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Expression of human Interferon Regulatory Factor 3 (IRF-3) in alveolar macrophages relates to clinical and functional traits in COPD. 肺泡巨噬细胞中人类干扰素调节因子 3 (IRF-3) 的表达与慢性阻塞性肺病的临床和功能特征有关。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-19 DOI: 10.1186/s12931-024-02952-6
Simonetta Baraldo, Matteo Bonato, Sebastiano Cassia, Paolo Casolari, Laura De Ferrari, Mariaenrica Tiné, Federico Baraldi, Tommaso Bigoni, Anna Maria Riccio, Fulvio Braido, Marina Saetta, Alberto Papi, Marco Contoli

Introduction: Chronic obstructive pulmonary disease (COPD) is a frequent cause of morbidity and mortality. Dysregulated and enhanced immune-inflammatory responses have been described in COPD. Recent data showed impaired immune responses and, in particular, of interferon (IFNs) signaling pathway in these patients.

Aim: To evaluate in peripheral lung of COPD patients, the expression of some of the less investigated key components of the innate immune responses leading to IFN productions including: IFN-receptors (IFNAR1/IFNAR2), IRF-3 and MDA-5. Correlations with clinical traits and with the inflammatory cell profile have been assessed.

Methods: Lung specimens were collected from 58 subjects undergoing thoracic surgery: 22 COPD patients, 21 smokers with normal lung function (SC) and 15 non-smoker controls (nSC). The expression of IFNAR1, IFNAR2, IRF-3 and MDA-5, of eosinophils and activated NK cells (NKp46+) were quantified in the peripheral lung by immunohistochemistry.

Results: A significant increase of IRF-3 + alveolar macrophages were observed in COPD and SC compared with nSC subjects. However, in COPD patients, the lower the levels of IRF-3 + alveolar macrophages the lower the FEV1 and the higher the exacerbation rate. The presence of chronic bronchitis (CB) was also associated with low levels of IRF-3 + alveolar macrophages. NKp46 + cells, but not eosinophils, were increased in COPD patients compared to nSC patients (p < 0.0001).

Conclusions: Smoking is associated with higher levels of innate immune response as showed by higher levels of IRF-3 + alveolar macrophages and NKp46 + cells. In COPD, exacerbation rates, severe airflow obstruction and CB were associated with lower levels of IRF-3 expression, suggesting that innate immune responses characterize specific clinical traits of the disease.

简介慢性阻塞性肺病(COPD)是一种常见的发病和死亡原因。慢性阻塞性肺病的免疫炎症反应失调和增强已有描述。目的:评估慢性阻塞性肺病患者外周肺中导致 IFN 生成的先天性免疫反应中一些研究较少的关键成分的表达情况,包括:IFN 受体(IFN-receptors,IFN-receptors,IFN-receptors,IFN-receptors,IFN-receptors,IFN-receptors,IFN-receptors,IFN-receptors,IFN-receptors):IFN受体(IFNAR1/IFNAR2)、IRF-3和MDA-5。评估了与临床特征和炎症细胞特征的相关性:方法:从 58 名接受胸腔手术的受试者身上采集肺标本,其中包括 22 名慢性阻塞性肺病患者、21 名肺功能正常的吸烟者(SC)和 15 名非吸烟对照组(nSC)。通过免疫组化方法对外周肺中 IFNAR1、IFNAR2、IRF-3 和 MDA-5、嗜酸性粒细胞和活化 NK 细胞(NKp46+)的表达进行了定量分析:结果:与 nSC 受试者相比,COPD 和 SC 受试者肺泡巨噬细胞中 IRF-3 + 的数量明显增加。然而,在 COPD 患者中,IRF-3 + 肺泡巨噬细胞的水平越低,FEV1 就越低,恶化率就越高。慢性支气管炎(CB)的存在也与低水平的 IRF-3 + 肺泡巨噬细胞有关。与 nSC 患者相比,慢性阻塞性肺疾病患者的 NKp46 + 细胞增加,但嗜酸性粒细胞没有增加(p 结论:慢性阻塞性肺疾病患者的 NKp46 + 细胞增加,但嗜酸性粒细胞没有增加:吸烟与较高水平的先天性免疫反应有关,表现为较高水平的 IRF-3 + 肺泡巨噬细胞和 NKp46 + 细胞。在慢性阻塞性肺病中,恶化率、严重气流阻塞和 CB 与较低水平的 IRF-3 表达有关,这表明先天性免疫反应是该疾病特定临床特征的特征。
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引用次数: 0
Distinctive field effects of smoking and lung cancer case-control status on bronchial basal cell growth and signaling. 吸烟和肺癌病例对照状态对支气管基底细胞生长和信号传导的不同场效应
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-19 DOI: 10.1186/s12931-024-02924-w
Olsida Zefi, Spencer Waldman, Ava Marsh, Miao Kevin Shi, Yosef Sonbolian, Batbayar Khulan, Taha Siddiqui, Aditi Desai, Dhruv Patel, Aham Okorozo, Samer Khader, Jay Dobkin, Ali Sadoughi, Chirag Shah, Simon Spivack, Yakov Peter

Rational: Basal cells (BCs) are bronchial progenitor/stem cells that can regenerate injured airway that, in smokers, may undergo malignant transformation. As a model for early stages of lung carcinogenesis, we set out to characterize cytologically normal BC outgrowths from never-smokers and ever-smokers without cancers (controls), as well as from the normal epithelial "field" of ever-smokers with anatomically remote cancers, including lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) (cases).

Methods: Primary BCs were cultured and expanded from endobronchial brushings taken remote from the site of clinical or visible lesions/tumors. Donor subgroups were tested for growth, morphology, and underlying molecular features by qRT-PCR, RNAseq, flow cytometry, immunofluorescence, and immunoblot.

Results: (a) the BC population includes epithelial cell adhesion molecule (EpCAM) positive and negative cell subsets; (b) smoking reduced overall BC proliferation corresponding with a 2.6-fold reduction in the EpCAMpos/ITGA6 pos/CD24pos stem cell fraction; (c) LUSC donor cells demonstrated up to 2.8-fold increase in dysmorphic BCs; and (d) cells procured from LUAD patients displayed increased proliferation and S-phase cell cycle fractions. These differences corresponded with: (i) disparate NOTCH1/NOTCH2 transcript expression and altered expression of potential downstream (ii) E-cadherin (CDH1), tumor protein-63 (TP63), secretoglobin family 1a member 1 (SCGB1A1), and Hairy/enhancer-of-split related with YRPW motif 1 (HEY1); and (iii) reduced EPCAM and increased NK2 homeobox-1 (NKX2-1) mRNA expression in LUAD donor BCs.

Conclusions: These and other findings demonstrate impacts of donor age, smoking, and lung cancer case-control status on BC phenotypic and molecular traits and may suggest Notch signaling pathway deregulation during early human lung cancer pathogenesis.

理论依据:基底细胞(BCs)是支气管的祖细胞/干细胞,可以再生受伤的气道,而吸烟者的气道可能会发生恶性转化。作为肺癌发生早期阶段的模型,我们着手研究从未吸烟者和曾经吸烟但未患癌症者(对照组)以及曾经吸烟但在解剖学上患有远处癌症(包括肺腺癌(LUAD)和鳞状细胞癌(LUSC))的人(病例)的正常上皮 "领域 "中长出的细胞学正常的基底细胞:方法:从远离临床或可见病变/肿瘤部位的支气管内刷取物中培养和扩增原发性BCs。结果:(a) BC 群体包括上皮细胞粘附分子(EpCAM)阳性和阴性细胞亚群;(b) 吸烟减少了 BC 的整体增殖,与此相对应的是 EpCAM 阳性细胞亚群减少了 2.6 倍;(c) LUSC 供体细胞显示畸形 BCs 增加了 2.8 倍;(d) 从 LUAD 患者处获得的细胞显示增殖和 S 期细胞周期部分增加。这些差异与(i)NOTCH1/NOTCH2转录本表达的差异和潜在下游(ii)E-cadherin (CDH1)、肿瘤蛋白-63 (TP63)、secretoglobin家族1a成员1 (SCGB1A1)和Hairy/enhancer-of-split related with YRPW motif 1 (HEY1)表达的改变;以及(iii)LUAD供体BC中EPCAM表达减少和NK2 homeobox-1 (NKX2-1) mRNA表达增加:这些及其他研究结果表明了供体年龄、吸烟和肺癌病例对照状态对 BC 表型和分子特征的影响,并可能提示了人类早期肺癌发病过程中 Notch 信号通路的失调。
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引用次数: 0
The role and mechanism of thrombospondin-4 in pulmonary arterial hypertension associated with congenital heart disease. 凝血酶原-4在与先天性心脏病相关的肺动脉高压中的作用和机制。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-17 DOI: 10.1186/s12931-024-02932-w
Haowei Zeng, Beidi Lan, Bingyi Li, Hang Xie, Enfa Zhao, Xiaoqin Liu, Xiaoyi Xue, Jingyan Sun, Linjie Su, Yushun Zhang

Background: Due to a special hemodynamic feature, pulmonary vascular disease in pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) has two stages: reversible and irreversible. So far, the mechanism involved in the transition from reversible to irreversible stage is elusive. Moreover, no recognized and reliable assessments to distinguish these two stages are available. Furthermore, we found that compared with control and reversible PAH, thrombospondin-4 (THBS4) was significantly upregulated in irreversible group by bioinformatic analysis. Hence, we further verify and investigate the expression and role of THBS4 in PAH-CHD.

Methods: We established the monocrotaline plus aorto-cava shunt-induced (MCT-AV) rat model. We measured the expression of THBS4 in lung tissues from MCT-AV rats. Double immunofluorescence staining of lung tissue for THBS4 and α-SMA (biomarker of smooth muscle cells) or vWF (biomarker of endothelial cells) to identify the location of THBS4 in the pulmonary artery. Primary pulmonary artery smooth muscle cells (PASMCs) were cultivated, identified, and used in this study. THBS4 was inhibited and overexpressed by siRNA and plasmid, respectively, to explore the effect of THBS4 on phenotype transformation, proliferation, apoptosis, and migration of PASMCs. The effect of THBS4 on pulmonary vascular remodeling was evaluated in vivo by adeno-associated virus which suppressed THBS4 expression. Circulating level of THBS4 in patients with PAH-CHD was measured by ELISA.

Results: THBS4 was upregulated in the lung tissues of MCT-AV rats, and was further upregulated in severe pulmonary vascular lesions. And THBS4 was expressed mainly in PASMCs. When THBS4 was inhibited, contractile markers α-SMA and MYH11 were upregulated, while the proliferative marker PCNA was decreased, the endothelial-mensenchymal transition marker N-cad was downregulated, proapototic marker BAX was increased. Additionally, proliferation and migration of PASMCs was inhibited and apoptosis was increased. Conversely, THBS4 overexpression resulted in opposite effects. And the impact of THBS4 on PASMCs was probably achieved through the regulation of the PI3K/AKT pathway. THBS4 suppression attenuated pulmonary vascular remodeling. Furthermore, compared with patients with simple congenital heart disease and mild PAH-CHD, the circulating level of THBS4 was higher in patients with severe PAH-CHD.

Conclusions: THBS4 is a promising biomarker to distinguish reversible from irreversible PAH-CHD before repairing the shunt. THBS4 is a potential treatment target in PAH-CHD, especially in irreversible stage.

背景:由于特殊的血流动力学特征,肺动脉高压伴先天性心脏病(PAH-CHD)的肺血管疾病分为两个阶段:可逆和不可逆。迄今为止,从可逆阶段过渡到不可逆阶段的机制尚不明确。此外,也没有公认可靠的评估方法来区分这两个阶段。此外,我们通过生物信息学分析发现,与对照组和可逆 PAH 相比,不可逆性组的血栓软骨素-4(THBS4)明显上调。因此,我们进一步验证和研究了 THBS4 在 PAH-CHD 中的表达和作用:方法:我们建立了单克尿嘧啶加主动脉分流诱导(MCT-AV)大鼠模型。我们测定了 MCT-AV 大鼠肺组织中 THBS4 的表达。对肺组织进行 THBS4 和 α-SMA(平滑肌细胞的生物标记)或 vWF(内皮细胞的生物标记)双重免疫荧光染色,以确定 THBS4 在肺动脉中的位置。本研究培养、鉴定并使用了原代肺动脉平滑肌细胞(PASMC)。通过 siRNA 和质粒分别抑制和过表达 THBS4,探讨 THBS4 对 PASMC 表型转化、增殖、凋亡和迁移的影响。通过抑制 THBS4 表达的腺相关病毒,在体内评估了 THBS4 对肺血管重塑的影响。用酶联免疫吸附法测定了 PAH-CHD 患者体内 THBS4 的循环水平:结果:THBS4在MCT-AV大鼠肺组织中上调,在严重肺血管病变中进一步上调。THBS4主要在PASMCs中表达。当抑制 THBS4 时,收缩标志物 α-SMA 和 MYH11 上调,而增殖标志物 PCNA 下降,内皮-间质转化标志物 N-cad 下调,促凋亡标志物 BAX 上调。此外,PASMC 的增殖和迁移受到抑制,凋亡增加。相反,THBS4 过表达则会导致相反的效果。而 THBS4 对 PASMCs 的影响可能是通过调节 PI3K/AKT 通路实现的。抑制 THBS4 可减轻肺血管重塑。此外,与单纯先天性心脏病和轻度PAH-CHD患者相比,重度PAH-CHD患者循环中的THBS4水平更高:结论:THBS4是在修复分流之前区分可逆和不可逆PAH-CHD的一种有希望的生物标志物。THBS4是PAH-CHD的潜在治疗靶点,尤其是在不可逆阶段。
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引用次数: 0
Inhaled tea polyphenol-loaded nanoparticles coated with platelet membranes largely attenuate asthmatic inflammation. 吸入涂有血小板膜的茶多酚纳米颗粒可在很大程度上减轻哮喘炎症。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-17 DOI: 10.1186/s12931-024-02947-3
Suidong Ouyang, Peishan Lu, Jianing Li, Hua Jin, Wanhua Wu, Renxing Luo, Bin Wang, Xueqin Huang, Xinlong Lian, Gonghua Huang

Background: Tea polyphenols (TPs), prominent constituents of green tea, possess remarkable antioxidant and anti-inflammatory properties. However, their therapeutic potential is limited due to low absorption and poor bioavailability. To address this limitation and enhance their efficacy, we developed a biomimetic nanoplatform by coating platelet membrane (PM) onto poly-lactic-co-glycolic acid (PLGA) nanoparticles (NPs) to create targeted delivery vehicles for TPs (PM@TP/NPs) to the inflamed tissues in asthma.

Methods: After synthesizing and characterizing PM@TP/NPs, we assessed their biocompatibility and biosafety through cell viability assays, hemolysis tests, and inflammation analysis in vivo and in vitro. The therapeutic effect of PM@TP/NPs on asthma was then evaluated using a mouse model of HDM-induced asthma. Additionally, PM@TP/NPs-mediated reactive oxygen species (ROS) scavenging capacity, as well as the activation of signaling pathways, were analyzed in HBE cells and asthmatic mice via flow cytometry, RT-qPCR, and western blotting.

Results: Compared with free TPs, PM@TP/NPs demonstrated excellent biocompatibility and safety profiles in both in vitro and in vivo, as well as enhanced retention in inflamed lungs. In HDM-induced mouse asthma model, inhaled PM@TP/NPs largely attenuated lung inflammation and reduced the secretion of type 2 pro-inflammatory cytokines in the lungs compared to free TPs. The therapeutic effects of PM@TP/NPs on asthma might be associated with an enhanced ROS scavenging capacity, increased activation of the Nrf2/HO-1 pathway, and decreased activation of the CCL2/MAPK and TLR4/NF-κB pathway in the lungs.

Conclusions: Our findings demonstrate that inhalation of PM@TP/NPs largely attenuated lung inflammation in HDM-induced asthmatic mice. These results suggest that PM@TP/NPs might be a novel therapeutic strategy for asthma.

背景:茶多酚(TPs)是绿茶的主要成分,具有显著的抗氧化和抗炎特性。然而,由于吸收率低、生物利用度差,茶多酚的治疗潜力受到了限制。为了解决这一局限性并提高其疗效,我们开发了一种仿生纳米平台,将血小板膜(PM)包覆在聚乳酸-共聚乙醇酸(PLGA)纳米颗粒(NPs)上,从而为哮喘患者的炎症组织提供靶向递送 TPs(PM@TP/NPs)的载体:在合成和表征了PM@TP/NPs之后,我们通过细胞存活率测定、溶血试验以及体内和体外炎症分析评估了它们的生物相容性和生物安全性。然后,我们利用 HDM 诱导的小鼠哮喘模型评估了 PM@TP/NPs 对哮喘的治疗效果。此外,还通过流式细胞术、RT-qPCR 和 Western 印迹法分析了 PM@TP/NPs 在 HBE 细胞和哮喘小鼠体内介导的活性氧清除能力以及信号通路的激活情况:结果:与游离 TPs 相比,PM@TP/NPs 在体外和体内均表现出良好的生物相容性和安全性,并增强了在发炎肺部的滞留性。在 HDM 诱导的小鼠哮喘模型中,与游离 TPs 相比,吸入 PM@TP/NPs 在很大程度上减轻了肺部炎症,减少了肺部 2 型促炎细胞因子的分泌。PM@TP/NPs对哮喘的治疗作用可能与ROS清除能力增强、Nrf2/HO-1通路激活增加以及肺部CCL2/MAPK和TLR4/NF-κB通路激活减少有关:我们的研究结果表明,吸入 PM@TP/NPs 在很大程度上减轻了 HDM 诱导的哮喘小鼠的肺部炎症。这些结果表明,PM@TP/NPs 可能是治疗哮喘的一种新策略。
{"title":"Inhaled tea polyphenol-loaded nanoparticles coated with platelet membranes largely attenuate asthmatic inflammation.","authors":"Suidong Ouyang, Peishan Lu, Jianing Li, Hua Jin, Wanhua Wu, Renxing Luo, Bin Wang, Xueqin Huang, Xinlong Lian, Gonghua Huang","doi":"10.1186/s12931-024-02947-3","DOIUrl":"10.1186/s12931-024-02947-3","url":null,"abstract":"<p><strong>Background: </strong>Tea polyphenols (TPs), prominent constituents of green tea, possess remarkable antioxidant and anti-inflammatory properties. However, their therapeutic potential is limited due to low absorption and poor bioavailability. To address this limitation and enhance their efficacy, we developed a biomimetic nanoplatform by coating platelet membrane (PM) onto poly-lactic-co-glycolic acid (PLGA) nanoparticles (NPs) to create targeted delivery vehicles for TPs (PM@TP/NPs) to the inflamed tissues in asthma.</p><p><strong>Methods: </strong>After synthesizing and characterizing PM@TP/NPs, we assessed their biocompatibility and biosafety through cell viability assays, hemolysis tests, and inflammation analysis in vivo and in vitro. The therapeutic effect of PM@TP/NPs on asthma was then evaluated using a mouse model of HDM-induced asthma. Additionally, PM@TP/NPs-mediated reactive oxygen species (ROS) scavenging capacity, as well as the activation of signaling pathways, were analyzed in HBE cells and asthmatic mice via flow cytometry, RT-qPCR, and western blotting.</p><p><strong>Results: </strong>Compared with free TPs, PM@TP/NPs demonstrated excellent biocompatibility and safety profiles in both in vitro and in vivo, as well as enhanced retention in inflamed lungs. In HDM-induced mouse asthma model, inhaled PM@TP/NPs largely attenuated lung inflammation and reduced the secretion of type 2 pro-inflammatory cytokines in the lungs compared to free TPs. The therapeutic effects of PM@TP/NPs on asthma might be associated with an enhanced ROS scavenging capacity, increased activation of the Nrf2/HO-1 pathway, and decreased activation of the CCL2/MAPK and TLR4/NF-κB pathway in the lungs.</p><p><strong>Conclusions: </strong>Our findings demonstrate that inhalation of PM@TP/NPs largely attenuated lung inflammation in HDM-induced asthmatic mice. These results suggest that PM@TP/NPs might be a novel therapeutic strategy for asthma.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology, ventilation management and outcomes of COVID-19 ARDS patients versus patients with ARDS due to pneumonia in the Pre-COVID era. COVID-19 ARDS 患者与前 COVID 时代肺炎所致 ARDS 患者的流行病学、通气管理和预后对比。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-17 DOI: 10.1186/s12931-024-02910-2
Fleur-Stefanie L I M van der Ven, Siebe G Blok, Luciano C Azevedo, Giacomo Bellani, Michela Botta, Elisa Estenssoro, Eddy Fan, Juliana Carvalho Ferreira, John G Laffey, Ignacio Martin-Loeches, Ana Motos, Tai Pham, Oscar Peñuelas, Antonio Pesenti, Luigi Pisani, Ary Serpa Neto, Marcus J Schultz, Antoni Torres, Anissa M Tsonas, Frederique Paulus, David M P van Meenen

Background: Ventilation management may differ between COVID-19 ARDS (COVID-ARDS) patients and patients with pre-COVID ARDS (CLASSIC-ARDS); it is uncertain whether associations of ventilation management with outcomes for CLASSIC-ARDS also exist in COVID-ARDS.

Methods: Individual patient data analysis of COVID-ARDS and CLASSIC-ARDS patients in six observational studies of ventilation, four in the COVID-19 pandemic and two pre-pandemic. Descriptive statistics were used to compare epidemiology and ventilation characteristics. The primary endpoint were key ventilation parameters; other outcomes included mortality and ventilator-free days and alive (VFD-60) at day 60.

Results: This analysis included 6702 COVID-ARDS patients and 1415 CLASSIC-ARDS patients. COVID-ARDS patients received lower median VT (6.6 [6.0 to 7.4] vs 7.3 [6.4 to 8.5] ml/kg PBW; p < 0.001) and higher median PEEP (12.0 [10.0 to 14.0] vs 8.0 [6.0 to 10.0] cm H2O; p < 0.001), at lower median ΔP (13.0 [10.0 to 15.0] vs 16.0 [IQR 12.0 to 20.0] cm H2O; p < 0.001) and higher median Crs (33.5 [26.6 to 42.1] vs 28.1 [21.6 to 38.4] mL/cm H2O; p < 0.001). Following multivariable adjustment, higher ΔP had an independent association with higher 60-day mortality and less VFD-60 in both groups. Higher PEEP had an association with less VFD-60, but only in COVID-ARDS patients.

Conclusions: Our findings show important differences in key ventilation parameters and associations thereof with outcomes between COVID-ARDS and CLASSIC-ARDS.

Trial registration: Clinicaltrials.gov (identifier NCT05650957), December 14, 2022.

背景:COVID-19 ARDS(COVID-ARDS)患者和COVID前ARDS(CLASSIC-ARDS)患者的通气管理可能不同;目前尚不确定COVID-ARDS患者的通气管理是否与CLASSIC-ARDS的预后相关:方法:对六项通气观察研究中的 COVID-ARDS 和 CLASSIC-ARDS 患者进行个体数据分析,其中四项研究是在 COVID-19 大流行期间进行的,两项研究是在大流行之前进行的。描述性统计用于比较流行病学和通气特征。主要终点是关键通气参数;其他结果包括死亡率和无呼吸机天数以及第 60 天的存活率(VFD-60):该分析包括 6702 名 COVID-ARDS 患者和 1415 名 CLASSIC-ARDS 患者。COVID-ARDS 患者接受的 VT 中位数较低(6.6 [6.0 至 7.4] vs 7.3 [6.4 至 8.5] ml/kg PBW;p 2O;p 2O;p 2O;p 2O;p 结论:我们的研究结果表明,COVID-ARDS 患者和 CLASSIC-ARDS 患者接受的 VT 中位数存在重要差异:我们的研究结果表明,COVID-ARDS和CLASSIC-ARDS的主要通气参数及其与预后的关系存在重大差异:试验注册:Clinicaltrials.gov(标识符 NCT05650957),2022 年 12 月 14 日。
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引用次数: 0
PARK2 as a susceptibility factor for nontuberculous mycobacterial pulmonary disease. PARK2 是非结核分枝杆菌肺病的易感因素。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-14 DOI: 10.1186/s12931-024-02946-4
Youngmok Park, Ji Won Hong, Eunsol Ahn, Heon Yung Gee, Young Ae Kang

Background: The genetic signatures associated with the susceptibility to nontuberculous mycobacterial pulmonary disease (NTM-PD) are still unknown. In this study, we performed RNA sequencing to explore gene expression profiles and represent characteristic factor in NTM-PD.

Methods: Peripheral blood samples were collected from patients with NTM-PD and healthy individuals (controls). Differentially expressed genes (DEGs) were identified by RNA sequencing and subjected to functional enrichment and immune cell deconvolution analyses.

Results: We enrolled 48 participants, including 26 patients with NTM-PD (median age, 58.0 years; 84.6% female), and 22 healthy controls (median age, 58.5 years; 90.9% female). We identified 21 upregulated and 44 downregulated DEGs in the NTM-PD group compared to those in the control group. NTM infection did not have a significant impact on gene expression in the NTM-PD group compared to the control group, and there were no differences in the proportion of immune cells. However, through gene ontology (GO), gene set enrichment analysis (GSEA), and protein-protein interaction (PPI) analysis, we discovered that PARK2 is a key factor associated with NTM-PD. The PARK2 gene, which is linked to the ubiquitination pathway, was downregulated in the NTM-PD group (fold change, - 1.314, P = 0.047). The expression levels of PARK2 remained unaltered after favorable treatment outcomes, suggesting that the gene is associated with host susceptibility rather than with the outcomes of infection or inflammation. The area under the receiver operating characteristic curve for the PARK2 gene diagnosing NTM-PD was 0.813 (95% confidence interval, 0.694-0.932).

Conclusion: We identified the genetic signatures associated with NTM-PD in a cohort of Korean patients. The PARK2 gene presents as a potential susceptibility factor in NTM-PD .

背景:与非结核分枝杆菌肺病(NTM-PD)易感性相关的基因特征仍然未知。在这项研究中,我们进行了 RNA 测序,以探索基因表达谱和代表 NTM-PD 特征因素的基因:方法:采集 NTM-PD 患者和健康人(对照组)的外周血样本。通过 RNA 测序确定差异表达基因(DEGs),并进行功能富集和免疫细胞解旋分析:我们招募了 48 名参与者,包括 26 名 NTM-PD 患者(中位年龄 58.0 岁;84.6% 为女性)和 22 名健康对照者(中位年龄 58.5 岁;90.9% 为女性)。与对照组相比,我们在 NTM-PD 组中发现了 21 个上调的 DEGs 和 44 个下调的 DEGs。与对照组相比,NTM-PD 组的基因表达没有受到 NTM 感染的显著影响,免疫细胞的比例也没有差异。然而,通过基因本体(GO)、基因组富集分析(GSEA)和蛋白相互作用(PPI)分析,我们发现 PARK2 是与 NTM-PD 相关的一个关键因素。与泛素化途径相关的 PARK2 基因在 NTM-PD 组中出现下调(折叠变化,- 1.314,P = 0.047)。在治疗取得良好效果后,PARK2 的表达水平保持不变,这表明该基因与宿主的易感性有关,而不是与感染或炎症的结果有关。PARK2 基因诊断 NTM-PD 的接收器操作特征曲线下面积为 0.813(95% 置信区间,0.694-0.932):结论:我们在一组韩国患者中发现了与 NTM-PD 相关的基因特征。PARK2基因是NTM-PD的潜在易感因素。
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引用次数: 0
The clinical impacts of lung microbiome in bronchiectasis with fixed airflow obstruction: a prospective cohort study. 固定气流阻塞支气管扩张症患者肺部微生物组的临床影响:一项前瞻性队列研究。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-14 DOI: 10.1186/s12931-024-02931-x
Yen-Fu Chen, Hsin-Han Hou, Ning Chien, Kai-Zen Lu, Chieh-Hua Lin, Yu-Chieh Liao, Kuo-Lung Lor, Jung-Yien Chien, Chung-Ming Chen, Chung-Yu Chen, Shih-Lung Cheng, Hao-Chien Wang, Po-Ren Hsueh, Chong-Jen Yu

Background: Airflow obstruction is a hallmark of disease severity and prognosis in bronchiectasis. The relationship between lung microbiota, airway inflammation, and outcomes in bronchiectasis with fixed airflow obstruction (FAO) remains unclear. This study explores these interactions in bronchiectasis patients, with and without FAO, and compares them to those diagnosed with chronic obstructive pulmonary disease (COPD).

Methods: This prospective observational study in Taiwan enrolled patients with either bronchiectasis or COPD. To analyze the lung microbiome and assess inflammatory markers, bronchoalveolar lavage (BAL) samples were collected for 16S rRNA gene sequencing. The study cohort comprised 181 patients: 86 with COPD, 46 with bronchiectasis, and 49 with bronchiectasis and FAO, as confirmed by spirometry.

Results: Patients with bronchiectasis, with or without FAO, had similar microbiome profiles characterized by reduced alpha diversity and a predominance of Proteobacteria, distinctly different from COPD patients who exhibited more Firmicutes, greater diversity, and more commensal taxa. Furthermore, compared to COPD and bronchiectasis without FAO, bronchiectasis with FAO showed more severe disease and a higher risk of exacerbations. A significant correlation was found between the presence of Pseudomonas aeruginosa and increased airway neutrophilic inflammation such as Interleukin [IL]-1β, IL-8, and tumor necrosis factor-alpha [TNF]-α, as well as with higher bronchiectasis severity, which might contribute to an increased risk of exacerbations. Moreover, in bronchiectasis patients with FAO, the ROSE (Radiology, Obstruction, Symptoms, and Exposure) criteria were employed to classify individuals as either ROSE (+) or ROSE (-), based on smoking history. This classification highlighted differences in clinical features, inflammatory profiles, and slight microbiome variations between ROSE (-) and ROSE (+) patients, suggesting diverse endotypes within the bronchiectasis with FAO group.

Conclusion: Bronchiectasis patients with FAO may exhibit two distinct endotypes, as defined by ROSE criteria, characterized by greater disease severity and a lung microbiome more similar to bronchiectasis without FAO than to COPD. The significant correlation between Pseudomonas aeruginosa colonization and increased airway neutrophilic inflammation, as well as disease severity, underscores the clinical relevance of microbial patterns. This finding reinforces the potential role of these patterns in the progression and exacerbations of bronchiectasis with FAO.

背景:气流阻塞是支气管扩张症疾病严重程度和预后的标志。固定气流阻塞(FAO)支气管扩张症患者的肺微生物群、气道炎症和预后之间的关系仍不清楚。本研究探讨了支气管扩张症患者(有固定气流阻塞和无固定气流阻塞)与慢性阻塞性肺病(COPD)患者之间的相互作用,并将其与慢性阻塞性肺病患者进行了比较:这项在台湾开展的前瞻性观察研究招募了支气管扩张症或慢性阻塞性肺病患者。为了分析肺部微生物组和评估炎症标志物,研究人员采集了支气管肺泡灌洗液(BAL)样本进行 16S rRNA 基因测序。研究队列由 181 名患者组成:其中 86 人患有慢性阻塞性肺病,46 人患有支气管扩张症,49 人患有支气管扩张症和 FAO(经肺活量测定证实):结果发现:无论是否患有FAO,支气管扩张症患者的微生物组特征都很相似,即α多样性降低,变形杆菌占主导地位,这与慢性阻塞性肺病患者截然不同,后者表现出更多的固缩菌、更高的多样性和更多的共生类群。此外,与无FAO的慢性阻塞性肺病和支气管扩张症患者相比,有FAO的支气管扩张症患者病情更严重,恶化风险更高。研究发现,铜绿假单胞菌的存在与气道中性粒细胞炎症(如白细胞介素[IL]-1β、IL-8和肿瘤坏死因子-α[TNF]-α)的增加以及支气管扩张的严重程度之间存在明显的相关性,这可能会增加病情恶化的风险。此外,在患有 FAO 的支气管扩张症患者中,采用了 ROSE(放射学、阻塞、症状和暴露)标准,根据吸烟史将患者分为 ROSE(+)或 ROSE(-)。这种分类方法凸显了ROSE(-)和ROSE(+)患者在临床特征、炎症特征和微生物组轻微变化方面的差异,表明患有FAO的支气管扩张症患者群体中存在不同的内型:结论:根据ROSE标准的定义,患有FAO的支气管扩张症患者可能表现出两种不同的内型,其特点是疾病严重程度更高,肺部微生物组与无FAO的支气管扩张症更相似,而与慢性阻塞性肺病更相似。铜绿假单胞菌定植与气道嗜中性粒细胞炎症增加以及疾病严重程度之间的显著相关性强调了微生物模式的临床意义。这一发现加强了这些模式在患有 FAO 的支气管扩张症的进展和恶化中的潜在作用。
{"title":"The clinical impacts of lung microbiome in bronchiectasis with fixed airflow obstruction: a prospective cohort study.","authors":"Yen-Fu Chen, Hsin-Han Hou, Ning Chien, Kai-Zen Lu, Chieh-Hua Lin, Yu-Chieh Liao, Kuo-Lung Lor, Jung-Yien Chien, Chung-Ming Chen, Chung-Yu Chen, Shih-Lung Cheng, Hao-Chien Wang, Po-Ren Hsueh, Chong-Jen Yu","doi":"10.1186/s12931-024-02931-x","DOIUrl":"10.1186/s12931-024-02931-x","url":null,"abstract":"<p><strong>Background: </strong>Airflow obstruction is a hallmark of disease severity and prognosis in bronchiectasis. The relationship between lung microbiota, airway inflammation, and outcomes in bronchiectasis with fixed airflow obstruction (FAO) remains unclear. This study explores these interactions in bronchiectasis patients, with and without FAO, and compares them to those diagnosed with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>This prospective observational study in Taiwan enrolled patients with either bronchiectasis or COPD. To analyze the lung microbiome and assess inflammatory markers, bronchoalveolar lavage (BAL) samples were collected for 16S rRNA gene sequencing. The study cohort comprised 181 patients: 86 with COPD, 46 with bronchiectasis, and 49 with bronchiectasis and FAO, as confirmed by spirometry.</p><p><strong>Results: </strong>Patients with bronchiectasis, with or without FAO, had similar microbiome profiles characterized by reduced alpha diversity and a predominance of Proteobacteria, distinctly different from COPD patients who exhibited more Firmicutes, greater diversity, and more commensal taxa. Furthermore, compared to COPD and bronchiectasis without FAO, bronchiectasis with FAO showed more severe disease and a higher risk of exacerbations. A significant correlation was found between the presence of Pseudomonas aeruginosa and increased airway neutrophilic inflammation such as Interleukin [IL]-1β, IL-8, and tumor necrosis factor-alpha [TNF]-α, as well as with higher bronchiectasis severity, which might contribute to an increased risk of exacerbations. Moreover, in bronchiectasis patients with FAO, the ROSE (Radiology, Obstruction, Symptoms, and Exposure) criteria were employed to classify individuals as either ROSE (+) or ROSE (-), based on smoking history. This classification highlighted differences in clinical features, inflammatory profiles, and slight microbiome variations between ROSE (-) and ROSE (+) patients, suggesting diverse endotypes within the bronchiectasis with FAO group.</p><p><strong>Conclusion: </strong>Bronchiectasis patients with FAO may exhibit two distinct endotypes, as defined by ROSE criteria, characterized by greater disease severity and a lung microbiome more similar to bronchiectasis without FAO than to COPD. The significant correlation between Pseudomonas aeruginosa colonization and increased airway neutrophilic inflammation, as well as disease severity, underscores the clinical relevance of microbial patterns. This finding reinforces the potential role of these patterns in the progression and exacerbations of bronchiectasis with FAO.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrated omics characterization reveals reduced cancer indicators and elevated inflammatory factors after thermal ablation in non-small cell lung cancer patients. 综合全息表征显示,非小细胞肺癌患者热消融后癌症指标降低,炎症因子升高。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-14 DOI: 10.1186/s12931-024-02917-9
Xinglu Zhang, Shuai Shao, Nan Song, Baolu Yang, Fengjiao Liu, Zhaohui Tong, Feng Wang, Jieqiong Li

Background: Thermal ablation is a minimally invasive treatment for non-small cell lung cancer (NSCLC). Aside from causing an immediate direct tumour cell injury, the effects of thermal ablation on the internal microenvironment are unknown. This study aimed to investigate the effects of thermal ablation on the plasma internal environment in patients with NSCLC.

Methods: 128 plasma samples were collected from 48 NSCLC (pre [LC] and after thermal ablation [LC-T]) patients and 32 healthy controls (HCs). Olink proteomics and metabolomics were utilized to construct an integrated landscape of the cancer-related immune and inflammatory responses after ablation.

Results: Compared with HCs, LC patients exhibited 58 differentially expressed proteins (DEPs) and 479 differentially expressed metabolites (DEMs), which might participate in tumour progression and metastasis. Moreover, 75 DEPs were identified among the HC, LC, and LC-T groups. Forty-eight highly expressed DEPs (eg, programmed death-ligand 1 [PD-L1]) in the LC group were found to be downregulated after thermal ablation. These DEPs had significant impacts on pathways such as angiogenesis, immune checkpoint blockade, and pro-tumour chemotaxis. Metabolites involved in tumour cell survival were associated with these proteins at the expression and functional levels. In contrast, 19 elevated proteins (eg, interleukin [IL]-6) were identified after thermal ablation. These proteins were mainly associated with inflammatory response pathways (NF-κB signalling and tumour necrosis factor signalling) and immune cell activation.

Conclusions: Thermal ablation-induced changes in the host plasma microenvironment contribute to anti-tumour immunity in NSCLC, offering new insights into tumour ablation combined with immunotherapy. Trial registration This study was registered on the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/index.html ). ID: ChiCTR2300076517. Registration Date: 2023-10-11.

背景:热消融是一种治疗非小细胞肺癌(NSCLC)的微创疗法。除了对肿瘤细胞造成直接伤害外,热消融对肿瘤内部微环境的影响尚不清楚。本研究旨在调查热消融对 NSCLC 患者血浆内部环境的影响。方法:从 48 名 NSCLC(热消融前 [LC] 和热消融后 [LC-T])患者和 32 名健康对照组(HCs)中收集 128 份血浆样本。利用Olink蛋白质组学和代谢组学构建了消融后癌症相关免疫和炎症反应的综合图谱:结果:与对照组相比,LC 患者表现出 58 种差异表达蛋白(DEPs)和 479 种差异表达代谢物(DEMs),这些蛋白和代谢物可能参与了肿瘤的进展和转移。此外,在 HC 组、LC 组和 LC-T 组中发现了 75 种 DEPs。发现热消融后,LC 组中 48 个高表达的 DEPs(如程序性死亡配体 1 [PD-L1])被下调。这些DEPs对血管生成、免疫检查点阻断和促肿瘤趋化等通路有重大影响。涉及肿瘤细胞存活的代谢物在表达和功能水平上与这些蛋白质相关。相比之下,热消融后发现了 19 种升高的蛋白质(如白细胞介素 [IL]-6)。这些蛋白质主要与炎症反应途径(NF-κB 信号传导和肿瘤坏死因子信号传导)和免疫细胞活化有关:热消融诱导的宿主血浆微环境变化有助于NSCLC的抗肿瘤免疫,为肿瘤消融与免疫疗法的结合提供了新的见解。试验注册 本研究已在中国临床试验注册中心 ( https://www.chictr.org.cn/index.html ) 注册。ID:ChiCTR2300076517.注册日期:2023-10-11。
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引用次数: 0
Proportion of confluent B-Lines predicts respiratory support in term infants shortly after birth. 汇合 B 线的比例可预测足月儿出生后不久的呼吸支持情况。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-13 DOI: 10.1186/s12931-024-02944-6
Xinao Lin, Hehua Zhang, Xuefeng Wang, Ruijie Zhang, Lu Zhang, Xueqin You, Lingling Xiao, Chuyan Wu, Feng Jiang, Jimei Wang

Objective: To develop and evaluate the predictive value of a simplified lung ultrasound (LUS) method for forecasting respiratory support in term infants.

Methods: This observational, prospective, diagnostic accuracy study was conducted in a tertiary academic hospital between June and December 2023. A total of 361 neonates underwent LUS examination within 1 h of birth. The proportion of each LUS sign was utilized to predict their respiratory outcomes and compared with the LUS score model. After identifying the best predictive LUS sign, simplified models were created based on different scan regions. The optimal simplified model was selected by comparing its accuracy with both the full model and the LUS score model.

Results: After three days of follow-up, 91 infants required respiratory support, while 270 remained healthy. The proportion of confluent B-lines demonstrated high predictive accuracy for respiratory support, with an area under the curve (AUC) of 89.1% (95% confidence interval [CI]: 84.5-93.7%). The optimal simplified model involved scanning the R/L 1-4 region, yielding an AUC of 87.5% (95% CI: 82.6-92.3%). Both the full model and the optimal simplified model exhibited higher predictive accuracy compared to the LUS score model. The optimal cut-off value for the simplified model was determined to be 15.9%, with a sensitivity of 76.9% and specificity of 91.9%.

Conclusions: The proportion of confluent B-lines in LUS can effectively predict the need for respiratory support in term infants shortly after birth and offers greater reliability than the LUS score model.

目的开发并评估用于预测足月婴儿呼吸支持的简化肺部超声(LUS)方法的预测价值:这项观察性、前瞻性、诊断准确性研究于 2023 年 6 月至 12 月在一家三级学术医院进行。共有 361 名新生儿在出生后 1 小时内接受了 LUS 检查。利用每个 LUS 征兆的比例来预测他们的呼吸系统结果,并与 LUS 评分模型进行比较。在确定了最佳预测 LUS 征象后,根据不同的扫描区域创建了简化模型。通过比较完整模型和 LUS 评分模型的准确性,选出最佳简化模型:随访三天后,91 名婴儿需要呼吸支持,270 名婴儿仍然健康。汇合 B 线比例对呼吸支持的预测准确率很高,曲线下面积 (AUC) 为 89.1%(95% 置信区间 [CI]:84.5-93.7%)。最佳简化模型涉及扫描 R/L 1-4 区域,其 AUC 为 87.5%(95% 置信区间 [CI]:82.6-92.3%)。与 LUS 评分模型相比,完整模型和最佳简化模型都显示出更高的预测准确性。简化模型的最佳临界值为 15.9%,灵敏度为 76.9%,特异度为 91.9%:结论:LUS 中汇合 B 线的比例可有效预测出生后不久的足月儿是否需要呼吸支持,其可靠性高于 LUS 评分模型。
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引用次数: 0
Longitudinal association of exclusive and dual use of cigarettes and cigars with asthma exacerbation among US adults: a cohort study. 美国成年人只吸食和双重吸食香烟和雪茄与哮喘恶化之间的纵向联系:一项队列研究。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-10 DOI: 10.1186/s12931-024-02930-y
Akash Patel, James H Buszkiewicz, Steven Cook, Douglas A Arenberg, Nancy L Fleischer

Background: Cigar use among adults in the United States has remained relatively stable in the past decade and occupies a growing part of the tobacco marketplace as cigarette use has declined. While studies have established the detrimental respiratory health effects of cigarette use, the effects of cigar use need further characterization. In this study, we evaluate the prospective association between cigar use, with or without cigarettes, and asthma exacerbation.

Methods: We used data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study to run generalized estimating equation models examining the association between time-varying, one-wave-lagged cigarette and cigar use and self-reported asthma exacerbation among US adults (18+). We defined our exposure as non-established (reference), former, exclusive cigarette, exclusive cigar, and dual use. We defined an asthma exacerbation event as a reported asthma attack in the past 12 months necessitating oral or injected steroid medication or asthma symptoms disrupting sleep at least once a week in the past 30 days. We adjusted for age, sex, race and ethnicity, household income, health insurance, established electronic nicotine delivery systems use, cigarette pack-years, secondhand smoke exposure, obesity, and baseline asthma exacerbation.

Results: Exclusive cigarette use (incidence rate ratio (IRR): 1.26, 95% confidence interval (CI): 1.03-1.54) and dual use (IRR: 1.41, 95% CI: 1.08-1.85) were associated with a higher rate of asthma exacerbation compared to non-established use, while former use (IRR: 1.01, 95% CI: 0.80-1.28) and exclusive cigar use (IRR: 0.70, 95% CI: 0.42-1.17) were not.

Conclusion: We found no association between exclusive cigar use and self-reported asthma exacerbation. However, exclusive cigarette use and dual cigarette and cigar use were associated with higher incidence rates of self-reported asthma exacerbation compared to non-established use. Studies should evaluate strategies to improve cigarette and cigar smoking cessation among adults with asthma who continue to smoke.

背景:在过去的十年中,美国成年人使用雪茄的情况相对稳定,而且随着卷烟使用量的下降,雪茄在烟草市场上所占的份额也越来越大。虽然已有研究证实使用香烟会对呼吸系统健康造成有害影响,但使用雪茄的影响还需要进一步确定。在这项研究中,我们评估了使用雪茄(无论是否吸烟)与哮喘恶化之间的前瞻性关联:我们使用烟草与健康人群评估研究第 1-5 波(2013-2019 年)的数据运行广义估计方程模型,研究美国成年人(18 岁以上)中使用香烟和雪茄与自我报告的哮喘恶化之间的时变、一波滞后关系。我们将暴露定义为非既定(参考)、曾经、专门使用香烟、专门使用雪茄和双重使用。我们将哮喘恶化事件定义为在过去 12 个月中报告的哮喘发作,需要口服或注射类固醇药物,或在过去 30 天中哮喘症状扰乱睡眠至少每周一次。我们对年龄、性别、种族和民族、家庭收入、医疗保险、已使用电子尼古丁递送系统、吸烟包年、二手烟暴露、肥胖和基线哮喘恶化进行了调整:结果:完全使用香烟(发病率比(IRR):1.26,95% 置信区间:1.26,95% 置信区间:1.26结果:与不吸烟的人相比,完全吸烟(发病率比(IRR):1.26,95% 置信区间(CI):1.03-1.54)和双重吸烟(发病率比(IRR):1.41,95% 置信区间(CI):1.08-1.85)与较高的哮喘恶化率有关,而以前吸烟(发病率比(IRR):1.01,95% 置信区间(CI):0.80-1.28)和完全吸烟(发病率比(IRR):0.70,95% 置信区间(CI):0.42-1.17)与较高的哮喘恶化率无关:结论:我们发现,只吸食雪茄与自我报告的哮喘恶化之间没有关联。然而,与不吸烟者相比,只吸烟者以及吸烟和抽雪茄的双重吸烟者自我报告的哮喘恶化发生率较高。研究应评估改善继续吸烟的成年哮喘患者戒烟和戒雪茄的策略。
{"title":"Longitudinal association of exclusive and dual use of cigarettes and cigars with asthma exacerbation among US adults: a cohort study.","authors":"Akash Patel, James H Buszkiewicz, Steven Cook, Douglas A Arenberg, Nancy L Fleischer","doi":"10.1186/s12931-024-02930-y","DOIUrl":"10.1186/s12931-024-02930-y","url":null,"abstract":"<p><strong>Background: </strong>Cigar use among adults in the United States has remained relatively stable in the past decade and occupies a growing part of the tobacco marketplace as cigarette use has declined. While studies have established the detrimental respiratory health effects of cigarette use, the effects of cigar use need further characterization. In this study, we evaluate the prospective association between cigar use, with or without cigarettes, and asthma exacerbation.</p><p><strong>Methods: </strong>We used data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study to run generalized estimating equation models examining the association between time-varying, one-wave-lagged cigarette and cigar use and self-reported asthma exacerbation among US adults (18+). We defined our exposure as non-established (reference), former, exclusive cigarette, exclusive cigar, and dual use. We defined an asthma exacerbation event as a reported asthma attack in the past 12 months necessitating oral or injected steroid medication or asthma symptoms disrupting sleep at least once a week in the past 30 days. We adjusted for age, sex, race and ethnicity, household income, health insurance, established electronic nicotine delivery systems use, cigarette pack-years, secondhand smoke exposure, obesity, and baseline asthma exacerbation.</p><p><strong>Results: </strong>Exclusive cigarette use (incidence rate ratio (IRR): 1.26, 95% confidence interval (CI): 1.03-1.54) and dual use (IRR: 1.41, 95% CI: 1.08-1.85) were associated with a higher rate of asthma exacerbation compared to non-established use, while former use (IRR: 1.01, 95% CI: 0.80-1.28) and exclusive cigar use (IRR: 0.70, 95% CI: 0.42-1.17) were not.</p><p><strong>Conclusion: </strong>We found no association between exclusive cigar use and self-reported asthma exacerbation. However, exclusive cigarette use and dual cigarette and cigar use were associated with higher incidence rates of self-reported asthma exacerbation compared to non-established use. Studies should evaluate strategies to improve cigarette and cigar smoking cessation among adults with asthma who continue to smoke.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Respiratory Research
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