRMfSAD) were generated from CT scans collected as part of the COPDGene study (n = 8956). Volume density (V) and Euler-Poincaré Characteristic (χ) image maps, measures of the extent and coalescence of pocket formations (i.e., topologies), respectively, were determined for both PRMNorm and PRMfSAD. Association with COPD severity, emphysema, and spirometric measures were assessed via multivariable regression models. Readouts were evaluated as inputs for predicting FEV1 decline using a machine learning model. RESULTS Multivariable cross-sectional analysis of COPD subjects showed that V and χ measures for PRMfSAD and PRMNorm were independently associated with the amount of emphysema. Readouts χfSAD (β of 0.106, p < 0.001) and VfSAD (β of 0.065, p = 0.004) were also independently associated with FEV1% predicted. The machine learning model using PRM topologies as inputs predicted FEV1 decline over five years with an AUC of 0.69. CONCLUSIONS We demonstrated that V and χ of fSAD and Norm have independent value when associated with lung function and emphysema. In addition, we demonstrated that these readouts are predictive of spirometric decline when used as inputs in a ML model. Our topological PRM approach using PRMfSAD and PRMNorm may show promise as an early indicator of emphysema onset and COPD progression.
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Affiliation(s)
- Alexander J Bell
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA
| | - Ravi Pal
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA
| | - Wassim W Labaki
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin A Hoff
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA
| | - Jennifer M Wang
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Susan Murray
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ella A Kazerooni
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Stefanie Galban
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA
| | - David A Lynch
- Department of Radiology, National Jewish Health, Denver, CO, USA
| | | | | | | | - MeiLan K Han
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sundaresh Ram
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA.
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Craig J Galban
- Department of Radiology, University of Michigan, 109 Zina Pitcher Place BSRB A506, Ann Arbor, MI, 48109-2200, USA.
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
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21
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Marchiori E, Hochhegger B, Zanetti G. Bullous emphysema in a cannabis user. J Bras Pneumol 2024; 50:e20230352. [PMID: 38422341 DOI: 10.36416/1806-3756/e20230352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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22
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El Gohary DAEW, Eltomey MA, Mohamed AS, Farahat AAER, Abd El Zaher AH. Bronchoscopic lung volume reduction by instillation of fibrinogen and thrombin in COPD patients with homogenous emphysema. BMC Pulm Med 2024; 24:86. [PMID: 38355502 PMCID: PMC10868100 DOI: 10.1186/s12890-024-02883-4] [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: 10/12/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The new endobronchial therapy called biological lung volume reduction (BioLVR) involves using a rapid polymerizing sealant to block off the most emphysematous portions of the lungs. The primary mechanism of action is resorption atelectasis, which is then followed by inflammation and remodeling of the airspace. The remodeling process will result in the formation of scars, leading to the contraction of the lung tissue. As a result, a decrease in functional lung volume is anticipated for a period of 6-8 weeks. OBJECTIVE Assessing the safety and effectiveness of bronchoscopic installation of (fibrinogen and thrombin) in COPD patients with homogeneous emphysema in terms of radiological, physiological, and quality of life outcomes. METHODS Between December 2017 and December 2019, 40 COPD patients with homogeneous emphysema were studied using a fiber optic bronchoscope while they were awake but sedated. Tanta University Hospitals' chest medicine department collaborated with the diagnostic radiology department of the Faculty of Medicine. RESULTS All the following parameters were reduced from their initial values: HRCT volumetry, RV/TLC, mMRC dyspnea scale, CAT score, 6MWT, FEV1, and the FEV1/FVC ratio at the first, third, and sixth months from the beginning (p = 0.001). One individual (0.025%) had pneumonia, whereas three individuals had COPD (0.075%). Using fibrin glue produced locally, biological lung volume reduction (Bio LVR) may be an effective treatment for advanced homogenous emphysema. CONCLUSION By using locally prepared fibrin glue the biologic lung volume reduction (Bio LVR) may be a convenient method to treat advanced homogenous emphysema.
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Affiliation(s)
| | - Mohamed Adel Eltomey
- Diagnostic Radiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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23
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Park H, Lee HJ, Lee JK, Park TY, Jin KN, Heo EY, Kim DK, Lee HW. Diffusing capacity as an independent predictor of acute exacerbations in chronic obstructive pulmonary disease. Sci Rep 2024; 14:2936. [PMID: 38316813 PMCID: PMC10844620 DOI: 10.1038/s41598-024-51593-8] [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: 08/05/2023] [Accepted: 01/07/2024] [Indexed: 02/07/2024] Open
Abstract
A weak correlation between diffusing capacity of the lung for carbon monoxide (DLCO) and emphysema has been reported. This study investigated whether impaired DLCO in chronic obstructive pulmonary disease (COPD) is associated with increased risk of acute exacerbation independent of the presence or extent of emphysema. This retrospective cohort study included patients with COPD between January 2004 and December 2019. The participants were divided into four groups based on visually detected emphysema and impaired DLCO. Among 597 patients with COPD, 8.5% had no emphysema and impaired DLCO whereas 36.3% had emphysema without impaired DLCO. Among the four groups, patients with impaired DLCO and emphysema showed a higher risk of moderate-to-severe or severe exacerbation than those with normal DLCO. Impaired DLCO was an independent risk factor for severe exacerbation (hazard ratio, 1.524 [95% confidence interval 1.121-2.072]), whereas the presence of emphysema was not. The risk of moderate-to-severe or severe exacerbation increases with the severity of impaired DLCO. After propensity-score matching for the extent of emphysema, impaired DLCO was significantly associated with a higher risk of moderate-to-severe (p = 0.041) or severe exacerbation (p = 0.020). In patients with COPD and heterogeneous parenchymal abnormalities, DLCO can be considered an independent biomarker of acute exacerbation.
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Affiliation(s)
- Heemoon Park
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyo Jin Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jung-Kyu Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Tae Yun Park
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Kwang Nam Jin
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Eun Young Heo
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Deog Kyeom Kim
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyun Woo Lee
- Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
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24
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Sugawara H, Kikkawa N, Ito K, Watanabe H, Kaku S, Akai H, Abe O, Watanabe SI, Yatabe Y, Kusumoto M. Is 18F-fluorodeoxyglucose PET recommended for small lung nodules? CT findings of 18F-fluorodeoxyglucose non-avid lung cancer. Br J Radiol 2024; 97:462-468. [PMID: 38308036 DOI: 10.1093/bjr/tqad048] [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: 07/09/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES To determine the image characteristics associated with low 18F-FDG (18F-fluorodeoxyglucose) avidity among 8-15 mm solid lung cancer. METHODS Patients satisfying the following criteria were included: underwent surgery between January 2014 and December 2019 for lung cancer, presented 8-15 mm nodule without measurable ground glass component on preoperative CT, and underwent 18F-FDG PET before resection. Image characteristics, including air bronchogram, concave shape, pleural attachment, and background emphysema, were evaluated by two board-certified radiologists. The Mann-Whitney U test was used to compare maximum standardized uptake (SUVmax) values from 18F-FDG PET images. RESULTS The analysis included 235 patients. The SUVmax values of lesions with air bronchogram and concave shape were significantly lower than the SUVmax values of lesions without these features (median: 1.55 vs 2.56 and 1.66 vs 2.45, both P < .001), whereas lesions arising from emphysematous lungs had significantly higher SUVmax values than lesions arising from non-emphysematous lungs (2.90 vs 1.69, P < .001). No significant differences were detected between lesions attached and not attached to pleura. The interobserver agreement was almost perfect for air bronchograms and background emphysema (κ = 0.882 and 0.927, respectively), and 89.7% of lesions with air bronchograms and arising from non-emphysematous lungs showed SUVmax values below 2.5. CONCLUSIONS Among 8-15 mm solid lung cancer, the presence of air bronchograms and concave shape and the absence of background emphysema were associated with low 18F-FDG accumulation. ADVANCES IN KNOWLEDGE 18F-FDG PET can be misleading in differentiating certain type of small solid lung cancer.
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Affiliation(s)
- Haruto Sugawara
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
- Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Nao Kikkawa
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Kimiteru Ito
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Hirokazu Watanabe
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Sawako Kaku
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Hiroyuki Akai
- Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Masahiko Kusumoto
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo 104-0045, Japan
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25
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Mahajan AK. EMPROVE 24-Month Follow-Up: Judge Success by Quality of Life, Not Just Spirometry. Ann Am Thorac Soc 2024; 21:206-207. [PMID: 38299921 PMCID: PMC10848902 DOI: 10.1513/annalsats.202311-1005ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- Amit K Mahajan
- Interventional Pulmonology, Department of Surgery, Inova Schar Cancer Institute, Inova Fairfax Hospital, Falls Church, Virginia
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26
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Criner GJ, Mallea JM, Abu-Hijleh M, Sachdeva A, Kalhan R, Hergott CA, Lazarus DR, Mularski RA, Calero K, Reed MF, Nsiah-Dosu S, Himes D, Kubo H, Kinsey CM, Majid A, Hogarth DK, Kaplan PV, Case AH, Makani SS, Chen TM, Delage A, Zgoda M, Shepherd RW. Sustained Clinical Benefits of Spiration Valve System in Patients with Severe Emphysema: 24-Month Follow-Up of EMPROVE. Ann Am Thorac Soc 2024; 21:251-260. [PMID: 37948704 PMCID: PMC10848907 DOI: 10.1513/annalsats.202306-520oc] [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: 06/07/2023] [Accepted: 11/10/2023] [Indexed: 11/12/2023] Open
Abstract
Rationale: Follow-up of patients with emphysema treated with endobronchial valves is limited to 3-12 months after treatment in prior reports. To date, no comparative data exist between treatment and control subjects with a longer follow-up. Objectives: To assess the durability of the Spiration Valve System (SVS) in patients with severe heterogeneous emphysema over a 24-month period. Methods: EMPROVE, a multicenter randomized controlled trial, presents a rigorous comparison between treatment and control groups for up to 24 months. Lung function, respiratory symptoms, and quality-of-life (QOL) measures were assessed. Results: A significant improvement in forced expiratory volume in 1 second was maintained at 24 months in the SVS treatment group versus the control group. Similarly, significant improvements were maintained in several QOL measures, including the St. George's Respiratory Questionnaire and the COPD Assessment Test. Patients in the SVS treatment group experienced significantly less dyspnea than those in the control group, as indicated by the modified Medical Research Council dyspnea scale score. Adverse events at 24 months did not significantly differ between the SVS treatment and control groups. Acute chronic obstructive pulmonary disease exacerbation rates in the SVS treatment and control groups were 13.7% (14 of 102) and 15.6% (7 of 45), respectively. Pneumothorax rates in the SVS treatment and control groups were 1.0% (1 of 102) and 0.0% (0 of 45), respectively. Conclusions: SVS treatment resulted in statistically significant and clinically meaningful durable improvements in lung function, respiratory symptoms, and QOL, as well as a statistically significant reduction in dyspnea, for at least 24 months while maintaining an acceptable safety profile. Clinical trial registered with www.clinicaltrials.gov (NCT01812447).
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Affiliation(s)
- Gerard J. Criner
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | | | | | | | - Ravi Kalhan
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | | | - Karel Calero
- Tampa General Hospital, University of South Florida, Tampa, Florida
| | - Michael F. Reed
- Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | | | - David Himes
- Olympus Corporation of the Americas, Westborough, Massachusetts
| | | | | | - Adnan Majid
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - Philip V. Kaplan
- Detroit Clinical Research Center, Beaumont Hospital, Farmington Hills, Michigan
| | | | - Samir S. Makani
- University of California, San Diego Medical Center, San Diego, California
| | | | - Antoine Delage
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Hôpital Laval, Quebec, Quebec, Canada
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Ravi A, Jia L, Wu X, van der Meer AD, Gosens R, Stolk J, van der Does AM, Koning F, Hiemstra PS, Khedoe PPJS. Loss of Pulmonary Endothelial Cells in Emphysema Impairs Support of Human Alveolar Epithelial Cell Growth. Am J Respir Cell Mol Biol 2024; 70:149-152. [PMID: 38299794 DOI: 10.1165/rcmb.2023-0084le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- Abilash Ravi
- Leiden University Medical Center Leiden, the Netherlands
| | - Li Jia
- Leiden University Medical Center Leiden, the Netherlands
| | - Xinhui Wu
- University of Groningen Groningen, the Netherlands
| | | | | | - Jan Stolk
- Leiden University Medical Center Leiden, the Netherlands
| | | | - Frits Koning
- Leiden University Medical Center Leiden, the Netherlands
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28
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Xue T, Zheng L, Dong F, Zhou G, Zhong X. [Single-cell RNA sequencing combined experimental verifies the core genes of dendritic cells in chronic obstructive pulmonary disease]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2024; 40:97-105. [PMID: 38284250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Objective Single-cell RNA sequencing (scRNA-Seq) and experimental verifies core genes of dendritic cells in chronic obstructive pulmonary disease (COPD). Methods scRNA-seq data GSE173896 and chip data GSE38974 were extracted from the Gene Expression Omnibus (GEO) database. GSE173896 was used to perform quality control, batch correction, dimensionality reduction clustering, cell type annotation and dendritic cell differentially expressed genes (DC-DEGs) identification. DEGs from the analysis of GSE38974 were intersected with DC-DEGs to obtain the common DC-DEGs. The diagnostic efficacy of the common DC-DEGs for COPD and their enrichment analysis were conducted. The correlation of the common DC-DEGs with activated dendritic cell (DCs), plasmacytoid dendritic cell (pDCs) and type 17 T helper(Th17) cells were analyzed. The mRNA expression level of the common DC-DEGs in the lung tissue of emphysema mice was verified. Results From GSE173896, 18 DC-DEGs were obtained between groups and from GSE38974, 646 DEGs were obtained. The intersection of the two resulted in 3 common DC-DEGs, including interleukin 1 receptor antagonist 1 (IL1RN), S100 calcicum-binding protein A8 (S100A8) and S100A9. Their respective area under curve (AUC) values were 0.841, 0.804 and 0.966. The GO and KEGG enrichment analysis mainly concentrated on chronic inflammatory response, collagen-containing extracellular matrix, receptor for advanced glycation end products (RAGE) binding, Toll-like receptor (TLR) binding and interleukin 17 (IL-17) signaling pathway. IL1RN, S100A8 and S100A9 were positively correlated with activated DCs, pDCs and Th17 cells. The results showed that the mRNA relative expression levels of IL1RN, S100A8 and S100A9 were up-regulated in the lung tissue of emphysema mice. Conclusion IL1RN, S100A8 and S100A9 may be the core genes of DCs in the pathogenesis of COPD, which potentially provide targets and a theoretical basis for subsequent COPD immunotherapy.
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Affiliation(s)
- Ting Xue
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Leting Zheng
- Department of Rheumatology and Immunology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Fei Dong
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Guang Zhou
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xiaoning Zhong
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. *Corresponding author, E-mail:
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van den Berge M, Faiz A. Blood Biomarkers of Emphysema: What Can They Really Tell Us? Am J Respir Crit Care Med 2024; 209:235-237. [PMID: 38078855 PMCID: PMC10840767 DOI: 10.1164/rccm.202311-2087ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Affiliation(s)
- Maarten van den Berge
- University Medical Center Groningen University of Groningen Groningen, the Netherlands
| | - Alen Faiz
- University Medical Center Groningen University of Groningen Groningen, the Netherlands
- Respiratory Bioinformatics and Molecular Biology Group The University of Technology Sydney Ultimo, New South Wales, Australia
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30
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Yu K, Sun L, Chen J, Reynolds M, Chaudhary T, Batmanghelich K. DrasCLR: A self-supervised framework of learning disease-related and anatomy-specific representation for 3D lung CT images. Med Image Anal 2024; 92:103062. [PMID: 38086236 PMCID: PMC10872608 DOI: 10.1016/j.media.2023.103062] [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: 02/17/2023] [Revised: 08/24/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024]
Abstract
Large-scale volumetric medical images with annotation are rare, costly, and time prohibitive to acquire. Self-supervised learning (SSL) offers a promising pre-training and feature extraction solution for many downstream tasks, as it only uses unlabeled data. Recently, SSL methods based on instance discrimination have gained popularity in the medical imaging domain. However, SSL pre-trained encoders may use many clues in the image to discriminate an instance that are not necessarily disease-related. Moreover, pathological patterns are often subtle and heterogeneous, requiring the ability of the desired method to represent anatomy-specific features that are sensitive to abnormal changes in different body parts. In this work, we present a novel SSL framework, named DrasCLR, for 3D lung CT images to overcome these challenges. We propose two domain-specific contrastive learning strategies: one aims to capture subtle disease patterns inside a local anatomical region, and the other aims to represent severe disease patterns that span larger regions. We formulate the encoder using conditional hyper-parameterized network, in which the parameters are dependant on the anatomical location, to extract anatomically sensitive features. Extensive experiments on large-scale datasets of lung CT scans show that our method improves the performance of many downstream prediction and segmentation tasks. The patient-level representation improves the performance of the patient survival prediction task. We show how our method can detect emphysema subtypes via dense prediction. We demonstrate that fine-tuning the pre-trained model can significantly reduce annotation efforts without sacrificing emphysema detection accuracy. Our ablation study highlights the importance of incorporating anatomical context into the SSL framework. Our codes are available at https://github.com/batmanlab/DrasCLR.
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Affiliation(s)
- Ke Yu
- School of Computing and Information, University of Pittsburgh, Pittsburgh, USA.
| | - Li Sun
- Department of Electrical and Computer Engineering, Boston University, Boston, USA
| | - Junxiang Chen
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, USA
| | - Maxwell Reynolds
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, USA
| | - Tigmanshu Chaudhary
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, USA
| | - Kayhan Batmanghelich
- Department of Electrical and Computer Engineering, Boston University, Boston, USA
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Suryadevara R, Gregory A, Lu R, Xu Z, Masoomi A, Lutz SM, Berman S, Yun JH, Saferali A, Ryu MH, Moll M, Sin DD, Hersh CP, Silverman EK, Dy J, Pratte KA, Bowler RP, Castaldi PJ, Boueiz A. Blood-based Transcriptomic and Proteomic Biomarkers of Emphysema. Am J Respir Crit Care Med 2024; 209:273-287. [PMID: 37917913 PMCID: PMC10840768 DOI: 10.1164/rccm.202301-0067oc] [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: 01/12/2023] [Accepted: 11/02/2023] [Indexed: 11/04/2023] Open
Abstract
Rationale: Emphysema is a chronic obstructive pulmonary disease phenotype with important prognostic implications. Identifying blood-based biomarkers of emphysema will facilitate early diagnosis and development of targeted therapies. Objectives: To discover blood omics biomarkers for chest computed tomography-quantified emphysema and develop predictive biomarker panels. Methods: Emphysema blood biomarker discovery was performed using differential gene expression, alternative splicing, and protein association analyses in a training sample of 2,370 COPDGene participants with available blood RNA sequencing, plasma proteomics, and clinical data. Internal validation was conducted in a COPDGene testing sample (n = 1,016), and external validation was done in the ECLIPSE study (n = 526). Because low body mass index (BMI) and emphysema often co-occur, we performed a mediation analysis to quantify the effect of BMI on gene and protein associations with emphysema. Elastic net models with bootstrapping were also developed in the training sample sequentially using clinical, blood cell proportions, RNA-sequencing, and proteomic biomarkers to predict quantitative emphysema. Model accuracy was assessed by the area under the receiver operating characteristic curves for subjects stratified into tertiles of emphysema severity. Measurements and Main Results: Totals of 3,829 genes, 942 isoforms, 260 exons, and 714 proteins were significantly associated with emphysema (false discovery rate, 5%) and yielded 11 biological pathways. Seventy-four percent of these genes and 62% of these proteins showed mediation by BMI. Our prediction models demonstrated reasonable predictive performance in both COPDGene and ECLIPSE. The highest-performing model used clinical, blood cell, and protein data (area under the receiver operating characteristic curve in COPDGene testing, 0.90; 95% confidence interval, 0.85-0.90). Conclusions: Blood transcriptome and proteome-wide analyses revealed key biological pathways of emphysema and enhanced the prediction of emphysema.
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Affiliation(s)
| | | | - Robin Lu
- Channing Division of Network Medicine
| | | | - Aria Masoomi
- Department of Electrical and Computer Engineering, Northeastern University, Boston, Massachusetts
| | - Sharon M. Lutz
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | | | - Jeong H. Yun
- Channing Division of Network Medicine
- Division of Pulmonary and Critical Care Medicine, and
| | | | | | - Matthew Moll
- Channing Division of Network Medicine
- Division of Pulmonary and Critical Care Medicine, and
- Pulmonary, Critical Care, Allergy, and Sleep Medicine Section, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts
| | - Don D. Sin
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, British Columbia, Canada
- Respiratory Division, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; and
| | - Craig P. Hersh
- Channing Division of Network Medicine
- Division of Pulmonary and Critical Care Medicine, and
| | - Edwin K. Silverman
- Channing Division of Network Medicine
- Division of Pulmonary and Critical Care Medicine, and
| | - Jennifer Dy
- Department of Electrical and Computer Engineering, Northeastern University, Boston, Massachusetts
| | | | - Russell P. Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado
| | - Peter J. Castaldi
- Channing Division of Network Medicine
- Division of General Medicine and Primary Care, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Adel Boueiz
- Channing Division of Network Medicine
- Division of Pulmonary and Critical Care Medicine, and
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32
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Rajasekar N, Gandhi D, Sivanantham A, Ravikumar V, Raj D, Paramasivam SG, Mukhopadhyay S, Rajasekaran S. Dietary tannic acid attenuates elastase-induced pulmonary inflammation and emphysema in mice. Inflammopharmacology 2024; 32:747-761. [PMID: 37947914 DOI: 10.1007/s10787-023-01381-z] [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: 09/07/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023]
Abstract
Emphysema is one of the major components of chronic obstructive pulmonary disease (COPD), which is characterised by the destruction and enlargement of air spaces, leading to airflow limitation and dyspnoea, finally progressing to oxygen dependency. The alveolar wall destruction is due to chronic inflammation, oxidative stress, apoptosis, and proteinase/anti-proteinase imbalance. So far, there has been no effective therapy for patients with COPD. We evaluated the therapeutic efficacy of tannic acid (TA), a naturally occurring plant-derived polyphenol in the murine emphysema model. In C57BL/6 J mice, we established emphysema by intratracheal instillation of elastase (EL). Then, mice were treated with TA and evaluated 1 and 21 days post-EL instillation. After 24 h, TA treatment significantly reduced EL-induced histopathological alterations, infiltrating leukocytes, and gene expression of markers of inflammation and apoptosis. Similarly, after 21 days, TA treatment suppressed the mean linear intercept, gene expression of proteinases, and increased elastic fiber contents in the lungs when compared to the EL-alone group. Furthermore, EL induced the activation of p38 mitogen-activated protein kinase (MAPK) and nuclear factor kappa light chain enhancer of activated B cells (NF-kB) p65 pathways in the lungs was suppressed by TA treatment. In summary, TA has the potential to mitigate EL-induced inflammation, apoptosis, proteinase/anti-proteinase imbalance, and subsequent emphysema in mice.
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Affiliation(s)
- Nandhine Rajasekar
- Department of Biotechnology, BIT-Campus, Anna University, Tiruchirappalli, Tamil Nadu 620024, India
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Deepa Gandhi
- Division of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, 462030, India
| | - Ayyanar Sivanantham
- Department of Biotechnology, BIT-Campus, Anna University, Tiruchirappalli, Tamil Nadu 620024, India
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Boston University, Boston, MA, 02118, USA
| | - Vilwanathan Ravikumar
- Department of Biochemistry, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu 620024, India
| | - Dharma Raj
- Division of Biostatistics and Bioinformatics, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh 462030, India
| | | | - Sramana Mukhopadhyay
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh 462026, India
| | - Subbiah Rajasekaran
- Division of Biochemistry, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, 462030, India.
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33
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Richmond BW, Marshall CB, Blackburn JB, Tufenkjian TS, Lehmann BD, Han W, Newcomb D, Gutor SS, Hunt RP, Michell DL, Vickers KC, Polosukhin VV, Blackwell TS, Pietenpol JA. Loss of p73 Expression Contributes to Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2024; 209:153-163. [PMID: 37931077 PMCID: PMC10806417 DOI: 10.1164/rccm.202303-0503oc] [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: 03/15/2023] [Accepted: 11/06/2023] [Indexed: 11/08/2023] Open
Abstract
Rationale: Multiciliated cell (MCC) loss and/or dysfunction is common in the small airways of patients with chronic obstructive pulmonary disease (COPD), but it is unclear if this contributes to COPD lung pathology. Objectives: To determine if loss of p73 causes a COPD-like phenotype in mice and explore whether smoking or COPD impact p73 expression. Methods: p73floxE7-E9 mice were crossed with Shh-Cre mice to generate mice lacking MCCs in the airway epithelium. The resulting p73Δairway mice were analyzed using electron microscopy, flow cytometry, morphometry, forced oscillation technique, and single-cell RNA sequencing. Furthermore, the effects of cigarette smoke on p73 transcript and protein expression were examined using in vitro and in vivo models and in studies including airway epithelium from smokers and patients with COPD. Measurements and Main Results: Loss of functional p73 in the respiratory epithelium resulted in a near-complete absence of MCCs in p73Δairway mice. In adulthood, these mice spontaneously developed neutrophilic inflammation and emphysema-like lung remodeling and had progressive loss of secretory cells. Exposure of normal airway epithelium cells to cigarette smoke rapidly and durably suppressed p73 expression in vitro and in vivo. Furthermore, tumor protein 73 mRNA expression was reduced in the airways of current smokers (n = 82) compared with former smokers (n = 69), and p73-expressing MCCs were reduced in the small airways of patients with COPD (n = 11) compared with control subjects without COPD (n = 12). Conclusions: Loss of functional p73 in murine airway epithelium results in the absence of MCCs and promotes COPD-like lung pathology. In smokers and patients with COPD, loss of p73 may contribute to MCC loss or dysfunction.
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Affiliation(s)
- Bradley W. Richmond
- Department of Veterans Affairs Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
- Department of Cell and Developmental Biology
| | - Clayton B. Marshall
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; and
- Department of Biochemistry, and
| | - Jessica B. Blackburn
- Department of Veterans Affairs Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | - Tiffany S. Tufenkjian
- Department of Veterans Affairs Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | - Brian D. Lehmann
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; and
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Wei Han
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | - Dawn Newcomb
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | - Sergey S. Gutor
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | - Raphael P. Hunt
- Department of Veterans Affairs Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | | | - Kasey C. Vickers
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Vasiliy V. Polosukhin
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
| | - Timothy S. Blackwell
- Department of Veterans Affairs Medical Center, Nashville, Tennessee
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, and
- Department of Cell and Developmental Biology
| | - Jennifer A. Pietenpol
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; and
- Department of Biochemistry, and
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34
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Ojha M, Smith NJ, Devine AJ, Joshi R, Goodman EM, Fan Q, Schuman R, Porollo A, Wells JM, Tiwary E, Batie MR, Gray J, Deshmukh H, Borchers MT, Ammerman SA, Varisco BM. Anti-CELA1 antibody KF4 prevents emphysema by inhibiting stretch-mediated remodeling. JCI Insight 2024; 9:e169189. [PMID: 38193533 PMCID: PMC10906462 DOI: 10.1172/jci.insight.169189] [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: 01/27/2023] [Accepted: 11/17/2023] [Indexed: 01/10/2024] Open
Abstract
There are no therapies to prevent emphysema progression. Chymotrypsin-like elastase 1 (CELA1) is a serine protease that binds and cleaves lung elastin in a stretch-dependent manner and is required for emphysema in a murine antisense oligonucleotide model of α-1 antitrypsin (AAT) deficiency. This study tested whether CELA1 is important in strain-mediated lung matrix destruction in non-AAT-deficient emphysema and the efficacy of CELA1 neutralization. Airspace simplification was quantified after administration of tracheal porcine pancreatic elastase (PPE), after 8 months of cigarette smoke (CS) exposure, and in aging. In all 3 models, Cela1-/- mice had less emphysema and preserved lung elastin despite increased lung immune cells. A CELA1-neutralizing antibody was developed (KF4), and it inhibited stretch-inducible lung elastase in ex vivo mouse and human lung and immunoprecipitated CELA1 from human lung. In mice, systemically administered KF4 penetrated lung tissue in a dose-dependent manner and 5 mg/kg weekly prevented emphysema in the PPE model with both pre- and postinjury initiation and in the CS model. KF4 did not increase lung immune cells. CELA1-mediated lung matrix remodeling in response to strain is an important contributor to postnatal airspace simplification, and we believe that KF4 could be developed as a lung matrix-stabilizing therapy in emphysema.
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Affiliation(s)
- Mohit Ojha
- Lincoln Medical Center and Mental Health Center, New York, New York, USA
| | - Noah J. Smith
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrew J. Devine
- Heritage College of Osteopathic Medicine, Ohio University, Athens Ohio, USA
| | - Rashika Joshi
- Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Emily M. Goodman
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Qiang Fan
- Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Richard Schuman
- Antibody and Immunoassay Consultants, Rockville, Maryland, USA
| | - Aleksey Porollo
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - J. Michael Wells
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- UAB Lung Health Center, Birmingham, Alabama, USA
| | - Ekta Tiwary
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- UAB Lung Health Center, Birmingham, Alabama, USA
| | | | - Jerilyn Gray
- Perinatal Institute, Center for Perinatal Immunity, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Hitesh Deshmukh
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Perinatal Institute, Center for Perinatal Immunity, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Michael T. Borchers
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Pulmonary and Critical Care Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Brian M. Varisco
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children’s Research Institute, Little Rock, Arkansas, USA
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35
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Marchiori E, Hochhegger B, Zanetti G. Paraseptal emphysema. J Bras Pneumol 2024; 49:e20230340. [PMID: 38198348 PMCID: PMC10760424 DOI: 10.36416/1806-3756/e20230340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Affiliation(s)
- Edson Marchiori
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | | | - Gláucia Zanetti
- . Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
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36
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Rojas-Quintero J, Ochsner SA, New F, Divakar P, Yang CX, Wu TD, Robinson J, Chandrashekar DS, Banovich NE, Rosas IO, Sauler M, Kheradmand F, Gaggar A, Margaroli C, San Jose Estepar R, McKenna NJ, Polverino F. Spatial Transcriptomics Resolve an Emphysema-Specific Lymphoid Follicle B Cell Signature in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2024; 209:48-58. [PMID: 37934672 PMCID: PMC10870877 DOI: 10.1164/rccm.202303-0507le] [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: 03/15/2023] [Accepted: 10/15/2023] [Indexed: 11/09/2023] Open
Abstract
Rationale: Within chronic obstructive pulmonary disease (COPD), emphysema is characterized by a significant yet partially understood B cell immune component. Objectives: To characterize the transcriptomic signatures from lymphoid follicles (LFs) in ever-smokers without COPD and patients with COPD with varying degrees of emphysema. Methods: Lung sections from 40 patients with COPD and ever-smokers were used for LF proteomic and transcriptomic spatial profiling. Formalin- and O.C.T.-fixed lung samples obtained from biopsies or lung explants were assessed for LF presence. Emphysema measurements were obtained from clinical chest computed tomographic scans. High-confidence transcriptional target intersection analyses were conducted to resolve emphysema-induced transcriptional networks. Measurements and Main Results: Overall, 115 LFs from ever-smokers and Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2 and GOLD 3-4 patients were analyzed. No LFs were found in never-smokers. Differential gene expression analysis revealed significantly increased expression of LF assembly and B cell marker genes in subjects with severe emphysema. High-confidence transcriptional analysis revealed activation of an abnormal B cell activity signature in LFs (q-value = 2.56E-111). LFs from patients with GOLD 1-2 COPD with emphysema showed significantly increased expression of genes associated with antigen presentation, inflammation, and B cell activation and proliferation. LFs from patients with GOLD 1-2 COPD without emphysema showed an antiinflammatory profile. The extent of centrilobular emphysema was significantly associated with genes involved in B cell maturation and antibody production. Protein-RNA network analysis showed that LFs in emphysema have a unique signature skewed toward chronic B cell activation. Conclusions: An off-targeted B cell activation within LFs is associated with autoimmune-mediated emphysema pathogenesis.
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Affiliation(s)
| | - Scott A. Ochsner
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas
| | - Felicia New
- Spatial Data Analysis Services, Nanostring Biotechnologies, Seattle, Washington
| | - Prajan Divakar
- Spatial Data Analysis Services, Nanostring Biotechnologies, Seattle, Washington
| | - Chen Xi Yang
- Center for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Jerid Robinson
- Field Application Scientists, Nanostring Biotechnologies, Seattle, Washington
| | | | | | | | - Maor Sauler
- Pulmonary and Critical Care Medicine, Yale University, New Haven, Connecticut
| | - Farrah Kheradmand
- Pulmonary Division, Department of Medicine, and
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Amit Gaggar
- Pulmonary and Critical Care Medicine, and
- Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; and
| | - Camilla Margaroli
- Pathology – Division of Cellular and Molecular Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Raul San Jose Estepar
- Applied Chest Imaging Laboratory, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Neil J. McKenna
- Spatial Data Analysis Services, Nanostring Biotechnologies, Seattle, Washington
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Kubooka M, Ishida M, Takafuji M, Ito H, Kokawa T, Nakamura S, Domae K, Araki S, Ichikawa Y, Murashima S, Sakuma H. Associating the Severity of Emphysema with Coronary Flow Reserve and Left Atrial Conduit Function for the Emphysema Patients with Known or Suspected Coronary Artery Disease. Magn Reson Med Sci 2024; 23:27-38. [PMID: 36517009 PMCID: PMC10838718 DOI: 10.2463/mrms.mp.2022-0025] [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: 02/09/2022] [Accepted: 10/04/2022] [Indexed: 01/05/2024] Open
Abstract
PURPOSE Pulmonary emphysema may associate with ischemic heart disease through systemic microvascular abnormality as a common pathway. Stress cardiovascular MR (CMR) allows for the assessment of global coronary flow reserve (CFR). The purpose of this study was to evaluate the association between the emphysema severity and the multiple MRI parameters in the emphysema patients with known or suspected coronary artery disease (CAD). METHODS A total of 210 patients with known or suspected CAD who underwent both 3.0T CMR including cine CMR, stress and rest perfusion CMR, stress and rest phase-contrast (PC) cine CMR of coronary sinus, and late gadolinium enhancement (LGE) CMR, and lung CT within 6 months were studied. Global CFR, volumes and functions of both ventricles and atria, and presence or absence of myocardial ischemia and infarction were evaluated. Emphysema severity was visually determined on lung CT by Goddard method. RESULT Seventy nine (71.0 ± 7.9 years, 75 male) of 210 patients with known or suspected CAD had emphysema on lung CT. Goddard score was significantly correlated with CFR (r = -0.246, P = 0.029), left ventricular end-diastolic volume index (LV EDVI) (r = -0.230, P = 0.041), right ventricular systolic volume index (RV SVI) (r = -0.280, P = 0.012), left atrial (LA) total emptying volume index (r = -0.269, P = 0.017), LA passive emptying volume index (r = -0.309, P = 0.006), LA systolic strain (Es) (r = -0.244, P = 0.030), and LA conduit strain (Ee) (r = -0.285, P = 0.011) in the patients with emphysema. Multiple linear regression analysis revealed LA conduit function was independently associated with emphysema severity as determined by Goddard method (beta = -0.361, P = 0.006). CONCLUSION LA conduit function independently associates with emphysema severity in the emphysema patients with known or suspected CAD after adjusting age, sex, smoking, and the CMR indexes including CFR. These findings suggest that impairment of LA function predominantly occurs prior to the reduction of the CFR in the emphysema patients with known or suspected CAD.
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Affiliation(s)
- Makiko Kubooka
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Masaki Ishida
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | | | - Haruno Ito
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Takanori Kokawa
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Satoshi Nakamura
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Kensuke Domae
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Suguru Araki
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | | | | | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
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38
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Engström G, Lampa E, Dekkers K, Lin YT, Ahlm K, Ahlström H, Alfredsson J, Bergström G, Blomberg A, Brandberg J, Caidahl K, Cederlund K, Duvernoy O, Engvall JE, Eriksson MJ, Fall T, Gigante B, Gummesson A, Hagström E, Hamrefors V, Hedner J, Janzon M, Jernberg T, Johnson L, Lind L, Lindberg E, Mannila M, Nilsson U, Persson A, Persson HL, Persson M, Ramnemark A, Rosengren A, Schmidt C, Skoglund Larsson L, Sköld CM, Swahn E, Söderberg S, Torén K, Waldenström A, Wollmer P, Zaigham S, Östgren CJ, Sundström J. Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications. Eur J Epidemiol 2024; 39:35-49. [PMID: 38165527 PMCID: PMC10811042 DOI: 10.1007/s10654-023-01088-z] [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: 08/31/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024]
Abstract
Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50-64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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Affiliation(s)
- Gunnar Engström
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
| | - Erik Lampa
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Koen Dekkers
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Yi-Ting Lin
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden
- Department of Family Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Kristin Ahlm
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Håkan Ahlström
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
- BFC, Uppsala University Hospital, Uppsala, Sweden
- Antaros Medical AB, Mölndal, Sweden
| | - Joakim Alfredsson
- Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - John Brandberg
- Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kenneth Caidahl
- Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg, Sweden
| | - Kerstin Cederlund
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Olov Duvernoy
- Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | - Jan E Engvall
- CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
- Department of Clinical Physiology; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Maria J Eriksson
- Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Bruna Gigante
- Division of Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Science, Danderyd University Hospital, Stockholm, Sweden
| | - Anders Gummesson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Genetics and Genomics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Viktor Hamrefors
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Jan Hedner
- Pulmonary Department, Sleep Disorders Center, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center of Sleep and Wake Disorders, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden
| | - Magnus Janzon
- Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Linda Johnson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Lars Lind
- Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Maria Mannila
- Heart and Vascular Theme, Department of Cardiology, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Ulf Nilsson
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Anders Persson
- CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
- Department of Radiology, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Hans Lennart Persson
- Respiratory Medicine, Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Anna Ramnemark
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden
| | - Caroline Schmidt
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - C Magnus Sköld
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden
- Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Swahn
- Department of Cardiology, Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Kjell Torén
- Section of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Waldenström
- Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University, Umeå, Sweden
| | - Per Wollmer
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Suneela Zaigham
- Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Carl Johan Östgren
- CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Huang XQ, Pan J, Fang YY, Wang X, Shen M, Yuan Y, Guo SL. Interaction of smoking and aging on emphysema and small airways disease in asymptomatic healthy men by CT-based parametric response mapping analysis. Clin Radiol 2024; 79:e156-e163. [PMID: 37867079 DOI: 10.1016/j.crad.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/06/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023]
Abstract
AIM To explore whether small airway disease and emphysema were affected by the interaction between smoking and aging on chest computed tomography (CT) images of asymptomatic healthy men analysed using a quantitative imaging tool parametric response mapping (PRM). MATERIALS AND METHODS In this retrospective study, 95 asymptomatic healthy men underwent biphasic chest CT. The PRM classifies lung as a percentage of normal (PRMNormal%), functional small airway disease (PRMfSAD%), and emphysema (PRMEmph%). The patients were divided into groups based on their age and smoking status. Multiple linear regression analysis was applied to explore the factors influencing lung injury. Simple effects analysis was performed to explore the interaction between different age groups and smoking status. RESULTS The interaction between aging and smoking significantly affected PRMfSAD% and PRMEmph% (p<0.001). The age range 60-69 and smoking were associated with increased PRMfSAD% and PRMEmph% (p<0.05). Futher stratification into different age subgroups showed that smoking was associated with increased PRMfSAD% and PRMEmph% in the 50-59 year age group. Besides, smoking in the 50-59 and 60-69 years group was associated with decreased PRMNormal%, while smoking in the 60-69 years group did not significantly influence the prevalence of PRMfSAD% and PRMEmph% (p>0.05). CONCLUSIONS PRM reveals the interplay between smoking and aging in the development of lung injury in asymptomatic healthy men. Aging and smoking are important factors of emphysema and small airway disease in the 50-69 years group. In the 60-69 years group, aging poses a greater risk of lung injury compared to smoking.
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Affiliation(s)
- X Q Huang
- The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, China; Department of Radiology, Lanzhou University First Hospital, Lanzhou, 730000, China
| | - J Pan
- Department of Geriatrics, Yan'an People's Hospital, Yan'an, 716000, China
| | - Y Y Fang
- Department of Imaging, Medical College of Yan'an University, Yan'an, 716000, China
| | - X Wang
- Department of Imaging, Medical College of Yan'an University, Yan'an, 716000, China
| | - M Shen
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, 716000, China
| | - Y Yuan
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, 716000, China
| | - S L Guo
- Department of Radiology, Lanzhou University First Hospital, Lanzhou, 730000, China.
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40
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Vegas Sánchez-Ferrero G, Díaz AA, Ash SY, Baraghoshi D, Strand M, Crapo JD, Silverman EK, Humphries SM, Washko GR, Lynch DA, San José Estépar R. Quantification of Emphysema Progression at CT Using Simultaneous Volume, Noise, and Bias Lung Density Correction. Radiology 2024; 310:e231632. [PMID: 38165244 PMCID: PMC10831481 DOI: 10.1148/radiol.231632] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 01/03/2024]
Abstract
Background CT attenuation is affected by lung volume, dosage, and scanner bias, leading to inaccurate emphysema progression measurements in multicenter studies. Purpose To develop and validate a method that simultaneously corrects volume, noise, and interscanner bias for lung density change estimation in emphysema progression at CT in a longitudinal multicenter study. Materials and Methods In this secondary analysis of the prospective Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) study, lung function data were obtained from participants who completed baseline and 5-year follow-up visits from January 2008 to August 2017. CT emphysema progression was measured with volume-adjusted lung density (VALD) and compared with the joint volume-noise-bias-adjusted lung density (VNB-ALD). Reproducibility was studied under change of dosage protocol and scanner model with repeated acquisitions. Emphysema progression was visually scored in 102 randomly selected participants. A stratified analysis of clinical characteristics was performed that considered groups based on their combined lung density change measured by VALD and VNB-ALD. Results A total of 4954 COPDGene participants (mean age, 60 years ± 9 [SD]; 2511 male, 2443 female) were analyzed (1329 with repeated reduced-dose acquisition in the follow-up visit). Mean repeatability coefficients were 30 g/L ± 0.46 for VALD and 14 g/L ± 0.34 for VNB-ALD. VALD measurements showed no evidence of differences between nonprogressors and progressors (mean, -5.5 g/L ± 9.5 vs -8.6 g/L ± 9.6; P = .11), while VNB-ALD agreed with visual readings and showed a difference (mean, -0.67 g/L ± 4.8 vs -4.2 g/L ± 5.5; P < .001). Analysis of progression showed that VNB-ALD progressors had a greater decline in forced expiratory volume in 1 second (-42 mL per year vs -32 mL per year; Tukey-adjusted P = .002). Conclusion Simultaneously correcting volume, noise, and interscanner bias for lung density change estimation in emphysema progression at CT improved repeatability analyses and agreed with visual readings. It distinguished between progressors and nonprogressors and was associated with a greater decline in lung function metrics. Clinical trial registration no. NCT00608764 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Goo in this issue.
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Affiliation(s)
- Gonzalo Vegas Sánchez-Ferrero
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Alejandro A. Díaz
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Samuel Y. Ash
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - David Baraghoshi
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Matthew Strand
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - James D. Crapo
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Edwin K. Silverman
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Stephen M. Humphries
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - George R. Washko
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - David A. Lynch
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
| | - Raúl San José Estépar
- From the Applied Chest Imaging Laboratory, Department of Radiology
(G.V.S.F., R.S.J.E.), Applied Chest Imaging Laboratory, Division of Pulmonary
and Critical Care Medicine, Department of Medicine (A.A.D., S.Y.A., G.R.W.), and
Channing Division of Network Medicine and Division of Pulmonary and Critical
Care Medicine, Department of Medicine (E.K.S.), Brigham and Women's
Hospital, 75 Francis St, Boston, MA 02115; and Division of Biostatistics and
Bioinformatics (D.B., M.S.), Division of Pulmonary and Critical Care Medicine,
Department of Medicine (J.D.C.), and Department of Radiology (S.M.H., D.A.L.),
National Jewish Health, Denver, Colo
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Zhang W, Zhao Y, Tian Y, Liang X, Piao C. Early Diagnosis of High-Risk Chronic Obstructive Pulmonary Disease Based on Quantitative High-Resolution Computed Tomography Measurements. Int J Chron Obstruct Pulmon Dis 2023; 18:3099-3114. [PMID: 38162987 PMCID: PMC10757779 DOI: 10.2147/copd.s436803] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose Quantitative computed tomography (QCT) techniques, focusing on airway anatomy and emphysema, may help to detect early structural changes of COPD disease. This retrospective study aims to identify high-risk COPD participants by using QCT measurements. Patients and Methods We enrolled 140 participants from the Second Affiliated Hospital of Shenyang Medical College who completed inspiratory high-resolution CT scans, pulmonary function tests (PFTs), and clinical characteristics recorded. They were diagnosed Non-COPD by PFT value of FEV1/FVC >70% and divided into two groups according percentage predicted FEV1 (FEV1%), low-risk COPD group: FEV1% ≥ 95%, high-risk group: 80% < FEV1% < 95%. The QCT measurements were analyzed by the Student's t-test (or Mann-Whitney U-test) method. Then, feature candidates were identified using the LASSO method. Meanwhile, the correlation between QCT measurements and PFTs was assessed by the Spearman rank correlation test. Furthermore, support vector machine (SVM) was performed to identify high-risk COPD participants. The performance of the models was evaluated in terms of accuracy (ACC), sensitivity (SEN), specificity (SPE), F1-score, and area under the ROC curve (AUC), with p <0.05 considered statistically significant. Results The SVM based on QCT measurements achieved good performance in identifying high-risk COPD patients with 85.71% of ACC, 88.34% of SEN, 84.00% of SPE, 83.33% of F1-score, and 0.93 of AUC. Further, QCT measurements integration of clinical data improved the performance with an ACC of 90.48%. The emphysema index (%LAA-950) of left lower lung was negatively correlated with PFTs (P < 0.001). The airway anatomy indexes of lumen diameter (LD) were correlated with PFTs. Conclusion QCT measurements combined with clinical information could provide an effective tool for an early diagnosis of high-risk COPD. The QCT indexes can be used to assess the pulmonary function status of high-risk COPD.
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Affiliation(s)
- Wenxiu Zhang
- Institute of Research and Clinical Innovations, Neusoft Medical Systems Co, Ltd, Shanghai, People’s Republic of China
| | - Yu Zhao
- Radiology Department, Second Affiliated Hospital of Shenyang Medical College, Shenyang, Liaoning, People’s Republic of China
| | - Yuchi Tian
- Institute of Research and Clinical Innovations, Neusoft Medical Systems Co, Ltd, Shanghai, People’s Republic of China
| | - Xiaoyun Liang
- Institute of Research and Clinical Innovations, Neusoft Medical Systems Co, Ltd, Shanghai, People’s Republic of China
| | - Chenghao Piao
- Radiology Department, Second Affiliated Hospital of Shenyang Medical College, Shenyang, Liaoning, People’s Republic of China
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42
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Mebratu YA, Jones JT, Liu C, Negasi ZH, Rahman M, Rojas-Quintero J, O’Connor GT, Gao W, Dupuis J, Cho MH, Litonjua AA, Randell S, Tesfaigzi Y. Bik promotes proteasomal degradation to control low-grade inflammation. J Clin Invest 2023; 134:e170594. [PMID: 38113109 PMCID: PMC10866658 DOI: 10.1172/jci170594] [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: 03/20/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
Although chronic low-grade inflammation does not cause immediate clinical symptoms, over the longer term, it can enhance other insults or age-dependent damage to organ systems and thereby contribute to age-related disorders, such as respiratory disorders, heart disease, metabolic disorders, autoimmunity, and cancer. However, the molecular mechanisms governing low-level inflammation are largely unknown. We discovered that Bcl-2-interacting killer (Bik) deficiency causes low-level inflammation even at baseline and the development of spontaneous emphysema in female but not male mice. Similarly, a single nucleotide polymorphism that reduced Bik levels was associated with increased inflammation and enhanced decline in lung function in humans. Transgenic expression of Bik in the airways of Bik-deficient mice inhibited allergen- or LPS-induced lung inflammation and reversed emphysema in female mice. Bik deficiency increased nuclear but not cytosolic p65 levels because Bik, by modifying the BH4 domain of Bcl-2, interacted with regulatory particle non-ATPase 1 (RPN1) and RPN2 and enhanced proteasomal degradation of nuclear proteins. Bik deficiency increased inflammation primarily in females because Bcl-2 and Bik levels were reduced in lung tissues and airway cells of female compared with male mice. Therefore, controlling low-grade inflammation by modifying the unappreciated role of Bik and Bcl-2 in facilitating proteasomal degradation of nuclear proteins may be crucial in treating chronic age-related diseases.
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Affiliation(s)
- Yohannes A. Mebratu
- Brigham and Women’s Hospital, Division of Pulmonary and Critical Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jane T. Jones
- University Geisel School of Medicine, Department of Microbiology and Immunology, Dartmouth, Hanover, New Hampshire, USA
| | - Congjian Liu
- Brigham and Women’s Hospital, Division of Pulmonary and Critical Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Zerihun H. Negasi
- Brigham and Women’s Hospital, Division of Pulmonary and Critical Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Mizanur Rahman
- Brigham and Women’s Hospital, Division of Pulmonary and Critical Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Joselyn Rojas-Quintero
- Brigham and Women’s Hospital, Division of Pulmonary and Critical Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - George T. O’Connor
- Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, USA
- National Heart, Lung, and Blood Institute’s (NHLBI’s) Framingham Heart Study, Framingham, Massachusetts, USA
| | - Wei Gao
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Michael H. Cho
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Scott Randell
- Marsico Lung Institute, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Yohannes Tesfaigzi
- Brigham and Women’s Hospital, Division of Pulmonary and Critical Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Stødle IH, Sen A, Høvik H, Verket A, Koldsland OC. Association between periodontitis stages and self-reported diseases in a Norwegian population: the HUNT study. BMC Oral Health 2023; 23:999. [PMID: 38093278 PMCID: PMC10720083 DOI: 10.1186/s12903-023-03743-z] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The relationships between periodontitis and non-communicable diseases (NCDs) have been investigated through several different case-definitions. The differences in methodology may have hindered the basis of comparison between these studies. The classification from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions offers a unison platform that may facilitate future comparison of such research. The present study aimed to reproduce associations between periodontitis and other NCDs using the 2017 Classification, in the Trøndelag Health Study (HUNT). MATERIAL AND METHODS The fourth HUNT-survey was carried out between 2017 and 2019. Clinical variables, blood samples and answers to questionnaires were collected from 4933 participants. Periodontal status was assessed based on the latest staging system, and its associations with NCDs were estimated by logistic regression models adjusted for potential confounders. RESULTS Compared to no or Stage I periodontitis, participants with Stage III/IV periodontitis (radiographic bone loss exceeding 33%) were associated with cardiovascular disease, hyperglycemia in participants with diabetes and chronic obstructive pulmonary disease (COPD)/emphysema. Associations with hyperglycemia in participants with diabetes and COPD/emphysema were also observed in participants with Stage II periodontitis. The only observed association when considering never-smokers alone, was with COPD/emphysema. CONCLUSION Periodontitis Stage II and III/IV were associated with major NCDs. Effect sizes increased with increasing periodontitis stages, which implies greater occurrence of coincident comorbidities in patients with severe periodontitis.
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Affiliation(s)
- Ida Haukåen Stødle
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 69, 0455, Oslo, Norway.
| | - Abhijit Sen
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Hedda Høvik
- Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway
| | - Anders Verket
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 69, 0455, Oslo, Norway
| | - Odd Carsten Koldsland
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Geitmyrsveien 69, 0455, Oslo, Norway
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Gaudêncio AS, Azami H, Cardoso JM, Vaz PG, Humeau-Heurtier A. Bidimensional ensemble entropy: Concepts and application to emphysema lung computerized tomography scans. Comput Methods Programs Biomed 2023; 242:107855. [PMID: 37852145 DOI: 10.1016/j.cmpb.2023.107855] [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] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/01/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND OBJECTIVE Bidimensional entropy algorithms provide meaningful quantitative information on image textures. These algorithms have the advantage of relying on well-known one-dimensional entropy measures dedicated to the analysis of time series. However, uni- and bidimensional algorithms require the adjustment of some parameters that influence the obtained results or even findings. To address this, ensemble entropy techniques have recently emerged as a solution for signal analysis, offering greater stability and reduced bias in data patterns during entropy estimation. However, such algorithms have not yet been extended to their two-dimensional forms. METHODS We therefore propose six bidimensional algorithms, namely ensemble sample entropy, ensemble permutation entropy, ensemble dispersion entropy, ensemble distribution entropy, and two versions of ensemble fuzzy entropy based on different models or parameters initialization of an entropy algorithm. These new measures are first tested on synthetic images and further applied to a biomedical dataset. RESULTS The results suggest that ensemble techniques are able to detect different levels of image dynamics and their degrees of randomness. These methods lead to more stable entropy values (lower coefficients of variations) for the synthetic data. The results also show that these new measures can obtain up to 92.7% accuracy and 88.4% sensitivity when classifying patients with pulmonary emphysema through a k-nearest neighbors algorithm. CONCLUSIONS This is a further step towards the potential clinical deployment of bidimensional ensemble approaches to detect different levels of image dynamics and their successful performance on emphysema lung computerized tomography scans. These bidimensional ensemble entropy algorithms have potential to be used in various imaging applications thanks to their ability to distinguish more stable and less biased image patterns compared to their original counterparts.
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Affiliation(s)
- Andreia S Gaudêncio
- LIBPhys, Department of Physics, University of Coimbra, Coimbra, P-3004 516, Portugal; Univ Angers, LARIS, SFR MATHSTIC, F-49000 Angers, France.
| | - Hamed Azami
- Centre for Addiction and Mental Health, Toronto Dementia Research Alliance, Univ Toronto, Toronto, ON, Canada
| | - João M Cardoso
- LIBPhys, Department of Physics, University of Coimbra, Coimbra, P-3004 516, Portugal
| | - Pedro G Vaz
- LIBPhys, Department of Physics, University of Coimbra, Coimbra, P-3004 516, Portugal
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Phillips EF, Karak PK. Diffuse bilateral 18F-Fluoroestradiol pulmonary uptake in patients with metastatic estrogen receptor positive breast cancer: A case report. J Med Imaging Radiat Sci 2023; 54:726-731. [PMID: 37620179 DOI: 10.1016/j.jmir.2023.08.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
INTRODUCTION Breast cancer is the most commonly diagnosed cancer in women and hormonal therapy is an established treatment for estrogen receptor (ER) positive breast cancers. 18F-Fluoroestradiol (FES) is an emerging radiotracer used to determine hormone status in patients with ER positive breast cancer as FES specifically binds to the alpha subtype of estrogen receptors. As with all radiotracers, FES demonstrates background uptake within various tissues and organs besides the targeted breast cancer and metastatic disease. To date, FES has mostly been shown to demonstrate uptake within the lungs from metastatic disease or in a more focal region after radiation therapy. CASE AND OUTCOMES We present two patients with stage IV ER positive breast cancer who underwent FES positron emission tomography and computed tomography (PET/CT) scans to evaluate for metastatic disease; both of which demonstrated diffuse bilateral mild-moderate pulmonary uptake. The first patient had a severe lung injury which was improving but still present at the time of her FES PET/CT. The second patient had a remote history of prior right breast radiation therapy for a prior breast cancer as well as emphysema and mild interstitial disease. DISCUSSION To date, FES uptake within the lungs has been shown to be secondary to fibrotic changes secondary to prior radiation therapy and the uptake is localized to a focal region within the lung corresponding to the localized region around the tumor needing radiation therapy. We present two FES PET/CT scans that demonstrate diffuse bilateral mild-moderate uptake. We believe the first patient's bilateral FES uptake was secondary to inflammatory changes from her acute lung injury. Our second patient has a remote history of right breast radiation therapy that would not account for her diffuse lung uptake but does have emphysema and mild interstitial disease which can account for the FES uptake seen in her FES PET/CT. CONCLUSION 18F-Fluoroestradiol is an emerging radiotracer that binds to estrogen receptors and is being used to determine hormone receptor status in women with ER positive breast cancers, which is the most commonly diagnosed cancer in women. Therefore, it's important to understand where it might demonstrate uptake and why. We highlighted two unique cases of mild-moderate pulmonary uptake of FES to provide further information about FES. Overall, we conclude that diffuse bilateral mild-moderate FES uptake within the lungs is likely secondary to inflammation, interstitial disease, or a combination thereof.
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Affiliation(s)
- Emily F Phillips
- Section of Nuclear Medicine, Department of Radiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06106, United States.
| | - Prasanta K Karak
- Section of Nuclear Medicine, Department of Radiology, Hartford Hospital, 80 Seymour Street, Hartford, CT 06106, United States
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DI Silvestre G, Sciamanna P, Angeletti C, Marinangeli F, Venturoni F, Scimia P. Bullous emphysema and breast surgery: could fascial blocks be the best strategy? Minerva Anestesiol 2023; 89:1149-1150. [PMID: 37705432 DOI: 10.23736/s0375-9393.23.17592-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Gabriele DI Silvestre
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy -
| | - Paola Sciamanna
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Department of Anesthesia and Intensive Care Unit, G. Mazzini Hospital, Teramo, Italy
| | - Chiara Angeletti
- Department of Anesthesia and Intensive Care Unit, G. Mazzini Hospital, Teramo, Italy
| | - Franco Marinangeli
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federica Venturoni
- Department of Anesthesia and Intensive Care Unit, G. Mazzini Hospital, Teramo, Italy
| | - Paolo Scimia
- Department of Anesthesia and Intensive Care Unit, G. Mazzini Hospital, Teramo, Italy
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Li K, Ye X, Xu M, Xu C, Lu P, Li J, Yuan G, Zhang C. MiR-23a-3p alleviates cigarette smoke extract-induced pulmonary vascular endothelial cell apoptosis by targeting DNAJB1 in emphysema. Clin Respir J 2023; 17:1223-1232. [PMID: 37828807 PMCID: PMC10730501 DOI: 10.1111/crj.13707] [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] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Cigarette smoke (CS) is an important risk factor for chronic obstructive pulmonary disease, including emphysema. MicroRNAs (miRNAs) are important regulators of emphysema progression. However, miR-23a-3p role in emphysema is unclear. METHODS CS exposure was used to construct emphysema mice models, and cigarette smoke extract (CSE)-induced pulmonary vascular endothelial cells (PMVECs) were used to mimic emphysema cell models. Mouse lung tissue was stained by immunohistochemical staining, hematoxylin and eosin staining, and TUNEL staining. MiR-23a-3p and DnaJ homolog subfamily B member 1 (DNAJB1) levels were tested using quantitative real-time PCR. DNAJB1 and apoptosis-related markers' protein levels were examined via western blot analysis. Cell viability and apoptosis were analyzed by MTT assay and flow cytometry. The interaction between miR-23a-3p and DNAJB1 was evaluated by dual-luciferase reporter assay and RIP assay. RESULTS MiR-23a-3p was downregulated, and DNAJB1 was upregulated in CS-induced emphysema mice models and CSE-induced PMVECs. MiR-23a-3p overexpression promoted viability and repressed apoptosis in CSE-induced PMVECs. MiR-23a-3p targeted DNAJB1 and negatively regulated DNAJB1 expression. Moreover, DNAJB1 knockdown repressed CSE-induced PMVECs apoptosis, and miR-23a-3p inhibitor reversed this effect. Additionally, miR-23a-3p alleviated lung tissue injury and improved emphysema in mice by reducing DNAJB1 expression. CONCLUSION MiR-23a-3p alleviated emphysema progression, which could inhibit CSE-induced PMVECs apoptosis by targeting DNAJB1.
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Affiliation(s)
- Ke Li
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Xianwei Ye
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Mei Xu
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Chuan Xu
- Department of Thoracic SurgeryGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Ping Lu
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Jiayi Li
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Guohang Yuan
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
| | - Cheng Zhang
- Department of Respiratory and Critical Care MedicineGuizhou Provincial People's HospitalGuiyang CityPeople's Republic of China
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Wen X, Deng Z, Peng J, Yang H, Wu F, Dai C, Zheng Y, Zhao N, Wang Z, Xiao S, Xu J, Lu L, Wu X, Zhou K, Dai J, Li B, Ran P, Zhou Y. Characteristics of inflammatory phenotypes in patients with chronic obstructive pulmonary disease: a cross-sectional study. BMJ Open Respir Res 2023; 10:e001454. [PMID: 38035712 PMCID: PMC10689359 DOI: 10.1136/bmjresp-2022-001454] [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: 09/13/2022] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The relationship between airway inflammation in chronic obstructive pulmonary disease (COPD) and clinical characteristics remains unclear. This study aimed to investigate the airway inflammatory phenotypes in COPD and their association with clinical characteristics. METHODS 895 patients with COPD were recruited from Guangdong Province, China in this study. Each patient underwent questionnaire interviews, spirometry testing, CT scans and induced sputum examination. Classification of airway inflammation phenotypes was based on sputum inflammatory cell counts. Covariance analysis was applied to assess associations with airway inflammation phenotypes. RESULTS In this study, we found that neutrophilic phenotype (NP, 58.0%) was the most common airway inflammation phenotype in patients with COPD, followed by mixed granulocytic phenotype (MGP, 32.6%), eosinophilic phenotype (EP, 5.4%) and paucigranulocytic phenotype (PP, 4.0%). Compared with NP patients, those with MGP exhibited more frequent chronic respiratory symptoms, and a higher proportion of individuals classified under Global Initiative for Chronic Obstructive Lung Disease stages 3 and 4. After adjusting for confounding factors, MGP patients had lower lung function, and more severe emphysema and air trapping. On the contrary, patients with PP had the best pulmonary function and less emphysema and air trapping. CONCLUSIONS NP was the most common airway inflammation phenotype in patients with COPD. Patients with MGP had more respiratory symptoms, greater loss of lung function, and more severe emphysema and gas trapping compared with those with NP. Meanwhile, PP may be a phenotype of mild damage to lung structure in patients with COPD.
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Affiliation(s)
- Xiang Wen
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Shenzhen Institute of Respiratory Disease & Department of Pulmonary and Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Zhishan Deng
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jieqi Peng
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou National Laboratory, Guangzhou, Guangdong, China
| | - Huajing Yang
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Fan Wu
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou National Laboratory, Guangzhou, Guangdong, China
| | - Cuiqiong Dai
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Youlan Zheng
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ningning Zhao
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zihui Wang
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shan Xiao
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Pulmonary and Critical Care Medicine, Longgang Central Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Jianwu Xu
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lifei Lu
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaohui Wu
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kunning Zhou
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jianwei Dai
- GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bing Li
- GMU-GIBH Joint School of Life Sciences, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou National Laboratory, Guangzhou, Guangdong, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease & National Center for Respiratory Medicine & Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Chen B, Liu Z, Lu J, Li Z, Kuang K, Yang J, Wang Z, Sun Y, Du B, Qi L, Li M. Deep learning parametric response mapping from inspiratory chest CT scans: a new approach for small airway disease screening. Respir Res 2023; 24:299. [PMID: 38017476 PMCID: PMC10683250 DOI: 10.1186/s12931-023-02611-2] [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: 09/01/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVES Parametric response mapping (PRM) enables the evaluation of small airway disease (SAD) at the voxel level, but requires both inspiratory and expiratory chest CT scans. We hypothesize that deep learning PRM from inspiratory chest CT scans can effectively evaluate SAD in individuals with normal spirometry. METHODS We included 537 participants with normal spirometry, a history of smoking or secondhand smoke exposure, and divided them into training, tuning, and test sets. A cascaded generative adversarial network generated expiratory CT from inspiratory CT, followed by a UNet-like network predicting PRM using real inspiratory CT and generated expiratory CT. The performance of the prediction is evaluated using SSIM, RMSE and dice coefficients. Pearson correlation evaluated the correlation between predicted and ground truth PRM. ROC curves evaluated predicted PRMfSAD (the volume percentage of functional small airway disease, fSAD) performance in stratifying SAD. RESULTS Our method can generate expiratory CT of good quality (SSIM 0.86, RMSE 80.13 HU). The predicted PRM dice coefficients for normal lung, emphysema, and fSAD regions are 0.85, 0.63, and 0.51, respectively. The volume percentages of emphysema and fSAD showed good correlation between predicted and ground truth PRM (|r| were 0.97 and 0.64, respectively, p < 0.05). Predicted PRMfSAD showed good SAD stratification performance with ground truth PRMfSAD at thresholds of 15%, 20% and 25% (AUCs were 0.84, 0.78, and 0.84, respectively, p < 0.001). CONCLUSION Our deep learning method generates high-quality PRM using inspiratory chest CT and effectively stratifies SAD in individuals with normal spirometry.
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Affiliation(s)
- Bin Chen
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Ziyi Liu
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China
| | - Jinjuan Lu
- Department of Radiology, Shanghai Geriatric Medical Center, Shanghai, China
| | - Zhihao Li
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China
| | - Kaiming Kuang
- Dianei Technology, Shanghai, China
- University of California San Diego, La Jolla, USA
| | - Jiancheng Yang
- Dianei Technology, Shanghai, China
- Computer Vision Laboratory, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
| | - Zengmao Wang
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China
| | - Yingli Sun
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China
| | - Bo Du
- School of Computer Science, Wuhan University, LuoJiaShan, WuChang District, Wuhan, Hubei, China.
- Artificial Intelligence Institute of Wuhan University, Wuhan, Hubei, China.
- Hubei Key Laboratory of Multimedia and Network Communication Engineering, Wuhan, Hubei, China.
| | - Lin Qi
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China.
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
| | - Ming Li
- Department of Radiology, Huadong Hospital Affiliated to Fudan University, 221, Yanan West Road, Jingan Temple Street, Jingan District, Shanghai, China.
- Zhang Guozhen Small Pulmonary Nodules Diagnosis and Treatment Center, Shanghai, China.
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Wang Q, Su W, Liu J, Zhao D. Advances in the investigation of the role of autophagy in the etiology of chronic obstructive pulmonary disease: A review. Medicine (Baltimore) 2023; 102:e36390. [PMID: 38013266 PMCID: PMC10681501 DOI: 10.1097/md.0000000000036390] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory illness. It arises from emphysema and chronic bronchitis and is characterized by progressive and irreversible airflow limitation and chronic inflammation of the lungs, which eventually progresses to pulmonary hypertension, chronic pulmonary heart disease and respiratory failure. Autophagy is a highly conserved cellular homeostasis maintenance mechanism that involves the transport of damaged organelles and proteins to lysosomes for destruction. Dysregulation of autophagy is one of the pathogenic mechanisms of many diseases and is strongly associated with the development of COPD, although the precise mechanisms are unknown. In this paper, we focus on macroautophagy, a type of autophagy that has been thoroughly studied, and describe the characteristics, processes, regulatory pathways, and functions of autophagy, and discuss its relationship with COPD from the perspectives of inflammation, emphysema, mucus hypersecretion, cilia structure and function, airway remodeling, vascular remodeling, and bacterial infections, with a view to searching for the therapeutic targets of COPD from the perspective of autophagy, which is hoped to be helpful for the clinical treatment.
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Affiliation(s)
- Qianxinhong Wang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Wenlong Su
- College of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Junnan Liu
- The Third Clinical Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Dongkai Zhao
- The Third Clinical Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China
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