Healthy Non-smokers Research Articles

Study of serum Ykl-40 level and its relationship to BODE index in patients with chronic obstructive pulmonary disease

BackgroundChronic obstructive pulmonary disease (COPD) is a significant global health concern characterized by growing rates of mortality and morbidity. The purpose of this work was to evaluate the serum YKL-40 level and its relationship to body mass index (BMI), obstruction of airflow, dyspnea, exercise capacity (BODE) index, and the extent of COPD.MethodsThis prospective work was carried out on 70 adult male patients, allocated into three groups: group A—36 smokers with stable COPD with different degrees of severity; group B—19 smokers without COPD; and group C—15 healthy non-smokers as a control group.ResultsThe BODE index was 5.56 ± 2.52. Prebronchodilator forced expiratory volume in 1 s (FEV1) and FVC were substantially decreased in group A contrasted to group B and group C (P value < 0.001). Prebronchodilator forced expiratory volume in 1/forced vital capacity (FEV1/FVC) ratio was substantially decreased in group A contrasted to groups B and C and lower in group B than in group C (P value < 0.001).Chest X-ray (CXR) signs of COPD and mMRC Dyspnea Scale were significantly higher in group A than in groups B and C (P value < 0.001). The 6-min walking test was substantially decreased in group A than in groups B and C and lower in group B than in group C (P value < 0.001 and 0.006 correspondingly). Serum YKL-40 was substantially greater in group A contrasted to group C (P value = 0.005). There was no correlation between serum YKL-40 and (BODE index, O2 saturation, or smoking index) in group A. A substantial positive association existed among serum YKL-40 and [degree of severity and white blood cells (WBCs)] in group A. Serum YKL-40 cannot predict the severity of COPD (P = 0.227 and AUC = 0.584) at cut-off > 0.394 with 80.65% sensitivity, 41.03% specificity, 52.1% PPV, and 72.7% NPV.ConclusionsSerum YKL-40 level was substantially greater in the COPD group contrasted to healthy non-smokers, no substantial association existed between serumYKL-40 and BODE index, O2 saturation, or smoking index. A substantial positive association existed between SerumYKL-40 and the degree of severity and WBCs.

Sputum metagenomics of people with bronchiectasis.

The microbiota in the sputum of people with bronchiectasis has repeatedly been investigated in cohorts of different geographic origin, but so far has not been studied to the species level in comparison to control populations including healthy adults and smokers without lung disease. The microbial metagenome from sputa of 101 European Bronchiectasis Registry (EMBARC) study participants was examined by using whole-genome shotgun sequencing. Our analysis of the metagenome of people with bronchiectasis revealed four clusters characterised by a predominance of Haemophilus influenzae, Pseudomonas aeruginosa or polymicrobial communities with varying compositions of nonpathogenic commensals and opportunistic pathogens. The metagenomes of the severely affected patients showed individual profiles characterised by low alpha diversity. Importantly, nearly 50% of patients with severe disease were grouped in a cluster characterised by commensals. Comparisons with the sputum metagenomes of healthy smokers and healthy nonsmokers revealed a gradient of depletion of taxa in bronchiectasis, most often Neisseria subflava, Fusobacterium periodonticum and Eubacterium sulci. The gradient of depletion of commensal taxa found in healthy airways is a key feature of bronchiectasis associated with disease severity.

Investigating the diagnostic potential of IL-1β, IL-10, and IL-36γ in gingival crevicular fluid in patients with different periodontal conditions

Background The study aimed to analyze cytokine levels, including interleukin (IL)-1β, IL-10, and IL-36γ, to investigate the link between pro- and anti-inflammatory responses in periodontal conditions and assess their potential as diagnostic biomarkers for distinguishing between different types of periodontal conditions. Methods 80 systemically healthy non-smokers (25 periodontally healthy, 25 with gingivitis, 30 with periodontitis) were included. Clinical periodontal parameters were recorded, and gingival crevicular fluid (GCF) samples were obtained. Receiver operating characteristic (ROC) curve analysis was applied to determine the diagnostic value of cytokines. Results IL-36γ had the highest sensitivity for diagnosing periodontitis, although its specificity for identifying those without periodontitis was relatively low. The combination of IL-1β and IL-36γ was the most effective in differentiating periodontitis from periodontal health. IL-10 was found to be an acceptable discriminator for distinguishing gingivitis from healthy conditions. However, its sensitivity and specificity for identifying gingivitis were lower. The combination of the three cytokines showed the highest ability to distinguish between periodontitis and gingivitis. Conclusion The levels of IL-1β, IL-10, and IL-36γ in GCF may provide insights into periodontal health and disease status. Further studies are needed to validate these results and explore the potential of these cytokines in periodontal disease management.

Modification of sensitive pyridine-pyrazolone method for determination of blood cyanide and its possible applications in fatal aircraft accidents

BackgroundFatal aviation accidents are a critical concern for armed forces, necessitating precise toxicological analysis of postmortem blood samples. This paper introduces a novel spectrophotometric method for quantifying cyanide in blood samples with an aim to aid in aircraft accident reconstruction in the future. MethodsBlood samples were collected from healthy non-smokers aged 20–45 years, excluding individuals with hepatic impairment, or those using drugs affecting blood cyanide levels. The spectrophotometric method involved cyanide adsorption in a sodium hydroxide solution using microdiffusion discs and chemical reactions resulting in a pinkish-purple end product. The optimal absorption wavelength (λmax) was determined, and the lower limits of detection and quantitation were established. The method underwent validation for precision, sensitivity, specificity, linearity, and accuracy. ResultsThe procedure yielded a pinkish-purple compound with an optimal absorption wavelength (λmax) of 531 nm. The established limits of detection (LoD) and quantitation (LoQ) were 0.0625 μg/ml and 0.125 μg/ml, respectively. The method demonstrated strong linearity up to cyanide concentrations of 4 μg/ml. It exhibited a sensitivity of 99.7% and accuracy of 85.92%. The intraday and inter-day precision were determined as 9.04% and 4.27%, respectively. The method was highly specific, showing no interference with blanks at the peak wavelength with a working range of 0.125–4 μg/ml. ConclusionThe study describes developing and validating a sensitive method for quantitatively estimating cyanide in blood samples. Incorporating this method into the existing postmortem toxicological sample collection and investigation protocol will enhance the analysis capabilities and improve aircraft accident investigation outcomes within the country.

Methylation of the Oxytocin, Oxytocin Receptor, and Vasopressin Gene Promoters in Tobacco Use Disorder during Cessation

Introduction: Vasopressin (AVP) and oxytocin (OT) exert sex-specific effects on social pair bonding and stress reactions while also influencing craving in substance use disorders. In this regard, intranasal oxytocin (OT) and AVP antagonists present potential treatments for tobacco use disorder (TUD). Since transcription of both hormones is also regulated by gene methylation, we hypothesized sex-specific changes in methylation levels of the AVP, OT, and OT receptor (OXTR) gene during nicotine withdrawal. Methods: The study population consisted of 49 smokers (29 males, 20 females) and 51 healthy non-smokers (25 males, 26 females). Blood was drawn at day 1, day 7, and day 14 of smoking cessation. Craving was assessed with the questionnaire on smoking urges (QSU). Results: Throughout cessation, mean methylation of the OT promoter gene increased in males and decreased in females. OXTR receptor methylation decreased in females, while in males it was significantly lower at day 7. Regarding the AVP promoter, mean methylation increased in males while there were no changes in females. Using mixed linear modeling, CpG position, time point, sex, and the interaction of time point and sex as well as time point, sex, and QSU had a significant fixed effect on OT and AVP gene methylation. The interaction effect suggests that sex, time point, and QSU are interrelated, meaning that, depending on the sex, methylation could be different at different time points and vice versa. There was no significant effect of QSU on mean OXTR methylation. Discussion: We identified differences at specific CpGs between controls and smokers in OT and AVP and in overall methylation of the AVP gene. Furthermore, we found sex-specific changes in mean methylation levels of the mentioned genes throughout smoking cessation, underlining the relevance of sex in the OT and vasopressin system. This is the first study on epigenetic regulation of the OT promoter in TUD. Our results have implications for research on the utility of the AVP and OT system for treating substance craving. Future studies on both targets need to analyze their effect in the context of sex, social factors, and gene regulation.

Relationship between tobacco smoking and hematological indices among Sudanese smokers

BackgroundTobacco Smoking is one of the leading causes of preventable morbidity and mortality in the world. It is well documented that tobacco smoking is risk factor for many diseases like: cancers, chronic respiratory and cardiovascular diseases, and the effects of tobacco smoking on hematological indices gets a little attention: the data is mostly inconsistent regarding the differential of WBCs, a conflicting studies described the effect of smoking on hemoglobin descriptive parameters and a regular monitoring of platelets count in smokers was advised.ObjectivesThe study aimed to evaluate the relationship between tobacco smoking and hematological parameters among Sudanese healthy Smokers at Bahri Town.MethodsThis was a cross sectional study conducted during 2022 in Bahri town, Khartoum state. A total of 120 male subjects participated in this study. Of them, 60 healthy non-smokers participants (Control), and 60 age matched smokers who were smoking tobacco for a minimum of 1 year. Smokers group was divided into three major sub-groups with each group contains 20 subjects: Cigarettes smokers (CS), Water pipes (Shisha) smokers (WP) and both Cigarettes and water pipes (shisha) smokers (CSWP). Data was collected through questionnaire interviews and laboratory investigation. A sample of Five ml venous blood was taken for Complete blood count testing using Urite 3000 plus semi-automated hematology analyzer. Data were analyzed using SPSS version 25. Assocation between the variables were estimated and p value ≤ 0.05 was considered statistically significant.ResultsSmokers had significantly higher RBCs count (p = 0.017), Hb level (p < 0.001), WBCs count (p = .017), Neutrophils (p < 0.001), MCH (p = 0.029), MCHC (p < 0.001), RDW (p < 0.001), and PDW (p < 0.001) compared to the non-smokers. In contrast, non-smokers had higher MPV (p < 0.001) and MCV (p < 0.001) levels than smokers. Between the non-smokers and different subtypes of the smokers (CS, WP & CSWP), there were significant differences between the subgroups for all hematological parameters except for PLTs and lymphocytes count. CS had lower levels of MCV (p < 0.001), MCHC (p < 0.001), HCT (p = 0.036), and RDW (p < 0.001) compared to the non-smokers, while both cigarette and shisha smokers had the higher levels of neutrophils count (p < 0.001) and PDW (p < 0.001) compared to the non-smokers.ConclusionSmoking affects hematological parameters; smokers had significantly higher RBCs count, Hb level, WBCs count, Neutrophils, MCH, MCHC, RDW and PDW compared to the non-smoker group. WP smoking caused higher levels of RBCs, Hb, neutrophils, MCH and MCHC. PDW was high in smokers’ sub-groups compared to control group, while MPV was lower despite insignificant change In PLTs count.

Evaluation of Periodontal Status and Serum C-Reactive Protein Levels in Adult Cigarette Smokers

Background: This study aimed to evaluate the periodontal status of adult smokers and assess their serum C-reactive protein (CRP) levels, hypothesizing an association between periodontal inflammation, smoking, and elevated serum CRP, a marker for cardiovascular diseases. The primary objective is to contribute to the assessment and prevention of potential cardiovascular diseases in adult smokers. Methods: This cross-sectional study was conducted at HIT Hospital and Dental Hospital HITEC-IMS Taxila Cantt over five months from October 20, 2021, to March 31, 2022, the study included 60 healthy male adult smokers and 20 healthy male non-smokers as a control. Basic periodontal examination involved the use of a periodontal probe, assessing parameters such as gingival index, bleeding on probing, oral pigmentation, presence of periodontal pockets, and gingival recession. Blood samples were collected to evaluate serum CRP levels. Results: Smokers exhibited higher rates of gingival recession (38.3%), gingival pigmentation (43.3%), and periodontal pocket formation (33.3%) compared to the nonsmokers control group, with significant p-values of 0.040 in gingival recession and 0.035 in the presence of periodontal pockets. Serum CRP levels were significantly elevated in adult smokers, with a significant p-value of 0.024. Conclusion: The study concluded that adult smokers show signs of periodontitis, and their serum CRP levels are elevated. Assessing periodontal status and serum CRP in adult smokers may aid in risk assessment and reducing the likelihood of developing future cardiovascular diseases.

Eye Washing Downregulated Angiotensin-Converting Enzyme 2 in Conjunctival Tissue Samples from Smokers.

This study aimed to (1) determine whether the expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 is increased in tobacco smokers, which potentially increases their susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and (2) assess whether eye rinsing can reduce susceptibility. This prospective study included 20 eyes of 10 smokers and 18 eyes of nine healthy non-smokers (control) for reverse-transcription polymerase chain reaction. This study also included 28 eyes of 14 smokers and 16 eyes of eight healthy non-smokers (control) for enzyme-linked immunosorbent assay. Tear and impression cytology samples were collected from the right eye of each patient. The left eye was then rinsed for 30 s, and after 5 min, the tear and impression cytology samples were collected in the same manner. The expression of the ACE2 gene was significantly higher in the conjunctiva of smokers (n = 17; median 3.07 copies/ng of total RNA) than in those of non-smokers (n = 17; median 1.92 copies/ng of total RNA, p = 0.003). Further, mRNA expression and protein levels of ACE2 were weakly correlated in smokers (r = 0.49). ACE2 protein levels in Schirmer's strip samples were significantly reduced from 5051 to 3202 pg/mL after eye washing (n = 10; p = 0.001). Ocular surface cells are susceptible to SARS-CoV-2 infection. Smoking may be a risk factor for SARS-CoV-2 infection, and eye rinsing may reduce the risk of infection.

Concentration-dependent alterations in the human plasma proteome following controlled exposure to diesel exhaust

Traffic-related air pollution (TRAP) exposure is associated with systemic health effects, which can be studied using blood-based markers. Although we have previously shown that high TRAP concentrations alter the plasma proteome, the concentration-response relationship between blood proteins and TRAP is unexplored in controlled human exposure studies. We aimed to identify concentration-dependent plasma markers of diesel exhaust (DE), a model of TRAP. Fifteen healthy non-smokers were enrolled into a double-blinded, crossover study where they were exposed to filtered air (FA) and DE at 20, 50 and 150 μg/m3 PM2.5 for 4h, separated by ≥ 4-week washouts. We collected blood at 24h post-exposure and used label-free mass spectrometry to quantify proteins in plasma. Proteins exhibiting a concentration-response, as determined by linear mixed effects models (LMEMs), were assessed for pathway enrichment using WebGestalt. Top candidates, identified by sparse partial least squares discriminant analysis and LMEMs, were confirmed using enzyme-linked immunoassays. Thereafter, we assessed correlations between proteins that showed a DE concentration-response and acute inflammatory endpoints, forced expiratory volume in 1 s (FEV1) and methacholine provocation concentration causing a 20% drop in FEV1 (PC20). DE exposure was associated with concentration-dependent alterations in 45 proteins, which were enriched in complement pathways. Of the 9 proteins selected for confirmatory immunoassays, based on complementary bioinformatic approaches to narrow targets and availability of high-quality assays, complement factor I (CFI) exhibited a significant concentration-dependent decrease (−0.02 μg/mL per μg/m3 of PM2.5, p = 0.04). Comparing to FA at discrete concentrations, CFI trended downward at 50 (−2.14 ± 1.18, p = 0.08) and significantly decreased at 150 μg/m3 PM2.5 (−2.93 ± 1.18, p = 0.02). CFI levels were correlated with FEV1, PC20 and nasal interleukin (IL)-6 and IL-1β. This study details concentration-dependent alterations in the plasma proteome following DE exposure at concentrations relevant to occupational and community settings. CFI shows a robust concentration-response and association with established measures of airway function and inflammation.

β-escin activates ALDH and prevents cigarette smoke-induced cell death

BackgroundThe tobacco use is one of the biggest public health threats worldwide. Cigarette smoke contains over 7000 chemicals among other aldehydes, regarded as priority toxicants. β-escin (a mixture of triterpenoid saponins extracted from the Aesculus hippocastanum. L) is a potent activator of aldehyde dehydrogenase (ALDH) – an enzyme catalyzing oxidation of aldehydes to non-toxic carboxylic acids. PurposeThe aim of this study was to evaluate the effect of β-escin on ALDH activity, ALDH isoforms mRNA expression and cytotoxicity in nasal epithelial cells exposed to cigarette smoke extract (CSE). MethodsNasal epithelial cells from healthy non-smokers were treated with β-escin (1 µM) and exposed to 5% CSE. After 6- or 24-hours of stimulation cell viability, DNA damage, ALDH activity and mRNA expression of ALDH isoforms were examined. Results24 h β-escin stimulation revised CSE induced cytotoxicity and DNA damage. Cells cultured with β-escin or exposed to CSE responded with strong increase in ALDH activity. This effect was more pronounced in cultures treated with combination of β-escin and CSE. The strongest stimulatory effect on ALDH isoform mRNA expression was observed in cells cultured simultaneously with β-escin and CSE: at 6 h for ALDH1A1 and ALDH3A1, and at 24 h for ALDH1A3, ALDH3A2, ALDH3B1, and ALDH18A1. Combined β-escin and CSE treatment prevented the CSE-induced inhibition of ALDH2 expression at 24 h. Conclusionsβ-escin is an effective ALDH stimulatory and cytoprotective agent and might be useful in the prevention or supportive treatment of tobacco smoke-related diseases.

Dose-response association of smoking with delayed healing of apical periodontitis after endodontic treatment.

A prospective cohort study aimed to assess the inhibitory effect of cigarette smoking on the rate of periapical bone healing after root canal treatment (RCT). Examination included both clinical and radiographic parameters to define healing status at baseline, 6 months, and 1 year after RCT. To examine and compare the healing rate of apical periodontitis (AP) after RCT between smokers and nonsmokers, and to evaluate how the intensity and duration of smoking affect AP healing up to 1-year follow-up. Study hypothesis was that smoking habits could delay or deteriorate AP healing. The study protocol was approved by the local ethics committee and all of the participants signed a consent form. Included were adult patients with a radiographically confirmed AP in a single tooth with a favorable periodontal prognosis and adequate coronal restoration, with no previous RCT. Excluded patients were those diagnosed with a systemic disease or on medications affecting bone metabolism, former and occasional smokers, pregnant patients, and those who refused to participate. Smokers were defined as those who consumed at least 100 cigarettes in their lifetime and currently smoke. Smoking intensity was classified according to cigarette consumption per day (CPD) into: heavy smoking (≥20 CPD) and mild smoking (˂20 CPD). Tobacco exposure over time was assessed by smoking index (=CPD ˟ duration of tobacco smoking in years) and categorized into: nonsmoker, <400, 400-799, and ≥800. The control group included healthy nonsmokers and matched the smoker group in termsof age and gender. All RCTs were performed by endodontic specialists following a standardized protocol. Clinical examination involved percussion and palpation tests, periodontal probing and examination of the coronal restoration; while the periapical healing was radiographically assessed using the periapical index (PAI) scoring. A total of 110 patients (55 smokers and 55 nonsmokers) were included. The two groups were comparable regarding age, gender, tooth type, socioeconomics, and periapical index scores at the baseline. The mean CPD among smokers was 12.22, and most of them were "mild smokers". At 12-month follow-up, nonsmokers showed a significantly higher healing rate compared to smokers (90.9% vs. 58.2%; χ2 = 13.846; p < 0.001). Conversely, smokers had significantly higher PAI when compared to the control group (p = 0.024). Regression analysis demonstrated that the risk of AP persistence increases with an increase in the smoking index [OR = 7.66; 95% CI: 2.51-23.28; p < 0.001, for smoking index <400 and (OR = 9.65; 95% CI: 1.45-64.14; p = 0.019, for smoking index 400-799]. Smoking was significantly associated with delayed AP healing after RCT. The likelihood of AP persistence rises as smoking exposure increases. These results could impact clinical decisions and guidelines concerning smokers.

Reference equations using segmented regressions for impulse oscillometry in healthy subjects aged 2.7-90 years.

Published reference equations for impulse oscillometry (IOS) usually encompass a specific age group but not the entire lifespan. This may lead to discordant predicted values when two or more non-coincident equations can be applied to the same person, or when a person moves from one equation to the next non-convergent equation as he or she gets older. Thus, our aim was to provide a single reference equation for each IOS variable that could be applied from infancy to old age. This was an ambispective cross-sectional study in healthy nonsmokers, most of whom lived in Mexico City, who underwent IOS according to international standards. A multivariate piecewise linear regression, also known as segmented regression, was used to obtain reference equations for each IOS variable. In a population of 830 subjects (54.0% female) aged 2.7 to 90 years (54.8% children ≤12 years), segmented regression estimated two breakpoints for age in almost all IOS variables, except for R5-R20 in which only one breakpoint was detected. With this approach, multivariate regressions including sex, age, height and body mass index as independent variables were constructed, and coefficients for calculating predicted value, lower and upper limits of normal, percentage of predicted and z-score were obtained. Our study provides IOS reference equations that include the major determinants of lung function, i.e. sex, age, height and body mass index, that can be easily implemented for subjects of almost any age.

Mixed-Thickness Tunnel Access (MiTT) through a Linear Vertical Mucosal Incision for a Minimally Invasive Approach for Root Coverage Procedures in Anterior and Posterior Sites: Technical Description and Case Series with 1-Year Follow-Up.

The goal of this article was to introduce a new root coverage (RC) technique, the mixed-thickness tunnel access (MiTT) technique, which approaches a full-split design and intends to augment soft tissues coronal to the gingival margin. It was shown step-by-step, and the results were presented in a case series. Healthy individuals (non-diabetics) and non-smokers with gingival recession (GR) type 1 or 2 (RT1 or RT2) were included. After evaluation, prophylaxis was performed 14 days before the surgical procedure. During the surgical appointment, one or two vertical incision(s) on the mucosa (around 1-2 mm apical to the MGJ), lateral to the papilla base, was/were performed after anesthesia. Initially, there was a partial incision to detach the mucosa of the muscles (split design). It was permitted (but not mandatory) to perform intrasulcular incisions. Through the vertical incision, internally, subperiosteal access from the MGJ toward the gingival margin (coronally) was performed to create a full-thickness tunnel. Then, communication from the vertical incision with the gingival sulcus and the papilla base occurred, keeping the papilla tip intact. A connective tissue graft was harvested and inserted through the linear incision or intrasulcularly. There were interrupted sutures. An adjunctive material may be applied (e.g., Endogain). The root coverage was measured using a periodontal probe and considered fully covered when the gingival margin was 1 mm coronal to the cementum-enamel junction (CEJ). Nine healthy individuals (seven females and two males) aged 19 and 43 were enrolled. They were treated following the MiTT steps. Four cases had a single GR; two patients had two teeth involved; and three others had three or four GR. There were seven cases of RT1 and two RT2. All RT1 cases achieved 100% RC, while the mean RC obtained for RT2 was around 80%. The MiTT technique can be considered a more straightforward approach for minimally invasive surgical techniques, which is a feasible option to treat RC with a high success rate, predictability, and esthetic preservation. Therefore, there is a technical sensitivity to performing the full-split design procedure.

Comparison of salivary MicroRNA-6734, microRNA-3123 and microRNA-4483 expression in smoker and nonsmoker patients: a case control study.

Tobacco is a major risk factor in oral diseases. Considering the important role of expression miRNA molecules in different diseases, the present study aimed to compare the expression of salivary miRNA-6734, miRNA-3123 and miRNA-4483 in smoker and non-smoker peoples. In this case-control study, salivary samples were obtained from 30 smoker's patients and 27 healthy nonsmokers and matched in term of age and sex. RNA was extracted in salivary samples and gene expression was evaluated in all samples. Statistical analysis of data was performed using T and chi-square tests by SPSS (Ver. 16) software at a significant level of less than 0.05. The results of this study showed that the expression level of miRNA-3123 and miRNA-4483 in smokers group was 2.8 and 3.2, respectively, which was increased compared to non-smokers with expression level of 1 (P<0.01). There was a significant decrease in the expression rate of miRNA-6734 in smokers (0.6%) compared to non-smokers (P<0.05). Based on the results of this study, considering the increasing miRNA-4483 and miRNA-3123 level, as well as the reducing miRNA-6734 level in smokers compared to non-smokers, it seems that evaluation of these two miRNAs as indicator for diagnosis and determination of prognosis of oral diseases associated with smoking can be used.

Serum Klotho Level and its Related Factors Among Male Opioids Addicts With Normal Renal Function Compared to Healthy Male Non-smokers and Smokers in Tabriz, Iran

Background: Klotho is an aging-suppressor gene that encodes a single-pass transmembrane protein and acts as a hormone. In this study, we aim to investigate the serum α-Klotho level in male opioids addicts with normal kidney function compared to healthy male non-smokers and smokers in Tabriz, Iran. Methods: Participnts were 87 men with normal kidney function referred to Sina Educational Research and Treatment Center in Tabriz, Iran (29 opioids addicts, 29 healthy non-smokers, and 29 healthy smokers). Blood samples were collected to measure the soluble a-Klotho level using an ELISA kit. Furthermore, blood creatinine (Cr) and hemoglobin (Hb) levels was measured. Body mass index (BMI) was also calculated for all participants. Results: In addicts, BMI, Hb, and Cr levels were significantly lower than in healthy non-smokers and smokers, but their Klotho level was higher (P&gt;0.05). The Klotho level in healthy smokers was significantly lower than in healthy non-smokers and addicts. The Klotho level of healthy smokers decreased as the pack year increased, but the duration of opioid addiction had no significant association with the Klotho level. There was no significant difference in the Klotho level between control groups (non-smokers and smokers) and men with addiction to different types of opioids. Conclusion: The Klotho level in male opioid addicts is significantly higher than in smokers. There is a significant negative correlation between BMI and Klotho levels among men with normal BMI and overweight. Further studies are recommended in these fields.

Estimating the salivary levels of IL-35 in smokers with periodontitis: A cross sectional study

BackgroundA refined network and integrated host immune response to bacteria are formed by anti-inflammatory cytokines and the cells that they are associated to IL-35 has been recognized as having strong suppressive activity in chronic inflammatory diseases, together with IL-10 and TGF-β. It is believed that inflammatory diseases like periodontitis trigger the inducible Treg population to express IL-35, expanding regulatory responses by increasing infection. AimThe objective is to estimate and compare the salivary IL-35 levels in Periodontally healthy subjects, smokers and non-smokers with Periodontitis in order to educate on the consequences of periodontal health among the diseased patients. Materials and MethodsTotally 42 subjects were included and they were categorized into Group 1 (n = 14) as Periodontally healthy subjects, Group 2 (n = 14) as systemically healthy non-Smokers with periodontitis and Group 3 (n = 14) as systemically healthy smokers with periodontitis. Each subject was assessed for clinical parameters such as Plaque index, Gingival index, Probing depth, clinical attachment. A polypropylene tube was used to collect unstimulated saliva and centrifuged it at 800 × g for 10 min. Supernatants were collected and stored at −80◦C. A commercially available enzyme-linked immunosorbent assay kit was used to analyse levels of human salivary IL-35. ResultsThe average age of the subjects in Group 1, Group 2 and Group 3 were 50.53, 52.93 and 52.07 years respectively. All three groups showed a statistically significant difference in clinical parameters including Plaque index, Gingival index, Probing depth and clinical attachment. The salivary IL-35 level was found to be elevated in non-smokers who have periodontitis compared to smokers with periodontitis and healthy individuals. Despite this, the salivary IL-35 levels were found to be statistically significant among three groups at P < 0.001. ConclusionThe salivary levels of IL-35 were found to increase in Periodontitis patients with/without smoking, along with increased clinical parameters. IL-35 is considered a influential biomarker for periodontal disease.

Sputum Neutrophil Gelatinase-Associated Lipocalin as a Biomarker in Asthma-COPD Overlap.

Asthma COPD overlap (ACO) is a consensus-based phenotype having characteristics of both COPD and asthma. Distinguishing ACO from other diseases is even more important as it is related to low health-related quality of life, augmented exacerbation rate and hospital admission, a rapid deterioration in lung function, and increased morbidity and mortality. But it cannot be diagnosed explicitly based on spirometry tests, patient demographics, radiology, or by-sputum cytology. There is an unmet need to develop biomarkers. To assess the role of sputum neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker of ACO. To find the correlation between sputum NGAL levels with forced expiratory volume 1 (FEV1) and exacerbation rate in ACO. To find the correlation between sputum NGAL level with sputum neutrophils and eosinophils in ACO. In this comparative correlational study, 180 subjects were enrolled into four groups with 45 patients each with asthma, COPD, ACO, and healthy nonsmokers respectively, respectively. After taking detailed history and demographics, sputum was analyzed for the differential count and NGAL. Asthma COPD overlap (ACO) cases had high sputum NGAL levels; the second was the COPD group, and the last in the case asthma group. Nonsmokers had notably lower readings than the diseased. Out of three, receiver operating characteristic (ROC) figures, the validity of NGAL was best in selecting patients of ACO than COPD and asthma. The area under curve (AUC) was highest for ACO and less than the acceptable limit for the remaining two. NGAL cut-off value of 2473 pg/mL had 80% sensitivity and 50% specificity for ACO. The present study investigated the sputum NGAL levels as a biomarker in ACO identified by the syndromic approach. Sputum NGAL, a biomarker associated with airway inflammation in airway diseases, was supportive of clinically differentiating ACO from asthma to COPD. How to cite this article: Babu A, Narayanswamy H, Baburao A. Sputum Neutrophil Gelatinase-Associated Lipocalin as a Biomarker in Asthma-COPD Overlap. J Assoc Physicians India 2023;71(9):34-38.

Chronic Electronic Cigarette Use and Atherosclerosis Risk in Young People: A Cross-Sectional Study-Brief Report.

Little is known whether electronic cigarettes (ECIG) increase vulnerability to future atherosclerotic cardiovascular disease. We determined, using an ex vivo mechanistic atherogenesis assay, whether proatherogenic changes including monocyte transendothelial migration and monocyte-derived foam cell formation are increased in people who use ECIGs. In a cross-sectional single-center study using plasma and peripheral blood mononuclear cells from healthy participants who are nonsmokers or with exclusive use of ECIGs or tobacco cigarettes (TCIGs), autologous peripheral blood mononuclear cells with patient plasma and pooled peripheral blood mononuclear cells from healthy nonsmokers with patient plasma were utilized to dissect patient-specific ex vivo proatherogenic circulating factors present in plasma and cellular factors present in monocytes. Our main outcomes were monocyte transendothelial migration (% of blood monocyte cells that undergo transendothelial migration through a collagen gel) and monocyte-derived foam cell formation as determined by flow cytometry and the median fluorescence intensity of the lipid-staining fluorochrome BODIPY in monocytes of participants in the setting of an ex vivo model of atherogenesis. Study participants (N=60) had median age of 24.0 years (interquartile range [IQR], 22.0-25.0 years), and 31 were females. Monocyte transendothelial migration was increased in people who exclusively used TCIGs (n=18; median [IQR], 2.30 [ 1.29-2.82]; P<0.001) and in people who exclusively used ECIGs (n=21; median [IQR], 1.42 [ 0.96-1.91]; P<0.01) compared with nonsmoking controls (n=21; median [IQR], 1.05 [0.66-1.24]). Monocyte-derived foam cell formation was increased in people who exclusively used TCIGs (median [IQR], 2.01 [ 1.59-2.49]; P<0.001) and in people who exclusively used ECIGs (median [IQR], 1.54 [ 1.10-1.86]; P<0.001) compared with nonsmoker controls (median [IQR], 0.97 [0.86-1.22]). Both monocyte transendothelial migration and monocyte-derived foam cell formation were higher in TCIG smokers compared with ECIG users and in ECIG users who were former smokers versus ECIG users who were never smokers (P<0.05 for all comparisons). The finding of alterations in proatherogenic properties of blood monocytes and plasma in TCIG smokers compared with nonsmokers validates this assay as a strong ex vivo mechanistic tool with which to measure proatherogenic changes in people who use ECIGs. Similar yet significantly less severe alterations in proatherogenic properties of monocytes and plasma were detected in the blood from ECIG users. Future studies are necessary to determine whether these findings are attributable to a residual effect of prior smoking or are a direct effect of current ECIG use.

Cigarette Smoking Contributes to Th1/Th2 Cell Dysfunction via the Cytokine Milieu in Chronic Obstructive Pulmonary Disease.

Dysregulation and pyroptosis of T-helper (Th) cells and inflammatory cytokines have been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, the immune response mechanisms as a consequence of tobacco smoke exposure are not fully understood. We hypothesized that cigarette smoke-induced inflammation could be modulated through the cytokine milieu and T-cell nicotinic acetylcholine receptors (nAChRs). The proportions of peripheral blood Th1 and Th2 cells from patients with COPD, smokers without airway obstruction and healthy nonsmokers were analyzed using flow cytometry. The levels of plasma proinflammatory cytokines and their potential association with pulmonary function were also measured. The influence of cigarette smoke extract (CSE) on the conditioned differentiation of T helper cell subsets was further examined in vitro. Significantly higher Th1 cell and plasma IFN-γ and IL-18 levels but lower levels of Th2 cells were found in the peripheral blood from patients with COPD. The increased plasma levels of IFN-γ and IL-18 were negatively correlated with pulmonary function (FEV1% predicted value). Pyroptosis participates in COPD development probably through the activation of the NLRP3 inflammasome upon exposure to CSE. CSE does not directly induce the differentiation of T helper cells; however, under conditioned medium, CSE promotes Th1 development through α7 nAChR modification, while it does not substantially interfere with Th2 differentiation. The differences in the cytokine milieu play a key role in the effects of CSE on the immune response in patients with COPD.

Impact of azithromycin on the migration of peripheral blood T lymphocytes from patients with chronic obstructive pulmonary disease to RANTES and IP-10

The inflammatory process specific for chronic obstructive pulmonary disease (COPD) is accompanied by T lymphocyte migration from peripheral blood to the respiratory tract. Suppression of T cell chemotaxis by drugs may attenuate the inflammatory response in patients with COPD.The aim of this study was to determine the ability of azithromycin in combination with glucocorticoids to affect the migration of blood T cells in patients with COPD.The percentage of T lymphocytes expressing chemokine receptors CCR5, CCR6, CCR7, CXCR3, CXCR4, CXCR6 was analyzed by flow cytometry in the peripheral blood of 54 smokers with COPD, 21 healthy smokers, and 20 healthy non-smokers, as well as in bronchoalveolar lavage (BAL) of 7 smokers with COPD and 7 healthy smokers. Additionally, we determined the effect of azithromycin (10 μg/ml) and budesonide (10 nM) on the migration of peripheral blood T helper cells and cytotoxic T lymphocytes from patients with COPD (n = 8) to chemokines RANTES (10 nM) and IP-10 (10 nM).The percentage of T lymphocytes expressing chemokine receptors CXCR3 and CCR5 increased in the peripheral blood of COPD smokers compared with healthy smokers and healthy non-smokers, as well as in the BAL of COPD smokers compared with healthy smokers. The proportion of T cells expressing chemokine receptors CXCR4, CXCR6, CCR6, and CCR7 did not differ in the peripheral blood and the BAL between COPD patients and healthy controls. Budesonide only inhibited the migration of cytotoxic T lymphocytes to RANTES. Azithromycin, alone and combined with budesonide, inhibited the migration of T helper cells and cytotoxic T lymphocytes to both RANTES and IP-10. Moreover, the inhibitory effect of azithromycin, in combination with budesonide and without it, on the T cell migration was significantly greater than the effect of budesonide alone.Our results suggest a role for CXCR3 and CCR5 in T cell recruitment into the lungs of COPD patients and demonstrate the ability of azithromycin to inhibit T lymphocyte migration.