Symptoms Of Chronic Bronchitis Research Articles

Acute Effect of E-Cigarette Inhalation on Mucociliary Clearance in E-Cigarette Users.

Background: Recent studies show e-cigarette (EC) users have increased rates of chronic bronchitic symptoms that may be associated with depressed mucociliary clearance (MCC). Little is known about the acute or chronic effects of EC inhalation on in vivo MCC. Methods: In vivo MCC was measured in young adult vapers (n = 5 males, mean age = 21) after controlled inhalation of a radiolabeled (Tc99m sulfur colloid) aerosol. Whole-lung clearance of radiolabeled deposited particles was measured over a 90-minute period for baseline MCC and associated with controlled periodic vaping over the first 60 minutes of MCC measurements. The vaping challenge was administered from a fourth generation box mod EC containing unflavored e-liquid (65% propylene glycol/35% vegetable glycerin, 3 mg/mL freebase nicotine). The challenge was administered at the start of each 10-minute interval of MCC measurements and consisted of 1 puff every 30 seconds for 5 minutes (i.e., 10 puffs for each 10-minute period for a total of 60 puffs during the initial 60 minutes of MCC measurements). Results: Compared with baseline, peripheral lung average clearance (%) over the 90 minutes of MCC measures was enhanced, associated with EC challenge, 12 (±6) versus 24 (±6), respectively (p < 0.05 by Wilcoxon signed-rank test). Conclusions: Acute enhancement of in vivo MCC during EC challenge is contrary to recent studies showing nicotine-associated slowing of ciliary beat and mucus transport at higher nicotine levels than those used here. However, our findings are consistent with an acute increase in fluid volume and mucin secretion to the bronchial airway surface that is likely short lived. Research reported in this publication was supported by the National Institutes of Health R01HL139369 and registered with ClinicalTrials.gov (NCT03700892).

Assessment Of Purine Catabolism And Morbidity In Miners Depending On Their Work Experience

Objective — The role of end products of purine metabolism as predictors of the development of pathological changes and diseases caused by the impact of dust on the human body in a professional environment vs. the work experience (duration of underground experience in the field). Material and Methods — We analyzed the content of the end products of purine metabolism in the blood plasma of coal miners depending on the length of working in dusty conditions and evaluated the morbidity in the studied individuals via an analysis of the biomarkers. Results — The median levels of xanthine and uric acid exhibited similar significant trends with a decrease in values with underground work experience under 3 years and an increase in values with 5 or more years of experience. When assessing outcomes 1-3 years after the selection of coal miners into the study, we revealed that both acute diseases (acute respiratory viral infection (ARVI), COVID-19, acute bronchitis, and community-acquired pneumonia) and chronic diseases were present in all groups. One coal miner (2.9%) from the group with 7-10 years of underground work experience was diagnosed with an occupational disease. The development of radiological changes in the chest organs (pulmonary fibrosis, symptoms of chronic bronchitis) was detected in the groups with an experience of up to 3 years, 3-5 years, 5-7 years, and 7-10 years in 6.4%, 9.4%, 11.1%, and 5.8% of miners, respectively. Conclusion — According to logistic regression data, underground experience of 7-10 years has led to the reduction in the levels of xanthine and uric acid in the blood, which inflicted a statistically significant effect on the development of diseases in miners. Long-term underground work yielded 8.6-fold increase in the risk of developing diseases in miners.

Electronic cigarette use and respiratory symptoms in the French population-based Constances cohort

BackgroundKnowledge about the consequences of electronic cigarette (EC) use on respiratory health is still limited. We aimed to assess whether EC use is associated with the occurrence of asthma symptoms and chronic bronchitis among the French adult population, with a specific focus on never combustible cigarettes (CC) smokers. We further investigated whether the association differed in men and women. MethodsConstances is a population-based cohort of adults aged 18–69 years at inception. We analyzed baseline data collected in 136,276 participants recruited in 2015–2019. Associations of current and former EC use with respiratory symptoms (asthma symptom score and chronic bronchitis) were assessed, controlling for CC smoking, cannabis use, demographics, education and body mass index (BMI). ResultsIncreased frequencies of respiratory symptoms were observed in both current and former EC users (for the asthma symptom score, adjusted mean score ratio (aMSR): 1.34 [95 % confidence interval: 1.28−1.41] and 1.39 [1.33−1.45], respectively; for chronic bronchitis, adjusted prevalence ratio (aPR): 1.27 [1.19−1.36] and 1.40 [1.32−1.48], respectively). Among never CC smokers, ever EC use was associated with an increased asthma symptom score in both men and women (aMSR = 1.44 [1.09−1.90] and 1.36 [1.01−1.83], respectively), and with a higher prevalence of chronic bronchitis only in women (aPR = 1.97 [1.27−3.05]). ConclusionEC use is associated with symptoms of asthma and chronic bronchitis, independently of CC smoking and cannabis use. The fact that these associations are observed among individuals who have never smoked tobacco adds further evidence of the deleterious effects of EC on respiratory health.

Systems pharmacology-based dissection of potential mechanisms of Exocarpium Citri Grandis for the treatment of chronic bronchitis

Exocarpium Citri Grandis (ECG), a precious traditional Chinese medicine (TCM), has been widely utilized to improve the symptoms of chronic bronchitis (CB) such as cough or sputum. However, its underlying pharmacological mechanisms remain unclear. To investigate the potential mechanisms of ECG for the treatment of CB, a comprehensive systems pharmacology strategy combining network pharmacology, molecular docking, molecular dynamics simulations, and molecular biology experiments in vitro was carried out. In this study, 46 potential targets of CB screened for 10 active ingredients of ECG were strongly linked to inflammatory responses, immune processes, and apoptosis. Molecular docking revealed that the active ingredients of ECG have high binding activity for MyD88, NF-κB p65, Caspase9, and Caspase3, respectively. Meanwhile, MD simulations confirmed that neohesperidin and naringenin have high stability and low binding free energy with NF-κB p65 and Caspase3 in the binding pocket. In the LPS-induced RAW264.7 cell inflammatory model, ECG markedly reduced the secretion of IL1β, IL6, TNF-α, and NO. Transcriptomics showed a total of 337 differential expression genes (DEGs) were screened after ECG treatment, of which 233 down-regulated DEGs were closely associated with the NF-κ B signaling pathway, the Toll-like receptor signaling pathway, the IL-17 signaling pathway, and the TNF signaling pathway. Further analysis results revealed that ECG significantly down-regulated the expression of TLR4, MyD88, NF-κB p65, NF-κB p-p65 (S536), p-IκBα (S36), COX2, ICAM1, and iNOS, and up-regulated the expression of IκBα, inhibited NF-κB p65 entry into the nucleus, thereby suppressing NF-κB signaling transduction. Furthermore, ECG also significantly up-regulated the expression of Bcl-2 and down-regulated the expression of Bax, Caspase3, Caspase8, and Caspase9, inhibiting apoptosis in a dose-dependent manner. Our study reveals the potential pharmacological mechanisms of ECG for the treatment of CB and provides a scientific basis for its clinical application.

From pre-COPD to COPD: a Simple, Low cost and easy to IMplement (SLIM) risk calculator.

The lifetime risk of developing clinical COPD among smokers ranges from 13% to 22%. Identifying at-risk individuals who will develop overt disease in a reasonable timeframe may allow for early intervention. We hypothesised that readily available clinical and physiological variables could help identify ever-smokers at higher risk of developing chronic airflow limitation (CAL). Among 2273 Lovelace Smokers' Cohort (LSC) participants, we included 677 (mean age 54 years) with normal spirometry at baseline and a minimum of three spirometries, each 1 year apart. Repeated spirometric measurements were used to determine incident CAL. Using logistic regression, demographics, anthropometrics, smoking history, modified Medical Research Council dyspnoea scale, St George's Respiratory Questionnaire, comorbidities and spirometry, we related variables obtained at baseline to incident CAL as defined by the Global Initiative for Chronic Obstructive Lung Disease and lower limit of normal criteria. The predictive model derived from the LSC was validated in subjects from the COPDGene study. Over 6.3 years, the incidence of CAL was 26 cases per 1000 person-years. The strongest independent predictors were forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.75, having smoked ≥30 pack-years, body mass index (BMI) ≤25 kg·m2 and symptoms of chronic bronchitis. Having all four predictors increased the risk of developing CAL over 6 years to 85% (area under the receiver operating characteristic curve (AUC ROC) 0.84, 95% CI 0.81-0.89). The prediction model showed similar results when applied to subjects in the COPDGene study with a follow-up period of 10 years (AUC ROC 0.77, 95% CI 0.72-0.81). In middle-aged ever-smokers, a simple predictive model with FEV1/FVC, smoking history, BMI and chronic bronchitis helps identify subjects at high risk of developing CAL.

Respiratory and population effects of e-cigarettes: A Chinese perspective.

Respiratory and population effects of e-cigarettes: A Chinese perspective.

Obstructive Lung Disease Linked to Occupational Exposures in Malawian Tobacco Farmers

ABSTRACT Nicotine and pesticide exposure in agricultural settings have been linked to the development of chronic respiratory disease in workers. However, this has not been extensively studied in Africa. The aim of this study was therefore to determine the prevalence of obstructive lung disease and its relationship to concurrent nicotine and pesticide exposure among small-scale tobacco farmers in Malawi. For this purpose, sociodemographic characteristics, occupational and environmental exposures were evaluated in relation to work-related respiratory symptoms and lung function impairment. A cross-sectional study was conducted enrolling 279 workers in flue-cured tobacco farms in Zomba, Malawi. The study instruments used for assessing the health outcomes were a standardised European Community Respiratory Health Survey II (ECRHS) questionnaire and Spirometry testing. The questionnaires were aimed at collecting relevant data on sociodemographic factors and self-reported respiratory health outcomes. Data were also collected on potential pesticide and nicotine exposures. Spirometry was done to evaluate objective respiratory impairment in accordance with American Thoracic Society guidelines. The mean age of participants was 38 years with 68% being male. The prevalence of work-related ocular nasal symptoms, chronic bronchitis, and work-related chest symptoms was 20%, 17%, and 29%, respectively. Airflow limitation (FEV1/FVC <70%) was found in 8% of workers. Self-reported exposure to pesticides varied from 72%- to 83%, whilst the prevalence of recent green tobacco sickness was 26%. Tasks linked to nicotine exposure, such as sowing (OR: 2.5; CI 1.1–5.7) and harvesting (OR: 2.6; CI 1.4–5.1), were significantly associated with work-related chest symptoms. Pesticide application (OR:1.96; CI 1.0–3.7) was associated with an increased risk of work-related oculonasal symptoms. Duration of pesticide exposure was also associated with obstructive impairment FEV1/FVC<LLN (OR: 5.11; CI 1.6–16.7) and FEV1/FVC <70% (OR: 4.68; CI 1.2–18.0). This study demonstrated that tobacco farmers in Malawi had a high prevalence of respiratory symptoms and airflow limitation due to obstructive lung disease. This could be attributed to nicotine or pesticide exposure in small-scale tobacco farming. The implementation of occupational health and safety measures to mitigate these exposures may play an important role in modifying the risk of obstructive lung disease in this population.

Dissociation between physical capacity and daily physical activity in COPD patients. A population-based approach

BadkgroundPhysical capacity (PC) and daily physical activity (PA) are two crucial factors in the clinical course of COPD, although they do not always maintain a close relationship. The objectives were to evaluate the frequency of PC-PA dissociation in patients with COPD and subjects without airflow limitation (AL) and to identify its risk factors. MethodsA sample of 319 COPD patients and 399 subjects without AL was consecutively obtained from a population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, lung function testing, blood analysis and low-dose computed tomography (CT) scan with evaluation of lung density and airway wall thickness. A distance walked in 6 min > 70% predicted was considered an indicator of normal PC, while a Yale Physical Activity Survey summary index score <51 was used to identify with sedentary lifestyle. Results166 COPD patients (52.0%) reported a sedentary lifestyle with evidence of preserved PC, while this phenomenon was present in 188 (47.1%) subjects without AL. In the COPD group, symptoms of chronic bronchitis, depression and elevated hematocrit and blood eosinophil count were identified as independent risk factors for PC-PA dissociation. In turn, in the subjects without AL, the risk factors for PC-PA dissociation were low fat-free mass, obesity and anxiety, as well as reduced levels of HDL-cholesterol and the absence of osteoporosis. ConclusionsAlmost half of COPD patients and subjects without airflow limitation with preserved PC maintain a sedentary lifestyle, with different risk factors for sedentarism between both groups.

Decreased Cardiac Autonomic Function is Associated with Higher Exacerbation Risk and Symptom Burden in Chronic Obstructive Pulmonary Disease.

Current measures of chronic obstructive pulmonary disease (COPD) severity, including lung function, do not fully explain symptom burden, and there is a need to identify predictors of exacerbation risk and morbidity. Autonomic dysfunction may be implicated in both cardiovascular and respiratory morbidity in COPD and convey risk for exacerbations. Heart rate variability (HRV) is a marker of cardiac autonomic function that is predictive of cardiovascular health and has promise as a non-invasive COPD biomarker. The CLEAN AIR Heart study provided an opportunity to investigate the association between HRV and COPD morbidity among former smokers with moderate-severe COPD. Eighty-five participants, contributing 305 HRV measurements, underwent repeated clinical assessments over 4 study periods that included a 24-Holter monitoring assessment of HRV. HRV measures of interest were standard deviation of normal-to-normal intervals, (SDNN) (overall HRV) and root-mean-square of successive differences (RMSSD) (parasympathetic function). Exacerbation risk was assessed using negative binomial models, and mixed-effects models analyzed associations between HRV and symptoms. Decreases in SDNN (incidence rate ratio [IRR]1.40; 95% confidence interval [CI] 1.13 to1.74) and RMSSD (IRR 1.60; 95% CI 1.07 to 2.37) were associated with severe exacerbation risk. Decreases in SDNN were associated with higher St George's Respiratory Questionnaire scores, COPD Assessment Test scores, and chronic bronchitis symptoms. Findings demonstrate that HRV is associated with COPD symptom burden and exacerbation risk. HRV may represent an important biomarker with the potential to identify high-risk COPD populations.

Performance of the Cough and Sputum Assessment Questionnaire (CASA-Q) in COPD: Evidence from Clinical and Online Patient Interaction Studies.

Patient perception of the burden of chronic bronchitis symptoms in chronic obstructive pulmonary disease (COPD) can be assessed using patient-reported outcome measures (PROMs). The Cough and Sputum Assessment Questionnaire (CASA-Q) was developed and tested for this purpose. This study reviewed the performance of the CASA-Q in published online studies and tested a novel approach to complement traditional methods of qualitative content validation. A targeted literature search was performed to identify published clinical studies of COPD using the CASA-Q as an endpoint. The performance of the questionnaire was examined in relation to other study endpoints, including clinical and functional measurements and other PROMs. Assessment of the content validity of the CASA-Q was carried out by comparing the content and structure of the questionnaire with published qualitative patient data from previously conducted online social media listening (SML) and online bulletin board (OBB) studies. In the interventional clinical trials, CASA-Q change scores were consistent with study objectives and other endpoints, including FEV1 and other PROMs. Two observational studies showed cross-sectional correlations with other PROMs like the St.-George's Respiratory Questionnaire (SGRQ) and COPD assessment test (CAT) scores. Qualitative data from the SML and OBB patient studies were consistent with the content and structure of the CASA-Q, supporting the content validity of the measure. Results suggest that the CASA-Q is appropriately responsive to changes in cough and sputum symptoms and clinical impact in trials of COPD. The mapping of qualitative findings from online SML and OBB studies to CASA-Q domains and items confirm the content validity of the instrument. These results suggest the CASA-Q can be a valuable tool for evaluating treatment effect in COPD trials.

Inhaled Marijuana and the Lung

Although vaping has recently increased as a mode of inhaling marijuana and has been associated with numerous and sometimes fatal cases of acute severe lung injury, smoking remains the most common method of inhaling marijuana and has been studied more extensively. Smoking marijuana has been shown to produce modest but significant short-term bronchodilation both in healthy subjects and in those with asthma. Long-term effects of habitual marijuana smoking include the following: (1) symptoms of chronic bronchitis (increased cough, sputum production, and wheezing); (2) modest effects on lung function in cross-sectional studies (no significant decrease in FEV1 but mild reductions in FEV1/forced vital capacity ratio, an increase in forced vital capacity and other lung volumes, reductions in specific airway conductance, and variable effects of maximal midexpiratory flow rates and diffusing capacity); and (3) variable effects on age-related decline in FEV1 in longitudinal studies. Most cohort and case-control studies have failed to show that marijuana smoking is a significant risk factor for lung cancer despite the presence of procarcinogenic components in marijuana smoke, although further study is warranted. The question whether marijuana smoking is associated with asthma is unclear and requires further investigation. Although delta-9 tetrahydrocannabinol, the principal psychoactive component of marijuana, has immunomodulatory properties that hypothetically could increase the risk of pneumonia, the few available studies in marijuana smokers have failed to find an increased risk of pneumonia in immunocompetent users, although effects in immunosuppressed individuals have been variable.

Effect of prolonged lipopolysaccharide exposure on lung function and health

RationalePatients with Chronic Obstructive Pulmonary Disease often have persistent inflammation of the airways that lead to symptoms of chronic bronchitis and airway obstruction. While it is known that long term exposure to cigarette smoke can cause persistent airways inflammation, it is not clear if this is a direct result of tobacco exposure or if it is a result of chronic inflammation. We hypothesized that a recurrent and prolonged inflammatory insult would result in alterations in lung mechanics characterized by airway obstruction.Methods. To test the independent effects of recurrent and persistent lung inflammation on lung mechanics, C57Bl/6 8 week old male mice were treated weekly with PBS or lipopolysaccharide (LPS) via direct intratracheal injection. Monthly, we evaluated lung function analysis including: airway resistance and compliance, tissue damping, pressure volume loops, and forced expiratory volume using the flexiVent system.Results. Airway resistance at month 1 was 0.5543±0.017 PBS vs 0.552±0.009 cmH2O.s/mL LPS (p=0.999), month 2 0.5177±0.015 PBS vs 0.576±0.017 LPS (p=0.999), month 3 0.461± 0.03 PBS vs 0.47±0.038 cmH2O.s/mL LPS (p=0.999), month 5 0.43±0.015 PBS vs 0.468±0.026 cmH2O.s/mL LPS (p=0.999), month 6 PBS 0.408± 0.06 vs LPS 0.6465±0.18 cmH2O.s/mL (p=0.999), and month 7 PBS 0.384 ± 0.023 vs LPS 0.3498 ± 0.015 cmH2O.s/mL (p=0.999). Forced expiratory volume 0.1 (FEV 0.1) at month 1 was 0.4±0.08 PBS vs 0.803±0.107 mL LPS (p=0.999), month 2 0.2115±0.01 PBS vs 0.184±0.03 mL LPS (p=0.999), month 3 1.071±0.09 PBS vs 1.098±0.06 mL LPS (p=0.999), month 5 0.853±0.243 vs 0.756±0.21 mL LPS (p=0.999), month 6 2.671±1.06 PBS vs 1.669±0.87 mL LPS (p=0.999), month 7 0.9049±0.27 PBS vs 1.127±0.152 mL LPS (p=0.999).ConclusionIt is well known that chronic smoking can have a significant impact of lung function. Through this project we aimed to discover whether chronic inflammation alone would alter lung function. Interestingly even after weekly direct intratracheal injections of LPS there were no significant changes in lung function compared to PBS treated mice. We have shown here that chronic inflammation alone was not sufficient to alter lung function in mice, and that the decrease in lung function seen in chronic smokers is attributable to numerous factors and not inflammation alone.

Prevalence of a decreased FEV3/FEV6 ratio in symptomatic smokers with preserved lung function

BackgroundThe ratio of forced expiratory volume in 3 seconds to forced expiratory volume in 6 seconds (FEV3/FEV6) has been proposed as an index of peripheral airway disease, and could be decreased in patients at risk for COPD. However, the prevalence of FEV3/FEV6 decrease has never been assessed in patients attending a pneumology clinic. Here we set out to assess the prevalence of a decreased FEV3/FEV6 in smokers with symptoms of chronic bronchitis, and to test its predictive value for COPD diagnosis. MethodsWe performed a retrospective analysis of databased pulmonary function tests (PFTs) for smokers and ex-smokers aged >40 years old, with symptoms of chronic bronchitis and a normal FEV1/FVC ratio. Clinical data were retrieved from the hospital records. Patients presenting with clinical conditions liable to interfere with PFT results were excluded. For those included, we controlled for onset of an obstructive ventilatory defect 1 year later. ResultsThe dataset included 67 patients (median age: 64 years [interquartile range: 53–72], 61% current smokers). FEV1/FVC was above lower limit of normal but lower than 0.7 in 18 patients (27%). FEV3/FEV6 was decreased below the lower limit of normal in 45 patients (67%). The latter did not differ from others patients in clinical data and PFTs except for a lower lung diffusion capacity (DLCO). We found a weak correlation between FEV3/FEV6 and DLCO (r=0.33, p=0.004). PFTs were repeated in 35 patients at 11 [7–12] months, and 20 (54%) presented with obstructive ventilatory defect defined by FEV1/FVC ratio <0.7. A reduction of FEV3/FEV6 was predictive of COPD onset one year later (p=0.04). These results may be biased by a discrepancy between the normality cut-offs used at inclusion and during follow-up (i.e. lower limit of normal and 0.7). ConclusionsDecreased FEV3/FEV6 suggestive of peripheral airway disease is highly prevalent in smokers with symptoms of chronic bronchitis and preserved pulmonary function. Altered FEV3/FEV6 is predictive of reduced FEV1/FVC ratio in the mid-term. A larger prospective study is needed to determine whether decreased FEV3/FEV6 could be used to detect patients at risk for COPD.

Clinical Impact of the Bronchiectasis with Chronic Bronchitis Symptoms in COPD: Analysis of a Longitudinal Cohort.

PurposeBronchiectasis (BE) is a poor prognostic factor in COPD. However, it is not clear whether the poor prognosis is a result of BE alone or accompanying chronic bronchitis symptoms. Therefore, we investigated the effect of chronic bronchitis symptoms on clinical outcomes in COPD patients with BE.Patients and MethodsWe analyzed data of COPD patients from the Korean Obstructive Lung Disease (KOLD) cohort. The presence of BE was verified by chest computed tomography. Chronic bronchitis symptoms were determined using items in the symptomatic domain of the SGRQ, which is also used as an alternative definition of chronic bronchitis (CB). Patients were divided into four groups according to the presence of BE and CB symptoms: BE/CB, BE-only, CB-only, and no BE/CB. Demographic features and clinical outcomes were compared among these groups.ResultsIn total, 389 COPD patients were included in the analysis. BE was present in 148 (38%) patients and CB symptoms were found in 123 patients (33.2%). The patients were divided according to BE and CB symptoms, and the numbers and percentages of each group were as follows: BE/CB, 52 (13.4%); BE-only, 96 (24.7%); CB-only, 77 (19.8%); no BE/CB, 164 (42.2%). No significant differences were observed in baseline characteristics of lung function, radiological findings, and inflammatory markers among the four groups. The proportion of annual exacerbators was higher in the BE/CB and CB-only groups than the other two groups. After adjusting other parameters, the BE/CB group was significantly associated with acute exacerbation of COPD (AE-COPD) (OR = 2.110, p = 0.045).ConclusionBE accompanying CB symptoms is associated with AE-COPD, while BE alone was not significantly associated. This finding suggests that it is more important to examine chronic bronchitis symptoms of BE to predict acute exacerbation than simply to identify BE in COPD patients.

053 Epidermal barrier dysfunction is associated with chronic bronchitis in adults: Results from the National Health and Nutrition Examination Survey, 1999-2006

Epidermal barrier dysfunction (EBD) has been associated with increased circulating pro-inflammatory cytokines (e.g., IL-1β, IL-6, TNF-α), many of which are also elevated in chronic bronchitis and emphysema; few studies have examined the relationship between EBD and these inflammatory lung conditions, which we investigated using the United States National Health and Nutrition Examination Survey (NHANES). The study population included adult participants (age ≥20 years) from survey years 1999-2006. The exposure of interest was EBD, defined as self-reported “dermatitis, eczema, rash in past year” for survey years 1999-2004 and “itchy rash at any time in past 12 months” for survey years 2005-2006. Outcomes of interest included self-reported ever diagnosis of chronic bronchitis and emphysema, as well as frequent cough and phlegm production in the past three months. We used survey-weighted multiple logistic regression to calculate adjusted odds ratios (aOR) for each outcome. Models were adjusted for survey cycle, sex, age group, race/ ethnicity, education level, income to poverty ratio, body mass index category, smoking history (≥100 cigarettes in lifetime), and alcohol use history (≥12 drinks in past year). Among 15,158 adult participants included in the study, 1,627 (10.7%) had EBD. After adjusting for covariates, EBD was associated with 61% increased odds of having a history of chronic bronchitis (aOR 1.61, 95% CI 1.29-2.01, P<0.001), but no association was seen for emphysema (aOR 1.25, 95% CI 0.76-2.05, P=0.37). EBD was also associated with frequent cough (aOR 1.69, 95% CI 1.36-2.09, P<0.001) and phlegm production (aOR 1.60, 95% CI 1.28-1.99, P<0.001). Associations of EBD with chronic bronchitis and related respiratory symptoms provide further support for the link between skin barrier disruption and systemic inflammatory processes. Additional research is needed to further elucidate this link and explore the role of skin barrier restoration in the management of pulmonary disorders.

Abstracts from The International Society for Aerosols in Medicine 23rd ISAM Congress Boise, Idaho May 22–26, 2021

Abstracts from The International Society for Aerosols in Medicine 23rd ISAM Congress Boise, Idaho May 22–26, 2021

ADHATODA VASICA (VASAPATRA): A REVIEW BASED UPON ITS MEDICINAL PROPERTIES

Adhatoda vasica (L.) Nees is also known as Justicia adhatoda L. belongs to the family Acanthaceae and is considered the most significant plant in the world. It is commonly known as Vasaka, Vasica, Adosa, Malbur nut and is distributed in various regions of India and throughout the world. It is a well-known plant in Ayurveda and Unani medicinal system. This plant has been used in the indigenous medicinal system of India for more than 2000 years. The plant has great medicinal importance and is used to treat various diseases and disorders mainly respiratory tract diseases like cough, symptoms of common cold, asthma, tuberculosis and chronic bronchitis. All the parts of the plant are used in medicines. Vasicine is the main chemical constituent present in this plant which possesses various medicinal properties and is used in different Ayurveda formulations. Also, it contains various reported pharmacological properties like antispasmodic, sedative, expectorant, antitussive, oxytocic, antibacterial, anti-diabetic, wound healing, abortifacient, antiasthma and anti-pyorrhea.

Wood Dust Exposure Levels and Respiratory Symptoms 6 Years Apart: An Observational Intervention Study Within the Danish Furniture Industry.

ObjectivesOccupational exposure to wood dust can cause respiratory diseases, but few studies have evaluated the impact of declining exposure on health outcome. This study aimed to investigate whether a decline in wood dust exposure between two cross sectional studies performed in 1997–1998 and 2003–2004 was related to the prevalences of respiratory symptoms among woodworkers in a well-defined geographical area.MethodsTwo thousand and thirty-two woodworkers from 54 plants in study 1 and 1889 woodworkers from 52 plants in study 2 returned a questionnaire on respiratory diseases and symptoms, employment and smoking habits. Current individual wood dust exposure level was assessed from 2 study specific job exposure matrix’s based on task, factory size and personal passive dust measurements (2217 in study 1 and 1355 in study 2).ResultsThe median (range) of inhalable dust was 1.0 mg/m3 (0.2–9.8), 0.6 mg/m3 (0.1–4.6) in study 1 and study 2, respectively. In study 2, the prevalence’s of self-reported asthma was higher and the prevalence’s of respiratory symptoms were lower compared to study 1. In adjusted logistic regression analyses using GEE methodology to account for clustering, dust exposure level could explain the differences in prevalence of coughing, chronic bronchitis and nasal symptoms between study 1 and study 2, while no effect was found for asthma.ConclusionsA 40% decline in wood dust exposure in a 6 year period may serve as an explanation for the decline in most respiratory symptoms, but do not seems to impact the prevalence of self-reported asthma.

Ambient air pollution exposure and chronic bronchitis in the Lifelines cohort

BackgroundFew large studies have assessed the relationship of long-term ambient air pollution exposure with the prevalence and incidence of symptoms of chronic bronchitis and cough.MethodsWe leveraged Lifelines cohort data on...

New bronchoscopic treatment modalities for patients with chronic bronchitis.

Chronic bronchitis is a chronic, progressive disease that is difficult to treat. Despite much effort, patients remain highly symptomatic. Currently, a number of innovative bronchoscopic treatments for this disease are under investigation. Liquid nitrogen metered cryospray, bronchial rheoplasty and balloon desobstruction all aim to destroy the hyperplastic goblet cells and excess submucous glands using different strategies. These therapies are in an early phase of clinical research and larger randomised controlled trials are needed to confirm the pilot data available and to evaluate the treatment durability. The fourth technique, targeted lung denervation (TLD), aims to decrease the release of acetylcholine, which regulates smooth muscle tone and mucus production by ablating the parasympathetic nerves running alongside the main bronchi. Evaluation of this treatment is at a more advanced stage and promising effects on exacerbation frequency have been shown. However, confirmation of the benefit in improvement in chronic bronchitis symptoms is still needed.