Bronchial Research Articles

Lobelia inflata L. as an Alternative Medicine for Respiratory Problems Provoked by Covid- 19: A Review

Lobelia inflata (Indian tobacco, Campanulaceae) is an herbal remedy for many respiratory conditions such as asthma, bronchitis, pneumonia, and cough. The main objective of the current review is to document the potential use of L. inflata as respiratory stimulant in patients suffering from Covid-19 infection. Native Americans smoked the plant as a treatment for asthma and today, lobelia is sometimes suggested to help clear mucus from the respiratory tract, including the throat, lungs, and bronchial tubes. Although few studies have evaluated the safety and effectiveness of lobelia, some herbalists use lobelia as part of a comprehensive treatment plan for asthma. In the 19th century, American physicians prescribed the herb to induce vomiting in order remove toxins from the body. However, because of its properties as a respiratory stimulant and expectorant, the plant should be used at the correct dose and together with herbs that are soothing to the throat and lungs, and it is often used in a synergistic herbal formula that includes L. inflata herb and seed, Zingiber officinale, and Hyssopus officinalis. The study species should not be used as a substitute for drug therapy during an asthma attack and its use is contraindicated during pregnancy. Lobelia inflata has no known adverse drug interactions and it is therefore a promising complementary therapy for the management of respiratory disorders, in particular in light of the recent increase in the prevalence of respiratory diseases associated with Covid-19. In conclusions, data of the current study has proven the possibility of using the plant in treating the respiratory disorders resulting from infection with Covid-19.

Prevalence of Foreign Body Aspiration in a Mozambican Quaternary Care Hospital

The presence of a foreign body in the airways results in a stressful situation for the patient, family and doctors due to the serious symptoms it can cause and, if not handled correctly, can have a fatal outcome. The objective of this study is to characterize the profile of patients treated at the Mozambican quaternary hospital with foreign bodies in the airways. This is a retrospective cross-sectional study based on 5 years of hospital records of all patients diagnosed (or suspected) of the presence of foreign bodies in the airways. 88 patients were observed, the majority of whom were male (70.45%). The most common location of foreign bodies was in the bronchial tree (75%). The majority of bronchial FBs were located on the right side (75.76%). The most common symptoms were dyspnea (96.59%), followed by a sensation of foreign bodies in the throat (3.40%). In the presence of sudden dyspnea in a child, without a history of upper respiratory tract infection and without leukocytosis, it is necessary to consider foreign body.

Dosimetric Analysis of Proximal Bronchial Tree Subsegments to Assess The Risk of Severe Toxicity After Stereotactic Body Radiation Therapy of Ultra-central Lung Tumors

Background and purposeStereotactic body radiotherapy (SBRT) of ultra-central lung tumors (UCLT) is associated with an increased risk of severe toxicity. The aim of this study was to perform a detailed dosimetric analysis of the proximal bronchial tree (PBT) anatomical sub-segments to evaluate the safety of risk-adapted SBRT and to evaluate potential differences in radiation tolerance between PBT sub-segments. Material and methodsFifty-seven patients treated with SBRT for UCLT between 2014 and 2021 were included. UCLT were defined as tumor abutting or overlapping with the trachea, PBT, or esophagus. This study analyzed overall survival, local control, progression-free survival, and grade ≥3 toxicity events. Bayesian inference was used to build a dose-response model with upper limits for toxicity. ResultsTwenty-seven (47.4%) of the irradiated lesions were primary or locoregionally recurrent NSCLC and 30 (52.6%) oligometastases. All patients were treated with risk-adapted SBRT of median 45.0 Gy (range: 30.0-60.0 Gy) in 8 or 10 fractions. Grade ≥3 radiation pneumonitis was observed in two patients (3.5%), while no bronchial stenosis, hemorrhage or fistula were observed. The dose-response model predicted a grade ≥3 toxicity (stenosis, hemorrhage or fistula) limited to 4.9% (0 - 11.4%) when delivering EQD2_3 = 100 Gy to any location of the PBT (D0.2cc). Detailed dosimetric analysis of PBT substructures showed no variation in the dose-response model between the anatomical PBT sub-segments. ConclusionRisk-adapted SBRT regimens delivered in 8 or 10 fractions for ultra-central lung tumors resulted in high rates of local tumor control with low toxicity rates, without differences in radiation tolerance between the anatomical PBT sub-segments.

Children with severe asthma have substantial structural airway changes on computed tomography.

In adults with severe asthma (SA) bronchial wall thickening, bronchiectasis and low attenuation regions (LAR) have been described on chest computed tomography (CT) scans. The extent to which these structural abnormalities are present in children with SA is largely unknown. Our aim was to study the presence and extent of airway abnormalities on chest CT of children with SA. 161 inspiratory and expiratory CT scans, either spirometer-controlled or technician-controlled, obtained in 131 children with SA (mean±SD age 11.0±3.8 years) were collected retrospectively. Inspiratory scans were analysed manually using a semi-quantitative score and automatically using LungQ (v2.1.0.1; Thirona B.V., Nijmegen, the Netherlands). LungQ segments the bronchial tree, identifies the generation for each bronchus-artery (BA) pair and measures the following BA dimensions: outer bronchial wall diameter (Bout), adjacent artery diameter (A) and bronchial wall thickness (Bwt). Bronchiectasis was defined as Bout/A ≥1.1, bronchial wall thickening as Bwt/A ≥0.14. LAR, reflecting small airways disease (SAD), was measured automatically on inspiratory and expiratory scans and manually on expiratory scans. Functional SAD was defined as FEF25-75 and/or FEF75 z-scores <-1.645. Results are shown as median and interquartile range. Bronchiectasis was present on 95.8% and bronchial wall thickening on all CTs using the automated method. Bronchiectasis was present on 28% and bronchial wall thickening on 88.8% of the CTs using the manual semi-quantitative analysis. The percentage of BA pairs defined as bronchiectasis was 24.62% (12.7-39.3%) and bronchial wall thickening was 41.7% (24.0-79.8%) per CT using the automated method. LAR was observed on all CTs using the automatic analysis and on 82.9% using the manual semi-quantitative analysis. Patients with LAR or functional SAD had more thickened bronchi than patients without. Despite a large discrepancy between the automated and the manual semi-quantitative analysis, bronchiectasis and bronchial wall thickening are present on most CT scans of children with SA. SAD is related to bronchial wall thickening.

Diagnostic efficacy and safety of radial probe endobronchial ultrasound-guided transbronchial needle aspiration for adjacent lesions in segmental or subsegmental bronchi: a single-center retrospective study

BackgroundPeripheral lung lesions can be sampled using various techniques, including computer tomography-guided transthoracic needle aspiration, electromagnetic navigation bronchoscopy, virtual navigation bronchoscopy, and radial probe endobronchial ultrasound transbronchial lung biopsy. Mediastinal lesions can be sampled using techniques like convex probe endobronchial ultrasound-guided transbronchial needle aspiration (CEBUS-TBNA) and endoscopic ultrasound-fine-needle aspiration. However, effective, safe techniques for lesions adjacent to the segmental or subsegmental bronchi are lacking. Herein, we retrospectively evaluated the diagnostic yield and safety of radial probe endobronchial ultrasound-assisted transbronchial needle aspiration (REBUS-TBNA) for lesions adjacent to the segmental bronchi, and explored the factors related to diagnostic yield.MethodsWe retrospectively analyzed the diagnostic yield and safety of REBUS-TBNA cases performed in our department from January 2019 to December 2022. Observation group patients had undergone REBUS-TBNA for lesions adjacent to the segmental bronchi; control group patients had undergone CEBUS-TBNA for mediastinal or hilar lesions. Patient characteristics and lesion sizes, diagnostic yield, adverse events, and relations between diagnostic yield and clinical characteristics were analyzed.ResultsThere were not statistically significant between-group differences in sex, age, diagnostic yield, or rate of adverse events. The observation group (n = 25; 17 male, 8 female) had a mean age of 64.76 ± 10.75 years. The average lesion size was 4.66 ± 1.07 cm, and lesions were predominantly in the upper lobes (80%). REBUS-TBNA diagnostic yield was 84%, with no adverse events reported. Diagnostic yield was not associated with lesion size or extent of bronchial stenosis; however, it was positively correlated with number of punctures. Patients with > 3 punctures had a significantly higher diagnostic yield than those with ≤ 3 punctures.ConclusionsREBUS-TBNA is a safe, effective diagnostic technique, particularly for lesions adjacent to the segmental or subsegmental bronchi of the upper lobe. Performing more than three punctures during the procedure improves the diagnostic yield. Larger-scale studies are warranted to confirm these results, and to further explore the clinical value of REBUS-TBNA.

Intradermal testing and serum allergen-specific IgE-testing in cats with naturally occurring feline bronchial disease.

While feline asthma (FA) is considered to be of allergic origin, the etiology of feline chronic bronchitis (CB) to date is unknown. Aim of the study was to compare the results of intradermal testing (IDT) and serum testing for allergen-specific immunoglobulin E (SAT) in cats diagnosed with FA and CB. Twenty-seven client-owned cats with clinical signs, suggestive of feline inflammatory bronchial disease (FBD) were prospectively enrolled in the study. Patients were assigned to 3 groups based on results of bronchoalveolar-lavage-fluid (BALF)-cytology: FA (n=8), CB (n=10), or cats with a physiological BALF cytology (PB; n=9). A standardized IDT for 27 allergens was performed in all cats. In addition, allergen-specific IgE was measured in serum samples using an FcεRIα-ELISA. The number of positive reactions in both tests was compared between groups, and agreement between test results of both tests was evaluated. Regarding the number of positive reactions, no statistically significant difference was detected between groups in IDT (p=0.65) and SAT (p=0.51). When comparing the 2 test systems, a weak correlation was found for the allergens Tyrophagus putrescentiae (k=0.256), Dermatophagoides farinae (k=0.276), and rye (k=0.273). The most commonly observed reactions were to house dust mites, storage mites, rye and nettle in IDT and to sheep sorrel, storage mites, and house dust mites in SAT. IDT and SAT in cats with feline inflammatory bronchial disease (FBD) cannot be used interchangeably for allergen detection. Sensitization to environmental allergens can occur in cats with and without airway inflammation. Therefore, a positive test result should always be assessed in context with clinical signs and allergen exposure.

Multi-slice computed tomographic analysis and identification of remarkable anatomical types of segmental bronchi in bilateral inferior lobes: based on extensive data.

The progress of interventional respiratory medicine necessitates a comprehensive knowledge of the segmental bronchi because of their complexity in branching patterns. Therefore, based on extensive research data, we aimed to examine the anatomical diversity and sex-related variations of the segmental bronchial branching patterns in the bilateral inferior lobes. Following the exclusion and inclusion criteria, a total of 10,000 participants who underwent multi-slice computed tomography (MSCT) scans from September 2019 to December 2021 at Cheeloo College of Medicine, Shandong University were enrolled in this retrospective study. The computed tomography (CT) data were utilized to generate three-dimensional (3D) and virtual bronchoscopy (VB) simulations of a bronchial tree using the syngo.via post-processing workstation. The distinct bronchial patterns in the bilateral inferior lobes were then found and categorized using the reconstructed images. The proportions of different types of bronchial branches and their sex-related correlations were analyzed by cross-tabulation and chi-square analysis. Our findings primarily identified four types of bronchial branching patterns in the right inferior lobe (RIL), i.e., (B6, B7, B8, B9+10), 71.44%; (B6, B7, B8+9, B10), 16.06%; (B6, B7+8, B9+10), 7.40%; (B6, B7, B8+9+10), 5.10%; and four types in the left inferior lobe (LIL), i.e., (B6, B7+8, B9+10), 82.89%; (B6, B7+8, B9, B10), 13.53%; (B6, B7, B8+9, B10), 2.88%; (B6, B7, B8+9+10), 0.70%. Besides various research methods and outcomes, this study has revealed the types of bronchial branches that were not seen in previous studies. In addition, the proportion of bronchial branches in the LIL did not differ significantly between males and females (P>0.05). However, there was a significant difference in the proportion of bronchial branches in the RIL between sexes (P<0.05). The current study has validated the segmental bronchial variations in the bilateral inferior lobes. The diagnosis of symptomatic patients as well as the performance of interventions like bronchoscopies, endotracheal intubation, and lung resections may be significantly influenced by our findings in the clinical setting.

Characteristics of the Acute Phase Inflammatory Marker — C-Reactive Protein in Patients with Chronic Bronchial Affections

Chronic lung diseases, particularly those affecting the bronchial tree, are a leading cause of disability and mortality worldwide. This emphasizes the importance of addressing issues related to the prevention, timely detection and treatment of conditions such as chronic bronchitis (CB), chronic obstructive pulmonary disease (COPD) and COPD with bronchiectasis. The use of highly sensitive methods for monitoring likely exacerbations and predicting the development of comorbidities in this patient cohort is justified. Objective — to study the nature and severity of changes in the acute phase inflammatory marker — C-reactive protein (CRP) in patients with chronic lung diseases. Materials and methods. A total of 62 hospitalized patients with CB, COPD and COPD with secondary bronchiectasis were examined. All patients underwent clinical, laboratory and instrumental investigations. The serum CRP level was measured in peripheral blood. A control group comprised 15 practically healthy individuals. Results and discussion. It was found that chronic inflammatory lung diseases were more prevalent in men (in the CB group — 55.0 %, in the COPD group — 86.96 %, in the COPD with secondary bronchiecta­sis group — 93.7 %). The CRP level in peripheral blood serum was elevated in all groups: in the CB group — (5.5 ± ± 0.12) mg/l, in the COPD group — (7.54 ± 0.98) mg/l, in the COPD with secondary bronchiectasis group — (12.93 ± 1.23) mg/l. This indicator was statistically significantly higher by 4.0, 5.6, and 9.6 times, respectively (all p &lt; 0.001) compared to the control group. The proportion of smokers was 60.0 % in the CB group, 73.9 % in the COPD group and 78.94 % in the COPD with secondary bronchiec­tasis group. Conclusions. Harmful habits, especially smoking, contribute significantly to the widespread occurrence of chronic lung diseases. Exacerbations and progression of chronic inflammatory processes in the bronchial tree are associated with an elevated level of CRP. The level of CRP significantly increases with the development of concomitant changes, particularly the presence of secondary bronchiectasis. There is a correlation between smoking and the severity of chronic inflammatory lung diseases, as well as a relation­ship between the severity of COPD and the duration of smoking.

Calcium-sensing receptor protein as a prognostic predictor of asthma formation and exacerbation in young children

Asthma remains the most common non-communicable disease among children, which often has a chronic course and leads to disability. Particular attention should be paid to the diagnosis of asthma in young children. To date, the calcium-sensing receptor (CaSR) is considered to be one of the specific markers in the development of bronchial obstructive diseases. Purpose - to assess the level of CaSR protein and its significance in preschool children with asthma. Materials and methods. The study included 37 patients divided into 3 groups. The Group 1 - children with mild persistent asthma (n=20), the Group 2 - children with moderate persistent asthma (n=17), the Group 3 - almost healthy children (n=20). The study of CaSR protein levels in the blood serum of patients with asthma was performed twice - in the first 2 days of clinical manifestations of the disease and when remission was achieved. The level of CaSR protein in the blood serum was analyzed by enzyme-linked immunosorbent assay (ELISA). All statistical analyses were performed using StatSoft STATISTICA version 8.0 (Tulsa, Oklahoma) and MedCalc version 17.2 statistical software. Results. There was no significant difference in CaSR protein levels between the Group 1 and the Group 2. The level of CaSR protein was significantly lower in the Group 1 and the Group 2 both in the period of acute and remission than in the control group. The level of the marker in the period of disease flare-up in the Group 1 and the Group 2 was significantly lower than in children of the same groups in the period of remission. Conclusions. In all patients with asthma, the level of CaSR protein at the acute stage of the disease is lower than at the remission stage, which is obviously associated with its redistribution from the peripheral blood to the smooth muscle of the lungs. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

A novel approach to pulmonary bronchial tree model construction and performance index study

A novel approach to pulmonary bronchial tree model construction and performance index study

Immediate and postponed results of resection interventions in pulmonary tuberculosis patients with local inflammatory changes in the bronchial tree

The objective: to study the frequency and nature of postoperative complications, immediate and postponed results of resection interventions in pulmonary tuberculosis patients depending on the presence and pathomorphological parameters of local infl ammatory changes in the bronchial tree.Subjects and Methods. 147 pulmonary tuberculosis patients who underwent pulmonary resection were enrolled in the prospective cohort study. Main Group (n=49) included patients with local infl ammatory changes in the bronchi before surgery; Comparison Group (n=98) included patients with no infl ammatory changes in the bronchi.Results. The presence of local infl ammatory changes in the bronchial tree detected by bronchoscopy, did not have a signifi cant impact on the development of complications during surgical treatment - neither on their number nor on structure. The incidence of complications of resection interventions depends on severity of tuberculosis lesions in the lung.

Experience of valve bronchial block in pulmonary tuberculosis patients with local inflammatory changes of the bronchial tree

The objective: to study results of bronchial block in pulmonary tuberculosis patients depending on the presence of local infl ammatory changes in their bronchial tree, the frequency and nature of complications in this category of patients.Subjects and Methods. In order to achieve the above objective, in 2018–2019 in Novosibirsk Tuberculosis Research Institute, all patients who had indications for bronchial block were enrolled in the study. 275 tuberculosis patients were divided into 2 groups: Main Group (n=108) consisted of the patients with infl ammatory changes in their bronchial tree, while Comparison Group (n=167) included patients with no such changes. The valve bronchial block was implanted, effi cacy of treatment and complications that developed were evaluated. Results. Effi cacy of valve bronchial blocking did not depend on the presence of local infl ammatory changes in the bronchi, so it can be used without waiting for the relief of infl ammatory changes. The profi le of complications in the groups was comparable.

Bilateral pulmonary sequestrations: Distinct types sharing a common celiac artery origin, presented with pneumonia and associated findings in a pediatric case.

A 14-year-old boy presented with shortness of breath, cough, and mild chest pain, with a history of intermittent milder symptoms. Physical examination and initial tests showed mild iron deficiency anemia, elevated C-reactive protein, and normal vital signs. Chest radiograph revealed abnormalities in the left lower zone, leading to contrast-enhanced chest CT. The CT scan revealed bilateral intrapulmonary sequestrations, both deriving blood supply from a common trunk originating from the celiac artery. The patient's symptoms initially attributed to a pulmonary infection improved with antibiotic therapy. Pulmonary sequestration is a congenital anomaly characterized by aberrant lung tissue lacking connections to bronchial tree or pulmonary arteries. It can lead to recurrent pulmonary infections and postinfectious sequelae. This case presented a unique bilateral sequestration, both originating from the celiac artery. Radiologists should be aware of sequestration types and associated anomalies, even in atypical locations. Blood supply can originate from various arteries, not just the aorta.

Open and Thoracoscopic Aortopexy for Airway Malacia in Children: 15 Year Single Centre Experience

ObjectivesThe objective was to report and analyse the characteristics and results of open aortopexy and thoracoscopic aortopexy for the treatment of airway malacia in a paediatric population. MethodsWe report a retrospective consecutive case series of paediatric patients undergoing aortopexy for the treatment of airway malacia at a quaternary referral centre between December 2006 and January 2021. Outcome measures included days to extubation, continued need for non-invasive ventilation, further intervention in the form of tracheostomy and death. Results169 patients underwent aortopexy: 147 had open procedures (135 via median/limited median sternotomy and 12 thoracotomy) and 22 thoracoscopic. Mean follow up was 8.46 yrs (range 1–20 yrs). Most common site of airway malacia was the trachea (n = 106, 62.7 %), and 48 (28.4 %) had additional involvement at the bronchi with tracheobronchomalacia (TBM). 15 (8.9 %) had bronchomalacia (BM) only. Incidence of bronchial disease was lower in the thoracoscopic than open group (13.6 % vs 40.82 %; p < 0.0001). Mean time to extubation was 1.45 days, 2.59 days, 5.23 days in tracheomalacia, TBM and BM groups, respectively (p = 0.0047). Mean time to extubation was 1.35 days, 2 days, 3.67 days, and 5 days in patients with external vascular compression, TOF/OA, primary airway malacia, and laryngeal reconstruction, respectively (p = 0.0002). There were 21 deaths across the cohort, and all were in the open group. 71.4 % (n = 15) had bronchial involvement of their airway malacia. ConclusionsOpen and thoracoscopic aortopexy are effective treatments for airway malacia in children. We have identified that involvement of the bronchi is a risk factor for adverse outcomes, and the optimum treatment for this patient cohort is still debatable. Level of EvidenceIV. Type of StudyRetrospective Study.

Correlation between pulmonary quantitative CT measurement indicators and respiratory symptoms in patients with chronic obstructive pulmonary disease in stable stage

Objective: To explore the correlation between pulmonary quantitative CT measurement indicators and respiratory symptoms in patients with stable chronic obstructive pulmonary disease (COPD). Methods: A total of 186 patients with COPD in stable stage who visited in the outpatient department of Beijing Hospital from March 2021 to February 2022 were prospectively included. Demographic data, respiratory symptoms and lung function were collected. The original DICOM data of high-resolution CT (HRCT) were processed using the FACT medical imaging information system and the pulmonary emphysema index pixel index-950 (PI-950) and the airway wall thickness (4-6 T) and the percentage of airway area (4-6 WA%) of the 4-6 generation bronchi which represent the segmental and subsegmental bronchi were measured automatically. According to the modified British medical research council dyspnea scale (mMRC, 0-1 point for low score group, 2-4 points for high score group), chronic obstructive pulmonary disease assessment test (CAT, score<10 points for low score group,≥10 points for high score group), cough, expectoration and wheezing (asymptomatic group and symptomatic group), they were divided into two groups as dependent variables. The relationship between imaging parameters and the above symptoms was evaluated using a logistic regression model. Results: The study ultimately included 186 patients who met the inclusion criteria, including 162 males and 24 females, aged (68.9±9.3) years old. There were 83 patients in the high mMRC group, 120 patients in the high CAT group, 146 patients in the cough group, 154 patients in the expectoration group, and 65 patients in the wheezing group. The age and emphysema parameter PI-950 in the high score group of mMRC were higher than those in the low score group, while the percentage of the forced expiratory volume in 1 second (FEV1) predicted value (FEV1 pred) after medication, the percentage of carbon monoxide diffusion volume (DLCO) predicted value (DLCO pred), and the percentage of the maximum midexpiratory flow (MMEF) predicted value (MMEF pred) after medication were lower than those in the low score group (all P<0.05). The age of the high CAT group was higher than that of the low score group, while FEV1 pred and MMEF pred after medication were lower than those of the low score group (all P<0.05). The proportion of males, patients with smoking history, and smoking index in the cough group were higher than those in the non cough group, while the 4 WA% was lower than that in the non cough group (all P<0.05). The proportion of males, patients with smoking history, smoking index, and PI-950 in the expectoration group were higher than those in the non expectoration group, while FEV1 pred after medication and 4 WA% were lower than those in the non expectoration group (all P<0.05). The 5 WA% and 6 WA% of the wheezing group were higher than those of the non wheezing group, while MMEF pred after medication was lower than that of the non wheezing group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for demographic characteristics, smoking, combined diseases, lung function and other confounding factors, for every 10% increase in PI-950, the likelihood of developing more severe dyspnea for the patients (high score group according to mMRC) increased by 67.3% (OR=1.673, 95%CI: 1.052-2.658); Every 10% increase in 6WA% increased the likelihood of wheezing by 3.189 times (OR=4.189, 95%CI: 1.070-16.395). No correlation was found between various imaging indicators and cough, expectoration, and CAT scores (P>0.05). Conclusion: Quantitative CT measurement indicators in stable COPD patients can explain the presence and severity of respiratory symptoms, the pulmonary emphysema indicator is associated with dyspnea, and the percentage of proximal airway wall area is associated with wheezing.

Serum Allergen-Specific Immunoglobulin E in Cats with Inflammatory Bronchial Disease.

The etiology of feline inflammatory bronchial disease is poorly understood. This study compares the degree of allergen-specific serum IgE responses between cats with feline asthma, chronic bronchitis, mixed inflammation, and clinically healthy cats (HCs). The retrospective case-control study used serum from eighteen cats with eosinophilic inflammation (EI), ten with neutrophilic inflammation (NI), six with mixed inflammation (MI), and fourteen HCs. Affected cats were categorized into groups based on bronchoalveolar lavage cytology. The measurement of IgE for 34 different allergens including fungal organisms, weeds, grasses, trees, mites, and insects was performed using an indirect ELISA. Positive reactions to allergens were detected in the serum of 17/18 cats with EI, 8/10 with NI, 6/6 with MI, and 11/14 HCs (p = 0.364). When overall positive reactions were compared between groups, cats with MI (p = <0.01) had significantly more positive reactions against mite allergens than HCs. Blood eosinophils inversely correlated with the absolute amount of allergen-specific serum IgE expressed in ELISA absorbance units (EAs) (p = 0.014). Sensitization against dust mites seems to be more prevalent in cats with MI. However, positive IgE reactions can be observed in healthy and diseased cats, and, therefore, need to be interpreted in the light of clinical findings and environmental conditions of individual patients.

A preliminary study of dynamic interactive simulation and computational CT scan of the ideal alveolus model.

While the development of CT imaging technique has brought cognition of in vivo organs, the resolution of CT images and their static characteristics have gradually become barriers of microscopic tissue research. Previous research used the finite element method to study the airflow and gas exchange in the alveolus and acinar to show the fate of inhaled aerosols and studied the diffusive, convective, and sedimentation mechanisms. Our study combines these techniques with CT scan simulation to study the mechanisms of respiratory movement and its imaging appearance. We use 3D fluid-structure interaction simulation to study the movement of an ideal alveolus under regular and forced breathing situations and ill alveoli with different tissue elasticities. Additionally, we use the Monte Carlo algorithm within the OpenGATE platform to simulate the computational CT images of the dynamic process with different designated resolutions. The resolutions show the relationship between the kinematic model of the human alveolus and its imaging appearance. The results show that the alveolus and the wall thickness can be seen with an image resolution smaller than 15.6μm. With ordinary CT resolution, the alveolus is expressed with four voxels. This is a preliminary study concerning the imaging appearance of the dynamic alveolus model. This technique will be used to study the imaging appearance of the dynamic bronchial tree and the lung lobe models in the future.

GENERAL REGULATIONS OF MACRO-AND MICROMORPHOLOGY OF THE LUNGS OF A MATURE HORSE (EQUUS FERUSCABALLUS L., 1758)

The rapidly changing ecological situation implies a high level of adaptation capabilities of the animal organism to the realities of the environment. In the conditions of animal husbandry, this is possible only with regular monitoring of the morphological state of organs and systems, especially the respiratory system, which is actively influenced by the features of housing, atmospheric air, feeding, as well as the medical and preventive measures that are carried out. Therefore, the functioning of the lungs as an open morphofunctional system directly depends on the nature of their dynamic interaction with a complex complex of physical and chemical environmental factors. In this regard, there is an obvious need for a detailed study of the macro- and micromorphology of the respiratory organs, since such organs are a system by which the body "builds itself from environmental conditions". It is also necessary to take into account that this system occupies one of the leading positions in ensuring the optimal level of functioning of the body, since the animal's development, metabolic processes, and its state of health largely depend on its work. Establishing the macro- and micromorphological features of the respiratory system is the foundation for preventive and therapeutic measures. The respiratory system ensures the intake of oxygen into the body and the excretion of carbon dioxide from it, and the gas exchange between blood and air.&#x0D; The scientific article is devoted to the study of the macro- and micromorphological features of the lungs of a sexually mature horse - Equus Feruscaballus L., 1758. With the help of anatomical preparation and macroscopic, histological, morphometric and statistical methods of research, the morphology of the lungs was investigated and their belonging to a certain anatomical type was determined. As a result of the research, the partial structure of the lungs was determined, their topography, shape, dimensions, branching of the bronchi of the bronchial tree, results of organometry (absolute and relative lung mass), morphometric assessment of their morphological structures, asymmetry coefficient, etc. were determined.&#x0D; According to the results of morphological studies, the characteristic morphological features of the macro- and microscopic structure of the lungs of a mature horse were revealed according to the class, age and species of animals. The presence of individual morphological features in the lobular structure of the lungs of horses was revealed. In particular, there are only two lobes in the left lung (cranial and caudal), and three lobes in the right lung (cranial, caudal and additional). The alveolar tree of the lungs of horses is shortened, wide and has a vesicular structure.&#x0D; The conducted research to a certain extent expands and supplements information about the species, breed and morphological features of the anatomical and histological structure of the lungs in domestic animals and is important for assessing the clinical and morphological state of animals in normal conditions and for identifying the pathogenesis of animal diseases related to the respiratory organs.

Lung Microbiota in Idiopathic Pulmonary Fibrosis, Hypersensitivity Pneumonitis, and Unclassified Interstitial Lung Diseases: A Preliminary Pilot Study.

(1) Introduction: Although historically, the lung has been considered a sterile organ, recent studies through 16S rRNA gene sequencing have identified a substantial number of microorganisms. The human microbiome has been considered an "essential organ," carrying about 150 times more information (genes) than are found in the entire human genome. The purpose of the present study is to characterize and compare the microbiome in three different interstitial lung diseases: idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, and nondifferential interstitial lung disease. (2) Material and methods: This was a prospective cohort study where the DNA of 28 patients with ILD was extracted from the lavage and then processed using the standard technique of 16S RNA gene sequencing. In a tertiary teaching hospital in the northern, western part of Romania, samples were collected through bronchoscopy and then processed. (3) Results: The same four species were found in all the patients but in different quantities and compositions: Firmicutes, Actinobacteria, Proteobacteria and Bacteroides. Streptococcus was the most prevalent genus, followed by Staphylococcus and Prevotella. Statistically significant differences in the OUT count for the ten most abundant taxa were found for the genus: Gemella, Actinobacteria, Prevotella, Neisseria, Haemophilus, and Bifidobacterium. The comparative analysis showed a richer microbiota in patients with IPF, as shown by the alpha diversity index. (4) Conclusions: In interstitial lung diseases, the microorganisms normally found in the lung are reduced to a restricted flora dominated by the Firmicutes family. These changes significantly disrupt the continuity of the observed bacterial pattern from the oropharynx to the bronchial tree and lung, possibly impacting the evolution and severity of interstitial lung diseases.

A clinical case of primary ciliary dyskinesia in a child under one year old with a pathogenic genetic variant of the DNAH5 gene described for the first time

Relevance: primary ciliary dyskinesia (PCD) is a rare hereditary autosomal recessive disease from the group of ciliopathies, which is based on a defect in the ultrastructure of the cilia of the epithelium of the respiratory tract and similar structures, leading to a violation of their motor function. It is characterized by the defeat of all parts of the respiratory tract with the formation of a chronic inflammatory process and bronchiectasis. About half of patients with PCD have a complete or incomplete reverse arrangement of internal organs with various variants of heterotaxy (situs inversus). Primary ciliary dyskinesia should be differentiated from cystic fibrosis, primary immunodeficiency conditions, congenital anomalies of the structure of the bronchial tree, bronchiectasis of other origin, bronchial asthma, congenital anomalies of the cardiovascular system. Objective: describe the clinical case of a PCD patient with the first-described pathogenic variant of the nucleotide sequence (chr5:13700862CCATAGA&gt;C) of the DNAH5 gene to familiarize doctors with the clinical features of the disease and modern diagnostic capabilities. Materials and methods: the data from the patient’s medical history, transmission electron microscopy to detect anomalies in the structure of cilia in the biopsy of the nasal mucosa and the results of molecular genetic diagnostics were used. Results. The patient was admitted for 8 months for examination and treatment in June 2022. A child from the 1st pregnancy, the first birth at 43 weeks. From anamnesis: suffered intrauterine pneumonia, otitis media without hearing loss, obstructive bronchitis, episodes of apnea. Neonatal screening for cystic fibrosis is negative. According to the PICADOR scale, 12 points were obtained. On high-speed video microscopy of cilia, there is a violation of the movements of the cilia. On computed tomography of the chest organs, the reverse location of the internal organs was noted, there were no pathological changes in the lungs. The total absence of external and internal dynein handles on transmission electron microscopy was revealed. Exome sequencing revealed the previously described variant of the nucleotide sequence in exon 68 of the DNAH5 gene (chr5:13735348G&gt; A) in a heterozygous state. Also, a previously undescribed variant of the nucleotide sequence (chr5:13700862CCATAGA&gt; C) in a heterozygous state was detected in exon 78 of the DNAH5 gene. Conclusion: modern possibilities of PCD diagnostics are demonstrated by the example of clinical observation. It is noted that patients with suspected PCD need a comprehensive examination. A pathogenic variant of the nucleotide sequence (chr5:13700862CCATAGA&gt;C) of the DNAH5 gene in a heterozygous state has been described for the first time, leading to the deletion of two amino acids without shifting the reading frame (c.13604_13609del p. (Val4535_Tyr4536del); NM_001369.3), which will help for the diagnosis of PCD in the future.