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Psoriasis may increase the risk of idiopathic pulmonary fibrosis: a two-sample Mendelian randomization study 银屑病可能增加特发性肺纤维化的风险:一项双样本孟德尔随机研究
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-26 DOI: 10.1186/s12931-024-02721-5
Lingli Chen, Yujie Wei, Mengjin Hu, Yile Liu, Xiangrong Zheng
Although some studies have indicated that Psoriasis could contribute to the risk of idiopathic pulmonary fibrosis (IPF), no study has reported a clear causal association between them. Our aim was to explore the potential relationship between Psoriasis and IPF using Mendelian randomization (MR) design. To explore a causal association between Psoriasis and IPF, we used genetic instruments from the largest available genome-wide association study (GWAS) of European ancestry, including psoriasis (5314 cases, 457,619 controls) and IPF (1028 cases, 196,986 controls). Our main analyses were conducted by inverse-variance weighted (IVW) method with random-effects model, with the other complementary four analyses: weighted median method, weighted mode, multivariable MR and MR-Egger approach. The results of IVW methods demonstrated that genetically predicted psoriasis was significantly associated with higher odds of IPF, with an odds ratio (OR) of 1.09 (95%CI, 1.01–1.18; P = 0.02). Weighted median method, weighted mode and multivariable MR also demonstrated directionally similar results (P < 0.05), while the MR-Egger regression did not reveal the impact of psoriasis on IPF (OR = 1.09, 95%CI, 0.98–1.21; P = 0.11). In addition, both funnel plots and MR-Egger intercepts indicated no directional pleiotropic effects between psoriasis and IPF. Our study provided potential evidence between genetically predicted psoriasis and IPF, which suggests that understanding the mutual risk factors between psoriasis and IPF can facilitate the clinical management of both diseases.
尽管一些研究表明,银屑病可能会增加特发性肺纤维化(IPF)的发病风险,但还没有研究报告表明二者之间存在明确的因果关系。我们的目的是采用孟德尔随机化(MR)设计,探讨银屑病与特发性肺纤维化之间的潜在关系。为了探讨银屑病与 IPF 之间的因果关系,我们使用了现有最大的欧洲血统全基因组关联研究(GWAS)中的遗传工具,包括银屑病(5314 例,457619 例对照)和 IPF(1028 例,196986 例对照)。我们的主要分析方法是采用随机效应模型的逆方差加权(IVW)法,以及其他四种补充分析方法:加权中值法、加权模式、多变量 MR 和 MR-Egger 法。IVW 方法的结果表明,遗传预测的银屑病与较高的 IPF 发生几率显著相关,其几率比(OR)为 1.09(95%CI,1.01-1.18;P = 0.02)。加权中值法、加权模式和多变量 MR 也显示出方向相似的结果(P < 0.05),而 MR-Egger 回归则没有显示出银屑病对 IPF 的影响(OR = 1.09,95%CI,0.98-1.21;P = 0.11)。此外,漏斗图和 MR-Egger 截距均表明银屑病与 IPF 之间不存在方向性多效应。我们的研究提供了银屑病和 IPF 基因预测之间的潜在证据,这表明了解银屑病和 IPF 之间的相互风险因素有助于这两种疾病的临床治疗。
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引用次数: 0
Atorvastatin for reduction of 28-day mortality in severe and critical COVID-19 patients: a randomized controlled trial 阿托伐他汀降低严重危重 COVID-19 患者 28 天死亡率:随机对照试验
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-22 DOI: 10.1186/s12931-024-02732-2
Naglaa Hamdi Eltahan, Neamat Hamdy Elsawy, Kholoud M. Abdelaaty, Amal Salah Elhamaky, Ahmed H. Hassan, Moataz Maher Emara
COVID-19 is an abnormal host response to the SARS-CoV-2 infection, which is associated with endothelial dysfunction and multi-organ failure. Atorvastatin has been proposed to reduce COVID-19 severity and mortality in chronic and de-novo users. This randomized double-blind trial included 220 COVID-19 patients admitted to Mansoura University's isolation hospital in Egypt. One hundred and ten cases were given 40 mg of atorvastatin once daily for 28 days (group A), while 110 received a placebo (group B). All patients received treatment as per hospital protocol. The primary outcome is all-cause mortality at 28 days. We also tracked 6-month mortality, time to clinical improvement, the risk of invasive mechanical ventilation, acute kidney injury, potential adverse events, and hospital and intensive care length of stay. The 28-day all-cause mortality was 52/104 (50%) in group A vs. 54/103 (52.4%) in group B, odds ratio (OR) = 0.907 (0.526, 1.565), P = 0.727; adjusted OR = 0.773 (0.407, 1.47), P = 0.433. Six-month mortality occurred in 53/102 (52%) and 59/79 (60.8%) in group A vs. B, respectively, P = 0.208. Among hospital survivors in group A vs. group B, the median time to clinical improvement was 10 days (7–14) vs. 10 (7–15), P = 0.715; the duration of hospital stay was 10 days (7–14) vs. 10 (8–17), P = 0.378. Discontinuation was higher in group B (four vs. one), but statistically insignificant, P = 0.369. In adults with severe or critical COVID-19, atorvastatin did not reduce the risk of 28-day or 6-month mortality and did not shorten the length of hospital stay or time to clinical improvement. Trial registration Clinical Trial Registry (NCT04952350) on July 1st, 2021. https://clinicaltrials.gov/ct2/show/NCT04952350
COVID-19 是宿主对 SARS-CoV-2 感染的一种异常反应,与内皮功能障碍和多器官功能衰竭有关。阿托伐他汀被认为可以减轻 COVID-19 的严重程度,并降低慢性和新发使用者的死亡率。这项随机双盲试验包括埃及曼苏尔大学隔离医院收治的 220 名 COVID-19 患者。110名患者接受了为期28天、每天一次、每次40毫克阿托伐他汀的治疗(A组),110名患者接受了安慰剂治疗(B组)。所有患者均按照医院规定接受治疗。主要结果是 28 天内的全因死亡率。我们还跟踪了 6 个月的死亡率、临床改善时间、有创机械通气风险、急性肾损伤、潜在不良事件以及住院时间和重症监护时间。A 组的 28 天全因死亡率为 52/104 例(50%),B 组为 54/103 例(52.4%),比值比 (OR) = 0.907 (0.526, 1.565),P = 0.727;调整后 OR = 0.773 (0.407, 1.47),P = 0.433。A 组与 B 组的六个月死亡率分别为 53/102(52%)和 59/79(60.8%),P = 0.208。在 A 组与 B 组的住院幸存者中,临床改善的中位时间分别为 10 天(7-14)与 10 天(7-15),P = 0.715;住院时间分别为 10 天(7-14)与 10 天(8-17),P = 0.378。B 组患者的停药率较高(4 对 1),但在统计学上并不显著,P = 0.369。在患有严重或危重COVID-19的成人患者中,阿托伐他汀并不能降低28天或6个月的死亡风险,也不能缩短住院时间或临床改善时间。试验注册 临床试验注册中心(NCT04952350)于 2021 年 7 月 1 日注册。https://clinicaltrials.gov/ct2/show/NCT04952350
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引用次数: 0
Distinct impacts of radiological appearance on lymph node metastasis and prognosis based on solid size in clinical T1 non-small cell lung cancer 在临床 T1 非小细胞肺癌患者中,基于实体大小的放射学表现对淋巴结转移和预后的不同影响
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-21 DOI: 10.1186/s12931-024-02727-z
Zhihua Li, Cheng Pan, Wenzheng Xu, Chen Zhao, Xianglong Pan, Zhibo Wang, Weibing Wu, Liang Chen
Solid nodules (SN) had more aggressive features and a poorer prognosis than part-solid nodules (PSN). This study aimed to evaluate the specific impacts of nodule radiological appearance (SN vs. PSN) on lymph node metastasis and prognosis based on solid size in cT1 non-small cell lung cancer (NSCLC). Patients with cT1 NSCLC who underwent anatomical resection between 2010 and 2019 were retrospectively screened. Univariable and multivariable logistic regression analyses were adopted to evaluate the associations between nodule radiological appearance and lymph node metastasis. The log-rank test and Cox regression analyses were applied for prognostic evaluation. The cumulative recurrence risk was evaluated by the competing risk model. There were 958 and 665 NSCLC patients with PSN and SN. Compared to the PSN group, the SN arm had a higher overall lymph node metastasis rate (21.7% vs. 2.7%, P < 0.001), including nodal metastasis at N1 stations (17.7% vs. 2.1%), N2 stations (14.0% vs. 1.6%), and skip nodal metastasis (3.9% vs. 0.6%). However, for cT1a NSCLC, no significant difference existed between SN and PSN (0 vs. 0.4%, P = 1). In addition, the impacts of nodule radiological appearance on lymph node metastasis varied between nodal stations. Solid NSCLC had an inferior prognosis than part-solid patients (5-year disease-free survival: 79.3% vs. 96.2%, P < 0.001). The survival inferiority only existed for cT1b and cT1c NSCLC, but not for cT1a. Strikingly, even for patients with nodal involvement, SN still had a poorer disease-free survival (P = 0.048) and a higher cumulative incidence of recurrence (P < 0.001) than PSN. Specifically, SN had a higher recurrence risk than PSN at each site. Nevertheless, the distribution of recurrences between SN and PSN was similar, except that N2 lymph node recurrences were more frequent in solid NSCLC (28.21% vs. 7.69%, P = 0.041). SN had higher risks of lymph node metastasis and poorer prognosis than PSN for cT1b and cT1c NSCLC, but not for cT1a. SN exhibited a greater proportion of N2 lymph node recurrence than PSN. SN and PSN needed distinct strategies for nodal evaluation and postoperative follow-up.
与部分实性结节(PSN)相比,实性结节(SN)的侵袭性更强,预后更差。本研究旨在根据cT1非小细胞肺癌(NSCLC)实性结节的大小,评估结节放射学外观(SN与PSN)对淋巴结转移和预后的具体影响。回顾性筛选了2010年至2019年期间接受解剖切除术的cT1 NSCLC患者。采用单变量和多变量逻辑回归分析评估结节放射学外观与淋巴结转移之间的关联。预后评估采用对数秩检验和 Cox 回归分析。采用竞争风险模型评估累积复发风险。分别有958名和665名NSCLC患者患有PSN和SN。与PSN组相比,SN组的总体淋巴结转移率更高(21.7% vs. 2.7%,P<0.001),包括N1站(17.7% vs. 2.1%)、N2站(14.0% vs. 1.6%)和跳结转移(3.9% vs. 0.6%)。然而,对于 cT1a NSCLC,SN 和 PSN 之间不存在显著差异(0 vs. 0.4%,P = 1)。此外,不同结节站的结节放射学外观对淋巴结转移的影响也不同。实性 NSCLC 患者的预后比部分实性患者差(5 年无病生存率:79.3% 对 96.2%,P < 0.001)。只有 cT1b 和 cT1c NSCLC 患者的生存率较低,而 cT1a 患者的生存率较低。令人吃惊的是,即使是结节受累的患者,SN的无病生存率(P = 0.048)和累积复发率(P < 0.001)仍低于PSN。具体来说,SN 在每个部位的复发风险都高于 PSN。不过,SN和PSN的复发分布情况相似,只是实性NSCLC的N2淋巴结复发率更高(28.21% vs. 7.69%,P = 0.041)。在cT1b和cT1c NSCLC中,SN比PSN有更高的淋巴结转移风险和更差的预后,但在cT1a中则没有。SN患者N2淋巴结复发的比例高于PSN患者。SN和PSN需要不同的结节评估和术后随访策略。
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引用次数: 0
Impact of preexisting interstitial lung disease on mortality in COVID-19 patients from the early pandemic to the delta variant epidemic: a nationwide population-based study 从早期大流行到三角变异流行期间,原有间质性肺病对 COVID-19 患者死亡率的影响:一项基于全国人口的研究
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-21 DOI: 10.1186/s12931-024-02723-3
Koichi Miyashita, Hironao Hozumi, Kazuki Furuhashi, Eiji Nakatani, Yusuke Inoue, Hideki Yasui, Yuzo Suzuki, Masato Karayama, Noriyuki Enomoto, Tomoyuki Fujisawa, Naoki Inui, Toshiyuki Ojima, Takafumi Suda
COVID-19 patients with preexisting interstitial lung disease (ILD) were reported to have a high mortality rate; however, this was based on data from the early stages of the pandemic. It is uncertain how their mortality rates have changed with the emergence of new variants of concern as well as the development of COVID-19 vaccines and treatments. It is also unclear whether having ILD still poses a risk factor for mortality. As COVID-19 continues to be a major concern, further research on COVID-19 patients with preexisting ILD is necessary. We extracted data on COVID-19 patients between January 2020–August 2021 from a Japanese nationwide insurance claims database and divided them into those with and without preexisting ILD. We investigated all-cause mortality of COVID-19 patients with preexisting ILD in wild-type-, alpha-, and delta-predominant waves, to determine whether preexisting ILD was associated with increased mortality. Of the 937,758 adult COVID-19 patients, 7,333 (0.8%) had preexisting ILD. The proportion of all COVID-19 patients who had preexisting ILD in the wild-type-, alpha-, and delta-predominant waves was 1.2%, 0.8%, and 0.3%, respectively, and their 60-day mortality was 16.0%, 14.6%, and 7.5%, respectively. The 60-day mortality significantly decreased from the alpha-predominant to delta-predominant waves (difference − 7.1%, 95% confidence intervals (CI) − 9.3% to − 4.9%). In multivariable analysis, preexisting ILD was independently associated with increased mortality in all waves with the wild-type-predominant, odds ratio (OR) 2.10, 95% CI 1.91–2.30, the alpha-predominant wave, OR 2.14, 95% CI 1.84–2.50, and the delta-predominant wave, OR 2.10, 95%CI 1.66–2.66. All-cause mortality rates for COVID-19 patients with preexisting ILD decreased from the wild-type- to the more recent delta-predominant waves. However, these patients were consistently at higher mortality risk than those without preexisting ILD. We emphasize that careful attention should be given to patients with preexisting ILD despite the change in the COVID-19 environment.
据报道,患有原有间质性肺病 (ILD) 的 COVID-19 患者死亡率很高;但这是基于大流行初期的数据。目前还不确定随着新的相关变种的出现以及 COVID-19 疫苗和治疗方法的开发,他们的死亡率会发生怎样的变化。此外,目前还不清楚 ILD 是否仍然是导致死亡的一个风险因素。由于 COVID-19 仍是一个令人担忧的重大问题,因此有必要对患有 ILD 的 COVID-19 患者进行进一步研究。我们从日本全国保险理赔数据库中提取了 2020 年 1 月至 2021 年 8 月期间 COVID-19 患者的数据,并将其分为患有和未患有 ILD 的患者。我们调查了野生型、α型和δ型占优波中已有 ILD 的 COVID-19 患者的全因死亡率,以确定已有 ILD 是否与死亡率增加有关。在 937,758 名 COVID-19 成年患者中,有 7,333 人(0.8%)患有原有的 ILD。在所有 COVID-19 患者中,野生型、α型和δ型显性波中患有原有 ILD 的比例分别为 1.2%、0.8% 和 0.3%,其 60 天死亡率分别为 16.0%、14.6% 和 7.5%。从α波为主到δ波为主,60 天死亡率明显下降(差异-7.1%,95% 置信区间(CI)-9.3% 到-4.9%)。在多变量分析中,原有的 ILD 与所有波的死亡率增加都有独立关联,其中野生型主导波的比值比 (OR) 为 2.10,95% CI 为 1.91-2.30;α 主导波的比值比为 2.14,95% CI 为 1.84-2.50;δ 主导波的比值比为 2.10,95%CI 为 1.66-2.66。从野生型到最近的δ主导波,COVID-19 患者的全因死亡率有所下降。但是,这些患者的死亡风险始终高于无 ILD 的患者。我们强调,尽管 COVID-19 的环境发生了变化,但仍应仔细关注已有 ILD 的患者。
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引用次数: 0
Assessing the acceptability and feasibility of remote spirometric monitoring for rural patients with interstitial lung disease: a multimethod approach 评估农村间质性肺病患者远程肺活量监测的可接受性和可行性:一种多方法方法
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-20 DOI: 10.1186/s12931-024-02735-z
Ryan D. Boente, Sydney Schacht, Rebecca Borton, Joseph Vincent, Lilian Golzarri-Arroyo, Nicholas Rattray
Interstitial lung disease encompasses a group of rare lung conditions causing inflammation and scarring of lung tissue. The typical method of monitoring disease activity is through pulmonary function tests performed in a hospital setting. However, accessing care can be difficult for rural patients due to numerous barriers. This study assesses the feasibility and acceptability of home spirometry telemonitoring using MIR-Spirometers and the patientMpower home-monitoring platform for rural patients with interstitial lung disease. Unblinded, uncontrolled, prospective, multiple-methods study of the feasibility and utility of remote monitoring of 20 rural subjects with interstitial lung disease. Study assessments include adherence to twice weekly spirometry for 3 months in addition to mMRC dyspnea and EQ-5D-5L health-related quality of life questionnaires with each spirometry maneuver. Upon completion, subjects were encouraged to complete an 11-question satisfaction survey and participate in semi-structured qualitative interviews to further explore expectations and perceptions of rural patients to telehealth and remote patient monitoring. 19 subjects completed the 3-month study period. Adherence to twice weekly spirometry was mean 53% ± 38%, with participants on average performing 2.26 ± 1.69 maneuvers per week. The median (Range) number of maneuvers per week was 2.0 (0.0, 7.0). The majority of participants responded favorably to the patient satisfaction survey questions. Themes regarding barriers to access included: lack of local specialty care, distance to center with expertise, and time, distance, and high cost associated with travel. Remote monitoring was well perceived amongst subjects as a way to improve access and overcome barriers. Remote spirometry monitoring through web-based telehealth is acceptable and feasible for rural patients. Perceived benefits include overcoming access barriers like time, distance, and travel costs. However, cost, reimbursement, and internet access must be addressed before implementing it widely. Future studies are needed to ensure long-term feasibility and to compare outcomes with usual care.
间质性肺病是一组罕见的肺部疾病,会导致肺组织发炎和结疤。监测疾病活动的典型方法是在医院进行肺功能检查。然而,由于障碍重重,农村患者很难获得医疗服务。本研究评估了使用 MIR-Spirometers 和 patientMpower 家庭监测平台对农村间质性肺病患者进行家庭肺活量远程监测的可行性和可接受性。对 20 名农村间质性肺病患者进行远程监测的可行性和实用性的非盲法、非对照、前瞻性、多方法研究。研究评估包括坚持每周两次肺活量测定,为期 3 个月,以及每次肺活量测定时的 mMRC 呼吸困难和 EQ-5D-5L 健康相关生活质量问卷。研究完成后,我们鼓励受试者完成一份由 11 个问题组成的满意度调查,并参加半结构化定性访谈,以进一步了解农村患者对远程医疗和远程患者监护的期望和看法。19 名受试者完成了为期 3 个月的研究。每周两次肺活量测定的坚持率平均为 53% ± 38%,参与者平均每周进行 2.26 ± 1.69 次肺活量测定。每周操作次数的中位数(范围)为 2.0(0.0,7.0)。大多数参与者都对患者满意度调查问题做出了积极回应。与就医障碍相关的主题包括:当地缺乏专科医疗服务、距离具有专业知识的中心较远,以及与旅行相关的时间、距离和高昂费用。受试者普遍认为远程监测是改善就医条件和克服障碍的一种方法。对于农村患者来说,通过网络远程医疗进行远程肺活量监测是可以接受的,也是可行的。受试者认为其好处包括克服了时间、距离和差旅费等就医障碍。然而,在广泛实施之前,必须解决成本、报销和互联网接入等问题。今后还需要进行研究,以确保其长期可行性,并将结果与常规护理进行比较。
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引用次数: 0
MiR-23a-5p alleviates chronic obstructive pulmonary disease through targeted regulation of RAGE-ROS pathway MiR-23a-5p 通过靶向调节 RAGE-ROS 通路缓解慢性阻塞性肺病
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-20 DOI: 10.1186/s12931-024-02736-y
Chenli Chang, Ke Huang, Xia Xu, Ruirui Duan, Tao Yu, Xu Chu, Chen Chen, Baicun Li, Ting Yang
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease and represents the third leading cause of death worldwide. This study aimed to investigate miRNA regulation of Receptor for Advanced Glycation End-products (RAGE), a causal receptor in the pathogenesis of cigarette smoke (CS)-related COPD, to guide development of therapeutic strategies. RAGE expression was quantified in lung tissue of COPD patients and healthy controls, and in mice with CS-induced COPD. RNA-sequencing of peripheral blood from COPD patients with binding site prediction was used to screen differentially expressed miRNAs that may interact with RAGE. Investigation of miR-23a-5p as a potential regulator of COPD progression was conducted with miR-23a-5p agomir in COPD mice in vivo using histology and SCIREQ functional assays, while miR-23a-5p mimics or RAGE inhibitor were applied in 16-HBE human bronchial epithelial cells in vitro. RNA-sequencing, ELISA, and standard molecular techniques were used to characterize downstream signaling pathways in COPD mice and 16-HBE cells treated with cigarette smoke extract (CSE). RAGE expression is significantly increased in lung tissue of COPD patients, COPD model mice, and CSE-treated 16-HBE cells, while inhibiting RAGE expression significantly reduces COPD severity in mice. RNA-seq analysis of peripheral blood from COPD patients identified miR-23a-5p as the most significant candidate miRNA interaction partner of RAGE, and miR-23a-5p is significantly downregulated in mice and cells treated with CS or CSE, respectively. Injection of miR-23a-5p agomir leads to significantly reduced airway inflammation and alleviation of symptoms in COPD mice, while overexpressing miR-23a-5p leads to improved lung function. RNA-seq with validation confirmed that reactive oxygen species (ROS) signaling is increased under CSE-induced aberrant upregulation of RAGE, and suppressed in CSE-stimulated cells treated with miR-23a-5p mimics or overexpression. ERK phosphorylation and subsequent cytokine production was also increased under RAGE activation, but inhibited by increasing miR-23a-5p levels, implying that the miR-23a-5p/RAGE/ROS axis mediates COPD pathogenesis via ERK activation. This study identifies a miR-23a-5p/RAGE/ROS signaling axis required for pathogenesis of COPD. MiR-23a-5p functions as a negative regulator of RAGE and downstream activation of ROS signaling, and can inhibit COPD progression in vitro and in vivo, suggesting therapeutic targets to improve COPD treatment.
慢性阻塞性肺病(COPD)是一种常见的呼吸系统疾病,是全球第三大死亡原因。高级糖化终产物受体(RAGE)是香烟烟雾(CS)相关慢性阻塞性肺病发病机制中的一个致病受体,本研究旨在研究 miRNA 对 RAGE 的调控,从而指导治疗策略的开发。对慢性阻塞性肺病患者和健康对照组的肺组织以及 CS 诱导的慢性阻塞性肺病小鼠的 RAGE 表达进行了量化。通过对慢性阻塞性肺病患者外周血进行 RNA 测序和结合位点预测,筛选出可能与 RAGE 相互作用的不同表达 miRNA。利用组织学和 SCIREQ 功能测试,在 COPD 小鼠体内使用 miR-23a-5p agomir 研究 miR-23a-5p 作为 COPD 进展的潜在调控因子,同时在体外 16-HBE 人类支气管上皮细胞中使用 miR-23a-5p 模拟物或 RAGE 抑制剂。RNA测序、酶联免疫吸附试验和标准分子技术被用来鉴定 COPD 小鼠和经香烟烟雾提取物(CSE)处理的 16-HBE 细胞的下游信号通路。在慢性阻塞性肺病患者、慢性阻塞性肺病模型小鼠和经 CSE 处理的 16-HBE 细胞的肺组织中,RAGE 的表达明显增加,而抑制 RAGE 的表达可明显减轻小鼠慢性阻塞性肺病的严重程度。对慢性阻塞性肺病患者外周血进行的 RNA-seq 分析发现,miR-23a-5p 是 RAGE 最重要的候选 miRNA 相互作用伙伴,而且 miR-23a-5p 分别在用 CS 或 CSE 处理的小鼠和细胞中显著下调。注射 miR-23a-5p 激动剂能明显减轻慢性阻塞性肺病小鼠的气道炎症并缓解症状,而过表达 miR-23a-5p 则能改善肺功能。RNA-seq验证证实,在CSE诱导的RAGE异常上调情况下,活性氧(ROS)信号转导增加,而在用miR-23a-5p模拟物或过表达处理的CSE刺激细胞中,活性氧信号转导受到抑制。在 RAGE 激活的情况下,ERK 磷酸化和随后的细胞因子产生也会增加,但 miR-23a-5p 水平的增加会抑制这种现象,这意味着 miR-23a-5p/RAGE/ROS 轴通过 ERK 激活介导慢性阻塞性肺病的发病机制。这项研究发现了慢性阻塞性肺病发病机制所需的miR-23a-5p/RAGE/ROS信号轴。MiR-23a-5p 作为 RAGE 的负调控因子和 ROS 信号转导的下游激活因子,可抑制 COPD 在体外和体内的进展,为改善 COPD 治疗提出了治疗靶点。
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引用次数: 0
Association of blood cadmium concentration with chronic obstructive pulmonary disease progression: a prospective cohort study 血液中镉浓度与慢性阻塞性肺病进展的关系:一项前瞻性队列研究
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-17 DOI: 10.1186/s12931-024-02726-0
Jing Sun, You-Peng Deng, Juan Xu, Feng-Min Zhu, Qi-Yuan He, Min-Min Tang, Ying Liu, Jin Yang, Hong-Yan Liu, Lin Fu, Hui Zhao
Prior studies in patients with chronic obstructive pulmonary disease (COPD) had indicated a potential correlation between cadmium (Cd) exposure and reduction in lung function. Nevertheless, the influence of Cd exposure on the progression of COPD remained unknown. Exploring the relationship between Cd exposure and the progression of COPD was the aim of this investigation. Stable COPD patients were enrolled. Blood samples were collected and lung function was evaluated. Regular professional follow-ups were conducted through telephone communications, outpatient services, and patients' hospitalization records. Each additional unit of blood Cd was associated with upward trend in acute exacerbation, hospitalization, longer hospital stay, and death within 2 years. Even after adjusting for potential confounding factors, each 1 unit rise in blood Cd still correlated with a rise in the frequencies of acute exacerbation, longer hospital stay, and death. Moreover, COPD patients with less smoking amount, lower lung function and without comorbidities were more vulnerable to Cd-induced disease deterioration. Patients with COPD who have higher blood Cd concentration are susceptible to worse disease progression.
之前对慢性阻塞性肺病(COPD)患者进行的研究表明,镉(Cd)暴露与肺功能下降之间存在潜在的相关性。然而,镉暴露对慢性阻塞性肺病进展的影响仍然未知。本研究旨在探讨镉暴露与慢性阻塞性肺病进展之间的关系。研究人员招募了病情稳定的慢性阻塞性肺病患者。采集血液样本并评估肺功能。通过电话沟通、门诊服务和患者住院记录进行定期专业随访。血镉每增加一个单位,急性加重、住院、住院时间延长和两年内死亡的趋势就会增加。即使在调整了潜在的混杂因素后,血 Cd 每上升 1 个单位仍与急性加重、住院时间延长和死亡的频率上升相关。此外,吸烟量较少、肺功能较低且无合并症的慢性阻塞性肺病患者更容易受到镉引起的病情恶化的影响。血液中镉浓度较高的慢性阻塞性肺病患者的病情更容易恶化。
{"title":"Association of blood cadmium concentration with chronic obstructive pulmonary disease progression: a prospective cohort study","authors":"Jing Sun, You-Peng Deng, Juan Xu, Feng-Min Zhu, Qi-Yuan He, Min-Min Tang, Ying Liu, Jin Yang, Hong-Yan Liu, Lin Fu, Hui Zhao","doi":"10.1186/s12931-024-02726-0","DOIUrl":"https://doi.org/10.1186/s12931-024-02726-0","url":null,"abstract":"Prior studies in patients with chronic obstructive pulmonary disease (COPD) had indicated a potential correlation between cadmium (Cd) exposure and reduction in lung function. Nevertheless, the influence of Cd exposure on the progression of COPD remained unknown. Exploring the relationship between Cd exposure and the progression of COPD was the aim of this investigation. Stable COPD patients were enrolled. Blood samples were collected and lung function was evaluated. Regular professional follow-ups were conducted through telephone communications, outpatient services, and patients' hospitalization records. Each additional unit of blood Cd was associated with upward trend in acute exacerbation, hospitalization, longer hospital stay, and death within 2 years. Even after adjusting for potential confounding factors, each 1 unit rise in blood Cd still correlated with a rise in the frequencies of acute exacerbation, longer hospital stay, and death. Moreover, COPD patients with less smoking amount, lower lung function and without comorbidities were more vulnerable to Cd-induced disease deterioration. Patients with COPD who have higher blood Cd concentration are susceptible to worse disease progression. ","PeriodicalId":21109,"journal":{"name":"Respiratory Research","volume":"291 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139750889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Viral coinfection in hospitalized patients during the COVID-19 pandemic in Southern Brazil: a retrospective cohort study 巴西南部 COVID-19 大流行期间住院病人的病毒合并感染:一项回顾性队列研究
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-05 DOI: 10.1186/s12931-024-02708-2
Jaqueline Rhoden, Andressa Taíz Hoffmann, Janaína Franciele Stein, Bruna Seixas da Rocha, Vinícius Monteagudo de Barros, Eduardo Viegas da Silva, Juliane Deise Fleck, Caroline Rigotto
Since the worldwide spread of SARS-CoV-2, different strategies have been followed to combat the pandemic and limit virus transmission. In the meantime, other respiratory viruses continued to circulate, though at decreased rates. This study was conducted between June and July 2022, in a hospital in the metropolitan region of Rio Grande do Sul state, in the southernmost state of Brazil. The 337 hospitalized patients included those with respiratory symptoms without delimitation of age. Reverse transcription-quantitative real-time polymerase chain reaction detected 15 different respiratory viruses and confirmed coinfections in the samples. Different statistical tests were applied to evaluate the association between associations of clinical characteristics and coinfection. Sampling corresponds to 337 selected and 330 patients analyzed. The principal clinical outcome found was hospital discharge in 309 (94%) cases, while 21 (6%) resulted in death. The principal viral agents related to coinfections were Human rhinovirus, Human enterovirus, and Respiratory syncytial virus. The most frequent viral agent detected was SARS-CoV-2, with 60 (18%) infections, followed by 51 (15%) cases of Respiratory syncytial virus B (15%) and 44 (13%) cases of Human rhinovirus 1. Coinfection was mainly observed in children, while adults and the elderly were more affected by a single infection. Analyzing COVID-19 vaccination, 175 (53%) were unvaccinated while the remainder had at least one dose of the vaccine. This study presents information to update the understanding of viral circulation in the region. Furthermore, the findings clarify the behavior of viral infections and possible coinfections in hospitalized patients, considering different ages and clinical profiles. In addition, this knowledge can help to monitor the population’s clinical manifestations and prevent future outbreaks of respiratory viruses.
自 SARS-CoV-2 在全球传播以来,人们采取了不同的策略来应对这一流行病并限制病毒传播。与此同时,其他呼吸道病毒仍在继续传播,但传播率有所下降。这项研究于 2022 年 6 月至 7 月间在巴西最南端的南里奥格兰德州大都会地区的一家医院进行。337名住院病人包括有呼吸道症状的病人,不分年龄。逆转录-定量实时聚合酶链反应检测出了 15 种不同的呼吸道病毒,并确认了样本中的合并感染。应用不同的统计检验来评估临床特征与合并感染之间的关联。共选取了 337 例样本,分析了 330 例患者。309例(94%)患者的主要临床结果是出院,21例(6%)患者死亡。与合并感染有关的主要病毒病原体是人类鼻病毒、人类肠道病毒和呼吸道合胞病毒。最常见的病毒病原体是 SARS-CoV-2,有 60 例(18%)感染病例,其次是 51 例(15%)呼吸道合胞病毒 B(15%)和 44 例(13%)人类鼻病毒 1。合并感染主要发生在儿童身上,而成人和老年人受单一感染的影响更大。在分析 COVID-19 疫苗接种情况时,有 175 人(53%)未接种疫苗,其余的人至少接种过一剂疫苗。这项研究提供的信息更新了人们对该地区病毒传播的认识。此外,考虑到不同的年龄和临床特征,研究结果还澄清了住院病人的病毒感染行为和可能的合并感染。此外,这些知识还有助于监测人群的临床表现,预防未来呼吸道病毒的爆发。
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引用次数: 0
Dynamics of host immune responses and a potential function of Trem2hi interstitial macrophages in Pneumocystis pneumonia 肺孢子虫肺炎中宿主免疫反应的动态和 Trem2hi 间质巨噬细胞的潜在功能
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-05 DOI: 10.1186/s12931-024-02709-1
Hu-Qin Yang, Han Sun, Kang Li, Ming-Ming Shao, Kan Zhai, Zhao-Hui Tong
Pneumocystis pneumonia (PCP) is a life-threatening opportunistic fungal infection with a high mortality rate in immunocompromised patients, ranging from 20 to 80%. However, current understanding of the variation in host immune response against Pneumocystis across different timepoints is limited. In this study, we conducted a time-resolved single-cell RNA sequencing analysis of CD45+ cells sorted from lung tissues of mice infected with Pneumocystis. The dynamically changes of the number, transcriptome and interaction of multiply immune cell subsets in the process of Pneumocystis pneumonia were identified according to bioinformatic analysis. Then, the accumulation of Trem2hi interstitial macrophages after Pneumocystis infection was verified by flow cytometry and immunofluorescence. We also investigate the role of Trem2 in resolving the Pneumocystis infection by depletion of Trem2 in mouse models. Our results characterized the CD45+ cell composition of lung in mice infected with Pneumocystis from 0 to 5 weeks, which revealed a dramatic reconstitution of myeloid compartments and an emergence of PCP-associated macrophage (PAM) following Pneumocystis infection. PAM was marked by the high expression of Trem2. We also predicted that PAMs were differentiated from Ly6C+ monocytes and interacted with effector CD4+ T cell subsets via multiple ligand and receptor pairs. Furthermore, we determine the surface markers of PAMs and validated the presence and expansion of Trem2hi interstitial macrophages in PCP by flow cytometry. PAMs secreted abundant pro-inflammation cytokines, including IL-6, TNF-α, GM-CSF, and IP-10. Moreover, PAMs inhibited the proliferation of T cells, and depletion of Trem2 in mouse lead to reduced fungal burden and decreased lung injury in PCP. Our study delineated the dynamic transcriptional changes in immune cells and suggests a role for PAMs in PCP, providing a framework for further investigation into PCP’s cellular and molecular basis, which could provide a resource for further discovery of novel therapeutic targets.
肺孢子菌肺炎(PCP)是一种威胁生命的机会性真菌感染,免疫力低下的患者死亡率很高,从 20% 到 80% 不等。然而,目前对不同时间点宿主对肺孢子菌的免疫反应变化的了解还很有限。在这项研究中,我们对从感染肺孢子虫的小鼠肺组织中分拣出的 CD45+ 细胞进行了时间分辨单细胞 RNA 测序分析。通过生物信息学分析,确定了肺炎过程中多种免疫细胞亚群的数量、转录组和相互作用的动态变化。然后,通过流式细胞术和免疫荧光验证了Trem2hi间质巨噬细胞在肺孢子虫感染后的积累。我们还在小鼠模型中通过消耗 Trem2 研究了 Trem2 在解决肺孢子虫感染中的作用。我们的研究结果表明,在小鼠感染肺孢子虫 0 至 5 周期间,肺部的 CD45+ 细胞组成发生了变化。PAM以Trem2的高表达为特征。我们还预测 PAM 由 Ly6C+ 单核细胞分化而来,并通过多种配体和受体对与效应 CD4+ T 细胞亚群相互作用。此外,我们还确定了 PAMs 的表面标记,并通过流式细胞术验证了 Trem2hi 间质巨噬细胞在 PCP 中的存在和扩增。PAMs 能分泌大量促炎细胞因子,包括 IL-6、TNF-α、GM-CSF 和 IP-10。此外,PAMs 还能抑制 T 细胞的增殖,小鼠体内 Trem2 的耗竭可减少真菌负担,减轻 PCP 的肺损伤。我们的研究描绘了免疫细胞的动态转录变化,并提出了 PAMs 在 PCP 中的作用,为进一步研究 PCP 的细胞和分子基础提供了框架,从而为进一步发现新的治疗靶点提供了资源。
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引用次数: 0
In vitro toxicological evaluation of aerosols generated by a 4th generation vaping device using nicotine salts in an air-liquid interface system 对在气液界面系统中使用尼古丁盐的第四代吸烟装置产生的气溶胶进行体外毒理学评估
IF 5.8 2区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2024-02-05 DOI: 10.1186/s12931-024-02697-2
Clément Mercier, Jérémie Pourchez, Lara Leclerc, Valérie Forest
Electronic cigarettes (EC) have gained popularity, especially among young people, with the introduction of fourth-generation devices based on e-liquids containing nicotine salts that promise a smoother vaping experience than freebase nicotine. However, the toxicological effects of nicotine salts are still largely unknown, and the chemical diversity of e-liquids limits the comparison between different studies to determine the contribution of each compound to the cytotoxicity of EC aerosols. Therefore, the aim of this study was to evaluate the toxicological profile of controlled composition e-liquid aerosols to accurately determine the effects of each ingredient based on exposure at the air-liquid interface. Human lung epithelial cells (A549) were exposed to undiluted aerosols of controlled composition e-liquids containing various ratios of propylene glycol (PG)/vegetable glycerin (VG) solvents, freebase nicotine, organic acids, nicotine salts, and flavoured commercial e-liquids. Exposure of 20 puffs was performed at the air-liquid interface following a standard vaping regimen. Toxicological outcomes, including cytotoxicity, inflammation, and oxidative stress, were assessed 24 h after exposure. PG/VG aerosols elicited a strong cytotoxic response characterised by a 50% decrease in cell viability and a 200% increase in lactate dehydrogenase (LDH) production, but had no effects on inflammation and oxidative stress. These effects occurred only at a ratio of 70/30 PG/VG, suggesting that PG is the major contributor to aerosol cytotoxicity. Both freebase nicotine and organic acids had no greater effect on cell viability and LDH release than at a 70/30 PG/VG ratio, but significantly increased inflammation and oxidative stress. Interestingly, the protonated form of nicotine in salt showed a stronger proinflammatory effect than the freebase nicotine form, while benzoic acid-based nicotine salts also induced significant oxidative stress. Flavoured commercial e-liquids was found to be cytotoxic at a threshold dose of ≈ 330 µg/cm². Our results showed that aerosols of e-liquids consisting only of PG/VG solvents can cause severe cytotoxicity depending on the concentration of PG, while nicotine salts elicit a stronger pro-inflammatory response than freebase nicotine. Overall, aerosols from fourth-generation devices can cause different toxicological effects, the nature of which depends on the chemical composition of the e-liquid.
第四代电子香烟(EC)采用含有尼古丁盐的电子烟液,承诺提供比游离尼古丁更顺畅的吸食体验,因此受到越来越多人的青睐,尤其是年轻人。然而,尼古丁盐的毒理效应在很大程度上仍不为人所知,而且电子烟液化学成分的多样性限制了不同研究之间的比较,无法确定每种化合物对电子烟气溶胶细胞毒性的贡献。因此,本研究旨在评估受控成分电子液体气溶胶的毒理学特征,以便根据空气-液体界面的暴露情况准确确定每种成分的影响。人类肺上皮细胞(A549)暴露于含有不同比例丙二醇(PG)/植物甘油(VG)溶剂、游离基尼古丁、有机酸、尼古丁盐和调味商用电子烟的受控成分电子烟的未稀释气溶胶中。按照标准的吸食方法,在空气-液体界面上吸食 20 口。暴露 24 小时后对毒理学结果进行了评估,包括细胞毒性、炎症和氧化应激。PG/VG气溶胶引起了强烈的细胞毒性反应,细胞存活率降低了50%,乳酸脱氢酶(LDH)生成量增加了200%,但对炎症和氧化应激没有影响。只有当 PG/VG 的比例为 70/30 时才会产生这些影响,这表明 PG 是气溶胶细胞毒性的主要成因。游离基尼古丁和有机酸对细胞活力和 LDH 释放的影响并不比 PG/VG 比率为 70/30 时更大,但却显著增加了炎症和氧化应激。有趣的是,盐中质子化形式的尼古丁比游离基尼古丁形式的尼古丁具有更强的促炎作用,而苯甲酸类尼古丁盐也会诱发明显的氧化应激。在阈值剂量≈ 330 微克/平方厘米时,发现调味商用电子液体具有细胞毒性。我们的研究结果表明,仅由 PG/VG 溶剂组成的电子烟的气溶胶会导致严重的细胞毒性,具体取决于 PG 的浓度,而尼古丁盐比游离基尼古丁会引起更强的促炎反应。总之,第四代设备产生的气溶胶会造成不同的毒理效应,其性质取决于电子液体的化学成分。
{"title":"In vitro toxicological evaluation of aerosols generated by a 4th generation vaping device using nicotine salts in an air-liquid interface system","authors":"Clément Mercier, Jérémie Pourchez, Lara Leclerc, Valérie Forest","doi":"10.1186/s12931-024-02697-2","DOIUrl":"https://doi.org/10.1186/s12931-024-02697-2","url":null,"abstract":"Electronic cigarettes (EC) have gained popularity, especially among young people, with the introduction of fourth-generation devices based on e-liquids containing nicotine salts that promise a smoother vaping experience than freebase nicotine. However, the toxicological effects of nicotine salts are still largely unknown, and the chemical diversity of e-liquids limits the comparison between different studies to determine the contribution of each compound to the cytotoxicity of EC aerosols. Therefore, the aim of this study was to evaluate the toxicological profile of controlled composition e-liquid aerosols to accurately determine the effects of each ingredient based on exposure at the air-liquid interface. Human lung epithelial cells (A549) were exposed to undiluted aerosols of controlled composition e-liquids containing various ratios of propylene glycol (PG)/vegetable glycerin (VG) solvents, freebase nicotine, organic acids, nicotine salts, and flavoured commercial e-liquids. Exposure of 20 puffs was performed at the air-liquid interface following a standard vaping regimen. Toxicological outcomes, including cytotoxicity, inflammation, and oxidative stress, were assessed 24 h after exposure. PG/VG aerosols elicited a strong cytotoxic response characterised by a 50% decrease in cell viability and a 200% increase in lactate dehydrogenase (LDH) production, but had no effects on inflammation and oxidative stress. These effects occurred only at a ratio of 70/30 PG/VG, suggesting that PG is the major contributor to aerosol cytotoxicity. Both freebase nicotine and organic acids had no greater effect on cell viability and LDH release than at a 70/30 PG/VG ratio, but significantly increased inflammation and oxidative stress. Interestingly, the protonated form of nicotine in salt showed a stronger proinflammatory effect than the freebase nicotine form, while benzoic acid-based nicotine salts also induced significant oxidative stress. Flavoured commercial e-liquids was found to be cytotoxic at a threshold dose of ≈ 330 µg/cm². Our results showed that aerosols of e-liquids consisting only of PG/VG solvents can cause severe cytotoxicity depending on the concentration of PG, while nicotine salts elicit a stronger pro-inflammatory response than freebase nicotine. Overall, aerosols from fourth-generation devices can cause different toxicological effects, the nature of which depends on the chemical composition of the e-liquid.","PeriodicalId":21109,"journal":{"name":"Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139688852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Respiratory Research
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