Pulmonary Function Features Research Articles

Pathophysiological relation between the systemic inflammation and the state of small airways in mild asthma with obesity

The aim of present study was to establish the relationship between the level of blood serum cytokines and indexes of pulmonary function as well as to identify the markers of evolving dysfunction of small airways in obese patients with partially controlled mild bronchial asthma. We have examined 53 patients with mild asthma of partially controlled clinical course complicated with obesity (I-II degree). The control group consisted of 25 healthy volunteers. All participants underwent spirometry, bodyplethysmography. Tumor necrosis factor alpha (TNFα), interferon gamma (IFNγ), interleukins (IL) IL2, IL-4, IL-6, IL-10, IL-17A were determined in blood serum. In the patients with partially controlled mild asthma, an increase in IL-17A by 55.8%, and IL-4 by 44.9% was detected, regardless of body mass. According to the results of cluster analysis, two sub-groups were discerned, depending on the state of the small airways and the levels of pro- and anti-inflammatory cytokines. The dysfunction of small airways was shown to be accompanied by hypercytokinemia being more common in bronchial asthma with predominant Th1-and Th17-immune responses. We have revealed an association between IL-17A, IL-6 levels and functional indices reflecting the state of the small airways, as well as correlation between IFNγ and the indices of bronchial obstruction. The features of pulmonary function were found to be dependent on the cytokine status in mild asthma with obesity. Two immuno-functional variants were identified, differing in activity of systemic inflammation, type of immune response, and functional state of the small airways. The revealed relationships allow us to consider IL-17A, IL-6 and IFNγ as markers of small airways dysfunction in mild asthma of partially controlled clinical course associated with obesity.

Metabolic Determinants of Impaired Pulmonary Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

Impaired lung function associates with deterioration of glycemic control and diabetes-related oxidative stress in long-standing type 2 diabetes. We hypothesized that recent-onset type 2 diabetes patients exhibit abnormal pulmonary function when compared to glucose-tolerant controls and that the frequencies of single-nucleotide polymorphisms (SNPs), known to associate with lung dysfunction, are different between both groups. Type 2 diabetes patients with a known disease duration<1 year (n=34) had similar age, sex distribution and BMI as overweight controls (n=26). Lung function was assessed by spirometry comprising predicted forced vital capacity (FVC%), predicted forced expiratory volume in one second (FEV1%) and the FEV1/FVC ratio. Multivariable linear regressions were performed to investigate group differences, which were adjusted for potential confounders such as age, sex, BMI, height and smoking status. SNP genotyping was conducted using real-time polymerase chain reaction-based allelic discrimination. Patients with type 2 diabetes had lower FEV1%, FEV1/FVC and VO2max (all p<0.05). Among patients with type 2 diabetes, FEV1% correlated positively with VO2max (r=0.40, p<0.05) and FEV1/FVC correlated negatively with HbA1c (r=-0.49, p<0.01). Regression analyses across the whole cohort indicated that the group differences in FEV1/FVC can be explained by the confounding effect of HbA1c. The frequencies of the SNPs rs1042713, rs1079572, rs11172113, rs12504628, rs1422795, rs1481345, rs2235910, rs2277027, rs2284746, rs4341, rs7068966, rs925284, rs993925 and rs3824658 did not differ between both groups. Recent-onset type 2 diabetes patients exhibit reductions in features of pulmonary function, which might be at least in part resulting from glucotoxicity.

Pulmonary function features of combined pulmonary fibrosis and emphysema

Objective To evaluate the pulmonary function characteristics of patients with combined pulmonary fibrosis and emphysema (CPFE),and to examine whether distinguishing CPFE,emphysemaalone (EA),and pulmonary fibrosis (IPF) without emphysema by the pulmonary function method.Methods The pulmonary function parameters of 48 patients with CPFE,50 cases of EA,and 46 cases of IPF without emphysema were analyzed and compared by conventional methods of lung function testing and impulse oscillometry system.Results Total lung capacity (TLC)％0 pred was normal in CPFE group [(86.9±17.8) ％].TLC％pred was decreased in IPF without emphysema group [(70.4±17.0)％].The forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) in CPFE group was normal [(72.0± 9.4)％].FEV1/FVC decreased in EA group [(56.5± 14.4)％].Diffusion capacity was lower in CPFEgroup [(57.2± 17.3)％],EA group [(62.8±25.7)％],and IPF without emphysema group [(66.9± 21.5)％],respectively.R5 ％ pred in CPFE group and IPF without emphysema group was normal by impulse oscillometry system.However,R5 ％ pred was significantly elevated in EA group [(161.3 ±69.0) ％].R5-R20 increased in the three groups.Compared with CPFE group and IPF without emphysema group,R5 R20 increased significantly in EA group (P =0.006,P =0.013).In addition,X5 reduced in the three groups.Compared with CPFE group and IPF without emphysema group,X5 decreased significantly in EA group (P 0.004,P =0.047).In CPFE group and EA group,there was positive correlation between R5-R20 and RV/TLC (r =0.44,P =0.01; r =0.66,P =0.01).In CPFE group and EA group,there was negative correlation betweenX5 and RV/TLC (r =0.51,P =0.01; r =0.66,P =0.01).In IPF without emphysema group,there was correlation between TLC％ pred and R5-R20 and X.5 (r =-0.50,P =0.01; r =0.6,P =0.01).Conclusions Pulmonary function features of CPFE show that lung volume,ventilation function,total airway resistance,and central airway resistance are normal,diffusion capacity and lung compliance are lower,peripheral airway resistance and elasticity resistance are higher. Key words: Pulmonary emphysema; Pulmonary fibrosis; Pulmonary function; Impulse oscillometry

Cryptogenic Fibrosing Alveolitis

Clinical, radiographic, and histologic data, together with pulmonary function features, in eleven patients with cryptogenic fibrosing alveolitis, are described in the following study. All these patients presented with a history of exertional dyspnea. Eight of the eleven had radiographic evidence of pleural involvement as manifested by blunting of one or both costophrenic angles. A restrictive defect was present in eight patients, all of whom had x-ray changes showing diffuse involvement. One of the patients presented showed marked improvement in all parameters including a repeat lung biopsy. Immunofluorescent studies of the lung biopsies from six patients revealed no evidence of immunologic damage. Based upon the histologic pattern of pulmonary reaction in the biopsies and the intervals between the onset of symptoms and the time of biopsy, a tenative scheme of temporal evolution of this disease is presented. Lung injury may lead either directly to diffuse interstitial pulmonary fibrosis (DIPF) or lungs may react to injury by an initial alveolar, mural or mixed pattern, all of which might ultimately progress to DIPF. An initial alveolar or mural pattern might change to a mixed pattern.