scholarly journals Serum NGAL is elevated in patients with asthma and persistent airflow obstruction

2020 ◽  
Author(s):  
Yuta Kono ◽  
Junichiro Kawagoe ◽  
Yuki Togashi ◽  
Kazutoshi Toriyama ◽  
Chika Yajima ◽  
...  
Keyword(s):  
Vital Capacity ◽  
Airway Remodeling ◽  
Pulmonary Function Tests ◽  
Airflow Obstruction ◽  
Chronic Obstructive ◽  
Blood Collection ◽  
Clinical Parameters ◽  
Lipocalin 2 ◽  
Ngal Level ◽  
Neutrophilic Inflammation

Abstract Background: Neutrophilic airway inflammation is one of the features of severe asthma. Neutrophil gelatinase-associated lipocalin (NGAL), or lipocalin-2, is a glycoprotein associated with neutrophilic inflammation and can be detected in blood. Recently, blood NGAL levels have been reported to be elevated in chronic obstructive pulmonary disease. However, the clinical significance of serum NGAL levels in patients with asthma has not been elucidated. The aim of this study was to explore the association between serum NGAL level and clinical parameters in patients with asthma.Methods: Sixty-one non-smoking people with stable asthma were enrolled in this study. All patients underwent blood collection and pulmonary function tests. The associations between serum NGAL levels and clinical parameters were analyzed retrospectively. Results: Serum NGAL levels in patients with asthma and obstructive ventilatory disorder were higher than those in patients with asthma without obstructive ventilatory disorder (76.4 ± 51.4 ng/mL vs 39.3 ± 27.4 ng/mL, p=0.0019). Serum NGAL levels were correlated with forced expired flow at 50% of vital capacity %predicted and forced expired flow at 25% of vital capacity %predicted (r=-0.3373, p=0.0089 and r=-0.2900, p=0.0234, respectively). Results of a multiple regression analysis demonstrated that serum NGAL level was independently associated with obstructive ventilatory disorder.Conclusion: Serum NGAL levels were elevated in patients with asthma and obstructive ventilatory disorder. NGAL may be involved in airway remodeling possibly mediated by neutrophilic inflammation in asthma.

scholarly journals Mechanisms of Orthopnoea in Patients with Advanced COPD

2020 ◽  
pp. 2000754
Author(s):  
Amany F. Elbehairy ◽  
Azmy Faisal ◽  
Hannah McIsaac ◽  
Nicolle J. Domnik ◽  
Kathryn M. Milne ◽  
...  
Keyword(s):  
Supine Position ◽  
Minute Ventilation ◽  
Pulmonary Function Tests ◽  
Work Of Breathing ◽  
Airflow Obstruction ◽  
Lung Compliance ◽  
Chronic Obstructive ◽  
Inspiratory Muscles ◽  
Elastic Loading ◽  
Dynamic Lung Compliance

Many patients with severe chronic obstructive pulmonary disease (COPD) report unpleasant respiratory sensation at rest, further amplified by adoption of supine position (orthopnoea). The mechanisms of this acute symptomatic deterioration are poorly understood.16 patients with advanced COPD and history of orthopnoea and 16 age- and sex-matched healthy controls (CTRL) underwent pulmonary function tests and detailed sensory-mechanical measurements including inspiratory neural drive (IND, diaphragm electromyography), oesophageal and gastric pressures in sitting and supine positions.Patients had severe airflow obstruction (FEV1: 40±18%predicted) and lung hyperinflation. Regardless of the position, patients had lower inspiratory capacity (IC) and higher IND for a given tidal volume (i.e. greater neuromechanical dissociation (NMD)), higher intensity of breathing discomfort, minute ventilation (⩒E) and breathing frequency (Fb) compared with CTRL (all p<0.05). In supine position in CTRL (versus sitting erect): IC increased (by 0.48L) with a small drop in ⩒E mainly due to reduced Fb (all p<0.05). By contrast, patients’ IC remained unaltered, but dynamic lung compliance decreased (p<0.05) in the supine position. Breathing discomfort, inspiratory work of breathing, inspiratory effort, IND, NMD and neuro-ventilatory uncoupling all increased in COPD in the supine position (p<0.05), but not in CTRL. Orthopnoea was associated with acute changes in IND (r=0.65, p=0.01), neuro-ventilatory uncoupling (r=0.76, p=0.001) and NMD (r=0.73, p=0.002).In COPD, onset of orthopnoea coincided with an abrupt increase in elastic loading of the inspiratory muscles in recumbency in association with increased IND and greater neuromechanical dissociation of the respiratory system.

scholarly journals Clinical, Physiological and Radiological Features in Asthma with Incomplete Reversibility of Airflow Obstruction Compared with Those of COPD

1998 ◽  
Vol 5 (4) ◽  
pp. 270-277 ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Hélène Turcotte ◽  
Catherine Hudon ◽  
Guy Carrier ◽  
François Maltais
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Airflow Obstruction ◽  
Smoking History ◽  
Arterial Oxygen ◽  
Wall Thickening ◽  
Chronic Obstructive ◽  
Outer Diameter ◽  
Exercise Tests ◽  
Copd Patients

OBJECTIVES: To compare clinical features, pulmonary function and high-resolution computed chest tomography (HRCT) findings of asthmatic patients with a component of incomplete reversibility of airflow obstruction (AIRAO) with those of patients with smoking-induced chronic obstructive pulmonary disease (COPD).METHODS: Thirteen patients with COPD (six males and seven females, mean age 59 years, mean smoking 50.5 pack-years) and 14 patients with AIRAO (six males and eight females, mean age 52 years) despite optimal treatment, with no significant smoking history (mean 1.5 pack-years) and no significant environmental exposure or any other respiratory disease, were studied. Patients had respiratory questionnaires, pulmonary function tests, allergy skin-prick tests and an HRCT to evaluate possible parenchymal or bronchial abnormalities. Eight patients in each group also had exercise tests. All patients were stable at the time of the study.RESULTS: As expected, atopy was more prevalent in AIRAO (n=13) than in COPD (n=1) patients. Mean forced expiratory volume in 1 s (FEV1) and forced vital capacity (percentage of predicted value) were 39% and 61%, respectively, in COPD patients and 49% and 71%, respectively, in AIRAO patients; FEV1improved by 18% in COPD patients and and by 22% in AIRAO patients after use of inhaled salbutamol. Mean functional residual capacity was greater in COPD patients than in AIRAO patients (178% versus 144% of the predicted value), while the mean carbon monoxide diffusing capacity of the lungs (DLCO) was lower in COPD patients than in AIRAO patients (62% versus 89% of the predicted value). Exercise tolerance was similar in both groups, as were postexercise changes in arterial oxygen pressure (PaO2). Emphysematous changes were observed in COPD patients and AIRAO patients who had evaluable HRCTs (10 versus two patients, although very mild in asthma), bronchial dilations (zero versus six patients), bronchial wall thickening (two versus eight patients) and an acinar pattern (one versus five patients). Mean thickness of the large airway wall to outer diameter (intermediary bronchus) ratio was 0.176 in COPD and 0.183 in AIRAO (P>0.05).CONCLUSIONS: Asthma may lead to physiological features similar to COPD but may be distinguished by demonstrating a preserved DLCO and a higher ratio of airway to parenchymal abnormalities on HRCT scan.

scholarly journals Low-dose cadmium exposure induces peribronchiolar fibrosis through site-specific phosphorylation of vimentin

2017 ◽  
Vol 313 (1) ◽  
pp. L80-L91 ◽  
Author(s):  
Fu Jun Li ◽  
Ranu Surolia ◽  
Huashi Li ◽  
Zheng Wang ◽  
Gang Liu ◽  
...  
Keyword(s):  
Low Dose ◽  
Airway Remodeling ◽  
Smooth Muscle Actin ◽  
Airflow Obstruction ◽  
Chronic Obstructive Lung Disease ◽  
Lung Fibroblasts ◽  
Chronic Obstructive ◽  
Collagen Secretion ◽  
Cd Exposure ◽  
Deficient Mice

Exposure to cadmium (Cd) has been associated with development of chronic obstructive lung disease (COPD). The mechanisms and signaling pathways whereby Cd causes pathological peribronchiolar fibrosis, airway remodeling, and subsequent airflow obstruction remain unclear. We aimed to evaluate whether low-dose Cd exposure induces vimentin phosphorylation and Yes-associated protein 1 (YAP1) activation leading to peribronchiolar fibrosis and subsequent airway remodeling. Our data demonstrate that Cd induces myofibroblast differentiation and extracellular matrix (ECM) deposition around small (<2 mm in diameter) airways. Upon Cd exposure, α-smooth muscle actin (α-SMA) expression and the production of ECM proteins, including fibronectin and collagen-1, are markedly induced in primary human lung fibroblasts. Cd induces Smad2/3 activation and the translocation of both Smad2/3 and Yes-associated protein 1 (YAP1) into the nucleus. In parallel, Cd induces AKT and cdc2 phosphorylation and downstream vimentin phosphorylation at Ser39 and Ser55, respectively. AKT and cdc2 inhibitors block Cd-induced vimentin fragmentation and secretion in association with inhibition of α-SMA expression, ECM deposition, and collagen secretion. Furthermore, vimentin silencing abrogates Cd-induced α-SMA expression and decreases ECM production. Vimentin-deficient mice are protected from Cd-induced peribronchiolar fibrosis and remodeling. These findings identify two specific sites on vimentin that are phosphorylated by Cd and highlight the functional significance of vimentin phosphorylation in YAP1/Smad3 signaling that mediates Cd-induced peribronchiolar fibrosis and airway remodeling.

Features of the immunological profile in various phenotypes of occupational bronchial asthma

2021 ◽  
pp. 19-26
Author(s):  
S.A. Babanov ◽  
A. G. Baykova
Keyword(s):  
Forced Vital Capacity ◽  
Occupational Asthma ◽  
Vital Capacity ◽  
Acute Phase Proteins ◽  
Solid Phase ◽  
Pulmonary Function Tests ◽  
Control Group ◽  
Chronic Obstructive ◽  
Fibrinogen Concentration ◽  
Expiratory Flow

Introduction. Occupational asthma is a complex and heterogeneous disease. Development of personalized treatment and prevention tactics becomes feasible due to phenotyping, which means identifying of markers to combine cases of occupational asthma with similar manifestations (clinical, instrumental, laboratory) and prognosis to phenotypes. The study aims to determination and comparative analysis of spirographic and immunological parameters for different phenotypes of occupational asthma. Materials and methods. In this study, we included 170 patients with different phenotypes of occupational asthma and 50 participants in control group. The spirographic examination was performed using computer spirograph with determination of the following parameters: forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), Tiffeneau-Pinelli index (FEV1/FVC), peak expiratory flow (PEF), maximal expiratory flow at 75 %, 50 %, 25 % of the forced vital capacity (MEF75 %VC, MEF50 %VC, MEF25 %VC). Quantification of the immunoglobulins IgA, IgM, and IgG in human serum was conducted by Mancini method; levels of IgE, C-reactive protein and fibronectin were determined using a solid-phase enzyme immunoassay. Fibrinogen concentration in plasma was measured by an automatic coagulometer. Haptoglobin concentration in serum was determined by spectrophotometry. Results. According to spirometry and laboratory results obtained, there is a strong evidence, that the phenotype «occupational asthma — occupational chronic obstructive pulmonary disease» has the lowest values in pulmonary function tests and the most significant changes in immunoglobulins, fibronectin and acute phase proteins levels among other studied phenotypes of occupational asthma.

Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters

2017 ◽  
Vol 3 (2) ◽  
pp. 50-54
Author(s):  
Mamatha B Patil ◽  
M Abhishek ◽  
BK Pradeep
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Airflow Obstruction ◽  
High Sensitivity ◽  
Chronic Obstructive ◽  
Clinical Parameters ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Hs Crp

ABSTRACT Introduction Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. By 2020, the World Health Organization predicts that COPD will become the third leading cause of death and the fifth leading cause of disability worldwide. The COPD is a complex disease characterized by slowly progressive and largely irreversible airflow obstruction due to chronic bronchitis and emphysema and associated with systemic inflammation. Objective This study aimed to correlate the plasma levels of high-sensitivity C-reactive protein (hs-CRP) with severity of COPD and pulmonary function tests [PFTs; according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages] and find out the relation between hs-CRP levels and clinical parameters of age, number of pack years, and body mass index (BMI) of the patient. Materials and methods A cross-sectional study of 102 male patients with clinically and spirometrically diagnosed cases of COPD was performed. Data on patient's demographic characteristics, pack years, BMI, PFTs, and hs-CRP were analyzed. Results A total of 76 of the patients had moderate airflow obstruction (GOLD stages II and III), mild airflow obstruction was present in 14 patients (GOLD stage I), and 12 patients had severe airflow obstruction (GOLD stage IV). The hs-CRP was normal in 6 patients, while it was raised in 96 patients. The value of hs-CRP was correlated with age, pack years, BMI, and GOLD stages. There was a significant negative correlation between hs-CRP and BMI and a significant positive correlation between hs-CRP and age, pack years, and GOLD stages. Conclusion A raised level of CRP in COPD indicates reduced lung function; it plays an important role in systemic inflammation. This study supports the role of hs-CRP as a simple, cost-effective biochemical marker in the staging and determining the severity of COPD other than spirometry. How to cite this article Patil MB, Abhishek M, Pradeep BK. Role of High-sensitivity C-reactive Protein as a Predictor of Severity of Chronic Obstructive Pulmonary Disease in Correlation with Clinical Parameters. J Med Sci 2017;3(2):50-54.

scholarly journals Malnutrition, Sarcopenia, and Malnutrition-Sarcopenia Syndrome in Older Adults with COPD

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 44
Author(s):  
Aleksandra Kaluźniak-Szymanowska ◽  
Roma Krzymińska-Siemaszko ◽  
Ewa Deskur-Śmielecka ◽  
Marta Lewandowicz ◽  
Beata Kaczmarek ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Muscle Mass ◽  
Pulmonary Function Tests ◽  
Airflow Obstruction ◽  
Rehabilitation Program ◽  
Elderly Subjects ◽  
Chronic Obstructive ◽  
World Population ◽  
Cross Sectional ◽  
European Working

Purpose: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world population. In addition to airflow obstruction, COPD is associated with multiple systemic manifestations, including impaired nutritional status or malnutrition and changes in body composition (low muscle mass, LMM). Poor nutritional status and sarcopenia in subjects with COPD leads to a worse prognosis and increases health-related costs. Data from previous studies indicate that 30–60% of subjects with COPD are malnourished, 20–40% have low muscle mass, and 15–21.6% have sarcopenia. This study aimed to assess the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in elderly subjects with COPD and investigate the relationship between COPD severity and these conditions.Patients and methods: A cross-sectional study involving 124 patients with stable COPD, aged ≥60, participating in a stationary pulmonary rehabilitation program. Nutritional status was assessed following the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia with the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The results of pulmonary function tests and exercise capacity were obtained from the hospital database. Results: 22.6% of participants had malnutrition according to the GLIM criteria. Subjects with malnutrition had lower gait speed (p = 0.0112) and worse results of the Six Minute Walk Test. Sixteen participants (12.9%) had sarcopenia; 12 subjects with sarcopenia had concomitant malnutrition. The prevalence of severe and very severe obstruction (GOLD3/GOLD4) was 91.7%. It was significantly higher in patients with malnutrition-sarcopenia syndrome. Conclusions: Malnutrition was found in nearly one out of four subjects with COPD, while sarcopenia was one out of seven patients. About 10% of our study sample had malnutrition-sarcopenia syndrome. The prevalence of severe and very severe obstruction was significantly higher in patients with malnutrition-sarcopenia syndrome.

scholarly journals A Comparison of Spirometric Parameters and Serum Malondialdehyde Level in Actively Smoking Chronic Obstructive Pulmonary Disease Patients and Non- Smoking Apparently Normals- A Crosssectional Comparative Study

2021 ◽  
pp. 103-110
Author(s):  
. Ranjana ◽  
Mishra Indira Sushil ◽  
Rajiv Ranjan Prasad
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Function ◽  
Pulmonary Disease ◽  
Flow Rate ◽  
Vital Capacity ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Introduction: The antioxidants requirement depend on one’s exposure to endogenous and exogenous reactive oxygen species.Cigarette smoking leads to increased exposure to reactive oxygen species,hence they require more antioxidant nutrients In this study, we aimed to study the serum levels of malondialdehyde (MDA) as a marker of oxidative stress and pulmonary function tests (PFT) and to study if there is any correlation between PFTand MDA levels in, smokers,chronic obstructive pulmonary disease (COPD) patients. Aim: To compare the pulmonary function tests (PFT) and serum malondialdehyde (MDA) level in smokers, chronic obstructive pulmonary disease (COPD) patients with non-smoker controls. Methods and Materials: N=30, 35-50 years age group smokers, COPD patients were enrolled as cases.N=30 age and sex matched were enrolled as control group. Serum MDA and PFT parameters like forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, Peak expiratory flow rate (PEFR) were measured. Result: PFT parameters like forced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1/FVC ratio, peak expiratory flow rate(PEFR) were decreased and found statistically significant in smokers, COPD group.MDA level were increase and found statistically highly significant in smokers, COPD group. Conclusion: MDA is negatively correlated with FEV1% predicted, FEV1/FVC % predicted ratio and FVC in smokers, COPD patients

Evidence-Based Medicine, Treatment Guidelines, and Literature Search Web Resources

2014 ◽  
Vol 19 (4) ◽  
pp. 6-6
Author(s):  
Christopher R. Brigham
Keyword(s):  
Treatment Guidelines ◽  
Pulmonary Function Tests ◽  
Airflow Obstruction ◽  
Interstitial Lung Diseases ◽  
Exercise Stress ◽  
Chronic Obstructive ◽  
Shortness Of Breath ◽  
Obstructive Pulmonary Disease ◽  
Static Tests ◽  
Sixth Edition

Abstract Cardiopulmonary exercise stress testing (CPET) provides objective data to assess cardiac and pulmonary impairment. This article discusses changes in the CPET section of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). The explanation of CPET in the AMA Guides, Sixth Edition, adds a single word, “static,” that significantly effects how this test should be conducted. Routine pulmonary function tests (PFTs) provide information about a person's ability to breathe, eg chronic obstructive pulmonary disease or asthma can stratify the severity of these diseases; they do not measure the ability of the lungs or heart to provide adequate oxygenation to metabolizing tissues. Static tests of lung function are the norm when diagnosing asbestosis, and the typical abnormalities seen are restriction, some airflow obstruction, and a diminished diffusing capacity. These abnormalities correlate linearly with the degree of abnormality found radiographically. In individuals with unexplained shortness of breath with exertion or fatigue that is not easily explained in the medical records, a CPET will allow secure diagnosis of causation. Thus CPET is a powerful tool to explain shortness of breath with exertion or fatigue, and CPET has a role in the impairment rating process of all individuals with interstitial lung diseases and in selected individuals with unexplained symptoms.

scholarly journals Free DNA in Cystic Fibrosis Airway Fluids Correlates with Airflow Obstruction

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Veronica Marcos ◽  
Zhe Zhou-Suckow ◽  
Ali Önder Yildirim ◽  
Alexander Bohla ◽  
Andreas Hector ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Disease ◽  
Airflow Obstruction ◽  
Chronic Obstructive Lung Disease ◽  
Fungal Colonization ◽  
Chronic Obstructive ◽  
Lung Function Decline ◽  
Neutrophilic Inflammation ◽  
Free Dna ◽  
Cystic Fibrosis Airway

Chronic obstructive lung disease determines morbidity and mortality of patients with cystic fibrosis (CF). CF airways are characterized by a nonresolving neutrophilic inflammation. After pathogen contact or prolonged activation, neutrophils release DNA fibres decorated with antimicrobial proteins, forming neutrophil extracellular traps (NETs). NETs have been described to act in a beneficial way for innate host defense by bactericidal, fungicidal, and virucidal actions. On the other hand, excessive NET formation has been linked to the pathogenesis of autoinflammatory and autoimmune disease conditions. We quantified free DNA structures characteristic of NETs in airway fluids of CF patients and a mouse model with CF-like lung disease. Free DNA levels correlated with airflow obstruction, fungal colonization, and CXC chemokine levels in CF patients and CF-like mice. When viewed in combination, our results demonstrate that neutrophilic inflammation in CF airways is associated with abundant free DNA characteristic for NETosis, and suggest that free DNA may be implicated in lung function decline in patients with CF.

scholarly journals Comparative efficacy of leukotriene modifier and inhaled corticosteroids in the complex treatment of steroid-naive patients with bronchial asthma combined with chronic obstructive pulmonary disease with neutrophilic type of inflammation

2021 ◽  
Vol 23 (4) ◽  
pp. 516-523
Author(s):  
Yu. I. Feshchenko ◽  
L. O. Yashyna ◽  
V. I. Ihnatieva ◽  
M. O. Polianska ◽  
S. H. Opimakh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inhaled Corticosteroids ◽  
Clinical Symptoms ◽  
Pulmonary Function Tests ◽  
Life Assessment ◽  
Chronic Obstructive ◽  
Neutrophilic Inflammation ◽  
Group I ◽  
Group Ii

The aim: to compare the efficacy and tolerability of the leukotriene modifier and inhaled corticosteroids in combination with long-acting β2-agonist formoterol in steroid-naive patients with asthma combined with COPD with neutrophilic inflammation. Materials and methods. After obtaining the written consent, 30 patients with asthma combined with COPD and a number of blood neutrophils >4000/μl were randomized (1:1): group I – received a fixed combination of budesonide/formoterol 160/4.5 μg/1 inhalation twice daily as a basic therapy; group II – montelukast 1 tab. (10 mg) once daily and inhalation of formoterol 12 mcg/dose twice daily. The duration of therapy was 12 weeks. General clinical methods, asthma control questionnaires, COPD questionnaire, physical tolerance evaluation (6-minute walk test), pulmonary function tests, quality of life assessment were performed to all the patients before and after the treatment course studied. Results. The combination of budesonide/formoterol improved clinical symptoms – significantly (P < 0.05) increased the total ACT score, decreased the average ACQ score, shortness of breath (mMRC scale), COPD symptoms. PFT indices were improved significantly (P < 0.05), bronchoobstruction at the level of large, medium and small bronchi was significantly reduced. Physical tolerance was significantly improved. There were no statistically significant dynamics of the studied indices in patient group II. The patients of both groups showed a tendency to improve their quality of life. In patients of I group, there was a significant decrease in activity limitations and the total SGRQ score. Conclusions. The combination of inhaled corticosteroid/formoterol has proven to be more effective than the leukotriene modifier or formoterol in steroid-naive patients with asthma combined with COPD and neutrophilic inflammation.

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