Changes In Respiratory Function Research Articles

THE METABOLIC COST OF BREATHING FOR EXERCISE VENTILATIONS: EFFECTS OF AGE AND SEX.

Forty healthy participants (10 young males 23±3yrs; 10 young females 23±3yrs; 10 older males 63±3yrs, 10 older females 63±6yrs) mimicked their exercise breathing patterns in the absence of exercise across a range of exercise intensities. At peak exercise, VO2RM represented a significantly greater fraction of peak oxygen consumption (VO2peak) in young females, 12.8±3.9%, compared to young males, 10.7±3.0% (P=0.027), while VO2RM represented 13.5±2.3% of VO2peak in older females and 13.2±3.3% in older males. At relative ventilations, there was a main effect of age, with older males consuming a significantly greater fraction of VO2RM (6.6%±1.9)than younger males (4.4%±1.3;P=0.012), and older females consuming a significantly greater fraction of VO2RM (6.9%±2.5)than younger females (5.1%±1.4;P=0.004) at 65% max. Furthermore, both younger and older males had significantly better respiratory muscle efficiency than their female counterparts at peak exercise (P=0.011;P=0.015). Similarly younger participants were significantly more efficient than older participants (6.5%±1.5% vs. 5.5±2.0%;P=0.001). Age-related changes in respiratory function, and sex-based differences in airway anatomy, influence the cost to breathe during exercise. It is possible the higher fraction of VO2RM during peak exercise predispose young females and older individuals to divert more blood flow to respiratory muscles at the expense of other muscles.

Sex differences in Acute Lung Injury (ALI)-Induced Respiratory Functional Changes in a Bleomycin Rat Model

Introduction: Acute lung injury (ALI) is a pathology characterized primarily by profound disruption of the epithelial-endothelial interface, leukocyte migration into the alveolar space, leading to disordered gas exchange and consequential respiratory failure. There exist several animal models to study the pathophysiology of ALI. Bleomycin, a cancer therapeutic, has been shown to consistently induce the ALI phenotype in rodent models. We have previously shown that intra-tracheal bleomycin instillation in rats produces deleterious changes in respiratory function in both acute and recovery phases of ALI. In this study, we sought to elucidate the effect of sex bleomycin-induced ALI. Methods: To do this, cohorts of male and female Sprague-Dawley rats were measured using whole-body plethysmography (WBP) where the following respiratory parameters were recorded prior to bleomycin exposure (Week 0): Volume of Oxygen consumed normalized to body weight (VO2/kg), Respiratory rate (RR), Tidal Volume normalized to body weight (TV/kg), Minute Ventilation normalized to body weight (MV/kg), enhanced pause (Penh), pause (PAU), ratio rate of achieving peak expiatory flow (Rpef), peak inspiratory flow (box) (PIFb), peak expiratory flow box (PEFb), inspiratory time (Ti), expiratory time (Te), expiratory flow at the point of 50%TV (EF50), end-inspiratory pause (EIP), end-expiratory pause (EEP), relaxation time (Tr) and time of brake (TB). A single dose of intra-tracheal bleomycin (2.5mg/kg) was instilled and subsequent WBP recordings were performed weekly during the acute phase of ALI (Week 1), and the recovery phase of ALI (Week 4). Results: Our results show that bleomycin-induced ALI resulted in greater DTE (Weeks 1-3) and DTR (Weeks 1-2) in females compared to males. Measures of airway obstruction were also shown to be sex-dependent, as DRpef (Week 1), DPAU (Weeks 2-4), and DPenh (Weeks 2-4) were significantly different between males and females. EF50, a metric highly correlated with lung pathologies, remained unchanged between sexes post-ALI. While inducing ALI did not alter DPIFb between the sexes, DPEFb was elevated among males compared to females (Weeks 2,4). DEIP and DEEP both showed sex-dependent changes post-ALI, with females displaying a greater decrease compared to males. Additionally, there was a greater decrease in DTV/kg among females compared to males post-ALI (Weeks 1-3). DRR, DMV/kg, and DVO2/kg were unchanged across the 4 weeks post-ALI between sexes. Conclusion: Our study reveals sex-specific nuances in bleomycin-induced acute lung injury (ALI) in Sprague-Dawley rats. Differential responses in airway obstruction measures and distinct impacts on respiratory dynamics underscore the importance of considering sex in researching ALI. This work is supported by NIH R01HL152160-01. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Surfactant protein D as a marker of persistent impairment of the lungs diffusion capacity in the long-term period in patients who had suffered from severe COVID-19

Introduction. The long-term consequences of COVID-19 (СOrona VIrus Disease 2019) for the respiratory system represent a socially significant problem. Long-lasting respiratory symptoms and functional changes in individuals who have suffered coronavirus infection justify the need to study pathogenetic mechanisms. There is little study of epithelial biomarkers and their potential role in the development of long-term respiratory complications.Аim. Тo study the level of the circulating marker surfactant protein-D (SP-D) in patients who suffered severe COVID-19-associated lung damage at 3 and 12 months after the acute form and its relation with indicators of respiratory function.Materials and methods. The study included 70 patients who were examined at 3 and 12 months after the acute phase of COVID-19, which occurred with severe and extremely severe lung damage. Patients underwent a comprehensive study of respiratory function (spirography, bodyplethysmography and diffusion test), a 6-minute step test with quantitative assessment of shortness of breath, both during exercise and in daily life; the study also determined the serum level of surfactant protein-D.Results. The results of the study indicate that 57% of patients who have suffered severe COVID-19-associated lung damage remain persistently impaired in the diffusion capacity of the lungs throughout the year. It was found that the level of SP-D was increased in all patients 3 months after the acute phase of the disease, but in the group with reduced DLco this level was significantly higher after 3 and 12 months (469 ng/ml and 295 ng/ml, respectively).Conclusion. Persistent impairments in the diffusion capacity of the lungs in some patients persist a year after suffering a severe form of COVID-19. Elevated SP-D levels have been found to be associated with decreased lung diffusion capacity. Thus, SP-D can be considered as a potential biomarker of lung injury severity in the long-term period of COVID-19.

A transcriptomic analysis of correlation between mitochondrial function and energy metabolism remodeling in mice with myocardial fibrosis following myocardial infarction

To investigate the changes of mitochondrial respiratory function during myocardial fibrosis in mice with myocardial infarction (MI) and its correlation with the increase of glycolytic flux. Forty C57BL/6N mice were randomized into two equal groups to receive sham operation or ligation of the left anterior descending coronary artery to induce acute MI. At 28 days after the operation, 5 mice from each group were euthanized and left ventricular tissue samples were collected for transcriptomic sequencing. FPKM method was used to calculate gene expression levels to identify the differentially expressed genes (DEGs) in MI mice, which were analyzed using GO and KEGG databases to determine the pathways affecting the disease process. Heat maps were drawn to show the differential expressions of the pathways and the related genes in the enrichment analysis. In primary cultures of neonatal mouse cardiac fibroblasts (CFs), the changes in mitochondrial respiration and glycolysis levels in response to treatment with the pro-fibrotic agonist TGF-β1 were analyzed using Seahorse experiment. The mouse models of MI showed significantly increased diastolic and systolic left ventricular diameter (P < 0.05) and decreased left ventricular ejection fraction (P < 0.0001). A total of 124 up-regulated and 106 down-regulated DEGs were identified in the myocardial tissues of MI mice, and GO and KEGG enrichment analysis showed that these DEGs were significantly enriched in fatty acid metabolism, organelles and other metabolic pathways and in the mitochondria. Heat maps revealed fatty acid beta oxidation, mitochondrial dysfunction and increased glycolysis levels in MI mice. In the primary culture of CFs, treatment with TGF-β1 significantly reduced the basal and maximum respiratory levels and increased the basal and maximum glycolysis levels (P < 0.0001). During myocardial fibrosis, energy metabolism remodeling occurs in the CFs, manifested by lowered mitochondrial function and increased energy generation through glycolysis.

The Effects of Volatile Anesthetics on Renal Sympathetic and Phrenic Nerve Activity during Acute Intermittent Hypoxia in Rats.

Coordinated activation of sympathetic and respiratory nervous systems is crucial in responses to noxious stimuli such as intermittent hypoxia. Acute intermittent hypoxia (AIH) is a valuable model for studying obstructive sleep apnea (OSA) pathophysiology, and stimulation of breathing during AIH is known to elicit long-term changes in respiratory and sympathetic functions. The aim of this study was to record the renal sympathetic nerve activity (RSNA) and phrenic nerve activity (PNA) during the AIH protocol in rats exposed to monoanesthesia with sevoflurane or isoflurane. Adult male Sprague-Dawley rats (n = 24; weight: 280-360 g) were selected and randomly divided into three groups: two experimental groups (sevoflurane group, n = 6; isoflurane group, n = 6) and a control group (urethane group, n = 12). The AIH protocol was identical in all studied groups and consisted in delivering five 3 min-long hypoxic episodes (fraction of inspired oxygen, FiO2 = 0.09), separated by 3 min recovery intervals at FiO2 = 0.5. Volatile anesthetics, isoflurane and sevoflurane, blunted the RSNA response to AIH in comparison to urethane anesthesia. Additionally, the PNA response to acute intermittent hypoxia was preserved, indicating that the respiratory system might be more robust than the sympathetic system response during exposure to acute intermittent hypoxia.

Selenite selectively kills lung fibroblasts to treat bleomycin-induced pulmonary fibrosis

BackgroundInterstitial lung disease (ILD) treatment is a critical unmet need. Selenium is an essential trace element for human life and an antioxidant that activates glutathione, but the gap between its necessity and its toxicity is small and requires special attention. Whether selenium can be used in the treatment of ILD remains unclear. MethodsWe investigated the prophylactic and therapeutic effects of selenite, a selenium derivative, in ILD using a murine model of bleomycin-induced idiopathic pulmonary fibrosis (IPF). We further elucidated the underlying mechanism using in vitro cell models and examined their relevance in human tissue specimens. The therapeutic effect of selenite in bleomycin-administered mice was assessed by respiratory function and histochemical changes. Selenite-induced apoptosis and reactive oxygen species (ROS) production in murine lung fibroblasts were measured. ResultsSelenite, administered 1 day (inflammation phase) or 8 days (fibrotic phase) after bleomycin, prevented and treated deterioration of lung function and pulmonary fibrosis in mice. Mechanistically, selenite inhibited the proliferation and induced apoptosis of murine lung fibroblasts after bleomycin treatment both in vitro and in vivo. In addition, selenite upregulated glutathione reductase (GR) and thioredoxin reductase (TrxR) in murine lung fibroblasts, but not in lung epithelial cells, upon bleomycin treatment. GR and TrxR inhibition eliminates the therapeutic effects of selenite. Furthermore, we found that GR and TrxR were upregulated in the human lung fibroblasts of IPF patient samples. ConclusionsSelenite induces ROS production and apoptosis in murine lung fibroblasts through GR and TrxR upregulation, thereby providing a therapeutic effect in bleomycin-induced IPF.

A study protocol to investigate if acipimox improves muscle function and sarcopenia: an open-label, uncontrolled, before-and-after experimental medicine feasibility study in community-dwelling older adults

IntroductionSarcopenia is the age-associated loss of muscle mass and strength. Nicotinamide adenine dinucleotide (NAD) plays a central role in both mitochondrial function and cellular ageing processes implicated in sarcopenia. NAD...

Recovery in Physical Function, Fatigue and Quality of Life in Post-Mild COVID-19 Infection

Mild COVID-19 patients are either asymptomatic or present with mild respiratory symptoms, but as high as 5-10% may experience prolonged symptoms. Insufficient knowledge on mild-COVID-19 recovery poses uncertainties among healthcare professionals and patients, potentially causing treatment delays and may lead to a cluster of people not recovering from post-COVID-19 infection. This study aims to determine changes in respiratory symptoms, physical function, dyspnoea and fatigue, and Quality of Life in mild COVID-19 patients up to 3 months after the onset of symptoms. The results showed significant improvements in all outcomes at 3 months, but the scores were below normal.

Sirolimus treatment for intractable lymphatic anomalies: an open-label, single-arm, multicenter, prospective trial.

Intractable lymphatic anomalies (LAs) include cystic lymphatic malformation (LM; macrocystic, microcystic, or mixed), generalized lymphatic anomaly, and Gorham-Stout disease. LAs can present with severe symptoms and poor prognosis. Thus, prospective studies for treatments are warranted. We conducted a prospective clinical trial of sirolimus for intractable LAs. This was an open-label, single-arm, multicenter, prospective trial involving five institutions in Japan. All patients with LAs received oral sirolimus once daily, and the dose was adjusted to ensure that the trough concentration remained within 5-15 ng/mL. We prospectively assessed the drug response (response rate for radiological volumetric change in target lesion), performance state, change in respiratory function, visceral impairment (pleural effusion, ascites, bleeding, pain), laboratory examination data, quality of life (QOL), and safety at 12, 24, and 52 weeks of administration. Eleven patients with LAs (9 generalized lymphatic anomaly, 1 cystic LM, 1 Gorham-Stout disease) were treated with sirolimus, of whom 6 (54.5%; 95% confidence interval: 23.4-83.3%) demonstrated a partial response on radiological examination at 52 weeks of administration. No patients achieved a complete response. At 12 and 24 weeks of administration, 8 patients (72.7%) already showed a partial response. However, patients with stable disease showed minor or no reduction after 12 weeks. Adverse events, such as stomatitis, acneiform dermatitis, diarrhea, and fever, were common with sirolimus. Sirolimus was safe and tolerable. Sirolimus can reduce the lymphatic tissue volume in LAs and may lead to improvements in clinical symptoms and QOL.

Short-Term Benefits of Smoking Cessation Improve Respiratory Function and Metabolism in Smokers.

Cigarette smoke exposure is the main preventable cause of chronic obstructive pulmonary disease (COPD). Airflow limitation is closely associated with smoking exposure. Smoking could also interfere with lipid metabolism. To determine the respiratory functional and metabolic changes after smoking cessation in smokers in the short term. All patients were current smokers. They were assessed by spirometry and questionnaires such as COPD assessment test(CAT), modified Medical Research Council (mMRC) test for dyspnea, Fagestrom's test for nicotine dependence. Exhaled CO was detected in order to evaluate smoking exposure and smoking cessation (normal value<7 ppm). A blood sampling was eventually taken for vitamin D and cholesterol assay. All patients underwent therapy with counselling and varenicline as first-line treatment according to its schedule. Detection time: at baseline and one month after smoking cessation. All patients quit smoking during treatment. The mean age was 62 with a prevalence of males. The analysis revealed the following mean values at baseline: CAT mean score was 15, pack-years 35.5, Fagestrom's Test mean score 5.0. The West's value was 8.5, whereas Body mass index (BMI) was 25.5.Cigarette daily consumption mean value was 22.5. The comparison before and at follow up one month after smoking cessation about functional and metabolic parameters, show us the following results: FEV 1 was increased by 200 mL (p<0.02), FEF 25/75 was improved as well as mMRC test. The eCO was dropped to as low as 8 ppM. Interestingly the vitamin D level was increased from 25 to 28 ng/mL without any support therapy. The cholesterol total level was reduced and CAT value and DLCO were also significantly improved. Quit smoking is useful to improve symptoms, respiratory function and metabolic parameters in the short term.

Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS).

Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19. A total of 5514 women with a symptomatic SARS-CoV-2 infection during pregnancy registered in the COVID-19 Related Obstetric and Neonatal Outcome Study were included. The COVID-19-related adverse maternal outcomes were compared in 165 multiple versus 5349 singleton pregnancies. Combined adverse maternal outcome was defined as presence of COVID-19-related hospitalization and/or pneumonia and/or oxygen administration and/or transfer to ICU and/or death. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals were calculated. The frequency of dyspnea, likelihood of developing dyspnea in a defined pregnancy week and duration of the symptomatic phase of the COVID-19 infection did not differ between the two groups. On average, COVID-19-related combined adverse outcome occurred earlier during pregnancy in women expecting more than one child than in singleton pregnancies. The overall incidence of singular and combined COVID-19-associated adverse maternal outcomes was not significantly different between groups. However, regression analysis revealed that multiple gestation, preconceptional BMI>30kg/m 2 and gestational age correlated significantly with an increased risk of combined adverse maternal outcome. Conversely, maternal age and medically assisted reproduction were not significant risk factors for combined adverse maternal outcome. Our data show that multiple gestation alone is a risk factor for COVID-19-associated combined adverse maternal outcome. Moreover, severe courses of COVID-19 in women expecting more than one child are observed earlier in pregnancy than in singleton pregnancies.

Abstract 17947: Mathematical Model of Cheyne-Stokes Respirations as an Educational Tool for Understanding Cardiorespiratory Interactions in Heart Failure

Background: Patients with heart failure often develop Cheyne-Stokes Respirations (CSR): a breathing pattern characterized by alternating periods of hyperventilation and apnea. The cardio-respiratory interactions that result in CSR are complex and often difficult to understand for students learning cardiovascular physiology. Aims: We developed a mathematical model of CSR where cardiac output (CO), respiratory rate (RR) and arterial CO 2 (pCO 2 ) can be manipulated to evaluate how periodic fluctuations in different physiological variables develop, thus providing a deeper understanding of cardiorespiratory interactions in heart failure. Methods: Our model consisted of 3 coupled differential equations. (1) pCO 2 is directly proportional to metabolic CO 2 production and inversely proportional to alveolar ventilation (V A ). V A depends on RR, alveolar volume, and CO, with the interaction between CO and ventilation calculated by combining Fick’s principle and the Alveolar Gas Equation. (2) Changes in RR are modeled as a Hill function dependent on pCO 2 . (3) Finally, CO depends on pCO 2 , arterial O 2, and RR. The model was propagated forward in time using Euler’s method. A graphical user interface allows users to easily manipulate variables and observe heart lung interactions. Results: Initial values for RR, CO, and PCO 2 resulting in stable, aperiodic breathing were 10 breaths/min, 6 L/Min, and 40 mmHg, respectively. Perturbing any of these values resulted in periodic fluctuations in RR, CO, and pCO 2 (Figure 1). A key insight of the model is that progressive decreases in CO induce more prominent oscillations in RR and pCO 2 and that pCO 2 directly influences CO. Conclusions: Our mathematical model of cardio-respiratory interactions allows users to easily manipulate physiological variables to graphically visualize how changes in CO and respiratory function give rise to CSR. This may enable students to obtain a deeper understanding of cardiovascular physiology.

Changes in respiratory structure and function after traumatic cervical spinal cord injury: observations from spinal cord and brain.

Respiratory difficulties and mortality following severe cervical spinal cord injury (CSCI) result primarily from malfunctions of respiratory pathways and the paralyzed diaphragm. Nonetheless, individuals with CSCI can experience partial recovery of respiratory function through respiratory neuroplasticity. For decades, researchers have revealed the potential mechanism of respiratory nerve plasticity after CSCI, and have made progress in tissue healing and functional recovery. While most existing studies on respiratory plasticity after spinal cord injuries have focused on the cervical spinal cord, there is a paucity of research on respiratory-related brain structures following such injuries. Given the interconnectedness of the spinal cord and the brain, traumatic changes to the former can also impact the latter. Consequently, are there other potential therapeutic targets to consider? This review introduces the anatomy and physiology of typical respiratory centers, explores alterations in respiratory function following spinal cord injuries, and delves into the structural foundations of modified respiratory function in patients with CSCI. Additionally, we propose that magnetic resonance neuroimaging holds promise in the study of respiratory function post-CSCI. By studying respiratory plasticity in the brain and spinal cord after CSCI, we hope to guide future clinical work.

The diffusing capacity of the lungs for carbon monoxide - an independent predictor of interstitial lung disease in patients with rheumatoid arthritis - results of a prospective study

Background. The diffusing capacity of the lungs for carbon monoxide (DLCO) represents the most sensitive independent factor for highlighting the interstitial lung disease associated with rheumatoid arthritis (RA-ILD). Many studies have analyzed this association between RA and lung modifications because it correlates with a decrease in the patients’ quality of life and a higher mortality. Objective. This study aimed to highlight the importance of DLCO as a predictor of ILD progression in RA, beside the pattern on high-resolution chest CT (HRCT) and the double seropositivity of the disease. Patients and method. This prospective cohort study, carried out between august 2022 and may 2023, included 48 RA patients with ILD, fulfilling the 1987 ACR or 2010 ACR/EULAR classification criteria. Important attention was paid to respiratory functional tests, immunological changes, and specific lung pattern on HRCT. Patients with current malignancies, active infections or Overlap syndrome were excluded from the study. Results. 48 RA patients, mostly women (81%) with a mean age of 65.54±10.58 years old and a median age of RA onset of 52.58±11.36 years, were included. The proportion of patients with a decreased DLCO was 64.6%. Using statistical tests, we found significant correlations between DLCO and age, double seropositivity and a specific pulmonary pattern on HRCT. Conclusion. ILD, an underrecognized disease, may be considered one of the most serious of all extra-articular manifestations in RA, the risk for mortality being triple in these cases. Our results are in correlation with the published data and support the key role of DLCO in the diagnosis and follow-up of these patients.

Inhalation with Vitamin D3 Metabolites—A Novel Strategy to Restore Vitamin D3 Deficiencies in Lung Tissue

Vitamin D3 deficiency has been recognized as a pandemic with serious health consequences including chronic respiratory diseases. Unfortunately, improvement in this situation by using vitamin D supplementation has failed. The direct delivery of 1,25(OH)2-vitamin D3 and its precursor into the respiratory tract, by nebulization, seemed to be a better option, as verified in the presented study. To induce vitamin D deficiency, mice received a diet with 0.05 IU/g cholecalciferol, while control animals were given feed with 0.5 IU/g cholecalciferol. Vitamin-D-deficient mice were exposed to different doses of calcidiol or calcitriol via nebulization for at least 7 days. At the end of the experiment, whole-body plethysmography was conducted. Pulmonary and serum levels of calcitriol were examined using ELISA. The calcitriol concentrations in mice on standard vs. deficient diet were 30.31/18.20 pg/mg (lungs) and 132.24/98.61 pg/mL (serum), respectively. Restoration of the physiological level of calcitriol in vitamin-D-deficient mice required 1-week exposure to 100 pg/g of calcidiol or 5 pg/g of calcitriol. The inhalations did not cause any side changes in murine respiratory function. The presented study revealed the usefulness and safety of chronic inhalation with a bioactive form of vitamin D3 or its precursor for the restoration of physiological calcitriol levels in animals with vitamin D deficiencies.

Comparative Dynamic Pulmonary Function Tests Between Apparently Healthy Young Adult Offspring of Asthmatic and Non-asthmatic Parents: A Pilot Study.

Background While the hereditary component of asthma has been established, its influence on early respiratory function changes in otherwise healthy offspring remains to be explored. Dynamic lung function tests assess airflow in and out of the lungs, providing valuable insights into respiratory health and detecting potential airflow limitations. This study aimed to compare the dynamic lung functions between offspring of asthmatic and non-asthmatic parents. Methodology A case-control design was employed comprising 30 cases (offspring of asthmatic parents) and 30 controls (offspring of non-asthmatic parents). Lung function parameters including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, forced expiratory flow between 25% and 75% of the FVC (FEF 25-75%), and maximum mid-expiratory flow at 50% of the FVC (Vmax 50%) were measured. Statistical analysis was conducted to compare the parameters between cases and controls using the unpaired t-test. Results The mean age of controls was 20.46 ± 2.82 years and the cases was 19.83 ± 1.41 years. The study revealed that cases exhibited lower FEV1 and Vmax 50% values compared to controls, indicating potential airflow limitations and altered mid-exhalation flow rates in the offspring of asthmatic parents. While trends were observed in FVC, FEV1/FVC ratio, and FEF 25-75%, these differences were not statistically significant. Conclusions The findings suggest a potential association between parental asthma and altered lung function parameters, specifically in FEV1 and Vmax 50%, among their offspring. These early respiratory function changes underscore the potential impact of hereditary factors on lung health. Healthcare professionals should take parental asthma into account when evaluating lung functions. This may lead to earlier detection and intervention. Further investigation is warranted to elucidate the underlying mechanisms and long-term implications of these findings.

Relationship of Mitochondrial-Related Protein Expression with the Differentiation, Metastasis, and Poor Prognosis of Oral Squamous Cell Carcinoma.

Mitochondrial dysfunction and respiratory function changes have been consistently associated with the initiation and progression of cancer. The purpose of this study was to retrospectively investigate the expression of mitochondrial tumor-suppressor and DNA-repair proteins in patients with oral squamous cell carcinoma (OSCC) and to evaluate the relationship between their expression and prognosis. We enrolled 197 patients with OSCC who underwent surgical resection between August 2013 and October 2018. Clinical, pathological, and epidemiological data were retrospectively collected from hospital records. The expression of peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α), mitochondrial transcription factor A, mitochondrial tumor suppressor gene 1, silent information regulator 3, and 8-hydroxyguanine DNA glycosylase was investigated using immunochemistry. The 3-year disease-specific survival (DSS) rates of patients showing positive expression of all selected proteins were significantly higher than those of patients showing a lack of expression. Multivariate analysis revealed that the expression of PGC-1α (hazard ratio, 4.684) and vascular invasion (hazard ratio, 5.690) can predict the DSS rate (p < 0.001). Low PGC-1α expression and vascular invasion are potential clinically effective predictors of the prognosis of OSCC.

Oscillometry and spirometry are not interchangeable when assessing the bronchodilator response in children and young adults born preterm.

The European Respiratory Society Oscillometry Taskforce identified that clinical correlates of bronchodilator responses are needed to advance oscillometry in clinical practice. The understanding of bronchodilator-induced oscillometry changes in preterm lung disease is poor. Here we describe a comparison of bronchodilator assessments performed using oscillometry and spirometry in a population born very preterm and explore the relationship between bronchodilator-induced changes in respiratory function and clinical outcomes. Participants aged 6-23 born ≤32 (N = 288; 132 with bronchopulmonary dysplasia) and ≥37 weeks' gestation (N = 76, term-born controls) performed spirometry and oscillometry. A significant bronchodilator response (BDR) to 400 μg salbutamol was classified according to published criteria. A BDR was identified in 30.9% (n = 85) of preterm-born individuals via spirometry and/or oscillometry, with poor agreement between spirometry and oscillometry definitions (k = 0.26; 95% confidence interval [CI] 0.18-0.40, p < .001). Those born preterm with a BDR by oscillometry but not spirometry had increased wheeze (33% vs. 11%, p = .010) and baseline resistance (Rrs5 z-score mean difference (MD) = 0.86, 95% CI 0.07-1.65, p = .025), but similar baseline spirometry to the group without a BDR (forced expiratory volume in 1 s [FEV1 ] z-score MD = -0.01, 95% CI -0.66 to 0.68, p > .999). Oscillometry was more feasible than spirometry (95% success rate vs. 85% (FEV1 ), 69% (forced vital capacity) success rate, p < .001), however being born preterm did not affect test feasibility. In the preterm population, oscillometry is a feasible and clinically useful supportive test to assess the airway response to inhaled salbutamol. Changes measured by oscillometry reflect related but distinct physiological changes to those measured by spirometry, and thus these tests should not be used interchangeably.

유산소 운동 시 마스크 타입에 따라 호흡 기능에 미치는 효과

Purpose: This study aimed to explore the effects of the type of mask worn during aerobic exercise on respiratory function. Methods: A total of 30 people were included in this study. The subjects were randomly assigned to two groups: the dental mask group (wearing dental masks during aerobic exercise, n=15) and the KF94 mask group (wearing KF94 masks during aerobic exercise, n=15). Aerobic exercise was performed using a sedentary cycle with eight levels of intensity control three times a week for 4 weeks. Respiratory function (forced vital capacity [FVC], forced expiratory volume in one second [FEV1], FEV1-to-FVC ratio [FEV1/FVC%], and peak expiratory flow [PEF]) was assessed using a spirometer at 0, 2, and 4 weeks. Results: A significant difference in all respiratory function parameters, including FVC, FEV1, FEV1/FVC%, and PEF, was observed between the two groups (p&lt;.05). The change in respiratory function was not statistically significantly different between the two groups. However, a significant difference in the amount of change in PEF was observed between the two groups at 4 weeks (p&lt;.05). Conclusion: The dental and KF94 mask groups showed increased respiratory function. However, no significant difference was observed between the two groups. Furthermore, no difference was observed in the amount of increase in respiratory function during aerobic exercise according to the mask type. Thus, we recommend wearing a dental mask that is easy to breathe during aerobic exercise.

Structural changes in lung morphology detected by MRI after modulating therapy with elexacaftor/tezacaftor/ivacaftor in adolescent and adult patients with cystic fibrosis

IntroductionElexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) improves CFTR function in cystic fibrosis (CF) patients homozygous or heterozygous for F508del mutation. The aim of the study was to evaluate the response to ELX/TEZ/IVA treatment both clinically and morphologically in terms of bronchiectasis, bronchial wall thickening, mucus plugging, abscess and consolidations. MethodsWe retrospectively collected data from CF patients followed at Parma CF Centre (Italy) treated by ELX/TEZ/IVA between March and November 2021. Post-treatment changes in respiratory function, quality of life, sweat chloride concentration, body mass index, pulmonary exacerbations and lung structure by chest magnetic resonance imaging (MRI) were assessed. T2-and T1-weighted sequences were acquired with a 20 min-long scanning protocol on a 1.5T MRI scanner (Philips Ingenia) without administration of intravenous contrast media. Results19 patients (32.5 ± 10.2 years) were included in the study. After 6 months of treatment with ELX/TEZ/IVA, MRI showed significant improvements in the morphological score (p < 0.001), with a reduction in bronchial wall thickening (p < 0.001) and mucus plugging (p 0.01). Respiratory function showed significant improvement in predicted FEV1% (58.5 ± 17.5 vs 71.4 ± 20.1, p < 0.001), FVC% (79.0 ± 11.1 vs 88.3 ± 14.4, p < 0.001), FEV1/FVC (0.61 ± 0.16 vs 0.67 ± 0.15, <0.001) and LCI2.5% (17.8 ± 4.3 vs 15.8 ± 4.1 p < 0.005). Significant improvement was found in body mass index (20.6 ± 2.7 vs 21.9 ± 2.4, p < 0.001), pulmonary exacerbations (2.3 ± 1.3 vs 1.4 ± 1.3 p 0.018) and sweat chloride concentration (96.5 ± 36.6 vs 41.1 ± 16.9, p < 0.001). ConclusionsOur study confirms the efficacy of ELX/TEZ/IVA in CF patients not only from a clinical point of view but also in terms of morphological changes of the lungs.