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Airway clearance

Nicola L D Overton, Axel A Brakhage, Andreas Thywißen, David W Denning, Paul Bowyer
Allergic bronchopulmonary aspergillosis (ABPA) in asthma is a severe, life-affecting disease that potentially affects over 4.8 million people globally. In the UK, ABPA is predominantly caused by the fungus Aspergillus fumigatus. Phagocytosis is important in clearance of this fungus, and Early Endosome Antigen 1 (EEA1) has been demonstrated to be involved in phagocytosis of fungi. We sought to investigate the role of EEA1 mutations and phagocytosis in ABPA. We used exome sequencing to identify variants in EEA1 associated with ABPA...
2018: PloS One
Yang Bai, Hannelore Bové, Tim S Nawrot, Benoit Nemery
BACKGROUND: Carbon load in airway macrophages (AM) has been proposed as an internal marker to assess long-term exposure to combustion-derived pollutant particles. However, it is not known how this biomarker is affected by changes in exposure. We studied the clearance kinetics of black carbon (BC) in AM, obtained by sputum induction, in a one-year panel study. METHODS: AM BC was measured 8 times with 6 weeks intervals in healthy young subjects: 15 long-term residents in Leuven, Belgium (BE, mean annual PM10 20-30 μg/m3 ) and 30 newcomers having arrived recently (< 3 weeks) in Leuven from highly polluted cities (mean annual PM10  > 50 μg/m3 ) in low and middle-income countries (LMIC, n = 15), or from low to moderately polluted cities in high-income countries (HIC, n = 15)...
March 14, 2018: Particle and Fibre Toxicology
Priya Sharma, V Prem, Sakshee Jain
Background and Aims: One potential complication of acute respiratory distress syndrome (ARDS) is reduced dynamic compliance, saturation for peripheral oxygenation (SpO2 ) and increased sputum in patients that are mechanically ventilated. Airway clearance technique is the treatment given for patients on mechanically ventilator with ARDS. The purpose of the case series is to know the immediate effects of Acapella® on dynamic lung compliance (Cdyn) in subject with ARDS. Subjects and Methods: Patients who are on ventilator for more than 48hrs were included in the study...
February 2018: Indian Journal of Critical Care Medicine
Arietta Spinou
Cough can be viewed as a continuum where extremes represent disease phenotypes. Under this unified concept, non-pharmacological treatment for the extremes of the cough spectrum includes both cough augmentation and cough control techniques. Supporting the cough motor output and exercising the cognitive control on coughing are the main directions of these techniques. Cough augmentation can be provided to patients who present low ability to generate adequate peak cough flows, with the aim to develop the sheering forces that are essential for effective airway clearance...
March 9, 2018: Respiratory Physiology & Neurobiology
L de Bari, M Favia, A Bobba, R Lassandro, L Guerra, A Atlante
Cystic fibrosis (CF) is associated to impaired Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) channel also causing decreased glutathione (GSH) secretion, defective airway bacterial clearance and inflammation. Here we checked the main ROS-producing and ROS-scavenging enzymes as potential additional factors involved in CF pathogenesis. We found that CFBE41o-cells, expressing F508del CFTR, have increased NADPH oxidase (NOX) activity and expression level, mainly responsible of the increased ROS production, and decreased glutathione reductase (GR) activity, not dependent on GR protein level decrease...
March 9, 2018: Journal of Bioenergetics and Biomembranes
Izabela Galvão, Luciana P Tavares, Renan O Corrêa, José Luís Fachi, Vitor Melo Rocha, Marcela Rungue, Cristiana C Garcia, Geovanni Cassali, Caroline M Ferreira, Flaviano S Martins, Sergio C Oliveira, Charles R Mackay, Mauro M Teixeira, Marco Aurélio R Vinolo, Angélica T Vieira
Pneumonia is one of the leading causes of death and mortality worldwide. The inflammatory responses that follow respiratory infections are protective leading to pathogen clearance but can also be deleterious if unregulated. The microbiota is known to be an important protective barrier against infections, mediating both direct inhibitory effects against the potential pathogen and also regulating the immune responses contributing to a proper clearance of the pathogen and return to homeostasis. GPR43 is one receptor for acetate, a microbiota metabolite shown to induce and to regulate important immune functions...
2018: Frontiers in Immunology
Madeline Gaynor, Jamie Wood
In cystic fibrosis (CF), acute exacerbations can decrease the effectiveness of patients' usual airway clearance techniques (ACT). In order to maintain effective airway clearance and preserve lung function, these ACT must be adapted to prevent further dyspnoea and fatigue and improve ease of expectoration. Mechanical insufflation-exsufflation (MI-E) is widely used in neuromuscular disorders to facilitate airway clearance and augment cough but has rarely been used in CF despite potential indications. The NIPPY Clearway, an airway clearance device with multiple modes including MI-E, can be set to deliver multiple insufflations prior to a single exsufflation...
May 2018: Respirology Case Reports
Amanda Wilson
No abstract text is available yet for this article.
February 23, 2018: International Journal of Nursing Studies
Shuai Ren, Yan Shi, Maolin Cai, Hongmei Zhao, Zhaozhi Zhang, Xiaohua Douglas Zhang
Coughing is an irritable reaction that protects the respiratory system from infection and improves mucus clearance. However, for the patients who cannot cough autonomously, an assisted cough device is essential for mucus clearance. Considering the low efficiency of current assisted cough devices, a new simulated cough device based on the pneumatic system is proposed in this paper. Given the uncertainty of airflow rates necessary to clear mucus from airways, the computational fluid dynamics (CFD) Eulerian Wall Film (EWF) model and cough efficiency (CE) were used in this study to simulate the cough process and evaluate cough effectiveness...
March 5, 2018: International Journal for Numerical Methods in Biomedical Engineering
Michelle Chatwin, Michel Toussaint, Miguel R Gonçalves, Nicole Sheers, Uwe Mellies, Jesus Gonzales-Bermejo, Jesus Sancho, Brigitte Fauroux, Tiina Andersen, Brit Hov, Malin Nygren-Bonnier, Matthieu Lacombe, Kurt Pernet, Mike Kampelmacher, Christian Devaux, Kathy Kinnett, Daniel Sheehan, Fabrizio Rao, Marcello Villanova, David Berlowitz, Brenda M Morrow
This is a unique state of the art review written by a group of 21 international recognized experts in the field that gathered during a meeting organized by the European Neuromuscular Centre (ENMC) in Naarden, March 2017. It systematically reports the entire evidence base for airway clearance techniques (ACTs) in both adults and children with neuromuscular disorders (NMD). We not only report randomised controlled trials, which in other systematic reviews conclude that there is a lack of evidence base to give an opinion, but also include case series and retrospective reviews of practice...
March 2018: Respiratory Medicine
Ditte Marie Jensen, Daniel Vest Christophersen, Majid Sheykhzade, Gry Freja Skovsted, Jens Lykkesfeldt, Rasmus Münter, Martin Roursgaard, Steffen Loft, Peter Møller
BACKGROUND: Humans are continuously exposed to particles in the gastrointestinal tract. Exposure may occur directly through ingestion of particles via food or indirectly by removal of inhaled material from the airways by the mucociliary clearance system. We examined the effects of food-grade particle exposure on vasomotor function and systemic oxidative stress in an ex vivo study and intragastrically exposed rats. METHODS: In an ex vivo study, aorta rings from naïve Sprague-Dawley rats were exposed for 30 min to food-grade TiO2 (E171), benchmark TiO2 (Aeroxide P25), food-grade vegetable carbon (E153) or benchmark carbon black (Printex 90)...
February 26, 2018: Particle and Fibre Toxicology
James D Chalmers, Sanjay H Chotirmall
European Respiratory Society guidelines for the management of adult bronchiectasis highlight the paucity of treatment options available for patients with this disorder. No treatments have been licensed by regulatory agencies worldwide, and most therapies used in clinical practice are based on very little evidence. Development of new treatments is needed urgently. We did a systematic review of scientific literature and clinical trial registries to identify agents in early-to-late clinical development for bronchiectasis in adults...
February 22, 2018: Lancet Respiratory Medicine
John J Brewington, Jessica Backstrom, Amanda Feldman, Elizabeth L Kramer, Jessica D Moncivaiz, Alicia J Ostmann, Xiaoting Zhu, L Jason Lu, John P Clancy
Traditional pulmonary therapies for cystic fibrosis (CF) target the downstream effects of CF transmembrane conductance regulator (CFTR) dysfunction (the cause of CF). Use of one such therapy, β-adrenergic bronchodilators (such as albuterol), is nearly universal for airway clearance. Conversely, novel modulator therapies restore function to select mutant CFTR proteins, offering a disease-modifying treatment. Recent trials of modulators targeting F508del-CFTR, the most common CFTR mutation, suggest that chronic β-agonist use may undermine clinical modulator benefits...
February 22, 2018: JCI Insight
Olufunmilola Abraham, Jenny S Li, Kathy E Monangai, Alison M Feathers, Daniel Weiner
OBJECTIVES: To describe the critical need for pharmacists' involvement in outpatient care for people living with cystic fibrosis (CF). DATA SOURCES: Not applicable. SUMMARY: CF is a pulmonary condition that affects more than 30,000 children and adults in the United States and 70,000 people worldwide. Various complex medication regimens are given to patients with CF, some depending on the type of mutation they have in their CF transmembrane conductance regulator protein...
February 16, 2018: Journal of the American Pharmacists Association: JAPhA
Hajime Kawasaki
Chronic exposure to titanium dioxide (TiO2 ) induces slight but significant pulmonary inflammation in experimental animals, and among potential mechanisms, particle overload is likely. Although mechanisms of particle overload are poorly understood, excess accumulation of dust particles in dust containing macrophages (dust cells) can impair their mobility, resulting in reduced clearance ability. Accordingly, retention half-times of inhaled TiO2 increase linearly with lung burden in rodents, and mathematical (Michaelis-Menten-like) models for pulmonary clearance rates of TiO2 as a function of lung burden have suggested an alternative mechanism for particle overload, involving excess accumulation of macrophages in the translocation pathway due to the narrow exit to the ciliated airway region, and leading to reduced pulmonary TiO2 clearance rates...
October 2017: Inhalation Toxicology
Lin Yang, Santasree Banerjee, Jie Cao, Xiaohong Bai, Zhijun Peng, Haixia Chen, Hui Huang, Peng Han, Shunyu Feng, Na Yi, Xueru Song, Jing Wu
Purpose: Primary ciliary dyskinesia (PCD) is a rare genetic disorder manifested with recurrent infections of respiratory tract and infertility. Mutations in more than 20 genes including the Coiled-Coil Domain Containing 40 ( CCDC40 ) gene are associated with PCD. A Chinese proband with a clinical diagnosis of PCD was analyzed for mutations in these genes to identify the genetic basis of the disease in the family. The proband showed altered mucociliary clearance of the airways, various degree of hyperemia and edema of the mucous membrane, left/right body asymmetry, infertility and ultrastructural abnormality of cilia in both sperm and bronchioles...
2018: Frontiers in Genetics
Sean R McMaster, Alexander N Wein, Paul R Dunbar, Sarah L Hayward, Emily K Cartwright, Timothy L Denning, Jacob E Kohlmeier
Resident memory CD8 T (TRM ) cells in the lung parenchyma (LP) and airways provide heterologous protection against influenza virus challenge. However, scant knowledge exists regarding factors necessary to establish and maintain lung CD8 TRM . Here we demonstrate that, in contrast to mechanisms described for other tissues, airway, and LP CD8 TRM establishment requires cognate antigen recognition in the lung. Systemic effector CD8 T cells could be transiently pulled into the lung in response to localized inflammation, however these effector cells failed to establish tissue residency unless antigen was present in the pulmonary environment...
February 16, 2018: Mucosal Immunology
Supravat Dey, Gladys Massiera, Estelle Pitard
Cilia are elastic hairlike protuberances of the cell membrane found in various unicellular organisms and in several tissues of most living organisms. In some tissues such as the airway tissues of the lung, the coordinated beating of cilia induces a fluid flow of crucial importance as it allows the continuous cleaning of our bronchia, known as mucociliary clearance. While most of the models addressing the question of collective dynamics and metachronal wave consider homogeneous carpets of cilia, experimental observations rather show that cilia clusters are heterogeneously distributed over the tissue surface...
January 2018: Physical Review. E
Andrew Low, Sarah George, Luke Howard, Nicholas Bell, Ann Millar, Robert M R Tulloh
BACKGROUND: Breathlessness is the most common symptom in people with pulmonary arterial hypertension and congenital heart disease (CHD-APAH), previously thought to be caused by worsening PAH, but perhaps also by inflammation and abnormalities of lung function. We studied lung function and airway inflammation in patients with CHD-APAH and compared the results with controls. METHODS AND RESULTS: Sixty people were recruited into the study: 20 CHD-APAH, 20 CHD controls, and 20 healthy controls...
February 14, 2018: Journal of the American Heart Association
Bryan A Garcia, Jacque L Carden, Dana L Goodwin, Tim A Smith, Amit Gaggar, Kevin Leon, Veena B Antony, Steven M Rowe, George M Solomon
BACKGROUND: Infection with Burkholderia cepacia complex (Bcc) results in a heterogeneous clinical course ranging from asymptomatic colonization of the airways to fulminant respiratory failure in patients with cystic fibrosis (CF). Early eradication of Pseudomonas aeruginosa improves clinical outcomes. The efficacy and clinical outcomes following implementation of an eradication protocol for Bcc are less well understood. METHODS: We developed and implemented a single center Bcc eradication protocol that included an intensive combination of intravenous, inhaled, and oral antibiotic therapies based on in vitro sensitivities...
February 14, 2018: BMC Pulmonary Medicine
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