Bronchial Infiltration Research Articles

Intrinsically bioactive multifunctional Poly(citrate-curcumin) for rapid lung injury and MRSA infection therapy

Dysregulated inflammation after trauma or infection could result in the further disease and delayed tissue reconstruction. The conventional anti-inflammatory drug treatment suffers to the poor bioavailability and side effects. Herein, we developed an amphiphilic multifunctional poly (citrate-polyglycol-curcumin) (PCGC) nano oligomer with the robust anti-inflammatory activity for treating acute lung injury (ALI) and Methicillin-resistant staphylococcus aureus (MRSA) infected wound. PCGC demonstrated the sustained curcumin release, inherent photoluminescence, good cellular compatibility, hemocompatibility, robust antioxidant activity and enhanced cellular uptake. PCGC could efficiently scavenge nitrogen-based free radicals, oxygen-based free radicals, and intracellular oxygen species, enhance the endothelial cell migration and reduce the expression of pro-inflammatory factors through the NF-κB signal pathway. Combined the anti-inflammation and antioxidant properties, PCGC can shortened the inflammatory process. In animal model of ALI, PCGC was able to reduce the pulmonary edema, bronchial cell infiltration, and lung inflammation, while exhibiting rapid metabolic behavior in vivo. The MRSA-infection wound model showed that PCGC significantly reduced the expression of pro-inflammatory factors, promoted the angiogenesis and accelerated the wound healing. The transcriptome sequencing and molecular mechanism studies further demonstrated that PCGC could inhibit multiple inflammatory related pathways including TNFAIP3, IL-15RA, NF-κB. This work demonstrates that PCGC is efficient in resolving inflammation and promotes the prospect of application in inflammatory diseases as the drug-loaded therapeutic system.

Exploration and machine learning model development for T2 NSCLC with bronchus infiltration and obstructive pneumonia/atelectasis

In the 8th edition of the American Joint Committee on Cancer (AJCC) staging system for Non-Small Cell Lung Cancer (NSCLC), tumors exhibiting main bronchial infiltration (MBI) near the carina and those presenting with complete lung obstructive pneumonia/atelectasis (P/ATL) have been reclassified from T3 to T2. Our investigation into the Surveillance, Epidemiology, and End Results (SEER) database, spanning from 2007 to 2015 and adjusted via Propensity Score Matching (PSM) for additional variables, disclosed a notably inferior overall survival (OS) for patients afflicted with these conditions. Specifically, individuals with P/ATL experienced a median OS of 12 months compared to 15 months (p < 0.001). In contrast, MBI patients demonstrated a slightly worse prognosis with a median OS of 22 months versus 23 months (p = 0.037), with both conditions significantly correlated with lymph node metastasis (All p < 0.001). Upon evaluating different treatment approaches for these particular T2 NSCLC variants, while adjusting for other factors, surgery emerged as the optimal therapeutic strategy. We counted those who underwent surgery and found that compared to surgery alone, the MBI/(P/ATL) group experienced a much higher proportion of preoperative induction therapy or postoperative adjuvant therapy than the non-MBI/(P/ATL) group (41.3%/54.7% vs. 36.6%). However, for MBI patients, initial surgery followed by adjuvant treatment or induction therapy succeeded in significantly enhancing prognosis, a benefit that was not replicated for P/ATL patients. Leveraging the XGBoost model for a 5-year survival forecast and treatment determination for P/ATL and MBI patients yielded Area Under the Curve (AUC) scores of 0.853 for P/ATL and 0.814 for MBI, affirming the model's efficacy in prognostication and treatment allocation for these distinct T2 NSCLC categories.

Multiple Myeloma Presenting with Multiple Thoracic Manifestations

Multiple myeloma is a malignant proliferation of plasma cells that affects mainly bone marrow but may also involve other organs as well. We report thoracic involvement in the form of left-sided pleural effusion, osseous lesions, bronchial infiltration, and mediastinal lymphadenopathy in a 61-year-old woman, non-smoker presented with chest pain, dyspnoea, cough and deterioration in general health over the preceding seven months. Immunoelectrophoresis and immunofixation showed raised kappa-light chain immunoglobulin G (IgG) in serum and pleural fluid. Bronchial and pleural biopsies documented myelomatous infiltration and bone marrow aspirate revealed extensive plasma cell infiltration. At eight months, following the fourth cycle of melphalan, endoxan and prednisone based chemotherapy, the patient died.

PSEUDOTUMORAL PULMONARY TB MASS: WHAT IS THE PLACE OF SURGERY FOR DIAGNOSIS?

TYPE: Abstract TOPIC: Cardiothoracic Surgery PURPOSE: The pseudotumoral form of pulmonary tuberculosis (PTPT) is extremely rare. It constitutes a diagnosis dilemma by simulating pulmonary cancer. Surgical investigation is required when non-invasive modalities of diagnostic don’t identify the PTPT. METHODS: Sixteen immunocompetent patients presenting a PTPT, were operated in the Thoracic and Cardiovascular Surgery Department of Ariana in Tunisia between 1997 and 2020. RESULTS: They were 14 men and 2 women. The average age was 53 years. Two patients had a history of treated pulmonary tuberculosis. Eleven patients were smokers. The median overall diagnostic delay was 6 months. Productive cough (n=4) and chest pain (n=4) were the major symptoms. The chest X-ray revealed a dishomogeneous opacity with an irregular outline in 75% of cases. The computed tomography of chest showed a tissue mass mimickig malignancy in 10 cases and a suspicious parenchymal condensation in 2 cases. The most common site involved is the upper right lobe (10 cases). Cavitation was seen in 3 cases. The bronchoscopy showed a stenosing bronchial wall infiltration in 5 cases. All bronchial biopsies were inconclusive. Sputum and bronchoalveolar fluid acid fast bacilli smear and culture were negative. Through a posterolateral thoracotomy, we performed a lobectomy (n=12), wedge resection (n=2) and tumor biopsy (n=2). Histological exam concluded to pulmonary tuberculosis. All patients received anti-bacillary therapy with good clinico-radiological evolution. CONCLUSIONS: The positive diagnosis of PTPT is difficult. Surgery remains the reliable means of diagnosis for initiating early medical management. CLINICAL IMPLICATIONS: Diagnosis of PTPT can be delayed and lead to surgical resection DISCLOSURE: Nothing to declare. KEYWORD: pseudotumoral, lung, tuberculosis, surgery

Diagnostic Accuracy of Right Bronchial Infiltration on Chest X-rays in Diagnosing COVID-19 Patients in the Early Stage of the Disease.

PurposeSARS-CoV-2 has been a diagnostic challenge for healthcare setups worldwide since 2019 due to its proximity to a myriad of pathological processes. Although reverse transcription - polymerase chain reaction (RT-PCR) and high-resolution computed tomography (HRCT) have helped in the diagnosis of the disease, they are not as widely available as chest X-rays. This study aims to investigate the diagnostic accuracy of right bronchial infiltration in chest X-ray in diagnosing COVID-19.Material and methodsThis was a validation study conducted in a single center in Riyadh, Saudi Arabia. A total of 114 patients were enrolled according to the selection criteria of the study. Consent was waived off on the condition of confidentiality maintenance as per the ethical review board. X-rays of suspected patients were viewed and analyzed by two blinded consultant radiologists. Patients were followed for their RT-PCR reports. Data were entered and analyzed in SPSS Statistics v.23.0 (IBM Corp., Armonk, USA).ResultsAmong the 114 patients, the mean age was 46.2±17.3 years and 85 (74.6%) were males. The total number of COVID-19-positive patients were 82 (71.9%) while the patients presenting with right bronchial infiltration (RBI) were 94 (82.5%). RBI was significantly associated with the presence and absence of COVID-19 on PCR (p<0.001) and the presence of comorbidities (p<0.001). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the sign were 84.04%, 85.00%, 96.34%, 53.12%, and 84.21%, respectively.ConclusionsRBI can be used as a diagnostic sign in X-rays for early identification of COVID-19 positive patients. This feature can be used in the triage of patients. This would decrease the spread of disease by providing early time to intervene to isolate patients.

Significance of detecting postmortem serum IgE in frozen corpses for the diagnosis of anaphylaxis in forensic.

The aim of this study was to detect the postmortem serum total IgE levels in frozen corpses and identify whether the death incident caused by an anaphylaxis in forensic medicine. Autopsy cases with pathological death (total, n=106; 4-214h postmortem) include cardiac disease (n=15), pulmonary infection (n=12), central nervous system disorder (n=6), pulmonary emboliszn (n=7), hapetic disease (n=5), kidney disease (n=6), enteric disease (n=10), necrotizing pancreatitis (n=7), diffuse peritonitis (n=6), MODS (n=6), toxicosis (n=5:), anaphylactic shock (n=7), bronchial asthma (n=8) and other disease (n=6) were examined. Results showed that there was no significant difference between serum IgE levels and ages, postmortem intervals (PMIs), gender as well as survival time. Serum IgE levels of deaths due to anaphylactic shock and bronchial asthma were higher than that of other groups. Forensic pathology examination results showed the main pathology changes of bronchial asthma were mucous congestion in bronchial lumen and eosinophils infiltration in bronchial mucosa. The main pathological features of anaphylactic shock were laryngeal edema and eosinophils infiltration in multiple organs (lung and spleen). This research proved that there was a great significance for IgE to infer whether the individual died due to an anaphylaxis even for a long PMI in frozen corpses. Furthermore, we can also preliminarily determine the type of allergic death combined with the examination of forensic pathology. These findings further verify the feasibility of postmortem serum IgE in the diagnosis of forensic causes of death and broaden the application scope of this marker.

Exacerbation of asthma and neutrophil-dominated airway inflammation in patients with cold-induced airway hyperresponsiveness

Background . Neutrophils can play a significant role in the formation of bronchial inflammation in asthma exacerbation in patients with cold-induced airway hyperresponsiveness (CIAHR). Aim. To evaluate the role of neutrophils in the dynamics of the inflammatory pattern of bronchi in the exacerbation of asthma in patients with CIAHR. Materials and methods. In 31 patients (average age (37.2 ± 2.7) years) with persistent bronchial asthma (BA) with moderate exacerbation and previously established cold-induced airway hyperresponsiveness during cold air isocapnic hyperventilation (– 20 ºC, 3 min) (CAIH), the level of asthma control (Asthma Control Test (ACT), score) and external respiration (forced expiratory volume in the first second (FEV 1 ), forced expiratory flow between 25% and 75% of the vital capacity (FEF 25–75 )) were assessed; induced sputum (IS) was examined initially and after 24 weeks of follow-up. At the time of the examination, the patients were additionally prescribed prednisone orally (at a maximum dose of 30 mg) for the first 10 days in order to stop the exacerbation, and then they continued treatment with a combination of budesonide / formoterol (640 / 18 μg per day) for 24 weeks. Results. At the time of the initial examination, the ACT score was 17.0 (13.0; 19.5), FEV 1 was 89.1 ± 3.9%, and the number of neutrophils in the sputum was 55.9 ± 5.6%. At the end of treatment, the ACT score was 22.0 (17.0; 24.5) ( p = 0.037), FEV 1 was 96.2 ± 2.9% ( p = 0.038), the number of neutrophils in IS decreased, but remained high enough (40.0 ± 5.5%; p = 0.048); and the number of eosinophils did not change. A linear regression equation was made reflecting the relationship between the initially high number of neutrophils in the sputum, other cellular elements in the sputum, the level of asthma control, and the degree of severity of the bronchial response after a bronchoprovocation test with CAIH. Conclusion . Asthma exacerbation in patients with CIAHR is associated with an increase in the neutrophil pool of the bronchial inflammatory infiltrate and correlates with the degree of severity of the airway reaction to cold bronchoprovocation and the level of asthma control.

Effects of Chronic Secondhand Smoke (SHS) Exposure on Cognitive Performance and Metabolic Pathways in the Hippocampus of Wild-Type and Human Tau Mice.

Background:Exposure to secondhand smoke (SHS) is a risk factor for developing sporadic forms of sporadic dementia. A human tau (htau) mouse model is available that exhibits age-dependent tau dysregulation, neurofibrillary tangles, neuronal loss, neuroinflammation, and oxidative stress starting at an early age (3–4 months) and in which tau dysregulation and neuronal loss correlate with synaptic dysfunction and cognitive decline.Objective:The goal of this study was to assess the effects of chronic SHS exposure (10 months’ exposure to ) on behavioral and cognitive function, metabolism, and neuropathology in mice.Methods:Wild-type (WT) and htau female and male mice were exposed to SHS (90% side stream, 10% main stream) using the SCIREQ® inExpose™ system or air control for 168 min per day, for 312 d, 7 d per week. The exposures continued during the days of behavioral and cognitive testing. In addition to behavioral and cognitive performance and neuropathology, the lungs of mice were examined for pathology and alterations in gene expression.Results:Mice exposed to chronic SHS exposure showed the following genotype-dependent responses: a) lower body weights in WT, but not htau, mice; b) less spontaneous alternation in WT, but not htau, mice in the Y maze; c) faster swim speeds of WT, but not htau, mice in the water maze; d) lower activity levels of WT and htau mice in the open field; e) lower expression of brain PHF1, TTCM1, , and HSP90 protein levels in WT male, but not female, mice; and f) more profound effects on hippocampal metabolic pathways in WT male than female mice and more profound effects in WT than htau mice.Discussion:The brain of WT mice, in particular WT male mice, might be especially susceptible to the effects of chronic SHS exposure. In WT males, independent pathways involving ascorbate, flavin adenine dinucleotide, or palmitoleic acid might contribute to the hippocampal injury following chronic SHS exposure. https://doi.org/10.1289/EHP8428

Relationship of granulocytic inflammation of bronches with the level of asthma control in patients with cold airway hyperresponsiveness under inhalation therapy of extrafine beclomethasone/formoterol

Introduction. Obstruction of small airways in asthma is accompanied by greater hypersensitivity to nonspecific irritants and inflammation activity, which is associated with a worsening of the clinical course of the disease. The combination of beclomethasone dipropionate/formoterol fumarate (BDP/FF), used in the form of an extrafine metered dose aerosol, is capable of having an anti-inflammatory effect on the small airways. Dynamic changes in the structure and function of granulocytes of inflammatory bronchial infiltrate after exposure to cold air in patients with asthma treated with BDP/FF have been little studied.Aim. To study the nature of changes in eosinophil and neutrophil pools of bronchial granulocytes in asthma patients with cold airway hyperresponsiveness (CAHR) during long-term therapy with extrafine BDP/FF.Materials and methods. The clinical study involved 25 asthma patients with CAHR. The design of the work included a questionnaire survey of patients using the Asthma Control Test (ACT) questionnaire, spirometry (Easy on PC, ndd Medizintechnik AG, Switzerland), an isocapnic hyperventilation by cold air (IHCA), collection and cytological examination of induced and spontaneously produced sputum. The examination was carried out at the beginning and after 12 weeks of BDP/FF therapy (100/6 μg, twice a day).Results. 12-week treatment with extrafine BDP/FF led to an improvement in asthma control (ACT increased from 17.1±1.1 to 22.5±0.5 points, p˂0.001) and patency of small bronchi (increase in МEF50 was 0.47±0.21 L/s, МEF25-75 – 0.42±0.17 L/s). BDP/FF therapy had a positive effect on cellular inflammation, leading to a decrease in the number of eosinophils in sputum from 9.5 (3.0; 19.5) to 2.2 (1.3; 4.7)% (p˂0,05). A decrease in the number of eosinophils was also observed after cold bronchoprovocation: from 9.0 (2.8; 15.4) to 4.7 (2.8; 7.8)% (p˂0.05). There was no dynamics in neutrophils after BDP/FF treatment before and after IHCA (59.9±1.3 and 57.1±2.0%, respectively, p&gt;0.05).Conclusion. Improvement of disease control in asthma patients with CAHR after 12 weeks of therapy with extrafine BDP/FF is associated with the regulation of eosinophilic inflammation, a decrease in the number of eosinophils in the airways and suppression of the activity of the neutrophilic pool of bronchial granulocytes in response to cold bronchoprovocation.

Molecular and Cellular Mechanisms of Respiratory Syncytial Viral Infection: Using Murine Models to Understand Human Pathology.

Respiratory syncytial virus (RSV) causes severe pathology of the lower respiratory tract in infants, immunocompromised people, and elderly. Despite decades of research, there is no licensed vaccine against RSV, and many therapeutic drugs are still under development. Detailed understanding of molecular and cellular mechanisms of the RSV infection pathology can accelerate the development of efficacious treatment. Current studies on the RSV pathogenesis are based on the analysis of biopsies from the infected patients; however deeper understanding of molecular and cellular mechanisms of the RSV pathology could be achieved using animal models. Mice are the most often used model for RSV infection because they exhibit manifestations similar to those observed in humans (bronchial obstruction, mucous hypersecretion, and pulmonary inflammation mediated by lymphocytes, macrophages, and neutrophils). Additionally, the use of mice is economically feasible, and many molecular tools are available for studying RSV infection pathogenesis at the molecular and cellular levels. This review summarizes new data on the pathogenesis of RSV infection obtained in mouse models, which demonstrated the role of T cells in both the antiviral defense and the development of lung immunopathology. T cells not only eliminate the infected cells, but also produce significant amounts of the proinflammatory cytokines TNFα and IFNγ. Recently, a new subset of tissue-resident memory T cells (TRM) was identified that provide a strong antiviral defense without induction of lung immunopathology. These cells accumulate in the lungs after local rather than systemic administration of RSV antigens, which suggests new approaches to vaccination. The studies in mouse models have revealed a minor role of interferons in the anti-RSV protection, as RSV possesses mechanisms to escape the antiviral action of type I and III interferons, which may explain the low efficacy of interferon-containing drugs. Using knockout mice, a significant breakthrough has been achieved in understanding the role of many pro-inflammatory cytokines in lung immunopathology. It was found that in addition to TNFα and IFNγ, the cytokines IL-4, IL-5, IL-13, IL-17A, IL-33, and TSLP mediate the major manifestations of the RSV pathogenesis, such as bronchial obstruction, mucus hyperproduction, and lung infiltration by pro-inflammatory cells, while IL-6, IL-10, and IL-27 exhibit the anti-inflammatory effect. Despite significant differences between the mouse and human immune systems, mouse models have made a significant contribution to the understanding of molecular and cellular mechanisms of the pathology of human RSV infection.

IT IS TIME FOR ENDOBRONCHIAL THERAPY TO REPLACE SURGERY IN THE TREATMENT OF TYPICAL BRONCHIAL CARCINOID

SESSION TITLE: Lung Cancer Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To diagnose and treat benign endobonchial tumors by cryo procedure.To discover the efficacy of cryo approach in diagnosis and treatment of typic carcinoid , endobronchial hamartoma and papilomatosis METHODS: Patients were consulted at tertiary care between 2016-2019.Patients underwent Chest X Ray examinations, Chest computed tomography (CT) and flexible bronchoscopy, cryo biopsy. Eight of them resulted in typical carcinoid, three with endobronchial hamartomas and one with tracheal papillomatosis. The patients signed consensus to continue endobronchial treatment.All of them hadn’t adenopathy and hadn’t bronchial wall infiltration All patients underwent general anesthesia. bronchoflex tube was used for intubation through which we put the balloon for hemostasis by fibrobronchoscop. The patients underwent devitalisations, debulking and cryotherapy of endobronchial mass. All patients have been successfully treated with complete tumor resection and received cryotherapy to base implantation of tumor RESULTS: Twelve patients underwent endobronchial treatment with the combination of cryo therapy with electrocautery.Eight patient had typical carcinoid, three women and five men. Three patients were diagnosed with endobronchial hamartoma two men and one woman. One patient with tracheal papillomatosis. The median age of patients with carcinoid was 45 years. Only one patient had smoked. These patients were followed up with flexible bronchoscopy every three months, with Chest computed tomography and flexible bronchoscopy after 6 months and each year. Median follow-up was 27 months with Flexible bronchoscopy and Chest computed tomography . So far none of the patients have had local or remote relapses. CONCLUSIONS: According to these results and other authors, for typical carcinoid, it is time to replace surgery with less invasive and safer procedure, endobronchial therapy such as cryo approach. CLINICAL IMPLICATIONS: The main complication was hemorrhage which was managed with balloon and TA reduction. In all cases of significant haemorrhage,the patients have been with arterial blood pressure in the range of 130-140 mmHg. Lowering arterial blood pressure below 120 mmHg is a necessary action for the rapid management of hemorrhage. DISCLOSURES: no disclosure on file for Prof.Dr Perlat Kapisyzi; no disclosure on file for Fahri Kokici; no disclosure on file for ilir peposhi; No relevant relationships by Eritjan Tashi, source=Web Response No relevant relationships by Alma Teferici, source=Web Response no disclosure on file for Daniela Xhemalaj

The IL-15 / sIL-15R\u03b1 complex modulates immunity without effect on asthma features in mouse

BackgroundInterleukin 15 (IL-15) is a growth and modulating factor for B, T lymphocytes and natural killer cells (NK). Its action on innate and adaptive immunity is modulated by its alpha chain receptor (IL-15Rα). The IL-15/sIL-15Rα complex (IL-15Cx) increases the bioavailability and activity of the cytokine in vivo. IL-15Cx has been used in diseases to dampen IL-15 inflammation by the use of soluble IL-15Ralpha specificity. Here, we aim to evaluate the interest of IL-15Cx in a mouse model of asthma.MethodsUsing a mouse model of asthma consisting in percutaneous sensitization and intranasal challenge with total house dust mite extract, we evaluated the effect of IL-15Cx injected intraperitoneally four times after a first nasal challenge. Respiratory function was assessed by the technique of forced oscillations (Flexivent®). The effect on bronchial remodeling was evaluated by lung histology. The inflammatory status was analyzed by flow cytometry.ResultsWe observed that the IL-15Cx modulates lung and systemic inflammation by increasing NK cells, CD8+ memory T cells and regulatory cells. However, IL-15Cx displays no effect on bronchial hyperreactivity, bronchial remodeling nor cellular bronchial infiltrate, but limits the secretion of bronchial mucus and modulates only inflammatory response in a HDM-allergic asthma murine model.ConclusionsIL-15Cx has a limited effect on immune response in asthma and has no effect on lung function in mice. Thus, it limits its therapeutic potential but might suggest a combinatory potential with other therapeutics.

Long-term Outcome After Resection of Isolated Thoracic Lymph Node Metastases of Renal Cell Cancer

Isolated thoracic lymph node metastases (ITLNMs) without any lung metastases of renal cell cancer are rare. Other than a few case reports and one study, there is no further literature on ITLNMs. For this reason, the goal of this study was to analyze our experiences, the long-term survival outcomes, and recurrence-free survival outcomes after the resection of ITLNMs. We analyzed our database of 15 patients with ITLNMs who underwent metastasectomy by systematic lymph node dissection from 2003 to 2017. The long-term outcomes and survival curves were analyzed with the Kaplan-Meier method. The median disease-free interval between primary cancer and ITLNM was 40 months (range, 0-171 months). The R0 resection rate was 93.3% (n= 14). There was one R2 resection, which was due to a tracheal and left main bronchial infiltration. The postoperative morbidity and 30-day mortality rates were 13.3% and 0%, respectively. Altogether, 14 patients were included in the long-term follow-up with a median follow-up time of 35.5 months (range, 2-108 months). The 1-, 3-, and 5-year survival rates were 93%, 73%, and 73%, respectively. The median overall progression-free survival after metastasectomy was 18 months (95% confidence interval, 8.6-27.4 months), and the 5-year local recurrence-free rate was 65%. Because of the long disease-free interval between primary cancer and ITLNM, a long oncologic follow-up that includes chest images should be mandatory. Altogether, metastasectomy of ITLNMs is feasible with low morbidity and mortality rates and might be associated with promising survival rates. Early detection and resection of ITLNMs may avoid severe complications.

English

The present work is focused on the evaluation of the Maytenus senegalensis roots effect on bronchial hyperleukocytosis and the search of its antioxidant potential both in vitro and in vivo. The roots of M. senegalensis (Celastraceae) are traditionally used for the treatment of cough and asthma. This study evaluates the effect of the hydroalcoholic extract of the roots of M. senegalensis on the bronchial hyperleukocytosis that occur during airway inflammation and determine its antioxidant capacity. In an eight days mouse asthma model sensitized to ovalbumin, the effect of the hydroethanolic extract of M. senegalensis on infiltration of leukocytes in general and eosinophils particularly in the airways was studied. The antioxidant activity of the extract was evaluated in vitro by the tests of DPPH, nitric oxide and AAPH then in vivo by the malondialdehyde dosage. The extract significantly inhibited bronchial infiltration of leukocytes in general, and eosinophils particularly (p&lt;0.01; p&lt;0.001). In vitro and in vivo, antioxidant tests revealed the reducing effect and the inhibitory of membrane lipoperoxidation potential of the extract. Phytochemical tests have shown that the extract contains polyphenols such as flavonoids. These compounds would be partly responsible for the antioxidant and anti-inflammatory activities of the extract. This study suggest that M. senegalensis roots would have an anti-inflammatory effect in asthma, which would be partially related to its antioxidant potential. Key words: Maytenus senegalensis, asthma, bronchial inflammation, antioxidant. &nbsp

Aspergillus fumigatus-sensitive IgE is associated with bronchial hypersensitivity in a murine model of neutrophilic airway inflammation

Neutrophils are the predominant inflammatory cells that infiltrate airways during acute exacerbation of asthma. The importance of A.fumigatus sensitization, and IgE response in the airways in patients with acute asthma is unclear. Rockefeller (RK) mice were sensitized with A.fumigatus extract protein. The animals were subsequently challenged with different degrees of A.fumigatus contamination in the cage bedding. All groups of mice were euthanized to obtain bronchoalveolar lavage fluid (BALF) for cytological and Elisa assays, and lung tissue for histological analysis. Moreover, several bioassays were conducted to determine whether BALF IgE antibodies can activate mast cells. In this study, we demonstrated that exposure of sensitized mice to a known concentration of A.fumigatus conidia produces bronchial hyperreactivity with marked neutrophilic bronchial infiltration and increased BALF IgE, capable of triggering mast cell degranulation. This study suggests that IgE may play a role in bronchial hyperreactivity associated to A.fumigatus exposure in mice. Mice sensitized and challenged with this fungus showed characteristics of severe asthma, with an increase of BALF neutrophils, histological changes consistent with severe asthma and an increase of IgE capable of triggering typeI hypersensitivity.

An Unusual Cause of Dysphagia with Bronchoesophageal Fistula

A 57-year-old man presented with a 4-week history of dysphagia and cough. Physical examination revealed mucocutaneous pallor, and laboratory tests showed a slight anemia (hemoglobin level 12,5 g/dL). An upper gastrointestinal endoscopy reveled an obstructive neoplasm in the midesophagus (Fig. 1); biopsy specimens showed fibrinonecrotic and granulation tissue. Chest computed tomography showed a large peribronchial mass with bronchoesophageal fistula (BEF) (Fig. 2), and bronchoscopy reveled bronchial infiltration and marked caliber reduction of the left main bronchus. The results of examinations of samples from repeat biopsies of esophageal and bronchial lesions were negative for dysplasia or neoplasia. The results of polymerase chain reaction testing for Mycobacterium tuberculosis were positive, so we began administration of tuberculostatics and systemic corticosteroids, assuming lymph node tuberculosis with mediastinal involvement. However, there was a worsening of dyspnea and weight loss, and the results of the Xpert MTB/RIF Assay (Cepheid, Sunnyvale, CA) and Lowenstein–Jensen culture were both negative, leading to the assumption of a false-positive result of the first test. Endoscopic reassessment showed increase esophageal lesion and extensive tracheobronchial destruction, forming a large necrotic cavity in the mediastinum (Fig. 3). Histopathological analysis revealed large lymphocytes with a diffuse growth pattern with negative immunostaining for cytokeratin AE1, cytokeratin AE3, and for cluster of

Vertical transmission of Trypanosoma evansi in dromedary camels and studies on fetal pathology, diagnosis and treatment.

In the present study, a total of 14 (73.68%) cases of abortions and two (100%) cases of still births were detected positive for Trypanosoma evansi infection by wet and dry blood smear examination and fetal tissue PCR in camels of an organized farm. The abortions in infected dams were recorded from 8 to 11.5 month of gestation, however majority occurred during 9th to 10th month. The important laboratorial findings in infected dams were anemia, hypoglycemia, hyperproteinemia and leukocytosis. At necropsy the T. evansi infected aborted and still born fetuses showed subcutaneous edema, presence of moderate amount of dark red hemolysed blood in thoracic and abdominal cavity, bronchopneumonia, hepatic necrosis and acute congestion in all vital organs. Microscopically, there was severe congestion, thickening of bronchial and alveolar wall and mononuclear infiltration in the fetal lung, necrotic and degenerative changes in the liver, nephritis along with severe congestion and tubular necrosis in the kidneys and necrotic and degenerative changes and congestion of capillaries in the brain. The T. evansi DNA was detected by PCR from blood, lung, spleen, liver, kidney and brain of all the infected aborted and still born fetuses. The results of the study indicated that T. evansi can cross placental barrier and cause pathological events in the fetus resulting into abortion or still birth in pregnant camels.

Anti-inflammatory effect of a novel food Cordyceps guangdongensis on experimental rats with chronic bronchitis induced by tobacco smoking.

Cordyceps guangdongensis T. H. Li, Q. Y. Lin & B. Song (Cordycipitaceae) is a novel food approved by the Ministry of Public Health of China in 2013. Preliminary studies revealed that this novel food has multiple pharmacological activities such as anti-fatigue effect, antioxidant ability, prolonging life, anti-avian influenza virus activity, and therapeutic effect on chronic renal failure. However, the anti-inflammatory effect on chronic bronchitis and the effective constituent are still unknown. The purpose of this study was to investigate both the anti-inflammatory effect of the edible fungus on experimental rats with chronic bronchitis induced by tobacco smoking, and the pilot effective constituent. Test rats were intragastrically administered with 3 doses of hot-water extract from C. guangdongensis (0.325, 0.65 and 1.30 g kg(-1) bw daily for low, middle and high dose, respectively) for 26 days. Biochemical indices and histological examinations in rats with chronic bronchitis induced by tobacco smoking were determined. The content and molecular weights of the polysaccharide from the hot-water extract were detected by the phenol-sulfuric acid method and gel permeation chromatography, respectively. Biochemical indices in the low, middle and high-dose groups with the hot-water extract of C. guangdongensis were only 53.4%, 46.0% and 40.4% of those in the model control group (total leukocytes), respectively; 70.7%, 60.3% and 58.1% (macrophages); 33.0%, 26.8% and 16.1% (neutrophils); and 22.2%, 23.5% and 13.6% (lymphocytes) of those in the model control group. The bronchial lesions and inflammatory cell infiltration were significantly alleviated in all groups with hot-water extract of C. guangdongensis. This study indicates that the hot-water extract from C. guangdongensis has a significant anti-inflammatory effect on chronic bronchitis. The content of the polysaccharide was 6.92%; the molecular weights of the 3 polysaccharide components were respectively 1.28 × 10(6), 2.36 × 10(4) and 5.21 × 10(3) Da.

Additive anti-allergic effects of anti-interleukin-33 and anti-Siglec-F treatments in a murine model of allergic asthma.

BackgroundAnti-interleukin-33 (anti-IL-33) and anti-Siglec-F antibodies have potent anti-allergic effects on murine allergic asthma and rhinitis and induce eosinophil apoptosis.ObjectiveWe aimed to determine whether post-sensitization with anti-IL-33/anti-Siglec-F treatments exhibited more potent effects compared to individual treatments in a murine allergic asthma model.Material and methodsTwenty-five BALB/c mice were separated into five groups (n = 5): Group A (control), Group B (ovalbumin [OVA] challenge), Group C (OVA + anti-IL-33), Group D (OVA + anti-Siglec-F), and Group E (OVA + anti-IL-33 + anti-Siglec-F). Serum total/ OVA-specific IgE, bronchoalveolar lavage (BAL) inflammatory cells and cytokines (IL-4 and IL-5), histopathological lung properties, and airway hyperreactivity were compared.ResultsOvalbumin challenge induced strong immune and inflammatory responses with > 6-fold IgE level increases; 10- to 25-fold BAL eosinophil, neutrophil, and lymphocyte count increases; and > 1.5-fold IL-4 and IL-5 level increases (p < 0.05). Whereas anti-IL-33 reduced neutrophil counts, anti-Siglec-F and anti-IL-33/anti-Siglec-F reduced both eosinophil and neutrophil counts (p < 0.05). Individual treatments reduced OVA-mediated bronchiolar infiltration by 50% (p <0.05). Ovalbumin challenge increased airway hyperreactivity by 4-fold (Group B; 2000.0 ±671.8% increase in Penh) compared to controls (Group A; 445.7 ±33.5% increase in Penh) (p = 0.016). The anti-IL-33 (Group C: 1579.4 ±973.6% increase in Penh) and anti-Siglec-F (Group D: 930.4 ±236.5%) groups demonstrated significantly reduced hyperreactivity (p = 0.029). Anti-IL-33/anti-Siglec-F therapy showed synergism towards neutrophil counts, IL-5 concentrations, bronchial infiltration, and hyperreactivity (p < 0.05).ConclusionsCombination treatment with anti-IL-33/anti-Siglec-F had more potent anti-allergic effects, reducing eosinophilic infiltration through their additive effects in a murine allergic asthma model.

Clinical features and prognostic factors of Churg-Strauss syndrome

Background/AimsChurg-Strauss syndrome (CSS) is a rare systemic necrotizing small-vessel vasculitis, with accompanying bronchial asthma, eosinophilia, and eosinophilic infiltration of various tissues. The purposes of our study were to characterize the clinical features of CSS and to identify factors associated with CSS prognosis in Koreans.MethodsMedical records were reviewed retrospectively for all physician-diagnosed CSS patients in the Seoul National University Hospital between January 1990 and March 2011.ResultsData from 52 CSS patients were analyzed. The respiratory tract was the most commonly involved organ (90.4%). Renal involvement was less frequent in antineutrophilic cytoplasmic antibody (ANCA)(-) patients than in ANCA(+) patients (p = 0.048). Clinical remission occurred in 95.3% of patients, but 16.3% of them relapsed. Patients who maintained remission for more than 6 months were relatively older (median, 51 years) at diagnosis (p = 0.004), had been diagnosed in earlier stages (p = 0.027), showed more frequent respiratory involvement (p = 0.024) and generalized symptoms (p = 0.039), and showed less frequent cutaneous involvement (p = 0.030) than those who did not achieve persistent (> 6 months) remission. Patients who achieved persistent remission also showed higher C-reactive protein (CRP) levels (p = 0.031) than those who did not.ConclusionsANCA(-) CSS patients showed less frequent renal involvement. Characteristics of good responders were older age, diagnosis at earlier stages, less cutaneous involvement, more respiratory involvement, high CRP values, and more generalized symptoms.