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The burden of cough in idiopathic pulmonary fibrosis and other interstitial lung diseases: a systematic evidence synthesis. 特发性肺纤维化和其他间质性肺病的咳嗽负担:系统证据综述。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-27 DOI: 10.1186/s12931-024-02897-w
Rhiannon Green, Michael Baldwin, Nick Pooley, Kate Misso, Maureen Pmh Rutten-van Mölken, Nina Patel, Marlies S Wijsenbeek

Background: Cough remains a persistent symptom in patients with idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases (ILDs). To inform future research, treatment and care models, we conducted the first systematic synthesis of evidence on its associated burden.

Methods: A literature search was performed for articles published between January 2010 and October 2023 using databases including Embase, MEDLINE and the Cochrane Library. Studies in patients with IPF and other ILDs reporting cough-related measures were eligible for inclusion. Included studies were categorised based on the types of ILD they examined and their design. Study details, patient characteristics and outcomes were extracted, and the risk of bias was assessed. A narrative synthesis approach was employed to interpret the findings.

Results: Sixty-one studies were included: 33 in IPF, 18 in mixed-ILDs, six in connective tissue disease-associated-ILDs and four in sarcoidosis. Across the studies, a range of tools to assess cough and its impact were used. The most frequently used measures of cough were cough severity visual analogue scale (VAS) and objective cough counts, whereas the most frequently used health-related quality of life (HRQoL)/impact measures were the St. George's Respiratory Questionnaire (SGRQ) and Leicester Cough Questionnaire (LCQ). In IPF, studies consistently reported correlations between various cough and HRQoL measures, including between cough VAS scores and objective cough counts, LCQ scores and SGRQ scores. Similar correlations were observed in studies in other ILDs, but data were more limited. Qualitative studies in both IPF and other ILDs consistently highlighted the significant cough-related burden experienced by patients, including disruption of daily activities, fatigue and social embarrassment. Although there were no studies specifically investigating the economic burden of cough, one study in patients with fibrotic ILD found cough severity was associated with workplace productivity loss.

Conclusions: Our study underscores the heterogeneity in assessing cough and its impact in IPF and other ILDs. The findings confirm the negative impact of cough on HRQoL in IPF and suggest a comparable impact in other ILDs. Our synthesis highlights the need for standardised assessment tools, along with dedicated studies, particularly in non-IPF ILDs and on the economic burden of cough.

背景:咳嗽仍然是特发性肺纤维化(IPF)和其他间质性肺疾病(ILDs)患者的一个顽固症状。为了给未来的研究、治疗和护理模式提供信息,我们首次对咳嗽相关负担的证据进行了系统综合:我们使用 Embase、MEDLINE 和 Cochrane Library 等数据库对 2010 年 1 月至 2023 年 10 月间发表的文章进行了文献检索。IPF和其他ILD患者中报告咳嗽相关措施的研究符合纳入条件。纳入的研究根据其研究的 ILD 类型和设计进行分类。提取了研究细节、患者特征和结果,并评估了偏倚风险。采用叙事综合法解释研究结果:结果:共纳入 61 项研究:结果:共纳入 61 项研究:33 项针对 IPF,18 项针对混合型ILD,6 项针对结缔组织病相关型ILD,4 项针对肉样瘤病。这些研究使用了一系列工具来评估咳嗽及其影响。最常用的咳嗽测量方法是咳嗽严重程度视觉模拟量表(VAS)和客观咳嗽次数,而最常用的健康相关生活质量(HRQoL)/影响测量方法是圣乔治呼吸问卷(SGRQ)和莱斯特咳嗽问卷(LCQ)。在 IPF 中,不断有研究报告称各种咳嗽与 HRQoL 测量之间存在相关性,包括咳嗽 VAS 评分与客观咳嗽次数、LCQ 评分与 SGRQ 评分之间的相关性。在其他 ILD 的研究中也观察到了类似的相关性,但数据较为有限。针对 IPF 和其他 ILD 的定性研究一致强调了患者承受的与咳嗽相关的巨大负担,包括日常活动受阻、疲劳和社交尴尬。虽然没有专门调查咳嗽经济负担的研究,但一项针对纤维化 ILD 患者的研究发现,咳嗽严重程度与工作场所生产力损失有关:我们的研究强调了评估咳嗽及其对 IPF 和其他 ILD 影响的异质性。研究结果证实了咳嗽对 IPF 患者 HRQoL 的负面影响,并表明咳嗽对其他 ILD 也有类似影响。我们的综述强调了标准化评估工具和专门研究的必要性,尤其是在非 IPF ILD 和咳嗽的经济负担方面。
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引用次数: 0
Cobalt exposure and pulmonary function reduction in chronic obstructive pulmonary disease patients: the mediating role of club cell secretory protein. 钴暴露与慢性阻塞性肺病患者肺功能下降:俱乐部细胞分泌蛋白的中介作用。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-24 DOI: 10.1186/s12931-024-02950-8
Fei Tang, Hong-Yan Liu, Qi-Yuan He, Ying Liu, Li-Ping Lv, Jun Fei, Lin Fu

Background: Cobalt (Co) is a metal which is widely used in the industrial production. The previous studies found the toxic effects of environmental Co exposure on multiple organs. However, the correlation of blood Co concentration with lung function was inconsistent in patients with chronic obstructive pulmonary disease (COPD).

Methods: All 771 stable COPD patients were recruited. Peripheral blood and clinical information were collected. The levels of blood Co and serum CC16 were measured.

Results: Cross-sectional study suggested that the level of blood Co was inversely and dose-dependently related to lung function parameters. Each 1 ppm elevation of blood Co was related to 0.598 L decline in FVC, 0.465 L decline in FEV1, 6.540% decline in FEV1/FVC%, and 14.013% decline in FEV1%, respectively. Moreover, higher age, enrolled in winter, current-smoking, higher smoking amount, and inhaled corticosteroids prominently exacerbated the negative correlation between blood Co and lung function. Besides, serum CC16 content was gradually reduced with blood Co elevation in COPD patients. Besides, serum CC16 was positively correlated with lung function, and inversely related to blood Co. Additionally, decreased CC16 substantially mediated 11.45% and 6.37% Co-triggered downregulations in FEV1 and FEV1%, respectively.

Conclusion: Blood Co elevation is closely related to the reductions of pulmonary function and serum CC16. CC16 exerts a significantly mediating role of Co-related to pulmonary function decrease among COPD patients.

背景:钴(Co)是一种广泛用于工业生产的金属。以往的研究发现,环境中的钴暴露会对多个器官产生毒性影响。然而,慢性阻塞性肺病(COPD)患者血液中 Co 浓度与肺功能的相关性并不一致:方法:招募了所有 771 名病情稳定的慢性阻塞性肺病患者。收集外周血和临床信息。结果:横断面研究表明,慢性阻塞性肺疾病(COPD)患者血液中的 Co 和血清中的 CC16 含量并不一致:横断面研究表明,血液中 Co 的水平与肺功能参数成反比,且与剂量有关。血Co每升高1 ppm,FVC下降0.598 L,FEV1下降0.465 L,FEV1/FVC%下降6.540%,FEV1%下降14.013%。此外,年龄越大、冬季入学、目前吸烟、吸烟量越大、吸入皮质类固醇等因素显著加剧了血 Co 与肺功能之间的负相关。此外,COPD 患者血清中的 CC16 含量随着血 Co 的升高而逐渐降低。此外,血清 CC16 与肺功能呈正相关,与血 Co 呈反相关。此外,CC16的降低在很大程度上分别导致11.45%和6.37%的FEV1和FEV1%在Co触发下下调:结论:血液中 Co 的升高与肺功能和血清 CC16 的降低密切相关。结论:血液中Co的升高与肺功能和血清CC16的降低密切相关。
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引用次数: 0
Transcriptomic analysis reveals distinct effects of cigarette smoke on murine airspace and bone-marrow derived macrophages. 转录组分析揭示了香烟烟雾对小鼠空腔和骨髓衍生巨噬细胞的不同影响。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-24 DOI: 10.1186/s12931-024-02939-3
Lynne Faherty, William Z Zhang, Mays M Salih, Elektra K Robinson, Elizabeth Perez, Kihwan Kim, Susan Carpenter, Suzanne M Cloonan

Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory airway disease characterized by emphysema and chronic bronchitis and a leading cause of mortality worldwide. COPD is commonly associated with several comorbid diseases which contribute to exacerbated patient outcomes. Cigarette smoke (CS) is the most prominent risk factor for COPD development and progression and is known to be detrimental to numerous effector functions of lung resident immune cells, including phagocytosis and cytokine production. However, how CS mediates the various pathologies distant from the lung in COPD, and whether CS has a similar biological effect on systemic immune cells remains unknown.

Methods: C57BL/6 mice were exposed to 8 weeks of CS as an experimental model of COPD. Bone marrow cells were isolated from both CS-exposed and room air (RA) control mice and differentiated to bone marrow-derived macrophages (BMDMs). Airspace macrophages (AMs) were isolated from the same CS-exposed and RA mice and bulk RNA-Seq performed. The functional role of differentially expressed genes was assessed through gene ontology analyses. Ingenuity Pathway Analysis was used to determine the activation states of canonical pathways and upstream regulators enriched in differentially expressed genes in both cell types, and to compare the differences between the two cell types.

Results: CS induced transcriptomic changes in BMDMs, including an upregulation of genes in sirtuin signalling and oxidative phosphorylation pathways and a downregulation of genes involved in histone and lysine methylation. In contrast, CS induced decreased expression of genes involved in pathogen response, phagosome formation, and immune cell trafficking in AMs. Little overlap was observed in differentially expressed protein-coding genes in BMDMs compared to AMs and their associated pathways, highlighting the distinct effects of CS on immune cells in different compartments.

Conclusions: CS exposure can induce transcriptomic remodelling in BMDMs which is distinct to that of AMs. Our study highlights the ability of CS exposure to affect immune cell populations distal to the lung and warrants further investigation into the functional effects of these changes and the ensuing role in driving multimorbid disease.

背景:慢性阻塞性肺疾病(COPD)是一种以肺气肿和慢性支气管炎为特征的气道炎症性疾病,也是导致全球死亡的主要原因。慢性阻塞性肺病通常伴有多种并发症,这些并发症会加重患者的病情。香烟烟雾(CS)是导致慢性阻塞性肺病发展和恶化的最主要风险因素,众所周知,它对肺部常驻免疫细胞的多种效应功能(包括吞噬作用和细胞因子的产生)有害。然而,CS 是如何介导慢性阻塞性肺病中远离肺部的各种病变的,以及 CS 是否对全身免疫细胞具有类似的生物效应,这些仍然是未知数:方法:将C57BL/6小鼠作为慢性阻塞性肺病的实验模型,暴露于8周的CS。从暴露于 CS 的小鼠和室内空气(RA)对照组小鼠身上分离出骨髓细胞,并将其分化为骨髓源性巨噬细胞(BMDMs)。从相同的CS暴露小鼠和RA对照小鼠身上分离出空腔巨噬细胞(AMs),并进行了大量RNA-Seq分析。通过基因本体分析评估了差异表达基因的功能作用。使用 Ingenuity Pathway Analysis 确定两种细胞类型中富含差异表达基因的典型通路和上游调控因子的激活状态,并比较两种细胞类型之间的差异:结果:CS诱导了BMDMs的转录组变化,包括上调sirtuin信号通路和氧化磷酸化通路中的基因,以及下调参与组蛋白和赖氨酸甲基化的基因。与此相反,CS 会诱导 AMs 中涉及病原体反应、吞噬体形成和免疫细胞贩运的基因表达减少。与AMs相比,BMDMs中不同表达的蛋白编码基因及其相关通路几乎没有重叠,这突显了CS对不同区室中免疫细胞的不同影响:结论:CS 暴露可诱导 BMDMs 的转录组重塑,这一点与 AMs 不同。我们的研究凸显了暴露于 CS 会影响肺远端免疫细胞群的能力,因此有必要进一步研究这些变化的功能效应及其在多病驱动中的作用。
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引用次数: 0
Surgery versus intrapleural fibrinolysis for management of complicated pleural infections: a systematic review and meta-analysis. 手术与胸膜内纤维蛋白溶解术治疗复杂性胸膜感染:系统综述与荟萃分析。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-24 DOI: 10.1186/s12931-024-02949-1
Jaewon Chang, Ben Indja, Jesse King, Stephanie Chan, Campbell D Flynn

Background: Complicated pleural infection comprises of complex effusions and empyema. When tube thoracostomy is ineffective, treatment options include surgical drainage, deloculation and decortication or intrapleural fibrinolysis. We performed a systematic review and meta-analysis to examine which technique is superior in treating complicated pleural infections.

Methods: PubMed, MEDLINE and EMBASE databases were searched for studies published between January 2000 to July 2023 comparing surgery and intrapleural fibrinolysis for treatment of complicated pleural infection. The primary outcome was treatment success. Secondary outcomes included hospital length of stay, chest drain duration and in-hospital mortality.

Results: Surgical management of complicated pleural infections was more likely to be successful than intrapleural fibrinolysis (RR 1.18; 95% CI 1.02, 1.38). Surgical intervention group benefited from statistically significant shorter hospital length of stay (MD: 3.85; 95% CI 1.09, 6.62) and chest drain duration (MD: 3.42; 95% CI 1.36, 5.48). There was no observed difference between in-hospital mortality (RR: 1.00; 95% CI 0.99, 1.02).

Conclusion: Surgical management of complicated pleural infections results in increased likelihood of treatment success, shorter chest drain duration and hospital length of stay in the adult population compared with intrapleural fibrinolysis. In-hospital mortality did not differ. Large cohort and randomized research need to be conducted to confirm these findings.

背景:并发胸膜感染包括复杂的积液和肺水肿。当管道胸腔造口术无效时,治疗方案包括手术引流、脱位和去骨瓣或胸膜内纤维蛋白溶解术。我们进行了一项系统性回顾和荟萃分析,以研究哪种技术在治疗复杂性胸膜感染方面更具优势:方法:我们在 PubMed、MEDLINE 和 EMBASE 数据库中检索了 2000 年 1 月至 2023 年 7 月间发表的比较手术和胸膜腔内纤维蛋白溶解术治疗复杂性胸膜感染的研究。主要结果为治疗成功率。次要结果包括住院时间、胸腔引流时间和院内死亡率:结果:与胸膜腔内纤维蛋白溶解术相比,手术治疗复杂性胸膜感染的成功率更高(RR 1.18;95% CI 1.02,1.38)。手术干预组的住院时间(MD:3.85;95% CI:1.09-6.62)和胸腔引流时间(MD:3.42;95% CI:1.36-5.48)明显短于手术干预组。院内死亡率无差异(RR:1.00;95% CI 0.99,1.02):结论:与胸膜腔内纤维蛋白溶解术相比,手术治疗复杂性胸膜感染可增加治疗成功的可能性,缩短胸腔引流时间和成人住院时间。院内死亡率没有差异。需要进行大规模的队列和随机研究来证实这些发现。
{"title":"Surgery versus intrapleural fibrinolysis for management of complicated pleural infections: a systematic review and meta-analysis.","authors":"Jaewon Chang, Ben Indja, Jesse King, Stephanie Chan, Campbell D Flynn","doi":"10.1186/s12931-024-02949-1","DOIUrl":"10.1186/s12931-024-02949-1","url":null,"abstract":"<p><strong>Background: </strong>Complicated pleural infection comprises of complex effusions and empyema. When tube thoracostomy is ineffective, treatment options include surgical drainage, deloculation and decortication or intrapleural fibrinolysis. We performed a systematic review and meta-analysis to examine which technique is superior in treating complicated pleural infections.</p><p><strong>Methods: </strong>PubMed, MEDLINE and EMBASE databases were searched for studies published between January 2000 to July 2023 comparing surgery and intrapleural fibrinolysis for treatment of complicated pleural infection. The primary outcome was treatment success. Secondary outcomes included hospital length of stay, chest drain duration and in-hospital mortality.</p><p><strong>Results: </strong>Surgical management of complicated pleural infections was more likely to be successful than intrapleural fibrinolysis (RR 1.18; 95% CI 1.02, 1.38). Surgical intervention group benefited from statistically significant shorter hospital length of stay (MD: 3.85; 95% CI 1.09, 6.62) and chest drain duration (MD: 3.42; 95% CI 1.36, 5.48). There was no observed difference between in-hospital mortality (RR: 1.00; 95% CI 0.99, 1.02).</p><p><strong>Conclusion: </strong>Surgical management of complicated pleural infections results in increased likelihood of treatment success, shorter chest drain duration and hospital length of stay in the adult population compared with intrapleural fibrinolysis. In-hospital mortality did not differ. Large cohort and randomized research need to be conducted to confirm these findings.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":"25 1","pages":"323"},"PeriodicalIF":5.8,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057021","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
Vitamin D ameliorates particulate matter induced mitochondrial damages and calcium dyshomeostasis in BEAS-2B human bronchial epithelial cells. 维生素 D 可改善微粒物质诱导的 BEAS-2B 人支气管上皮细胞线粒体损伤和钙失衡。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-22 DOI: 10.1186/s12931-024-02951-7
Ju Chang-Chien, Jing-Long Huang, Hui-Ju Tsai, Shih-Ling Wang, Ming-Ling Kuo, Tsung-Chieh Yao

Background: Mitochondria is prone to oxidative damage by endogenous and exogenous sources of free radicals, including particulate matter (PM). Given the role of mitochondria in inflammatory disorders, such as asthma and chronic obstructive pulmonary disease, we hypothesized that supplementation of vitamin D may play a protective role in PM-induced mitochondrial oxidative damages of human bronchial epithelial BEAS-2B cells.

Methods: BEAS-2B cells were pretreated with 1,25(OH)2D3, an active form of vitamin D, for 1 h prior to 24-hour exposure to PM (SRM-1648a). Oxidative stress was measured by flow cytometry. Mitochondrial functions including mitochondrial membrane potential, ATP levels, and mitochondrial DNA copy number were analyzed. Additionally, mitochondrial ultrastructure was examined using transmission electron microscopy. Intracellular and mitochondrial calcium concentration changes were assessed using flow cytometry based on the expression of Fluo-4 AM and Rhod-2 AM, respectively. Pro-inflammatory cytokines, including IL-6 and MCP-1, were quantified using ELISA. The expression levels of antioxidants, including SOD1, SOD2, CAT, GSH, and NADPH, were determined.

Results: Our findings first showed that 24-hour exposure to PM led to the overproduction of reactive oxygen species (ROS) derived from mitochondria. PM-induced mitochondrial oxidation resulted in intracellular calcium accumulation, particularly within mitochondria, and alterations in mitochondrial morphology and functions. These changes included loss of mitochondrial membrane integrity, disarrayed cristae, mitochondrial membrane depolarization, reduced ATP production, and increased mitochondrial DNA copy number. Consequently, PM-induced mitochondrial damage triggered the release of certain inflammatory cytokines, such as IL-6 and MCP-1. Similar to the actions of mitochondrial ROS inhibitor MitoTEMPO, 1,25(OH)2D3 conferred protective effects on mtDNA alterations, mitochondrial damages, calcium dyshomeostasis, thereby decreasing the release of certain inflammatory cytokines. We found that greater cellular level of 1,25(OH)2D3 upregulated the expression of enzymatic (SOD1, SOD2, and CAT) and non-enzymatic (GSH and NADPH) antioxidants to modulate cellular redox homeostasis.

Conclusion: Our study provides new evidence that 1,25(OH)2D3 acts as an antioxidant, enhancing BEAS-2B antioxidant responses to regulate mitochondrial ROS homeostasis and mitochondrial function, thereby enhancing epithelial defense against air pollution exposure.

背景:线粒体容易受到包括颗粒物(PM)在内的内源性和外源性自由基的氧化损伤。鉴于线粒体在哮喘和慢性阻塞性肺病等炎症性疾病中的作用,我们假设补充维生素 D 可能对 PM 诱导的人支气管上皮 BEAS-2B 细胞线粒体氧化损伤起到保护作用:方法:在24小时暴露于可吸入颗粒物(SRM-1648a)之前,用1,25(OH)2D3(维生素D的一种活性形式)预处理BEAS-2B细胞1小时。氧化应激通过流式细胞术进行测量。分析了线粒体功能,包括线粒体膜电位、ATP水平和线粒体DNA拷贝数。此外,还使用透射电子显微镜检查了线粒体的超微结构。根据 Fluo-4 AM 和 Rhod-2 AM 的表达,分别使用流式细胞术评估了细胞内和线粒体钙浓度的变化。前炎症细胞因子(包括 IL-6 和 MCP-1)采用 ELISA 法进行量化。测定了抗氧化剂(包括 SOD1、SOD2、CAT、GSH 和 NADPH)的表达水平:结果:我们的研究结果首先表明,24 小时暴露于 PM 会导致线粒体产生过量的活性氧(ROS)。PM 诱导的线粒体氧化导致细胞内钙积累,尤其是在线粒体内,并改变了线粒体的形态和功能。这些变化包括线粒体膜完整性丧失、嵴混乱、线粒体膜去极化、ATP生成减少以及线粒体DNA拷贝数增加。因此,PM 诱导的线粒体损伤引发了某些炎症细胞因子的释放,如 IL-6 和 MCP-1。与线粒体 ROS 抑制剂 MitoTEMPO 的作用类似,1,25(OH)2D3 对线粒体 DNA 改变、线粒体损伤和钙失衡具有保护作用,从而减少了某些炎症细胞因子的释放。我们发现,细胞中 1,25(OH)2D3水平越高,酶(SOD1、SOD2 和 CAT)和非酶(GSH 和 NADPH)抗氧化剂的表达量就越高,从而调节细胞氧化还原平衡:我们的研究提供了新的证据,证明 1,25(OH)2D3 可作为一种抗氧化剂,增强 BEAS-2B 的抗氧化反应,调节线粒体 ROS 平衡和线粒体功能,从而增强上皮细胞对空气污染暴露的防御能力。
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引用次数: 0
Impact of radiomics features, pulmonary emphysema score and muscle mass on the rate of pneumothorax and chest tube insertion in CT-guided lung biopsies. 放射组学特征、肺气肿评分和肌肉质量对 CT 引导肺活检中气胸和胸管插入率的影响。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-22 DOI: 10.1186/s12931-024-02936-6
Jakob Leonhardi, Ulrike Dahms, Benedikt Schnarkowski, Manuel Florian Struck, Anne-Kathrin Höhn, Sebastian Krämer, Sebastian Ebel, Gordian Prasse, Armin Frille, Timm Denecke, Hans-Jonas Meyer

Iatrogenic pneumothorax is a relevant complication of computed tomography (CT)-guided percutaneous lung biopsy. The aim of the present study was to analyze the prognostic significance of texture analysis, emphysema score and muscle mass derived from CT-imaging to predict postinterventional pneumothorax after CT-guided lung biopsy. Consecutive patients undergoing CT-guided percutaneous lung biopsy between 2012 and 2021 were analyzed. Multivariate logistic regression analysis included clinical risk factors and CT-imaging features to detect associations with pneumothorax development. Overall, 479 patients (178 females, mean age 65 ± 11.7 years) underwent CT-guided percutaneous lung biopsy of which 180 patients (37.5%) developed pneumothorax including 55 patients (11.5%) requiring chest tube placement. Risk factors associated with pneumothorax were chronic-obstructive pulmonary disease (COPD) (p = 0.03), age (p = 0.02), total lung capacity (p < 0.01) and residual volume (p = 0.01) as well as interventional parameters needle length inside the lung (p < 0.001), target lesion attached to pleura (p = 0.04), and intervention duration (p < 0.001). The combined model demonstrated a prediction accuracy of the occurrence of pneumothorax with an AUC of 0.78 [95%CI: 0.70-0.86] with a resulting sensitivity 0.80 and a specificity of 0.66. In conclusion, radiomics features of the target lesion and the lung lobe CT-emphysema score are predictive for the occurrence of pneumothorax and need for chest insertion after CT-guided lung biopsy.

先天性气胸是计算机断层扫描(CT)引导下经皮肺活检的一种相关并发症。本研究旨在分析 CT 图像中的纹理分析、肺气肿评分和肌肉质量对预测 CT 引导下肺活检术后介入性气胸的预后意义。研究分析了2012年至2021年间接受CT引导经皮肺活检术的连续患者。多变量逻辑回归分析包括临床风险因素和CT成像特征,以检测气胸发生的相关性。共有 479 名患者(178 名女性,平均年龄 65 ± 11.7 岁)接受了 CT 引导下经皮肺活检,其中 180 名患者(37.5%)出现气胸,包括 55 名患者(11.5%)需要放置胸管。与气胸相关的风险因素有:慢性阻塞性肺病(COPD)(p = 0.03)、年龄(p = 0.02)、总肺活量(p = 0.05)、胸腔积液(p = 0.05
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引用次数: 0
Artificial intelligence in COPD CT images: identification, staging, and quantitation. 慢性阻塞性肺病 CT 图像中的人工智能:识别、分期和量化。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-22 DOI: 10.1186/s12931-024-02913-z
Yanan Wu, Shuyue Xia, Zhenyu Liang, Rongchang Chen, Shouliang Qi

Chronic obstructive pulmonary disease (COPD) stands as a significant global health challenge, with its intricate pathophysiological manifestations often demanding advanced diagnostic strategies. The recent applications of artificial intelligence (AI) within the realm of medical imaging, especially in computed tomography, present a promising avenue for transformative changes in COPD diagnosis and management. This review delves deep into the capabilities and advancements of AI, particularly focusing on machine learning and deep learning, and their applications in COPD identification, staging, and imaging phenotypes. Emphasis is laid on the AI-powered insights into emphysema, airway dynamics, and vascular structures. The challenges linked with data intricacies and the integration of AI in the clinical landscape are discussed. Lastly, the review casts a forward-looking perspective, highlighting emerging innovations in AI for COPD imaging and the potential of interdisciplinary collaborations, hinting at a future where AI doesn't just support but pioneers breakthroughs in COPD care. Through this review, we aim to provide a comprehensive understanding of the current state and future potential of AI in shaping the landscape of COPD diagnosis and management.

慢性阻塞性肺病(COPD)是一项重大的全球性健康挑战,其错综复杂的病理生理表现往往需要先进的诊断策略。最近,人工智能(AI)在医学影像领域的应用,尤其是在计算机断层扫描中的应用,为慢性阻塞性肺病诊断和管理的变革提供了一条大有可为的途径。本综述深入探讨了人工智能的能力和进步,尤其关注机器学习和深度学习,以及它们在慢性阻塞性肺病识别、分期和成像表型中的应用。重点是人工智能对肺气肿、气道动力学和血管结构的洞察。此外,还讨论了与错综复杂的数据有关的挑战以及将人工智能融入临床的问题。最后,综述以前瞻性的视角,强调了人工智能在慢性阻塞性肺病成像方面的新兴创新以及跨学科合作的潜力,预示着人工智能在慢性阻塞性肺病治疗中不仅是支持,而且是突破性的先驱。通过本综述,我们旨在全面了解人工智能在塑造慢性阻塞性肺疾病诊断和管理方面的现状和未来潜力。
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引用次数: 0
Pulmonary adaptation to repeated poly(I:C) exposure is impaired in asthmatic mice: an observational study. 哮喘小鼠肺部对重复多聚(I:C)暴露的适应性受损:一项观察性研究。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-19 DOI: 10.1186/s12931-024-02948-2
Benoit Allard, Olga Ousova, Zhanna Savitskaya, Hannah Levardon, Elise Maurat, Marilyne Campagnac, Thomas Trian, Patrick Berger

Background: While asthma exacerbations remain a major challenge in patient management, few animal models exist to explore the underlying mechanisms. Here, we established an animal model of asthma that can be used to study pathophysiological mechanisms and therapeutic strategies on asthma exacerbation.

Methods: Female BALB/c mice were sensitized and exposed to PBS or Dermatophagoides pteronyssinus (DerP) extract for 11 weeks. Asthmatic phenotype was assessed through lung inflammation, bronchial hyperresponsiveness and bronchial smooth muscle remodeling. Asthmatic and control mice were exposed once or three times to poly(I:C) to simulate virus-induced inflammation.

Results: Fourteen days after exposure to DerP, asthmatic mice showed resolution of inflammation with sustained bronchial hyperresponsiveness and bronchial smooth muscle remodeling compared to control. At this stage, when mice were subjected to a single exposure to poly(I:C), control and asthmatic mice were characterized by a significant increase in neutrophilic inflammation and bronchial hyperresponsiveness. When mice were repeatedly exposed to poly(I:C), control mice showed a significant decrease in neutrophilic inflammation and bronchial hyperresponsiveness, while asthmatic mice experienced worsening of these outcomes.

Conclusions: This observational study report an asthmatic mouse model that can undergo exacerbation after repeated exposure to poly(I:C). Our findings on pulmonary adaptation in control mice may also pave the way for further research into the mechanism of adaptation that may be impaired in asthma and raise the question of whether asthma exacerbation may be a loss of adaptation.

背景:虽然哮喘恶化仍是患者管理的一大挑战,但很少有动物模型可用于探索其潜在机制。在此,我们建立了一种哮喘动物模型,可用于研究哮喘恶化的病理生理机制和治疗策略:方法:将雌性 BALB/c 小鼠致敏并暴露于 PBS 或 Dermatophagoides pteronyssinus(DerP)提取物 11 周。通过肺部炎症、支气管高反应性和支气管平滑肌重塑评估哮喘表型。哮喘小鼠和对照组小鼠暴露于聚(I:C)一次或三次,以模拟病毒诱发的炎症:结果:与对照组相比,接触 DerP 14 天后,哮喘小鼠的炎症缓解,但支气管高反应性和支气管平滑肌重塑持续存在。在此阶段,当小鼠单次接触聚(I:C)时,对照组和哮喘小鼠的中性粒细胞炎症和支气管高反应性显著增加。当小鼠反复接触多聚物(I:C)时,对照组小鼠的中性粒细胞炎症和支气管高反应性显著下降,而哮喘组小鼠的这些结果则恶化:这项观察性研究报告了一种哮喘小鼠模型,这种小鼠在反复接触多聚物(I:C)后病情会加重。我们在对照小鼠肺适应性方面的发现也为进一步研究哮喘患者可能受损的适应性机制铺平了道路,并提出了哮喘恶化是否可能是适应性丧失的问题。
{"title":"Pulmonary adaptation to repeated poly(I:C) exposure is impaired in asthmatic mice: an observational study.","authors":"Benoit Allard, Olga Ousova, Zhanna Savitskaya, Hannah Levardon, Elise Maurat, Marilyne Campagnac, Thomas Trian, Patrick Berger","doi":"10.1186/s12931-024-02948-2","DOIUrl":"10.1186/s12931-024-02948-2","url":null,"abstract":"<p><strong>Background: </strong>While asthma exacerbations remain a major challenge in patient management, few animal models exist to explore the underlying mechanisms. Here, we established an animal model of asthma that can be used to study pathophysiological mechanisms and therapeutic strategies on asthma exacerbation.</p><p><strong>Methods: </strong>Female BALB/c mice were sensitized and exposed to PBS or Dermatophagoides pteronyssinus (DerP) extract for 11 weeks. Asthmatic phenotype was assessed through lung inflammation, bronchial hyperresponsiveness and bronchial smooth muscle remodeling. Asthmatic and control mice were exposed once or three times to poly(I:C) to simulate virus-induced inflammation.</p><p><strong>Results: </strong>Fourteen days after exposure to DerP, asthmatic mice showed resolution of inflammation with sustained bronchial hyperresponsiveness and bronchial smooth muscle remodeling compared to control. At this stage, when mice were subjected to a single exposure to poly(I:C), control and asthmatic mice were characterized by a significant increase in neutrophilic inflammation and bronchial hyperresponsiveness. When mice were repeatedly exposed to poly(I:C), control mice showed a significant decrease in neutrophilic inflammation and bronchial hyperresponsiveness, while asthmatic mice experienced worsening of these outcomes.</p><p><strong>Conclusions: </strong>This observational study report an asthmatic mouse model that can undergo exacerbation after repeated exposure to poly(I:C). Our findings on pulmonary adaptation in control mice may also pave the way for further research into the mechanism of adaptation that may be impaired in asthma and raise the question of whether asthma exacerbation may be a loss of adaptation.</p>","PeriodicalId":49131,"journal":{"name":"Respiratory Research","volume":"25 1","pages":"314"},"PeriodicalIF":5.8,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005681","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
Assessment and monitoring of lung disease in patients with severe alpha 1 antitrypsin deficiency: a european delphi consensus of the EARCO group. 严重α1 抗胰蛋白酶缺乏症患者肺部疾病的评估和监测:EARCO 小组达成的欧洲德尔菲共识。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-19 DOI: 10.1186/s12931-024-02929-5
Marc Miravitlles, Alice M Turner, Maria Sucena, Jean-François Mornex, Timm Greulich, Marion Wencker, N Gerard McElvaney

Background: Currently, there is conflicting information and guidance on the effective management of Alpha 1 Antitrypsin Deficiency (AATD). Establishing a consensus of assessment and disease management specific to AATD is important for achieving a standardized treatment pathway and for improving patient outcomes. Here, we aim to utilize the Delphi method to establish a European consensus for the assessment and management of patients with severe AATD.

Methods: Two rounds of a Delphi survey were completed online by members of the European Alpha-1 Research Collaboration (EARCO). Respondents were asked to indicate their agreement with proposed statements for patients with no respiratory symptoms, stable respiratory disease, and worsening respiratory disease using a Likert scale of 1-7. Levels of agreement between respondents were calculated using a weighted average.

Results: Round 1 of the Delphi survey was sent to 103 members of EARCO and 38/103 (36.9%) pulmonologists from across 15 countries completed all 109 questions. Round 2 was sent to all who completed Round 1 and 36/38 (94.7%) completed all 79 questions. Responses regarding spirometry, body plethysmography, high-resolution computed tomography, and the initiation of augmentation therapy showed little variability among physicians, but there was discordance among other aspects, such as the use of low-dose computed tomography in both a research setting and routine clinical care.

Conclusions: These results provide expert opinions for the assessment and monitoring of patients with severe AATD, which could be used to provide updated recommendations and standardized treatment pathways for patients across Europe.

背景:目前,关于如何有效管理α1 抗胰蛋白酶缺乏症(AATD)的信息和指导存在冲突。就针对 AATD 的评估和疾病管理达成共识对于实现标准化治疗路径和改善患者预后非常重要。在此,我们希望利用德尔菲法就严重 AATD 患者的评估和管理达成欧洲共识:方法:欧洲阿尔法-1 研究合作组织 (EARCO) 的成员在线完成了两轮德尔菲调查。调查要求受访者用 1-7 分的李克特量表来表示他们是否同意针对无呼吸道症状、呼吸道疾病稳定和呼吸道疾病恶化患者提出的声明。受访者之间的同意程度采用加权平均法计算:第一轮德尔菲调查发送给了 103 位 EARCO 成员,来自 15 个国家的 38/103 位(36.9%)肺病学专家完成了全部 109 个问题。第二轮调查发给了所有完成第一轮调查的人员,36/38(94.7%)人完成了全部 79 个问题。医生们对肺活量测定、体褶造影术、高分辨率计算机断层扫描和启动增强疗法的回答几乎没有差异,但在其他方面,如在研究环境和常规临床护理中使用低剂量计算机断层扫描方面,则存在分歧:这些结果为评估和监测严重急性肺动脉高压症患者提供了专家意见,可用于为欧洲各地的患者提供最新建议和标准化治疗路径。
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引用次数: 0
Levosimendan mediates the BMP/Smad axis through upregulation of circUSP34-targeted miR-1298 to alleviate pulmonary hypertension. 左西孟旦通过上调circUSP34靶向miR-1298介导BMP/Smad轴,从而缓解肺动脉高压。
IF 5.8 2区 医学 Q1 Medicine Pub Date : 2024-08-19 DOI: 10.1186/s12931-024-02945-5
Qiang Meng, Linhong Song, Hui Wang, Gang Wang, Gengxu Zhou

Background: Pulmonary hypertension (PH) is a long-term disease that impacts approximately 1% of the world's population. Currently, levosimendan (Lev) is proposed for PH treatment. However, the mechanism of Lev in the treatment of PH is unknown.

Methods: We used hypoxia-induced pulmonary artery smooth muscle cells (PASMCs) to establish a PH cell model. A number of cell biology methods were performed to assay alterations in cell proliferation, migration and apoptosis after Lev treatment. qRT-PCR and WB were performed to test the levels of circUSP34 and miR-1298, and BMP/Smad protein respectively. In addition, the regulatory relationship between circUSP34 or BMPR2 with miR-1298 was verified through the use of double luciferase as well as RIP assay. In addition, we explored the regulatory effect of Lev on the circUSP34/miR-1298/BMP/Smad axis using a rat PH model.

Results: Our results demonstrate that Lev inhibited PASMCs cell proliferation, migration and promoted apoptosis exposed to hypoxia. In hypoxia-treated PASMCs, circUSP34 expression got downregulated while miR-1298 upregulated, whereas the addition with Lev resulted in upregulation of circUSP34 expression and downregulation of miR-1298 expression, indicating that circUSP34 can target and regulate miR-1298. In addition, miR-1298 targets and regulates the expression of BMPR2. In a rat PH model induced by hypoxia combined with SU5416, Lev upregulated circUSP34 targeting miR-1298-mediated BMP/Smad axis to alleviate the PH phenotype.

Conclusion: We have shown that Lev can be used as a therapeutic drug for PH patients, which works through the circUSP34/miR-1298/BMP/Smad axis to alleviate PH symptoms.

背景:肺动脉高压(PH)是一种长期疾病,影响着全球约 1%的人口。目前,左西孟旦(Lev)被提议用于治疗肺动脉高压。然而,Lev 治疗 PH 的机制尚不清楚:我们使用缺氧诱导的肺动脉平滑肌细胞(PASMCs)建立了 PH 细胞模型。方法:我们利用缺氧诱导的肺动脉平滑肌细胞(PASMC)建立了 PH 细胞模型,并采用多种细胞生物学方法检测了 Lev 治疗后细胞增殖、迁移和凋亡的变化。此外,我们还通过双荧光素酶和 RIP 试验验证了 circUSP34 或 BMPR2 与 miR-1298 之间的调控关系。此外,我们还利用大鼠PH模型探讨了Lev对circUSP34/miR-1298/BMP/Smad轴的调控作用:结果:我们的研究结果表明,Lev 可抑制缺氧条件下 PASMCs 细胞的增殖、迁移并促进其凋亡。在缺氧处理的 PASMCs 中,circUSP34 表达下调,miR-1298 表达上调,而加入 Lev 后,circUSP34 表达上调,miR-1298 表达下调,这表明 circUSP34 可靶向调控 miR-1298。此外,miR-1298 还能靶向调节 BMPR2 的表达。在缺氧与 SU5416 联合诱导的大鼠 PH 模型中,Lev 上调了靶向 miR-1298 介导的 BMP/Smad 轴的 circUSP34,从而缓解了 PH 表型:我们的研究表明,Lev可作为PH患者的治疗药物,通过circUSP34/miR-1298/BMP/Smad轴缓解PH症状。
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引用次数: 0
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Respiratory Research
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