BMC Pulmonary Medicine最新文献

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.

Background: Cystic fibrosis (CF) is a multi-organ disorder in which respiratory complications account for the majority of its cause of mortality. This study aimed to investigate the factors associated with pulmonary hypertension (PH) in pediatric patients with CF and acute pulmonary exacerbations (PEx).

Methods: This is a prospective cross-sectional study that enrolled children with CF who were hospitalized with PEx in a university hospital between 2020 and 2022. All patients underwent echocardiography, and their pulmonary artery pressure (PAP) was measured. They were then divided into two groups based on the presence or absence of PH. Clinical symptoms, spirometry, six-minute walk tests, laboratory findings, chest radiography, and other clinical parameters were compared in these two groups. The restricted cubic spline was plotted for variables with nonlinear associations with PH.

Result: A total of 107 pediatric patients were included in this study. The prevalence of PH in the studied population was 24.3%. Group 1 consisted of 81 patients with normal PAP values (PAP < 25 mmHg), and group 2 included 26 patients with increased levels of PAP (PAP ≥ 25 mmHg). Group 2 had significantly higher median age, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) levels, as well as a greater frequency of major chest X-ray abnormalities and NIV use compared to group 1. Univariate logistic regression demonstrated that older age (OR 1.191, 95% CI 1.052-1.348, p = 0.006), elevated CRP (OR 1.027, 95% CI 1.009-1.046, p = 0.004), ESR ≥ 21 mm/hr (OR: 3.567, 95% CI: 1.350-9.427, p = 0.010), lower lymphocyte counts (OR 0.972, 95% CI 0.946-0.999, p = 0.044), and NIV requirement (OR 3.055, 95% CI 1.230-7.586, p = 0.016) were significantly associated with an increased likelihood of PH. In multivariate analyses adjusted for confounders, older age (OR 1.176, 95% CI 1.035-1.337, p = 0.013), elevated CRP (OR 1.024, 95% CI 1.004-1.044, p = 0.020), ESR ≥ 21 mm/hr (OR: 1.149, 95% CI: 1.008-1.310, p = 0.037), and NIV requirement (OR 2.860, 95% CI 1.102-7.422, p = 0.031) remained independently associated with having PH.

Conclusion: In patients with CF and PEx, factors that suggest the possibility of concurrent PH include older age, infiltration or bronchiectasis on chest X-ray, NIV requirements, and elevated inflammatory markers.