Respiratory Tract Disease Research Articles

THE CONDITION OF MUCOCILIARY CLEARANCE IN PATIENTS WITH NASAL SEPTUM DEVIATION AND POSTNASAL DRIP SYNDROME

Introduction. Mucociliary clearance is a vital defense mechanism in the human upper respiratory tract that safeguards the body against inhaled harmful substances. Ciliary activity was first discovered by Sharpey in 1835, and it took nearly a century for this function to be recognized as a central component in the physiology of the sinuses.
 The aim of this study is to investigate the status of mucociliary clearance in patients with a nasal septum deviation and concomitant postnasal drip syndrome.
 Materials and Methods: A total of 54 patients, aged between 23 and 55 years, were enrolled in the study. All participants underwent a saccharin test and an assessment of the motor activity of the ciliated epithelium. Exclusion criteria included the presence of infectious and inflammatory diseases of the upper respiratory tract within the last month.
 Results: In the control group of patients, no significant difference was observed in the speed of saccharin test passage, both in the right and left parts of the nasal cavity, with test times ranging from 8.35 to 14.52 minutes. However, in the second clinical group comprising patients with nasal septum deviation, the average time for the saccharin test on the mucous membrane of the concave side of the nasal septum was significantly longer than on the convex side, measuring 21.52 ± 3.04 minutes and 12.36 ± 2.73 minutes, respectively (P = 0.02). When assessing the data from patients in the third clinical group based on the curvature side, a significant difference (P < 0.05) was observed in the reduction of saccharin test speed compared to the control group.
 Conclusions: The data obtained indicate a significant influence of nasal septum deviation on subsequent changes in nasal cavity physiology, resulting in a slowdown of mucociliary clearance. This can lead to excessive mucus stagnation in the nasal cavity and, consequently, the development of postnasal drip syndrome.

Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023

Respiratory syncytial virus (RSV) is a cause of severe respiratory illness in older adults. In May 2023, the Food and Drug Administration approved the first vaccines for prevention of RSV-associated lower respiratory tract disease in adults aged ≥60 years. Since May 2022, the Advisory Committee on Immunization Practices (ACIP) Respiratory Syncytial Virus Vaccines Adult Work Group met at least monthly to review available evidence regarding the safety, immunogenicity, and efficacy of these vaccines among adults aged ≥60 years. On June 21, 2023, ACIP voted to recommend that adults aged ≥60 years may receive a single dose of an RSV vaccine, using shared clinical decision-making. This report summarizes the body of evidence considered for this recommendation and provides clinical guidance for the use of RSV vaccines in adults aged ≥60 years. RSV vaccines have demonstrated moderate to high efficacy in preventing RSV-associated lower respiratory tract disease and have the potential to prevent substantial morbidity and mortality among older adults; postmarketing surveillance will direct future guidance.

Можливості верифікації позагоспітальної пневмонії в дітей за змінами багатопараметричної поляризаційно-фазової мікроскопії полікристалічних плівок легеневого експірату

The problem of early diagnosis and selection of target treatment of pneumonia in children during the years of the COVID-19 pandemic became acute, in particular, with regard to predicting the risk of severe disease, which prompted the search for new non-invasive diagnostic methods for verifying inflammation of the lung parenchyma. Purpose - to increase the effectiveness of the diagnosis of community-acquired pneumonia in children based on the analysis of the diagnostic value of the method of multiparameter polarization-phase microscopy of polycrystalline membranes of pulmonary expiratory condensate in the aspect of differential diagnosis in relation to patients with infectious inflammatory diseases of the upper respiratory tract. Materials and methods. In the Chernivtsi Regional Pediatric Hospital, 98 children with infectious inflammatory respiratory diseases were examined, in particular, 64 patients with pneumonia and 34 children suffering from infectious and inflammatory diseases of the upper respiratory tract. Biological material was collected from patients on the first day of hospitalization. The investigation of the laser-polarimetric images structure of pulmonary expiratory condensate was carried out in the traditional arrangement of the Stokes polarimeter. A universal analytical statistical approach was used for each two-dimensional distribution of the polarization azimuth values of the polycrystalline membranes of pulmonary expiratory condensate, namely, the determination of a set of statistical moments of the 1st to 4th orders (mean, variance, skewness and kurtosis). The obtained results were analyzed using methods of clinical epidemiology. Results. Polarization azimuth indexes and histograms of their values were determined for images of pulmonary expiratory samples of both groups of children. The comparative analysis of the obtained data confirmed that both samples are characterized by optical heterogeneity as an increase in the sensitivity of polarization mapping of lung expiratory samples. An increase in the optical anisotropy of polycrystalline membranes of lung expiratory condensate from patients with pneumonia was also revealed. The obtained indexes of all statistical moments for the purpose of pneumonia verifying had high sensitivity exceeding 98% and sufficient specificity. Conclusions. Sufficient diagnostic value of the method of multi-parameter polarization-phase microscopy of pulmonary expiratory air, which can be used in the verification of inflammation of the pulmonary parenchyma in children relative to patients with infectious inflammatory diseases of the upper respiratory tract, has been established. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The effect of biologics in lung function and quality of life of patients with united airways disease: A systematic review

Increasing evidence supports the united airway disease concept for the management of upper and lower respiratory tract diseases, particularly in patients with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). However, evidence for a combined approach in asthma and CRSwNP is scarce. In this systematic review, we focused on the role of biologics in the lung function and quality of life in patients with severe asthma and CRSwNP. We conducted a systematic search of 3 electronic databases using 2 search strategies to identify studies published from January 2010 to March 2022. Quality assessment was performed with the Critical Appraisal Skills Programme. Of 1030 studies identified, 48 original studies reporting data of benralizumab (12), dupilumab (14), mepolizumab (10), omalizumab (13), and reslizumab (2) were analyzed. Primary diagnosis was mostly asthma or CRSwNP, with only 15 studies, mainly observational, performed in populations with united airway disease. In total, 18 studies reported data on quality of life (mostly 22-item Sino-Nasal Outcome Test score), 8 on lung function (mostly FEV1), and 22 on both outcomes. Significant FEV1 and 22-item Sino-Nasal Outcome Test score improvements were consistently observed after 24-week treatment, and thereafter, mostly in real-world studies that included variable proportions of patients with asthma/CRSwNP. The use of biologics in patients with severe asthma and CRSwNP was overall associated with significant improvements in lung function and quality of life. However, we observed a high heterogeneity of populations and outcome measurements across studies. Notwithstanding the need of larger studies, our results reinforce the joint management of asthma and CRSwNP as united airway disease in clinical practice.

Chronic rhinosinusitis is not associated with increased incidence of acute myocardial infarction: A national population-based study.

Chronic rhinosinusitis (CRS) is one of the most prevalent upper respiratory tract diseases. However, little is known the effect of CRS on the cardiovascular aspects of patients. This study aimed to investigate the incidence of acute myocardial infarction (AMI) in patients with CRS compared with that in the general population. This retrospective cohort study was performed using the Korean National Health Insurance Service (NHIS) database. To minimize confounding, age, sex, and cardiovascular risk profiles were adjusted. The primary endpoint was newly diagnosed AMI in patients between January 2005 and December 2018. The relative risk of AMI in patients with CRS was compared with that in controls. Kaplan-Meier survival curves and Cox proportional regression tests were used for statistical analyses. Among 5,179,981 patients from the NHIS database, 996,679 patients with CRS were selected. The control group was 10 times (n = 9,966,790) the number of individuals in the CRS group. The CRS group had better cardiovascular profiles than those of the control group and had an adjusted hazard ratio of 0.99 (95% confidence interval, 0.97-1.02) for AMI. There was no significant association between the two groups regardless of the presence of nasal polyps. This is the first study adjusting cardiovascular risk profiles and analyzing the relationship between CRS and AMI. CRS was not associated with a high incidence of AMI after adjusting for cardiovascular risk factors.

Patients with Cerebral Palsy Who are Admitted to a Chest Diseases Hospital may have Higher Mortality Rates Serebral Palsili Hastaların Göğüs Hastalıkları Hastanesine Yatışları Mortal Seyredebilir

Objective: Epilepsy, pneumonia, gastritis, esophagitis, malnutrition, dehydration, fractures, and non-pneumonic lung disorders (asthma, pleural fluid, respiratory failure) are the leading causes of hospitalization among cerebral palsy (CP) patients. This study aimed to determine respiratory tract diseases and mortality rates in patients with CP admitted to the chest diseases hospital. 
 Materials and Methods: Patients diagnosed with CP and hospitalized in Chest Diseases Hospital between January 2010 and December 2017 were included in the study and analyzed retrospectively. As the endpoint, hospitalized patients' respiratory tract infection-related 30-days mortality were examined.
 Results: Forty-three hospitalizations of 23 patients were evaluated. The mean length of hospital stay was 15.5 (1-62) days. The reasons for hospitalization in patients with CP were mainly composed of respiratory tract infections (pneumonia %88,4, lung abscess %7). The most frequently isolated pathogenic microorganisms were gram-negative bacteria. Wheezing, bacterial culture growth, vasopressor and invasive mechanical ventilation were all factors that increased 30-day mortality (respectively p=0,016; p=0,024; p=0,003; p=0,003). The 30-day mortality rate was %21,7. While 2 patients died at first hospitalization, 4 patients died on recurrent hospitalizations. 
 Conclusion: Patients with CP are often hospitalized due to respiratory tract infections. Recurrent hospitalizations may increase mortality. This study emphasizes the importance of close follow-up with these patients considering the high mortality rate among CP patients hospitalized for respiratory tract infections.

Long term respiratory morbidity of cesarean-delivered second twin compared to their vaginally-delivered sibling: A retrospective population-based cohort study.

Offspring born via cesarean delivery (CD) may be more prone to develope long-term respiratory diseases, compared to those delivered vaginally (VD). In this study, we compared the rates of respiratory diseases between first twins VDand second twins delivered via CD. This was a retrospective database study. All twin deliveries encompassed at the Soroka University Medical Center, a large tertiary hospital in southern Israel, between 1991 and 2020, in which the first twin was VDand the second via CD were included. Respiratory diseases included respiratory tract diseases such as bronchiolitis and bronchial asthma. The cumulative incidence of respiratory diseases was compared between the twins using Kaplan-Meier survival analysis and multivariable Cox models to adjust for confounding variables. A total of 395,408 deliveries occurred during the study period, with 13,402 (3.4%) of all deliveriesbeing twins. Of these, 184 (1.4%) were first twins VDand second twins delivered via CD. The second CD twin was more likely to have a non-reassuring fetal heart rate pattern and an Apgar score less than 7 at 5 min. No other differences were found between the siblings. The incidence of long-term respiratory diseases was not statistically different between the CD and VD siblings (7.6% vs. 9.4%, respectively; OR = 0.54; 95%CI: 0.23-1.26). Similarly, the cumulative incidence of respiratory diseases was not statistically different (Kaplan-Meier, log-rank, p = .59), and in the multivariable analysis which adjusted for birthweight and fetal distress during delivery (adjusted hazard ratio = 1.06; 95%CI: 0.43-26.25). While the immediate outcomes for the CD twin were slightly worse compared to the VD twin, there was no difference in long-term respiratory diseases between the siblings.

Nirsevimab (Beyfortus) for prevention of severe RSV disease in young children.

The FDA has approved nirsevimab-alip (Beyfortus – AstraZeneca/Sanofi), a long-acting monoclonal antibody, for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants born during or entering their first RSV season, and in children ≤24 months old who are at increased risk for severe RSV disease through their second RSV season. Nirsevimab is the first drug to be approved for protection of all infants during their first RSV season.

ANAMNESIS, CLINICAL AND PARACLINICAL CHARACTERISTIC OF CHILDREN WITH AUTOIMMUNE THYROIDITIS

Purpose. 
 To conduct a comparative characterization of anamnesis and clinical and paraclinical data of children suffering from autoimmune thyroiditis and those with no thyroid pathology in order to optimize early diagnosis of the disease.
 Materials and Methods. 
 This examination was carried out on 132 children (55 boys and 77 girls) diagnosed with autoimmune thyroiditis at the age of 11.68±0.35. For comparison, 577 children (268 boys and 309 girls) without thyroid pathology at the age of 11.49±0.17 were included in the control group. Statistical study techniques were applied using the licensed software package Statistica. The differences of р<0.05, р<0.01, р<0.001 were considered statistically significant.
 Results. 
 The comparative study of children diagnosed with autoimmune thyroiditis and those with no thyroid pathology showed that euthyroidism was diagnosed in 78.31% of patients in the primary observation group, hypothyroidism in 17.39%, and hyperthyroidism in 4.3% of patients. Children diagnosed with autoimmune thyroiditis showed thyroperoxidase antibody levels ranging from 209.7 to 694.7 IU/mL, TSH from 0.01 to 5.93 to 89.9 IU/mL, and free T4 from 1.14 to 28.8 ng/dL. The criteria for early diagnosis of autoimmune thyroiditis included: a burdened familial history of thyroid disease (15.9%); complaints of psychoemotional, neurological (35.6%) and heart rhythm disorders (14.4%), predominantly in boys (58.2% and 18.18%), prolonged low-grade fever (5.3%), predominantly in girls (6.5%); comorbid conditions: respiratory tract diseases (25.76%) and lymphadenitis (28.03%); ultrasonic changes of the thyroid gland with increased (31.06%) or decreased (4.55%) volume, cystous nodules (40.15%), increased vascular pulsation (39%) and changes in echogenicity of the thyroid gland.
 Conclusion. 
 At the current stage, early diagnosis of autoimmune thyroiditis in children is important for the timely prevention of the negative impact of the disease on the functional state and development of the child's body.

TLR7 promotes chronic airway disease in RSV-infected mice.

Respiratory syncytial virus (RSV) commonly infects the upper respiratory tract (URT) of humans, manifesting with mild cold or flu-like symptoms. However, in infants and the elderly, severe disease of the lower respiratory tract (LRT) often occurs and can develop into chronic airway disease. A better understanding of how an acute RSV infection transitions to a LRT chronic inflammatory disease is critically important to improve patient care and long-term health outcomes. To model acute and chronic phases of the disease, we infected wild-type C57BL/6 and toll-like receptor 7 knockout (TLR7 KO) mice with RSV and temporally assessed nasal, airway and lung inflammation for up to 42 days post-infection. We show that TLR7 reduced viral titers in the URT during acute infection but promoted pronounced pathogenic and chronic airway inflammation and hyperreactivity in the LRT. This study defines a hitherto unappreciated molecular mechanism of lower respiratory pathogenesis to RSV, highlighting the potential of TLR7 modulation to constrain RSV pathology to the URT.

Epidemiological survey of feline viral infectious diseases in China from 2018 to 2020

AbstractTo analyze the prevalence of feline viral diseases in China, including feline panleukopenia virus (FPV), feline calicivirus (FCV), feline herpesvirus 1 (FHV‐1), and feline coronavirus (FCoV) infectious diseases from 2018 to 2020, swab samples from 304 cats and serum samples from 193 cats in 18 cities were collected. The etiological investigation results of 304 cats showed that 256 (84.21%) cats were positive, infected with at least one virus, and the positive rates for FPV, FCV, FHV‐1, and FCoV were 61.51%, 10.86%, 4.61%, and 55.92%, respectively. The mixed infection exhibited high complexity, and a total of eight mixed infection patterns were detected. The risk factor analysis of each pathogen in different clinical scenarios indicated that FPV positive status was significantly related to all the studied diseases, FCV positive status exhibited the most significant association with gingivostomatitis and conjunctivitis, and FHV‐1 positive status was significantly related to upper respiratory tract disease, but FCoV positive status was not significantly related to any disease. Additionally, the prevalence of FPV exhibited a strong seasonality and was related to age, while the prevalence of FCV, FHV‐1, and FCoV had nothing to do with season or age. FCV infection was sex related in cats, whereas the prevalence of FCV, FHV‐1, and FCoV was not sex related. FPV, FCV, FHV‐1, and FCoV were unrelated to breed or residential density. Antibody detection results of 193 serum samples by the virus neutralizing method indicated that the current commercial vaccines might not protect hosts against wild strains of FPV, FCV, and FHV‐1 in China. In general, this study enriches epidemiological survey data of common viral diseases in cats in China and provides a theoretical basis for further development of vaccines.

Respiratory Syncytial Virus Prefusion F Protein Vaccine Is Efficacious in Older Adults With Underlying Medical Conditions.

Older adults with chronic cardiorespiratory or endocrine/metabolic conditions are at increased risk of respiratory syncytial virus (RSV)-related acute respiratory illness (RSV-ARI) and severe respiratory disease. In an ongoing, randomized, placebo-controlled, multicountry, phase 3 trial in ≥60-year-old participants, an AS01E-adjuvanted RSV prefusion F protein-based vaccine (RSVPreF3 OA) was efficacious against RSV-related lower respiratory tract disease (RSV-LRTD), severe RSV-LRTD, and RSV-ARI. We evaluated efficacy and immunogenicity among participants with coexisting cardiorespiratory or endocrine/metabolic conditions that increase the risk of severe RSV disease ("conditions of interest"). Medically stable ≥60-year-old participants received 1 dose of RSVPreF3 OA or placebo. Efficacy against first RSV-LRTD and RSV-ARI episodes was assessed in subgroups with/without coexisting cardiorespiratory or endocrine/metabolic conditions of interest. Immunogenicity was analyzed post hoc in these subgroups. In total, 12 467 participants received RSVPreF3 OA and 12 499 received placebo. Of these, 39.6% (RSVPreF3 OA) and 38.9% (placebo) had ≥1 coexisting condition of interest. The median efficacy follow-up was 6.7 months. Efficacy against RSV-LRTD was high in participants with ≥1 condition of interest (94.6%), ≥1 cardiorespiratory (92.1%), ≥1 endocrine/metabolic (100%), and ≥2 conditions of interest (92.0%). Efficacy against RSV-ARI was 81.0% in participants with ≥1 condition of interest (88.1% for cardiorespiratory, 79.4% for endocrine/metabolic conditions) and 88.0% in participants with ≥2 conditions of interest. Postvaccination neutralizing titers were at least as high in participants with ≥1 condition of interest as in those without. RSVPreF3 OA was efficacious against RSV-LRTD and RSV-ARI in older adults with coexisting medical conditions associated with an increased risk of severe RSV disease. ClinicalTrials.gov: NCT04886596.

Characterization of the SARS-CoV-2 BA.5.5 and BQ.1.1 Omicron variants in mice and hamsters.

The continued evolution and emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have resulted in challenges to vaccine and antibody efficacy. The emergence of each new variant necessitates the need to re-evaluate and refine animal models used for countermeasure testing. Here, we tested a recently circulating SARS-CoV-2 Omicron lineage variant, BQ.1.1, in multiple rodent models including K18-human ACE2 (hACE2) transgenic, C57BL/6J, and 129S2 mice, and Syrian golden hamsters. In contrast to a previously dominant BA.5.5 Omicron variant, inoculation of K18-hACE2 mice with BQ.1.1 resulted in substantial weight loss, a characteristic seen in pre-Omicron variants. BQ.1.1 also replicated to higher levels in the lungs of K18-hACE2 mice and caused greater lung pathology than the BA.5.5 variant. However, in C57BL/6J mice, 129S2 mice, and Syrian hamsters, BQ.1.1 did not cause increased respiratory tract infection or disease compared to animals administered BA.5.5. Moreover, the rates of direct contact or airborne transmission in hamsters were not significantly different after BQ.1.1 and BA.5.5 infections. Taken together, these data suggest that the BQ.1.1 Omicron variant has increased virulence in rodent species that express hACE2, possibly due to the acquisition of unique spike mutations relative to earlier Omicron variants. IMPORTANCE As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve, there is a need to rapidly assess the efficacy of vaccines and antiviral therapeutics against newly emergent variants. To do so, the commonly used animal models must also be re-evaluated. Here, we determined the pathogenicity of the BQ.1.1 SARS-CoV-2 variant in multiple SARS-CoV-2 animal models including transgenic mice expressing human ACE2 (hACE2), two strains of conventional laboratory mice, and Syrian hamsters. While BQ.1.1 and BA.5.5 infection resulted in similar levels of viral burden and clinical disease in hamsters and the conventional strains of laboratory mice tested, increases in lung infection were detected in hACE2-expressing transgenic mice, which corresponded with greater levels of pro-inflammatory cytokines and lung pathology. Taken together, our data highlight important differences in two closely related Omicron SARS-CoV-2 variant strains and provide a foundation for evaluating countermeasures.

Study on sIgE distribution characteristics and the sensitization pattern of allergen in 1 161 patients with allergic diseases of respiratory tract in northwest China

Objective: To explore the allergen map of patients with allergic diseases in northwest China, to investigate the distribution characteristics of serum specific Immunoglobulin E (sIgE) in different ages, genders, diseases and the sensitization patterns of allergens. Methods: This study is a cross-sectional study, a total of 1 161 patients with confirmed respiratory allergic diseases were selected retrospectively from outpatient or inpatient department of Gansu Provincial People's Hospital, Gansu Provincial Maternity and Child Care Hospital, General Hospital of Ningxia Medical University, Yinchuan Maternal and Child Health Care Hospital, Xijing Hospital, Air Force Military Medical University and Tumor Hospital of Inner Mongolia Autonomous Region from June 2019 to October 2022. HAIKE ALLEOS 2000 fluorescent magnetic particle chemiluminescence method was used to quantify their serum for 12 inhaled allergen-specific IgE. Chi square test or Fisher's exact test were used for comparison between count data groups (Bonferroni correction was used for further pairwise comparison in multiple groups, two-sided P<0.05/3=0.017 considered that the difference was statistically significant). Pearson correlation analysis was used for correlation of continuous numerical variables. Results: The positive detection rate of sIgE in 1 161 patients was 66.8%(776/1 161). The three highest positive rate of inhaled allergen were mugwort(599/1 161, 51.6%), French chrysanthemum(565/1 161, 48.7%) and dandelion(412/1 161, 35.5%). In different age groups, the highest positive rate of sIgE was 7-18 age group(379/513, 73.9%) while the lowest positive rate was 4-6 age group(222/370, 60.0%), the difference between groups was statistically significant(χ2=21.177, P<0.001). The sensitization peak of mugwort, French chrysanthemum, plantain, timothy, birch, dermatophagoides pteronyssinus, dermatophagoides farinae, cat epithelium, dog epithelium and German cockroach appeared in 7-18 age group. In different disease groups, the highest positive rate of sIgE was allergic rhinitis with asthma group (500/717, 69.7%) while the lowest positive rate was asthma group (76/144, 52.8%), the difference between groups was statistically significant(χ2=15.563, P<0.001). In different gender groups, the positive rate of sIgE in male (503/711, 70.7%) was higher than in female (273/450, 60.7%), the difference between groups was statistically significant(χ2=12.630, P<0.001). The multiple-sensitization rate was 86.9%(674/776) and the double-sensitization rate was 16.8%(130/776) in sIgE positive patients. Pearson correlation results showed that there was an extremely strong correlation between dandelion and French chrysanthemum(r=0.93,P<0.001). There was a strong correlation between mugwort and French chrysanthemum(r=0.64,P<0.001). In the co-sensitization analysis, the number of patients sensitized by mugwort, French chrysanthemum, dandelion, plantain and timothy accounted for 25.2%(170/674)of the total number of multiple sensitization. The number of patients sensitized by mugwort, French chrysanthemum and dandelion accounted for 58.3%(393/674)of the total number of multiple sensitization. The number of patients sensitized by mugwort, French chrysanthemum, dandelion and plantain accounted for 35.6%(240/674) of the total number of multiple sensitization. Conclusion: Mugwort, French chrysanthemum, dandelion are the major inhaled allergens in northwest China. The positive rate of sIgE was different in different ages, diseases and genders. The multiple-sensitization rate of allergen was high and there was a certain positive correlation between pollen allergen-specific IgE pairwise, suggesting that there may exist co-sensitization or cross-reactions among allergens.

Assessment of working conditions and health conditions of employees of non-ferrous metallurgy enterprises

The production conditions of non-ferrous metallurgy enterprises can be characterized by a high severity of the labor process due to excessive physical exertion, constant exposure to intense noise, increased vibration levels; inhalation of industrial aerosols, dust and chemicals; exposure to unfavorable industrial microclimate. The most common types of professionally conditioned and occupational pathology in employees of non-ferrous metallurgy departments are sensorineural hearing loss, vibration disease, radiculopathy, lung and upper respiratory tract diseases, diseases of the musculoskeletal system.&#x0D; In order to summarize the information and identify the peculiarities of working conditions and health status of employees of non-ferrous metallurgy enterprises, the researchers analyzed the relevant scientific literature on the bibliographic databases Scopus, Web of Science, MedLine and RSCI using theoretical methods of scientific cognition.&#x0D; The most intense impact of production factors is characterized by the working conditions of workers of underground divisions of non-ferrous metallurgy enterprises.&#x0D; At the same time, the presence of a specific chemical factor associated with exposure to dust and gas mixtures and aerosols of non-ferrous metals causes the development of morbidity in workers of metallurgical industries for processing and enriching raw materials of non-ferrous metals with toxic alveolitis, bronchial asthma, malignant neoplasms, diseases of the skin and subcutaneous tissue, blood and central nervous system. In this regard, at non-ferrous metallurgy enterprises, when planning a set of preventive measures, the identification of groups of diseases associated with working conditions and caused by the presence of a specific chemical factor of exposure to dust and gas mixtures and aerosols of non-ferrous metals should be considered a necessary condition for preserving the health of workers.&#x0D; Ethics. This study did not require the conclusion of the ethics committee.

Periodontitis is associated with multimorbidity in a large dental school population.

To investigate whether and which diseases co-occur with periodontitis (PD) to assess the prevalence of comorbidities and multimorbidity and to identify patterns and profiles of comorbidity and multimorbidity and the influence of demographic and lifestyle factors to identify distinct groups of multimorbid patients. A database from the Academic Centre of Dentistry Amsterdam (ACTA) with 37,801 adult individuals containing information about demographic (age, sex, socio-economic position [SEP]) and lifestyle factors (smoking, alcohol use and addictive substance use) and PD and systemic diseases was constructed. PD assessment was based on clinical information by the use of claim codes and systemic diseases data were derived from self-reported medical history. For analyses, univariable and multivariable (adjusted for age, sex, SEP, smoking, alcohol use and addictive substance use) logistic regression analyses and cluster analysis were used. Individuals with PD more often had one or multiple diseases. The adjusted odds ratio (OR) for PD patients having up to four systemic diseases ranged from 1.46 to 1.20. Co-occurrence of PD with several systemic diseases and a higher prevalence of multimorbidity was found (adjusted OR comorbidity = 1.36; 95% confidence interval (CI): 1.30-1.43; multimorbidity = 1.18; 95% CI: 1.11-1.25). Four clusters existed: cluster 1 was defined as a periodontal and systemically healthy group and cluster 4 as burdened with PD but not containing any systemic diseases. Individuals in cluster 1 were of the lowest age (44.9 [SD: 15.5]) and had the lowest prevalence of the lifestyle factors of smoking (13.6%) and alcohol use (3.9%). Clusters 2 and 3 contained both PD and had several systemic diseases but were different from each other. Cluster 2 contained 34.5% of PD individuals and had mainly respiratory tract, immune system and digestive system diseases. Cluster 3 contained 45.9% of PD individuals and had mainly cardiometabolic diseases. Cluster 2 had the highest prevalence of females (63.1%) and the highest prevalence of smokers (23.8%) and addictive substance users (8.9%). Cluster 3 included individuals of the highest age (63.5 [SD: 11.9]), and had highest prevalence of alcohol users (17.7%) and lowest prevalence of addictive substance users (3.8%). This study shows that individuals with PD are more often burdened with comorbidity and multimorbidity. Presence of distinct clusters suggests overlap in pathophysiology between certain types of PD and specific systemic diseases. Therefore, PD can be considered as part of multimorbidity, as one of the systemic diseases co-occurring in certain groups of individuals.

Research progress on active ingredients of animal-derived traditional Chinese medicine in treatment of allergic rhinitis

Allergic rhinitis(AR) is a common chronic inflammatory disease of the upper respiratory tract. Due to its high prevalence, high recurrence rate, and lack of a definitive cure, it is considered a global health issue by the World Health Organization. The pathogenesis of AR is complex and mainly involves B cells, helper T cells, eosinophils, basophils, macrophages, as well as the cytokines and inflammatory mediators they secrete. Clinical treatment primarily focuses on inhibiting inflammatory mediators such as histamine and leukotrienes. In recent years, active ingredients of animal-derived traditional Chinese medicine(TCM) have shown unique advantages and potential in AR treatment thanks to their high safety, specificity, selectivity, and biopotency. This study systematically reviewed the therapeutic effects and mechanisms of active ingredients and mixed extracts from animal-derived TCM, such as bovine spleen, honeycomb, bee venom, maggot, and human placenta, which have been shown by modern pharmacological research to regulate the immune function in AR, providing a reference for further exploration and clinical development of active ingredients from animal-derived TCM. Studies have found that the active ingredients from animal-derived TCM can produce definite therapeutic effects in AR by modulating multiple immune balances in the body, with great clinical prospects. However, their mechanisms of action still require further investigation, and the quality control techniques for effective ingredients need to be improved. Currently, the research on active ingredients from animal-derived TCM in China has adopted an interactive system consisting of &quot;traditional medical experience-based research, bioinformatics and artificial intelligence predictions, and validation and development through new experimental techniques&quot;. Based on this system, animal-derived TCM can combine modern scientific and technological means to maximize the therapeutic effects of active ingredients and serve the clinical application of AR in a more efficient and innovative manner.

An Andrographis paniculata Burm. Nees extract standardized for three main Andrographolides prevents house dust mite-induced airway inflammation, remodeling, and hyperreactivity by regulating Th1/Th2 gene expression in mice

Ethnopharmacological relevanceAndrographis paniculata Burm. Nees (AP) is an herb used traditionally in Indian and Chinese traditional medicine for the treatment of various inflammatory and respiratory tract diseases. However, the anti-inflammatory potential of standardized Andrographis paniculata 50% ethanol extract (APEE50) in the murine model of asthma has not been investigated. Aim of the studyThis study aimed to evaluate the protective anti-inflammatory potential and better understand the underlying mechanism of action of APEE50 in a clinically-relevant mouse asthma model. Thereafter, develop the ethanolic extract of AP as a supplement for asthma prophylaxis. Materials and methodAPEE50 was prepared and standardized for AGP, NAG, and DDAG using a high-performance liquid chromatography system. Asthma was induced according to a 14-day house dust mite (HDM) induction protocol. The prophylactic potential of APEE50 (50 mg/kg – 200 mg/kg) was determined by assessing cardinal asthma features, which included BALF leukocyte and differential cell count, BALF cytokine assay, histology, gene expression, and airway hyperreactivity study. ResultsAPEE50 significantly inhibited HDM-induced airway eosinophilia and neutrophilia. In addition to decreased levels of IL-4, IL-5, IL-13, and eotaxin in bronchoalveolar fluid, APEE50 abrogated HDM-induced airway mucus over-secretion and airway hyper-responsiveness. Administration of APEE50 downregulated HDM-induced upregulation of the oxidative stress enzyme Duox1 (dual oxidase 1) and marginally induced Nfe2l2 (nuclear factor erythroid 2-related factor 2) gene expressions. Similarly, Th2-related (Serpinb2, Clca3a1, Il4 and Il13) and Muc5ac gene expression were significantly downregulated. ConclusionProphylactic administration of APEE50 prevented the progression of HDM-induced asthmatic responses by down-regulating Th2 cytokine gene expression and oxidative stress level.

Ecoimmunological differences among congeneric tortoises in the United States

AbstractComparative studies, especially of related species that span across ecoregions, have the potential to increase our understanding of different ecological or evolutionary pressures that may drive host–pathogen dynamics. We quantified differences in immune investment, via differential leukocyte counts and bacteria‐killing assays, across four closely related species of Gopherus tortoises, found across a gradient from the desert southwest to the subtropical southeast of the United States. We further quantified differences in a commensal nasal microbe (Pasteurella testudinis) and tested for associations among immune measures, P. testudinis, and previously quantified levels of the pathogen Mycoplasma agassizii and upper respiratory tract disease (URTD). We also evaluated the potential influence of environmental variables on immune investment, P. testudinis, and disease. We found that tortoise species in more arid environments had a reduced investment in inflammatory leukocytes, possibly as a strategy to reduce water loss, and invested more heavily in innate anti‐inflammatory leukocytes. Conversely, we found that species in moister, resource‐rich environments may face greater pathogen pressure, likely due to increased population densities and transmission rates among host tortoises. These tortoises had increased investment in inflammatory cells and appeared to reduce their nasal microbes (including P. testudinis) when they exhibited URTD. Thus, we quantified two negative correlational patterns: (1) between inflammatory responses and water conservation and (2) between resource quality and transmission rates. We hypothesize that these relationships across species may reflect variable development or evolution of innate immune functions.

Effect of ultrasonographic lung consolidation on health and growth in dairy calves: A longitudinal study

Bovine respiratory disease (BRD) is a common and complex disease process in calves. Subclinical disease exists and early detection can be challenging due to inconsistent or nonexistent clinical signs. Thoracic ultrasonography (TUS) is often used and has the potential to improve the identification of respiratory diseases. Combining systematic TUS with clinical examination allows distinguishing BRD, including upper respiratory tract disease (clinical signs of respiratory disease, but no significant lung consolidation), clinical pneumonia (clinical signs of respiratory disease along with lung consolidations), and subclinical pneumonia (no clinical signs, but lung consolidations). Data on subclinical pneumonia are scarce, particularly outside of the North American or European contexts similar to Iran in west Asia with a dry and semi-arid climate and intensive breeding systems similar to North America which breeding calves begin in individual boxes, then moving to group pens, and finally to free stall or open shed housing systems. The first objective of this longitudinal study was to use weekly ultrasonography to monitor calves from birth until weaning in an Iranian dairy herd. The second objective was to look for any association between individual lung consolidation episode or cumulative consolidation episodes on preweaning growth. Thoracic ultrasonography TUS was performed on calves (n = 221) weekly from birth to weaning (8 wk), and scanning occasions for each calf were equally distributed with 1-wk intervals (using consolidation threshold ≥3 cm as a specific lung consolidation definition, and ≥1 cm as a more sensitive threshold). Calf body weights were recorded using a weight tape. Other information recorded were transfer of passive immunity (TPI) using serum Brix (%) ≥8.4% as adequate TPI within the first week after birth and the treatment history of the calves. The main strategy for modeling was to determine how long-term lung consolidation affects average daily gain (ADG) during the preweaning period. A linear model was used to determine the effect of the number of weeks with consolidation on ADG. Using consolidation threshold of ≥3 cm, the mean (±SD) of total ADG for calves with no consolidation episode, one consolidation episode, and 2 or more consolidation episodes were: 0.45 (±0.10), 0.39 (±0.10), and 0.38 (±0.11) kg/d, respectively. In the final multivariable regression analysis model and based on consolidation threshold of ≥3 cm, calves with one and 2 or more consolidation episodes had significantly lower ADG ± standard error of 0.04 ± 0.02 kg/d, and 0.06 ± 0.02 kg/d, respectively compared with animals with no consolidation episode. A total of 20% of calves (46/229 calves that entered the study) were treated for respiratory disease based on clinical signs (based on farmer examination). The final model also included specific confounders related to ADG and their interactions with lung consolidation (transfer of passive immunity [TPI] and BRD treatment). An overall of 86% of adequate TPI was obtained. BRD treatment based on farmer diagnosis had a larger negative effect on preweaning ADG than ultrasonography-diagnosed consolidation episodes (lower ADG ± SE of 0.10 ± 0.03 kg/d). When using a more sensitive consolidation threshold (≥1 cm as consolidation), the number of weeks with consolidation was also negatively associated with the ADG in the multivariable linear regression model with significant difference of 0.05 ± 0.02 kg/d for nonconsolidated calves versus calves consolidated for 2 or more weeks and insignificant difference of 0.01 ± 0.02 kg/d for nonconsolidated calves versus calves with 1 consolidation episode.