Sticky Mucus Research Articles

Linaclotide Use for the Treatment of Constipation and Gastrointestinal Symptoms in People With Cystic Fibrosis.

Cystic Fibrosis (CF) is a multisystem autosomal recessive disease characterized by thick, sticky mucus which causes lung disease, pancreatic insufficiency, and many other manifestations. Constipation is a common complication in CF and few advances in treatment have been made until recent years. Linaclotide is a treatment approved for chronic idiopathic constipation and irritable bowel syndrome with constipation. This case series investigates the potential for use of this agent in adult people with CF (pwCF). A retrospective case series of 39 pwCF who are currently or previously prescribed linaclotide was completed at two adult Cystic Fibrosis Foundation (CFF) Accredited Care Centers. All patients 18 years and older were included with no exclusions. We reported results using descriptive statistics. A total of 39 patients were identified for inclusion. The daily starting dose of linaclotide did vary with 18%, 72%, and 10% started on 72 mcg, 145 mcg, and 290 mcg respectively. Most patients (n = 30, 77%) reported experiencing no side effects. Of the total patients, 15% (n = 6) reported the medicine was not effective and 10% (n = 4) had to stop therapy due to adverse reactions. More than half of patients started on therapy were able to reduce baseline treatments for constipation. While this case series shows compelling data that may indicate benefit and tolerability of linaclotide use in pw CF, more research is needed to fully evaluate safety and efficacy of linaclotide for treating constipation in pwCF.

EXPLORING BEE VENOM VOLATILES: A PROMISING AVENUE FOR CYSTIC FIBROSIS

Bee venom, a complex mixture of bioactive compounds, has demonstrated anti-inflammatory, antimicrobial, and immunomodulatory properties. Notably, the volatiles released by bee venom components have garnered attention for their potential in respiratory-related disease conditions. Cystic fibrosis (CF) is a challenging disorder, characterized by a genetic mutation affecting the CFTR protein, leading to the production of thick and sticky mucus in various organs, particularly the lungs and digestive system, and necessitating innovative therapeutic approaches. This research explored both bee venom volatiles’ chemical composition and the effects on airway inflammation and mucus viscosity in CF patients by in silico methods. GC/MS analyses with various SPME fibers have conducted the identification of 67 distinct components in volatile compounds of bee venom. For CW/DVB, CAR-PDMS, and DVB-PDMS fibers, the compounds identified in the highest amounts were perilla alcohol (42.21%), tetradecane (11.48%), and 1,2-benzenedicarboxylic acid, 1,2-bis(2-methylpropyl) ester (39.98%), respectively. In silico analyses subsequently indicated that these components exhibit anti-inflammatory effects by modulating key cytokines and reducing inflammatory markers in CF airways. This research highlights the potential of bee venom volatiles as a novel therapeutic avenue for managing CF symptoms. Harnessing the unique properties of bee venom may offer new perspectives in the development of targeted therapies for individuals affected by cystic fibrosis.

Bacteriophages as potential antibiotic potentiators in cystic fibrosis: A new model to study the combination of antibiotics with a bacteriophage cocktail targeting dual species biofilms of Staphylococcus aureus and Pseudomonas aeruginosa

Staphylococcus aureus and Pseudomonas aeruginosa co-infections in patients with cystic fibrosis (CF) are associated with disease severity. Their treatment is complicated by biofilm formation in the sticky mucus obstructing the airways. We investigated the activity of phages-antibiotics combinations using a dual species biofilm (P. aeruginosa/S. aureus) formed in artificial sputum medium. Biofilmswere incubated with broad-spectrum antibiotics (meropenem, ceftazidime, ciprofloxacin, tobramycin) combined with a cocktail of two (bacterio)phages (PSP3 and ISP) proven active via spot tests and double agar on P. aeruginosa PAO1 and S. aureus ATCC 25923. At the highest tested concentrations (100 x MIC), antibiotics alone caused a 20-50% reduction in biomass and reduced S. aureus and P. aeruginosa CFU of 2.3 to 2.8 and 2.1 to 3.6 log10, respectively. Phages alone reduced biofilm biomass by 23% and reduced P. aeruginosa CFU of 2.1 log10, but did not affect S. aureus viability. Phages enhanced antibiotic effects on biomass and exhibited additive effects with antibiotics against P. aeruginosa, but not against S. aureus. Following inhibition of bacterial respiration by phages in planktonic cultures rationalised these observations by demonstrating that PSP3 was effective at multiplicities of infection (MOI) as low as 10-4 plaque forming units (PFU)/CFU on P. aeruginosa, but ISP, at higher MOI (> 0.1) against S. aureus. Pre-screening inhibition of bacterial respiration by phages may assist in selecting those showing activity at sufficiently low titers to showcase anti-biofilm activity in this complex but clinically-relevant in vitro model of biofilm.

Unveiling Cystic Fibrosis: Causes, Symptoms, Complications and Treatment Options

Cystic fibrosis is a progressive genetic condition causing thick, sticky mucus buildup in organs like the lungs and digestive system. Cystic fibrosis occurs due to the mutation in the Cystic Fibrosis Transmembrane conductance Regulator(CFTR) gene inherited from both parents. Symptoms of cystic fibrosis vary and can include chronic cough, wheezing, greasy stool, lung infection, and poor growth. The Sweat Test is used to diagnose Cystic Fibrosis. It checks for the amount of chloride in one's sweat. While there's no cure for cystic fibrosis, treatment focuses on symptom management, such as ensuring clear airways and maintaining proper nutrition through medications, therapies, and sometimes surgery.

Pseudomonas aeruginosa Bacteriophages and Their Clinical Applications.

Antimicrobial resistance poses a serious risk to contemporary healthcare since it reduces the number of bacterial illnesses that may be treated with antibiotics, particularly for patients with long-term conditions like cystic fibrosis (CF). People with a genetic predisposition to CF often have recurrent bacterial infections in their lungs due to a buildup of sticky mucus, necessitating long-term antibiotic treatment. Pseudomonas aeruginosa infections are a major cause of CF lung illness, and P. aeruginosa airway isolates are frequently resistant to many antibiotics. Bacteriophages (also known as phages), viruses that infect bacteria, are a viable substitute for antimicrobials to treat P. aeruginosa infections in individuals with CF. Here, we reviewed the utilization of P. aeruginosa bacteriophages both in vivo and in vitro, as well as in the treatment of illnesses and diseases, and the outcomes of the latter.

Ocular Changes in Cystic Fibrosis: A Review.

Cystic fibrosis (CF), also known as mucoviscidosis, is the most common autosomal recessive genetic disease in the Caucasian population, with an estimated frequency of 1:2000-3000 live births. CF results from the mutation of the cystic fibrosis transmembrane conductance regulator (CFTR) gene localized in the long arm of chromosome 7. The product of CFTR gene expression is CFTR protein, an adenosine triphosphate (ATP)-binding cassette (ABC) transporter that regulates the transport of chloride ions (Cl-) across the apical cell membrane. Primary manifestations of CF include chronic lung and pancreas function impairment secondary to the production of thick, sticky mucus resulting from dehydrated secretions. It is well known that CF can cause both anterior and posterior ocular abnormalities. Conjunctival and corneal xerosis and dry eye disease symptoms are the most characteristic manifestations in the anterior segment. In contrast, the most typical anatomical and functional changes relating to the posterior segment of the eye include defects in the retinal nerve fiber layer (RNFL), vascular abnormalities, and visual disturbances, such as reduced contrast sensitivity and abnormal dark adaptation. However, the complete background of ophthalmic manifestations in the course of CF has yet to be discovered. This review summarizes the current knowledge regarding ocular changes in cystic fibrosis.

Factors at Insemination and Subsequent Conception of Cattle under Heat-Stress Tie-Stall Environments

This research aimed to compare the conception rates among AI at 12, 24, and 36 h after estrus in cattle living in tie-stall barns in a tropical environment. The second study was to determine factors at insemination at 24 h after estrus, including secondary signs of estrus behavior, reproductive tract characteristics, and heat-stress factors, in relation to conception. The study was conducted on 22 tie-stall dairy farms in Chiang Mai, Thailand. After secondary signs of estrus were observed, all farmers were informed for data collection at the insemination time. Repeated logistic regression models were used to determine factors associated with conception. The results revealed that cattle inseminated 24 h after estrus detection had the highest conception rate (67.5%). The study also found that cattle with three or two secondary estrus signs before insemination had a higher risk of conception than those with only one sign. Interestingly, there was an increased risk of conception when sticky or no cervical mucus was observed during insemination (OR = 6.85 and OR = 5.96, respectively). Moreover, increases in body temperature and ambient relative humidity were related to a decrease in the chances of conception. This study recommends delaying insemination to 24 h after the initiation of secondary estrus signs. Multiple signs of estrus, sticky cervical mucus, and lower body temperature increased conception risk in dairy cattle living in tie-stall barns in a heat-stress environment.

Predicting Helicobacter pylori infection from endoscopic features.

Helicobacter pylori infection, prevalent in more than half of the global population, is associated with various gastrointestinal diseases, including peptic ulcers and gastric cancer. The effectiveness of early diagnosis and treatment in preventing gastric cancer highlights the need for improved diagnostic methods. This study aimed to develop a simple scoring system based on endoscopic findings to predict H. pylori infection. A retrospective analysis was conducted on 1,007 patients who underwent upper gastrointestinal endoscopy at Asan Medical Center from January 2019 to December 2021. Exclusion criteria included prior H. pylori treatment, gastric surgery, or gastric malignancies. Diagnostic techniques included rapid urease and 13C-urea breath tests, H. pylori culture, and assessment of endoscopic features following the Kyoto gastritis classification. A new scoring system based on endoscopic findings including regular arrangement of collecting venules (RAC), nodularity, and diffuse or spotty redness was developed for predicting H. pylori infection, utilizing logistic regression analysis in the development set. The scoring system demonstrated high predictive accuracy for H. pylori infection in the validation set. Scores of 2 and 3 were associated with 96% and 99% infection risk, respectively. Additionally, there was a higher prevalence of diffuse redness and sticky mucus in cases where the initial H. pylori eradication treatment failed. Our scoring system showed potential for improving diagnostic accuracy in H. pylori infection. H. pylori testing should be considered upon spotty redness, diffuse redness, nodularity, and RAC absence on endoscopic findings as determined by the predictive scoring system.

Intragastric bacterial infection and endoscopic findings in Helicobacter pylori-negative patients.

In the present study, the authors examined the association between gastric bacterial infection and gastric endoscopic findings in Helicobacter pylori (H. pylori)-negative patients. The subjects were 105 H. pylori-negative patients. The mean age was 72.8 ± 9.1 years. Endoscopy and gastric juice culture were performed. The presence or absence of endoscopic findings was checked according to the Kyoto classification of gastritis. Culture was positive in 69 patients (65.7%), with Streptococcus α-hemolytic being the most common (51 patients), followed by Neisseria sp. (43 patients). According to the univariate analysis, there was a significant difference between the results of culture and background factors in the use of gastric antisecretory drugs and between the results of culture and various endoscopic findings in atrophic gastritis, intestinal metaplasia, regular arrangement of collecting venule, mucosal swelling, sticky mucus, hyperplastic polyps, hematin, and gastric cobblestone-like lesions. Furthermore, multivariate analysis revealed significant differences in background factors such as the use of gastric antisecretory drugs and endoscopic findings only in patients with mucosal swelling. Endoscopic findings of non-H. pylori bacteria-positive gastritis differed from endoscopic findings of H. pylori-infected gastritis in several respects. In conclusion, our results suggest that non-H. pylori bacteria may infect the stomach and cause gastric inflammation, especially in patients who long term use gastric antisecretory drugs.

Land planarians (Platyhelminthes) also prey on web-building spiders

Although spiders and land planarians constitute diverse groups of terrestrial predators, interactions between them are still unknown. Here, we describe a predatory event of a land planarian (Choeradoplana cf. gladismariae) on a web-building spider (Helvibis longicauda) in the Brazilian Atlantic Forest. The prey was constricted and covered with sticky mucus while remaining on its web trying to protect its egg sac. The event was observed in the middle-end afternoon at ca. 1.80 m height. Our observation broadens the scope of possible natural enemies of web-building spiders and the prey items of land planarians. It also indicates that these organisms can capture and overpower dangerous predatory arthropods, suggesting that even complex three-dimensional sticky webs can be ineffective against the attack of land planarians. Finally, we also show that land planarians can exhibit a flexible foraging strategy, exploiting the environment during the day and at higher heights from the ground. Our observation opens new possibilities involving focal observations and experiments using spiders and land planarians as models in predator-prey research.

Validation of a Novel Endoscopic Feature that Predicts Helicobacter pylori-negative Status: Does the Scratch Sign Reflect H. pylori Non-infection?

Background/Aims: Identification of <i>Helicobacter pylori</i> infection status is necessary as <i>H. pylori</i> is associated with gastric malignancy. Recently, a red linear scrape-like appearance on the gastric mucosa, called the “scratch sign,” was reported to be associated with <i>H. pylori</i>-negative gastric mucosal status. Herein, we aimed to validate the association between the scratch sign and <i>H. pylori</i> infection status.Methods: The data of patients who underwent screening endoscopy at Bundang Jesaeng General Hospital between March 2023 and April 2023 were reviewed. Patients were classified as having an <i>H. pylori</i> current infection or non-infection status based on the results of rapid urease tests. Patients who had undergone <i>H. pylori</i> eradication therapy were excluded. Endoscopic features of the gastric mucosa were assessed using the Kyoto classification of gastritis.Results: The scratch sign appeared more frequently in patients with non-infection than in those with current infection status (32.7% vs. 10.6%, respectively; <i>P</i><0.001). Multivariate analysis showed that only the presence of sticky mucus was significantly associated with the presence of the scratch sign. Patient without the scratch sign had a higher prevalence of open-type atrophy, intestinal metaplasia, enlarged folds, and diffuse redness, which reflected a higher Kyoto score.Conclusions: Presence of the gastric mucosal scratch sign, a novel endoscopic marker, is indicative of <i>H. pylori</i>-negative status and appears to be inversely correlated with the presence of sticky mucus. In addition to the Kyoto classification of gastritis, detection of the scratch sign may facilitate identification of the <i>H. pylori </i>infection status.

Antibacterial and Antibiofilm Effects of Lactobacilli Strains against Clinical Isolates of Pseudomonas aeruginosa under Conditions Relevant to Cystic Fibrosis.

Therapy of lung infections sustained by Pseudomonas aeruginosa in cystic fibrosis (CF) patients is challenging due to the presence of a sticky mucus in the airways and the ability of the bacterium to form biofilm, which exhibits increased antibiotic tolerance. A lung-directed bacteriotherapy through the airway administration of probiotics could represent an alternative approach to probiotic diet supplementation to improve the benefits and clinical outcomes of this kind of intervention in CF patients. This study aims to evaluate the ability of probiotic strains to grow in artificial sputum medium (ASM), mimicking the CF lung microenvironment, and to affect the planktonic and biofilm growth of CF clinical strains of P. aeruginosa in the same conditions. The results demonstrate that Lacticaseibacillus rhamnosus and Lactiplantibacillus plantarum (LP) can grow in ASM. LP inhibited the planktonic growth of P. aeruginosa, while both lactobacilli reduced the pre-formed biofilm of P. aeruginosa. Interestingly, LP was demonstrated to reduce the amount of polysaccharides in the extracellular matrix of P. aeruginosa biofilms and to potentiate the antibiofilm effects of tobramycin. Overall, the results indicated that LP is a promising candidate as an adjuvant in the antimicrobial therapy of P. aeruginosa infections in CF patients.

P232 Analysis of the lung microbiome in cystic fibrosis patients using 16s sequencing

Cystic fibrosis patients often develop lung infections that range anywhere in severity from mild to life-threatening due to the presence of thick and sticky mucus that fills their airways. Since many of these infections are chronic, they not only affect a patient’s ability to breathe but also increase chances of mortality by respiratory failure. With a publicly available dataset of DNA sequences from bacterial species in the lung microbiome of cystic fibrosis patients, we investigated the correlations between different microbial species in the lung and the extent of deterioration of lung function. 16S sequencing technologies allowed us to determine the microbiome composition of the samples in the dataset. For our statistical analyses, we distinguished between taxonomies using this referencing and determined the proportions of a certain taxa relative to another. We found that the Fusobacterium, Actinomyces, and Leptotrichia microbial types all had positive correlation with FEV1 score, indicating potential displacement of these species by pathogens as the disease progresses. However, the dominant pathogens themselves, including Pseudomonas Aeruginosa and Staphylococcus Aureus, did not have statistically significant negative correlations with FEV1 score as described by past literature. Examining the lung microbiology of cystic fibrosis patients can help with the prediction of the current condition of lung function, with the potential to guide doctors when designing personalized treatment plans for patients.

Endoscopic Features According to Helicobacter pylori Infection Status

It is important to evaluate Helicobacter pylori (<i>H. pylori</i>) infection based on endoscopic results because numerous studies have shown a link between <i>H. pylori</i> infection and upper gastrointestinal conditions, such as gastric cancer. The association between <i>H. pylori</i> infection and gastritis is fully described in the Kyoto classification of gastritis. Typical endoscopic findings in the absence of <i>H. pylori</i> infection are a regular arrangement of collecting venules, fundic gland polyps, red streaks, and other similar features. By contrast, typical endoscopic findings in individuals with active <i>H. pylori</i> infection include diffuse mucosal erythema, atrophy, intestinal metaplasia, inflated or tortuous folds, discharge of sticky mucus, mucosal nodularity, foveolar hyperplastic polyps, and/or xanthomas. Patchy mucosal redness and map-like mucosal redness are typical endoscopic findings in previously infected people. Because of its straightforward application in standard clinical practice, this categorization can reflect the risk of stomach cancer and be useful for both primary care physicians and experienced endoscopists.

Microbiota and fungal-bacterial interactions in the cystic fibrosis lung.

The most common genetic hereditary disease affecting Caucasians is cystic fibrosis (CF), which is caused by autosomal recessive mutations in the CFTR gene. The most serious consequence is the production of a thick and sticky mucus in the respiratory tract, which entraps airborne microorganisms and facilitates colonization, inflammation and infection. Therefore, the present article compiles the information about the microbiota and, particularly, the inter-kingdom fungal-bacterial interactions in the CF lung, the molecules involved and the potential effects that these interactions may have on the course of the disease. Among the bacterial compounds, quorum sensing-regulated molecules such as homoserine lactones, phenazines, rhamnolipids, quinolones and siderophores (pyoverdine and pyochelin) stand out, but volatile organic compounds, maltophilin and CF-related bacteriophages are also explained. These molecules exhibit diverse antifungal mechanisms, including iron starvation and induction of reactive oxygen and nitrogen species production. The fungal compounds are less studied, but they include cell wall components, siderophores, patulin and farnesol. Despite the apparent competition between microorganisms, the persistence of significant rates of bacterial-fungal co-colonization in CF suggests that numerous variables influence it. In conclusion, it is crucial to increase scientific and economic efforts to intensify studies on the bacterial-fungal inter-kingdom interactions in the CF lung.

Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population

ObjectiveTo determine whether early ear and upper respiratory signs are associated with the development of high levels of autistic traits or diagnosed autism.DesignLongitudinal birth cohort: Avon Longitudinal Study of Parents...

Analysis of the lung microbiome in cystic fibrosis patients using 16S sequencing

Cystic fibrosis (CF) patients often develop lung infections that range anywhere in severity from mild to life-threatening due to the presence of thick, sticky mucus that fills their airways. Since many of these infections are chronic, they not only affect a patient’s ability to breathe but also increase chances of mortality by respiratory failure. Examining the lung microbiology of CF patients can help with the prediction of the current condition of lung function, with the potential to guide doctors when designing personalized and thereby more effective treatment plans for patients. With a publicly available dataset of DNA sequences from bacterial species in the lung microbiome of CF patients, we investigated the correlations between different microbial species in the lung and the extent of deterioration of lung function. 16S sequencing technologies allowed us to determine the microbiome composition of the samples in the dataset. We found that the Fusobacterium, Actinomyces, and Leptotrichia microbial types all had positive correlation with forced expiratory volume in 1 second (FEV1) score, indicating potential displacement of these species by pathogens as the disease progresses. However, the dominant pathogens themselves, including Pseudomonas aeruginosa and Staphylococcus aureus, did not have statistically significant negative correlations with FEV1 score as described in past literature.

Establishment of a modified Kyoto classification scoring model and its significance in the diagnosis of Helicobacter pylori current infection

We aimed to establish a modified model of the Kyoto classification score and verify its accuracy for predicting Helicobacter pylori (HP) infection during endoscopy. Patients who underwent gastroscopy from June 2020 to March 2021 were included in this study. Atrophy, intestinal metaplasia, hypertrophy of the gastric fold, nodularity, diffuse redness, sticky mucus, spotty redness, xanthoma, map-like redness, fundic gland polyp, and regular arrangement of collecting venules (RAC) were recorded according to the Kyoto classification of gastritis. The HP infection status of participants was determined by a 13C breath test, anti-HP antibody, and histopathologic hematoxylin and eosin staining. The modified Kyoto classification scoring model was established based on univariate analysis and logistic regression analysis. The modified scoring model was used to judge the status of HP infection in patients undergoing gastroscopy from July to September 2021 and to evaluate the accuracy of the prediction. Of 667 participants in the derivation dataset, 326 cases had HP infection and 341 cases did not. Atrophy, hypertrophy of the gastric fold, nodularity, diffuse redness, sticky mucus, and spotty redness were associated with HP current infection. Thus, a new scoring model, termed the modified Kyoto classification scoring model, was constructed that included atrophy, hypertrophy of the gastric fold, nodularity, diffuse redness, sticky mucus, spotty redness, fundic gland polyp, and RAC as indicators. To test the model, 808 subjects, including 251 HP-positive patients, comprised the validation dataset. The modified Kyoto classification scoring model improved the accuracy of endoscopic determination of HP current infection and has clinical application potential in the Chinese population.

Quantity and quality of airway clearance in children and young people with cystic fibrosis

Children and young people with CF (CYPwCF) get advice about using positive expiratory pressure (PEP) or oscillating PEP (OPEP) devices to clear sticky mucus from their lungs. However, little is known about the quantity (number of treatments, breaths, or sets) or quality (breath pressures and lengths) of these daily airway clearance techniques (ACTs) undertaken at home. This study used electronic pressure sensors to record real time breath-by-breath data from 145 CYPwCF (6–16y) during routine ACTs over 2 months. ACT quantity and quality were benchmarked against individual prescriptions and accepted recommendations for device use. In total 742,084 breaths from 9,081 treatments were recorded. Individual CYPwCF maintained consistent patterns of ACT quantity and quality over time. Overall, 60% of CYPwCF did at least half their prescribed treatments, while 27% did fewer than a quarter. About 77% of pre-teens did the right number of daily treatments compared with only 56% of teenagers. CYPwCF usually did the right number of breaths. ACT quality (recommended breath length and pressure) varied between participants and depended on device. Breath pressures, lengths and pressure-length relationships were significantly different between ACT devices. PEP devices encouraged longer breaths with lower pressures, while OPEP devices encouraged shorter breaths with higher pressures. More breaths per treatment were within advised ranges for both pressure and length using PEP (30–31%) than OPEP devices (1–3%). Objective measures of quantity and quality may help to optimise ACT device selection and support CYPwCF to do regular effective ACTs.

Drug treatment of cystic fibrosis.

Cystic fibrosis is the most common life-limiting autosomal recessive condition in Australia. A defect in the cystic fibrosis transmembrane conductance regulator protein affects chloride transport across epithelial cells. Patients with cystic fibrosis produce thick sticky mucus. This causes problems in multiple organs, particularly the lungs. Cystic fibrosis modulator therapies can partially correct the underlying pathophysiology and improve chloride transport, thereby improving morbidity. Life expectancy is improving, so many patients are now developing chronic diseases associated with ageing. All health professionals should be aware that the cystic fibrosis modulator therapies are metabolised via cytochrome P450 pathways in the liver. There are therefore significant drug-drug interactions with medicines metabolised by the same pathways.