Chronic Respiratory Tract Disease Research Articles

Human nasal microbiota shifts in healthy and chronic respiratory disease conditions

BackgroundAn increasing number of studies investigate various human microbiotas and their roles in the development of diseases, maintenance of health states, and balanced signaling towards the brain. Current data demonstrate that the nasal microbiota contains a unique and highly variable array of commensal bacteria and opportunistic pathogens. However, we need to understand how to harness current knowledge, enrich nasal microbiota with beneficial microorganisms, and prevent pathogenic developments.ResultsIn this study, we have obtained nasal, nasopharyngeal, and bronchoalveolar lavage fluid samples from healthy volunteers and patients suffering from chronic respiratory tract diseases for full-length 16 S rRNA sequencing analysis using Oxford Nanopore Technologies. Demographic and clinical data were collected simultaneously. The microbiome analysis of 97 people from Lithuania suffering from chronic inflammatory respiratory tract disease and healthy volunteers revealed that the human nasal microbiome represents the microbiome of the upper airways well.ConclusionsThe nasal microbiota of patients was enriched with opportunistic pathogens, which could be used as indicators of respiratory tract conditions. In addition, we observed that a healthy human nasal microbiome contained several plant- and bee-associated species, suggesting the possibility of enriching human nasal microbiota via such exposures when needed. These candidate probiotics should be investigated for their modulating effects on airway and lung epithelia, immunogenic properties, neurotransmitter content, and roles in maintaining respiratory health and nose-brain interrelationships.

Psoriasis and atopic dermatitis in terms of psychosomatic effects

The aim of this paper is to present the review of research into the psychological functioning of children and adults suffering from chronic diseases, with particular emphasis on psoriasis and atopic dermatitis. We have reviewed the scientific articles available in research databases on the topic: psoriasis and atopic dermatitis in terms of psychosomatic effects. It was found that psoriasis and atopic dermatitis interfere with patients’ most vital processes and negatively affect their immediate vicinity. They cause changes in the somatic, mental and social functioning of the patient. Frequently, they also cause a change in behaviour and negatively affect the quality of patients’ lives. Patients with severe psoriasis have an increased risk of death due to circulatory system diseases, cancer, chronic diseases of the lower respiratory tract, diabetes, dementia, infections and kidney diseases. Atopic dermatitis is correlated and may predispose to an increased risk of other atopic disorders, including asthma, hay fever, food allergies, and eosinophilic oesophagitis. It seems that patients with atopic dermatitis are more susceptible to infections and cardiovascular diseases and numerous neuropsychiatric disorders, including depression, attention deficit hyperactivity disorder, speech disorders in childhood, headaches and seizures. There is also a multifactor correlation between AD and osteoporosis, injuries, and fractures. Psoriasis is not only associated with anxiety disorders, depressive disorders and suicidal ideation, but also with significant cognitive functions impairment. In the case of atopic dermatitis, many authors emphasize the association between the occurrence of this skin disease and cognitive impairment, including reduced attention, visual and verbal memory, executive functions and abstract thinking.

Endoscopic autofluorescence imaging in the diagnosis of premalignant lesions and laryngeal/hypopharyngeal cancer

The purpose of the study was to assess the diagnostic value of endoscopic autofluorescence imaging (AFI) in patients with premalignant lesions and primary laryngeal/hypopharyngeal cancer.Material and Methods. The diagnostic value of AFI was assessed in 53 patients with chronic hyperplastic laryngeal/hypopharyngeal lesions and 48 patients with laryngeal/hypopharyngeal cancer.Results. The inclusion of video laryngoscopy with AFI in the algorithm for examining patients with chronic diseases of the upper respiratory tract made it possible to significantly improve the diagnostic efficacy of endoscopic examination in patients with premalignant lesions (high grade dysplasia) of the laryngeal mucosa. Video laryngoscopy with AFI was found to achieve higher sensitivity, specificity and accuracy rates than white light video laryngoscopy (87.5, 96.9 and 92.5 vs 50.0, 96.0 and 71.7 %, respectively, p<0.05). The video laryngoscopy with AFI allowed identification of not only pathological changes in the laryngeal and hypopharyngeal mucosa but also their malignant potential, as well as identification of areas for targeted biopsy. In 9 (18.8 %) laryngeal cancer patients, the standard white light video laryngoscopy demonstrated difficulties in the differential diagnosis of laryngeal cancer (n=4) and in assessing the extent of laryngeal cancer (n=5). In 3 out of 4 diagnostically difficult cases, video laryngoscopy with AFI made it possible to confirm the diagnosis of laryngeal cancer and in 5 cases to accurately determine the extent of hypopharyngeal cancer.Conclusion. The addition of standard videolaryngoscopy with a hightech technique of autofluorescence endoscopy makes it possible to accurately diagnose premalignant and malignant lesions of the larynx and hypopharynx.

Research progress on active ingredients of animal-derived traditional Chinese medicine in treatment of allergic rhinitis

Allergic rhinitis(AR) is a common chronic inflammatory disease of the upper respiratory tract. Due to its high prevalence, high recurrence rate, and lack of a definitive cure, it is considered a global health issue by the World Health Organization. The pathogenesis of AR is complex and mainly involves B cells, helper T cells, eosinophils, basophils, macrophages, as well as the cytokines and inflammatory mediators they secrete. Clinical treatment primarily focuses on inhibiting inflammatory mediators such as histamine and leukotrienes. In recent years, active ingredients of animal-derived traditional Chinese medicine(TCM) have shown unique advantages and potential in AR treatment thanks to their high safety, specificity, selectivity, and biopotency. This study systematically reviewed the therapeutic effects and mechanisms of active ingredients and mixed extracts from animal-derived TCM, such as bovine spleen, honeycomb, bee venom, maggot, and human placenta, which have been shown by modern pharmacological research to regulate the immune function in AR, providing a reference for further exploration and clinical development of active ingredients from animal-derived TCM. Studies have found that the active ingredients from animal-derived TCM can produce definite therapeutic effects in AR by modulating multiple immune balances in the body, with great clinical prospects. However, their mechanisms of action still require further investigation, and the quality control techniques for effective ingredients need to be improved. Currently, the research on active ingredients from animal-derived TCM in China has adopted an interactive system consisting of "traditional medical experience-based research, bioinformatics and artificial intelligence predictions, and validation and development through new experimental techniques". Based on this system, animal-derived TCM can combine modern scientific and technological means to maximize the therapeutic effects of active ingredients and serve the clinical application of AR in a more efficient and innovative manner.

Investigation of Serum allergen-specific IgE concentrations in feline asthma: a clinical experience

The aim of this study is to investigate allergen agents by allergen-specific serum IgE analysis in domestic cats diagnosed with feline asthma (FA). A total of 21 cats (16 FA and 5 control cats) were included in the study. Allergen-specific serum IgE levels were measured in cats diagnosed with feline asthma and in the control group. Allergen levels were classified as negative, weak, moderate and strong. The difference between the two groups was compared statistically. While the mean age of the cats in the FA group was 3.9kg ±2.4 years, the mean age of the cats in the control group was 3.4±2.2 years. The most common clinical manifestations in cats with FA were cough, sneezing, wheezing, and acute dyspnea, respectively. Allergen-specific IgE levels tested for 20 different allergens showed that 14 out of 16 cats developed a reaction to more than one allergen. The vast majority of cats with FA had a moderate or strong positive reaction to house dust mites. In conclusion, FA is an important and common chronic lower respiratory tract disease of feline patients and allergen-specific serum IgE levels can be easily used in clinical practice to guide the selection of allergens in the treatment of this disease and adjust for the quality of life and well-being of cats.

Alcohol consumption and all-cause and cause-specific mortality among US adults: prospective cohort study

BackgroundPrevious studies have shown inconsistent findings regarding the association of light to moderate alcohol consumption with cause-specific mortality. Therefore, this study sought to examine the prospective association of alcohol consumption with all-cause and cause-specific mortality in the US population.MethodsThis was a population-based cohort study of adults aged 18 years or older in the National Health Interview Survey (1997 to 2014) with linkage to the National Death Index records through December 31, 2019. Self-reported alcohol consumption was categorized into seven groups (lifetime abstainers; former infrequent or regular drinkers; and current infrequent, light, moderate, or heavy drinkers). The main outcome was all-cause and cause-specific mortality.ResultsDuring an average follow-up of 12.65 years, among the 918,529 participants (mean age 46.1 years; 48.0% male), 141,512 adults died from all causes, 43,979 from cardiovascular disease (CVD), 33,222 from cancer, 8246 from chronic lower respiratory tract diseases, 5572 from accidents (unintentional injuries), 4776 from Alzheimer’s disease, 4845 from diabetes mellitus, 2815 from influenza and pneumonia, and 2692 from nephritis, nephrotic syndrome, or nephrosis. Compared with lifetime abstainers, current infrequent, light, or moderate drinkers were at a lower risk of mortality from all causes [infrequent—hazard ratio: 0.87; 95% confidence interval: 0.84 to 0.90; light: 0.77; 0.75 to 0.79; moderate 0.82; 0.80 to 0.85], CVD, chronic lower respiratory tract diseases, Alzheimer’s disease, and influenza and pneumonia. Also, light or moderate drinkers were associated with lower risk of mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. In contrast, heavy drinkers had a significantly higher risk of mortality from all causes, cancer, and accidents (unintentional injuries). Furthermore, binge drinking ≥ 1 day/week was associated with a higher risk of mortality from all causes (1.15; 1.09 to 1.22), cancer (1.22; 1.10 to 1.35), and accidents (unintentional injuries) (1.39; 1.11 to 1.74).ConclusionsInfrequent, light, and moderate alcohol consumption were inversely associated with mortality from all causes, CVD, chronic lower respiratory tract diseases, Alzheimer’s disease, and influenza and pneumonia. Light or moderate alcohol consumption might also have a beneficial effect on mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. However, heavy or binge had a higher risk of all-cause, cancer, and accidents (unintentional injuries) mortality.

Efficiency of topical bacterial lysates in inflammatory diseases of the oral cavity and pharynx

Acute and chronic infectious and inflammatory diseases of the upper respiratory tract occupy one of the leading places in the structure of morbidity of the population of the world and remain the most frequent cause of patients seeking medical care. The prevalence and frequency of respiratory infectious diseases make a significant contribution to the structure of the causes of temporary disability, which entails negative socio-economic consequences. Specific attention in the current epidemic season is attracted by the change in the traditional structure of pathogens associated with several strict anti-epidemic measures during the COVID-19 pandemic, as well as a decrease in the activity of other pathogens during the active circulation of SARS-CoV-2. In this aspect, the increased resistance of pathogens to etiotropic drugs and insufficiency of the arsenal of pathogenic drugs dictate the need to search for alternative approaches to the treatment of inflammatory diseases of the mouth and throat. The main purpose of non-specific preventive measures of acute and recurrent diseases of the oral cavity and pharynx is to reduce bacterial content of mucous membranes by various pathogens and to activate own protective anti-infective mechanisms. In clinical practice medicines which contain bacterial lysates are considered to be an effective part of treatment of upper respiratory tract’s inflammatory diseases. They allow achieving elimination of a pathogenic organism and also help to restore autoregulation of immune response in the whole organism, reduce the frequency of infectious diseases. Topical bacterial lysates, acting directly in the locus of inflammation, do not harm the human microbiome, have a high safety profile, combine well with other medicines and can be used for patients of different ages. Topical immunotherapy has a significant preventive effect, preventing possible complications and improving the quality of life. The use of Imudon and IRS 19 leads to positive clinical and immunological shifts and promotes the efficiency of rehabilitation and preventive measures.

An ayurvedic management of Tamakshwasa with special reference to bronchial asthma: A case study

Bronchial asthma is a chronic inflammatory disease of respiratory tract with airway hyper responsiveness producing symptoms such as wheezing, cough and dyspnea. Exposure to the dust, smoke, respiratory infections, new dietic preparation, stress and change in climate are some of the causative factors of Bronchial Asthma. In Modern medicine there is no permanent cure for asthma, only symptoms can be. If it is left untreated or not treated in time,it is fatal in nature. Although various studies have been performed across the globe in last few decades and some good drugs are discovered. Due to changes in life style and change in environment, mainly pollution, study shows clear indication that the prevalence of Shwasa (Bronchial Asthma) has increased significantly in all age groups. Tamakshwasa is of 5 types of Shwasa , which is said to be Kashtasadhya or Yapya by Madhavnidan. Presently, nebulization is the fastest way of relieving the symptom of Shwaskashtata in Bronchial Asthma, for which bronchodilator and steroidal preparations are widely used. But they have some ill effects when used for prolonged period. A 40-year-old female having increase in symptoms of Shortness of breath, Expiratory wheezes, Chest pressure sensation, Patient had taken allopathic medicine for 1 month, but she had no satisfactory relief. Shaman and Shodhan as ApunarbhavChikitsa is given. Significant improvement observed in subjective and objective parameters.

The effect of COVID-19 infection on the course of chronic inflammatory diseases of the upper respiratory tract and the state of immunity. Message 1. The clinical course of chronic diseases of upper respiratory tract with different variants of contact of patients with coronavirus and the state of the basic parameters of immunity

The effect of COVID-19 infection on the course of chronic inflammatory diseases of the upper respiratory tract and the state of immunity. Message 1. The clinical course of chronic diseases of upper respiratory tract with different variants of contact of patients with coronavirus and the state of the basic parameters of immunity

Effects of Pendrin Protein in Nasal Epithelial Cells on Mucin Production in the Context of Type 2 Inflammation.

Chronic rhinosinusitis (CRS) is a heterogeneous disease. The pathogenesis of chronic sinusitis is still unclear; however, the nasal cavity and paranasal sinuses are commonly affected by type 2 inflammation, which is caused by Th2 cytokines such as interleukin (IL)-5, IL-4, and IL-13. Previous studies have shown that pendrin promotes local infiltration of neutrophils through the production of human neutrophil elastase (HNE), which is essential for the secretion of mucin 5AC (MUC5AC) in chronic inflammatory diseases of the lower respiratory tract. This study investigated pendrin expression and its relationship to mucin in type 2 inflammation. A total of 40 patients (10 CRS patients with nasal polyps,10 CRS patients without nasal polyps, and 20 nasal septum deviation patients) were included in this study and were divided into the CRS group and the NC group. A normal nasal mucosa tissue culture model was established in vitro. IL-13 was used to stimulate primary cultures of human nasal epithelial cells (HNECs). Western blot (WB), enzyme-linked immunosorbent assay (ELISA), and quantitative real-time polymerase chain reaction (qRT-PCR) were used to detect the expression of pendrin, MUC5AC, and MUC5B. After transfecting HNECs with siRNA pendrin or negative control (NC), EGF receptor (EGFR), HNE, MUC5AC, and MUC5B expression were analyzed using qRT-PCR, WB, or ELISA in terms of their relationships with pendrin. Pendrin expression in the tissue was also analyzed. After IL-13 stimulation, pendrin, MUC5AC, and MUC5B expression levels were upregulated; the optimal concentration of IL-13 was 50 ng/mL. The expression levels of HNE, EGFR, MUC5AC, and MUC5B were downregulated after transfection with siRNA pendrin-1650. Pendrin expression in the NC group was lower than in the CRS group. IL-13 is implicated in the inflammation of nasal mucosa, and pendrin is closely related to the excessive secretion of mucin. The expression of mucin is downregulated after transfection with siRNA pendrin. There is a positive relationship between pendrin and EFGR/HNE. Moreover, pendrin plays an important role in type 2 inflammation.

Smoking and Carcinoma Trends in Recurrent Respiratory Papillomatosis Patients.

Recurrent respiratory papillomatosis (RRP) is a chronic disease of the upper respiratory tract caused by human papillomavirus types 6 and 11. The disease course is characteristically unpredictable, ranging from spontaneous remission to aggressive, recurrent disease. Thus, management is often challenging and requires unique approaches tailored to each individual patient. While recent literature has described risk factors for more aggressive disease, few sources have investigated the impact of smoking on RRP disease course and risk for malignant transformation. A retrospective chart review was conducted for adult RRP patients evaluated at an academic tertiary care center between 2005 and 2020. A total of 188 patients were identified. Demographic and clinical data were collected, including smoking and alcohol history, HPV subtype, history of dysplasia and/or carcinoma, voice handicap index scores, Derkay scores, debulkings (in office and operating room), and days to papilloma recurrence. Malignant degeneration in RRP occurred in 16.3% of smokers and 3.6% of nonsmokers. Smokers who developed carcinoma had less debulkings per years of evaluation than those not developing carcinoma (0.21 vs 0.92, P = .004). Additionally, patients that either presented with or developed carcinoma during their course had a higher pack-year smoking history (18.0 vs 12.21, P = .0002). No difference in days to recurrence or inter-surgical interval was demonstrated between smokers and nonsmokers. The report demonstrates that smoking can increase the risk of malignant transformation in RRP patients.

INFORMATION ON PROGNOSTIC MARKERS OF SEVERE ACUTE BRONCHITIS IN PRESCHOOLERS: A STUDY IN SUMY REGION IN NORTH-EASTERN UKRAINE

Introduction. Respiratory infections, especially in children, are a significant global health concern. Understanding the implications of respiratory infections like acute bronchitis is crucial for devising effective management strategies. These infections, including bronchitis, pneumonia, and influenza, contribute substantially to pediatric hospitalizations. Predicting the severity of acute bronchitis in children is essential for personalized treatment and resource allocation. Developing reliable prognostic tools for acute bronchitis can improve outcomes and optimize healthcare resource utilization. Methods. The study spanned four years (2018–2021) at "Saint Zinaida's Children's Clinical Hospital" and "Primary Health Care Center No. 2" in Sumy City Council. It involved 135 preschool children with acute bronchitis (study group) and 28 healthy children (control). The control group matched the age and gender of the acute bronchitis group. Inclusion criteria comprised parental consent, ages 3–6, and a diagnosis of acute bronchitis; exclusions included parental refusal, ages below 3 or above 7, concurrent somatic or allergic diseases, non-compliance, and diagnoses other than acute bronchitis. Various methods were employed, including clinical, laboratory, instrumental, and statistical analyses. The severity of acute bronchitis was gauged using the BSS-ped clinical tool. Immunological status assessment involved determining cellular immunity indicators via enzyme-linked immunosorbent assay. Hormonal status analysis included thyroid and cortisol levels via enzyme-linked immunosorbent assay. Statistical analysis utilized SPSS 26 and probabilistic modeling based on Bayes' theorem for building prognostic models and assessing risk factors for acute bronchitis. Fisher's criterion determined reliability at a significance level of 0.05, categorizing risk degrees from low to critically high based on a posteriori chances. Results. The study successfully identified key clinical, anamnestic, hormonal, and immunological risk factors for severe acute bronchitis in preschoolers, constructing a predictive mathematical model. Breastfeeding and mixed feeding in infants were not associated with increased severity, contrasting with chronic upper respiratory tract disease and parental habits, notably smoking, linked to heightened severity. Cough severity and auscultatory wheezing, with a BSS-ped score of 4, moderately impacted severe acute bronchitis. An outlined prognostic model confirmed hormonal indicators' influence, particularly elevated reverse triiodothyronine levels, on increased risk. Immune cellular activity, specifically CD8+, CD4+, and CD22+, demonstrated pronounced impacts on severe acute bronchitis in preschoolers. A combined aberration of CD3+ and free triiodothyronine, CD3+ and total triiodothyronine, or CD4+ and free triiodothyronine indicated a critically high risk. The model's reliability was affirmed via ROC analysis, displaying a sensitivity of 91.7 %, specificity of 68.2 %, and an AUC of 0.869, indicating its high quality. Conclusions. In summary, chronic upper respiratory tract disease and parental smoking, particularly when both parents smoke, are significant clinical and anamnestic risk factors for severe acute bronchitis in preschoolers. Cough severity and wheezing on the BSS-ped scale contribute to its development. Hormonal indicators, especially reverse triiodothyronine, display notable impacts, with weaker associations observed for total triiodothyronine and cortisol. Immunological status indicators such as CD22+, CD4+, and CD8+ are also linked to severe acute bronchitis. Combinations of altered CD4+ and free triiodothyronine, CD3+ and free triiodothyronine, CD3+ and total triiodothyronine intensify the risk. When evaluating preschoolers with acute bronchitis, attention to clinical history (chronic upper respiratory disease, parental smoking, severe cough, and pulmonary rales) and specific laboratory parameters (concentration of triiodothyronine, cortisol, and serum levels of CD22+, CD4+, and CD8+) is advisable.

Можливості використання декаметоксину у пацієнтів з хронічними захворюваннями нижніх дихальних шляхів при гострих респіраторних вірусних інфекціях

The annual increase in the number of patients with chronic respiratory diseases and a significant increase in the level of antibiotic resistance in Ukraine and in the world has set modern scientists an extremely important task - the search for new effective ways of combating infectious agents of viral and bacterial exacerbations of pathologies of the tracheobronchial tree. The aim: to assess the efficacy and safety of decamethoxine in patients with exacerbations of chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB). Materials and methods: clinical symptoms were evaluated in 19 patients with COPD (group I) and 38 patients with COPD (group II) with signs of acute respiratory viral infection (ARVI) at three visits: the initial visit (at the time of the initial visit to the family doctor ), the second visit (on days 3-5 after the initial application) and the third visit (on days 7-10 after the initial application). Subgroups were divided depending on the prescribed anti-infective therapy: subgroups Ib and IIb received symptomatic therapy, and subgroups Ia and IIa additionally received decamethoxine. The results. One of the most frequent symptoms at the initial visit was cough for the patients of both groups. Decamethoxine contributed to a decrease in the frequency of cough on the 7-10th day of treatment by two times in subgroup Ia (p < 0.05) and by almost 5 times in subgroup IIa (p < 0.001). The dynamics of dyspnea in patients with COPD who did not receive additional therapy with decame thoxine was not variable during the entire study period. Patients with CB extremely rare had such a symptom as shortness of breath. In both subgroups of patients treated with decamethoxine, a certain tendency to an increase in cases of purulent sputum was observed only at visit 2, however, at the third visit, the number of such patients decreased and clearly coincided with the appointment of antibacterial drugs. Manifestations of the intoxication syndrome decreased over time in all subgroups, and at the third visit were less pronounced compared to the first two visits in most patients and practically did not depend on the additional intake of decamethoxine. There was no significant difference in the reduction of symptoms of nasopharyngoconjunctival syndrome. The conducted analysis of the frequency of hospitalization showed that only 1 patient from subgroups Ia and IIa continued treatment in hospital conditions at visit 3, and in patients with standard basic therapy by the time of visit 3, hospitalization was required for 2 patients of subgroup Ib and two from IIb. Conclusions. The inclusion of decamethoxin solution in the complex treatment of ARVI in patients with chronic diseases of the lower respiratory tract allows to reduce the duration of cough, shortness of breath, producing of purulent sputum, manifestations of nasopharyngeal syndrome by 1.5-3 times. Additional inhalation use of 0.02 % decamethoxine solution reduces the need to prescribe antibacterial drugs and the risk of hospitalization by 2.2 times among patients with COPD. Patients with CB who received inhalation nebulizer therapy with a sterile solution of decamethoxine used antibiotics 2.2 times less often, and none of them were hospitalized.

FEATURES OF THE COURSE OF CHRONIC RHINOSINUSITIS AGAINST THE BACKGROUND OF COVID-19

Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the upper respiratory tract with a wide range of clinical variants. As our understanding of the pathophysiology of the disease develops, so does our philosophy regarding the approach and treatment of CRS. Endotyping gains an advantage over phenotype-based classifications due to its potential to predict disease severity and provide accurate treatment. Endotyping is particularly useful in complex cases of CRS with a nasal polyp, for which new treatment options such as biologics are now available. The latest European position paper on rhinosinusitis and nasal polyps (EPOS2020) reflects these developments with updated rhinosinusitis classifications and new integrated care schemes.

The state of the oropharyngeal microbiome in patients with migraine

To determine a role of changes in the oropharyngeal microbiome in the development and clinical manifestations of migraine. Seventy patients with migraine, aged 21-56 years, and 15 healthy subjects matched for age and sex were examined using headache diary, MIDAS and VAS, the Gastrointestinal Symptom Rating Scale (GSRS), microbiological smear examination from the mucous membrane of the posterior wall of the oropharynx with evaluation by the method of mass spectrometry of microbial markers (MSMM) with determination of 57 microorganisms. The following changes in the oropharynx of individuals with migraine compared with the group of healthy individuals (control group) were found: a) a significant increase in the content of markers of resident (conditionally pathogenic) microorganisms characteristic of chronic diseases of the upper respiratory tract (strepto- and staphylococci); b) the appearance of markers of transient microorganisms normally absent, characteristic of the intestinal microflora (clostridia, gram-negative rods, enterobacteria, anaerobes); c) the appearance of viral markers of cytomegaloviruses, Herpes group, Epstein-Barr; d) a significant decrease in the content of bifidobacteria and lactobacilli). All people with migraine had a history or were found on examination to have chronic diseases of the upper respiratory tract (sinusitis in 48%, pharyngitis in 43%, tonsillitis in 25% of people), and gastrointestinal diseases. Dyspepsia was the most frequent and pronounced of the gastrointestinal syndromes on the GSRS in people with migraine (87%). This corresponds to the data on the extremely frequent occurrence of IBS (70% of patients) and other gastrointestinal pathology obtained from the patient history. In our work, the microbiota of the oropharynx in patients with migraine was studied for the first time using a new MSMM method. Disturbance of the oropharyngeal microbiome compared to the norm was detected in 100% of people with migraine. The changes characteristic of most patients included a significant decrease in the content of normal flora, an increase in the concentration of conditionally pathogenic microorganisms and the appearance of pathogenic microflora characteristic of chronic diseases of the upper respiratory tract and gastrointestinal tract, which may indicate their role in the pathogenesis of migraine.

Global Disease Burden and Attributable Risk Factor Analysis of Asthma in 204 Countries and Territories From 1990 to 2019.

Asthma is a common chronic inflammatory respiratory tract disease with high morbidity and mortality. The global trends in asthma burden remain poorly understood, and asthma incidence has increased during the worldwide coronavirus disease 2019 (COVID-19) pandemic. This study aimed to provide a comprehensive view of the global distribution of asthma burden and its attributable risk factors from 1990 to 2019. Based on the Global Burden of Disease Study 2019 Database, asthma incidence, deaths, disability-adjusted life years (DALYs), the corresponding age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), age-standardized DALY rate, and estimated annual percentage change were analyzed according to age, sex, sociodemographic index (SDI) quintiles, and locations. Risk factors contributing to asthma deaths and DALYs were also investigated. Globally, the asthma incidence increased by 15%, but deaths and DALYs decreased. The corresponding ASIR, ASDR, and age-standardized DALY rate also decreased. The high SDI region had the highest ASIR, and the low SDI region had the highest ASDR. The ASDR and age-standardized DALY rate were negatively correlated with the SDI. The low-middle SDI region, particularly South Asia, showed the highest asthma-related deaths and DALYs. The incidence peak was under 9 years old, and more than 70% of all deaths occurred in the population over 60 years old. Smoking, occupational asthmagens, and a high body mass index were the main risk factors for asthma-related mortality and DALYs, and their distributions varied between sexes. Globally, the asthma incidence has increased since 1990. The greatest asthma burden is borne by the low-middle SDI region. The 2 groups that need special attention are those under 9 years old and those over 60 years old. Targeted strategies are needed to reduce the asthma burden based on geographic and sex-age characteristics. Our findings also provide a platform for further investigation into the asthma burden in the era of COVID-19.

Cytodiagnosis of rhinoscleroma and its morphological clues: Our experience with four cases

Rhinoscleroma, a chronic progressive inflammatory disease of the upper respiratory tract, has a prolonged course and passes through three overlapping clinicopathologic stages. The histopathology findings are well illustrated in the literature; however, there is a paucity of reports explaining cytomorphological features of rhinoscleroma. It is the proliferative stage when disease presents as a nodular mass which can be targeted for cytological study. Here, the authors report fine-needle aspiration (FNA) cytology of four cases of rhinoscleroma who presented with intranasal firm, nodular lesions; its cytology revealed numerous, large, singly scattered histiocytes in a dense inflammatory background of lymphocytes, plasma cells, and few eosinophils. The microorganisms were visualized as intracytoplasmic loosely clustered, short rods within the histiocytes (Mikulicz cells) in May-Grunwald-Giemsa (MGG) smears. FNA sampling of rhinoscleroma in its nodular stage can yield classic cytomorphology with demonstration of organisms on air-dried smears which can further substantiate the cytodiagnosis. Thus, high index of suspicion and diligent search can aid in early and accurate diagnosed even on cytology with the help of conventional wet fixed Pap and air-dried MGG stain; both being complementary to each other and further can be supported with special stains such as periodic acid–Schiff stain or Gram whenever required.

An Evaluation of Health-Related Quality of Life in Children with Nasal Septum Deviation.

From the 1950s, the quality of life criterion came to be studied in earnest, originally forming a part of measurement of human development in Western Europe and the USA. The present study aims to compare the health-related quality of life (HRQL) between children with nasal septum deviation and healthy children controls. Subjects were children suffering from nasal septum deviation, one of the commonest chronic diseases of the upper respiratory tract. Controls were randomly recruited from kindergarten, primary and secondary schools (junior high school & high school). All schools and subjects were randomly selected. The CHQ-PF50 questionnaire was used and outcome scores were calculated by an algorithm for the 13 tested HRQL variables. Means for all outcome scores in the test subjects (i.e., children with deviated nasal septums) varied between 3.65-89.27 with a standard deviation between 0.83-25.66 and a median between 3.4-100 (n = 101). Those for the controls (n = 102) were 3.78-97.11, 0.86-14.21 and 4.40-100, respectively. Test subjects showed significant scoring declines in Physical Fitness, Role/Social-Emotional/Behavioral, Role/Social-Physical, Mental Health, Self-esteem, General Health Perceptions, Parental Impact Emotional and Time and Family Limitations in Activities. 1. The well-being of children with nasal septum deviation was found to be chiefly limited by their physical fitness, effects of physical condition on social behavior/interaction and how health is perceived. 2. Parents considered their children's health to be paramount, as demonstrated by assessing the HRQL.

Alveolar type 2 epithelial cell senescence and radiation-induced pulmonary fibrosis.

Radiation-induced pulmonary fibrosis (RIPF) is a chronic and progressive respiratory tract disease characterized by collagen deposition. The pathogenesis of RIPF is still unclear. Type 2 alveolar epithelial cells (AT2), the essential cells that maintain the structure and function of lung tissue, are crucial for developing pulmonary fibrosis. Recent studies indicate the critical role of AT2 cell senescence during the onset and progression of RIPF. In addition, clearance of senescent AT2 cells and treatment with senolytic drugs efficiently improve lung function and radiation-induced pulmonary fibrosis symptoms. These findings indicate that AT2 cell senescence has the potential to contribute significantly to the innovative treatment of fibrotic lung disorders. This review summarizes the current knowledge from basic and clinical research about the mechanism and functions of AT2 cell senescence in RIPF and points to the prospects for clinical treatment by targeting senescent AT2 cells.

The role of the palatine tonsils in the regulation of the state of humoral local immunity in patients with chronic inflammatory diseases of the nose and perinasal sinuses when infected with viruses of the respiratory group

Topicality: Acute respiratory diseases of the upper respiratory tract, which in the vast majority of cases are caused by viruses, especially with frequent recurrences of diseases, reduce local and system immunity, which often leads to the accumulation of bacterial infection due to the activation of endogenous microflora or exogenous infection and causes the development of viral-bacterial diseases. Recurrent respiratory diseases contribute to the formation of chronic pathology of the oro- and nasopharynx, which in turn supports the violation of the body's protective mechanisms. Previous studies have shown that the tonsils of the lymphadenoid pharyngeal ring perform the function of immunological protection, and the absence of palatine tonsils (PT) negatively affects the state of both local and system immunity. Aim: to determine the role of the palatine tonsils in the realization of local humoral reactions in patients with chronic inflammatory diseases of nose and paranasal sinuses when infected with viruses of the respiratory group. Materials and methods: Studies were conducted in 134 patients with chronic inflammatory diseases (CID) of nose and paranasal sinuses (PNS) in remission, among whom 93 had a diagnosis of chronic rhinosinusitis, 27 – chronic catarrhal rhinitis, 14 – allergic rhinitis with chronic bronchitis. The control group consisted of 47 practically healthy persons without pathology from the ENT organs. The examined persons were divided into those who had PT and those from whom they were surgically removed no earlier than five years ago. All examinees were divided into those who had anamnestic antibodies in their blood to one or more of the respiratory viruses, such as: adenovirus, respiratory syncytial virus and influenza A virus in a clinically significant titer, and those in whom antibodies were not detected. The local humoral immunity state of patients was assessed by the content of immune complexes (IC) and concentrations of secretory immunoglobulin A (sIgA), interferons alpha- (α-IFN) and gamma- (γ-IFN) in the oropharyngeal secretion (OS), which were determined by the immunoenzymatic method using sets of reagents for enzyme-linked immunosorbent assays ("Cytokin", RF) and the Stat Fax-2100 analyzer (USA). All examined patients had a healthy state of the oral cavity. Results: The presence or absence of palatine tonsils changes the levels of number of humoral factors of local immunity in oropharyngeal secretion in practically healthy donors and in patients with chronic inflammatory diseases of the nose and PNS. The production of sIgA and α-IFN in OS depends on PM, decreasing in practically healthy persons of the control group who underwent tonsillectomy. Chronic inflammatory diseases of the nose and PNS caused a decrease in the concentration of IC and α-IFN in the OS of patients of both groups- with or without PT. In patients with normal PMs who got sick with viral infections, in contrast to those with removed PMs, α-IFN level in OS increased and practically did not differ from those in healthy donors. The greatest suppression of α-IFN production was determined in patients with CID of the nose and PNS with removed PM and with the absence of clinically significant titers of antiviral antibodies. The level of γ-IFN production did not reliably change in the OS of patients with CID of nose and PNS in the remission phase both with normal PT and after tonsillectomy, but depended to a greater extent on the transferred infectious disease caused by viruses of the respiratory group. Conclusion: PTs play a significant role in the formation of a number of reactions of local immunity in the naso- and oropharynx, both in practically healthy individuals and in patients with chronic inflammatory disease of nose and paranasal sinuses. Therefore, the determination of local immunity indices in patients with chronic inflammatory diseases of the upper respiratory tract with different status of the palatine tonsils, who are in contact or had contact with respiratory viruses, provides an opportunity to identify the most vulnerable links in the system of their anti-infective protection, which should first of all be paid attention to during examination and treatment of patients with chronic inflammatory diseases of the upper respiratory tract, especially in cases of frequent recurrence of acute respiratory diseases.