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The Down-Regulation of Lactoferrin Expression Induced by Cigarette Smoke can Induce Ferroptosis in COPD. 吸烟诱导乳铁蛋白表达下调可诱导COPD患者铁下垂。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-09-23 DOI: 10.1007/s00408-025-00849-9
Yuxiu Wang, Wenjing Xu, Kaiqi Ren, Jingjing Yang, Lingfeng Min

Purpose: Lactoferrin (LTF) plays a crucial role in iron homeostasis, immune response, and inflammation. In the context of chronic obstructive pulmonary disease (COPD), LTF's expression is significantly influenced by environmental factors, particularly cigarette smoke. The pathological mechanism by which cigarette smoke regulates LTF and affects iron metabolism in COPD remains unclear. This study aims to clarify the mechanism therein.

Methods: In this study, cigarette smoke extract (CSE) was used to construct mouse and cell models of chronic obstructive pulmonary disease (COPD). Transcriptomic and proteomic tests were performed on the lung tissues of the mouse model of COPD to screen or measure the Hub gene. The interaction network prediction of LTF-related proteins was carried out using the STRING database. The Beas-2B cell model with LTF overexpression and interference was constructed by lentivirus transfection, and then the cell viability, cytotoxicity, lipid reactive oxygen species (ROS), iron ion deposition, and iron-related markers of bronchial epithelial cells after CSE exposure were detected. The morphological changes of mitochondria in bronchial epithelial cells were observed by transmission electron microscopy. The expression levels of ACSL4 and GPX4 proteins in bronchial epithelial cells were detected by Western blotting.

Results: The expression of LTF is down-regulated in both lung tissue of the COPD mouse model and bronchial epithelial cells, and it plays a key role in ferroptosis of CSE-induced bronchial epithelial cells. In the LTF-interfered bronchial epithelial cells treated with CSE, ferroptosis-related markers (such as ROS and MDA) were significantly increased, GSH was significantly decreased, mitochondrial volume was reduced, cristae were decreased, the expression of ACSL4 protein was increased, while the expression of GPX4 protein was decreased. Meanwhile, overexpression of LTF can reverse the ferroptosis status of bronchial epithelial cells treated with CSE.

Conclusion: Under CSE induction, the decrease in LTF expression level will lead to the accumulation of ferrous ions in bronchial epithelial cells and induce the occurrence of ferroptosis.

目的:乳铁蛋白(LTF)在铁稳态、免疫反应和炎症中起重要作用。在慢性阻塞性肺疾病(COPD)的背景下,LTF的表达受环境因素,特别是吸烟的影响显著。吸烟调节慢性阻塞性肺疾病LTF和影响铁代谢的病理机制尚不清楚。本研究旨在阐明其中的机制。方法:本研究采用香烟烟雾提取物(CSE)构建慢性阻塞性肺疾病(COPD)小鼠和细胞模型。对COPD小鼠模型肺组织进行转录组学和蛋白质组学检测,筛选或测定Hub基因。利用STRING数据库进行ltf相关蛋白的相互作用网络预测。通过慢病毒转染构建LTF过表达和干扰的Beas-2B细胞模型,检测CSE暴露后支气管上皮细胞的细胞活力、细胞毒性、脂质活性氧(ROS)、铁离子沉积及铁相关标志物的变化。透射电镜观察支气管上皮细胞线粒体形态变化。Western blotting检测ACSL4和GPX4蛋白在支气管上皮细胞中的表达水平。结果:慢性阻塞性肺病小鼠模型肺组织和支气管上皮细胞中LTF表达均下调,在慢性阻塞性肺病小鼠模型肺组织和支气管上皮细胞中LTF表达下调,在慢性阻塞性肺病小鼠模型肺组织中LTF表达在慢性阻塞性肺病小鼠模型肺组织中起关键作用。在ltf干扰支气管上皮细胞经CSE处理后,凋亡相关标志物(如ROS、MDA)显著升高,GSH显著降低,线粒体体积减小,嵴减少,ACSL4蛋白表达升高,GPX4蛋白表达降低。同时,LTF的过表达可以逆转CSE处理后支气管上皮细胞的铁下垂状态。结论:在CSE诱导下,LTF表达水平的降低会导致支气管上皮细胞中亚铁离子的积累,诱导铁下垂的发生。
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引用次数: 0
FUNDC1 Promoted Ferroptosis via JNK Pathway in Cigarette Smoking-Induced Chronic Obstructive Pulmonary Disease. FUNDC1通过JNK通路促进吸烟诱导的慢性阻塞性肺疾病中的铁下垂。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-09-22 DOI: 10.1007/s00408-025-00850-2
Yi Feng, Jiali Weng, Chenfei Li, Qi Liu, Qing Chang, Hai Zhang, Mengnan Li, Kai Wang, Xiaohui Wang, Kian Fan Chung, Ian M Adcock, Feng Li

Background: Cigarette smoking (CS), the major risk factor for chronic obstructive pulmonary disease (COPD), induces oxidative stress, mitophagy, and ferroptosis. Because FUN14 domain-containing protein 1 (FUNDC1), a mitophagy receptor, may drive the onset and progression of COPD, we investigated its role in CS-induced ferroptosis in COPD and to explore the underlying cellular signaling mechanisms.

Methods: Wild-type (C57BL/6J background) and FUNDC1-knockdown (KD) mice were exposed to CS for 12 weeks. FUNDC1-KD and FUNDC1-overexpressing (OE) alveolar epithelial A549 cells were exposed to CS extracts (CSE) in the presence and absence of the JNK inhibitor, SP6001 (10 mM). Oxidative stress, inflammation, mitochondrial function, and ferroptosis were measured.

Results: FUNDC1 expression was increased in lung tissues from COPD patients and CS-exposed mice. CS exposure induced airway inflammation, reduced lung function, and enhanced ferroptosis in mice. FUNDC1-KD prevented CS-induced lung injury in mice. Similarly, CSE exposure up-regulated FUNDC1 expression, promoted ferroptosis, inflammation, oxidative stress, lipid peroxidation, and mitochondrial damage in A549 cells. FUNDC1-KD prevented CSE-induced cellular damage. Transcriptomic data indicated that FUNDC1 mediated ferroptosis through the JNK pathway. These in vitro results were further confirmed by pretreatment with the JNK inhibitor SP6001.

Conclusion: FUNDC1 plays an important role in CS-exposed alveolar epithelial cells and in a mouse model of COPD through the JNK-ferroptosis pathway.

背景:吸烟(CS)是慢性阻塞性肺疾病(COPD)的主要危险因素,可诱导氧化应激、线粒体自噬和铁下垂。由于含FUN14结构域蛋白1 (FUNDC1),一种线粒体自噬受体,可能驱动COPD的发生和进展,我们研究了它在cs诱导的COPD铁下沉中的作用,并探索潜在的细胞信号传导机制。方法:野生型(C57BL/6J背景)和fundc1敲低(KD)小鼠暴露于CS 12周。在存在和不存在JNK抑制剂SP6001 (10 mM)的情况下,将FUNDC1-KD和fundc1过表达(OE)的肺泡上皮A549细胞暴露于CS提取物(CSE)中。测量氧化应激、炎症、线粒体功能和铁下垂。结果:COPD患者及cs暴露小鼠肺组织中FUNDC1表达升高。CS暴露诱导小鼠气道炎症、肺功能降低和铁下垂增强。FUNDC1-KD可预防cs诱导的小鼠肺损伤。同样,CSE暴露可上调A549细胞中FUNDC1的表达,促进铁下垂、炎症、氧化应激、脂质过氧化和线粒体损伤。FUNDC1-KD阻止cse诱导的细胞损伤。转录组学数据表明,FUNDC1通过JNK途径介导铁下垂。用JNK抑制剂SP6001预处理进一步证实了这些体外结果。结论:FUNDC1在cs暴露的肺泡上皮细胞和COPD小鼠模型中通过JNK-ferroptosis通路发挥重要作用。
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引用次数: 0
Lactate and Lactylation in Respiratory Diseases: from Molecular Mechanisms to Targeted Strategies. 呼吸系统疾病中的乳酸和乳酸化:从分子机制到靶向策略。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-09-10 DOI: 10.1007/s00408-025-00848-w
Qi Jia, Quan Yuan, Xiangdong Chen, Zhiqiang Hu

Introduction: Lactate has emerged as a multifunctional signaling molecule regulating various physiological and pathological processes. Furthermore, lactylation, a newly identified posttranslational modification triggered by lactate accumulation, plays significant roles in human health and diseases. This study aims to investigate the roles of lactate/lactylation in respiratory diseases.

Methods: Comprehensive literature analysis was conducted using PubMed database, utilizing a range of keywords including "lactate", "lactylation", "lung", "pulmonary", and "disease".

Results: Emerging evidence indicates that increased glycolytic flux, resultant lactate accumulation, and elevated lactylation levels play key roles in the pathogenesis of respiratory diseases, including lung cancer, idiopathic pulmonary fibrosis (IPF), acute lung injury/acute respiratory distress syndrome (ALI/ARDS), pulmonary hypertension (PH), and asthma. Under these conditions, the upregulation of glycolytic enzymes and increased lactate transport are observed. Elevated levels of lactate and lactylation profoundly influence multiple biological processes, such as inflammatory responses, immune cell activation, autophagy, ferroptosis, EMT, tumorigenesis, and fibrosis, and lactate/lactylation-targeted therapies have demonstrated therapeutic efficacy against diverse respiratory illnesses.

Conclusions: Elevated levels of lactate and lactylation play key roles in the pathogenesis of various respiratory diseases, and lactate/lactylation-targeted therapies appear to be potential therapeutic strategies for these respiratory diseases.

乳酸作为一种调节多种生理和病理过程的多功能信号分子已经出现。此外,乳酸化是一种新发现的由乳酸积累引发的翻译后修饰,在人类健康和疾病中起着重要作用。本研究旨在探讨乳酸/乳酸化在呼吸系统疾病中的作用。方法:利用PubMed数据库综合文献分析,使用“乳酸”、“乳酸化”、“肺”、“肺”、“疾病”等关键词。结果:越来越多的证据表明,糖酵解通量增加、由此产生的乳酸积累和乳酸化水平升高在呼吸系统疾病的发病机制中起关键作用,包括肺癌、特发性肺纤维化(IPF)、急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)、肺动脉高压(PH)和哮喘。在这些条件下,观察到糖酵解酶的上调和乳酸转运的增加。乳酸和乳酸化水平的升高深刻影响多种生物过程,如炎症反应、免疫细胞激活、自噬、铁死亡、EMT、肿瘤发生和纤维化,乳酸/乳酸化靶向治疗已证明对多种呼吸系统疾病具有治疗效果。结论:乳酸和乳酸化水平升高在各种呼吸系统疾病的发病机制中起关键作用,乳酸/乳酸化靶向治疗似乎是这些呼吸系统疾病的潜在治疗策略。
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引用次数: 0
Neuroinflammatory Consequences of Rhinovirus Infection in Human Epithelial and Neuronal Models. 鼻病毒感染在人上皮和神经元模型中的神经炎症后果。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-09-07 DOI: 10.1007/s00408-025-00846-y
Orla M Dunne, Nicola A M Roe, Aurélie Mousnier, S Lorraine Martin, Gerard P Sergeant, Imad About, Ikhlas El-Karim, Fionnuala T Lundy, Lorcan P McGarvey

Introduction: Rhinovirus (RV) is the leading cause of exacerbations of lung disease. A sensory neuronal model, derived from human dental pulp stem cells and differentiated into peripheral neuronal equivalents (PNEs), was used to examine RV's effects on airway sensory nerves. We investigated whether RV can directly infect and alter PNEs or whether it exerts effects indirectly via the release of mediators from infected epithelial cells.

Methods: PNEs or primary bronchial epithelial cells (PBECs) were infected with the RV-A16 strain. Viral replication was confirmed by viral titration assays, immunofluorescence (IF) for the double-stranded RNA (dsRNA) replication intermediate and western blotting (WB). RNA sequencing was used to determine transcriptomic changes in PNEs, and inflammatory responses were assessed by inflammatory microarray. Calcium mobilisation assays were used to investigate the effect of interleukin-1β (IL-1β) on PNE transient receptor potential (TRP) A1 channel responses.

Results: Viral titrations, WB and IF confirm RV-A16 entry and replication in PNEs and PBECs. Gene signatures associated with antiviral immune responses, sensory neuropathies and N-Methyl-D-aspartic acid (NMDA) receptor activity were upregulated in RV infected PNEs. Several cytokines were increased from PNEs and PBECs following RV infection, most notably IL-1β. Treatment of PNEs with IL-1β resulted in heightened TRPA1 channel sensitivity.

Conclusion: We report the suitability of an airway neuronal model for the study of the direct effects of RV infection on nerves. RV-induced release of IL-1β from airway epithelium heightens neuronal TRPA1 responses suggesting a mechanism for virus-induced cough hypersensitivity.

鼻病毒(RV)是肺部疾病恶化的主要原因。利用人牙髓干细胞分化为外周神经元当量(peripheral neuronal equivalents, PNEs)的感觉神经元模型,研究RV对气道感觉神经的影响。我们研究了RV是否可以直接感染和改变PNEs,还是通过从感染的上皮细胞释放介质间接发挥作用。方法:用RV-A16菌株感染PNEs或原代支气管上皮细胞(PBECs)。通过病毒滴定法、免疫荧光(IF)检测双链RNA (dsRNA)复制中间体和western blotting (WB)证实病毒复制。使用RNA测序来确定PNEs的转录组变化,并通过炎症芯片评估炎症反应。采用钙动员法研究白细胞介素-1β (IL-1β)对PNE瞬时受体电位(TRP) A1通道反应的影响。结果:病毒滴定、WB和IF证实了RV-A16在PNEs和PBECs中的进入和复制。在RV感染的PNEs中,与抗病毒免疫反应、感觉神经病变和n -甲基- d -天冬氨酸(NMDA)受体活性相关的基因特征上调。RV感染后,PNEs和PBECs中几种细胞因子增加,最明显的是IL-1β。用IL-1β治疗PNEs可提高TRPA1通道的敏感性。结论:我们报告气道神经元模型适合研究RV感染对神经的直接影响。rv诱导的IL-1β从气道上皮释放增强神经元TRPA1反应,提示病毒诱导的咳嗽超敏反应的机制。
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引用次数: 0
Age-Dependent Risk of Bronchial Asthma Exacerbation in Respiratory Syncytial Virus Co-infection. 呼吸道合胞病毒合并感染支气管哮喘加重的年龄依赖性风险
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-09-03 DOI: 10.1007/s00408-025-00847-x
Ken Arimura, Keiko Kan-O, Yasuto Sato, Ken Kikuchi, Hitomi Miura, Asako Sato, Mitsuko Kondo, Etsuko Tagaya

Introduction: Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are common viral etiologies of respiratory infections. Although co-infection with other respiratory pathogens is frequently observed, its clinical significance remains unclear.

Methods: We retrospectively analyzed 57,746 patients who underwent FILMARRAY®, a comprehensive multiplex polymerase chain reaction testing, between November 2020 and March 2023. Clinical features were compared between single infection and co-infection involving RSV or hMPV using χ2 or Fisher's exact tests. Multiple logistic regression was performed to identify associations with bronchial asthma (BA) exacerbation, adjusting for age, sex, testing period, and RSV co-infection.

Results: Among RSV-positive patients, co-infection was associated with higher prevalence of BA history, wheeze, BA exacerbation, combined BA history and exacerbation, systemic steroid use, and age under 6 years compared to that with single infection. RSV co-infection with coronavirus, parainfluenza virus, adenovirus, and rhinovirus/enterovirus was particularly associated with BA exacerbation. Age under 6 years and RSV co-infection were identified as independent risk factors for BA exacerbation using multiple logistic regression. In contrast, no associations were observed in the hMPV co-infection.

Conclusion: RSV co-infection with other respiratory viruses increases the risk of BA exacerbation, especially in age under 6 years patients. Given the proven efficacy of RSV vaccine for adults and monoclonal antibody for high-risk children in preventing RSV-related lower respiratory tract disease, RSV-targeted prevention strategies for younger children appear effective in reducing respiratory disease burden.

呼吸道合胞病毒(RSV)和人偏肺病毒(hMPV)是引起呼吸道感染的常见病毒。虽然经常观察到与其他呼吸道病原体合并感染,但其临床意义尚不清楚。方法:我们回顾性分析了2020年11月至2023年3月期间接受FILMARRAY®综合多重聚合酶链反应测试的57,746例患者。采用χ2或Fisher精确检验比较单纯感染与合并感染RSV或hMPV的临床特征。对年龄、性别、检测周期和RSV合并感染进行校正,采用多元logistic回归来确定与支气管哮喘(BA)加重的相关性。结果:在rsv阳性患者中,与单一感染相比,合并感染与BA病史、喘息、BA加重、合并BA病史和加重、全身性类固醇使用和6岁以下的患病率相关。RSV与冠状病毒、副流感病毒、腺病毒和鼻病毒/肠病毒合并感染与BA加重特别相关。采用多元logistic回归分析,确定年龄小于6岁和RSV合并感染为BA加重的独立危险因素。相比之下,在hMPV合并感染中没有观察到关联。结论:RSV合并其他呼吸道病毒感染可增加BA加重的风险,特别是在6岁以下的患者中。鉴于成人RSV疫苗和高危儿童单克隆抗体在预防RSV相关下呼吸道疾病方面的有效性已得到证实,针对低龄儿童的RSV预防策略似乎可以有效减轻呼吸道疾病负担。
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引用次数: 0
Emerging Therapeutics in COPD: Mapping Innovation to Treatable Traits. 慢性阻塞性肺病的新兴治疗方法:将创新映射到可治疗的特征。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-09-03 DOI: 10.1007/s00408-025-00844-0
Mario Cazzola, Vanessa M McDonald, Daiana Stolz, Paola Rogliani, Maria Gabriella Matera

Chronic Obstructive Pulmonary Disease (COPD) is a complex, heterogeneous condition characterized by diverse clinical phenotypes and underlying pathobiological mechanisms. Traditional "one-size-fits-all" management strategies have limited effectiveness in addressing this heterogeneity. The Treatable Traits (TTs) approach represents a precision medicine paradigm that targets specific, identifiable, and modifiable traits in individual patients, regardless of diagnostic labels. This paper explores the alignment between the TTs framework and emerging pharmacological therapies, with a particular focus on anti-inflammatory agents and bronchodilators currently under investigation. Each drug category is mapped to relevant TTs, such as eosinophilic or neutrophilic inflammation, corticosteroid resistance, chronic bronchitis, and frequent exacerbations. This review highlights the importance of biomarker-driven phenotyping and real-world data in designing TT-based clinical trials. It emphasizes challenges such as trait instability over time, comorbidity clustering, and trial design heterogeneity. Moreover, we advocate for incorporating digital health tools, long-term follow-up, and cost-effectiveness analyses to ensure translational relevance. In conclusion, integrating emerging therapies with the TTs approach holds substantial promise for personalizing COPD management, improving outcomes, and facilitating targeted drug development.

慢性阻塞性肺疾病(COPD)是一种复杂的、异质性的疾病,具有不同的临床表型和潜在的病理生物学机制。传统的“一刀切”管理策略在解决这种异质性方面的有效性有限。可治疗特征(TTs)方法代表了一种精准医学范式,它针对个体患者的特定、可识别和可修改的特征,而不考虑诊断标签。本文探讨了TTs框架与新兴药理疗法之间的一致性,特别关注目前正在研究的抗炎剂和支气管扩张剂。每个药物类别都映射到相关的tt,如嗜酸性粒细胞或中性粒细胞炎症、皮质类固醇抵抗、慢性支气管炎和频繁恶化。这篇综述强调了生物标志物驱动的表型和现实世界数据在设计基于tt的临床试验中的重要性。它强调挑战,如随时间的特征不稳定性,合并症聚类和试验设计异质性。此外,我们提倡整合数字健康工具、长期随访和成本效益分析,以确保翻译的相关性。综上所述,将新兴疗法与TTs方法相结合,对于个性化COPD管理、改善预后和促进靶向药物开发具有重大前景。
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引用次数: 0
Changes in Lung Function and Patient-Reported Outcomes in Patients with Idiopathic Pulmonary Fibrosis. 特发性肺纤维化患者肺功能的改变和患者报告的预后。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-08-27 DOI: 10.1007/s00408-025-00845-z
Jamie L Todd, Megan L Neely, Anne S Hellkamp, Daniel A Culver, Justin M Oldham, Peide Li, Divya C Patel, Scott M Palmer

We evaluated relationships between changes in lung function and changes in patient-reported outcomes (PROs) in 736 patients with idiopathic pulmonary fibrosis (IPF) enrolled in the IPF-PRO Registry. Weak correlations were observed between changes in percent predicted values for forced vital capacity or diffusing capacity of the lungs (DLco) and changes in St George's Respiratory Questionnaire (SGRQ) total and activity scores and the 12-item Short Form Survey (SF-12) physical component summary score over 12-month periods. Patients who had a deterioration in SGRQ activity score or SF-12 PCS score of ≥ 5 units had numerically larger declines in lung function than other patients, but the differences were small. The weak relationships observed between changes in lung function and changes in PROs underscore the importance of evaluating both changes in lung function and changes in HRQL in clinical practice and clinical trials.

我们评估了在IPF- pro注册的736例特发性肺纤维化(IPF)患者肺功能变化与患者报告预后(PROs)变化之间的关系。在12个月期间,在强迫肺活量或肺弥散能力(DLco)的百分比预测值的变化与圣乔治呼吸问卷(SGRQ)总得分和活动得分以及12项简短形式调查(SF-12)物理成分总结得分的变化之间观察到弱相关性。SGRQ活动评分恶化或SF-12 PCS评分≥5个单位的患者肺功能下降的数值大于其他患者,但差异很小。肺功能变化与pro变化之间的弱相关性强调了在临床实践和临床试验中评估肺功能变化和HRQL变化的重要性。
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引用次数: 0
Sputum Transcriptomic Analysis and Clustering Reveals Insight Into Asthma Heterogeneity. 痰转录组学分析和聚类揭示哮喘异质性。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-08-20 DOI: 10.1007/s00408-025-00843-1
Janne Goossens, Anne-Charlotte Jonckheere, Sien De Boodt, Ellen Dilissen, Nora Marain, Tatjana Decaesteker, Alvaro Cortes, Jeroen A Vanoirbeek, Sven F Seys, Lieven Dupont, Dominique M A Bullens

Introduction: Asthma is a heterogenous disease shaped by different inflammatory pathways. The aim is to investigate transcriptomic profiles in asthmatic patients and associate these with inflammation, airway damage and lung function.

Methods: Adult asthma patients attending the outpatient pneumology clinic in our tertiary center, underwent diagnostic sputum induction and upon consent remaining sputum RNA was used for bulk RNA-sequencing (n = 56) coupled with unsupervised clustering. A retrospective analysis of comorbidities was performed. Sputum cytokine mRNA levels were determined via qPCR. Airway damage markers were determined in sputum supernatant RESULTS: Unsupervised clustering subdivided all asthmatic patients in one of three clusters. Cluster 1 contained most of the pauci-granulocytic asthma patients in whom oxidative stress was upregulated and TLR-signalling and several cytokine pathways down-regulated. Cluster 2 had upregulated S100 family signalling pathway genes, was mostly associated to type 2 inflammation with elevated sputum eosinophils, epithelial damage, IL-4 mRNA levels and allergy. Asthma patients in cluster 3 had worse lung function, upregulated inflammatory genes, increased sputum neutrophils and calprotectin levels.

Conclusion: Three different asthma clusters could be identified bridging over the classical type 2/non-type 2 classification.

Clinical trial: ClinicalTrials.gov Identifier: NCT01224938 registered on 19 October 2010.

简介:哮喘是一种由不同炎症途径形成的异质性疾病。目的是研究哮喘患者的转录组谱,并将其与炎症、气道损伤和肺功能联系起来。方法:在我们三级中心门诊肺炎门诊就诊的成年哮喘患者,进行了诊断性痰诱导,经同意后,将剩余的痰RNA用于批量RNA测序(n = 56)并结合无监督聚类。对合并症进行回顾性分析。通过qPCR检测痰液细胞因子mRNA水平。结果:无监督聚类将所有哮喘患者细分为三个聚类之一。聚类1包含大多数缺氧粒细胞性哮喘患者,氧化应激上调,tlr信号通路和几种细胞因子通路下调。簇2表达上调S100家族信号通路基因,主要与2型炎症相关,包括痰嗜酸性粒细胞升高、上皮细胞损伤、IL-4 mRNA水平升高和过敏。类群3哮喘患者肺功能较差,炎症基因上调,痰中性粒细胞和钙保护蛋白水平升高。结论:在经典的2型/非2型分类上,可以识别出3种不同的哮喘类型。临床试验:ClinicalTrials.gov标识符:NCT01224938,注册于2010年10月19日。
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引用次数: 0
Modified Tracheobronchoplasty for Chronic Cough Due to Excessive Dynamic Airway Collapse: A Case Series. 改良气管支气管成形术治疗因过度动态气道塌陷引起的慢性咳嗽:一个病例系列。
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-08-15 DOI: 10.1007/s00408-025-00842-2
Alessandro Gonfiotti, Alessandra Sorano, Massimo O Jaus, Giulia Fabietti, Luca Voltolini, Giovanni A Fontana, Federico Lavorini
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引用次数: 0
Serum Cytokeratin 18 and Fragment as Biomarkers for Severity and Prognosis in Acute Exacerbation of Chronic Obstructive Pulmonary Disease. 血清细胞角蛋白18和片段作为慢性阻塞性肺疾病急性加重严重程度和预后的生物标志物
IF 3.9 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-08-11 DOI: 10.1007/s00408-025-00841-3
Ming-Yan Liu, Kai-Xin Qu, Kai-Shu Ma, Zhen-Yu Cheng, Xiang Cai, Hai-Long Miu, Meng-Xue Liu, Yi-Qun Wang, Hui Zhao, Ling Zheng, Lin Fu, Jin Yang

Background: Cytokeratin (CK)18 is present in the bronchi and alveolar epithelium of the lung, and its cleavage product, CK-18M30, serves as a biological marker of apoptosis. However, the specific roles of CK-18 and CK-18M30 in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remain unclear.

Methods: This study enrolled 289 patients with AECOPD who met the inclusion criteria. Demographic information and clinical characteristics of the patients were documented. A 3-year follow-up period was implemented to evaluate acute exacerbations and mortality. Serum CK-18 and CK-18M30 concentrations were measured using enzyme-linked immunosorbent assays.

Results: Serum concentrations of CK-18/CK-18M30 at admission in patients with AECOPD were higher than those in the control group. As severity increased, serum CK-18/CK-18M30 levels increased progressively in AECOPD patients. Pearson's correlation analysis revealed that serum CK-18/CK-18M30 concentrations were positively correlated with several clinical parameters. Linear and logistic regression models demonstrated positive correlations between serum CK-18 and CK-18M30 levels at admission and severity scores. Furthermore, higher serum CK-18/CK-18M30 levels at admission were associated with increased frequency of death and acute exacerbation in patients with AECOPD within 3 years.

Conclusion: Serum CK-18/CK-18M30 levels at admission were positively correlated with severity and poor prognosis in patients with AECOPD within 3 years. Therefore, serum CK-18 and CK-18M30 concentrations may serve as novel diagnostic and prognostic biomarkers for patients with AECOPD.

背景:细胞角蛋白(CK)18存在于肺的支气管和肺泡上皮中,其裂解产物CK- 18m30是细胞凋亡的生物学标志物。然而,CK-18和CK-18M30在慢性阻塞性肺疾病(AECOPD)急性加重中的具体作用尚不清楚。方法:本研究纳入289例符合入选标准的AECOPD患者。记录患者的人口学信息和临床特征。随访3年,评估急性加重和死亡率。采用酶联免疫吸附法测定血清CK-18和CK-18M30浓度。结果:AECOPD患者入院时血清CK-18/CK-18M30浓度高于对照组。随着病情加重,AECOPD患者血清CK-18/CK-18M30水平逐渐升高。Pearson相关分析显示血清CK-18/CK-18M30浓度与多个临床参数呈正相关。线性和逻辑回归模型显示入院时血清CK-18和CK-18M30水平与严重程度评分呈正相关。此外,入院时较高的血清CK-18/CK-18M30水平与3年内AECOPD患者死亡和急性加重的频率增加有关。结论:入院时血清CK-18/CK-18M30水平与AECOPD患者3年内的严重程度和不良预后呈正相关。因此,血清CK-18和CK-18M30浓度可作为AECOPD患者新的诊断和预后生物标志物。
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