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Small airway change with age

Dirkje S Postma, Chris Brightling, Simonetta Baldi, Maarten Van den Berge, Leonardo M Fabbri, Alessandra Gagnatelli, Alberto Papi, Thys Van der Molen, Klaus F Rabe, Salman Siddiqui, Dave Singh, Gabriele Nicolini, Monica Kraft
BACKGROUND: Small airways dysfunction (SAD) is well recognised in asthma, yet its role in the severity and control of asthma is unclear. This study aimed to assess which combination of biomarkers, physiological tests, and imaging markers best measure the presence and extent of SAD in patients with asthma. METHODS: In this baseline assessment of a multinational prospective cohort study (the Assessment of Small Airways Involvement in Asthma [ATLANTIS] study), we recruited participants with and without asthma (defined as Global Initiative for Asthma severity stages 1-5) from general practices, the databases of chest physicians, and advertisements at 29 centres across nine countries (Brazil, China, Germany, Italy, Spain, the Netherlands, the UK, the USA, and Canada)...
March 12, 2019: Lancet Respiratory Medicine
Surya P Bhatt, Sandeep Bodduluri, Vrishank Raghav, Nirav R Bhakta, Carla G Wilson, Young-Il Kim, Michael Eberlein, Frank C Sciurba, MeiLan K Han, Mark T Dransfield, Arie Nakhmani
RATIONALE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation. Spirometry loops are not smooth curves and have undulations and peaks that likely reflect heterogeneity of airflow. OBJECTIVE: To assess whether the Peak Index, the number of peaks adjusted for lung size, is associated with clinical outcomes. METHODS: We analyzed spirometry data of 9584 participants enrolled in the COPDGene study, and counted the number of peaks in the descending part of the expiratory flow-volume curve from the peak expiratory flow to end-expiration...
March 13, 2019: Annals of the American Thoracic Society
J Ong, R R Woldhuis, I M Boudewijn, A van den Berg, J Kluiver, K Kok, M M Terpstra, V Guryev, M de Vries, C J Vermeulen, W Timens, M van den Berge, C A Brandsma
Knowledge on age-related miRNA changes in healthy individuals and their interaction with mRNAs is lacking. We studied age-related mRNA and miRNA expression changes and their interactions in normal airways. RNA and small RNA sequencing was performed on bronchial biopsies of 86 healthy individuals (age: 18-73) to determine age-related expression changes. Per age-related miRNA we determined the enrichment of age-related predicted targets and their correlation. We identified 285 age-related genes and 27 age-related miRNAs...
March 6, 2019: Scientific Reports
Katarzyna Walicka-Serzysko, Magdalena Postek, Justyna Milczewska, Dorota Sands
The impact of infections caused by bacteria, especially Gram-negative, on the progression of lung disease in cystic fibrosis is well established. Decline in pulmonary function commence already at early age. In this group of patients, the lung clearance index seems to be a better marker than FEV1 allowing non-invasive monitoring of changes in small airways. The aim of this study was to investigate the association between the microbiological status and LCI derived from multiple breath washout (MBW) technique as well as FEV1 and FVC in children suffering from cystic fibrosis...
March 5, 2019: Pediatric Pulmonology
Kathy C Richards, Nalaka Gooneratne, Barry Dicicco, Alexandra Hanlon, Stephen Moelter, Fannie Onen, Yanyan Wang, Amy Sawyer, Terri Weaver, Alicia Lozano, Patricia Carter, Jerry Johnson
BACKGROUND/OBJECTIVES: Obstructive sleep apnea (OSA) has been linked to an increased risk for Alzheimer's disease (AD), but little prospective evidence exists on the effects of OSA treatment in preclinical AD. The objective was to determine if continuous positive airway pressure (CPAP) treatment adherence, controlling for baseline differences, predicts cognitive and everyday function after 1 year in older adults with mild cognitive impairment (MCI) and to determine effect sizes for a larger trial...
March 2019: Journal of the American Geriatrics Society
Kana R Jat, Joseph L Mathew
BACKGROUND: Acute bronchiolitis is one of the most frequent causes of emergency department visits and hospitalisation in children. There is no specific treatment for bronchiolitis except for supportive treatment, which includes ensuring adequate hydration and oxygen supplementation. Continuous positive airway pressure (CPAP) aims to widen the lungs' peripheral airways, enabling deflation of overdistended lungs in bronchiolitis. Increased airway pressure also prevents the collapse of poorly supported peripheral small airways during expiration...
January 31, 2019: Cochrane Database of Systematic Reviews
Katherine Harris, Dylan Kneale, Toby J Lasserson, Vanessa M McDonald, Jonathan Grigg, James Thomas
BACKGROUND: Asthma is a common respiratory condition in children that is characterised by symptoms including wheeze, shortness of breath, chest tightness, and cough. Children with asthma may be able to manage their condition more effectively by improving inhaler technique, and by recognising and responding to symptoms. Schools offer a potentially supportive environment for delivering interventions aimed at improving self-management skills among children. The educational ethos aligns with skill and knowledge acquisition and makes it easier to reach children with asthma who do not regularly engage with primary care...
January 28, 2019: Cochrane Database of Systematic Reviews
Christine Racette, Zihang Lu, Krzysztof Kowalik, Olivia Cheng, Glenda Bendiak, Reshma Amin, Aimee Dubeau, Renée Jensen, Susan Balkovec, Per Gustafsson, Felix Ratjen, Padmaja Subbarao
Background: Pulmonary function testing has been recommended as an adjunct to symptom monitoring for assessment of asthma control. Lung clearance index (LCI) measures ventilation inhomogeneity and is thought to represent changes in the small airways. It has been proposed as a useful early marker of airway disease in asthmatic subjects, and determining it is feasible in preschool children. This study aims to assess whether LCI remains elevated in symptomatically controlled asthmatic children with a history of severe asthma, compared with healthy controls...
August 2018: Health Science Reports
Daniel P Krowchuk, Ilona J Frieden, Anthony J Mancini, David H Darrow, Francine Blei, Arin K Greene, Aparna Annam, Cynthia N Baker, Peter C Frommelt, Amy Hodak, Brian M Pate, Janice L Pelletier, Deborah Sandrock, Stuart T Weinberg, Mary Anne Whelan
Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common benign tumor of infancy. Most IHs are small, innocuous, self-resolving, and require no treatment. However, because of their size or location, a significant minority of IHs are potentially problematic. These include IHs that may cause permanent scarring and disfigurement (eg, facial IHs), hepatic or airway IHs, and IHs with the potential for functional impairment (eg, periorbital IHs), ulceration (that may cause pain or scarring), and associated underlying abnormalities (eg, intracranial and aortic arch vascular abnormalities accompanying a large facial IH)...
January 2019: Pediatrics
Nada Lukkahatai, Brian Walitt, Enrique J Deandrés-Galiana, Juan Luis Fernández-Martínez, Leorey N Saligan
Objectives: Fibromyalgia syndrome (FMS) is a chronic and often debilitating condition that is characterized by persistent fatigue, pain, bowel abnormalities, and sleep disturbances. Currently, there are no definitive prognostic or diagnostic biomarkers for FMS. This study attempted to utilize a novel predictive algorithm to identify a group of genes whose differential expression discriminated individuals with FMS diagnosis from healthy controls. Methods: Secondary analysis of gene expression data from 28 women with FMS and 19 age-and race-matched healthy women...
2018: Journal of Pain Research
Genny Raffaeli, Chiara Veneroni, Stefano Ghirardello, Anna Lavizzari, Sofia Passera, Fabio Mosca, Giacomo Cavallaro, Raffaele L Dellacà
Respiratory management during extracorporeal membrane oxygenation (ECMO) is complex. Assessment of lung mechanics might support a patient-tailored ventilatory strategy. We report, for the first time, the use of the forced oscillation technique (FOT) to evaluate lung function during neonatal ECMO to improve the individualization of respiratory support. The patient was a formerly preterm infant at a corrected age of 40 weeks (gestational age 32 weeks) undergoing veno-arterial ECMO for refractory respiratory failure secondary to influenza A (H1N1) pneumonia...
2018: Frontiers in Pediatrics
David Langton, Alvin Ing, Joy Sha, Kim Bennetts, Nicole Hersch, McKinny Kwok, Virginia Plummer, Francis Thien, Claude Farah
BACKGROUND AND OBJECTIVE: Bronchial thermoplasty (BT) has been consistently shown to reduce symptoms, exacerbations and the need for reliever medication in patients with severe asthma. Paradoxically, no consistent improvement in spirometry has been demonstrated. It has been suggested that this is due to a reduction in peripheral resistance in small airways, not captured by spirometry. Therefore, in this study, we evaluate the response to BT using oscillometry. METHODS: A total of 43 patients with severe asthma from two centres were evaluated at baseline, 6 weeks and 6 months post BT, using spirometry, plethysmography and oscillometry, in addition to medication usage, exacerbation frequency and the Asthma Control Questionnaire (5-item version) (ACQ-5)...
November 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
G Hodge, S Hodge, A Yeo, P Nguyen, E Hopkins, H Liu, C L Holmes-Liew, M Holmes
Immunosuppression therapies including corticosteroids fail to prevent bronchiolitis obliterans syndrome (BOS), primarily a disease of the small airways, following lung transplantation. We reported increases in steroid-resistant proinflammatory lymphocytes and their loss of histone deacetylase 2 (HDAC2), an important mediator of steroid action, in the blood of stable lung transplant recipients. We noted similar increases in the steroid-resistant lymphocytes in both the blood and small airways in BOS compared with the large airways...
October 10, 2018: Clinical and Experimental Immunology
Peter Wark, Vanessa M McDonald
BACKGROUND: Impaired mucociliary clearance characterises lung disease in cystic fibrosis (CF). Hypertonic saline enhances mucociliary clearance and may lessen the destructive inflammatory process in the airways. This is an update of a previously published review. OBJECTIVES: To investigate efficacy and tolerability of treatment with nebulised hypertonic saline on people with CF compared to placebo and or other treatments that enhance mucociliary clearance. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register, comprising references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings...
September 27, 2018: Cochrane Database of Systematic Reviews
Shu Mei Teo, Howard H F Tang, Danny Mok, Louise M Judd, Stephen C Watts, Kym Pham, Barbara J Holt, Merci Kusel, Michael Serralha, Niamh Troy, Yury A Bochkov, Kristine Grindle, Robert F Lemanske, Sebastian L Johnston, James E Gern, Peter D Sly, Patrick G Holt, Kathryn E Holt, Michael Inouye
Repeated cycles of infection-associated lower airway inflammation drive the pathogenesis of persistent wheezing disease in children. In this study, the occurrence of acute respiratory tract illnesses (ARIs) and the nasopharyngeal microbiome (NPM) were characterized in 244 infants through their first five years of life. Through this analysis, we demonstrate that >80% of infectious events involve viral pathogens, but are accompanied by a shift in the NPM toward dominance by a small range of pathogenic bacterial genera...
September 12, 2018: Cell Host & Microbe
Moisés Selman, Fernando J Martinez, Annie Pardo
Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) are generally progressive and irreversible chronic-degenerative disorders. COPD is associated with chronic inflammation, and changes in both the alveolar and airway compartments, resulting in small airways disease and emphysema. IPF is driven by an abnormal activation of the alveolar lung epithelium resulting in progressive scarring of the lung parenchyma. Both diseases are heterogeneous with several clinical phenotypes, and usually occur in aged individuals, mostly smokers...
September 13, 2018: American Journal of Respiratory and Critical Care Medicine
Joshua D Chandler, Camilla Margaroli, Hamed Horati, Matthew B Kilgore, Mieke Veltman, H Ken Liu, Alexander J Taurone, Limin Peng, Lokesh Guglani, Karan Uppal, Young-Mi Go, Harm A W M Tiddens, Bob J Scholte, Rabindra Tirouvanziam, Dean P Jones, Hettie M Janssens
Cystic fibrosis (CF) lung disease progressively worsens from infancy to adulthood. Disease-driven changes in early CF airway fluid metabolites may identify therapeutic targets to curb progression.CF patients aged 12-38 months (n=24; three out of 24 later denoted as CF screen positive, inconclusive diagnosis) received chest computed tomography scans, scored by the Perth-Rotterdam Annotated Grid Morphometric Analysis for CF (PRAGMA-CF) method to quantify total lung disease (PRAGMA-%Dis) and components such as bronchiectasis (PRAGMA-%Bx)...
October 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
X Y Gai, C Chang, J Wang, Y Liang, M J Li, Y C Sun, B He, W Z Yao
OBJECTIVE: To investigate the distribution of airway inflammation phenotype in patients with bronchial asthma (asthma), and to analyze clinical characteristics, inflammatory cytokines, pulmonary small vessels remodeling and small airway wall remodeling in patients with neutrophilic asthma. METHODS: Sixty-three patients with asthma were enrolled from January 2015 to December 2015 in Peking University Third Hospital. Clinical data including gender, age, body mass index (BMI), pulmonary function tests (PFTs), asthma control test (ACT) were recorded...
August 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Hee Eun Lee, Andrew Churg, Jay H Ryu, Ana Maria Bilawich, Brandon T Larsen, Henry D Tazelaar, Eunhee S Yi
Primary biliary cholangitis (PBC) is a progressive autoimmune disease of the liver causing destruction of intrahepatic bile ducts, associated with lymphocytic and granulomatous inflammation. PBC has been associated with many extrahepatic manifestations including interstitial lung disease. However, comprehensive pulmonary histopathology in PBC has not been well documented. Sixteen PBC patients who underwent lung biopsies were identified from surgical pathology files in three institutions. Histopathologic review was performed...
July 29, 2018: Human Pathology
S Ritchie-McLean, V Ferrier, B Clevenger, M Thomas
The selection of an appropriately-sized tracheal tube is of critical importance in paediatric patients to reduce both the risk of subglottic stenosis from a tracheal tube that is too large, and inadequate ventilation or poor end-tidal gas monitoring from a tracheal tube that is too small. Age formulae are widely used, but known to be unreliable, often resulting in a need to change the tracheal tube. Previous work has shown that the length of the middle finger and the internal diameter can both be used to guide depth of tracheal tube insertion...
October 2018: Anaesthesia
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