Chronic bronchopulmonary diseases in children with bronchial obstruction syndrome

Introduction. The results of long-term observations of children with chronic bronchopulmonary diseases occurring with bronchoobstructive syndrome and poorly responding to standard therapy are presented. To optimize treatment, it is necessary to accurately determine the nosological variant of the pathology, to identify the main causes of the formation of dysontogenetic disorders.Aim. To study the main nosological options and clinical and diagnostic criteria for chronic obstructive pulmonary diseases in children to justify an individual approach to treatment and follow-up.Materials and methods. 148 children with chronic bronchopulmonary diseases occurring with bronchial obstruction syndrome (excluding bronchial asthma and cystic fibrosis) were exаmined according to the differential diagnostic algorithm developed by us, including anamnestic, clinical, X-ray, functional and morphological methods.Results. The main group of 148 cases consisted of 73 children (49,3%) with lung malformations with insufficiency of the muscular-elastic and cartilaginous framework of the trachea and bronchi, local malformations, with impaired lung growth and development, causing bronchial obstruction. Acquired variants of chronic obstructive pulmonary diseases in children were noted by us in the form of chronic obstructive bronchitis (25.2%) and in the outcome of bronchopulmonary dysplasia (11.5%), chronic obliterating bronchiolitis (6.1%), gastroesophageal reflux disease (0.7%). Acquired local forms of obstruction (foreign object, scar stenosis, tumors) were noted in 4.5% of cases. Hereditary lung diseases, including primary ciliary dyskinesia, were detected in 2.7% of cases.Conclusion. Chronic obstructive pulmonary diseases are diseases of various etiology and pathogenesis that occur at an early age in children with perinatal disorders against the background of various lung malformations, bronchial dysplasia, lung tissue malformations and are the pathomorphological basis for the further formation of chronic obstructive pulmonary disease in adult patients.

Echocardiographic Monitoring of Cardiac Parameters to Predict Bronchial Dysplasia in Very Premature Infants

Echocardiography was used to measure the cardiac parameters in high-risk premature infants prone to bronchopulmonary dysplasia (BPD). These measurements were used to determine the correlation between the parameters and BPD and whether they could be used to predict the parameters associated with cardiac health of BPD in very premature infants at a very early stage. Seventy-four very premature infants (gestational age < 32 weeks) were recruited in this retrospective, single-center, observational studies. All infants were examined using echocardiography within a week after birth, and the cardiac chamber parameters were recorded. Of these, 14 infants with BPD were reexamined at 4 weeks after birth. Statistical analysis and comparison of the data of these 14 infants indicated that 1-week after birth, the inner diameters of PA/AS/AO/LA/ROVT/LVPW/LV were significantly smaller (P < 0.05), and that of AS/AO/LA/LV were highly significantly smaller (P < 0.001) in the BPD group compared with the non-BPD group. Comparing the cardiac parameters between 1 and 4 weeks after birth in infants with BPD showed a significant difference in the diameter of PA/AS/AO/ROVT/IVS/LVPW/LV, suggesting that the ventricular cavity developed more efficiently during growth.

Immune Escape Is an Early Event in Pre-Invasive Lesions of Lung Squamous Cell Carcinoma

Bronchial dysplasia is the pre-neoplastic lesion recognized for invasive squamous cell carcinoma. The mechanisms leading to invasive squamous cell carcinoma for this lesion are not fully known. Programmed Death-Ligand 1 (PD-L1) expression by the bronchial dysplasia neoplastic epithelium might suggest a response to immunotherapy. The objective of this work is to further characterize PD-L1 and CD8 expression in bronchial dysplasia and bronchial metaplasia compared to normal bronchial epithelium. Immunohistochemical analysis of PD-L1 and CD8 staining were characterized in bronchial dysplasia of 24 patients and correlated with clinical data. We also compared PD-L1 expression in dysplasia samples to 30 normal epithelium and 20 samples with squamous bronchial metaplasia. PD-L1 was never expressed in normal epithelium and in metaplastic epithelium whereas 37.5% of patients with bronchial dysplasia were stained by PD-L1 (p < 0.001). PD-L1 expression was not related to the degree of dysplasia or a medical history of invasive squamous cell carcinoma, while CD8 expression and its localization were related to medical history of squamous cell carcinoma (p = 0.044). Our results show that PD-L1 is expressed in roughly one third of patients with bronchial dysplasia and is not expressed in normal and metaplastic epithelium. This suggests that PD-L1 is expressed in preneoplastic lesions of squamous cell carcinoma.