Development Of Respiratory Diseases Research Articles

Rothia from the Human Nose Inhibit Moraxella catarrhalis Colonization with a Secreted Peptidoglycan Endopeptidase.

Moraxella catarrhalis is found almost exclusively within the human respiratory tract. This pathobiont is associated with ear infections and the development of respiratory illnesses, including allergies and asthma. Given the limited ecological distribution of M. catarrhalis, we hypothesized that we could leverage the nasal microbiomes of healthy children without M. catarrhalis to identify bacteria that may represent potential sources of therapeutics. Rothia was more abundant in the noses of healthy children compared to children with cold symptoms and M. catarrhalis. We cultured Rothia from nasal samples and determined that most isolates of Rothia dentocariosa and "Rothia similmucilaginosa" were able to fully inhibit the growth of M. catarrhalis in vitro, whereas isolates of Rothia aeria varied in their ability to inhibit M. catarrhalis. Using comparative genomics and proteomics, we identified a putative peptidoglycan hydrolase called secreted antigen A (SagA). This protein was present at higher relative abundance in the secreted proteomes of R. dentocariosa and R. similmucilaginosa than in those from non-inhibitory R. aeria, suggesting that it may be involved in M. catarrhalis inhibition. We produced SagA from R. similmucilaginosa in Escherichia coli and confirmed its ability to degrade M. catarrhalis peptidoglycan and inhibit its growth. We then demonstrated that R. aeria and R. similmucilaginosa reduced M. catarrhalis levels in an air-liquid interface culture model of the respiratory epithelium. Together, our results suggest that Rothia restricts M. catarrhalis colonization of the human respiratory tract in vivo. IMPORTANCE Moraxella catarrhalis is a pathobiont of the respiratory tract, responsible for ear infections in children and wheezing illnesses in children and adults with chronic respiratory diseases. Detection of M. catarrhalis during wheezing episodes in early life is associated with the development of persistent asthma. There are currently no effective vaccines for M. catarrhalis, and most clinical isolates are resistant to the commonly prescribed antibiotics amoxicillin and penicillin. Given the limited niche of M. catarrhalis, we hypothesized that other nasal bacteria have evolved mechanisms to compete against M. catarrhalis. We found that Rothia are associated with the nasal microbiomes of healthy children without Moraxella. Next, we demonstrated that Rothia inhibit M. catarrhalis in vitro and on airway cells. We identified an enzyme produced by Rothia called SagA that degrades M. catarrhalis peptidoglycan and inhibits its growth. We suggest that Rothia or SagA could be developed as highly specific therapeutics against M. catarrhalis.

Association between Air Pollution and Squamous Cell Lung Cancer in South-Eastern Poland.

Air pollution is closely associated with the development of respiratory illness. The aim of the present study was to assess the relationship between long-term exposure to PM2.5, PM10, NO2, and SO2 pollution and the incidence of lung cancer in the squamous subtype in south-eastern Poland from the years 2004 to 2014. We collected data of 4237 patients with squamous cell lung cancer and the level of selected pollutants. To investigate the relationship between the level of concentrations of pollutants and the place of residence of patients with lung cancer in the squamous subtype, proprietary pollution maps were applied to the places of residence of patients. To analyze the data, the risk ratio was used as well as a number of statistical methods, i.e., the pollution model, inverse distance weighted interpolation, PCA, and ordered response model. Cancer in women and in men seems to depend in particular on the simultaneous inhalation of NO2 and PM10 (variable NO2PM10) and of NO2 and SO2 (variable NO2 SO2), respectively. Nitrogen dioxide exercises a synergistic leading effect, which once composed with the other elements it becomes more persistent in explaining higher odds in the appearance of cancers and could constitute the main cause of squamous cancer.

Role of Diet, Lifestyle and Yoga in the Prevention and Management of Respiratory Illnesses in Children

Acute respiratory infection is the biggest cause for mortality among children aged less than 5 years, especially in developing countries. A community-based survey study showed that prevalence of respiratory infections was found to be 63.7% and 53.7% in urban and rural areas respectively. Respiratory infections account for 40% of child mortality globally. Burden of acute respiratory infection is increasing day by day due to the growing trend of modernization and urbanization. Overcrowding, repeated exposure to several allergens, poor nutrition are the other major etiological factors in the development of respiratory illness. After Corona virus 2019 (Covid-19) pandemic, the number of cases rose to millions and several countries across the globe were impacted severely.
 Ayurveda is a holistic science which aims at health protection, promotion and strengthening immunity to overcome diseased condition. Diet and lifestyle modification, Yogic methods like Asana, Pranayama and Neti improve respiratory health by cleansing airways, strengthening respiratory muscles, enhancing lung capacity and tissue oxygenation. Assessment of Prakriti, cause behind the illness, treating the existing morbidity, Rasayana prayoga, following necessary precautions and using certain home remedies at an early stage are important to maintain respiratory as well as overall health.
 This paper highlights preventive modalities in every level of health condition, both physical and mental, stressing especially on diet and lifestyle practices of a child.

COMPLICATED PLEURAL EFFUSION CAUSED BY PASTEURELLA MULTOCIDA IN A PATIENT WITH RHABDOMYOLOYSIS: A CASE REPORT

SESSION TITLE: Medical Student/Resident Pulmonary Manifestations of Systemic Disease Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Pasteurella multocida is present in the oral, nasopharyngeal and upper respiratory tract of cats, dogs, and other animals. This organism most commonly causes skin and soft tissue infections following animal bites and scratches; however, cases of respiratory illness have been reported. Here, we present an interesting case of P. multocida bacteremia and complicated pleural effusion discovered in a patient with rhabdomyolysis. CASE PRESENTATION: A 73-year-old female immunocompetent patient suffered a fall, spent two days on the ground, and was brought to the emergency department by EMS. There she was found to have rhabdomyolysis as well as bacteremia which grew Pasteurella multocida. Computed Tomography (CT) scans demonstrated loculated effusions in the bilateral lower lobes, initially more severe on the right side. The patient required a right-sided thoracentesis and left sided chest tube with administration of tPA-dornase and recovered with initiation of antimicrobial therapy. DISCUSSION: Pasteurella multocida is a gram-negative bacterium transmitted to humans by animal bite, though reports of transference through saliva alone have been reported. Our patient remembered being bitten by her cat when she initially fell, but a history of exposure cannot always be elicited. Indeed, many elderly patients cannot recall the events surrounding a fall but those exposed to secretions of pets through inhalation or bites can develop P. Multocida complications. In most immunocompetent persons, this bacteria causes cellulitis or localized wound infections. Our patient subsequently developed a complicated effusion. Pasteurella multocida infection of the respiratory tract is an unusual, but a known sequela of bacteremia among case reports. The development of pleural effusion secondary to P. multocida mostly occurred in the setting of chronic respiratory disease or immunocompromised state. We were unable to identify any reports of P.multocida pleural effusions occurring concurrently with or sequentially to rhabdomyolysis, as was seen in this patient. Rhabdomyolysis can develop after bacterial infections including legionella(1) and mycoplasma pneumonia(2), as well as after viral infections including influenza. However, rhabdomyolysis has not been directly linked as an inciting factor in the development of respiratory illness in humans. In rats, it was found that rhabdomyolysis induced ultrastructural impairment of the lung with Type II cell damage. This suggests that rhabdomyolysis can induce tissue injury associated with increased oxidative stress which can progress to acute lung injury.(3) CONCLUSIONS: In conclusion, we presented a case of complicated pleural effusion secondary to P. multocida infection in a patient with rhabdomyolysis. Obtaining patient history of animal contact is an important addition to fall questionnaires, as it may encourage the use of empiric treatment to cover for P.multocida. Reference #1: Sutarjono B, Alexis J, Sachidanandam JC. Legionella pneumonia complicated by rhabdomyolysis. BMJ Case Reports. 2019;12(6):10-12. doi:10.1136/bcr-2019-229243 Reference #2: Byrd RP, Roy TM. Rhabdomyolysis and bacterial pneumonia. Respiratory Medicine. 1998;92(2):359-362. doi:10.1016/S0954-6111(98)90123-8 Reference #3: Rodrigo R, Trujillo S, Bosco C. Biochemical and ultrastructural lung damage induced by rhabdomyolysis in the rat. Experimental Biology and Medicine. 2006;231(8):1430-1438. doi:10.1177/153537020623100817 DISCLOSURES: No relevant relationships by Katherine Polednik, source=Web Response No relevant relationships by Tejas Sangoi, source=Web Response No relevant relationships by Keniesha Thompson, source=Web Response

Air pollution, respiratory illness and behavioral adaptation: Evidence from South Korea.

Air pollution is closely associated with the development of respiratory illness. Behavioral adaptations of people to air pollution may influence its impact, yet this has not been investigated in the literature. Our hypothesis is that people experience and learn the underlying air quality to decide their adaptation, and they have a stronger incentive to behaviorally adapt to the air quality as it deteriorates. We tested our hypothesis on a sample of approximately 25,700 individuals from South Korea from 2002 to 2013 that contained information on daily doctor’s visits due to respiratory disease. We matched individuals to the mean of the past seven-day concentration of the particulate matter of size between 2.5 and 10 micrometers (PM10) in their county of residence. We examined whether people living in counties with greater air pollution suffer less from respiratory disease when the concentration increases. For the analysis, we separated counties into quintiles based on their mean seven-day PM10, and regressed the binary indicator of a daily doctor’s visit with a resulting diagnosis of respiratory disease on the seven-day PM10 concentration of the county of residence interacted with the quintile dummies. The key findings are that a 1-standard-deviation increase in the seven-day PM10 concentration in the two lowest quintiles is associated with an increase of 0.054 percentage points in the likelihood of a doctor’s visit with a resulting diagnosis of respiratory disease, which is about 40% larger than the effect in higher quintiles, and the size of 1-standard-deviation gradually increases from 0.037 percentage points in the third quintile to 0.040 percentage points in the fifth quintile. The smaller increase in the likelihood of respiratory disease in more polluted locations can be explained by the behavioral adaptation to the environment, but the effectiveness of the adaptation seems limited among the highly polluted locations.

Inflammatory markers predict episodes of wheezing during the first year of life in Bangladesh

BackgroundEnvironmental factors that influence wheezing in early childhood in the developing world are not well understood and may be useful in predicting respiratory outcomes. Therefore, our objective was to determine the factors that can predict wheezing. MethodsChildren from Dhaka, Bangladesh were recruited at birth and episodes of wheezing were measured alongside nutritional, immunological and socioeconomic factors over a one-year period. Poisson Regression with variable selection was utilized to determine what factors were associated with wheezing. ResultsElevated serum IL-10 (rate ratio (RR) = 1.51, 95% confidence interval (CI): 1.22–1.87), IL-1β (RR = 1.55, 95% CI: 1.26–1.93) C-reactive protein (CRP) (RR = 1.41, 95% CI: 1.03–1.93) in early life, and male gender (RR = 1.52, 95% CI: 1.27–1.82) predicted increased wheezing episodes. Conversely, increased fecal alpha-1-antitrypsin (RR = 0.87, 95% CI: 0.76–1.00) and family income (RR = 0.98, 95% CI: 0.97–0.99) were associated with a decreased number of episodes of wheezing. ConclusionsSystemic inflammation early in life, poverty, and male sex placed infants at risk of more episodes of wheezing during their first year of life. These results support the hypothesis that there is a link between inflammation in infancy and the development of respiratory illness later in life and provide specific biomarkers that can predict wheezing in a low-income country.

Associations between respiratory illnesses and secondhand smoke exposure in flight attendants: A cross-sectional analysis of the Flight Attendant Medical Research Institute Survey.

BackgroundSecondhand tobacco smoke (SHS) is associated with increased risk of respiratory illness, cancer, and cardiovascular disease. Prior to smoking bans on airlines in the late 1980s, flight attendants were exposed to a significant amount of SHS. In the present study, we examine associations between flight attendant SHS exposure and development of respiratory illnesses and cardiovascular disease.MethodsBetween December 2006 and October 2010, three hundred sixty-two flight attendants completed an online questionnaire with information regarding experience as a flight attendant, medical history, smoking history, and SHS exposure. Rates of illnesses in flight attendants were compared with an age and smoking history matched population sample from NHANES 2005-2006. Logistic regression analysis was used to examine the association of reported medical conditions and pre-ban years of exposure.ResultsCompared with the sample from NHANES 2005-2006, flight attendants had increased prevalence of chronic bronchitis (11.7% vs. 7.2%, p < 0.05), emphysema/COPD (3.2% vs. 0.9%, p < 0.03), and sinus problems (31.5% vs. 20.9%, p < 0.002), despite a lower prevalence of medical illnesses including high blood pressure, diabetes, high cholesterol, heart failure, cancer, and thyroid disease. Amongst flight attendants who reported never smoking over their lifetimes, there was not a significant association between years of service as a flight attendant in the pre-smoking ban era and illnesses. However, in this same group, there was a significantly increased risk of daily symptoms (vs. no symptoms) of nasal congestion, throat, or eye irritation per 10-year increase of years of service as a flight attendant prior to the smoking ban (OR 2.14, 95% CI 1.41 - 3.24).ConclusionsFlight attendants experience increased rates of respiratory illnesses compared to a population sample. The frequency of symptoms of nasal congestion, throat or eye irritation is associated with occupational SHS exposure in the pre-smoking ban era.

Role of interferon gamma in the pathogenesis of primary respiratory syncytial virus infection in BALB/c mice.

Immunologic mechanisms are thought to contribute to the pathogenesis of respiratory syncytial virus (RSV) bronchiolitis in humans. RSV-infected BALB/c mice exhibit tachypnea and signs of outflow obstruction, similar to symptoms in humans. Interferon gamma (IFNgamma) has been found to be the predominant cytokine produced in humans and mice with RSV infection. We therefore undertook this study to evaluate the role of IFNgamma in the development of respiratory illness in RSV-infected mice. BALB/c mice were infected with RSV, and lung function was assessed by plethysmography. Bronchoalveolar lavage (BAL) fluids were analyzed for the concentration of interferon gamma (IFNgamma) and the presence of inflammatory cells, and lung tissue sections were examined for histopathologic changes. The role of IFNgamma was further addressed in studies of IFNgamma knock-out mice (IFNgamma(-/-)) and of mice depleted of IFNgamma by in vivo administration of a neutralizing antibody. After infection, mice developed respiratory symptoms that were strongly associated with the number of inflammatory cells in BAL, as well as with the concentrations of IFN-gamma. Both IFN-gamma(-/-) mice and mice treated with anti-IFNgamma developed more extensive inflammation of the airways than control mice. However mice lacking IFNgamma exhibited less severe signs of airway obstruction. Together these data suggest a protective role of IFNgamma in RSV infection in terms of limiting viral replication and inflammatory responses but also a pathogenic role in causing airway obstruction.

Relative chronic effects of different occupational dusts on respiratory indices and health of workers in three Ethiopian factories

The respiratory effects of dusts in different sections of yarn, cement, and cigarette factories were studied in 211 nonsmoking male and female workers aged 21-57 years. The controls used were 211 healthy nonsmoking and nonexposed male and female subjects aged 20-57 years from the general population. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), FEV1/FVC ratio, forced expiratory flow (FEF200-1,200 ml), forced mid-expiratory flow (FMF25-75%) and peak expiratory flow rate (PEFR) were recorded in all subjects with and without respiratory symptoms. Taking exposures to all dusts of different concentrations together, it was found that the frequency of respiratory illness was greater among exposed workers (40.5% in males, 36% in females) than it was among controls (21.6% in males, 18% in females). In exposed subjects, the symptom prevalence was only 4.5% higher in males than in females. The mean lung function indices, including FEV1, FEV1%, FEF200-1,200 ml, FMF25-75%, and PEFR, in subjects exposed to all dusts in general decreased markedly, with dust concentration being more important than duration of exposure, and FMF being affected slightly more consistently. About 38.4% of the dust-exposed subjects developed corresponding respiratory illnesses including chronic cough (24.7%), chronic bronchitis (21.8%) and bronchial asthma (24.2%). The respective control values were 9.0%, 9.5%, and 8.5%. Exposure to different occupational dusts resulted in the development of respiratory illness with different rates of prevalence. The effects of exposure to cotton and cement dusts on respiratory health of exposed subjects were relatively more significant (p < 0.001) than that of exposure to tobacco dust (p < 0.05).

Detection, pathogenesis, and therapy of respiratory syncytial virus infections.

Respiratory syncytial virus (RSV) infection is a major cause of serious lower respiratory disease in infancy and early childhood. The unique pathogenesis of lower respiratory illness due to RSV offers some intriguing clues to the role of the human immune system in both protection against and development of respiratory illness. More than any other virus, rapid diagnostic techniques have been especially successful in identifying RSV infection. Many of these techniques could be easily adaptable to diagnosis of influenza virus infection and other agents. Finally, ribavirin therapy of RSV infection represents one of the few instances in which antiviral therapy has been shown to be effective for respiratory illnesses. Fundamental observations in these areas in the case of RSV infection open up new and exciting pathways for investigation of respiratory infection due to other viral, chlamydial, and mycoplasmal agents.