BMC Pulmonary Medicine最新文献

Background: Idiopathic pulmonary fibrosis (IPF) and rheumatoid arthritis-associated interstitial lung disease (RA-ILD) share several risk factors, genetic backgrounds, and morphological features, including the usual interstitial pneumonia pattern on computed tomography and histopathology. Anti-cyclic citrullinated peptide antibodies (ACPAs) are RA-related autoantibodies that are associated with RA-ILD. ACPA production can be induced in the lungs of patients with IPF.

Methods: Forty-four patients with IPF and 10 patients with RA-ILD underwent bronchoalveolar lavage fluid (BALF) collection. The concentrations of IgG ACPAs in the BALF were measured and corrected for total IgG levels. The relationships between corrected BALF ACPA levels and clinical features were investigated.

Results: The proportion of ACPAs (ACPA-IgG level adjusted by total IgG level) in the BALF was significantly lower in patients with IPF than in those with RA-ILD (1222 ± 1424 U/mg vs. 9058 ± 15159 U/mg, p < 0.01). Compared with the group with low ACPA proportions (n = 29), the IPF group with high ACPA proportions (n = 15) in the BALF was younger (65.2 ± 9.4 years vs. 70.9 ± 6.8 years, p = 0.03) and had more females (6 out of 15 (40%) vs. 2 out of 29 (7%), p = 0.01). Additionally, the IPF patients with a high ACPA proportion in the BALF had significantly better outcomes than those with a low ACPA proportion did (median overall survival time: 92.4 months vs. 41.1 months, p = 0.04).

Conclusion: The corrected BALF ACPA level might be an important biomarker for identifying IPF phenotypes with favourable outcomes.

BromAc^® (MP-171) is a novel first in class therapeutic agent under investigation for its potential in treating respiratory diseases. Evaluating its safety profile following inhalation is necessary for future clinical application. Here, we evaluated BromAc^® safety in an extended subacute short-term inhalation study. Forty BALB/c mice were divided into five groups (N = 8 each): sham control, saline control, and three BromAc^® dose groups at 0.250/20, 0.500/20, and 0.750/20 mg/mL. Treatments were administered by inhalation three times daily for 28 days. A final single dose was given on Day 29 before euthanasia. Various parameters were assessed during the study to evaluate the effect of BromAc such as wellbeing and bodyweight, along with tissue pathology and inflammatory cytokine assessment. The results indicated that inhalation of BromAc^® over 28 days did not affect general health, behavior, or body weight compared to controls. No signs of respiratory distress, hemorrhage, hypoxia, or any other disorders were observed. Mild, non-dose-dependent lung pathology and inflammatory changes were observed across all groups including controls. There was no difference between treated and control groups on multiplex immunoassay. These findings suggest that BromAc^® is safe for inhalation at the tested concentrations and exposure duration.

Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous, progressive pulmonary disorder with persistent respiratory symptoms resulting from abnormalities in the airways and/or alveoli and was prevalent globally in 10.3% of people aged 30-79 years in 2019. The prevalence of COPD has increased rapidly in women in the past decade. This may be due to increased tobacco use, but may also involve sex-specific factors.

Purpose: To evaluate the prevalence of COPD in the context of sex and tobacco exposure.

Data sources and searches: Comprehensive searches of MEDLINE (OVID), EMBASE and CENTRAL were conducted for articles published from inception to July 22, 2022.

Study selection: We independently evaluated titles, abstracts and full-text articles in a duplicated two-staged process. Studies were included if they reported the prevalence of COPD as a primary outcome in the context of sex and tobacco exposure.

Data synthesis and analysis: Pooled analysis was conducted with Review Manager 5, and heterogeneity was assessed with the I² statistic. For 163, 450 individuals the prevalence of COPD was 3.5-20.7% in males and 6.3-18.5% in females, and we observed a non-statistically significant difference of 1.53% [95% CI: -5.83, 8.89] (p = 0.68) in females compared to males with tobacco exposure (Tau² = 54.02; Chi² = 53.15; df = 4 (P < 0.00001); I² = 92%). Females with COPD had earlier mortality, greater co-morbidities involving cardiovascular disease and others, and decreased FEV₁% predicted, as compared to males with COPD. Estrogen and androgens may protect against COPD, but smoking-induced hypogonadism may diminish these effects. Menopause could also be a contributor to worse COPD outcomes.

Limitations: Included articles are limited by the quality of data on tobacco smoke exposure, primarily reported as a binary risk factor, with lack of availability on duration and intensity of exposure.

Conclusion: There was earlier mortality and reduced FEV₁ in females with COPD, as compared to males with COPD. Thus, sex-specific considerations are important in understanding the pathophysiology of COPD and should be a focus of further research.