Bronchial Responsiveness Research Articles

Bronchial granulocytes in the development of epithelial destruction and oxidative lipid modification in patients with bronchial asthma with cold and osmotic airway hyperresponsiveness

Free radical damage to the respiratory tract in patients with asthma leads to the destruction of the bronchial parenchyma and the generation of signaling molecules of inflammation by parenchymal cells. Objective: to study the role of the structural and functional status of granulocytes in the development of epithelial destruction and oxidative lipid modification in the bronchi of asthma patients with airway hyperresponsiveness to cold and hyperosmolar stimuli. Material and methods. In 48 asthma patients, the level of asthma control was assessed according to the Asthma Control Test (ACT) questionnaire; lung function; bronchial response to 3-minute isocapnic hyperventilation with cold (- 20 °C) air (IHCA) and with ultrasonic inhalation of hypertonic (4.5 %) NaCl solution (IHS). The cellular composition and the degree of cellular destruction in induced sputum (IS) were measured. Reaction products for enzymes from the group of heme-containing peroxidases (myeloperoxidase in neutrophils, peroxidase in eosinophils) with the calculation of the average cytochemical coefficient were studied. The content of lipid peroxidation products in according to ultraviolet absorption spectra of lipid extracts in exhaled breath condensate (EBC) was assessed. Results. Patients of group 1 (n=15) with airway hyperresponsiveness to IHCA and IHS in relation to group 2 (n=33) with a negative reaction had lower ACT (14.7±1.4 vs. 18.4±0.8 points, p=0.017). In sputum, the number of neutrophils in groups 1 and 2 was 41.8±6.4 vs. 33.6±3.4 %, eosinophils – 23.5±3.5 vs. 14.9±2.6 %; average cytochemical coefficient of peroxidase 117.5±12.5 vs. 88.8±8.9 pixels (p=0.07), cell destruction index (CDI) of bronchial epithelium 0.56±0.04 vs. 0.39±0.02 r.u. (p =0.0002). The content of diene conjugates (E233) in EBC in group 1 was higher than in group 2 (0.07±0.008 vs. 0.05±0.005 optical units, p˂0.05). A correlation was found between peroxidase level and CDI, the number of totally destroyed cells (IV class of cell destruction), between the number of neutrophils in IS and E233, as well as the ratio of E233 to E206 (non-oxidized lipids) in EBC. Conclusion. In asthma patients with airway hyperresponsiveness to cold and hyperosmolar stimuli, changes in the structure of the epithelium and the structural and functional profile of granulocytes are associated with the activation of the peroxidase function of granulocytes and are interrelated with lipid peroxidation.

Elucidation of the Host Bronchial Lymph Node miRNA Transcriptome Response to Bovine Respiratory Syncytial Virus.

Bovine respiratory disease (BRD) causes substantial morbidity and mortality, affecting cattle of all ages. One of the main causes of BRD is an initial inflammatory response to bovine respiratory syncytial virus (BRSV). MicroRNAs are novel and emerging non-coding small RNAs that regulate many biological processes and are implicated in various inflammatory diseases. The objective of the present study was to elucidate the changes in the bovine bronchial lymph node miRNA transcriptome in response to BRSV following an experimental viral challenge. Holstein-Friesian calves were either administered a challenge dose of BRSV (103.5 TCID50/ml × 15 ml) (n = 12) or were mock inoculated with sterile phosphate buffered saline (n = 6). Daily scoring of clinical signs was performed and calves were euthanized at day 7 post-challenge. Bronchial lymph nodes were collected for subsequent RNA extraction and sequencing (75 bp). Read counts for known miRNAs were generated using the miRDeep2 package using the UMD3.1 reference genome and the bovine mature miRNA sequences from the miRBase database (release 22). EdgeR was used for differential expression analysis and Targetscan was used to identify target genes for the differentially expressed (DE) miRNAs. Target genes were examined for enriched pathways and gene ontologies using Ingenuity Pathway Analysis (Qiagen). Multi-dimensional scaling (MDS) based on miRNA gene expression changes, revealed a clearly defined separation between the BRSV challenged and control calves, although the clinical manifestation of disease was only mild. One hundred and nineteen DE miRNAs (P < 0.05, FDR < 0.1, fold change > 1.5) were detected between the BRSV challenged and control calves. The DE miRNAs were predicted to target 465 genes which were previously found to be DE in bronchial lymph node tissue, between these BRSV challenged and control calves. Of the DE predicted target genes, 455 had fold changes that were inverse to the corresponding DE miRNAs. There were eight enriched pathways among the DE predicted target genes with inverse fold changes to their corresponding DE miRNA including: granulocyte and agranulocyte adhesion and diapedesis, interferon signalling and role of pathogen recognition receptors in recognition of bacteria and viruses. Functions predicted to be increased included: T cell response, apoptosis of leukocytes, immune response of cells and stimulation of cells. Pathogen recognition and proliferation of cytotoxic T cells are vital for the recognition of the virus and its subsequent elimination.

Inhibition of Both Cyclooxygenase-1 and -2 Promotes Epicutaneous Th2 and Th17 Sensitization and Allergic Airway Inflammation on Subsequent Airway Exposure to Protease Allergen in Mice

Introduction: Epicutaneous (e.c.) allergen exposure is an important route of sensitization toward allergic diseases in the atopic march. Allergen sources such as house dust mites contain proteases that involve in the pathogenesis of allergy. Prostanoids produced via pathways downstream of cyclooxygenases (COXs) regulate immune responses. Here, we demonstrate effects of COX inhibition with nonsteroidal anti-inflammatory drugs (NSAIDs) on e.c. sensitization to protease allergen and subsequent airway inflammation in mice. Methods: Mice were treated with NSAIDs during e.c. sensitization to a model protease allergen, papain, and/or subsequent intranasal challenge with low-dose papain. Serum antibodies, cytokine production in antigen-restimulated skin or bronchial draining lymph node (DLN) cells, and airway inflammation were analyzed. Results: In e.c. sensitization, treatment with a nonspecific COX inhibitor, indomethacin, promoted serum total and papain-specific IgE response and Th2 and Th17 cytokine production in skin DLN cells. After intranasal challenge, treatment with indomethacin promoted allergic airway inflammation and Th2 and Th17 cytokine production in bronchial DLN cells, which depended modestly or largely on COX inhibition during e.c. sensitization or intranasal challenge, respectively. Co-treatment with COX-1-selective and COX-2-selective inhibitors promoted the skin and bronchial DLN cell Th cytokine responses and airway inflammation more efficiently than treatment with either selective inhibitor. Conclusion: The results suggest that the overall effects of COX downstream prostanoids are suppressive for development and expansion of not only Th2 but also, unexpectedly, Th17 upon exposure to protease allergens via skin or airways and allergic airway inflammation.

Interleukin-1α Is a Critical Mediator of the Response of Human Bronchial Fibroblasts to Eosinophilic Inflammation.

Eosinophils contribute to allergic inflammation in asthma in part via elaboration of a complex milieu of soluble mediators. Human bronchial fibroblasts (HBF) respond to stimulation by these mediators by acquiring a pro-inflammatory profile including induction of interleukin 6 (IL6) and IL8. This study sought to determine key component(s) of eosinophil soluble factors that mediate IL6 and IL8 induction in HBF. HBF treated with eosinophil-derived soluble mediators were analyzed for gene expression, intracellular signaling, and IL6 and IL8 secretion following inhibition of inflammatory signaling. Segmental allergen bronchoprovocation (SBP-Ag) was performed in mild asthmatics and bronchoalveolar lavage fluid was analyzed for eosinophils and cytokines. We found that signaling via the IL1α/IL1 receptor is an essential component of the response of HBF to eosinophil-derived soluble factors. IL1α-dependent activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) signaling is required to induce IL6 secretion. However, NFκB signaling is dispensable for the induction of IL8, whereas Src is required. IL1α is associated with eosinophilic inflammation in human airways after SBP-Ag. Conclusions: IL1α appears to be a critical component of the soluble eosinophil-derived milieu that drives pro-inflammatory bronchial fibroblast responses and associates with eosinophilic inflammation following SBP-Ag. Disruption of IL1α-signaling could modify the downstream effects of eosinophilic inflammation on airway remodeling.

Reduction of bronchial response to mannitol after partial switch from conventional tobacco to electronic cigarette consumption

BackgroundRegarding the multiple health effects of e-cigarettes, there are insufficient data on potential effects on bronchial reactivity (BHR). In the present study, we assessed the impact of a switch from conventional to e-cigarettes on BHR under realistic conditions over a period of 3 months. MethodsSixty subjects who declared to reduce or stop their tobacco consumption by inhalation of nicotine-containing liquids via e-cigarette, and 20 volunteers participating in a stop-smoking program were included. Data was analysed using parametric and non-parametric statistical procedures. Spirometry, determinations of exhaled carbon monoxide (eCO) and nitric oxide (FeNO), provocation testing with mannitol as an indirect bronchial stimulus, and cotinine measurements were used to investigate BHR and nicotine abstinence. ResultsBHR to mannitol significantly decreased in the group using e-cigarettes and nicotine-containing liquids over a period of three months in this real-life setting. Participants reduced their tobacco consumption to about 25% or lower, confirmed by a reduction in eCO. Changes in lung function and FeNO were small and not statistically significant, and changes in the stop-smoking group were similar to those in the e-cigarette group. ConclusionThe reduction in BHR that can be expected after a reduction of cigarette consumption was not abolished by the concomitant use of e-cigarettes. Whether the decrease in BHR observed after 3 months is maintained when using e-cigarettes over longer time periods or has an individual prognostic value, must be clarified in long-term studies.

Examination of Bronchial Reactivity in Workers Exposed to Microparticles PM2.5 and PM10 during Coal Surface Mining in the Bellaqevc Power Plants of Kosovo

The impact of air pollution with microparticles (PM2.5 and PM10) on the respiratory systems of workers engaged in thesurface mining of coal at the Bellaqevc power plants of Kosovo is studied in this paper. The parameters of lung functionare defined via body plethysmography. The resistance of the airways (Raw) was recorded, intrathoracic gas volume (ITGV) was measured, and the specific resistanceof the airways (SRaw) and specific conductance (SGaw) were calculated. The research was performed withintwo groups: a control group and experimental group. The control group consisted of 28 healthy people, whereas the experimental group consisted of 50 workers engaged in the surface mining of coal at the Bellaqevc power plants of Kosovo.&#x0D; The results obtained from this research indicated that the mean specific resistance (SRaw) was ​​significantly increased in the experimental group (p&lt;0.01) compared to the control group (p&gt;0.1). The study also found that smoking favors the adverse effects of air pollution caused by coalsurface mining at the Bellaqevc power plants (p&lt;0.01).&#x0D; Measurements of the respiratory systems were made prior to and following provocation with histamine–aerosol (1 mg/ml) in the control and experimental groups. Changes between these two groups following this provocation with histamine–aerosol were found to be statistically significant (p&lt;0.01).&#x0D; In order to cause a respiratory pathology from air pollution, it is required a lot of time, such pollution can permanently cause respiratory system disorders. These scientific findings suggest that the long-term exposure of workers to microparticles PM2.5 and PM10 during the processof surface mining coal at the Bellaqevc power plants of Kosovo poses a risk to their health by causing increased bronchial reactivity, bronchial asthma, orchronic obstructive pulmonary disease (COPD).

ОСОБЛИВОСТІ ПЕРЕБІГУ ХОЗЛ У ПАЦІЄНТІВ ІЗ РІЗНИМИ АЛЕЛЯМИ A46G (RS1042713) ГЕНА ADRB2

PECULIARITIES OF THE COURSE OF COPD IN PATIENTS WITH DIFFERENT A46G (RS1042713) ALLELES OF ADRB2 GENE K. D. Dmytriiev, Y. M. Mostovoy, N. S. Slepchenko, N. I. Sinchuk Abstract A significant number of genetic factors, modulating inflammation, fibrosis and bronchial responsiveness, plays an important role in development of chronic obstructive pulmonary disease. Particularly, polymorphism of ADRB2 gene is associated with the development and severity of COPD, as well as with a response to beta-2 agonists. Aim — to study the prevalence of ADRB2 gene polymorphism among COPD patients and to reveal its possible relationship with the development of COPD and its clinical course. Materials and methods. 100 patients with the diagnosis of COPD were included into the study. An mean age was 64.09 ± 1.94 years. There were 66 men (66 %) and 34 women (34 %). There were 68 smokers (68 %), an average smoking experience was 24,44 ± 4,84 pack-years. Mean COPD duration was — 9.35 ± 2.42 years. We collected data about the amount of exacerbations, use of antibiotics, glucocorticoids, methylxanthines, data of mMRC and CAT questionnaires in all patients. Questionnaire data were collected during three visits — visit of inclusion, visit 2 (5±1 weeks), visit 3 (1 year). Data about exacerbation and drugs use were collected for the year prior to the study and the year of participation. Results. Regarding the presence of ADRB2 gene polymorphism all patients were allocated to 3 groups: group 1 — 23 (23 %) A46A allele carriers; group 2 - 39 (39 %) A46G allele cariers and group 3 — 38 (38 %) G46G allele carriers. Duration of COPD was greater in group 3 compared to the group 1 (7,08±1,59 vs 10,5±0,98) (p &lt; 0,05). Group 2 and group 3 had greater proportion of patients with COPD GOLD D (46,15±8,32 % and 44,73±8,28 % correspondingly), when compared to group 1 (17,39±8,38 %) (p &lt; 0,05). Group 1 had less exacerbations (2,13 ± 0,22) when compared to group 2 (2,97 ± 0,28), and group 3 (2,86 ± 0,25) (p &lt; 0,05). Duration of treatment with antibiotics was significantly shorter in A46A allele carriers (8,61 ± 1,60 days), when compared to two other groups (in group 2 - 13,64 ± 1,25 days, in group 3 - 13,00 ± 1,28 days) (p &lt; 0,05). Duration of treatment with GCS in group 1 (2,95 ± 0,85 days), A46A allele carriers, was shorter when compared to group 2 (5,28 ± 0,94 days), A46G allele carriers (p &lt; 0,05). Conclusions. Occurrence of polymorphic (A46G) and mutant (G46G) alleles of ADRB2 gene was associated with more severe course of COPD, greater amount of exacerbations and hospital admissions, greater need in antibiotics and GCS, indicating an important role of this gene in regulation of the airways responsiveness and response to treatment. Key words: COPD, ADRB2 gene polymorphism.

Opportunistic Infections in Late Kidney Transplantation with Death Outcome: Case Report

Cytomegalovirus (CMV) and Pneumocystis jirovecii fungus are the main opportunistic microorganisms that affect transplanted individuals. Immunosuppressive drugs administered to prevent organ rejection leave the immune system vulnerable to these infections. The present report is about a kidney transplanted patient using immunosuppressants who was diagnosed with cytomegalovirus and pneumocystosis requiring admission to the intensive care unit (ICU). Female patient, 57 years old, a kidney transplanted three years ago, with comorbidities, such as systemic arterial hypertension, hypertriglyceridemia and type 2 diabetes mellitus. She was admitted to the hospital in January 2020 with a history of diarrhea, cough, malaise and weight loss of seven kg in a month. She made continuous use of the immunosuppressants tacrolimus® and mycophenolate sodium (MFS). After five days of hospitalization, she was transferred to the ICU due to refractory diarrhea, worsening renal function and respiratory pattern, requiring mechanical ventilation. Chest tomography showed changes that led to the diagnostic hypothesis of CMV pneumonia or Pneumocystis jirovecii. Treatment with Ganciclovir® and Bactrim® was started. The bronchial lavage polymerase chain reaction test confirmed the infectious condition for CMV and Pneumocystis jirovecii. Despite the drug therapy instituted, there was no improvement in the infectious condition. The patient started to present a general and progressive worsening of the clinical picture with loss of renal graft function, respiratory failure, metabolic acidosis, hemodynamic instability and severe distributive shock, evolving to death. In the present report, it was observed that after late kidney transplantation the fragility of the immune system caused by the use of immunosuppressants contributed to the development of a severe infection with CMV and Pneumocystis jirovecii. Adjusting the doses of immunosuppressants to individual needs can be an important measure for maintaining the proper immune system and consequently avoiding late opportunistic infections and death outcomes.

Suberose- a Doença Profissional mais Portuguesa

Introduction/ background/ objectives Portugal is the world’s largest producer of cork. It is derived from the cork oak (quercus suber) and consists of dead cells with cellulose. The tasks with the highest load are usually assigned to the male and the most repetitive to the female; this implies a different occupational exposure, meaning that exposures of higher risk generally occur almost exclusively in male positions. The first reference to Suberose (cork = suber) was in 1947. However, most studies in the sector were carried out in companies with good working conditions, so the conclusions may not be easily extrapolated to most cork workers. The aim of this bibliographic review is to summarize the most relevant information about the topic. Methodology This is a Bibliographic Review, initiated through a survey conducted in October 2020 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP ”. Content The first articles related to the Cork sector highlight the role that some microorganisms have, like Penicillium glabrum (formerly known as frequentans); more recent documents add Chrysonilia Sitophila and Mucor. In places with less humidity the fungal concentration decreases. Workers with Suberosis had skin reactions to the fungus in question and the inhalation of the respective aerosols caused the characteristic symptoms. Some authors also believe that some mites may have some relevance in cork asthma (such as P notatum, Cladosporium, A fumigatus, Alternaria alternata, Acarus siro and Tyrophagus putrescentiae). The suberin found abundantly in cork, may also be associated with some symptoms. Workers are also exposed to cork dust; yet it is less prevalent in the workplace than fungi. Suberose is a pathology of the pulmonary interstitium caused by repeated exposure to dust and mold from cork; in fact, it is the most prevalent disease of the pulmonary interstitium in the north of the country. However, Asthma may also be associated with a lower prevalence. Depending on the size of the fungal spores, Asthma or Hypersensitivity Pneumonitis will be more likely, that is, if smaller (1 to 2 micromers), an alveolar response (alveolitis) will appear more frequently; if larger, a bronchial response, like asthma, can occur. Conclusions The cork industry is reasonably developed in some areas of the country, but knowledge about Suberosis is not always abundant. It would be relevant that all professionals in the Occupational Health Teams with clients in this area were comfortable in the way how to approach the sector; in addition, it is very relevant to develop recent research, disseminating it internationally, not least because Portugal is the country that most developed the sector, worldwide.

EFFECTIVENESS OF FIXED COMBINATION OF FORMULATIONS FOR COUGHING

There are many respiratory diseases, which despite the difference in aetiology, pathogenesis, the peculiarities in progression may have some common features, resulting in the localization of the pathological process in the respiratory systems. These common signs include changes in bronchial secretion that ultimately leads to mucostasis and burdens the course of any respiratory disease. There are very few combined formulations capable of impacting several mechanisms of mucostasis at once. One of them is Ascoril possessing a double effect of bronchodilator and expectorant. The aim of this study was to evaluate the clinical efficacy and safety of Ascoril therapy for patients with acute respiratory diseases. The study included 105 patients aged 25 ± 0.5 to 55 ± 1.6 years with mild or moderate acute respiratory disease, who had acute respiratory diseases with cough due to laryngitis, pharyngitis, tracheitis, bronchitis. Patients of the 1st group (75 patients, the main group) received the treatment with Ascoril, the patients of the 2nd group (30 patients, the comparison group) received Bromhexine. The patients in both groups were comparable by age and sex. The patients treated with Ascoril showed the disappearance of cough symptoms 3 – 4 days earlier than the patients in the comparison group (p &lt; 0.05). The total score assessment of clinical symptoms during the treatment demonstrated the administration of Ascoril promoted the effectiveness of therapy, which was found significantly higher than in the 2nd group (p &lt; 0.05). We can conclude Ascoril reduces the duration of the disease, cut down the need in antibiotics, lowers the manifestations of bronchial hyper reactivity, and promotes faster clinical recovery, the last but not the least, it is safe.

Cough in children: the most common problem in pediatrics

Cough is a common problem in childhood, which leads to frequent paediatrician visits, affects the quality of life, and causes material losses to the family and society. In pediatric practice, cough is most often associated with acute respiratory infections, which can develop in children up to 5–8 times a year. 50–70% of children under 1 year old and 30–60% of school age children visit pediatricians with this problem. Examination of patients with cough shows that the most common causes of recurrent cough may include bronchial asthma, lingering bacterial bronchitis, chronic ENT diseases, gastroesophageal reflux, as well as bronchial reactivity after respiratory syncytial, rhinovirus or pertussis infections. Mucociliary clearance in children may decrease under the influence of external factors, which contributes to the development of infections. The effectiveness of cough in children, especially young children, depends on the severity of the cough reflex, bronchial patency, viscosity of bronchial secretion. The choice of therapy to treat cough should take into account the age and etiology of the cough. The inappropriate antibiotic therapy for prolonged cough increases the risk of developing antibiotic resistance. Due to potential side effect in the form of respiratory depression and opioid toxicity, codeine-containing drugs are not recommended for use in children under 12 years of age. An alternative to cough drugs is herbal medicines with compound effect: anti-inflammatory, bronchodilator, expectorant and mucolytic.

Oral Administration of Acrylamide Worsens the Inflammatory Responses in the Airways of Asthmatic Mice Through Agitation of Oxidative Stress in the Lungs.

Acrylamide is a toxic chemical substance produced when starch-rich foods are fried at high temperatures. Asthma is a chronic and complicated respiratory disease, of which genetic and environmental factors are the main triggers. Orally-received components may have an effect on asthma pathophysiology. The aim of this study was to investigate the role of AA as a stimulus in asthma. BALB/c mice were allocated into four groups as follows: two OVA-sensitized asthmatic groups, including one treated with AA by gavage feeding and one non-treated (asthma group), and two healthy (non-asthmatic) groups, one treated with AA by gavage feeding and one non-treated (negative control group). Airway hyperresponsiveness, cell count, cytokine levels in BAL fluid, lung histopathology, IgE levels, and oxidative stress indices including plasma level of MDA, pulmonary antioxidant enzymes (SOD and CAT) levels, HP content, and collagen fiber accumulation in lung tissue were measured. We found that the group of mice treated with both OVA and AA (asthmatic and AA-treated mice) experienced higher levels of asthma-associated biomarkers, including higher enhanced pause (Penh value), eosinophilic inflammation, mucus hyper secretion, goblet cell hyperplasia, total and OVA-specific IgE levels, IL-4, IL-5, and IL-13 levels than the group sensitized only with OVA (asthmatic mice). The OVA-AA-treated mice also experienced worsened levels of oxidative stress indicators. Healthy (non-asthmatic) mice that only received AA were in similar conditions to healthy untreated mice (negative control group). The OVA-AA-treated group showed more severe allergic asthma symptoms in comparison to the group only sensitized with OVA. Therefore, food/water contaminated with AA can act as a stimulant of allergic asthma and exacerbate the bronchial inflammatory responses.

Relation between Substitution of Threonine for Isoleucine at Β2 Adrenergic Receptor on Bronchial Asthma in Children

Introduction: Pediatric asthma is a complex disorder involving immunologic, genetic, environmental and other factors. Objective: To evaluate the role of substitution of threonine for isoleucine at codon 164 on bronchial asthma susceptibility, severity and response to short- and long- term acting β2-adrenergic receptor agonists in children. Patients and Methods: This study was a prospective case control study, which was done in Pediatric Department of Zagazig University Hospital from Pulmonology Clinic in the period from February 2016 to February 2018. 100 children were included, 50 of them had asthma with bronchodilator and their ages ranged from 5 to 12 years (25 males and 25 females) with the mean age of 6.8 ± 2.5 years. In addition, 50 healthy age and sex matched worked as control children. All studied groups were subjected to full history taking, clinical examination, pulmonary function tests, total serum IgE and identification of adrenergic β2 receptor (ADRβ2) substitution of threonine for isoleucine at codon 164 polymorphism. Results: In this study, there was a significant association between homozygous isoleucine and increase incidence of asthma, this mean that the gene gives harmful effect when it is in a homozygous form. However, there was no statistically significant difference between asthma severity and gene polymorphism (CC, CT and TT). Conclusion: In the present study ADRβ Thr164Ile polymorphism is reported as an important variant at salbutamol refractoriness in sever asthmatics. In addition, the polymorphism form is susceptible variant to develop asthma risk.

MANIFESTATION OF BRONCHIAL REACTIVITY IN THE WORKERS EXPOSED TO VARIOUS GASES AT THE GASIFICATION DEPARTMENT OF THE POWER PLANTS OF KOSOVO

Objective: This study aimed to determine the effects of indoor air pollution on workers and the effects of discharged gases, such as CO, CO2, NO2, O3, SO2, NH3, and PM, on the manifestation of bronchial reactivity during the process of gasification at the power plants in Kastriot, Kosovo.&#x0D; Methods: Parameters of lung function were determined using body plethysmography. Airway resistance (Raw) and intrathoracic gas volume (ITGV) were measured; based on these values, specific airway resistance (SRaw) and specific airway conductance were calculated.&#x0D; Results: The study was performed in two groups: the control group and the experimental group. The control group consisted of 32 healthy people, whereas the experimental group consisted of 55 workers of the gasification department of the power plants in Kastriot, Kosovo. The results of this study indicated that the mean value of SRaw significantly increased in the experimental group (p&lt;0.05) compared to the control group (p&gt;0.1). This study also showed that smoking is in favor of the negative effects of air pollution at the premises of the gasification department (p&lt;0.01). Measurements of the respiratory systems were made before and following provocation with histamine–aerosol (1 mg/ml) in the control and experimental groups. Changes between these two groups following this provocation with histamine–aerosol were found to be statistically significant (p&lt;0.01).&#x0D; Conclusion: Although air pollution requires time to cause a respiratory pathology, it permanently affects the manifestation of bronchial reactivity. This finding suggests that the real situation of these workers exposed to air pollution during the process of gasification poses a serious risk to their health and particularly to normal respiratory function.

Normal Predicted Reference Values for Spirometry in Korean Children and Adolescents.

Pulmonary function tests are useful to evaluate airway obstructions and bronchial responsiveness. We aimed to determine the reference values applicable to Korean children and adolescents. In total, 5590 (2607 males, 2983 females) healthy children aged 4 to 17 years old were recruited from three regions in Korea. Simple and multiple regression analyses were applied using age, height, and weight as variables to predict the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum mid-expiratory flow (MMEF) and the peak expiratory flow rate (PEFR). There were significant correlations between the variables and parameters (P < 0.001). The coefficient of determination (R2) values of polynomial equations with two variables were lower than those with two variables but higher than those of monomial equations based on height. The prediction equations by height were obtained, and the R2 value of the FEV1 was the highest. The predicted spirometric values for males were higher than those for females except for the MMEF. The R2 values for the FEV1 and FVC were higher than previous studies except for the R2 value of the FVC for males in European data. This study provided updated regression equations of normal predicted values for spirometry applicable to Korean children and adolescents.

From the pages of AllergyWatch®: November 2020

For this month's edition of "From the Pages of AllergyWatch," I have chosen reviews of articles of interest to the clinical allergist. The first study found that wheezing infants with atopic sensitization at the time of the first wheezing episode was strongly associated with bronchial reactivity in childhood. The next review, of an article published in the Annals of Allergy, Asthma & Immunology, investigated the complexity of atopic sensitization to foods in children with atopic dermatitis (AD). The final study confirms the determination of the US Environmental Protection Agency to the likely causal link between exposures to particulate matter and ozone and respiratory illness.

Cytokine-induced molecular responses in airway smooth muscle cells inform genome-wide association studies of asthma

BackgroundA challenge in the post-GWAS era is to assign function to disease-associated variants. However, available resources do not include all tissues or environmental exposures that are relevant to all diseases. For example, exaggerated bronchoconstriction of airway smooth muscle cells (ASMCs) defines airway hyperresponsiveness (AHR), a cardinal feature of asthma. However, the contribution of ASMC to genetic and genomic studies has largely been overlooked. Our study aimed to address the gap in data availability from a critical tissue in genomic studies of asthma.MethodsWe developed a cell model of AHR to discover variants associated with transcriptional, epigenetic, and cellular responses to two AHR promoting cytokines, IL-13 and IL-17A, and performed a GWAS of bronchial responsiveness (BRI) in humans.ResultsOur study revealed significant response differences between ASMCs from asthma cases and controls, including genes implicated in asthma susceptibility. We defined molecular quantitative trait loci (QTLs) for expression (eQTLs) and methylation (meQTLs), and cellular QTLs for contractility (coQTLs) and performed a GWAS of BRI in human subjects. Variants in asthma GWAS were significantly enriched for ASM QTLs and BRI-associated SNPs, and near genes enriched for ASM function, many with small P values that did not reach stringent thresholds of significance in GWAS.ConclusionsOur study identified significant differences between ASMCs from asthma cases and controls, potentially reflecting trained tolerance in these cells, as well as a set of variants, overlooked in previous GWAS, which reflect the AHR component of asthma.

PREDICTION OF TREATMENT EFFECTIVENESS IN PATIENTS WITH ASTHMA-COPD OVERLAP COMBINED WITH HYPERTENSION

Introduction. Recently, there has been an increase in the prevalence of comorbid conditions, including a combination of bronchial asthma and chronic obstructive pulmonary disease, called asthma-chronic obstructive pulmonary disease overlap, and their combination with hypertension. The presence of combined pathology causes an increase in the severity of symptoms and functional disorders, in numbers of exacerbations, deterioration of quality of life and tolerance to exercise, and also causes difficulties in selecting a comprehensive treatment for this group of patients. That is why the aim of our study was to optimize and predict the effectiveness of treatment of patients with bronchial asthma in combination with the chronic obstructive pulmonary disease on the background of hypertension based on assessing the dynamics of clinical and laboratory and functional status in different treatment regimens. Materials and methods. 100 patients with bronchial asthma in combination with the chronic obstructive pulmonary disease on the background of hypertension were selected. Patients underwent: general clinical examination, determination of respiratory function, clinical blood tests and enzyme-linked immunosorbent assays, questionnaires to determine symptoms and quality of life, as well as a functional study with a six-minute walk test in the dynamics of complex basic treatment with the physical rehabilitation program. Research results. Adding an active rehabilitation program to standard medical treatment significantly improves the bronchial response to the action of bronchodilators according to the spirometry, reduces clinical manifestations, shortness of breath, and improves the quality of life and exercise tolerance. The presence of such criteria as the forced expiratory volume in 1 second &lt; 69%, the forced expiratory flow 50% &lt; 21.6% and the forced expiratory flow 75% &lt; 31.65%, C-reactive protein &gt; 7.6 g / l, interleukin 8 &gt; 18.13 pg/ml may provide tolerance to the program of physical rehabilitation and the inexpediency of its use. Conclusions. Under the influence of rehabilitation measures applied by us, patients experienced some positive changes in cardiovascular and respiratory function, exercise tolerance, and quality of life, although some patients do not respond to the addition of a comprehensive rehabilitation program associated with such baseline parameters as forced expiratory volume in 1 second, forced expiratory flow 50% and the forced expiratory flow 75%, C-reactive protein, interleukin 8

Different Development Forms of Local Allergic Rhinitis towards Birch.

Background Efficacy of allergen immunotherapy (AIT) in local allergic rhinitis (LAR) is a new subject of research. The presence of asthmatic symptoms in patients with LAR in the context of AIT is unexplored. Objective The efficacy and safety of AIT in patients with LAR towards birch pollen were investigated. The possibility of concomitant local allergic asthma in studied patients and the impact of AIT on it were examined. Methods 36 patients with LAR towards birch were included in three years of AIT in a double-blind, placebo-control study. Primary outcome measurement was the mean changes in the combined symptom and medication scores (CSMSs) after AIT, and the second is the changes in the quality of life (QoL). Skin prick tests, serum, nasal allergen-specific IgE to birch, nasal and bronchial provocation challenge tests with birch allergen, methacholine tests, and spirometry were carried out at baseline and after AIT. Results Mean CSMSs of three years of AIT were significantly decreased in the active group from 5.88 (range: 4.11-9.01) to 1.98 (range: 1.22-4.51; p < 0.05). After three years of AIT, there was a significant increase of toleration for birch allergen from the mean concentration of 6250 ± 1200 SQ-U/ml up to 45000 ± 2500 SQ-U/ml (p = 0.02) during repeated nasal challenges. 16 patients with LAR had the positive results of methacholine tests, and 11 of them had a positive bronchial challenge to birch allergen. After AIT, the significant decrease of bronchial responsiveness to birch allergen in 5 from 7 patients was confirmed (p = 0.03). QoL assessed by the use of the RQLQ score was improved after AIT from 1.84 (95% CI: 1.53-1.97) to 1.45 (95% CI: 1.32-1.62) score in the active group after three years of AIT therapy (p = 0.03). Conclusion AIT to birch can be useful and safe in a patient with local allergic rhinitis and also with concomitant asthmatic symptoms. Further studies are needed.

Asthma, biologics, corticosteroids, and coronavirus disease 2019

Asthma, biologics, corticosteroids, and coronavirus disease 2019