scholarly journals Correlation between TNF-α -308 and +489 Gene Polymorphism and Acute Exacerbation of Chronic Obstructive Pulmonary Diseases

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Suyun Yu ◽  
Min Xue ◽  
Zhijun Yan ◽  
Bin Song ◽  
Haiping Hong ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Bronchial Artery ◽  
Close Correlation ◽  
Chronic Obstructive ◽  
Necrosis Factor Alpha ◽  
Obstructive Pulmonary Disease ◽  
Bronchial Wall ◽  
Chronic Obstructive Pulmonary Diseases ◽  
Tnf Α ◽  
Acute Exacerbations

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is becoming a common respiratory disease, leading to increased morbidity and mortality worldwide. Tumor necrosis factor-alpha (TNF-α) is a powerful proinflammatory cytokine involved in the pathogenesis of AECOPD. Therefore, we proposed a close correlation between the TNF-α polymorphism [-308G/A (rs1800629), +489G/A (rs1800610)] and the disease progress of patients with AECOPD. Comparison of the TNF-α genotypes between the 198 AECOPD diagnosed patients groups and 195 healthy peoples suggested their significant differences of the three genotypes (AA, GA, GG) distribution for TNF-α -308 ( P < 0.05 ), but no differences of that for TNF-α +489. We found that patients with TNF-α -308 GA/AA genotypes showed smaller adjacent arterial diameter, thicker bronchial wall, higher bronchial artery ratio, higher bronchial wall grading, and higher frequency of acute exacerbations than those with TNF-α -308 GG genotype. Patients with TNF-α +489 GA/AA genotypes showed the same AECOPD properties as patients with TNF-α -308 except for the high frequency of acute exacerbations. Further experiment showed that the TNF-α -308 and+489 gene polymorphisms could affect the expression level of TNF-α in macrophages, suggesting the involvement of the macrophage population in disease regulation of AECOPD patients with TNF-α -308G/A and+489G/A genotype heterogeneity. In conclusion, the TNF-α -308 G/A genotype was related to AECOPD susceptibility and progress, while the TNF-α +489G/A genotype was related to AECOPD progress, but not AECOPD susceptibility.

scholarly journals Detection of respiratory viruses and expression of inflammatory cytokines in patients with acute exacerbation chronic obstructive pulmonary disease in Mongolia China

2022 ◽  
Vol 82 ◽  
Author(s):  
Y. Feng ◽  
E. Liu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Inflammatory Markers ◽  
Bacterial Infections ◽  
Smoking History ◽  
Severe Illness ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Tnf Α

Abstract Chronic obstructive pulmonary disease (COPD) was estimated to be the third cause of global mortality by 2020. Acute exacerbation COPD (AECOPD) is a sudden worsening of COPD symptoms and could be due to virus/bacterial infections and air pollution. Increased expression of inflammatory markers in patients with AECOPD is associated with viral infection. This study aimed to detect different viruses and analyze the expression of various inflammatory markers associated with AECOPD patients. Three hundred and forty-seven patients diagnosed with COPD according to GOLD criteria were included in this study. Swab samples and blood were collected for the detection of viruses by RT-PCR and expression of inflammatory markers, respectively. Of the swab samples, 113 (32.6%) of samples were positive for virus detection. Of these, HRV (39.8%) was the predominant virus detected followed by FluB (27.4%) and FluA (22.1%). The presence of HRV was significantly higher (p=0.044) among the other detected viruses. When compared to healthy controls the expression levels of TNF-α, IL-6 and IL-8 were significantly higher (p<0.05) in virus-positive patients. The IL-6 and IL-8 were the next predominantly expressed in markers among the samples. The higher expression rate of IL-8 was significantly (p<0.05) associated with patients having COPD GOLD III severity level and smoking history. Although HRV was the predominant virus detected the combined prevalence of Influenza A and B surpassing the rate of HRV. The high-level expression of well known inflammatory markers of AECOPD, TNF-α, IL-6 and IL-8 indicates a chronic severe illness. These markers play an important role and could be used as a marker for determining the severity of AECOPD.

scholarly journals Computed Tomography Images under Iterative Reconstruction Algorithm in Analysis of the Efficacy of Honey-Fried Herba Ephedrae along with Western Medicine on Acute Exacerbation Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jun Xue ◽  
Jun Zhang ◽  
Li Li ◽  
Ping Zang
Keyword(s):  
Iterative Algorithm ◽  
Western Medicine ◽  
Reconstruction Algorithm ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bronchial Wall ◽  
Ctrl Group ◽  
Wall Area ◽  
Tnf Α

To explore the application value of the reconstruction algorithm based on an iterative algorithm in the analysis of CT image and analyze the therapeutic effect of honey-fried Herba Ephedrae combined with Western medicine on acute exacerbation chronic obstructive pulmonary disease (AECOPD), a total of 96 AECOPD patients admitted to our hospital from January 2018 to December 2019 were selected as research subjects. According to a different treatment method, the subjects were divided into a control group (Ctrl group, conventional therapy) and an observation group (OG, conventional therapy + honey-fried Herba Ephedrae), with 48 in each group. The CT image algorithm was established based on the iterative algorithm, and the CT dose indexes of the reconstruction algorithm and the Filtered Back Projection (FBP) algorithm under the same conditions were compared ( P < 0.05 ). After using CT to confirm the diagnosis of the subjects, the difference in indicators of forced expiratory volume in one second (FEV1), forced expiratory volume in one second to forced vital capacity ratio (FEV1%), and forced vital capacity (FVC), inflammatory factors of serum interleukin-8 (IL-8), serum interleukin-10 (IL-10), and tumor necrosis factor (TNF-α), the bronchial wall area, and the total treatment efficiency before and after different treatment was analyzed. The results suggested that the Computed Tomography Dose Index (CTDI) of iterative reconstruction (IR) algorithm when scanning different parts was higher than that of the FBP algorithm. The pulmonary function indexes and the expression of IL-8 and TNF-α in the OG were higher than those in the Ctrl group ( P < 0.05 ); the bronchial wall area, bronchial wall area percentage, and IL-10 expression in the OG were all lower than those in the Ctrl group ( P < 0.05 ). The effectiveness and improvement rates of the Ctrl group were 47.92% and 25%, respectively, significantly lower than those in the OG group, 56.25% and 31.25% ( P < 0.05 ), and the total efficiency of the observation group was 87.5%, which was significantly higher than that in the Ctrl group (72.92%) ( P < 0.05 ). In conclusion, based on the iterative algorithm, a CT reconstruction algorithm with better noise reduction performance was established, and the use of honey-fried Herba Ephedrae combined with Western medicine can improve the effective rate of treatment.

scholarly journals Drug Safety of Benzodiazepines in Asian Patients With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 11 ◽  
Author(s):  
Yi-Hsiang Liao ◽  
Liang-Yu Chen ◽  
Kuang-Ming Liao ◽  
Chung-Yu Chen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Drug Safety ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbations ◽  
All Cause Mortality

Purpose: Many comorbidities, including depression, anxiety, and insomnia, occur in patients with chronic obstructive pulmonary disease (COPD). These patients may be prescribed benzodiazepines (BZDs). However, there are some concerns that benzodiazepines increase the risk of drug overdose, hypercapnic respiratory failure, acute exacerbation and increased mortality. The aim of our study was to evaluate the drug safety of BZDs in patients with COPD.Methods: We used the National Health Insurance Research database in Taiwan from 2002 to 2016 to perform a retrospective cohort study. We enrolled patients who were exposed to the first prescription of BZDs, non-BZDs or a combination (mix user) after COPD diagnosis. We performed 1:1:1 propensity score matching in three groups. The outcomes were COPD with acute exacerbation and all-cause mortality. Poisson regression analysis was performed to evaluate the incidence rate ratios for the outcomes in the groups.Results: After propensity score matching, there were 2,856 patients in each group. After adjusting for confounding factors, we found that compared to BZD users, non-BZD and mix users had nonsignificant differences in outpatient management of acute exacerbations, hospitalization management of acute exacerbations, emergency department management of acute exacerbations and all-cause mortality. BZD and mix groups showed significantly increased admission for acute exacerbation of COPD compared with that of the nonuser group, with IRRs of 2.52 (95% CI, 1.52–4.18; p = 0.0004) and 2.63 (95% CI, 1.57–4.40; p = 0.0002), respectively.Conclusion: BZD, non-BZD, and mix users showed increased COPD-related respiratory events compared to nonusers in Asian subjects.

scholarly journals Drug Safety of Benzodiazepines in Patients with Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Yi-Hsiang Liao ◽  
Liang-Yu Chen ◽  
Kuang-Ming Liao ◽  
Chung-Yu Chen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Drug Safety ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Acute Exacerbations ◽  
All Cause Mortality

Abstract Many comorbidities, including depression, anxiety, dyspnea, and insomnia, occur in patients with chronic obstructive pulmonary disease (COPD). These patients may be prescribed benzodiazepines (BZDs). However, there are some concerns that benzodiazepines increase the risk of drug overdose, hypercapnic respiratory failure, acute exacerbation and increased mortality. The aim of our study was to evaluate the drug safety of BZDs in patients with COPD. We used the National Health Insurance Research Database (NHIRD) in Taiwan from 2002 to 2016 to perform a retrospective cohort study. We enrolled patients who were exposed to the first prescription of BZDs, non-BZDs or a combination (mix user) after COPD diagnosis. We performed 1:1:1:1 propensity score matching in three groups. The outcomes were COPD with acute exacerbation and all-cause mortality. Poisson regression analysis was performed to evaluate the incidence rate ratios (IRRs) for the outcomes in the groups. After propensity score matching, there were 2856 patients in each group. After adjusting for confounding factors, we found that compared to BZD users, non-BZD and mix users had nonsignificant differences in outpatient management of acute exacerbations, hospitalization management of acute exacerbations, emergency department management of acute exacerbations and all-cause mortality. Using BZDs or non-BZDs is safe in terms of COPD exacerbation. However, BZD, non-BZD, and mix users showed increased COPD-related respiratory events compared to nonusers.

scholarly journals Carcino Embryonic Antigen, Cardiac Troponin I and Tumor Necrosis Factor-Alpha Levels in Male Cigarette Smokers in Nnewi Metropolis

2019 ◽  
Vol 5 (2) ◽  
pp. 88-93
Author(s):  
PO Manafa ◽  
◽  
KL Ekebor ◽  
GO Chukwuma ◽  
OM Chukwuma ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Control Group ◽  
Chronic Obstructive ◽  
Necrosis Factor Alpha ◽  
Chronic Obstructive Pulmonary Diseases ◽  
Tnf Α ◽  
Factor Alpha ◽  
Average Serum

Cigarette smoking is known to be associated with the risk of developing certain types of cancers, cardiovascular diseases and chronic obstructive pulmonary diseases. This study was aimed at evaluating the risks of certain types of cancers, cardiovascular diseases and chronic obstructive pulmonary diseases in smokers. A total of 90 subjects were recruited for this study. This comprised 60 male smokers and 30 male non-smokers within the age range of 18 and 65. The levels of carcinoembryonic antigen (CEA), cardiac troponin I (cTnI) and tumor necrosis factor-alpha (TNF-α) were determined using Enzyme-linked Immunosorbent Assay (ELISA) technique. Smokers had significantly higher levels of CEA compared with non smokers P<0.05). However, the average serum level of TNF-α was significantly decreased in the test compared with the control group (P < 0.05). No statistically significant difference was observed in the average serum level of cardiac troponin I in the test subjects compared with that of the control group (P>0.05). However, a strong correlation existed between duration of smoking and the mean levels of CEA (r = 0.296) and cTnI I (r = 0.170) while a negative correlation was observed between the duration of smoking and the mean levels of TNF-α (r = -0.073). The highest serum CEA and cTnI levels were obtained in moderate smokers and the highest serum TNF-α level was observed in heavy smokers. This work suggests that smokers have increased levels of CEA and may regularly face the risk of certain types of cancers.

scholarly journals Comparison of Immediate and Sequential Withdrawal of a Systemic Glucocorticoid in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Multicenter, Randomized, Double-Blind, Parallel-Controlled, Open-Label Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ling Zhou ◽  
Yuanyuan Fang ◽  
Wei Liu ◽  
Jianchu Zhang ◽  
Yingnan Wang ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Open Label ◽  
Double Blind ◽  
Obstructive Pulmonary Disease ◽  
Open Label Study ◽  
Label Study ◽  
Acute Exacerbations ◽  
Systemic Glucocorticoids

Patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) were treated with immediate or sequential withdrawal after 5 days of systemic glucocorticoids. The effects of the two withdrawal methods on the prognosis of patients were compared at 30, 90, 180, and 360 days after discharge. A multicenter, randomized, double-blind, parallel-controlled, open-label study was conducted in the respiratory department of tertiary hospitals in Central China. Patients met inclusion criteria for AECOPD and needed to use systemic glucocorticoids. They were randomly assigned to immediate and sequential withdrawal groups at a 1:1 ratio. The study was completed in August 2020 and is registered at the China Clinical Trials Registry (Chictr.org) (ChiCTR1800018894). According to general data and clinical characteristics, there were no statistically significant differences between the 329 patients in the immediate withdrawal group and the 310 patients in the sequential withdrawal group (P &gt; 0.05). At the 30, 90, 180, and 360-days follow-up, the acute exacerbation frequency, rehospitalization rate, mortality, and intensive care unit (ICU) treatment rate were not significantly different between the immediate withdrawal group and sequential withdrawal group (P &gt; 0.05). The modified Medical Research Council (mMRC) and COPD assessment test (CAT) scores were also not significantly different between the two groups. At the 180- and 360-day follow-up, forced expiratory volume in 1 s (FEV1%) and peak expiratory flow (PEF) were not significantly different between the two groups (P &gt; 0.05). The time from discharge to first acute exacerbation was significantly lower in the immediate withdrawal group (46.12 days) than in sequential withdrawal group (49.02 days) (P &lt; 0.05). The time of stay in the hospital for the first time after discharge was not significantly different between the two groups (P &gt; 0.05). Adverse events were not significantly different between the immediate withdrawal group and sequential withdrawal group (P &lt; 0.05). Subgroup analysis was performed according to age, degree of disease, and relevant indicators. At the 30-day follow-up, the acute exacerbation frequency of patients with advanced age, high global strategy for chronic obstructive lung disease (GOLD), and high fractional exhaled nitric oxide was significantly higher in the immediate withdrawal group than in the sequential withdrawal group (P &lt; 0.05). In addition, according to receiver operating characteristic (ROC) curve analysis, the frequency of acute exacerbations at the 30-day follow-up was significantly higher in patients with age &gt; 63.5 years or GOLD &gt; 3 in the immediate withdrawal group than in the sequential withdrawal group, suggesting that the short-term efficacy was poor.

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