Presence of bronchial nodules, younger age, and heavier body weight are associated with a diagnosis of eosinophilic lung disease in dogs with cough

OBJECTIVE To describe the association between a diagnosis of eosinophilic lung disease (ELD) in dogs with signalment and bronchoscopic features and evaluate the accuracy of visualization of nodules for the diagnosis of ELD. ANIMALS 781 dogs with cough that underwent bronchoscopy between 2014 and 2016. PROCEDURES Data were extracted from the medical records of each included dog. Multivariable logistic regression was performed to investigate associations between ELD and patient characteristics. RESULTS ELD was diagnosed in 113 (14.5%) dogs. More than 3 nodular lesions of the bronchial mucosa were detected in 64 (8.2%) dogs. The odds of having ELD were greater in dogs with nodules (adjusted OR [aOR], 26.0; 95% CI, 13.0 to 52.0) and static bronchial collapse (aOR, 2.3; 95% CI, 1.1 to 4.6), and lower in dogs having focal versus diffuse inflammation (aOR, 0.05; 95% CI, 0.01 to 0.37). The odds of having ELD decreased for each 1-year increase in age (aOR, 0.86; 95% CI, 0.80 to 0.92), and increased for each 1-kg increase in weight (aOR, 1.04; 95% CI, 1.01 to 1.06). Visualization of nodules during bronchoscopy had a overall accuracy of 89.4% (95% CI, 87.0% to 91.4%), sensitivity of 41.6% (32.4% to 51.2%), and specificity of 97.5% (96.0% to 98.5%) for a diagnosis of ELD. CLINICAL RELEVANCE On the basis of high specificity and negative predictive value, lack of visualization of bronchial nodules during bronchoscopy can be used to preliminarily rule out ELD. However, visualization of bronchial nodules does not imply presence of ELD. This could be especially relevant when results of BAL cytology are available several days after the actual bronchoscopy.

Exercise-Induced Bronchoconstriction in Children

Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5–15 min after physical activity. The pathophysiology of EIB is related to the thermal and osmotic changes of the bronchial mucosa, which cause the release of mediators and the development of bronchoconstriction in the airways. EIB in children often causes an important limitation to physical activities and sports. However, by taking appropriate precautions and through adequate pharmacological control of the condition, routine exercise is extremely safe in children. This review aims to raise awareness of EIB by proposing an update, based on the latest studies, on pathological mechanisms, diagnosis, and therapeutic approaches in children.

Susceptibility of Human Airway Tissue Models Derived From Different Anatomical Sites to Bordetella pertussis and Its Virulence Factor AdenyRaylate Cyclase Toxin

To study the interaction of human pathogens with their host target structures, human tissue models based on primary cells are considered suitable. Complex tissue models of the human airways have been used as infection models for various viral and bacterial pathogens. The Gram-negative bacterium Bordetella pertussis is of relevant clinical interest since whooping cough has developed into a resurgent infectious disease. In the present study, we created three-dimensional tissue models of the human ciliated nasal and tracheo-bronchial mucosa. We compared the innate immune response of these models towards the B. pertussis virulence factor adenylate cyclase toxin (CyaA) and its enzymatically inactive but fully pore-forming toxoid CyaA-AC-. Applying molecular biological, histological, and microbiological assays, we found that 1 µg/ml CyaA elevated the intracellular cAMP level but did not disturb the epithelial barrier integrity of nasal and tracheo-bronchial airway mucosa tissue models. Interestingly, CyaA significantly increased interleukin 6, interleukin 8, and human beta defensin 2 secretion in nasal tissue models, whereas tracheo-bronchial tissue models were not significantly affected compared to the controls. Subsequently, we investigated the interaction of B. pertussis with both differentiated primary nasal and tracheo-bronchial tissue models and demonstrated bacterial adherence and invasion without observing host cell type-specific significant differences. Even though the nasal and the tracheo-bronchial mucosa appear similar from a histological perspective, they are differentially susceptible to B. pertussis CyaA in vitro. Our finding that nasal tissue models showed an increased innate immune response towards the B. pertussis virulence factor CyaA compared to tracheo-bronchial tissue models may reflect the key role of the nasal airway mucosa as the first line of defense against airborne pathogens.

Case Reports: Bronchial Mucosal Vasculature Is Also Involved in the Acute Vascular Distress Syndrome of COVID-19

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which targets the pulmonary vasculature is supposed to induce an intrapulmonary right to left shunt with an increased pulmonary blood flow. We report here what may be, to the best of our knowledge, the first videoendoscopic descriptions of an hypervascularization of the bronchial mucosa in two patients hospitalized for coronavirus disease 2019 (COVID-19) pneumonia.Cases Presentation: Two patients, 27- and 37-year-old, were addressed to our Pneumology department for suspicion of COVID-19 pneumonia. Their symptoms (fever, dry cough, and dyspnoea), associated to pulmonary ground glass opacities on thoracic CT, were highly suggestive of a COVID-19 disease despite repeated negative pharyngeal swabs RT-PCR. In both patients, bronchoscopy examination using white light was unremarkable but NBI bronchoscopy revealed a diffuse hypervascularization of the mucosa from the trachea to the sub-segmental bronchi, associated with dilated submucosal vessels. RT-PCR performed in bronchoalveolar lavage (BAL) confirmed the presence of Sars-CoV-2.Conclusions: These two case reports highlight the crucial importance of the vascular component of the viral disease. We suggest that such bronchial hypervascularization with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterizes the COVID-19 related Acute Vascular Distress Syndrome (AVDS). The presence of diffuse bronchial hypervascularization in the context of COVID-19 pandemic should prompt the search for Sars-CoV-2 in BAL samples.

Relationship between nitric oxide levels and the activity of fibrogenic cytokine TGF-β1 and their role in diagnostics of the development of irreversible morphofunctional changes in bronchi of smoking adolescents

The aim is to study the relationship between the level of exhaled nitric oxide (FeNO) and the activity of the fibrogenic cytokine TGF-β1 in blood serum and brush biopsy samples of bronchial mucosa in order to determine their role in the development of irreversible morphological and functional changes in smoking adolescents. Materials and methods. 20 adolescent smokers with chronic bronchitis (CB) (average age – 17.5 ± 0.2 years) were exa­mined. The comparison group consisted of 37 adolescent smokers without respiratory symptoms (average age – 15.9 ± 0.2 years) and 15 healthy adolescents, who never smoked (average age – 15.9 ± 0.4 years). In adolescent smokers the tobacco smoking status was assessed. To confirm active smoking, the nicotine metabolite cotinine was determined in urine. Instrumental methods included spirometry, chest X-ray, tracheobronchoscopy. The FeNO level was measured using a Niox Mino. TGF-β1 level was determined in the blood serum and brush biopsy samples of the bronchial mucosa. Results. The FeNO levels were significantly lower in adolescent smokers with CB in comparison with adolescent smokers without respiratory symptoms (6.1 ± 0.3 ppb versus 8.8 ± 0.6 ppb, P < 0.05). The relationship between the FeNO levels and indicators of the tobacco smoking status has been established in patients with CB and in asymptomatic smokers. There was a significant increase in the TGF-β1 levels in the blood serum in patients with CB compared with asymptomatic smokers (478.7 ± 57.9 pg/ml versus 231.5 ± 23.5 pg/ml, P < 0.05). In smoking adolescents a relationship between a FeNO level and an increased activity of the fibrogenic cytokine TGF-β (r = -0.63; P < 0.05) has been established. In one third of patients the TGF-β1 factor was identified in the bronchial endothelium. The presence of this factor in the bronchial endothelium is a serious prognostic criterion for the risk of developing “inadequate” pneumofibrosis, which can lead to irreversible remodeling processes in the bronchi. Conclusions. Determination of FeNO levels and TGF-β1 in the blood serum in smoking adolescents has a reliable diagnostic value for determining the risk group for the development of irreversible morphological and functional changes in the bronchi and can improve the efficiency of early diagnosis of chronic respiratory pathology.

Cytological research of exophytic tumors of the bronchi and the growth pattern of lung cancer

Background. The study of the growth of lung cancer (LC) has an important clinical significance for morphological verification, the choice of the treatment method, and the determining of prognosis. Investigation of this question allows to clarify the histogenesis of LC. The aim of our study was to compare the results of cytological studies of the material obtained during flexible bronchoscopy (FBS) and scrapings from the operated tumors of the bronchi to clarify the nature of LC growth. Design. To study the growth of tumors in the bronchi in relation to the bronchial mucosa, the cytological examination of the material obtained by FBS and scrapings from the surface of the operated bronchial tumors of 31 patients has been performed. Results. In the preoperative period, in the material of FBS, tumor cells were found only in 1/3 of patients. To obtain the optimal material from exophytic tumors of the bronchus, scrapings were carried out from the entire surface surgical material of the same patients. Cytological preparations of the obtained scrapings confirmed the presence of cancer cells in more than 1/3 of patients. In the rest of the observations, scrapings from the tumor surface contained only cells of the cylindrical epithelium. Conclusions. The cytological investigations made it possible to state that in 2/3 scrapings from surfaces of exophytic tumors of the bronchus contained only cells of the cylindrical epithelium; therefore, the tumors grow under it.

Technologies of medical rehabilitation of children with bronchial asthma

Review purpose: the presentation of modern technologies of medical rehabilitation of children with bronchial asthma. Basic provisions: Recently, the increasing significance is attached to non-drug methods of treatment of bronchial asthma owing to the high frequency of undesirable effects when using medicinal preparations. The main objectives of medical rehabilitation in bronchial asthma are normalizing respiratory function, rendering anti-inflammatory and anti-edematous effect on bronchial mucosa, normalizing the state of the central and autonomic nervous system, increasing tolerance to an exercise stress, and strengthening protective forces of an organism. Conclusion: The treatment of children with bronchial asthma with the use of non-drug technologies is applied at all stages of medical rehabilitation.

The impact of the weakly-fibrogenic bauxite dust on lungs in mine workers

Introduction. New cases of pneumoconiosis are detected annually at the bauxite mining enterprises of the Sverdlovsk Region. Differential diagnosis of bauxite pneumoconiosis with other interstitial lung diseases using only lung radiography can be difficult. The aim of the work was to clarify the nature of changes in the lungs of workers exposed to weakly fibrogenic dust of bauxite, and the relationship of changes in the lungs with working conditions in cases of difficulty in making the final diagnosis of pneumoconiosis. Material and methods. Underground miners of a working face and underground drifters with a work experience of at least ten years in conditions of exposure to bauxite dust were examined. All patients underwent a plain chest x-ray and high-resolution computed tomography (HRCT), bodyplethysmography, bronchoscopic examination with trans-bronchial biopsy, and subsequent histological examination of the biopsy. To determine the elemental composition of micro- and nanoparticles in biological tissue samples, scanning electron microscopy with X-ray spectral microanalysis was used. Results. During the histopathological examination of lung tissue biopsy materials by a bright-field method and polarized filter and using electron microscopy, the composition of dust in the lung tissue complied with the composition of industrial aerosol. It is formed during bauxite mining (aluminum, iron, and quartz compounds). High-resolution computed tomography (HRCT) and bronchoscopy can detect signs of exposure to industrial aerosol of complex composition represented by early interstitial parenchymal fibrosis and changes in bronchial mucosa. This is typical for individuals at risk of occupational respiratory diseases development without radiological features specific to pneumoconiosis. Before X-ray pattern formation, typical for pneumoconiosis, bronchitis syndrome and atrophic changes in the bronchial mucosa are developed. This happens in workers exposed to weakly-fibrogenic dust of a complex composition formed during the mining of bauxite. The changes are permanently observed long after the exposure to the dust factor has ceased.

Effect of Exposure to E-Cigarette Smoke on Lung Histology of Balb/c Male Mice (Mus musculus L.)

Background: Electric cigarette is a type of cigarette that change the liquid containing nicotine and other ingredients in the form of steam. This research aimed to identify the effect of exposure to e-cigarette smoke towards the thickness of bronchioles mucosa and the alveolar septa on male Balb'C mice (M. musculus). Methods: This research was an experimental design used 24 male divided into four groups, i.e., control dan three treatment groups. Treatment groups were given different volume of e-cigarettes liquid, i.e., 1 ml; 2 ml; and 4 ml. The exposure of e-cigarette was done in 4 weeks, respectively. Results: Electric cigarette exposure with different fluid volumes leads to an increase in the bronchioles mucosa's thickness and the alveoli septa. Increasing the volume of fluid used results in an increase in bronchioles mucosal thickness, but decreases the alveoli septa's thickness, resulting in destruction and dilatation of the alveoli. Conclusion: Exposure to e-cigarette smoke with a liquid volume of 1 ml affects the increase in the average thickness of the bronchial mucosa and alveoli septa. An increase in the average thickness of the bronchioles mucosa occurs along with increased fluid volume in exposure to e-cigarette smoke.