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Small airway disease

Sharon L I Wong, Maria B Sukkar
Secreted protein acidic and rich in cysteine (SPARC) is a matricellular protein which regulates interactions between cells and their surrounding extracellular matrix (ECM), and thus governs fundamental cellular functions such as cell adhesion, proliferation and differentiation. SPARC also regulates the expression and activity of numerous growth factors and matrix metalloproteinases essential for ECM degradation and turnover. Studies in SPARC-null mice have revealed a critical role for SPARC in tissue development, injury and repair, and in the regulation of the immune response...
October 19, 2016: British Journal of Pharmacology
Choua Thao, Amir Lagstein, Tadashi Allen, Huseyin Erhan Dincer, Hyun Joo Kim
Respiratory involvement in Crohn's disease (CD) is a rare manifestation known to involve the large and small airways, lung parenchyma, and pleura. The clinical presentation is nonspecific, and diagnostic tests can mimic other pulmonary diseases, posing a diagnostic challenge and delay in treatment. We report a case of a 60-year-old female with a history of CD and psoriatic arthritis who presented with dyspnea, fever, and cough with abnormal radiological findings. Diagnostic testing revealed an elevated CD4:CD8 ratio in the bronchoalveolar lavage fluid, and cryoprobe lung biopsy results showed non-necrotizing granulomatous inflammation...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Martin Wolley, Diane Cowley, Ashraf Ahmed, Richard Gordon, Michael Stowasser
OBJECTIVE: Obstructive sleep apnoea (OSA) is known to commonly co-exist with primary aldosteronism (PA), but it is unknown if treatment via mineralocorticoid receptor blockade or adrenalectomy (for aldosterone producing adenoma, APA), improves sleep apnoea parameters in these patients. We therefore aimed to determine if specific medical or surgical treatment of PA improves OSA, as measured by the apnoea hypopnoea index (AHI). DESIGN AND METHOD: Patients undergoing diagnostic workup for PA were recruited if they had symptoms suggestive of OSA...
September 2016: Journal of Hypertension
Engi F Attia, Robert F Miller, Rashida A Ferrand
PURPOSE OF REVIEW: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. RECENT FINDINGS: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live...
October 7, 2016: Current Opinion in Infectious Diseases
Emma C Reilly, Kris Lambert-Emo, David J Topham
After disease resolution, a small subset of influenza specific CD8+ T cells can remain in the airways of the lung as a tissue resident memory population (TRM). These cells are critical for protection from subsequent infections with heterosubtypic influenza viruses. Although it is well established that expression of the collagen IV binding integrin alpha 1 is necessary for the retention and maintenance of TRM cells, other requirements allowing them to localize to the airways and persist are less well understood...
2016: PloS One
Carolyn Tubby, Ola H Negm, Timothy Harrison, Patrick J Tighe, Ian Todd, Lucy C Fairclough
OBJECTIVE: The three main types of killer cells - CD8(+) T cells, NK cells and NKT cells - have been linked to asthma and chronic obstructive pulmonary disease (COPD). However, their role in a small subset of asthma patients displaying fixed airway obstruction (FAO), similar to that seen in COPD, has not been explored. The objective of the present study was to investigate killer cell numbers, phenotype and function in peripheral blood from asthma patients with FAO, asthma patients without FAO, and healthy individuals...
October 13, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Hanna Knihtilä, Anne Kotaniemi-Syrjänen, Anna S Pelkonen, Satu Kalliola, Mika J Mäkelä, L Pekka Malmberg
INTRODUCTION: Early origins of chronic obstructive pulmonary disease have been recognized. Impulse oscillometry (IOS) is suitable for assessment of lung function also in preschool children, and some novel indices have been connected to assessment of small airway function. However, limited data exist on the sensitivity of these new indices to detect lung function deficits in young symptomatic children. METHODS: IOS measurements of 103 healthy preschool children were evaluated to establish reference equations for the difference between respiratory resistance at 5 and 20 Hz (R5-20), the relative difference of R5-20 (R5-20%), and area under the reactance curve (AX)...
October 13, 2016: Pediatric Pulmonology
Masashi Mikamo, Tomoyuki Fujisawa, Yoshiyuki Oyama, Masato Kono, Noriyuki Enomoto, Yutaro Nakamura, Naoki Inui, Hiromitsu Sumikawa, Takeshi Johkoh, Takafumi Suda
PURPOSE: Small airway disease (SAWD) in patients with interstitial lung disease (ILD) is often assessed by high-resolution computed tomography (HRCT). However, frequent HRCT examinations result in a high level of radiographic exposure. This study investigated the utility of the forced oscillation technique (FOT) to evaluate SAWD in patients with ILD. METHODS: Broadband FOT using a commercially available device (MostGraph-01) and pulmonary function tests (PFT) were performed in 90 patients with ILD...
October 12, 2016: Lung
W Joon Chung, Jennifer L Goeckeler-Fried, Viktoria Havasi, Annette Chiang, Steven M Rowe, Zackery E Plyler, Jeong S Hong, Marina Mazur, Gary A Piazza, Adam B Keeton, E Lucile White, Lynn Rasmussen, Allan M Weissman, R Aldrin Denny, Jeffrey L Brodsky, Eric J Sorscher
Small molecules that correct the folding defects and enhance surface localization of the F508del mutation in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR) comprise an important therapeutic strategy for cystic fibrosis lung disease. However, compounds that rescue the F508del mutant protein to wild type (WT) levels have not been identified. In this report, we consider obstacles to obtaining robust and therapeutically relevant levels of F508del CFTR. For example, markedly diminished steady state amounts of F508del CFTR compared to WT CFTR are present in recombinant bronchial epithelial cell lines, even when much higher levels of mutant transcript are present...
2016: PloS One
Vibe Maria Laden Nielsen, Jacob Madsen, Anette Aasen, Anne Pernille Toft-Petersen, Kenneth Lübcke, Bodil Steen Rasmussen, Erika Frischknecht Christensen
BACKGROUND: Patients with acute respiratory failure are at risk of deterioration during prehospital transport. Ventilatory support with continuous positive airway pressure (CPAP) can be initiated in the prehospital setting. The objective of the study is to evaluate adherence to treatment and effectiveness of CPAP as an addition to standard care. METHODS: In North Denmark Region, patients with acute respiratory failure, whom paramedics assessed as suffering from acute cardiopulmonary oedema, acute exacerbation of chronic obstructive pulmonary disease or asthma were treated with CPAP using 100 % O2 from 1 March 2014 to 3 May 2015...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Abigail V Berniker, Travis S Henry
Small airways disease, or bronchiolitis, encompasses many conditions that result in bronchiolar inflammation and/or fibrosis. Bronchioles are distal airways within secondary pulmonary lobules that are only visible on imaging when abnormal. High-resolution computed tomography plays an important role in diagnosing small airways disease. The predominant direct high-resolution computed tomography sign of bronchiolitis includes centrilobular nodules, whereas air trapping is the main indirect finding. This article reviews bronchiolar anatomy, discusses the differential diagnosis for cellular and constrictive bronchiolitis with a focus on key imaging features, and discusses how to distinguish important mimics...
November 2016: Radiologic Clinics of North America
Seth Kligerman, Teri J Franks, Jeffrey R Galvin
The direct toxicity of cigarette smoke and the body's subsequent response to this lung injury leads to a wide array of pathologic manifestations and disease states that lead to both reversible and irreversible injury to the large airways, small airways, alveolar walls, and alveolar spaces. These include emphysema, bronchitis, bronchiolitis, acute eosinophilic pneumonia, pulmonary Langerhans cell histiocytosis, respiratory bronchiolitis, desquamative interstitial pneumonia, and pulmonary fibrosis. Although these various forms of injury have different pathologic and imaging manifestations, they are all part of the spectrum of smoking-related diffuse parenchymal lung disease...
November 2016: Radiologic Clinics of North America
Peter J Barry, Patrick A Flume
Cystic fibrosis airways disease is characterized by chronic inflammation and infection resulting in bronchiectasis. Published guidelines recommend medications for use by CF patients to maintain lung health. There are conflicting recommendations regarding inhaled bronchodilators. This is primarily because of the interpretation of the available evidence, which suffers from studies using small numbers of subjects, varying doses and durations of treatment, and modest effects on clinically relevant endpoints. Areas covered: Herein we review the available evidence demonstrating the challenge in determining whether bronchodilators have benefit for patients...
October 8, 2016: Expert Review of Respiratory Medicine
Jannie M B Sand, Diana J Leeming, Inger Byrjalsen, Asger R Bihlet, Peter Lange, Ruth Tal-Singer, Bruce E Miller, Morten A Karsdal, Jørgen Vestbo
BACKGROUND: There is a need to identify individuals with COPD at risk for disease progression and mortality. Lung tissue remodeling is associated with the release of extracellular matrix (ECM) fragments into the peripheral circulation. We hypothesized that ECM remodeling was associated with mortality in COPD and measured neo-epitopes originating from ECM proteins associated with lung tissue remodeling. METHODS: Biomarkers of ECM remodeling were assessed in a subpopulation (n = 1000) of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) cohort...
October 4, 2016: Respiratory Research
Hao Wang, Ting Yang, Diandian Li, Yanqiu Wu, Xue Zhang, Caishuang Pang, Junlong Zhang, Binwu Ying, Tao Wang, Fuqiang Wen
BACKGROUND: Plasminogen activator inhibitor-1 (PAI-1) and soluble urokinase-type plasminogen activator receptor (suPAR) participate in inflammation and tissue remolding in various diseases, but their roles in chronic obstructive pulmonary disease (COPD) are not yet clear. This study aimed to investigate if PAI-1 and suPAR were involved in systemic inflammation and small airway obstruction (SAO) in COPD. METHODS: Demographic and clinical characteristics, spirometry examination, and blood samples were obtained from 84 COPD patients and 51 healthy volunteers...
2016: International Journal of Chronic Obstructive Pulmonary Disease
A K A Wright, C Newby, R A Hartley, V Mistry, S Gupta, R Berair, K M Roach, R Saunders, T Thornton, M Shelley, K Edwards, B Barker, C E Brightling
BACKGROUND: The role of fibrocytes in COPD is unknown. We sought to enumerate blood and tissue fibrocytes in COPD and determine the association of blood fibrocytes with clinical features of disease. METHODS: Utilising flow cytometry to identify circulating, collagen type-1(+) cells we found two populations 1) CD45(+) CD34(+) (fibrocytes) and 2) CD45(+) CD34(-) (myeloid-derived suppressor cell [MDSC]-like fibrocytes) cells in stable COPD (n=41) and control (n=29) subjects...
October 6, 2016: Allergy
S Vamsee Raju, Hyunki Kim, Stephen A Byzek, Li Ping Tang, John E Trombley, Patricia Jackson, Lawrence Rasmussen, J Michael Wells, Emily Falk Libby, Erik Dohm, Lindy Winter, Sharon L Samuel, Kurt R Zinn, J Edwin Blalock, Trenton R Schoeb, Mark T Dransfield, Steven M Rowe
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the US. The majority of COPD patients have symptoms of chronic bronchitis, which lacks specific therapies. A major impediment to therapeutic development has been the absence of animal models that recapitulate key clinical and pathologic features of human disease. Ferrets are well suited for the investigation of the significance of respiratory diseases, given prior data indicating similarities to human airway physiology and submucosal gland distribution...
September 22, 2016: JCI Insight
C Heiser, B Hofauer
Obstructive sleep apnea (OSA) is a common disease in western industrialized countries with increasing prevalence. Gold standard of therapy is nocturnal positive pressure ventilation by continuous positive airway pressure (CPAP). Due to complications and side effects of ventilation, therapy adherence is limited. Recently an alternative surgical treatment has become available for these patients, which uses established techniques to stimulate the hypoglossus nerve to open the upper airway during sleep. The aim of this work is to provide an overview of the history and current state of scientific knowledge of this therapy in the treatment of OSA...
September 29, 2016: HNO
William T Harris, J Todd Boyd, Gary L McPhail, Alan S Brody, Rhonda D Szczesniak, Leslie L Korbee, Michael L Baker, John P Clancy
RATIONALE: Refractory lung function decline in association with recurrent pulmonary exacerbations is a common, yet poorly explained finding in CF. We reviewed clinically-indicated lung biopsy specimens obtained during a period of persistent decline to investigate histopathologic mechanisms of pulmonary deterioration during adolescence and early adulthood. OBJECTIVES: To determine if peribronchiolar remodeling is prominent in lung biopsy specimens obtained in CF adolescents refractory to conventional therapy...
September 29, 2016: Annals of the American Thoracic Society
Hiroki Daijo, Yuma Hoshino, Shinichi Kai, Kengo Suzuki, Kenichiro Nishi, Yoshiyuki Matsuo, Hiroshi Harada, Kiichi Hirota
Cigarette smoke (CS) is a major contributor to the development of a large number of fatal and debilitating disorders. However, the precise molecular mechanisms underlying the effects of CS in lung disease are largely unknown. To elucidate these pathophysiological processes, we examined the in vitro and in vivo effects of CS extract (CSE) and CS on the transcription factor, hypoxia-inducible factor 1 (HIF-1). CSE induced concentration- and time-dependent accumulation of HIF-1α protein in human lung epithelial-like cells under non-hypoxic conditions...
September 29, 2016: Scientific Reports
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