scholarly journals IL-20 Cytokines Are Involved in Epithelial Lesions Associated with Virus-Induced COPD Exacerbation in Mice

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1838
Author(s):  
Mélina Le Roux ◽  
Anaïs Ollivier ◽  
Gwenola Kervoaze ◽  
Timothé Beke ◽  
Laurent Gillet ◽  
...  
Keyword(s):  
Viral Infections ◽  
Intercellular Junctions ◽  
Antiviral Response ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Interferon Stimulated Genes ◽  
Copd Exacerbations ◽  
Tissue Damages ◽  
Exacerbation Of Copd ◽  
Epithelial Lesions

(1) Background: viral infections are a frequent cause of chronic obstructive pulmonary disease (COPD) exacerbations, which are responsible for disease progression and mortality. Previous reports showed that IL-20 cytokines facilitate bacterial lung infection, but their production and their role in COPD and viral infection has not yet been investigated. (2) Methods: C57BL/6 WT and IL-20 Rb KO mice were chronically exposed to air or cigarette smoke (CS) to mimic COPD. Cytokine production, antiviral response, inflammation and tissue damages were analyzed after PVM infection. (3) Results: CS exposure was associated with an increase in viral burden and antiviral response. PVM infection in CS mice enhanced IFN-γ, inflammation and tissue damage compared to Air mice. PVM infection and CS exposure induced, in an additive manner, IL-20 cytokines expression and the deletion of IL-20 Rb subunit decreased the expression of interferon-stimulated genes and the production of IFN-λ2/3, without an impact on PVM replication. Epithelial cell damages and inflammation were also reduced in IL-20 Rb-/- mice, and this was associated with reduced lung permeability and the maintenance of intercellular junctions. (4) Conclusions: PVM infection and CS exposure additively upregulates the IL-20 pathway, leading to the promotion of epithelial damages. Our data in our model of viral exacerbation of COPD identify IL-20 cytokine as a potential therapeutic target.

INFLUENCE OF OZONE THERAPY ON THE DYNAMICS OF HUMORAL IMMUNITY INDEXESIN OBSERVATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
pp. 60-64
Author(s):  
А. М. ЖУКЕМБАЕВА ◽  
К.С. ЛАТКИНА ◽  
К. М. КАПАРОВА ◽  
А.К. КУАТ ◽  
Ж. К. АТХАН ◽  
...  
Keyword(s):  
Personal Data ◽  
Chronic Obstructive ◽  
Ozone Therapy ◽  
Immunological Parameters ◽  
Study Program ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Group I ◽  
Group Ii ◽  
Exacerbation Of Copd

Проведен анализ результатов изменений иммунологических показателей на фоне проводимого лечения обострения ХОБЛ, проведенного у 55 больных. Все больные, рассматриваемые в нашей работе, подписали письменное информированное согласие на участие в программе исследований и неразглашении личных данных. Установлено, что через 7 суток после начала лечения уровень IgM в сыворотке крови во II группе, где проводилась озонотерапия, был достоверно меньше, чем в I, что свидетельствовало о более быстрой регрессии воспалительного процесса во II группе (P< 0,05). При этом показатели HCT-индуцированного фагоцитоза, на фоне проводимой озонотерапии во II группе, были достоверно больше, чем в I, где озонотерапия не проводилась (P<0,05). То есть, резервы кислород зависимой фагоцитарной активности нейтрофилов во II группе на фоне проведения озонотерапии были более функционально активны. Особого внимания заслуживает то, что во II группе элиминация ЦИК происходила достоверно быстрее, чем в I (P< 0,05). Это свидетельствовало об эффективности применения озонотерапии при лечении обострения ХОБЛ. Таким образом, положительное влияние инфузионной озонотерапии на различные звенья воспаления при обострении ХОБЛ свидетельствуют о перспективности дальнейших исследований в этом направлении. The analysis of the results of changes in immunological parameters in the treatment of complications of COPD in 55 patients. All patients considered in our study signed a written informed consent to participate in the study program and not to disclose their personal data. Serum IgM levels in group II treated with ozone therapy 7 days after the start of treatment were significantly lower than in group I, indicating a more rapid regression of the inflammatory process in group II (P <0.05). At the same time, the incidence of HCT-induced phagocytosis in group II ozone therapy was significantly higher than in group I without ozone therapy (P <0.05). That is, in the context of ozone therapy, the reserves of oxygen-dependent phagocytic activity of neutrophils of group II were functionally active. Particular attention should be paid to the fact that the elimination of AIC in group II was faster than in group I (P <0.05). This demonstrated the effectiveness of ozone therapy in the treatment of COPD exacerbations. Thus, the positive effect of infusion ozone therapy at different stages of inflammation during the exacerbation of COPD indicates the prospects for further research in this area.

scholarly journals Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis

2017 ◽  
Vol 26 (143) ◽  
pp. 160073 ◽  
Author(s):  
Alexander G. Mathioudakis ◽  
Victoria Chatzimavridou-Grigoriadou ◽  
Alexandru Corlateanu ◽  
Jørgen Vestbo
Keyword(s):  
Bacterial Infections ◽  
Viral Infections ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Chronic Obstructive ◽  
Antibiotic Administration ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Meta Analyses

Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD.Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD. We followed Cochrane and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidance to assess risk of bias, quality of evidence and to perform meta-analyses.We included eight trials evaluating 1062 patients with AECOPD. Procalcitonin-based protocols decreased antibiotic prescription (relative risk (RR) 0.56, 95% CI 0.43–0.73) and total antibiotic exposure (mean difference (MD) −3.83, 95% CI (−4.32–−3.35)), without affecting clinical outcomes such as rate of treatment failure (RR 0.81, 0.62–1.06), length of hospitalisation (MD −0.76, −1.95–0.43), exacerbation recurrence rate (RR 0.96, 0.69–1.35) or mortality (RR 0.99, 0.58–1.69). However, the quality of the available evidence is low to moderate, because of methodological limitations and small overall study population.Procalcitonin-based protocols appear to be clinically effective; however, confirmatory trials with rigorous methodology are required.

scholarly journals Clinical efficacy of mechanical bacterial lysate in the prevention of infectious exacerbations of chronic obstructive pulmonary disease

2020 ◽  
Vol 92 (4) ◽  
pp. 57-63
Author(s):  
S. N. Avdeev ◽  
G. S. Nuralieva ◽  
V. V. Gainitdinova ◽  
G. E. Baimakanova ◽  
A. K. So ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Conventional Therapy ◽  
Control Group ◽  
Chronic Obstructive ◽  
Bacterial Lysate ◽  
Obstructive Pulmonary Disease ◽  
Basic Therapy ◽  
Copd Exacerbations ◽  
Exacerbation Of Copd

Aim. To evaluate the efficacy of mechanical bacterial lysate on the prevention of infectious exacerbations of chronic obstructive pulmonary disease in patients with frequent exacerbations. Materials and methods. The study included patients (n=60) with frequent exacerbations of COPD (groups C and D according to the GOLD classification). All COPD patients were divided into two groups by blind method. The first group (n=30) received conventional therapy for COPD plus MBL (the course included 3 cycles of 10 days therapy with 20-day intervals between them). The second group of patients (control, n=30) received conventional therapy for COPD without MBL.We evaluated the severity of symptoms, frequency of recurrence of COPD exacerbations, readmissions, need for emergency care and changes in basic therapy of COPD. Evaluations were done on 10 days, 1, 3 and 6 months from the start of the study. Results. Adding of MBL to the therapy list of COPD resulted in a significant decrease of biomarkers of systemic inflammation and sputum purulence during compared to the control group. After 6 months of observation MBL group demonstrated statistically significant improvement of respiratory function, decrease in frequency of COPD exacerbations, needs for emergency medical service, reduced changes in basic therapy and hospitalization for exacerbation of COPD. Therapy with MBL showed a high degree of safety and low incidence of adverse events. Conclusion. The results of the study indicate that MBL may be used for the prevention of severe infectious exacerbations of COPD.

scholarly journals The Christmas Season as a Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbations

2010 ◽  
Vol 17 (6) ◽  
pp. 275-281 ◽  
Author(s):  
Neil W Johnston ◽  
Andrew McIvor ◽  
Kim Lambert Reg N ◽  
Justina M Greene ◽  
Pat Hussac ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Viral Infections ◽  
Winter Season ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Daily Diaries ◽  
Copd Exacerbations ◽  
Holiday Period ◽  
Respiratory Viral Infections

BACKGROUND: Epidemics of hospitalization for chronic obstructive pulmonary disease (COPD) occur annually during the Christmas holidays, and COPD exacerbations commonly coincide with respiratory viral infections.OBJECTIVE: To compare the incidence and determinants of COPD exacerbations occurring between the Christmas holiday period and the remainder of the winter season.METHODS: Seventy-one subjects with COPD of mixed severity faxed daily symptom diaries to a computer monitoring system from December 1, 2006, to April 30, 2007. Possible exacerbations prompted a home visit for assessment, spirometry and specimen collection for virological testing.RESULTS: Study subjects submitted a total of 95.4% of possible daily symptom diary sheets by fax. Of 114 possible COPD exacerbations detected using the faxed diaries, 110 met the Anthonisen criteria for true exacerbations. A total of 47 exacerbations (mean 6.7/week) occurred during the Christmas holiday period, while 63 exacerbations (mean 4.3/week) occurred during the remainder of winter. Of the Christmas period exacerbations and of those in the balance of winter, 21 (44%) and 20 (32%), respectively, coincided with respiratory viral infections.CONCLUSIONS: The incidence of COPD exacerbations during the Christmas period was greater than during the rest of winter in 2006/2007 and peaked immediately before Christmas – in contrast to hospital presentation for COPD, which peaked during the Christmas week. No clear role of respiratory viral infections in the increased rate of exacerbations during the Christmas period was established in the present study. COPD patients were highly compliant with daily symptom reporting using faxed daily diaries, which permitted nearly complete detection of all exacerbations that occurred at incidence.

scholarly journals Acute mechanical forces cause deterioration in lung structure and function in elastase-induced emphysema

2012 ◽  
Vol 303 (7) ◽  
pp. L567-L574 ◽  
Author(s):  
M. V. Szabari ◽  
H. Parameswaran ◽  
S. Sato ◽  
Z. Hantos ◽  
E. Bartolák-Suki ◽  
...  
Keyword(s):  
Structure And Function ◽  
Forced Oscillations ◽  
Chronic Obstructive ◽  
Alveolar Wall ◽  
Mechanical Forces ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Lung Structure ◽  
Exacerbation Of Copd ◽  
And Function

The relation between the progression of chronic obstructive pulmonary disease (COPD) and exacerbations is unclear. Currently, no animal model of acute exacerbation of COPD (AECOPD) exists. The objectives of this study were to evaluate the effects of mechanical forces induced by deep inspirations (DIs) on short-term deterioration of lung structure and function to mimic AECOPD. At 2, 7, or 21 days after treatment with elastase, mice were ventilated with or without DIs (35 cmH2O airway pressure for 3 s, 2 times/min) for 1 h. Functional residual capacity (FRC) was measured with body plethysmography, and respiratory compliance, resistance, and hysteresivity were obtained via forced oscillations. From hematoxylin and eosin-stained sections, equivalent airspace diameters (D), alveolar wall thickness (Wt), number of septal ruptures (Nsr), and attachment density (Ad) around airways were determined. FRC, compliance, and hysteresivity statistically significantly increased with time, and both increased due to DIs. Interestingly, DIs also had an effect on FRC, compliance, resistance, and hysteresivity in control mice. The development of emphysema statistically significantly increased D and Wt in time, and the DIs caused subtle differences in D. At 21 days, the application of DIs changed the distribution of D, increased Wt and Nsr, and decreased Ad. These results suggest that once a critical remodeling of the parenchyma has been reached, acute mechanical forces lead to irreversible changes in structure and function, mimicking COPD exacerbations. Thus, the acute application of DIs in mice with emphysema may serve as a useful model of AECOPD.

scholarly journals Domiciliary Cough Monitoring for the Prediction of COPD Exacerbations

Lung ◽  
2021 ◽  
Vol 199 (2) ◽  
pp. 131-137
Author(s):  
Michael G. Crooks ◽  
Albertus C. den Brinker ◽  
Susannah Thackray-Nocera ◽  
Ralph van Dinther ◽  
Caroline E. Wright ◽  
...  
Keyword(s):  
Automated System ◽  
Chronic Obstructive ◽  
Service Utilisation ◽  
Alert System ◽  
Obstructive Pulmonary Disease ◽  
Prospective Longitudinal Study ◽  
Copd Exacerbations ◽  
Cough Frequency ◽  
Copd Patients ◽  
Prospective Longitudinal

Abstract Introduction Acute exacerbations of COPD (AE-COPD) are a leading cause of health service utilisation and are associated with morbidity and mortality. Identifying the prodrome of AE-COPD by monitoring symptoms and physiological parameters (telemonitoring) has proven disappointing and false alerts limit clinical utility. We report objective monitoring of cough counts around AE-COPD and the performance of a novel alert system identifying meaningful change in cough frequency. Methods This prospective longitudinal study of cough monitoring included chronic obstructive pulmonary disease (COPD) patients experienced in telemonitoring that had two or more AE-COPD in the past year. Participants underwent cough monitoring and completed a daily questionnaire for 90 days. The automated system identified deteriorating trends in cough and this was compared with alerts generated by an established telemonitoring questionnaire. Results 28 patients [median age 66 (range 46–86), mean FEV-1% predicted 36% (SD 18%)] completed the study and had a total of 58 exacerbations (43 moderate and 15 severe). Alerts based on cough monitoring were generated mean 3.4 days before 45% of AE-COPD with one false alert every 100 days. In contrast, questionnaire-based alerts occurred in the prodrome of 88% of AE-COPD with one false alert every 10 days. Conclusion An alert system based on cough frequency alone predicted 45% AE-COPD; the low false alert rate with cough monitoring suggests it is a practical and clinically relevant tool. In contrast, the utility of questionnaire-based symptom monitoring is limited by frequent false alerts.

scholarly journals Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: a meta-analysis

2015 ◽  
Vol 24 (137) ◽  
pp. 451-461 ◽  
Author(s):  
Mario Cazzola ◽  
Luigino Calzetta ◽  
Clive Page ◽  
Josè Jardim ◽  
Alexander G. Chuchalin ◽  
...  
Keyword(s):  
Relative Risk ◽  
Airway Obstruction ◽  
Chronic Bronchitis ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Regular Treatment ◽  
Copd Exacerbations ◽  
Copd Patients ◽  
High Doses

In order to clarify the possible role of N-acetylcysteine (NAC) in the treatment of patients with chronic bronchitis and chronic obstructive pulmonary disease (COPD), we have carried out a meta-analysis testing the available evidence that NAC treatment may be effective in preventing exacerbations of chronic bronchitis or COPD and evaluating whether there is a substantial difference between the responses induced by low (≤600 mg per day) and high (>600 mg per day) doses of NAC.The results of the present meta-analysis (13 studies, 4155 COPD patients, NAC n=1933; placebo or controls n=2222) showed that patients treated with NAC had significantly and consistently fewer exacerbations of chronic bronchitis or COPD (relative risk 0.75, 95% CI 0.66–0.84; p<0.01), although this protective effect was more apparent in patients without evidence of airway obstruction. However, high doses of NAC were also effective in patients suffering from COPD diagnosed using spirometric criteria (relative risk 0.75, 95% CI 0.68–0.82; p=0.04). NAC was well tolerated and the risk of adverse reactions was not dose-dependent (low doses relative risk 0.93, 95% CI 0.89–0.97; p=0.40; high doses relative risk 1.11, 95% CI 0.89–1.39; p=0.58).The strong signal that comes from this meta-analysis leads us to state that if a patient suffering from chronic bronchitis presents a documented airway obstruction, NAC should be administered at a dose of ≥1200 mg per day to prevent exacerbations, while if a patient suffers from chronic bronchitis, but is without airway obstruction, a regular treatment of 600 mg per day seems to be sufficient.

scholarly journals Periodontal Health and Chronic Obstructive Pulmonary Disease (COPD) Exacerbations: A Systematic Review

2021 ◽  
Author(s):  
Niamh Kelly ◽  
Lewis Winning ◽  
Christopher Irwin ◽  
Fionnuala Lundy ◽  
Dermot Linden ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Risk Of Bias ◽  
Chronic Obstructive ◽  
Periodontal Health ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Copd Patients

Abstract BackgroundA growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal health and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations. MethodsPubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life and hospitalisation. Studies were assessed for eligibility and quality by two assessors independently.Results Searches identified 532 records and 8 met the inclusion criteria. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores with exacerbation but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of high risk of bias.ConclusionThe data supports possible association between poor periodontal health, the frequency of exacerbations and quality of life in COPD patients. The evidence is limited by high risk of bias suggesting need for well-designed and adequately powered randomised control trials.The PROSPERO registration number CRD42020180328

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