BMC Pulmonary Medicine最新文献

Background: This study aimed to assess how Elexacaftor/Tezacaftor/Ivacaftor (ETI) influences lung function, Body Mass Index (BMI), Sweat Test (ST) and mental health of Cystic Fibrosis (CF) patients, emphasizing on depression and anxiety.

Methods: We conducted an observational, prospective, multicentre study including 108 patients over 18 years old who initiated ETI therapy between December 2019 and December 2023. Patients underwent regular evaluations, including clinical, functional, and microbiological assessments, alongside completion of quality of life, anxiety, and depression questionnaires. We evaluated whether there was a difference in anxiety and depression levels over time.

Results: After 12 months of treatment, significant improvements were noted in BMI, lung function (FEV1%), ST and various aspects of quality of life (CFQ-R). However, anxiety and depression levels did not differ significantly during the follow-up. When we stratified our sample by key groups, we observed that younger patients (under 28 years) and those with homozygous Phe508del mutations experienced significant higher anxiety with no differences on depression. Furthermore, anxiety and depression demonstrated a moderate correlation, strengthening over time.

Conclusions: Treatment with ETI establishes significant improvements in lung function, BMI, ST and quality of life in patients with CF. However, despite these positive outcomes, there were no significant changes observed in levels of anxiety and depression, except for individuals with homozygous mutation type and those younger than 28 years old, who exhibited significant higher levels of anxiety.

Background: Severe asthma (SA) is characterised by persistent asthma symptomatology despite adherence to intensive treatment and control of asthma triggers. It is estimated that approximately 50% of individuals with SA have current employment, considerably less than rates in the general population. Poor physical and mental health status have been suggested as a potential explanation for this, but the relationship has not been investigated in depth. We investigated how bio-psycho-social and cultural factors influence work ability and employment in SA patients.

Methods: Participants were recruited from the Birmingham Regional NHS Severe Asthma Service via opportunity sampling, with the exclusion criteria being individuals who had never been employed, currently in full-time education, or non-English speakers. Subsequently, men and those with minority-ethnic backgrounds were purposefully selected to gain a balanced sample. Interviews were performed either face-to-face, online or via telephone, transcribed using software and edited manually. Data were analysed using Reflexive Thematic Analysis.

Results: The study included 12 participants (9 females and 3 males). Four major themes were constructed: impact of patients' asthma control on work, psychological burden of living with SA, costs and benefits of being in employment, and adaptations and strategies for remaining in employment.

Conclusions: Our findings highlight the potential for physical, occupational, psychological, and social support to address the diverse job-related difficulties experienced by people with SA. Additionally, national policy reforms should be considered to improve work capacity and promote employment opportunities.

Background: Health-related quality of life (HRQL) in patients with sarcoidosis has been related to treatment, symptoms, organ involvement and disease severity, but little is known about its association with occupation. The aim was to quantify HRQL in occupationally exposed sarcoidosis patients compared to their nonexposed counterparts.

Methods: A total of 221 sarcoidosis patients (median age 49 years, interquartile range (IQR) 37-60 years) with a histologically confirmed diagnosis were recruited from university hospitals and outpatient centers in Belarus, Kazakhstan, and the Russian Federation. General (with SF-8) and specific (with K-BILD) HRQL were compared between patients who were ever exposed to 24 occupational factors and nonexposed patients in adjusted multivariable models.

Results: Work in the office and office equipment (beta - 3.60 (95% confidence interval (CI) -6.91;-0.29)) was significantly associated with a poorer SF-8 physical component score (PCS) independent of sex, whereas exposure to irritant gases was strongly associated with a worse mental component score (MCS), adjusted for sex and smoking beta - 7.11 (95% CI -12.83;-1.39). Irritant gas (beta - 17.2 (95% CI -29.3;-5.1)) and work in the office (beta - 7.9 (95% CI -14.7;-1.0)) were associated with worse K-BILD total scores, while only the latter was associated with breathlessness and activities (BA) scores. Exposure to flour, irritant gas and office work were associated with the psychological (P) domain. Exposure to flour, irritant gas and work in the office could predict chest symptom (CS) scores.

Conclusions: In patients with sarcoidosis and occupational exposure, patients may exhibit worse HRQL, but further research is needed to ascertain the interplay of individual and occupational factors.

Background: The relationship between vitamin D deficiency and Pseudomonas aeruginosa (P. aeruginosa) colonization in bronchiectasis patients is not well understood.

Methods: This study was conducted at Shanghai Pulmonary Hospital from June 2014 to May 2018. Serum 25-hydroxyvitamin D levels were measured in patients with bronchiectasis, and clinical data including sputum culture results were collected. To investigate the relationship between vitamin D levels and P. aeruginosa colonization, we conducted correlation analysis and logistic regression. Additionally, in vitro experiments with bone marrow-derived macrophages (BMDMs) infected with P. aeruginosa strain PAO1 were performed to further explore the influence of vitamin D on the bacterial infection and inflammatory response.

Results: Among the 195 patients with bronchiectasis, 83.1% (162/195) were vitamin D deficient. A significant negative correlation was observed between serum vitamin D levels and the BSI (Bronchiectasis Severity Index) score. Patients with vitamin D deficiency showed higher rates of P. aeruginosa colonization compared to those with adequate vitamin D levels. Female gender and vitamin D deficiency were identified as risk factors for P. aeruginosa colonization in patients with bronchiectasis. Additionally, serum interleukin (IL)-1β levels were significantly elevated in the vitamin D-deficiency group. In vitro experiments, 1,25-dihydroxyvitamin D [1,25D] was shown to inhibit PAO1 phagocytosis in BMDMs and to suppress IL-1β secretion.

Conclusions: Vitamin D deficiency was strongly associated with an increased risk of P. aeruginosa colonization in patients with bronchiectasis. Furthermore, vitamin D demonstrated protective effects by reducing P. aeruginosa survival in cells and modulating the inflammatory dysregulation induced by the bacterium.

Background: While respiratory virus infection has been implicated in the onset of bacterial pneumonia, no research has investigated the association of respiratory viruses with the onset of aspiration pneumonia (AP). This study aimed to investigate the role of respiratory virus infections in AP.

Methods: Patients presenting with acute respiratory symptoms and undergoing influenza antigen testing at the emergency department of Okinawa Chubu Hospital from February 2020 to January 2021, and diagnosed with lower respiratory tract infections, were included. Cases were categorized into AP, pneumonia other than AP (non-AP), and acute bronchitis (AB) based on physician diagnoses recorded in medical records. The residual nasal swab specimens were further tested with multiplex PCR tests for respiratory viruses.

Results: A total of 209 subjects were included in the study: 59 in the AP group, 118 in the non-AP group, and 32 in the AB group. The AP group was characterized by older age, higher rates of nursing home residency, a greater prevalence of comorbidities such as cerebrovascular disease and dementia, a lower sputum culture positivity rate, and a different spectrum of causative pathogens compared to the other groups. The virus positivity rate in the AP group was 47%, compared to 50% in the non-AP group and 53% in the AB group, with no significant difference observed. The AP group exhibited the highest rate of only respiratory viruses detected and the lowest rate of both respiratory viruses and bacteria detected among the groups. There was no significant difference in the types of viruses detected between the AP group and the other groups, with rhinovirus being the most frequently detected virus across all groups. In the AP group, virus-negative cases were significantly older on average. No other significant differences in background, symptoms, or clinical data were observed between virus-positive and virus-negative cases within the AP group.

Conclusion: In the AP group, the rate of respiratory virus detections was comparable to that of the non-AP and AB groups. This suggests a potential link between respiratory virus infections and the development of AP, emphasizing the need for novel preventive strategies. While distinguishing between AP patients with and without respiratory virus detections based on clinical findings was challenging, recognizing the frequent involvement of respiratory virus infections in AP highlights the importance of enhanced infection control and awareness in its management.

Background: Acinetobacter pittii, belongs to the genus Acinetobacter, has a special pathogenesis and is commonly known as nosocomial pathogen; community infections are rare.

Objective: To present a case study of community-acquired pneumonia and septic shock resulting from infection with Acinetobacter pittii and to investigate the diagnosis, clinical features and treatment of Acinetobacter pittii infection.

Methods: The clinical features and prognosis of patients with Acinetobacter pittii, infection were analyzed retrospectively.

Results: The sepsis caused by Acinetobacter pittii, was improved after treatment.

Discussion and conclusion: Pneumonia caused by fully sensitive hypervirulent Acinetobacter pittii is rare, usually with acute course, severe illness and high mortality. It is necessary to identify the infectious agent as soon as possible, and early treatment can improve the success rate of treatment.

Background: This study aimed to develop a guinea pig model of concurrent allergic rhinitis and asthma.

Methods: Thirty-three guinea pigs were randomly divided into the control group and the experimental group. Guinea pigs in the experimental group were sensitized by intraperitoneal injection of recombinant wild-type Dermatophagoides farinae group 2 allergen (wt Der f 2) plus Al(OH)₃ on day 1 and 8, followed by inhalation of an aerosol of wt Der f 2 on day 16 and 23. The sensitized guinea pigs were challenged with intranasal instillation of wt Der f 2 plus Al(OH)₃ gel on day 19 and 26 for nasal symptoms scoring, and on day 30 for the active cutaneous anaphylaxis (ACA) test. Control group guinea pigs received normal saline (N.S.) plus Al(OH)₃ in parallel. Cutaneous provocation tests were performed to exclude nonsensitized guinea pigs, and nasal symptom assessments were conducted to exclude non-allergic guinea pigs from the study. The allergic airway model was finally validated using the ACA test, Evans blue dye quantification with wt Der f2, histopathology evaluation, and immunohistochemistry analysis of MUC5AC expression in both nasal mucosa and lung tissue.

Results: Two guinea pigs with negative cutaneous reactions and three with less than 5 points of the nasal symptom assessment were excluded from the experimental group. The ACA test showed enhanced allergic reactions in the experimental group, and the quantification of extravasated Evans blue dye demonstrated significantly higher absorbance in the wt Der f 2 spots compared to mu Der f 2. Histologic analyses illustrated pathologic features typical of allergic rhinitis and asthma. MUC5AC levels in the nasal mucosa and lung samples were significantly higher in the experimental group than in the control group.

Conclusion: We successfully established a guinea pig model of concurrent allergic rhinitis and asthma using a combination of sensitization, challenge, and validation methodologies with the allergen Der f 2, suitable for pathophysiological studies.

Clinical trial number: Not applicable.

Background: Google Trends (GT) is a free tool that provides insights into the public's interest and information-seeking behavior on specific topics. In this study, we utilized GT data on patients' search history to better understand their questions and information needs regarding asthma.

Methods: We extracted the relative GT search volume (RSV) for keywords associated with asthma to explore information-seeking behaviors and assess internet search patterns regarding asthma disease from 2004 to 2024 in both English and Persian languages. In addition, a correlation analysis was conducted to assess terms correlated with asthma searches. Then, the AutoRegressive predictive models were developed to estimate future patterns of asthma-related searches and the information needs of individuals with asthma.

Results: The analysis revealed that the mean total RSV for asthma-related keywords over the 20-year period was 41.79 ± 6.07. The researchers found that while asthma-related search volume has shown a consistent upward trend in Persian-speaking countries over the last decade, English-speaking countries have experienced less variability in such searches except for a spike during the COVID-19 pandemic. The correlation analysis of related subjects showed that "air pollution", "infection", and "insomnia" have a positive correlation with asthma. Developing AutoRegressive predictive models on retrieved Google Trends data revealed a seasonal pattern in global asthma-related search interest. In contrast, the models forecasted a growing increase in information-seeking behaviors regarding asthma among Persian-speaking patients over the coming decades.

Conclusions: There are significant differences in how people search for and access asthma information based on their language and regional context. In English-speaking countries, searches tend to focus on broader asthma-related topics like pollution and infections, likely due to the availability of comprehensive asthma resources. In contrast, Persian speakers prioritize understanding specific aspects of asthma-like symptoms, medications, and complementary treatments. To address these divergent information needs, health organizations should tailor content to these divergent needs.

Background: Abnormal expression of N-acetyltransferase 10 (NAT10) has been shown to promote the progression of various tumors, including non-small cell lung cancer (NSCLC). This study was designed to investigate the role of NAT10 in NSCLC and the underlying mechanism.

Methods: Reverse transcription-quantitative polymerase chain reaction and Western blot were used to analyze the levels of NAT10 in NSCLC cell lines. The cell viability, proliferation, and apoptosis of A549 and PC9 cell lines were detected by cell counting kit-8, colony formation, and flow cytometry. N4-acetylcytidine (ac⁴C)-RNA immunoprecipitation assay was performed to detect the level of ac⁴C of α-enolase (ENO1) mRNA in A549 and PC9 cell lines. The relationship between NAT10 and ENO1 was performed by dual-luciferase reporter assay.

Results: NAT10 was increased in NSCLC cell lines. The ac⁴C level of ENO1 mRNA in A549 and PC9 cell lines was downregulated after NAT10 inhibition. Knockdown of NAT10 inhibited cell viability and glycolysis and promoted cell apoptosis in A549 and PC9 cell lines, and the results were reversed after ENO1 overexpressing.

Conclusions: NAT10 regulated glycolysis and apoptosis in NSCLC via ac⁴C acetylating ENO1, which might provide new ideas for the clinical treatment of NSCLC.

Background: At the time of Omicron BA.2 outbreak, it was shown that mild to moderate COVID-19 was associated with worsening of asthma control after recovery. Whether the same phenomenon was also observed at a later phase of COVID-19 pandemic by other variants have not been reported.

Methods: We conducted a follow-up study on patients with asthma who received clinical care in Queen Mary Hospital. The patients were first recruited in the study entitled "Worsening of asthma control after recovery from mild to moderate COVID-19 in patients from Hong Kong". The primary outcome was the asthma control test (ACT) score difference among the patients who never had COVID-19 (no COVID-19 group), patients who had COVID-19 diagnosed in the initial study (past COVID-19 group) and patients who had COVID-19 diagnosed in the follow-up period (new COVID-19 group) of the current study.

Results: 189 patients were included. The change of ACT score from the last visit in the previous study to the last follow-up visit in current study was - 0.34 ± 3.7 in the no COVID-19 group, -0.0 ± 5.0 in the past COVID-19 group and - 0.17 ± 4.5 in the new COVID-19 group (p = 0.94). There were 10 (24.4%), 24 (25.5%) and 12 (22.2%) patients in the no COVID-19, past COVID-19 and new COVID-19 group who had worsening of asthma control by an increase in ACT score ≥ 3 from the last visit in the previous study to the last follow-up visit in current study (p = 0.90).

Conclusion: Patients who had COVID-19 in 2023 with Omicron XBB as the dominant strain did not have worsening of asthma control seen in previous study done in 2022 with Omicron BA.2 as the circulating strain. Patients who had worsening of asthma control after COVID-19 in 2022 had subsequent improvement of asthma control with longer follow-up interval.