Prevalence Of Lung Disease Research Articles

Experimental Mouse Models of Asthma and Analysis of CD4 T Cells.

Asthma is a highly prevalent lung disease, characterized by airway dysfunction and chronic inflammation. Asthma occurs in both children and adults, but frequently originates in early life. Heterogeneous asthma phenotypes exist, but Th2 cells are key players in a large proportion of cases, while other CD4+ T cell subsets are also implicated in driving and limiting pathology. In this chapter, we describe methods for establishing allergic airway disease to model asthma in adult and neonatal mice, along with protocols for measuring key disease parameters and quantifying and phenotyping CD4+ T cell subtypes.

Rcn3 Suppression Was Responsible for Partial Relief of Emphysema as Shown by Specific Type II Alveolar Epithelial Cell Rcn3 CKO Mouse Model.

BackgroundChronic obstructive pulmonary disease (COPD), characterized by irreversible airflow limitation, is a highly prevalent lung disease worldwide and imposes increasing disease burdens globally. Emphysema is one of the primary pathological features contributing to the irreversible decline of pulmonary function in COPD patients, but the pathogenetic mechanisms remain unclear. Reticulocalbin 3 (Rcn3) is an endoplasmic reticulum (ER) lumen protein localized in the secretory pathway of living cells. Rcn3 in type II alveolar epithelial cell (AECIIs) has been reported to play a critical role in regulating perinatal lung development and bleomycin-induced lung injury-repair processes. We hypothesized that Rcn3 deficiency is associated with the development of emphysema during COPD, which is associated with the dysfunction of injury-repair modulated by alveolar epithelial cells.Materials and MethodsWe examined Rcn3 expression in lung specimens from COPD patients and non-COPD control patients undergoing lung lobectomy or pneumonectomy. Two mouse models of emphysema were established by cigarette smoke (CS) exposure and intratracheal instillation of porcine pancreatic elastase (PPE). Rcn3 expression was detected in the lung tissues from these mice. Furthermore, conditional knockout (CKO) mice with Rcn3 deletion specific to AECIIs were used to explore the role of Rcn3 in PPE-induced emphysema progression. Rcn3 protein expression in lung tissues was evaluated by Western blot and immunohistochemistry. Rcn3 mRNA expression in lung tissues was detected by qPCR.ResultsRcn3 expression was significantly increased in the lung specimens from COPD patients versus non-COPD patients and the level of Rcn3 increase was associated with the degree of emphysema. Rcn3 expression were also significantly up-regulated in both CS-induced and PPE-induced emphysematous mouse lungs. Moreover, the selective ablation of Rcn3 in AECIIs significantly alleviated severity of the mouse emphysema in response to intratracheal installation of PPE.ConclusionOur data, for the first time, indicated that suppression of Rcn3 expression in AECIIs has a beneficial effect on PPE-induced emphysema.

Study on the Prevalence of Lung Disease of Non-Tuberculosis Mycobacterium Isolated from Respiratory Specimens in Gwangju Second Hospital over the Last 10 Years

최근 호흡기 검체에서 결핵균(Mycobacterium tuberculosis complex, MTBC) 검출은 감소하고 비결핵 항산균(nontuberculous mycobacteria, NTM)은 증가하고 있다. 본 연구는 2010년부터 2019년까지 광주 2차 병원에 의뢰된 호흡기검체 132,359예를 대상으로 NTM 검출 증가 대비 NTM 폐질환 환자의 증가와 연령 및 성별 분포를 조사하였다. 그리고 NTM양성환자의 폐결핵 감염 여부를 확인하고자 하였다. 항산균배양 양성률은 2010년 21.9% (1,624/7,403), 2019년 17.4% (1,937/11,161)였다. NTM 분리 비율은 2010년 38.0% (617/1,624)에서 2019년에 72.4% (1,403/1,937)로 증가하였다. NTM 양성환자의 NTM 폐질환 진단률은 평균 27.1%였다. 이 중 현재 폐결핵에 감염된 사례는 2010년 44.4%에서 2019년 23.5%로 감소하고 과거 진단 또는 치료 사례도 15.6%에서 10.6%로 감소하였다. 전체 NTM 폐질환 중 69.0%가 60대 이상이었으며 남자보다 여자 환자가 더 많았다. 향후 고령화와 결핵 관리 정책에 따라 NTM 검출은 증가하는 반면 MTBC는 감소할 것으로 예상되며, 실험실에서는 이 현상에 세심한 주의를 기울이고 지속적으로 검사 결과를 감시해야 할 것이다.

The Role of Connexin 43 in Lung Disease.

The term lung disease describes a broad category of disorders that impair lung function. More than 35 million Americans have a preventable chronic lung disease with high mortality rates due to limited treatment efficacy. The recent increase in patients with lung disease highlights the need to increase our understanding of mechanisms driving lung inflammation. Connexins, gap junction proteins, and more specifically connexin 43 (Cx43), are abundantly expressed in the lung and are known to play a role in lung diseases. This review focuses on the role of Cx43 in pathology associated with acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD) and asthma. Additionally, we discuss the role of Cx43 in preventing disease through the transfer of mitochondria between cells. We aim to highlight the need to better understand what cell types are expressing Cx43 and how this expression influences lung disease.

Asthma-associated risk for COVID-19 development

The newly described severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for a pandemic (coronavirus disease 2019 [COVID-19]). It is now well established that certain comorbidities define high-risk patients. They include hypertension, diabetes, and coronary artery disease. In contrast, the context with bronchial asthma is controversial and shows marked regional differences. Because asthma is the most prevalent chronic inflammatory lung disease worldwide and SARS-CoV-2 primarily affects the upper and lower airways leading to marked inflammation, the question arises about the possible clinical and pathophysiological association between asthma and SARS-CoV-2/COVID-19. Here, we analyze the global epidemiology of asthma among patients with COVID-19 and propose the concept that patients suffering from different asthma endotypes (type 2 asthma vs non–type 2 asthma) present with a different risk profile in terms of SARS-CoV-2 infection, development of COVID-19, and progression to severe COVID-19 outcomes. This concept may have important implications for future COVID-19 diagnostics and immune-based therapy developments.

Use of E-Cigarettes and Self-Reported Lung Disease Among US Adults.

Initially marketed for smoking cessation, electronic cigarettes (e-cigarettes) are commonly regarded as safer than combustible cigarettes because they usually contain less nicotine and do not use combustion. However, few studies have examined the health effects of e-cigarettes. The objective of this study was to examine whether e-cigarette use had a differential effect on the prevalence of lung disease among current, former, and never tobacco users. We analyzed data from respondents aged ≥18 (n = 45 908) who responded to questions about e-cigarette use and lung disease in the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey. We calculated crude odd ratios (ORs) and ORs adjusted by 15 sociodemographic and health behavior factors: age, sex, race/ethnicity, annual household income, health insurance, personal physician, health status, body mass index, education, marital status, exercise, alcohol use, tobacco smoking, tobacco chewing, and metropolitan status. We found a significant association between e-cigarette use and lung disease, which was significantly modified by tobacco use. Among never tobacco users, the adjusted odds of reporting lung disease were 4.36 (95% CI, 1.76-10.77) times higher among everyday e-cigarette users than among never e-cigarette users. Among current tobacco users, the adjusted odds of reporting lung disease were 1.47 (95% CI, 1.13-1.92) times higher among everyday e-cigarette users than among never e-cigarette users. People who have never smoked combustible cigarettes should refrain from starting e-cigarettes, because e-cigarettes carry a significant risk of lung disease independent of tobacco smoking. Additional prospective research into the harmful effects of e-cigarettes would help to further elucidate this link.

An Inflamed Human Alveolar Model for Testing the Efficiency of Anti-inflammatory Drugs in vitro.

A large number of prevalent lung diseases is associated with tissue inflammation. Clinically, corticosteroid therapies are applied systemically or via inhalation for the treatment of lung inflammation, and a number of novel therapies are being developed that require preclinical testing. In alveoli, macrophages and dendritic cells play a key role in initiating and diminishing pro-inflammatory reactions and, in particular, macrophage plasticity (M1 and M2 phenotypes shifts) has been reported to play a significant role in these reactions. Thus far, no studies with in vitro lung epithelial models have tested the comparison between systemic and direct pulmonary drug delivery. Therefore, the aim of this study was to develop an inflamed human alveolar epithelium model and to test the resolution of LPS-induced inflammation in vitro with a corticosteroid, methylprednisolone (MP). A specific focus of the study was the macrophage phenotype shifts in response to these stimuli. First, human monocyte-derived macrophages were examined for phenotype shifts upon exposure to lipopolysaccharide (LPS), followed by treatment with MP. A multicellular human alveolar model, composed of macrophages, dendritic cells, and epithelial cells, was then employed for the development of inflamed models. The models were used to test the anti-inflammatory potency of MP by monitoring the secretion of pro-inflammatory mediators (interleukin [IL]-8, tumor necrosis factor-α [TNF-α], and IL-1β) through four different approaches, mimicking clinical scenarios of inflammation and treatment. In macrophage monocultures, LPS stimulation shifted the phenotype towards M1, as demonstrated by increased release of IL-8 and TNF-α and altered expression of phenotype-associated surface markers (CD86, CD206). MP treatment of inflamed macrophages reversed the phenotype towards M2. In multicellular models, increased pro-inflammatory reactions after LPS exposure were observed, as demonstrated by protein secretion and gene expression measurements. In all scenarios, among the tested mediators the most pronounced anti-inflammatory effect of MP was observed for IL-8. Our findings demonstrate that our inflamed multicellular human lung model is a promising tool for the evaluation of anti-inflammatory potency of drug candidates in vitro. With the presented setup, our model allows a meaningful comparison of the systemic vs. inhalation administration routes for the evaluation of the efficacy of a drug in vitro.

Which Balance Subcomponents Distinguish Between Fallers and Non-Fallers in People with COPD?

RationaleChronic obstructive pulmonary disease (COPD) is an increasingly prevalent lung disease linked to dysfunctional balance and an increased risk of falls. The Balance Evaluation Systems Test (BESTest) evaluates the six underlying subcomponents of functional balance. The aim of this study was to determine the specific balance subcomponents and cut-off scores that discriminate between fallers and non-fallers with COPD to guide fall risk assessment and prevention.MethodsA secondary analysis of cross-sectional data from two prior studies in COPD was performed. Independent samples t-tests were used to explore the differences in the BESTest sub-system scores between fallers and non-fallers. Receiver operating characteristic curves were used to determine the optimal subcomponent cut-off scores that identified fallers, and the area under the curve (AUC) was used to assess test accuracy.ResultsData from 72 subjects with COPD (mean age, 70.3 ± 7.4y; mean forced expiratory volume in 1 second, 38.9 ± 15.8% predicted) were analyzed. Two BESTest subcomponents, stability limits/verticality (fallers: 75.4%, non-fallers: 83.8%; p=0.002) and postural responses (fallers: 67.5%, non-fallers: 79.7%; p=0.008) distinguished between fallers and non-fallers. Stability limits/verticality had an AUC of 0.70 and optimal cut-off score of 73.8% for identifying fallers; postural responses had an AUC of 0.67 and optimal cut-off score of 69.4%.ConclusionThe stability limits/verticality and postural responses subcomponents of the BESTest distinguished between fallers and non-fallers with COPD. The stability limits/verticality subcomponent can also be used to identify whether an individual with COPD is at risk of falling using a cut-off score of 73.8%. These findings suggest that specific subcomponents of balance could be targeted to optimize fall risk assessment and prevention in COPD.

Study of Applications of Artificial Neural Networks

This study is related to the different methods of identification of artificial neural networks. These techniques assess and detect lung cancer in the early stage of life, therefore, preventing lung disease. Growth in lung cancer is Pakistan's principal cause of death, so early identification of lung disease is crucial. The position and expectation of growth of lung cancer is guided by the pre-treatment plan in which sections, smoothing, and improvement measures were prepared which includes procedures based on pictures and steps. Lung malignancy was linked to the proper model of the false neural system and paces of the endurance of patients with lung disease were also determined. The role of artificial neural systems in the medical profession is significant Nowadays most ailment treatment strategies are prepared to upgrade the yield display with the aid of man-made brainpower. The artificial neural network model is useful in lung cancerous growth disorder because lung type of cancer can be detected. The main aim of this paper is to study the different methods of artificial neural network techniques used to detect, assess, and treat patients with lung cancer.

THU0120 OVERLAPPING SJOGREN’S SYNDROME AND ULTRASOUND REMISSION, FUNCTIONAL DISABILITY AND MANAGEMENT IN RHEUMATOID ARTHRITIS PATIENTS: A PROPENSITY SCORE MATCHED REAL-WORLD COHORT FROM 2009 TO 2019

Background:Rheumatoid arthritis (RA) patients with Sjogren’s syndrome (SS) are often referred to as more severe synovitis.Objectives:We intend to clarify the impact of overlapping SS on ultrasound remission, functional ability improvement and clinical decision-making in RA patients in a real-world cohort from 2009 to 2019.Methods:The medical records of RA patients in our medical center from 2009 to 2019 were reviewed. Cox proportional hazards models of ultrasound remission and health assessment questionnaire (HAQ) improvement were conducted in both the 1-to-1 nearest propensity score matched (PSM) and unmatched cohorts between those RA patients with SS (RA-SS) and without (RA-noSS) to correct critical confounders. Four kinds of PSM methods were used and the corresponding average treatment effect on the treated (ATT) was calculated to clarify the effect of overlapping SS on distinguishable characteristics or drug prescription in RA patients.Results:A total of 1100 RA patients were included in the study, of which 133 (12.1%) overlapped with SS. Among 256 patients consisting of 128 RA-SS and 128 RA-noSS after 1-to-1 nearest PSM, overlapping SS was associated with a 44%, 32% lower probability of reaching ultrasound remission, no-functional disability in RA patients, respectively. More prevalent interstitial lung disease (ILD), leukopenia, hypergammaglobulinemia, rheumatoid factor (RF) positivity, higher erythrocyte sedimentation rate (ESR) and more hydroxychloroquine (HCQ) usage, less biologic disease-modifying anti-rheumatic drugs (bDMARDs) prescription were confirmed to be correlated with overlapping SS by the robust PSM.Conclusion:Overlapping SS is associated with a lower probability of reaching ultrasound remission and functional activity improvement, higher prevalence of ILD, leukopenia and hypergammaglobulinemia in RA patients. Weaker interventions such as HCQ may be the mainstream of clinical decision making.Table.Hazard Ratios for Ultrasound Remission/No Functional Disability Associated with Overlapping SSUnmatched cohortMatched cohortUS remissionNo functional disabilityUS remissionNo functional disabilityUnstratified0.63 (0.51, 0.79)0.60 (0.52, 0.70)0.56 (0.42, 0.74)0.68 (0.55, 0.83)Stratified Gender0.62 (0.50, 0.77)0.63 (0.54, 0.74)0.53 (0.40, 0.71)0.66 (0.54, 0.80) Age0.63 (0.51, 0.78)0.60 (0.52, 0.70)0.54 (0.40, 0.72)0.62 (0.50, 0.76) RF0.64 (0.52, 0.80)0.63 (0.54, 0.73)0.56 (0.42, 0.74)0.68 (0.55, 0.83) ACPA0.63 (0.51, 0.79)0.59 (0.50, 0.68)0.57 (0.43, 0.76)0.63 (0.51, 0.78) Seropositivity0.64 (0.52, 0.80)0.63 (0.54, 0.74)0.59 (0.45, 0.79)0.75 (0.61, 0.92) RA duration0.64 (0.51, 0.79)0.61 (0.52, 0.71)0.58 (0.44, 0.77)0.70 (0.57, 0.86) BLDAS28CRP0.64 (0.51, 0.80)0.62 (0.53, 0.72)0.54 (0.41, 0.72)0.66 (0.54, 0.81)Values are presented as total and stratified Hazard Ratio (95% CI) for ultrasound remission and no functional disability associated with overlapping SS in RA patients according to gender, age, RF/ACPA status, RA duration and DAS28-CRP at 1stvisit. US remission refers to ultrasound GS<2 and PD=0. Unmatched cohort refers to whole sample (n=1100), matched cohort refers to propensity score matched (PSM) patients (n=256). The values are statistically significant at the level of 0.01.Disclosure of Interests:None declared

Conventional and Nanotechnology Based Approaches to Combat Chronic Obstructive Pulmonary Disease: Implications for Chronic Airway Diseases.

Chronic obstructive pulmonary disease (COPD) is the most prevalent obstructive lung disease worldwide characterized by decline in lung function. It is associated with airway obstruction, oxidative stress, chronic inflammation, mucus hypersecretion, and enhanced autophagy and cellular senescence. Cigarette smoke being the major risk factor, other secondary risk factors such as the exposure to air pollutants, occupational exposure to gases and fumes in developing countries, also contribute to the pathogenesis of COPD. Conventional therapeutic strategies of COPD are based on anti-oxidant and anti-inflammatory drugs. However, traditional anti-oxidant pharmacological therapies are commonly used to alleviate the impact of COPD as they have many associated repercussions such as low diffusion rate and inappropriate drug pharmacokinetics. Recent advances in nanotechnology and stem cell research have shed new light on the current treatment of chronic airway disease. This review is focused on some of the anti-oxidant therapies currently used in the treatment and management of COPD with more emphasis on the recent advances in nanotechnology-based therapeutics including stem cell and gene therapy approaches for the treatment of chronic airway disease such as COPD and asthma.

Oral feeding with probiotic Lactobacillus rhamnosus attenuates cigarette smoke-induced COPD in C57Bl/6 mice: Relevance to inflammatory markers in human bronchial epithelial cells.

COPD is a prevalent lung disease with significant impacts on public health. Affected airways exhibit pulmonary neutrophilia and consequent secretion of pro-inflammatory cytokines and proteases, which result in lung emphysema. Probiotics act as nonspecific modulators of the innate immune system that improve several inflammatory responses. To investigate the effect of Lactobacillus rhamnosus (Lr) on cigarette smoke (CS)-induced COPD C57Bl/6 mice were treated with Lr during the week before COPD induction and three times/week until euthanasia. For in vitro assays, murine bronchial epithelial cells as well as human bronchial epithelial cells exposed to cigarette smoke extract during 24 hours were treated with Lr 1 hour before CSE addition. Lr treatment attenuated the inflammatory response both in the airways and lung parenchyma, reducing inflammatory cells infiltration and the production of pro-inflammatory cytokines and chemokines. Also, Lr-treated mice presented with lower metalloproteases in lung tissue and lung remodeling. In parallel to the reduction in the expression of TLR2, TLR4, TLR9, STAT3, and NF-κB in lung tissue, Lr increased the levels of IL-10 as well as SOCS3 and TIMP1/2, indicating the induction of an anti-inflammatory environment. Similarly, murine bronchial epithelial cells as well as human bronchial epithelial cells (BEAS) exposed to CSE produced pro-inflammatory cytokines and chemokines, which were inhibited by Lr treatment in association with the production of anti-inflammatory molecules. Moreover, the presence of Lr also modulated the expression of COPD-associated transcription found into BALF of COPD mice group, i.e., Lr downregulated expression of NF-κB and STAT3, and inversely upregulated increased expression of SOCS3. Thus, our findings indicate that Lr modulates the balance between pro- and anti-inflammatory cytokines in human bronchial epithelial cells upon CS exposure and it can be a useful tool to improve the lung inflammatory response associated with COPD.

The Prevalence and Burden of Non-AIDS Comorbidities Among Women Living With or at Risk for Human Immunodeficiency Virus Infection in the United States.

The prevalence and burden of age-related non-AIDS comorbidities (NACMs) are poorly characterized among women living with HIV (WLWH). Virologically suppressed WLWH and HIV-seronegative participants followed in the Women's Interagency HIV Study (WIHS) through at least 2009 (when >80% of WLWH used antiretroviral therapy) were included, with outcomes measured through 31 March 2018. Covariates, NACM number, and prevalence were summarized at most recent WIHS visit. We used linear regression models to determine NACM burden by HIV serostatus and age. Among 3232 women (2309 WLWH, 923 HIV-seronegative) with median observation of 15.3 years, median age and body mass index (BMI) were 50 years and 30 kg/m2, respectively; 65% were black; 70% ever used cigarettes. WLWH had a higher mean NACM number than HIV-seronegative women (3.6 vs 3.0, P < .0001) and higher prevalence of psychiatric illness, dyslipidemia, non-AIDS cancer, kidney, liver, and bone disease (all P < .01). Prevalent hypertension, diabetes, and cardiovascular and lung disease did not differ by HIV serostatus. Estimated NACM burden was higher among WLWH versus HIV-seronegative women in those aged 40-49 (P < .0001) and ≥60 years (P = .0009) (HIV × age interaction, P = .0978). In adjusted analyses, NACM burden was associated with HIV, age, race, income, BMI, alcohol abstinence, cigarette, and crack/cocaine use; in WLWH, additional HIV-specific indices were not associated, aside from recent abacavir use. Overall, NACM burden was high in the cohort, but higher in WLWH and in certain age groups. Non-HIV traditional risk factors were significantly associated with NACM burden in WLWH and should be prioritized in clinical guidelines for screening and intervention to mitigate comorbidity burden in this high-risk population.

Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings.

The incidence and prevalence of lung disease caused by non-tuberculous mycobacteria (NTM-LD) has increased worldwide and its diagnosis represents a complex challenge. This article aims to review the tomographic findings of NTM-LD in order to facilitate their definitive diagnosis. The search for publications on the subject was performed in PMC and Scielo using the keywords ‘non-tuberculous mycobacteria’, ‘lung disease and computed tomography (CT)’ and ‘radiological findings’. The radiological findings described by 18 articles on mycobacteriosis were reviewed. In addition, CT images of patients diagnosed with NTM-LD were considered to represent radiological findings. Eighteen publications were used whose main findings were pulmonary cavitation (88.9%), bronchiectasis (77.8%), and pulmonary nodules (55.6%). Despite the overlaps in imaging-related analysis of myocobacterioses with other pulmonary infections, such as tuberculosis, the predominant involvement of the middle lobe and lingula should raise suspicion for NTM-LD.

Histopathological Spectrum of Lesions in Lungs on Post-mortem Specimen in a Tertiary Centre of Bastar Region- A Retrospective Study

Introduction: Lungs are the major organ involved in a number of infectious, inflammatory and occupational disease, secondarily involved in almost all form of terminal disease. So many people around the world suffer from preventable lung disease. Many a times it has been found that when gross pathology could not help to evaluate cause of death, histopathology provide the valuable information. Aim: To study the spectrum of histopathological finding in lung autopsy and the incidental findings identified during histopathological examination. Materials and Methods: This was a retrospective study done in the Department of Pathology, Lt B.R.K.M G.M.C, Bastar, Chhattisgarh, India, over a period of 10 years i.e., from January 2010 to December 2019. The study consisted of Lung specimens (474 cases) from medico-legal autopsies, irrespective of their age and sex, received during this period. Gross and Microscopic features were documented, and diagnosis was made. The results were analysed based on gross findings and the histopathological examination. Results: Among 474 cases studied during period of 10 years, maximum cases were seen in 30-39 (141 cases) years of age group. Males were more commonly affected 345 (73%) as compared to Females 129 (27%). Pathological findings of Lung were seen in 441 cases, of which Pulmonary Oedema with Congestion was found in 352 cases, along with Intra-alveolar Haemorrhage in 41 cases, Bronchopneumonia in 14 cases, Lobar Pneumonia in 11 cases, seven cases of Tuberculosis, Interstitial Pneumonia in seven cases, Vegetative material in three cases, Emphysema in three cases, Aspiration pnuemonitis in two cases and one case of Chronic Bronchitis. Conclusion: Autopsy study of lung specimens gives valuable information, improves clinical diagnosis and provides diagnostic setup for better clinical assessment. Histopathological examination proves to be the great diagnostic tool in the identification of lung lesions which were incidental finding or direct cause of death. Limitation was non-availability of large specimens, detailed clinical history and autolysis of the organ.

Distinct Chronic Post-Viral Lung Diseases upon Infection with Influenza or Parainfluenza Viruses Differentially Impact Superinfection Outcome

Chronic obstructive pulmonary disease (COPD) and asthma remain prevalent human lung diseases. Variability in epithelial and inflammatory components that results in pathologic heterogeneity complicates the development of treatments for these diseases. Early childhood infection with parainfluenza virus or respiratory syncytial virus is strongly associated with the development of asthma and COPD later in life, and exacerbations of these diseases correlate with the presence of viral RNA in the lung. Well-characterized animal models of postviral chronic lung diseases are necessary to study the underlying mechanisms of viral-related COPD and asthma and to develop appropriate therapies. In this study, we cross-analyzed chronic lung disease caused by infection with Sendai virus (SeV) or influenza A virus in mice. Differences were observed in lesion composition and inflammatory profiles between SeV- and influenza A virus-induced long-term lung disease. In addition, a primary SeV infection led to worsened pathologic findings on secondary heterologous viral challenge, whereas the reversed infection scheme protected against disease in response to a secondary viral challenge >1 month after the primary infection. These data demonstrate the differential effect of primary viral infections in the susceptibility to disease exacerbation in response to a different secondary viral infection and highlight the usefulness of these viral models as tools to understand the underlying mechanisms that mediate distinct chronic postviral lung diseases.

Relationship between Ureaplasma urealyticum Colonization and Bronchopulmonary Dysplasia in Very Low Birth Weight Premature Infants: A Prospective Cohort Study

Background: Bronchopulmonary dysplasia (BPD) is the second prevalent lung disease and one of the care challenges of premature newborns. Different risk factors play an important role in the development of this disease. Therefore, the aim of the present study was to investigate the relationship between colonization with Ureaplasma urealyticum and BPD.Methods: This prospective cohort study was conducted in 2017 in the neonatal intensive care unit of Alzahra Hospital in Tabriz, Iran. The samples included newborns weighing less than 1500 g with the gestational age of less than 32 weeks who required intubation within 72 h after birth. Following recording the initial information, the secretions within the trachea were aspirated and Ureaplasma urealyticum was detected in reference laboratory by polymerase chain reaction. Afterwards, we completed a follow-up of 28 days after birth for BPD.Results: Our findings demonstrated that out of 82 infants, 21 cases (26.3%) were excluded from the study due to discharge from hospital or death before the age of 28 days. Among the rest (61 newborns), three cases (4.3%) were shown to have secretions infected with Ureaplasma and 33 cases (54.1%) suffered from BPD. All the three newborns infected with Ureaplasma had BPD. However, no significant relationship was observed between Ureaplasma infection and BPD (P=0.24).According to the analysis of data, the most important factors contributing to BPD among the patients were the gestational age and birth weight. In other words, for one week increase in the age of pregnancy and for each 100 g increase in birth weight, the likelihood of BPD is reduced by 55% and 1%, respectively. In the present study, no relationship was found between Ureaplasma infection and BPD, which might be due to the low prevalence of this infection. Nonetheless, prematurity and low birth weight could be regarded as the two considerable risk factors for BPD.Conclusion: In order to perfectly determine the role of bacterial colonization within the trachea in BPD, collecting and analyzing various samples for the existence of other bacteria are recommended.

Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study

Former smokers now outnumber current smokers in many developed countries, and current smokers are smoking fewer cigarettes per day. Some data suggest that lung function decline normalises with smoking cessation; however, mechanistic studies suggest that lung function decline could continue. We hypothesised that former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers, including among those without prevalent lung disease. We used data on six US population-based cohorts included in the NHLBI Pooled Cohort Study. We restricted the sample to participants with valid spirometry at two or more exams. Two cohorts recruited younger adults (≥17 years), two recruited middle-aged and older adults (≥45 years), and two recruited only elderly adults (≥65 years) with examinations done between 1983 and 2014. FEV1 decline in sustained former smokers and current smokers was compared to that of never-smokers by use of mixed models adjusted for sociodemographic and anthropometric factors. Differential FEV1 decline was also evaluated according to duration of smoking cessation and cumulative (number of pack-years) and current (number of cigarettes per day) cigarette consumption. 25 352 participants (ages 17-93 years) completed 70 228 valid spirometry exams. Over a median follow-up of 7 years (IQR 3-20), FEV1 decline at the median age (57 years) was 31·01 mL per year (95% CI 30·66-31·37) in sustained never-smokers, 34·97 mL per year (34·36-35·57) in former smokers, and 39·92 mL per year (38·92-40·92) in current smokers. With adjustment, former smokers showed an accelerated FEV1 decline of 1·82 mL per year (95% CI 1·24-2·40) compared to never-smokers, which was approximately 20% of the effect estimate for current smokers (9·21 mL per year; 95% CI 8·35-10·08). Compared to never-smokers, accelerated FEV1 decline was observed in former smokers for decades after smoking cessation and in current smokers with low cumulative cigarette consumption (<10 pack-years). With respect to current cigarette consumption, the effect estimate for FEV1 decline in current smokers consuming less than five cigarettes per day (7·65 mL per year; 95% CI 6·21-9·09) was 68% of that in current smokers consuming 30 or more cigarettes per day (11·24 mL per year; 9·86-12·62), and around five times greater than in former smokers (1·57 mL per year; 1·00-2·14). Among participants without prevalent lung disease, associations were attenuated but were consistent with the main results. Former smokers and low-intensity current smokers have accelerated lung function decline compared with never-smokers. These results suggest that all levels of smoking exposure are likely to be associated with lasting and progressive lung damage. National Institutes of Health, National Heart Lung and Blood Institute, and US Environmental Protection Agency.

ROMANIAN AWARENESS CAMPAIGNS FOR EARLY DETECTION OF OBSTRUCTIVE LUNG DISEASE

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Obstructive Lungs Diseases are a major health problem and knowing its prevalence is extremely useful in health services planning. On World Asthma and COPD Days, Romanian Society of Pneumology (SRP) organized awareness campaigns consisting of press conference, radio campaign, dedicated website, free testing (spirometry) for general public. The aims of the study were (1) to identify subjects with airflow limitation, (2) to assess the relationships between the presence and severity of respiratory symptoms and spirometry values. METHODS: Spirometry and questionnaire has been performed in 2017. The questionnaire has 17 questions and addresses different issues, like possible suggestive symptoms, risk factors (smoking, noxious exposure, history of allergy), previous lung function tests, known obstructive lung disease, history of exacerbations, existence of any check-up or respiratory therapy. Statistical analysis has been done using Microsoft Office Excel 2007. RESULTS: A total of 650 persons with mean age = 60.4 ± 15.2 years were screened by spirometry, of which 33.3% (217) had lung function impairment with mean FEV1 = 67.6 ± 14%. From symptomatic ones 53.5% (239) had dyspnea, 66.2% (294) cough, 40.5% (181) chest tightness and 41.2% (184) wheezing. Although 31.7% (206) were symptomatic with smoking history, only 17% (35) of them had performed spirometry in the last 6 months. Moreover, 44% (286) were symptomatic with normal lung function and 23.7% (154) previously undiagnosed patients were detected with abnormal spirometry. Even if 20.6% (134) cases had diagnosis of lung disorder (37-asthma, 21-COPD, 5-emphysema, 71-bronchitis) only 52 had treated their disease and 24 had performed spirometry in the last 6 months. CONCLUSIONS: Disease severity: 73.7% (479) had at least an exacerbation/year, 28.2% received antibiotic treatment, 7% presented to the emergency room, 2.7% required hospitalization.Treating obstructive lung disease is still deficitary in Romania, pulmonologists was responsible for managing these disorders in less than 50% of cases. Atopies are more frequent in women, as well as tendency to be treated and seeing by physicians on regularly basis, for assessing asthma control. CLINICAL IMPLICATIONS: Epidemiological data on Obstructive Lung Disease prevalence are limited in Romania. Despite being a major health problem, its expected burden will increase in the coming decades, mostly due to continued exposure to risk factors, missed or delayed diagnosis, social and economical conditions. The campaigns were usefully for detecting new cases, but also for already diagnosed cases, who were not followed up properly, regarding treatment or assessing control. DISCLOSURES: No relevant relationships by Florin Mihaltan, source=Web Response No relevant relationships by RAMONA ELENA NEDELCU, source=Web Response No relevant relationships by Roxana Maria Nemes, source=Web Response No relevant relationships by Ruxandra Ulmeanu, source=Web Response

SAT-043 HOME & SATELLITE HAEMODIALYSIS PATIENTS: A COMPARISON OF OUTCOMES

Home haemodialysis (HD) has been associated with improvements in clinical and non-clinical outcomes. Previous studies have shown improvements in biochemical parameters, intradialytic blood pressure control, reduction in recovery time after dialysis, reduction in frequency of adverse events including hospitalisation, and improved quality of life and survival. At the end of 2017, there were 1023 patients on home HD in Australia, accounting for 9.6% of HD patients. In comparison, satellite dialysis accounts for 51.4% of HD patients. Satellite HD requires patients to travel to the HD centre typically thrice weekly for 4-5 hours of dialysis per session. Home HD removes the need for travel while increasing dialysis hours to 5-8 hours on alternate days with less interference with other activities of living, as the majority of patients dialyse overnight. The aim of this study was to determine whether or not there were significant differences in outcomes between home and satellite HD patients in an Australian centre. Prevalent home HD patients from a tertiary centre were included as of January 2008, and incident patients were added up until June 2017. Three controls (satellite HD patients) were matched to each home HD patient on age, gender and cause of end stage kidney failure (ESKD) treated at our centre. The primary outcomes were all-cause mortality (censored for transplantation) and transplantation. Secondary outcomes were average biochemical levels (haemoglobin, corrected calcium, phosphate and parathyroid hormone), proportion of patients in each group with a haemoglobin below 100g/L and phosphate above 1.8mmol/L, and whether or not transplanted patients were alive 6 months post-transplant. 542 patients were included in the analysis with 2135 person-years of data. The incidence rate of death was 6 per 100 person-years. There were no significant between group differences in average age, gender, race, smoking status, late referral, or cause of ESKD. BMI was significantly higher in home dialysis patients – 30.2kg/m2 compared to 27.3kg/m2 (p<0.0001). There was significantly higher prevalence of cerebrovascular disease at baseline in satellite compared to home HD patients (p=0.001), but no differences in prevalence of lung disease, coronary artery disease, peripheral vascular disease, cancer, diabetes, or hepatitis C. Home dialysis patients had a significantly reduced risk of death (HR=0.28, 95% CI 0.17-0.47, p<0.001). Transplant rates were higher in home patients compared to satellite patients - 61.8% and 51.6% (p=0.03). Survival rate at 6 months post transplantation was very high in both groups – 99.5% in satellite dialysis patients and 100% in home dialysis patients. Proportion of patients with low Hb (defined as Hb < 100g/L) was not significantly different between groups (p=0.35). Proportion of patients with high phosphate (defined as phosphate > 1.80mmol/L) in satellite patients compared to home patients were 46.6% and 35.8% (p<0.05). Home HD is associated with reduced risk of mortality, increased rates of transplantation, and improved phosphate control in an Australian dialysis population. With only 9.6% of dialysis patients in Australia dialysing at home, it would be worthwhile working to improve access to home HD for Australians with ESKD.