Biomarkers of Lung Tissue Remodeling in Pulmonary Diseases: Implications for Clinical Practice and Research

Lung surgery is one of the youngest departments of surgical science. The basis for the development of methods of operative intervention in pulmonary diseases lies in the 1st possibility of preventing the danger of pneumothorax, which (danger) is currently so insignificant that some surgeons consider it even necessary to cause preliminary pneumothorax. On the other hand, the experimental data have shown the possibility of the loss of parts of the lung tissue and the conditions for the healing of its wounds.

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Matrix metalloproteinase 12 silencing: A therapeutic approach to treat pathological lung tissue remodeling?

Pulmonary Pharmacology & Therapeutics ◽

10.1016/j.pupt.2009.03.001 ◽

2009 ◽

Vol 22 (4) ◽

pp. 267-278 ◽

Cited By ~ 27

Author(s):

Nancy Garbacki ◽

Emmanuel Di Valentin ◽

Jacques Piette ◽

Didier Cataldo ◽

Céline Crahay ◽

...

Keyword(s):

Matrix Metalloproteinase ◽

Lung Tissue ◽

Therapeutic Approach ◽

Tissue Remodeling ◽

Matrix Metalloproteinase 12

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Individualized flow-controlled ventilation compared to best clinical practice pressure-controlled ventilation: a prospective randomized porcine study.

10.21203/rs.3.rs-55104/v1 ◽

2020 ◽

Author(s):

Patrick Spraider ◽

Judith Martini ◽

Julia Abram ◽

Gabriel Putzer ◽

Bernhard Glodny ◽

...

Keyword(s):

Clinical Practice ◽

Lung Tissue ◽

Current Guideline ◽

Controlled Ventilation ◽

Pressure Controlled Ventilation ◽

Tracheal Pressure ◽

Significant Difference ◽

Long Term Ventilation ◽

Pressure Controlled

Abstract Background: Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilation (FCV) and current guideline-conform pressure-controlled ventilation (PCV) in long-term ventilation.Methods: Anesthetized pigs were ventilated with either FCV or PCV over a period of ten hours with a fixed FiO2 of 0.3. FCV settings were individualized by compliance-guided positive end-expiratory pressure (PEEP) and peak pressure (Ppeak) titration. Flow was adjusted to maintain normocapnia and the inspiration to expiration ratio (I:E ratio) was set at 1:1. PCV was performed with a PEEP of 5 cm H2O and Ppeak was set to achieve a tidal volume (VT) of 7 ml/kg. The respiratory rate was adjusted to maintain normocapnia and the I:E ratio was set at 1:1.5. Repeated measurements during observation period were assessed by linear mixed-effects model.Results: In FCV (n=6) respiratory minute volume was significantly reduced (6.0 vs 12.7, MD -6.8 (-8.2 to -5.4) l/min; p<0.001) as compared to PCV (n=6). Oxygenation was improved in the FCV group (paO2 119.8 vs 96.6, MD 23.2 (9.0 to 37.5) torr; 15.97 vs 12.87, MD 3.10 (1.19 to 5.00) kPa; p=0.010) and CO2 removal was more efficient (paCO2 40.1 vs 44.9, MD -4.7 (-7.4 to -2.0) torr; 5.35 vs 5.98, MD -0.63 (-0.99 to -0.27) kPa; p=0.006). Ppeak and driving pressure were comparable in both groups, whereas PEEP was significantly lower in FCV (p=0.002). Computed tomography revealed a significant reduction in non-aerated lung tissue in individualized FCV (p=0.026) and no significant difference in overdistended lung tissue, although a significantly higher VT was applied (8.2 vs 7.6, MD 0.7 (0.2 to 1.2) ml/kg; p=0.025).Conclusion: Our long-term ventilation study demonstrates the applicability of a compliance-guided individualization of FCV settings, which resulted in significantly improved gas exchange and lung tissue aeration without signs of overinflation as compared to best clinical practice PCV.

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Copeptin and Stress

Endocrines ◽

10.3390/endocrines2040035 ◽

2021 ◽

Vol 2 (4) ◽

pp. 384-404

Author(s):

Marianna Martino ◽

Giorgio Arnaldi

Keyword(s):

Clinical Practice ◽

Disease Severity ◽

Prognostic Biomarker ◽

Plasma Osmolality ◽

Pulmonary Diseases ◽

Acute Conditions ◽

Molecular Stability ◽

Reliable Marker

Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response to osmotic and hemodynamic stimuli in clinical practice. Moreover, evidence highlighting the prognostic potential of copeptin in several acute diseases, where the activation of the AVP system is primarily linked to stress, as well as in psychologically stressful conditions, has progressively emerged. Furthermore, organic stressors induce a rise in copeptin levels which, although non-specific, is unrelated to plasma osmolality but proportional to their magnitude: suggesting disease severity, copeptin proved to be a reliable prognostic biomarker in acute conditions, such as sepsis, early post-surgical period, cardiovascular, cerebrovascular or pulmonary diseases, and even in critical settings. Evidence on this topic will be briefly discussed in this article.

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DIFFICULTIES IN DIFFERENTIATED DIAGNOSIS OF LUNG CANCER AND INFLAMMATORY CHANGES IN LUNG TISSUE

Siberian Journal of Oncology ◽

10.21294/1814-4861-2018-17-5-119-124 ◽

2018 ◽

Vol 17 (5) ◽

pp. 119-124

Author(s):

Z. V. Grigorievskaya ◽

V. L. Utkina ◽

V. А. Byakhova ◽

I. N. Petukhova ◽

N. S. Bagirova ◽

...

Keyword(s):

Lung Cancer ◽

Differential Diagnosis ◽

Lung Tissue ◽

Lung Diseases ◽

Clinical Case ◽

Optimal Treatment ◽

Pulmonary Diseases ◽

Benign Tumors ◽

Diagnosis Of Lung Cancer ◽

Inflammatory Changes

The differential diagnosis of pulmonary diseases is extremely difficult and requires high qualifications of the radiologist and clinician. The differential diagnosis is used to distinguish different lung diseases: nonspecific inflammatory lung diseases (empyema, abscess, pneumonia), tuberculosis, sarcoidosis, benign tumors, lung cancer, lymphogranulomatosis, metastatic changes, and inflammatory changes in lung tissue. We present a clinical case, in which the differential diagnosis between tumor and inflammatory changes in lung tissue allowed the choice of optimal treatment tactics.

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Respiratory mechanics and lung tissue remodeling in a hepatopulmonary syndrome rat model

Respiratory Physiology & Neurobiology ◽

10.1016/j.resp.2011.10.001 ◽

2011 ◽

Vol 179 (2-3) ◽

pp. 326-333 ◽

Cited By ~ 5

Author(s):

César Augusto Melo-Silva ◽

Eduardo Gaio ◽

José E. Trevizoli ◽

Caio S. Souza ◽

Alessandra S. Gonçalves ◽

...

Keyword(s):

Lung Tissue ◽

Rat Model ◽

Respiratory Mechanics ◽

Tissue Remodeling ◽

Hepatopulmonary Syndrome

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Protease Inhibitors Extracted fromCaesalpinia echinataLam. Affect Kinin Release during Lung Inflammation

Pulmonary Medicine ◽

10.1155/2016/9425807 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Ilana Cruz-Silva ◽

Viviane Abreu Nunes ◽

Andrezza Justino Gozzo ◽

Priscila Praxedes-Garcia ◽

Aparecida Sadae Tanaka ◽

...

Keyword(s):

Protease Inhibitors ◽

Lung Tissue ◽

Neutrophil Elastase ◽

Lung Inflammation ◽

Lavage Fluid ◽

Negative Control ◽

Cathepsin G ◽

Pulmonary Diseases ◽

Elastase Inhibitor

Inflammation is an essential process in many pulmonary diseases in which kinins are generated by protease action on kininogen, a phenomenon that is blocked by protease inhibitors. We evaluated kinin release in anin vivolung inflammation model in rats, in the presence or absence of CeKI (C. echinatakallikrein inhibitor), a plasma kallikrein, cathepsin G, and proteinase-3 inhibitor, and rCeEI (recombinantC. echinataelastase inhibitor), which inhibits these proteases and also neutrophil elastase. Wistar rats were intravenously treated with buffer (negative control) or inhibitors and, subsequently, lipopolysaccharide was injected into their lungs. Blood, bronchoalveolar lavage fluid (BALF), and lung tissue were collected. In plasma, kinin release was higher in the LPS-treated animals in comparison to CeKI or rCeEI groups. rCeEI-treated animals presented less kinin than CeKI-treated group. Our data suggest that kinins play a pivotal role in lung inflammation and may be generated by different enzymes; however, neutrophil elastase seems to be the most important in the lung tissue context. These results open perspectives for a better understanding of biological process where neutrophil enzymes participate and indicate these plant inhibitors and their recombinant correlates for therapeutic trials involving pulmonary diseases.

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Individualized flow-controlled ventilation compared to best clinical practice pressure-controlled ventilation: a prospective randomized porcine study

Critical Care ◽

10.1186/s13054-020-03325-3 ◽

2020 ◽

Vol 24 (1) ◽

Author(s):

Patrick Spraider ◽

Judith Martini ◽

Julia Abram ◽

Gabriel Putzer ◽

Bernhard Glodny ◽

...

Keyword(s):

Clinical Practice ◽

Lung Tissue ◽

Current Guideline ◽

Controlled Ventilation ◽

Pressure Controlled Ventilation ◽

Tracheal Pressure ◽

Significant Difference ◽

Long Term Ventilation ◽

Pressure Controlled

Abstract Background Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilation (FCV) and current guideline-conform pressure-controlled ventilation (PCV) in long-term ventilation. Methods Anesthetized pigs were ventilated with either FCV or PCV over a period of 10 h with a fixed FiO2 of 0.3. FCV settings were individualized by compliance-guided positive end-expiratory pressure (PEEP) and peak pressure (Ppeak) titration. Flow was adjusted to maintain normocapnia and the inspiration to expiration ratio (I:E ratio) was set at 1:1. PCV was performed with a PEEP of 5 cm H2O and Ppeak was set to achieve a tidal volume (VT) of 7 ml/kg. The respiratory rate was adjusted to maintain normocapnia and the I:E ratio was set at 1:1.5. Repeated measurements during observation period were assessed by linear mixed-effects model. Results In FCV (n = 6), respiratory minute volume was significantly reduced (6.0 vs 12.7, MD − 6.8 (− 8.2 to − 5.4) l/min; p < 0.001) as compared to PCV (n = 6). Oxygenation was improved in the FCV group (paO2 119.8 vs 96.6, MD 23.2 (9.0 to 37.5) Torr; 15.97 vs 12.87, MD 3.10 (1.19 to 5.00) kPa; p = 0.010) and CO2 removal was more efficient (paCO2 40.1 vs 44.9, MD − 4.7 (− 7.4 to − 2.0) Torr; 5.35 vs 5.98, MD − 0.63 (− 0.99 to − 0.27) kPa; p = 0.006). Ppeak and driving pressure were comparable in both groups, whereas PEEP was significantly lower in FCV (p = 0.002). Computed tomography revealed a significant reduction in non-aerated lung tissue in individualized FCV (p = 0.026) and no significant difference in overdistended lung tissue, although a significantly higher VT was applied (8.2 vs 7.6, MD 0.7 (0.2 to 1.2) ml/kg; p = 0.025). Conclusion Our long-term ventilation study demonstrates the applicability of a compliance-guided individualization of FCV settings, which resulted in significantly improved gas exchange and lung tissue aeration without signs of overinflation as compared to best clinical practice PCV.

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