Progression Of Pulmonary Disease Research Articles

Ultrasensitive 129Xe Magnetic Resonance Imaging: From Clinical Monitoring to Molecular Sensing.

Magnetic resonance imaging (MRI) is a cornerstone technology in clinical diagnostics and in vivo research, offering unparalleled visualization capabilities. Despite significant advancements in the past century, traditional 1H MRI still faces sensitivity limitations that hinder its further development. To overcome this challenge, hyperpolarization methods have been introduced, disrupting the thermal equilibrium of nuclear spins and leading to an increased proportion of hyperpolarized spins, thereby enhancing sensitivity by hundreds to tens of thousands of times. Among these methods, hyperpolarized (HP) 129Xe MRI, also known as ultrasensitive 129Xe MRI, stands out for achieving the highest polarization enhancement and has recently received clinical approval. It effectively tackles the challenge of weak MRI signals from low proton density in the lungs. HP 129Xe MRI is valuable for assessing structural and functional changes in lung physiology during pulmonary disease progression, tracking cells, and detecting target molecules at pico-molar concentrations. This review summarizes recent developments in HP 129Xe MRI, including its physical principles, manufacturing methods, in vivo characteristics, and diverse applications in biomedical, chemical, and material sciences. In addition, it carefully discusses potential technical improvements and future prospects for enhancing its utility in these fields, further establishing HP 129Xe MRI's importance in advancing medical imaging and research.

Recombinant RAGE antagonist peptide promotes alveolar epithelial cell regeneration via the RAGE/MAPKs/MMP2 pathway in emphysema

The progression of chronic obstructive pulmonary disease (COPD) results in irreversible pulmonary damage and sustained inflammatory responses. While alternative approaches have been explored, the specific role of alveolar epithelial cells in the pathogenesis of COPD remains unclear. Additionally, the association between emphysema and DAMP-RAGE signaling in COPD patients are not understood. Therefore, this study demonstrates to determine the therapeutic effect of a RAGE antagonist peptide (RAP), which we previously identified on the pathogenesis of COPD. We assessed the expression of RAGE ligands and RAGE binding signaling in COPD patients using GEO data. PPE-induced emphysema mouse model and AGER-/- mouse were employed, along treated with RAP. The association between RAGE and the development of emphysema was examined in H&E staining and western blot analysis in mouse lung tissue and BALF. We next analyzed the damage caused by oxidative stress and inflammation through CSE and RAP in human alveolar epithelial cell line A549. Our results show that inhibiting of RAGE alleviates emphysema by suppressing inflammation and MMP activity. Inhibition of RAGE in alveolar epithelial cells significantly induced the mitigation of lung injury, independent of macrophage infiltration. Furthermore, it was confirmed that RAP ameliorated CSE-induced oxidative stress, inflammation, and cell cycle arrest in human alveolar epithelial cells. These findings demonstrate that inhibiting RAGE in alveolar epithelial cells suppress lung injury and emphysema by inhibiting oxidative stress-induced inflammation and MMPs, while promoting alveolar epithelial cell proliferation. Furthermore, blocking of the DAMP-RAGE interaction through RAP offers a promising therapeutic approach for mitigating emphysema.

Modulation of chronic obstructive pulmonary disease progression by antioxidant metabolites from Pediococcus pentosaceus: enhancing gut probiotics abundance and the tryptophan-melatonin pathway

ABSTRACT Chronic obstructive pulmonary disease (COPD), a condition primarily linked to oxidative stress, poses significant health burdens worldwide. Recent evidence has shed light on the association between the dysbiosis of gut microbiota and COPD, and their metabolites have emerged as potential modulators of disease progression through the intricate gut-lung axis. Here, we demonstrate the efficacy of oral administration of the probiotic Pediococcus pentosaceus SMM914 (SMM914) in delaying the progression of COPD by attenuating pulmonary oxidative stress. Specially, SMM914 induces a notable shift in the gut microbiota toward a community structure characterized by an augmented abundance of probiotics producing short-chain fatty acids and antioxidant metabolisms. Concurrently, SMM914 synthesizes L-tryptophanamide, 5-hydroxy-L-tryptophan, and 3-sulfino-L-alanine, thereby enhancing the tryptophan-melatonin pathway and elevating 6-hydroxymelatonin and hypotaurine in the lung environment. This modulation amplifies the secretion of endogenous anti-inflammatory factors, diminishes macrophage polarization toward the M1 phenotype, and ultimately mitigates the oxidative stress in mice with COPD. The demonstrated efficacy of the probiotic intervention, specifically with SMM914, not only highlights the modulation of intestine microbiota but also emphasizes the consequential impact on the intricate interplay between the gastrointestinal system and respiratory health.

Effects of smoking cessation on individuals with COPD: a systematic review and meta-analysis.

Despite smoking being a significant risk factor in the occurrence and progression of chronic obstructive pulmonary disease (COPD), no comprehensive analysis has been conducted to determine the potential benefits of smoking cessation for patients with established COPD or identify specific indicators that may be improved. The aim of our meta-analysis was to elucidate the positive impact of smoking cessation on COPD. We conducted a comprehensive search of PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wan Fang and VIP databases to identify studies that met our eligibility criteria from inception up to 1, May 2024. Data were extracted independently by two authors and pooled using a random-effects model. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS). Preliminary screening of publications gave a total of 13,460 documents after which the repetitive and non-compliant studies were removed. Eventually, 11 studies were included for follow-up analysis. The pooled results showed that cessation of smoking produced significant improvements in forced expiratory volume in one second (FEV1)% predicted (MD = 6.72, 95% CI, 4.55-8.89, P < 0.001; I2 = 53%), FEV1/forced vital capacity (FVC) (MD = 6.82, 95% CI, 5.09-8.54, P < 0.001; I2 = 0%), modified Medical Research Council (mMRC) (MD = -0.49, 95% CI, -0.95--0.02, P = 0.040; I2 = 73%), 6-minute walk test (6-MWT) (MD = 64.46, 95% CI 14.60-114.32, P = 0.010; I2 = 94%), partial oxygen pressure (MD = 1.96, 95% CI, 1.03-2.89, P < 0.001; I2 = 0%), mortality (RR = 0.75, 95% CI, 0.56-1.00, P = 0.05; I2 = 44%). Our meta-analysis presented suggestive evidence that smoking cessation offered significant benefits to COPD patients, notably in the improvement of specific key indicators of pulmonary function (FEV1% predicted, FEV1/FVC), alleviating symptoms, enhancing exercise tolerance, and could reduce mortality. https://www.crd.york.ac.uk/prospero/, identifier: CRD42022384123.

Fractal Analysis of Chest Radiographs Using Image-J-FIJI Software- A Pilot Study

Background: Lung vasculature has nutritive and functional roles. Unlike the bronchial tree which branches dichotomously into twenty-one generations, the pulmonary arteries give supernumerary branches to perfuse the neighboring parenchyma. The pulmonary arteries additionally branch for five more generations than airways before forming capillaries. Further pulmonary veins are interlobular in position. Hence the characterization quantifying the pulmonary vascular networks is challenging. Objective: In this study, we assessed the pulmonary vasculature in chest radiographs using the fractal analysis method on Image-J-Fiji software. Design: Cross-sectional study Settings: Patients referred to the Department of Radiodiagnosis, Akash Institute of Medical Sciences and Research Centre and Dr. B. R. Ambedkar Medical College, Bangalore, Karnataka, India Participants: One hundred and thirty-two chest radiographs of normal healthy individuals (aged 2 months to 80 years) were photographed. Each of these images was processed in the Image-J-Fiji software. A box-counting algorithm quantified the images. Data results of the fractal dimensions were validated at the probability of significance [0.05]. Results: The mean fractal dimension of the pulmonary vasculature was 1.39. For males and females, the Pearson's correlation coefficient between the fractal dimension and age in years was 0.102 and 0.16, respectively. In males, a chi-square value of 0.58, in females, a chi-square value of 1.03, degree of freedom 2 and critical value of p-value 0.05, showed the relation was statistically not significant. Comparison between fractal dimension and Gender using Cramer’s V test in males, 0.066, and in females, 0.088, indicates a weak association between fractal dimension and gender. Conclusion: The applicability of the fractal dimensions is to screen the high risks of severe chronic obstructive pulmonary diseases. The determination of fractal values helps evaluate the complexity of lung tumors. The baseline data concerning fractal properties of pulmonary vasculature obtained from this study helps to evaluate lung diseases like emphysema and vascular abnormalities during the progression of chronic obstructive pulmonary disease. KEYWORDS: Chest Radiograph, Image Analysis, Fractal dimension, Pulmonary vasculature.

Liuwei Buqi Formula delays progression of chronic obstructive pulmonary disease in rats by regulating the NLRP3/caspase-1/GSDMD pyroptosis pathway

To explore the therapeutic mechanism of Liuwei Buqi (LWBQ) Formula for chronic obstructive pulmonary disease (COPD) in rat models. SD rat models of COPD established by cigarette smoking combined with intratracheal lipopolysaccharide (LPS) instillation and hormone injection were treated with LWBQ Formula by gavage with or without intraperitoneal injection of MCC950 for 3 weeks, starting at the 5th week of modeling. After the treatments, the rats were examined for lung pathologies, lung function, total cell count and white blood cell count in bronchoalveolar lavage fluid (BALF), and serum levels of IL-6, TNF-α, IL-18 and NO. The mRNA expressions of NLRP3, ASC, caspase-1, GSDMD-N, IL-1β, and IL-18 in the lung tissue were detected with qRT-PCR. Compared with the normal control rats, the COPD rat models had severe lung pathologies and showed significantly decreased lung function, increased total cell and leukocyte subset counts in BALF, and increased serum levels of IL-6, TNF-α, IL-18 and NO and mRNA expressions of pyroptosis-related proteins in the lung tissue. Treatment of the rat models with LWBQ Formula significantly improved lung pathology and lung function, reduced total cell and leukocyte counts in BALF, and decreased serum levels of the inflammatory factors and expressions of pyroptosis-related proteins in the lung tissue. The combined treatment with MCC950 further improved lung pathology and function in spite of a significant difference, but BALF cell counts, serum inflammatory factor levels and pulmonary expressions of pyroptosis-related proteins were all significantly reduced following the treatment. LWBQ Formula can delay the progression of COPD in rats possibly by inhibiting lung tissue pyroptosis via regulating the NLRP3/caspase-1/GSDMD pathway to reduce inflammatory response and lung damage.

TRIM13 Reduces Damage to Alveolar Epithelial Cells in COPD by Inhibiting Endoplasmic Reticulum Stress-Induced ER-Phagy

PurposeTripartite motif-containing protein 13 (TRIM13) directly or indirectly participates in autophagy and apoptosis. However, it remains unclear whether TRIM13 participates in chronic obstructive pulmonary disease (COPD) progression. This study aimed to reveal the molecular mechanisms through which TRIM13 regulates alveolar epithelial cell injury in COPD to provide new molecular targets for COPD treatment.MethodsThe TRIM13 expression levels were determined in clinical COPD patients and a rat emphysema model. A cigarette smoke-induced model of endoplasmic reticulum stress (ERS) and endoplasmic reticulum autophagy (ER-phagy) was developed using A549 cells, and the effects of TRIM13 gene overexpression/knockdown on ERS, ER-phagy, and cell apoptosis were assessed in these cells.ResultsTRIM13 expression was significantly decreased in the lung tissues of COPD patients and rats with emphysema. Moreover, the apoptosis level was significantly increased in the lung tissues of rats with emphysema. TRIM13 gene overexpression reduced the expression levels of ERS-related molecules (GRP78, GRP94, XBP-1, and eIF2a) in the COPD model; it also lowered the ER-phagy level, as evidenced by decreased number of autolysosomes observed by transmission electron microscopy, improved endoplasmic reticulum structure, reduced LC3-II/LC3-I and Beclin1 expression levels, and increased expression level of the autophagy inhibitory molecule Bcl-2. TRIM13 gene knockdown, however, led to opposite results.ConclusionTRIM13 expression attenuated alveolar epithelial cell injury in COPD by inhibiting ERS-induced ER-phagy.

A model of mechanical loading of the lungs including gravity and a balancing heterogeneous pleural pressure.

Recent years have seen the development of multiple in silico lung models, notably with the aim of improving patient care for pulmonary diseases. These models vary in complexity and typically only consider the implementation of pleural pressure, a depression that keeps the lungs inflated. Gravity, often considered negligible compared to pleural pressure, has been largely overlooked, also due to the complexity of formulating physiological boundary conditions to counterbalance it. However, gravity is known to affect pulmonary functions, such as ventilation. In this study, we incorporated gravity into a recent lung poromechanical model. To do so, in addition to the gravitational body force, we proposed novel boundary conditions consisting in a heterogeneous pleural pressure field constrained to counterbalance gravity to reach global equilibrium of applied forces. We assessed the impact of gravity on the global and local behavior of the model, including the pressure-volume response and porosity field. Our findings reveal that gravity, despite being small, influences lung response. Specifically, the inclusion of gravity in our model led to the emergence of heterogeneities in deformation and stress distribution, compatible with in vivo imaging data. This could provide valuable insights for predicting the progression of certain pulmonary diseases by correlating areas subjected to higher deformation and stresses with disease evolution patterns.

Association between oxidative balance score and chronic obstructive pulmonary disease: A cross-sectional study.

Oxidative stress is an essential contributor to the progression of chronic obstructive pulmonary disease (COPD). A systematic assessment of diet patterns and lifestyle with the oxidative balance score (OBS) to reflect oxidative stress levels will help predict the risk of COPD. This study conducted a cross-sectional analysis to assess the link between OBS and COPD. 5162 participants were collected from 2013 to 2018 from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models were applied to assess the relationship between OBS and COPD prevalence. The linearity of the association was explored using smoothed curve fitting. In addition, further subgroup analysis and interaction tests were conducted to ascertain the consistency of the relationship across diverse populations. Results of the multivariate logistic regression models indicated a negative association between OBS and the odds of COPD prevalence. Each incremental unit in OBS correlated with a 3% reduction in the odds of COPD in the fully adjusted model (OR 0.97, 95% CI 0.95-0.99). Further analysis by OBS tertiles indicated that individuals in the highest OBS tertile (T3) had a 17% lower probability of COPD compared to those in the lowest tertile (T1) in the fully adjusted model (OR 0.83, 95% CI 0.64-0.97). The smoothed curve fitting supported the negative association between OBS and COPD. Subgroup analyses revealed that the protective effect of OBS was notably pronounced among the non-hypertensive and non-diabetic populations. These findings suggest a negative link between OBS and COPD, underscoring the importance of antioxidant-rich diets and lifestyles in preventing COPD.

Differential miRNA Profiling Reveals miR-4433a-5p as a Key Regulator of Chronic Obstructive Pulmonary Disease Progression via PIK3R2- mediated Phenotypic Modulation.

In this study, a high-throughput sequencing technology was used to screen the differentially expressed miRNA in the patients with "fast" and "slow" progression of chronic obstructive pulmonary disease (COPD). Moreover, the possible mechanism affecting the progression of COPD was preliminarily analyzed based on the target genes of candidate miRNAs. The "fast" progressive COPD group included 6 cases, "slow" and Normal progressive COPD groups included 5 cases each, and COPD group included 3 cases. The peripheral blood samples were taken from the participants, followed by total RNA extraction and high throughput miRNA sequencing. The differentially expressed miRNAs among the progressive COPD groups were identified using bioinformatics analysis. Then, the candidate miRNAs were externally verified. In addition, the target gene of this miRNA was identified, and its effects on cell activity, cell cycle, apoptosis, and other biological phenotypes of COPD were analyzed. Compared to the Normal group, a total of 35, 16, and 7 differentially expressed miRNAs were identified in the "fast" progressive COPD, "slow" progressive COPD group, and COPD group, respectively. The results were further confirmed using dual-luciferase reporter assay and transfection tests with phosphoinositide- 3-kinase, regulatory subunit 2 (PIK3R2) as a target gene of miR-4433a-5p; the result showed a negative regulatory correlation between the miRNA and its target gene. The phenotype detection showed that the activation of the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (AKT) signaling pathway might participate in the progression of COPD by promoting the proliferation of inflammatory A549 cells and inhibiting cellular apoptosis. MiR-4433a-5p can be used as a marker and potential therapeutic target for the progression of COPD. As a target gene of miR-4433a-5p, PIK3R2 can affect the progression of COPD by regulating phenotypes, such as cellular proliferation and apoptosis.

High relative humidity environment alleviates hypoxia-induced pulmonary arterial hypertension in mice

The environment has long been considered a crucial factor influencing the onset and progression of pulmonary diseases. Environmental therapy is also a practical treatment approach for many conditions. While research has explored the effects of factors like air pressure and oxygen concentration on pulmonary arterial hypertension (PAH), the impact of air humidity on PAH has not been investigated. In this study, we examined the role of different air humidity levels in a mouse model of PAH by controlling relative humidity. We induced PAH in mice using 10 % hypoxia, which led to significant thickening of the pulmonary vasculature, elevated right ventricular systolic pressure, and an increased right ventricular hypertrophy index (RVHI). However, when exposed to an environment with 80–95 % relative humidity, there was a marked reduction in the extent of pulmonary vascular remodeling, decreased vascular thickening, and lower RVHI, effectively preserving right heart function. Notably, changes in the Bmpr2/Tgf-β signaling pathway were significant and may play a pivotal role in this protective effect. In summary, our findings indicate that high relative humidity confers a protective effect on hypoxia-induced PAH in mice, providing novel insights into potential treatments for PAH.

Lower respiratory tract microbiota in patients with clinically suspected nontuberculous mycobacterial pulmonary disease according to the presence of gastroesophageal reflux.

Although gastroesophageal reflux has been recognized as one of the risk factors of nontuberculous mycobacterial pulmonary disease (NTM-PD) progression, the effect of reflux on the lower respiratory tract microbiota has not been studied in detail. We investigated the composition of the lower respiratory tract microbiota in patients with clinically suspected NTM-PD, comparing them based on the presence of reflux. Forty-seven patients suspected of having NTM-PD were enrolled and assigned according to presence of reflux (n = 22) and non- reflux (n = 25). We performed a pepsin ELISA assay to identify the presence of reflux and 16S ribosomal RNA gene amplicon sequencing to evaluate the microbiota in bronchoalveolar lavage fluid. There were no significant differences in the diversity or composition of the lower respiratory microbiota between the NTM-PD and non-NTM-PD groups. Bacterial richness was observed in the non-reflux group than in the reflux group [P = 0.03] and a cluster in the reflux group was observed. The reflux group showed a predominance for Pseudomonas aeruginosa or Staphylococcus aureus among the NTM-PD group and for P. aeruginosa, Haemophilus influenzae, Klebsiella pneumoniae, or Eikenella species among the non-NTM-PD group. The non-reflux groups presented diverse patterns. A linear discriminant analysis and volcano plot demonstrated that P. aeruginosa, H. haemolyticus, Selenomonas artemidis, and Dolosigranulum pigrum were specifically associated with the NTM-PD reflux group, while P. aeruginosa was specifically associated with the non-NTM-PD reflux group. These observations confirm that the lower respiratory microbiota is consistently altered by reflux but not in NTM-PD.

In vitro evidence of antioxidant and anti-inflammatory effects of a new nutraceutical formulation explains benefits in a clinical setting of COPD patients.

Background and Aim: Increased oxidative stress within the airways is associated to epithelial damage and amplification of inflammatory responses that in turn contribute to Chronic Obstructive Pulmonary Disease (COPD) progression. This study was aimed to identify whether a new formulation of N-acetylcisteine (NAC), carnitine, curcumin and B2 vitamin could counteract oxidative stress and downstream pro-inflammatory events promoted by cigarette smoke extract (CSE) exposure in primary bronchial epithelial cells (PBEC), both submerged/undifferentiated (S-PBEC) and cultured at the air-liquid interface (ALI-PBEC). Methods: PBEC were exposed to CSE with/without the new formulation or NAC alone and ROS production, IL-8 and IL-6 gene expression and protein release were evaluated. Results: CSE increased ROS, IL-8 and IL-6 gene expression and protein release and the new formulation counteracted these effects. NAC alone was not effective on IL-8 and IL-6 release. The effects of a similar nutraceutical formulation were evaluated in COPD patients treated for six months. The results showed that the treatment reduced the concentration of IL-8 in nasal wash and improved quality of life. Conclusion: The tested formulation, exerting antioxidant and anti-inflammatory effects, can preserve airway epithelial homeostasis and improve clinical symptoms in COPD.

A Low Expression of NRF2 Enhances Oxidative Stress and Autophagy in Myofibroblasts, Promoting Progression of Chronic Obstructive Pulmonary Disease.

The inflammation phenotypes are often closely related to oxidative stress and autophagy pathway activation, which could be developed as a treatment target. The aim of this study was to explore the underlying mechanism of inflammation in chronic obstructive pulmonary disease (COPD). The lung tissue single-cell RNA-seq (scRNA-seq) dataset of GSE171541 was downloaded from the Gene Expression Omnibus (GEO) database. The marker genes were obtained from the CellMarker database. "Seurat" and "harmony" R packages were used for single-cell profiling analysis. Then, the "AUCell" R package was employed to calculate the reactive oxygen species (ROS) and autophagy pathway scores. Gene regulation network analysis was performed by applying the "SCENIC" package, followed by conducting correlation analysis with Spearman's rank correlation method. The cigarettes were used to develop a traumatic model in mice, and the expression of relevant genes was measured by qRT-PCR. The scRNA-seq analysis classified 12 cell subgroups in which the contractility of myofibroblasts was closely associated with the progression of COPD. Further analysis showed that ROS and autophagy pathways were significantly activated in myofibroblasts and that the nuclear factor erythroid 2-related factor 2 (NRF2) and its mediated oxidative stress pathway were inhibited in myofibroblasts. In addition, the downregulated NRF2 gene was negatively correlated with the expression of autophagy and ROS activation. In the traumatic mice model, NRF2 was downregulated in COPD mice but further elevated in the COPD+NRF2 mice group. Interestingly, the mRNA levels of Kelchlike ECH-associated protein 1 (Keap1), NADPH oxidase (NOX), and Cathepsin B (CTSB) were upregulated in COPD group in comparison to the control group but they were downregulated by NRF2. These results suggested that low-expressed NFR2 promoted autophagy and ROS pathway activation in myofibroblasts for COPD progression. We identified a cell myofibroblast cluster closely associated with COPD progression using the scRNA-seq analysis. The downregulated NFR2, as a key risk factor, mediated myofibroblast death by activating the oxidative stress and autophagy pathway for COPD progression.

Construction of metal interpretable scoring system and identification of tungsten as a novel risk factor in COPD

Numerous studies have highlighted the correlation between metal intake and deteriorated pulmonary function, emphasizing its pivotal role in the progression of Chronic Obstructive Pulmonary Disease (COPD). However, the efficacy of traditional models is often compromised due to overfitting and high bias in datasets with low-level exposure, rendering them ineffective in delineating the contemporary risk trends associated with pulmonary diseases. To address these limitations, we embarked on developing advanced, interpretable models, crucial for elucidating the intricate mechanisms of metal toxicity and enriching the domain knowledge embedded in toxicity models. In this endeavor, we scrutinized extensive, long-term metal exposure datasets from NHANES to explore the interplay between metal and pulmonary functionality. Employing a variety of machine-learning approaches, we opted for the “Mixer of Experts” model for its proficiency in identifying a myriad of toxicological trends and sensitivities. We conceptualized and illustrated the TSAP (Toxicity Score at Population-level), a metal interpretable scoring system offering performance nearly equivalent to the amalgamation of standard interpretable methods addressing the “black box” conundrum. This streamlined, bifurcated procedural analysis proved instrumental in discerning established risk factors, thereby uncovering Tungsten as a novel contributor to COPD risk. SynopsisTSAP achieved satisfied performance with transparent interpretability, suggesting tungsten intake need further action for COPD prevention.

Causal inference analysis of the radiologic progression in the chronic obstructive pulmonary disease

There is limited evidence regarding the causal inference of emphysema and functional small airway disease in the subsequent progression of chronic obstructive pulmonary disease (COPD). Patients consisting of two independent cohorts diagnosed with COPD and underwent two serial chest CT scans were included. Total percent emphysema (PRMEmph) and fSAD (PRMfSAD) was quantified via PRM. To investigate the progression of emphysema, we divided COPD patients with PRMEmph < 10% into low and high PRMfSADgroup, matched with similar baseline characteristics, and conducted nonparametric hypothesis tests based on randomization inference using Wilcoxon signed rank test and Huber’s M statistics. In patients with baseline PRMEmph < 10%, there were 26 and 16 patients in the low PRMfSA group and 52 and 64 patients in the high PRMfSA in the derivation and validation cohorts, respectively. In the both low and high PRMfSAD groups, there were 0.11 and 1.43 percentage point increases (Huber’s M statistic p = 0.016) and 0.58 and 2.09 percentage point increases (p = 0.038) in the proportion of emphysema in the derivation and validation cohorts, respectively. On the contrary, among patients with baseline PRMfSAD < 20%, there was no significant differences in the interval changes of PRMfSAD between the low and high PRMEmph groups in both cohorts. In COPD patients with low emphysema, group with baseline high PRMfSAD showed greater change of PRMEmph than those with low PRMfSAD in both the derivation and validation cohorts. Imaging-based longitudinal quantitative analysis may provide important evidence that small airway disease precedes emphysema in CT-based early COPD patients.

Phenotypes of regulatory T cells in different stages of COPD

BackgroundPrevious studies have shown that failure to control inflammatory processes mediated by regulatory T (Treg) cells contributes to chronic obstructive pulmonary disease (COPD) development and progression. The activity of Treg cells depends on their phenotypic characteristics: resting Treg (rTreg, CD3+CD4+CD25+FOXP3+CD25++CD45RA+) and activated Treg (aTreg, CD3+CD4+CD25+FOXP3+CD25+++CD45RA−) cells exhibit immunosuppressive activity, while cytokine-secreting T cells (FrIII, CD3+CD4+CD25+FOXP3+CD25++CD45RA−) exhibit proinflammatory activity. Previous findings have shown an increased density of cytokine-secreting T cells in COPD patients experiencing exacerbation. However, the methods for evaluating COPD under stable conditions are lacking. AimTo evaluate Treg cell phenotypes in patients with different stages of COPD under stable conditions. MethodsPeripheral blood mononuclear cells (PBMCs) were isolated from non-obstructed smokers and ex-smokers (NOS group, n = 19) and COPD patients at different stages (COPD I-II group, n = 25; COPD III-IV group, n = 25). The phenotypic characteristics of Treg cells and Th17 cells and their respective intracellular cytokines were analyzed by flow cytometry. ResultsBoth obstructed groups showed an increase in the proportion of rTregs, while the COPD III-IV group showed additional increases in total Treg and Th17 cells and in IL-10+ cells. There was an increase in proinflammatory mediators (CD3+CD4+IL-17+ cells; CD3+CD4+RORγt+ cells) in the COPD I-II group. In contrast, the NOS group demonstrated high proportions of proinflammatory Treg cells and proinflammatory CD8+ T cells (CD3+CD8+IL-17+). ConclusionDespite the increase in both total Treg cells and the rTreg phenotype from the early stages of COPD, there was a decrease in cells expressing IL-10, suggesting a failure in controlling the inflammatory process. These events precede the progression of the inflammatory process mediated by Th17 cells.

Mitochondrial dynamics in pulmonary disease: Implications for the potential therapeutics.

Mitochondria are dynamic organelles that continuously undergo fusion/fission to maintain normal cell physiological activities and energy metabolism. When mitochondrial dynamics is unbalanced, mitochondrial homeostasis is broken, thus damaging mitochondrial function. Accumulating evidence demonstrates that impairment in mitochondrial dynamics leads to lung tissue injury and pulmonary disease progression in a variety of disease models, including inflammatory responses, apoptosis, and barrier breakdown, and that the role of mitochondrial dynamics varies among pulmonary diseases. These findings suggest that modulation of mitochondrial dynamics may be considered as a valid therapeutic strategy in pulmonary diseases. In this review, we discuss the current evidence on the role of mitochondrial dynamics in pulmonary diseases, with a particular focus on its underlying mechanisms in the development of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis (PF), pulmonary arterial hypertension (PAH), lung cancer and bronchopulmonary dysplasia (BPD), and outline effective drugs targeting mitochondrial dynamics-related proteins, highlighting the great potential of targeting mitochondrial dynamics in the treatment of pulmonary disease.

Causal Involvement of Immune Cells in Chronic Obstructive Pulmonary Disease: A Mendelian Randomization Study.

The immune cells play a substantial role in the development and progression of chronic obstructive pulmonary disease (COPD). We aim to investigate the causal involvement of immune cells in COPD via a Mendelian randomization (MR) analysis. Published genome-wide association studies (GWAS) statistics on immune cells were analyzed, with genetic variants identified as instrumental variables (IVs). Inverse-variance weighting (IVW), weighted median, and MR-Egger regression methods were employed, along with simple mode and weighted mode adopted in the two-sample MR analysis. Sensitivity analysis was conducted to examine the heterogeneity, horizontal pleiotropy, and stability of the causal relationship. IVW results suggested that CCR2 on CD62L+ plasmacytoid dendritic cells (DC), CCR2 on plasmacytoid DC, CD11b on CD66b++ myeloid cells, CD19 on CD20- CD38- CD24+ memory B cell subset, CD25 on transitional B cells, and CD25++CD8br %CD8br T cells were risk factors for the development of COPD. Besides, CD127 on effector memory-like cytotoxic T lymphocytes lacking expression of co-stimulatory molecule 28 (CD28-EM CTLs) and HLA DR+ NK ACs expressing human leukocyte antigen DR molecules while being natural killer cells (%NK ACs) were protective factors for COPD. This study unveiled a causal relationship between immune cell phenotype and COPD. These findings offer new insights for the prevention and treatment of COPD using COPD-associated immune cells.

Integrated bioinformatic analysis and experimental validation for exploring the key immune checkpoint of COPD

BackgroundThere is growing evidence indicating immune inflammation is a key factor in the progression of chronic obstructive pulmonary disease (COPD). Immune checkpoints (ICs) are crucial targets for modulating the functional activation and differentiation of immune cells, particularly in relation to immune inflammation and the regulation of T cell activation and exhaustion. However, the precise mechanisms of ICs in COPD remain understood. MethodsCOPD datasets were obtained from the Gene Expression Omnibus (GEO) and analyzed using GEO2R and Limma to identify differentially expressed genes. LASSO regression was then applied to screen ICs closely associated with COPD. Finally, target genes were selected based on gene expression profiles. Gene ontology (GO), immune infiltration analysis, and gene set enrichment analysis (GSEA) were utilized to assess the relationship between IC genes (ICGs) and immune cells. Subsequently, tobacco-exposed mice, anti-Tim3-treated mice, and HAVCR2-knockout mice were generated, with flow cytometry being used to confirm the results. ResultsThrough the analysis of GSE38974 and LASSO regression, five ICGs were identified. Subsequent validation using GSE20257 and GSE76925 confirmed these findings. Gene expression profiling highlighted HAVCR2 as having the strongest correlation with COPD. Further investigation through immune infiltration analysis, GO, and GSEA indicated a link between HAVCR2 and CD8+ T cells in COPD. Flow cytometry experiments demonstrated high Tim3 expression in CD8+ T cells of mice exposed to tobacco, promoting Tc1 and inhibiting Tc17, thus affecting CD8+ Tem activation and CD8+ Tcm formation, leading to an immune imbalance within CD8+ T cells. ConclusionProlonged exposure to tobacco upregulates Tim3 in CD8+ T cells, triggering its regulatory effects on Tc1/Tc17. Knocking out HAVCR2 further upregulated the expression of CD8+ Tem while suppressing the expression of CD8+ Tcm, indicating that Tim3 plays a role in the activation and differentiation of CD8+ T cells in the context of tobacco exposure.