Risk Factor For Respiratory Diseases Research Articles

Regular cannabis use, with and without tobacco co-use, is associated with respiratory disease

BackgroundCannabis use is a potential risk factor for respiratory disease but its role apart from tobacco use is unclear. We evaluated the association between regular cannabis use, with and without tobacco co-use, and onset of asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. MethodsAnalysis of a limited data set obtained through IBM Watson Health Explorys, an electronic-health-record-integration platform. Matched controls using Mahalanobis distance within propensity score calipers were defined for: 1) cannabis-using patients (n = 8932); and subgroups of cannabis-using patients: 2) with an encounter diagnosis for tobacco use disorder (TUD; n = 4678); and 3) without a TUD diagnosis (non-TUD; n = 4254). Patients had at least: one recorded blood pressure measurement and one blood chemistry lab result in the MetroHealth System (Cleveland, Ohio). Cannabis-using patients had an encounter diagnosis of cannabis abuse/dependence and/or ≥2 cannabis-positive urine drug screens (UDSs). Control patients, not having cannabis-related diagnoses or cannabis-positive UDSs, were matched to the cannabis-using patients on demographics, residential zip code median income, body mass index, and, for the total sample, TUD-status. ResultsRegular cannabis use was significantly associated with greater risk for asthma (odds ratio (OR) = 1.44; adjusted odds ratio (aOR) = 1.50; OR = 1.32), COPD (OR = 1.56; aOR = 1.44; OR = 2.17), and pneumonia (OR = 1.80; OR = 1.84; OR = 2.13) in the total sample and TUD and non-TUD subgroups, respectively. TUD-patients had the greatest prevalence of respiratory disease, regardless of cannabis-use indication. ConclusionsRegular cannabis use is associated with significantly greater risk of respiratory disease regardless of TUD status. Future research to understand the impact of cannabis use on respiratory health is warranted.

Air Pollution in a Nationally Representative Sample: Findings from the National Adult Tobacco Survey of Lao PDR.

In Southeast Asia, household air pollution (HAP) from solid fuel use is the leading cause of disability-adjusted life years (DALYs), a risk which is compounded by exposure to other sources of indoor and outdoor air pollution including secondhand tobacco smoke (SHS). The purpose of this study was to measure the individual and combined prevalence of exposure to household and community sources of air pollution in a national sample of adults in Lao PDR. We analyzed data from the 2012 National Adult Tobacco Survey (NATSL) of Lao PDR—a multi-stage stratified cluster sample of 9706 subjects from 2822 households located in all 17 provinces. Our findings indicate a high prevalence of exposure to household air pollution from cooking fires (78%) and SHS exposure in the home (74.5%). More than a third (32.8%) reported exposure to both inside the home. Exposure to outdoor sources of smoke from cooking, trash, and crop fires was substantial (30.1% to 56.0%). The aggregation of exposures from multiple sources of household air pollution raises the need for initiatives that establish programmatic linkages in the health, environmental, and agricultural sectors to provide a comprehensive strategy to reduce risk factors for respiratory disease in Lao PDR and the region.

Pulmonary outcomes in adults with a history of Bronchopulmonary Dysplasia differ from patients with asthma

BackgroundBronchopulmonary dysplasia (BPD) is a risk factor for respiratory disease in adulthood. Despite the differences in underlying pathology, patients with a history of BPD are often treated as asthmatics. We hypothesized that pulmonary outcomes and health-related quality of life (HRQoL) were different in adults born preterm with and without a history of BPD compared to asthmatics and healthy individuals.MethodsWe evaluated 96 young adults from the LUNAPRE cohort (clinicaltrials.gov/ct2/show/NCT02923648), including 26 individuals born preterm with a history of BPD (BPD), 23 born preterm without BPD (preterm), 23 asthmatics and 24 healthy controls. Extensive lung function testing and HRQoL were assessed.ResultsThe BPD group had more severe airway obstruction compared to the preterm-, (FEV1− 0.94 vs. 0.28 z-scores; p ≤ 0.001); asthmatic- (0.14 z-scores, p ≤ 0.01) and healthy groups (0.78 z-scores, p ≤ 0.001). Further, they had increased ventilation inhomogeneity compared to the preterm- (LCI 6.97 vs. 6.73, p ≤ 0.05), asthmatic- (6.75, p = 0.05) and healthy groups (6.50 p ≤ 0.001). Both preterm groups had lower DLCO compared to healthy controls (p ≤ 0.001 for both). HRQoL showed less physical but more psychological symptoms in the BPD group compared to asthmatics.ConclusionsLung function impairment and HRQoL in adults with a history of BPD differed from that in asthmatics highlighting the need for objective assessment of lung health.

Prevalence of Anaemia in Children Diagnosed with Pneumonia in a Tertiary Hospital in Quito, Ecuador: Correspondence

Dear editor,
 We read with interest the article “Prevalence of Anaemia in Children Diagnosed with Pneumonia in a Tertiary Hospital in Quito, Ecuador” in the recent issue of your esteemed journal and found it very useful and informative1. This article presents the prevalence of anemia in children with pneumonia. However, there are certain points we would like to comment and highlight which might bring more clarity to this issue and will be useful to the readers of JNPS.
 
 In the abstract (conclusion section), the authors have mentioned that “anaemia or nutritional deficiencies could be a risk factor for respiratory diseases”. The authors seem to draw a conclusion on “nutritional deficiencies” as a risk factor for respiratory disease without any evidence or data provided in the results. We feel that it should better be omitted from the conclusion.
 The authors have mentioned that they used physical findings such as: fever, tachypnea, breathing difficulties, rhonchi, crackles, and wheezing to diagnose pneumonia and them again have mentioned using WHO tachypnea threshold to diagnose pneumonia. It is very unlikely for all the 80 cases to have all the above listed physical findings. Diagnosis of pneumonia in children remains an important yet difficult clinical problem. WHO criteria which uses the presence of cough, fast breathing and chest indrawing to diagnose pneumonia may over-estimate the diagnosis of actual pneumonia2. Chest radiograph remains a diagnostic test of choice in hospitals3. The readers would be keen to know which diagnostic criteria the authors had used to diagnose pneumonia (either clinical or radiological?). If they had used the clinical criteria, what were the exact parameters used to diagnose pneumonia needs further clarification. The authors also need to reply the reason of not including cough and retractions in the inclusion criteria to diagnose pneumonia. The readers would also be keen to know that if any attempt was made to exclude pneumonia like illnesses e.g., bronchiolitis, asthma or cardiac diseases which can mimic pneumonia.
 The authors have mentioned that diagnosis of concomitant conditions that could affect anthropometric or haemoglobin parameters, or that could predispose to pneumonia were excluded. The readers would be interested to know (a) what anthropometric parameters or hemoglobin parameters were excluded and (b) what factors predisposing to pneumonia were excluded which is missing in the material and methods.
 The authors have concluded that anaemia is a frequent condition in paediatric pneumonia and could be a risk factor for respiratory diseases. The study done by the authors was a cross-sectional study which has always a chance of selection bias4. The increased prevalence of anemia in pneumonia patients could have been due to chance, we do not know. Therefore, it is very difficult to answer (in a cross-sectional study) either anemia is prevalent in children with pneumonia or not unless we have some cohort studies on the same. This should have been mentioned as one of the limitations of the study.
 The readers would be interested to know regarding any iron supplements in children aged more than 3 years which might be the cause of decrease prevalence of anemia in this age group.
 In the discussion section, the authors have tried to convince that anemia in the study groups was most likely due to iron deficiency. They have used hemoglobin, MCV and RDW to support the diagnosis of iron deficiency anemia. The sensitivity and specificity of MCV to diagnose IDA is 61.7% and 59.1% respectively with a positive predictive value of 70% 5 whereas using RDW as a criteria to diagnose IDA has a sensitivity of 81% and specificity of 53.4%6.
 
 In the discussion, the authors have emphasized iron deficiency as the cause of anemia in the cases. The authors need to explain that how can they be sure that all the cases of anemia in their study was due to iron deficiency without undergoing iron profile (serum ferritin, % saturation, TIBC).
 
 It is well known that with subclinical infection, serum iron concentrations are reduced, altering the synthesis of hemoglobin, the main indicator of anemia7. The readers would be interested to know if any attempts were made to exclude those subclinical infections from the enrolled cases with pneumonia.

Association between choice of cooking fuel and peak expiratory flow rate among rural women in the Niger Delta, Nigeria

Background: Long-term exposure to indoor air pollution from biomass fuel combustion is a risk factor for respiratory disease, which is an increasingly prevalent contributor to morbidity and mortality in low- and middle-income countries. This study evaluated the association between household fuel use and the peak expiratory flow rate (PEFR) of rural-dwelling women in selected communities of the Niger Delta. Methods: This was a cross-sectional study including 321 non-smoking women aged 18 years and older. Questionnaires were used to obtain data on predominant fuel used and a brief medical history. Women with current respiratory symptoms were excluded. Fuel use was classified into three categories: biomass fuels (BMF), such as wood, animal dung and coal, kerosene and liquefied petroleum gas (LPG). The PEFR was measured with an Omron peak flow meter using standard protocols and was abnormal if it was less than 80% of predicted value based on age and height. Results: The mean age of the 321 women was 38.5±14.2 years. The biomass fuel users had significantly lower PEFR (353.9±104.4) compared to kerosene users (376.2±70.1) and LPG users (393.6± 93.3) (p=0.030). The overall prevalence of abnormal PEFR was 22.4%. The PEFR was abnormal in more BMF users (28%) than kerosene users (13.4%) and LPG users (9.4%) (p=0.005). The PEFR of women who used LPG was 20.8 l/min higher than BMF users (p=0.012). The users of BMF were 5.8 times more likely to have abnormal PEFR than LPG users (OR 5.8, 95% CI 1.62, 20.52, p=0.007). Conclusion: In this population, the use of biomass fuel was significantly associated with abnormal PEFR. This needs to be further explored in this population with a larger study using more objective measures, such as spirometry testing, to guide policies for the implementation of preventive strategies to protect vulnerable women from chronic obstructive airway disease.

In vivo and in vitro evidence for the involvement of Nrf2-antioxidant response element signaling pathway in the inflammation and oxidative stress induced by particulate matter (PM10): the effective role of gallic acid

Environmental pollution is one of the risk factors for respiratory diseases. The nuclear factor erythroid 2-related factor 2 (Nrf2) is the major mechanisms contributing to cellular defense against oxidative damage. Gallic acid (GA) is regarded as potent anti-inflammatory and antioxidant agents. The aim was to evaluate the role of Nrf2 pathway in particulate matter (PM10) exposure on lung and epithelial cells with an emphasis on the role of GA. In in vivo part, the rats were divided as control, GA (30 mg/kg), particulate matter (PM) (0.5, 2.5, and 5 mg/kg), and PM + GA. In in vitro study, the cells were divided as control, PM10 (100, 250, and 500 µg/ml), GA (50 µmol/L) and PM10+GA. Inflammation, oxidative stress and Nrf2-pathway factors were assessed. PM10 groups showed a considerable increase in the epithelial permeability and inflammatory parameters. We also found a significant decrease in the expression of Nrf2 and its up-stream regulators genes. Accordingly, the biosynthesis of glutathione (GSH) and other antioxidant activities significantly decreased. Gallic acid was identified to restore the antioxidant status to the normal levels. Our findings approved that Nrf2 is involved in PM10-induced oxidative damages and showed that Nrf2 activation by natural agents could ameliorate respiratory injuries induced by PM10.

Study of prevalence and risk factors associated with respiratory illness in children admitted in a teaching hospital in rural Telangana

Introduction: Acute respiratory tract illness is common in children especially under 5 years of age. Poor hygiene, poor sanitation, over-crowding are the major risk factors for respiratory infections in paediatric age group. Aim of the Study: To study the prevalence and risk factors associated with respiratory illness in children admitted in a teaching hospital in rural Telangana. Materials and Methods: This was a hospital based cross sectional descriptive study done for duration of 2 years from August 2016 to July 2018 in the department of paediatrics at Government Medical College, Nizamabad, Telangana. About 3678 children with respiratory illness aged 2 months to 12 years were included in the study. Results: The prevalence of respiratory illnesses is about 30.65%. Of the 3678 children admitted with respiratory illness majority were among 2 months to 12 months, 38.8% (1428/3678) followed by 35.6% (1312/3678) among 1 year to 5 years. Boys comprised 68.7% (2527/3678) and girls were 31.2% (1151/3678). Based on clinical symptoms, 86.7% of children with respiratory illness had cough. In the present study most common respiratory illness was acute bronchiolitis (38.4%) followed by bronchopneumonia (28.2%), and bronchial asthma in 13.9% cases. Others were 1.7% of foreign body aspirations, 2.7% of bronchiectasis, 7.9% of pleural effusions, 1.1% of aspiration pneumonitis, and 5.7% of pulmonary tuberculosis. Over-crowding and poor sanitation were present in 88.8% of cases. Conclusion: In the present study the prevalence of respiratory illness among children aged 2 months to12 years was about 30.6% and risk factors associated with respiratory illnesses were poor sanitation, overcrowding, and low socioeconomic status. Keywords: Respiratory illnesses, Prevalence in children, Risk factors for respiratory illness.

Prevalence of Anaemia in Children Diagnosed with Pneumonia in a Tertiary Hospital in Quito, Ecuador

Introduction: Anaemia and pneumonia are frequent diseases which affect children. However, these two conditions could coexist. The aim of this study is presenting the prevalence of anemia among Ecuadorian children diagnosed with pneumonia, hospitalized in a tertiary hospital.
 Material and Methods: An observational and cross-sectional study conducted through a secondary source in that 80 children, between six months and 15 years of age were included. All the patients involved were admitted to the paediatric department presenting pneumonia. The medical evaluation included anthropometric measurements and complete blood count. Risk associations were evaluated using odds ratio.
 Results: Anaemia was found in 21.25% of the whole group. Nonetheless, the children under three years of age were more affected by this condition (18.75%). Low mean corpuscular volume and high red cells distribution width were more frequent than anaemia itself; 38.75% and 28.75%, respectively. Additionally, the prevalence of anaemia in children under 36 months was higher than the patients with over three years, with a significant risk of anaemia in the first group (OR 13.04; CI 95% 11.48-14.61; p<0.05) and low haematocrit (OR 14.64; CI 95% 12.53-16.75; p<0.05). This was also seen in low mean corpuscular volume (OR 3.23; CI 95% 2.3-4.17; p<0.05), high red cells distribution width (OR 2.77; CI 95% 1.76-3.78; p<0.05), and mean corpuscular haemoglobin (OR 8.48; CI 95% 7.14-9.82; p<0.01). 
 Conclusions: Anaemia is a frequent condition in paediatric pneumonia, particularly during the first three years of life. Therefore, anaemia or nutritional deficiencies could be a risk factor for respiratory diseases.

Ambient fine particulate matter inhibits innate airway antimicrobial activity in preschool children in e-waste areas

Ambient fine particulate matter (PM2.5) is a risk factor for respiratory diseases. Previous studies suggest that PM2.5 exposure may down-regulate airway antimicrobial proteins and peptides (AMPs), thereby accelerating airway pathogen infection. However, epidemiological research is scarce. Hence, we estimated the associations between individual PM2.5 chronic daily intake (CDI) and the levels of the airway AMP salivary agglutinin (SAG), as well as peripheral leukocyte counts and pro-inflammatory cytokines, of preschool children in Guiyu (an e-waste area) and Haojiang (a reference area located 31.6 km to the east of Guiyu). We recruited 581 preschool children from Guiyu and Haojiang, of which 222 were included in this study for a matching design (Guiyu: n = 110 vs. Haojiang: n = 112). Air PM2.5 pollution data was collected to calculate individual PM2.5 CDI. The mean concentration of PM2.5 in Guiyu was higher than in Haojiang, resulting in a higher individual PM2.5 CDI. Concomitantly, saliva SAG levels were lower in Guiyu children (5.05 ng/mL) than in Haojiang children (8.68 ng/mL), and were negatively correlated with CDI. Additionally, peripheral counts of white blood cells, and the concentrations of interleukin-8 and tumor necrosis factor-alpha, in Guiyu children were greater than in Haojiang children, and were positively associated with CDI. Similar results were found for neutrophils and monocytes. To our knowledge, this is the first study on the relationship between PM2.5 exposure and innate airway antimicrobial activity in children, in an e-waste area, showing that PM2.5 pollution may weaken airway antimicrobial activity by down-regulation of saliva SAG levels, which might accelerate airway pathogen infection in children.

The transcriptomic response of Streptococcus pneumoniae following exposure to cigarette smoke extract

Exposure to cigarette smoke is a risk factor for respiratory diseases. Although most research has focused on its effects on the host, cigarette smoke can also directly affect respiratory pathogens, in some cases enhancing virulence. Streptococcus pneumoniae (the pneumococcus) is a leading cause of community-acquired pneumonia worldwide, however data on the effects of cigarette smoke on the pneumococcus are sparse. Using RNA-seq, we show that pneumococci exposed to cigarette smoke extract in a concentrated acute exposure in vitro model initiate a ‘survival’ transcriptional response including the upregulation of detoxification enzymes, efflux pumps and osmoregulator transporters, as well as the downregulation of fatty acid and D-alanyl lipoteichoic acid biosynthesis genes. Except for the downregulation of the pneumolysin gene, there were no changes in the expression of major virulence factors following exposure to cigarette smoke. Compared to unexposed pneumococci, smoke-exposed pneumococci did not exhibit any changes in viability, adherence, hydrophobicity or cell lysis susceptibility. In this study, we demonstrate that pneumococci adapt to acute noxious cigarette smoke exposure by inducing a gene expression signature that allows the bacteria to resist its harmful effects.

Vaccinate Your Baby and Do Not Smoke: Integrated Approach of Lung Health for Premature Babies

Background and context: Since 2008 Republic of Moldova registers and provides medical care to newborns from 500 g and 22 weeks of gestation. Thus, challenges related to lung health (respiratory distress in neonatal period, respiratory infections in childhood) are faced while taking care of premature babies. More 400 of them (from 2000 preterms in the country) are born in our institution. While in neonatal period we succeed to save them, the quality of their life depends on further protection from risk factors, as infections, environment polluants and second hand smoke. Aim: To rise awareness among parents about evidence based approaches for protecting a premature baby from infection (one of that being the immunization) and from second hand smoke harm (through smoking cessation among parents, but also among other family members). Strategy/Tactics: Early neonatal period is a very sensitive, but also a precious opportunity to speak with parents about risk factors for a healthy childhood. Smoking being one of factors for premature birth, but also for lung diseases in childhood, our neonatal team included “smoking” issue while speaking with parents about the severity of baby´s condition in neonatal intensive care unit. The discussion target the risk factors for respiratory diseases. This year we changed the approach - we include in the same discussion not only smoking issue, but also immunization, to see if it´s more effective than to aware about smoking only. Program/Policy process: When combining two topics (immunization and no-smoking) parents are less reticent to discussion, thus measured by: •How often they recall discussion, or come back with other questions. •Their reaction (body language, duration of discussion) to physicians´ explanation. Outcomes: 1. Targeting both topics help a smoking parent “not to fill so guilty”, “obtaining other leverages to ensure good quality of life for the baby”. Comparing to the period when we were targeted only smoking issue, parents (especially fathers) were more likely to recall discussion (72%, compared with 41% in the previous stage) and they were more willing/open for communication (77%, compared with 48%). 2. This strategy it´s an opportunity to catch parents´ attention for important things. Usually, when they come in neonatal intensive care unit to see their baby, they expect to be told only about the treatment the baby receives in the unit, and not about smoking (“this is not a drug?”) or vaccination (“something that they see long further”). What was learned: A holistic preventive approach for healthy lifestyle (vaccination + not to expose to tobacco smoke) as measures for premature baby respiratory health, seems to be better accepted by smoking parents, that related on smoking only.

Smoking Reduces Plasma Bilirubin: Observational and Genetic Analyses in the Copenhagen General Population Study.

Observational studies have found lower concentrations of plasma bilirubin in current smokers compared with former and never smokers. However, whether there is a causal relationship between smoking and bilirubin is unknown. In a Mendelian randomization analysis, we tested the hypothesis that higher tobacco consumption is causally associated with lower concentrations of plasma bilirubin. We genotyped 103 557 individuals aged 20-100 years from the Copenhagen General Population Study for the CHRNA3 rs1051730 genotype, known to be associated with higher tobacco consumption. Tobacco consumption was defined as daily and cumulative tobacco consumption. In observational multivariable-adjusted analyses, a 10 g/day higher daily tobacco consumption was associated with a 0.28 µmol/L (95% confidence interval = 0.20 to 0.35) lower concentration of plasma bilirubin in current smokers, and a 10 pack-year higher cumulative tobacco consumption was associated with a 0.19 µmol/L (0.17 to 0.21) lower concentration of plasma bilirubin in former and current smokers. Using the CHRNA3 rs1051730 genotype as a proxy for daily and cumulative tobacco consumption, the difference in plasma bilirubin per T-allele was -0.12 µmol/L (-0.23 to -0.002) in current smokers and -0.09 µmol/L (-0.15 to -0.01) in current and former smokers combined. Furthermore, observationally bilirubin concentrations increased with time from smoking cessation in former smokers. Higher daily and cumulative tobacco consumption were associated with lower concentrations of plasma bilirubin in observational and genetic analyses, suggesting that the association is causal. Our results are compatible with two possible interpretations of previous observational studies, either that bilirubin is a mediator of smoking-induced respiratory disease or that the association between plasma bilirubin and respiratory disease stems from residual confounding because of smoking. Future studies should examine whether bilirubin is a causal risk factor for respiratory disease, or merely a marker of smoking status.

The association of household fine particulate matter and kerosene with tuberculosis in women and children in Pune, India

ObjectivesHousehold air pollution (HAP) is a risk factor for respiratory disease, however has yet to be definitively associated with tuberculosis (TB). We aimed to assess the association between HAP and...

Risk factors for respiratory illness in a community of wild chimpanzees (Pan troglodytes schweinfurthii).

Respiratory illnesses have caused significant mortality in African great ape populations. While much effort has been given to identifying the responsible pathogens, little is known about the factors that influence disease transmission or individual susceptibility. In the Kanyawara community of wild chimpanzees, respiratory illness has been the leading cause of mortality over 31 years, contributing to 27% of deaths. Deaths were common in all age groups except juveniles. Over 22 years of health observations, respiratory signs were rare among infants and most common among older adults of both sexes. Respiratory signs were also common among males during the transition to adulthood (ages 10–20 years), particularly among those of low rank. Respiratory signs peaked conspicuously in March, a pattern that we could not explain after modelling climatic factors, group sizes, diet or exposure to humans. Furthermore, rates of respiratory illness in the chimpanzees did not track seasonal rates of illness in the nearby village. Our data indicate that the epidemiology of chimpanzee respiratory illness warrants more investigation but clearly differs in important ways from humans. Findings on individual susceptibility patterns suggest that respiratory signs are a robust indicator for investigating immunocompetence in wild chimpanzees.

Tobacco cultivationin Salento (Apulia Region, Southern Italy) from 1929 to 1993: possible health implications

The Province of Lecce (Apulia Region, Southern Italy) is one of the Italian areas where the prevalence of respiratory disease and cancer of the respitartory tract is very high. Through a descriptive analysis of the historical series of tobacco culture indicators, a historical reconstruction of the development of tobacco cultivation in Salento (the area where the Province of Lecce is located) is here presented, in order to provide an additional element of knowledge on potential risk factors for respiratory diseases and cancers. Data regarding extensions in hectares and crop productions in the province of Lecce, in Apulia, and in Italy are from the Chamber of commerce of Lecce province and from the Italian National Institute of Statistics (Istat). From 1929 to 1993, the province of Lecce provided between 75% and 94% of the tobacco cultivated in Apulia Region and 25% of the national tobacco until 1945. Since the late Sixties, a growing increase in annual average production was observed, reaching 21.5 quintals per hectare in 1991 in Salento. This large tobacco production, associated with intensive use of pesticides, could be an element to be observed in analytical studies as a determining potential for the high prevalence of respiratory diseases and pulmonary cancers in the male population of the province of Lecce.

Negative Binomial regression model for analysis of the relationship between hospitalization and air pollution

Air pollution is currently one of the major environmental risk to human health in the world. Several studies link health to air pollution through the Poisson regression model. However, this study showed that the best method is the regression model with Negative Binomial distribution. The analysis was made based on daily data for the period between 2010 and 2014 regarding hospitalizations due to circulatory and respiratory diseases, stratified by age due to the concentration of air pollutants: CO, PM10, NO2, SO2 and O3 and meteorological variables. The results with Negative Binomial distribution model indicate, for interquartile range (IQR), that CO is a risk factor (1.00259–1.19688, 95% CI) for circulatory diseases in the elderly (aged over 64) and for respiratory diseases in the population aged 10–19 years old, while NO2 is a risk factor for the population in the range of 20–64 years (1.00313–1.25827, 95% CI) in the city of Araucaria. In Curitiba, air pollutants presenting a risk factor for respiratory diseases were PM10 (RR = 1.05322) in the range of 0–9 years old, CO and O3 (RR = 1.05047) in the range of 20–64 years old, and CO for the elderly. It could be verified that exposure to air pollutants is harmful to health even when their concentrations are below the standards set out in legislation. Additionally, the city of Araucaria presented the highest number of hospital admissions, which may be associated with the large number of industries and lower human development index in the city.

Respiratory health status is impaired in UK HIV‐positive adults with virologically suppressed HIV infection

We sought to evaluate whether people living with HIV (PLWH) using effective antiretroviral therapy (ART) have worse respiratory health status than similar HIV-negative individuals. We recruited 197 HIV-positive and 93 HIV-negative adults from HIV and sexual health clinics. They completed a questionnaire regarding risk factors for respiratory illness. Respiratory health status was assessed using the St George's Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) breathlessness scale. Subjects underwent spirometry without bronchodilation. PLWH had worse respiratory health status: the median SGRQ Total score was 12 [interquartile range (IQR) 6-25] in HIV-positive subjects vs. 6 (IQR 2-14) in HIV-negative subjects (P<0.001); breathlessness was common in the HIV-positive group, where 47% compared with 24% had an MRC breathlessness score ≥2 (P=0.001). Eighteen (11%) HIV-positive and seven (9%) HIV-negative participants had airflow obstruction. In multivariable analyses (adjusted for age, gender, smoking, body mass index and depression), HIV infection remained associated with higher SGRQ and MRC scores, with an adjusted fold-change in SGRQ Total score of 1.54 [95% confidence interval (CI) 1.14-2.09; P=0.005] and adjusted odds ratio of having an MRC score of ≥2 of 2.45 (95% CI 1.15-5.20; P=0.02). Similar findings were obtained when analyses were repeated including only HIV-positive participants with a viral load <40 HIV-1 RNA copies/mL. Despite effective ART, impaired respiratory health appears more common in HIV-positive adults, and has a significant impact on health-related quality of life.

Impact of diversity of Mycoplasma hyopneumoniae strains on lung lesions in slaughter pigs

The importance of diversity of Mycoplasma hyopneumoniae (M. hyopneumoniae) strains is not yet fully known. This study investigated the genetic diversity of M. hyopneumoniae strains in ten pig herds, and assessed associations between the presence of different strains of M. hyopneumoniae and lung lesions at slaughter. Within each herd, three batches of slaughter pigs were investigated. At slaughter, from each batch, 20 post mortem bronchoalveolar lavage fluid samples were collected for multiple locus variable-number tandem repeat analysis (MLVA), and lung lesions (Mycoplasma-like lesions, fissures) were examined. Multivariable analyses including potential risk factors for respiratory disease were performed to assess associations between the number of different strains per batch (three categories: one strain, two–six strains, ≥seven strains), and the lung lesions as outcome variables. In total, 135 different M. hyopneumoniae strains were found. The mean (min.–max.) number of different strains per batch were 7 (1–13). Batches with two–six strains or more than six strains had more severe Mycoplasma-like lesions (P = 0.064 and P = 0.012, respectively), a higher prevalence of pneumonia [odds ratio (OR): 1.30, P = 0.33 and OR: 2.08, P = 0.012, respectively], and fissures (OR = 1.35, P = 0.094 and OR = 1.70, P = 0.007, respectively) compared to batches with only one strain. In conclusion, many different M. hyopneumoniae strains were found, and batches of slaughter pigs with different M. hyopneumoniae strains had a higher prevalence and severity of Mycoplasma-like lung lesions at slaughter, implying that reducing the number of different strains may lead to less lung lesions at slaughter and better respiratory health of the pigs.

Polydatin protects the respiratory system from PM2.5 exposure

Atmospheric particle is one of the risk factors for respiratory disease; however, their injury mechanisms are poorly understood, and prevention methods are highly desirable. We constructed artificial PM2.5 (aPM2.5) particles according to the size and composition of actual PM2.5 collected in Beijing. Using these artificial particles, we created an inhalation-injury animal model. These aPM2.5 particles simulate the physical and chemical characteristics of the actual PM2.5, and inhalation of the aPM2.5 in rat results in a time-dependent change in lung suggesting a declined lung function, injury from oxidative stress and inflammation in lung. Thus, this aPM2.5-caused injury animal model may mimic that of the pulmonary injury in human exposed to airborne particles. In addition, polydatin (PD), a resveratrol glucoside that is rich in grapes and red wine, was found to significantly decrease the oxidative potential (OP) of aPM2.5in vitro. Treating the model rats with PD prevented the lung function decline caused by aPM2.5, and reduced the level of oxidative damage in aPM2.5-exposed rats. Moreover, PD inhibited aPM2.5-induced inflammation response, as evidenced by downregulation of white blood cells in bronchoalveolar lavage fluid (BALF), inflammation-related lipids and proinflammation cytokines in lung. These results provide a practical means for self-protection against particulate air pollution.

Airborne fine particulate matter induces an upregulation of endothelin receptors on rat bronchi

Airborne fine particulate matter (PM2.5) is a risk factor for respiratory diseases. However, little is known about the effects of PM2.5 on bronchi. The present study investigated the effect of airborne PM2.5 on rat bronchi and the underlying mechanisms. Isolated rat bronchial segments were cultured for 24 h. Endothelin (ET) receptor-mediated contractile responses were recorded using a wire myograph. The mRNA and protein expression levels of ET receptors were studied using quantitative real-time PCR, Western blotting, and immunohistochemistry. The results demonstrated that ETA and ETB receptor agonists induced remarkable contractile responses on fresh and cultured bronchial segments. PM2.5 (1.0 or 3.0 μg/ml) significantly enhanced ETA and ETB receptor-mediated contractile responses in bronchi with a markedly increased maximal contraction compared to the DMSO or fresh groups. PM2.5 increased the mRNA and protein expression levels of ETA and ETB receptors. U0126 (a MEK1/2 inhibitor) and SB203580 (a p38 inhibitor) significantly suppressed PM2.5-induced increases in ETB receptor-mediated contractile responses, mRNA and protein levels. SP600125 (a JNK inhibitor) and SB203580 significantly abrogated the PM2.5-induced enhancement of ETA receptor-mediated contraction and receptor expression. In conclusion, PM2.5 upregulates ET receptors in bronchi. ETB receptor upregulation is associated with MEK1/2 and p38 pathways, and the upregulation of ETA receptor is involved in JNK and p38 pathways.