Journal of Clinical Medicine

2 pages, 137 KiB

Open AccessEditorial

Comment from the Editor of the Special Issue: “Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF”

by Nazia Chaudhuri

North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK

J. Clin. Med. 2019, 8(12), 2060; https://doi.org/10.3390/jcm8122060 - 23 Nov 2019

Viewed by 2402

Abstract

This Special Issue on lung diseases is aimed at giving emergent researchers and clinicians an important forum to share their original research and expert reviews on key topics within respiratory diseases. This Special Issue will be of interest to general physicians and respiratory [...] Read more.

This Special Issue on lung diseases is aimed at giving emergent researchers and clinicians an important forum to share their original research and expert reviews on key topics within respiratory diseases. This Special Issue will be of interest to general physicians and respiratory specialist and will equip the reader with up-to-date knowledge on a wide array of lung diseases, including interstitial lung diseases, COPD, and Asthma. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

17 pages, 4005 KiB

Open AccessArticle

Gene Expression Changes Associated with Nintedanib Treatment in Idiopathic Pulmonary Fibrosis Fibroblasts: A Next-Generation Sequencing and Bioinformatics Study

by Chau-Chyun Sheu^1,2,3

, Wei-An Chang^1,2,3, Ming-Ju Tsai^1,2,3

, Ssu-Hui Liao², Inn-Wen Chong^1,3 and Po-Lin Kuo^2,*

¹ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan

² Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

³ Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

J. Clin. Med. 2019, 8(3), 308; https://doi.org/10.3390/jcm8030308 - 5 Mar 2019

Cited by 21 | Viewed by 9060

Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal interstitial lung disease. Therapeutic options for IPF remain limited. Nintedanib, a tyrosine kinase inhibitor approved for IPF treatment, is known to inhibit fibroblasts proliferation, migration and transformation to myofibroblasts. However, how nintedanib changes [...] Read more.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal interstitial lung disease. Therapeutic options for IPF remain limited. Nintedanib, a tyrosine kinase inhibitor approved for IPF treatment, is known to inhibit fibroblasts proliferation, migration and transformation to myofibroblasts. However, how nintedanib changes gene regulations in IPF has never been systematically investigated. We conducted a next-generation sequencing and bioinformatics study to evaluate the changes of mRNA and miRNA profiles in IPF fibroblasts treated with 2 µM and 4 µM nintedanib, compared to those without treatment. We identified 157 upregulated and 151 downregulated genes and used STRING and DAVID databases for analysis of protein–protein interactions, biological pathways, and molecular functions. We found strong protein–protein interactions within these dysregulated genes, mostly involved in the pathways of cell cycle and mitotic cell cycle. We also discovered 13 potential miRNA–mRNA interactions associated with nintedanib treatment. After validation using miRDB, TargetScan, and RT-qPCR, we identified 4 downregulated genes (DDX11, E2F1, NPTX1, and PLXNA4) which might be repressed by the upregulated hsa-miR-486-3p. According to the proposed functions of DDX11, E2F1, and PLXNA4 reported in previous studies, these gene expression changes together might contribute to decreased proliferation of fibroblasts and decreased angiogenesis in the microenvironment of IPF. Our findings need further studies to confirm. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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14 pages, 826 KiB

Open AccessReview

Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)—Current Considerations for Clinical Practice

by Frederik Trinkmann^1,*

, Joachim Saur¹, Martin Borggrefe^1,2 and Ibrahim Akin^1,2

¹ 1st Department of Medicine (Cardiology, Angiology, Pulmonary and Intensive Care), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany

² DZHK (German Center for Cardiovascular Research), partner site Mannheim, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany

J. Clin. Med. 2019, 8(1), 69; https://doi.org/10.3390/jcm8010069 - 10 Jan 2019

Cited by 62 | Viewed by 14253

Abstract

In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in context of a “cardiopulmonary continuum” rather than being simply attributed to shared risk factors such as cigarette [...] Read more.

In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in context of a “cardiopulmonary continuum” rather than being simply attributed to shared risk factors such as cigarette smoking. Overlapping symptoms such as dyspnea or chest pain lead to a worse prognosis due to missed concomitant diagnoses. Moreover, medication is often withheld as a result of unfounded concerns about side effects. Despite the frequent coincidence, current guidelines are still mostly restricted to the management of the individual disease. Future diagnostic and therapeutic strategies should therefore be guided by an integrative perspective as well as a refined phenotyping of disease entities. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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11 pages, 2065 KiB

Open AccessArticle

Comprehensive Lung Function Assessment Does not Allow to Infer Response to Pulmonary Rehabilitation in Patients with COPD

by Ingrid M. L. Augustin^1,2,*, Emiel F. M. Wouters^1,3, Sarah Houben-Wilke¹, Swetlana Gaffron⁴

, Daisy J. A. Janssen¹

, Frits M. E. Franssen^1,3 and Martijn A. Spruit^1,2,3

¹ CIRO+, center of expertise for chronic organ failure, 6085 NM Horn, The Netherlands

² NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6229 ER Maastricht, The Netherlands

³ Department of Respiratory Medicine, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands

⁴ Viscovery Software GmbH, 1130 Vienna, Austria

J. Clin. Med. 2019, 8(1), 27; https://doi.org/10.3390/jcm8010027 - 27 Dec 2018

Cited by 23 | Viewed by 5645

Abstract

The degree of lung function is frequently used as referral criterion for pulmonary rehabilitation. The efficacy of pulmonary rehabilitation was assessed in 518 chronic obstructive pulmonary disease (COPD) patients, after clustering based on a comprehensive pre-rehabilitation lung function assessment. Mean improvements in dyspnea, [...] Read more.

The degree of lung function is frequently used as referral criterion for pulmonary rehabilitation. The efficacy of pulmonary rehabilitation was assessed in 518 chronic obstructive pulmonary disease (COPD) patients, after clustering based on a comprehensive pre-rehabilitation lung function assessment. Mean improvements in dyspnea, exercise performance, health status, mood status and problematic activities of daily life after pulmonary rehabilitation were mostly comparable between the seven clusters, despite significant differences in the degree of lung function. The current study demonstrates no significant relationship between the seven lung-function-based clusters and response to pulmonary rehabilitation. Therefore, baseline lung function cannot be used to identify those who will respond well to pulmonary rehabilitation, and moreover, cannot be used as a criterion for referral to pulmonary rehabilitation in patients with COPD. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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11 pages, 2579 KiB

Open AccessArticle

Effects of Corticosteroid Treatment and Antigen Avoidance in a Large Hypersensitivity Pneumonitis Cohort: A Single-Centre Cohort Study

by Laurens J. De Sadeleer^1,2,*

, Frederik Hermans¹

, Els De Dycker¹, Jonas Yserbyt¹, Johny A. Verschakelen³, Eric K. Verbeken⁴, Geert M. Verleden^1,2 and Wim A. Wuyts^1,2

¹ Department of Respiratory Diseases, Unit for interstitial lung diseases, University Hospitals Leuven, Leuven B-3000, Belgium

² Laboratory of Respiratory Diseases, Department of Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven B-3000, Belgium

³ Department of Radiology, University Hospitals Leuven, Leuven B-3000, Belgium

⁴ Department of Pathology, University Hospitals Leuven, Leuven B-3000, Belgium

J. Clin. Med. 2019, 8(1), 14; https://doi.org/10.3390/jcm8010014 - 21 Dec 2018

Cited by 111 | Viewed by 7089

Abstract

Background: Although the third most frequent interstitial lung disease, hypersensitivity pneumonitis (HP) remains an enigmatic disease without clear diagnostic and therapeutic guidelines. We assessed the effect of the commonly used therapeutic interventions (i.e. exposure avoidance and corticosteroid treatment) in an HP cohort. Methods: [...] Read more.

Background: Although the third most frequent interstitial lung disease, hypersensitivity pneumonitis (HP) remains an enigmatic disease without clear diagnostic and therapeutic guidelines. We assessed the effect of the commonly used therapeutic interventions (i.e. exposure avoidance and corticosteroid treatment) in an HP cohort. Methods: We collected clinical data of all HP patients followed at our centre between January 1, 2005, and December 31, 2016. HP patients were stratified according to the presence of fibrosis on chest CT. Survival was analysed using the multivariate Cox proportional hazards model. Forced vital capacity (percent predicted, FVC%) and diffusing capacity of the lung for carbon monoxide (percent predicted, DLCO%) evolution were analysed using linear mixed-effect models. Results: Two hundred and two HP patients were identified: 93 non-fibrotic HP (nfHP) and 109 fibrotic HP (fHP), experiencing a monthly FVC% decline before treatment of 0.93% and 0.56%, respectively. While nfHP had an excellent survival, fHP patients experienced a median survival of 9.2 years. Corticosteroid treatment and exposure avoidance did not result in survival differences. Although nfHP patients showed FVC% and DLCO% increase after corticosteroid initiation, no therapeutic effect was seen in fHP patients. FVC% and DLCO% increased in nfHP patients after exposure avoidance, while a positive numerical trend was seen for FVC% after exposure avoidance in fHP patients (p = 0.15). Conclusions: nfHP patients experienced an excellent survival with good therapeutic effect on pulmonary function tests with both corticosteroid initiation as well as antigen avoidance. In contrast, fHP patients experienced a dismal prognosis (median survival of 9.2 years) without any therapeutic effect of corticosteroid treatment. Whether antigen avoidance is useful in fHP patients is still unclear. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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11 pages, 537 KiB

Open AccessArticle

Tarsal Tunnel Mechanosensitivity Is Increased in Patients with Asthma: A Case-Control Study

by César Calvo-Lobo¹

, Roi Painceira-Villar², Daniel López-López^2,*

, Vanesa García-Paz³, Ricardo Becerro-de-Bengoa-Vallejo⁴

, Marta Elena Losa-Iglesias⁵

and Patricia Palomo-López⁶

¹ Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Faculty of Health Sciences, Universidad de León, 24401 León, Spain

² Research, Health and Podiatry Unit, Department of Health Sciences. Faculty of Nursing and Podiatry, Universidade da Coruña, 15403 Ferrol, Spain

³ Departament of Allergology, Complexo Hospitalario Universitario de Ferrol, 15405 Ferrol, Spain

⁴ Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28670 Madrid, Spain

⁵ Faculty of Health Sciences, Universidad Rey Juan Carlos, 28670 Alcorcón, Spain

⁶ Department of Nursing, University Center of Plasencia, University of Extremadura, 10600 Plasencia, Spain

J. Clin. Med. 2018, 7(12), 541; https://doi.org/10.3390/jcm7120541 - 12 Dec 2018

Cited by 11 | Viewed by 4494

Abstract

Background: Based on changes in lung function and musculoskeletal disorders in patients with asthma, this study aimed to compare the tarsal tunnel and fibular bone pressure pain thresholds (PPTs) of patients with asthma and healthy matched-paired controls. Methods: A case-control study was performed. [...] Read more.

Background: Based on changes in lung function and musculoskeletal disorders in patients with asthma, this study aimed to compare the tarsal tunnel and fibular bone pressure pain thresholds (PPTs) of patients with asthma and healthy matched-paired controls. Methods: A case-control study was performed. One hundred participants were recruited: 50 asthma patients and 50 healthy matched-paired controls. Bilaterally, tarsal tunnel and fibula bone PPTs were registered. Results: Statistically significant differences (p < 0.01) were shown bilaterally for tarsal tunnel PPT. With the exception of fibula PPT (p > 0.05), asthma patients presented less tarsal tunnel PPT than healthy participants. Statistically significant differences (p < 0.05) were shown for two linear regression prediction models of the right (R² = 0.279) and left (R² = 0.249) tarsal tunnels PPTs as dependent variables, and based on sex, group, contralateral tarsal tunnel PPT and ipsilateral fibula PPT as independent variables. Conclusions: The study findings showed that a bilateral tarsal tunnel mechanosensitivity increase is exhibited in patients diagnosed with asthma. The presence of asthma may bilaterally predict the PPT of tarsal tunnel. These findings may suggest the presence of central sensitization in asthma patients, which could clinically predispose them to musculoskeletal disorders, such as tarsal tunnel syndrome. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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12 pages, 508 KiB

Open AccessArticle

Small Airway Disease in Pulmonary Hypertension—Additional Diagnostic Value of Multiple Breath Washout and Impulse Oscillometry

by Frederik Trinkmann^1,*

, Joshua Gawlitza²

, Monique Künstler¹, Julia Schäfer¹, Michele Schroeter¹, Julia D. Michels¹, Ksenija Stach^1,3, Christina Dösch^1,3, Joachim Saur¹, Martin Borggrefe^1,3 and Ibrahim Akin^1,3

¹ First Department of Medicine (Cardiology, Angiology, Pulmonary and Intensive Care), University Medical Center Mannheim, 68135 Mannheim, Germany

² Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, 68135 Mannheim, Germany

³ DZHK (German Center for Cardiovascular Research), Partner Site Mannheim, University Medical Center Mannheim, 68135 Mannheim, Germany

J. Clin. Med. 2018, 7(12), 532; https://doi.org/10.3390/jcm7120532 - 9 Dec 2018

Cited by 9 | Viewed by 4033

Abstract

Airways obstruction is frequent in patients with pulmonary hypertension (PH). Small airway disease (SAD) was identified as a major contributor to resistance and symptoms. However, it is easily missed using current diagnostic approaches. We aimed to evaluate more elaborate diagnostic tests such as [...] Read more.

Airways obstruction is frequent in patients with pulmonary hypertension (PH). Small airway disease (SAD) was identified as a major contributor to resistance and symptoms. However, it is easily missed using current diagnostic approaches. We aimed to evaluate more elaborate diagnostic tests such as impulse oscillometry (IOS) and SF₆-multiple-breath-washout (MBW) for the assessment of SAD in PH. Twenty-five PH patients undergoing body-plethysmography, IOS and MBW testing were prospectively included and equally matched to pulmonary healthy and non-healthy controls. Lung clearance index (LCI) and acinar ventilation heterogeneity (S_acin) differed significantly between PH, healthy and non-healthy controls. Likewise, differences were found for all IOS parameters between PH and healthy, but not non-healthy controls. Transfer factor corrected for ventilated alveolar volume (TLCO/VA), frequency dependency of resistance (D5-20), resonance frequency (F_res) and S_acin allowed complete differentiation between PH and healthy controls (AUC (area under the curve) = 1.0). Likewise, PH patients were separated from non-healthy controls (AUC 0.762) by D5-20, LCI and conductive ventilation heterogeneity (S_cond). Maximal expiratory flow (MEF) values were not associated with additional diagnostic values. MBW and IOS are feasible in PH patients both providing additional information. This can be used to discriminate PH from healthy and non-healthy controls. Therefore, further research targeting SAD in PH and evaluation of therapeutic implications is justified. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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11 pages, 845 KiB

Open AccessArticle

Mucolytic Agents and Statins Use is Associated with a Lower Risk of Acute Exacerbations in Patients with Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap

by Vincent Yi-Fong Su^1,2,3,†, Diahn-Warng Perng^3,4,†, Ting-Chun Chou^5,6, Yueh-Ching Chou^5,6,7,*, Yuh-Lih Chang^5,6,*, Chia-Chen Hsu^5,6, Chia-Lin Chou^5,6, Hsin-Chen Lee⁶, Tzeng-Ji Chen^3,8,9

and Po-Wei Hu⁴

¹ Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei 11146, Taiwan

² Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan

³ Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan

⁴ Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan

⁵ Department of Pharmacy, Taipei Veterans General Hospital, Taipei 11217, Taiwan

⁶ Department and Institute of Pharmacology, National Yang-Ming University, Taipei 11221, Taiwan

⁷ School of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan

⁸ Department of Family Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan

⁹ Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 11221, Taiwan

^† These authors contributed equally to this manuscript.

J. Clin. Med. 2018, 7(12), 517; https://doi.org/10.3390/jcm7120517 - 4 Dec 2018

Cited by 11 | Viewed by 4983

Abstract

Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from 2000 to [...] Read more.

Background: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap (BCO) is a neglected area of trials, and it is not covered by guidelines for clinical practice. Methods: Using the National Health Insurance Research Database of Taiwan, COPD patients with or without bronchiectasis from 2000 to 2009 were enrolled as the BCO and COPD alone cohorts, respectively. Patients followed for <28 days, diagnosed with COPD who were not prescribed with COPD medications, and those diagnosed with bronchiectasis who did not receive a chest X-ray or computed tomography were excluded. The primary endpoints were acute exacerbations and mortality. Results: There were 831 patients in the BCO cohort and 3321 patients in the COPD alone cohort, covering 3763.08 and 17,348.95 person-years, respectively, from 2000 to 2011. The BCO cohort had higher risk for exacerbations (adjusted hazard ratio (HR) 2.26, 95% confidence interval (CI) 1.94–2.63) and mortality (HR 1.46, 95% CI 1.24–1.73) than the COPD alone cohort. In the patients overall, the use of statins, macrolides, and mucolytic agents was associated with significantly lower risks of acute exacerbations (statins, HR 0.37, 95% CI 0.29–0.46; macrolides, HR 0.65, 95% CI 0.45–0.93; mucolytic agents, HR 0.68, 95% CI 0.59–0.78). Statins were associated with a significantly lower risk of mortality (HR 0.32, 95% CI 0.25–0.41). In the BCO group, statins and mucolytic agents use was associated with significantly lower risks of acute exacerbations (statins, HR 0.44, 95% CI 0.29–0.65; mucolytic agents, HR 0.58, 95% CI 0.45–0.75). Conclusion: Statins and mucolytic agents use may lower risk of acute exacerbation in patients with BCO. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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27 pages, 1721 KiB

Open AccessReview

Interstitial Lung Disease and Pulmonary Fibrosis: A Practical Approach for General Medicine Physicians with Focus on the Medical History

by Or Kalchiem-Dekel^1,*

, Jeffrey R. Galvin², Allen P. Burke³, Sergei P. Atamas^1,4 and Nevins W. Todd^1,4

¹ Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA

² Department of Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA

³ Department of Pathology, University of Maryland School of Medicine, Baltimore, MD 21201, USA

⁴ Baltimore Veterans Affairs Medical Center, Baltimore, MD 21201, USA

J. Clin. Med. 2018, 7(12), 476; https://doi.org/10.3390/jcm7120476 - 24 Nov 2018

Cited by 77 | Viewed by 26963

Abstract

Interstitial lung disease (ILD) and pulmonary fibrosis comprise a wide array of inflammatory and fibrotic lung diseases which are often confusing to general medicine and pulmonary physicians alike. In addition to the myriad of clinical and radiologic nomenclature used in ILD, histopathologic descriptors [...] Read more.

Interstitial lung disease (ILD) and pulmonary fibrosis comprise a wide array of inflammatory and fibrotic lung diseases which are often confusing to general medicine and pulmonary physicians alike. In addition to the myriad of clinical and radiologic nomenclature used in ILD, histopathologic descriptors may be particularly confusing, and are often extrapolated to radiologic imaging patterns which may further add to the confusion. We propose that rather than focusing on precise histologic findings, focus should be on identifying an accurate etiology of ILD through a comprehensive and detailed medical history. Histopathologic patterns from lung biopsy should not be dismissed, but are often nonspecific, and overall treatment strategy and prognosis are likely to be determined more by the specific etiology of ILD rather than any particular histologic pattern. In this review, we outline a practical approach to common ILDs, highlight important aspects in obtaining an exposure history, clarify terminology and nomenclature, and discuss six common subgroups of ILD likely to be encountered by general medicine physicians in the inpatient or outpatient setting: Smoking-related, hypersensitivity pneumonitis, connective tissue disease-related, occupation-related, medication-induced, and idiopathic pulmonary fibrosis. Accurate diagnosis of these forms of ILD does require supplementing the medical history with results of the physical examination, autoimmune serologic testing, and chest radiographic imaging, but the importance of a comprehensive environmental, avocational, occupational, and medication-use history cannot be overstated and is likely the single most important factor responsible for achieving the best possible outcomes for patients. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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11 pages, 1410 KiB

Open AccessArticle

Fatigue is Highly Prevalent in Patients with Asthma and Contributes to the Burden of Disease

by Maarten Van Herck^1,2,*

, Martijn A. Spruit^1,2,3,4

, Chris Burtin¹, Remco Djamin⁵

, Jeanine Antons⁶, Yvonne M. J. Goërtz², Zjala Ebadi⁷, Daisy J. A. Janssen^2,8

, Jan H. Vercoulen⁷, Jeannette B. Peters⁷, Melissa S. Y. Thong⁹, Jacqueline Otker¹⁰, Arnold Coors¹¹, Mirjam A. G. Sprangers⁹, Jean W. M. Muris¹²

, Emiel F. M. Wouters^2,3 and Alex J. Van ’t Hul⁶

¹ REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium

² Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands

³ Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands

⁴ NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 ER Maastricht, The Netherlands

⁵ Department of Respiratory Medicine, Amphia Hospital, 4818 CK Breda, The Netherlands

⁶ Department of Pulmonary Medicine, Radboud University Medical Center (Radboudumc), 6525 GA Nijmegen, The Netherlands

⁷ Department of Medical Psychology, Radboudumc, 6525 GA Nijmegen, The Netherlands

⁸ Centre of expertise for palliative care, MUMC+, 6229 HX Maastricht, The Netherlands

⁹ Department of Medical Psychology, Amsterdam University Medical Centers, location AMC, 1105 AZ Amsterdam, The Netherlands

¹⁰ Member of Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands

¹¹ Member of Patient Advisory Board, Radboudumc, 6525 GA Nijmegen, The Netherlands

¹² Department of General Practice, MUMC+, 6229 HX Maastricht, The Netherlands

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J. Clin. Med. 2018, 7(12), 471; https://doi.org/10.3390/jcm7120471 - 23 Nov 2018

Cited by 46 | Viewed by 7735

Abstract

The 2018 update of the Global Strategy for Asthma Management and Prevention does not mention fatigue-related symptoms. Nevertheless, patients with asthma frequently report tiredness, lack of energy, and daytime sleepiness. Quantitative research regarding the prevalence of fatigue in asthmatic patients is lacking. This [...] Read more.

The 2018 update of the Global Strategy for Asthma Management and Prevention does not mention fatigue-related symptoms. Nevertheless, patients with asthma frequently report tiredness, lack of energy, and daytime sleepiness. Quantitative research regarding the prevalence of fatigue in asthmatic patients is lacking. This retrospective cross-sectional study of outpatients with asthma upon referral to a chest physician assessed fatigue (Checklist Individual Strength-Fatigue (CIS-Fatigue)), lung function (spirometry), asthma control (Asthma Control Questionnaire (ACQ)), dyspnea (Medical Research Council (MRC) scale), exercise capacity (six-minute walk test (6MWT)), and asthma-related Quality-of-Life (QoL), Asthma Quality of Life Questionnaire (AQLQ) during a comprehensive health-status assessment. In total, 733 asthmatic patients were eligible and analyzed (47.4 ± 16.3 years, 41.1% male). Severe fatigue (CIS-Fatigue ≥ 36 points) was detected in 62.6% of patients. Fatigue was not related to airflow limitation (FEV1, ρ = −0.083); was related moderately to ACQ (ρ = 0.455), AQLQ (ρ = −0.554), and MRC (ρ = 0.435; all p-values < 0.001); and was related weakly to 6MWT (ρ = −0.243, p < 0.001). In stepwise multiple regression analysis, 28.9% of variance in fatigue was explained by ACQ (21.0%), MRC (6.5%), and age (1.4%). As for AQLQ, 42.2% of variance was explained by fatigue (29.8%), MRC (8.6%), exacerbation rate (2.6%), and age (1.2%). Severe fatigue is highly prevalent in asthmatic patients; it is an important determinant of disease-specific QoL and a crucial yet ignored patient-related outcome in patients with asthma. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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18 pages, 3238 KiB

Open AccessArticle

Effects of Macrolide Treatment during the Hospitalization of Children with Childhood Wheezing Disease: A Systematic Review and Meta-Analysis

by Chien-Yu Lin¹

, Tzu-Lin Yeh^2,3

, Shu-Jung Liu⁴

, Hsin-Hui Lin⁵

, Yu-Jyun Cheng¹

, Hua-His Hung¹, Mu-Chieh Tsai¹, Jui-Ming Liu^6,7

and Wei-Te Lei^1,8,*

¹ Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 30071, Taiwan

² Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu 30071, Taiwan

³ Institue of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 10055, Taiwan

⁴ Department of Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City 25160, Taiwan

⁵ Department of Family Medicine, Taipei MacKay Memorial Hospital, Taipei 10449, Taiwan

⁶ Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan

⁷ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan

⁸ Graduate Institue of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan

J. Clin. Med. 2018, 7(11), 432; https://doi.org/10.3390/jcm7110432 - 9 Nov 2018

Cited by 6 | Viewed by 5151

Abstract

Children are susceptible to a variety of respiratory infections. Wheezing is a common sign presented by children with respiratory infections. Asthma, bronchiolitis, and bronchitis are common causes of childhood wheezing disease (CWD) and are regarded as overlapping disease spectra. Macrolides are common antimicrobial [...] Read more.

Children are susceptible to a variety of respiratory infections. Wheezing is a common sign presented by children with respiratory infections. Asthma, bronchiolitis, and bronchitis are common causes of childhood wheezing disease (CWD) and are regarded as overlapping disease spectra. Macrolides are common antimicrobial agents with anti-inflammatory effects. We conducted a comprehensive literature search and a systematic review of studies that investigated the influences of macrolide treatment on CWD. The primary outcomes were the impact of macrolides on hospitalization courses of patients with CWD. Data pertaining to the study population, macrolide treatment, hospital courses, and recurrences were analyzed. Twenty-three studies with a combined study population of 2210 patients were included in the systematic review. Any kind of benefit from macrolide treatment was observed in approximately two-thirds of the studies (15/23). Eight studies were included in the meta-analysis to investigate the influence of macrolides on the length of stay (LOS), duration of oxygen demand (DOD), symptoms and signs of respiratory distress, and re-admission rates. Although the benefits of macrolide treatment were reported in several of the studies, no significant differences in LOS, DOD, symptoms and signs of respiratory distress, or re-admission rates were observed in patients undergoing macrolide treatment. In conclusion, any kind of benefit of macrolide treatment was observed in approximately two-thirds of the studies; however, no obvious benefits of macrolide treatment were observed in the hospitalization courses of children with CWD. The routine use of macrolides to improve the hospitalization course of children with CWD is not suggested. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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22 pages, 4459 KiB

Open AccessArticle

The Anti-Inflammatory Effects of Fermented Herbal Roots of Asparagus cochinchinensis in an Ovalbumin-Induced Asthma Model

by Jun Young Choi¹, Ji Eun Kim¹, Jin Ju Park¹, Mi Rim Lee¹, Bo Ram Song¹, Ji Won Park¹, Mi Ju Kang¹, Hee Seob Lee², Hong Joo Son¹, Jin Tae Hong³

and Dae Youn Hwang^1,*,†

¹ College of Natural Resources and Life Science/Life and Industry Convergence Research Institute, Pusan National University, Miryang 627-706, Korea

² College of Human Ecology, Pusan National University, Busan 609-735, Korea

³ College of Pharmacy, Chungbuk National University, Chungju 361-763, Korea

^† Current Address: Department of Biomaterials Science, College of Natural Resources and Life Science, Pusan National University, 50 Cheonghak-ri, Samnangjin-eup Miryang-si, Gyeongsangnam-do 627-706, Korea.

J. Clin. Med. 2018, 7(10), 377; https://doi.org/10.3390/jcm7100377 - 22 Oct 2018

Cited by 17 | Viewed by 5260

Abstract

Introduction: Roots of Asparagus cochinchinensis, which have pharmacologically active ingredients, have received great attention because they show good therapeutic effects for various inflammatory diseases without specific toxicity. This study investigated the anti-asthmatic effects of a butanol extract of Asparagus cochinchinensis roots that [...] Read more.

Introduction: Roots of Asparagus cochinchinensis, which have pharmacologically active ingredients, have received great attention because they show good therapeutic effects for various inflammatory diseases without specific toxicity. This study investigated the anti-asthmatic effects of a butanol extract of Asparagus cochinchinensis roots that had been fermented with Weissella cibaria (BAW) and its possible underlying cholinergic regulation. Methods: Alterations of the anti-asthmatic markers and the molecular response factors were measured in an ovalbumin (OVA)-induced asthma model after treatment with BAW. Results: Treatment with BAW decreased the intracellular reactive oxygen species (ROS) production in lipopolysaccharides (LPS) activated RAW264.7 cells. The results of the animal experiments revealed lower infiltration of inflammatory cells and bronchial thickness, and a significant reduction in the number of macrophages and eosinophils, concentration of OVA-specific IgE, and expression of Th2 cytokines in the OVA + BAW treated group. In addition, a significant recovery of goblet cell hyperplasia, MMP-9 expression, and the VEGF signaling pathway was observed upon airway remodeling in the OVA + BAW treated group. Furthermore, these responses of BAW were linked to recovery of acetylcholine esterase (AChE) activity and muscarinic acetylcholine receptor (mAChR) M3 downstream signaling pathway in epithelial cells, smooth muscle cells, and afferent sensory nerves of OVA + BAW-treated mice. Conclusion: Overall, these findings are the first to provide evidence that the therapeutic effects of BAW can prevent airway inflammation and remodeling through the recovery of cholinergic regulation in structural cells and inflammatory cells of the chronic asthma model. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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30 pages, 948 KiB

Open AccessReview

Drug-Induced Interstitial Lung Disease: A Systematic Review

by Sarah Skeoch^1,2, Nicholas Weatherley³, Andrew J. Swift³, Alexander Oldroyd¹, Christopher Johns³, Conal Hayton⁴, Alessandro Giollo^5,6

, James M. Wild³, John C. Waterton^7,8

, Maya Buch⁵, Kim Linton⁹

, Ian N. Bruce^1,10, Colm Leonard⁴, Stephen Bianchi¹¹ and Nazia Chaudhuri^4,*

¹ Arthritis Research UK Centre for Epidemiology, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, UK

² Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 1RL, UK

³ Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield S10 2TN, UK

⁴ North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK

⁵ Leeds Institute of Rheumatic and Musculoskeletal Medicine, NIHR Leeds Biomedical Research Centre, University of Leeds, Leeds LS2 9JT, UK

⁶ Rheumatology Unit, Department of Medicine, University of Verona, 37134 Verona, Italy

⁷ Bioxydyn Limited, Rutherford House, Manchester Science Park, Manchester M15 6SZ, UK

⁸ Centre for Imaging Sciences, Division of Informatics Imaging & Data Sciences, School of Health Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, UK

⁹ Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9PL, UK

¹⁰ The Kellgren Centre for Rheumatology, NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M6 8HD, UK

¹¹ Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK

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J. Clin. Med. 2018, 7(10), 356; https://doi.org/10.3390/jcm7100356 - 15 Oct 2018

Cited by 292 | Viewed by 31534

Abstract

Background: Drug-induced interstitial lung disease (DIILD) occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Methods: In this PRISMA-compliant systematic review, we aimed to evaluate and synthesise the current literature on [...] Read more.

Background: Drug-induced interstitial lung disease (DIILD) occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Methods: In this PRISMA-compliant systematic review, we aimed to evaluate and synthesise the current literature on DIILD. Results: Following a quality assessment, 156 full-text papers describing more than 6000 DIILD cases were included in the review. However, the majority of the papers were of low or very low quality in relation to the review question (78%). Thus, it was not possible to perform a meta-analysis, and descriptive review was undertaken instead. DIILD incidence rates varied between 4.1 and 12.4 cases/million/year. DIILD accounted for 3–5% of prevalent ILD cases. Cancer drugs, followed by rheumatology drugs, amiodarone and antibiotics, were the most common causes of DIILD. The radiopathological phenotype of DIILD varied between and within agents, and no typical radiological pattern specific to DIILD was identified. Mortality rates of over 50% were reported in some studies. Severity at presentation was the most reliable predictor of mortality. Glucocorticoids (GCs) were commonly used to treat DIILD, but no prospective studies examined their effect on outcome. Conclusions: Overall high-quality evidence in DIILD is lacking, and the current review will inform larger prospective studies to investigate the diagnosis and management of DIILD. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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21 pages, 1658 KiB

Open AccessReview

Clinical Application of Mesenchymal Stem Cell-Derived Extracellular Vesicle-Based Therapeutics for Inflammatory Lung Diseases

by Yu Fujita^1,2,*

, Tsukasa Kadota^1,2

, Jun Araya¹, Takahiro Ochiya² and Kazuyoshi Kuwano¹

¹ Division of Respiratory Diseases, Department of Internal Medicine, Jikei University School of Medicine, Tokyo 105-0003 Japan

² Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, Tokyo 104-0045, Japan

J. Clin. Med. 2018, 7(10), 355; https://doi.org/10.3390/jcm7100355 - 14 Oct 2018

Cited by 142 | Viewed by 9632

Abstract

It is currently thought that extracellular vesicles (EVs), such as exosomes and microvesicles, play an important autocrine/paracrine role in intercellular communication. EVs package proteins, mRNA and microRNA (miRNA), which have the ability to transfer biological information to recipient cells in the lungs. Depending [...] Read more.

It is currently thought that extracellular vesicles (EVs), such as exosomes and microvesicles, play an important autocrine/paracrine role in intercellular communication. EVs package proteins, mRNA and microRNA (miRNA), which have the ability to transfer biological information to recipient cells in the lungs. Depending on their origin, EVs fulfil different functions. EVs derived from mesenchymal stem cells (MSCs) have been found to promote therapeutic activities that are comparable to MSCs themselves. Recent animal model-based studies suggest that MSC-derived EVs have significant potential as a novel alternative to whole-cell therapies. Compared to their parent cells, EVs may have a superior safety profile and can be stored without losing function. It has been observed that MSC-derived EVs suppress pro-inflammatory processes and reduce oxidative stress, pulmonary fibrosis and remodeling in a variety of in vivo inflammatory lung disease models by transferring their components. However, there remain significant challenges to translate this therapy to the clinic. From this view point, we will summarize recent studies on EVs produced by MSCs in preclinical experimental models of inflammatory lung diseases. We will also discuss the most relevant issues in bringing MSC-derived EV-based therapeutics to the clinic for the treatment of inflammatory lung diseases. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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13 pages, 8303 KiB

Open AccessArticle

Translational Medicine in Pulmonary-Renal Crosstalk: Therapeutic Targeting of p-Cresyl Sulfate Triggered Nonspecific ROS and Chemoattractants in Dyspneic Patients with Uremic Lung Injury

by Jia-Feng Chang^1,2,3,4,5,6, Shih-Shin Liang^7,8, Pounraj Thanasekaran⁹

, Hsueh-Wei Chang¹⁰

, Li-Li Wen^11,12, Chung-Hua Chen¹³, Jian-Chiun Liou¹⁴, Jih-Chen Yeh¹⁵, Shih-Hao Liu¹⁶, Huei-Min Dai² and Wei-Ning Lin^2,*

¹ Program in Nutrition and Food Sciences, College of Human Ecology, Fu Jen Catholic University, New Taipei City 242, Taiwan

² Graduate Institution of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan

³ Division of Nephrology, Department of Internal Medicine, En-Chu-Kong Hospital, New Taipei City 237, Taiwan

⁴ Renal Care Joint Foundation, New Taipei City 220, Taiwan

⁵ Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan

⁶ Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 300, Taiwan

⁷ Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung 804, Taiwan

⁸ Department of Biotechnology, College of Life Science; Center for Research, Resources and Development, Kaohsiung Medical University, Kaohsiung 807, Taiwan

⁹ Institute of Chemistry, Academia Sinica, Taipei 115, Taiwan

¹⁰ Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung 807, Taiwan

¹¹ Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu 300, Taiwan

¹² Department of Clinical Laboratory, En Chu Kong Hospital, New Taipei City 237, Taiwan

¹³ Department of Chest Medicine, En Chu Kong Hospital, New Taipei City 237, Taiwan

¹⁴ School of Biomedical Engineering, Taipei Medical University, Taipei 110, Taiwan

¹⁵ Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan

¹⁶ Division of Pathology, En-Chu-Kong Hospital, New Taipei City 237, Taiwan

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J. Clin. Med. 2018, 7(9), 266; https://doi.org/10.3390/jcm7090266 - 9 Sep 2018

Cited by 25 | Viewed by 6481

Abstract

Molecular mechanisms and pathological features of p-Cresyl sulfate (PCS)-induced uremic lung injury (ULI) in chronic kidney disease (CKD) remain unclear. We analyzed pleural effusions (PE) from CKD and non-CKD patients for uremic toxins, reactive oxygen species (ROS), and chemotactic cytokines. Correlations between PE [...] Read more.

Molecular mechanisms and pathological features of p-Cresyl sulfate (PCS)-induced uremic lung injury (ULI) in chronic kidney disease (CKD) remain unclear. We analyzed pleural effusions (PE) from CKD and non-CKD patients for uremic toxins, reactive oxygen species (ROS), and chemotactic cytokines. Correlations between PE biomarkers and serum creatinine were also studied. Cell viability and inflammatory signaling pathways were investigated in PCS-treated human alveolar cell model. To mimic human diseases, CKD-ULI mouse model was developed with quantitative comparison of immunostaining and morphometric approach. PE from CKD patients enhance expressions of uremic toxins, hydroxyl radicals, and IL-5/IL-6/IL-8/IL-10/IL-13/ENA-78/GRO α/MDC/thrombopoietin/VEGF. PE concentrations of ENA-78/VEGF/IL-8/MDC/PCS/indoxyl sulphate correlate with serum creatinine concentrations. In vitro, PCS promotes alveolar cell death, cPLA2/COX-2/aquaporin-4 expression, and NADPH oxidase/mitochondria activation-related ROS. Intracellular ROS is abrogated by non-specific ROS scavenger N-acetyl cysteine (NAC), inhibitors of NADPH oxidase and mitochondria-targeted superoxide scavenger. However, only NAC protects against PCS-induced cell death. In vivo, expressions of cPLA2/COX2/8-OHdG, resident alveolar macrophages, recruited leukocytes, alveolar space, interstitial edema and capillary leakage increase in lung tissues of CKD-ULI mice, and NAC pretreatment ameliorates alveolar–capillary injury. PCS causes alveolar–capillary injury through triggering intracellular ROS, downstream prostaglandin pathways, cell death, and activating leukocytes to release multiplex chemoattractants and extracellular ROS. Thus PCS and nonspecific ROS serve as potential therapeutic targets. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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12 pages, 987 KiB

Open AccessArticle

Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients

by Chin-Hsiao Tseng^1,2,3

¹ Department of Internal Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan

² Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei 10048, Taiwan

³ Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Zhunan 350, Taiwan

J. Clin. Med. 2018, 7(9), 264; https://doi.org/10.3390/jcm7090264 - 9 Sep 2018

Cited by 59 | Viewed by 5868

Abstract

Background: Metformin may show an antibiotic effect, but whether its use can reduce the risk of tuberculosis infection has rarely been investigated in population-based studies. Methods: This is a retrospective cohort analysis of the Taiwan’s National Health Insurance database. New-onset type 2 diabetes [...] Read more.

Background: Metformin may show an antibiotic effect, but whether its use can reduce the risk of tuberculosis infection has rarely been investigated in population-based studies. Methods: This is a retrospective cohort analysis of the Taiwan’s National Health Insurance database. New-onset type 2 diabetes patients, 148,468 ever users and 15,799 never users of metformin, identified during 1999–2005 were followed up until 31 December 2011 for the incidence of tuberculosis infection. Hazard ratios were estimated by Cox regression incorporated with the inverse probability of treatment weighting using propensity score. Results: A total of 360 never users and 1976 ever users developed a tuberculosis infection with respective incidence of 510.91 and 282.94 per 100,000 person–years. The overall hazard ratio of presenting a tuberculosis infection among metformin ever users in respect to never users was 0.552 (95% confidence interval: 0.493–0.617). The hazard ratios for the first (<27.10 months), second (27.10–58.27 months), and third (>58.27 months) tertile of cumulative duration of metformin therapy were 1.116 (0.989–1.261), 0.543 (0.478–0.618), and 0.200 (0.171–0.233), respectively; and were 1.037 (0.918–1.173), 0.533 (0.469–0.606), and 0.249 (0.215–0.288), respectively, for the first (<817,000 mg), second (817,000–2,047,180 mg), and third (>2,047,180 mg) tertile of cumulative doses of metformin. The findings were consistent when analyses were restricted to pulmonary tuberculosis. Additionally, regular users of metformin tended to have greater benefit than irregular users. Conclusions: Metformin use is associated with a reduced risk of tuberculosis infection in a dose–response pattern in type 2 diabetes patients. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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20 pages, 1087 KiB

Open AccessReview

Proteases and Their Inhibitors in Chronic Obstructive Pulmonary Disease

by Tapan Dey^1,2

, Jatin Kalita¹, Sinéad Weldon³

and Clifford C. Taggart^3,*

¹ Biological Sciences and Technology Division, CSIR-North East Institute of Science and Technology, Jorhat 785006, Assam, India

² Centre for Biotechnology and Bioinformatics, Dibrugarh University, Dibrugarh 786004, Assam, India

³ Airway Innate Immunity Research Group, Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland BT9 7BL, UK

J. Clin. Med. 2018, 7(9), 244; https://doi.org/10.3390/jcm7090244 - 28 Aug 2018

Cited by 47 | Viewed by 9498

Abstract

In the context of respiratory disease, chronic obstructive pulmonary disease (COPD) is the leading cause of mortality worldwide. Despite much development in the area of drug development, currently there are no effective medicines available for the treatment of this disease. An imbalance in [...] Read more.

In the context of respiratory disease, chronic obstructive pulmonary disease (COPD) is the leading cause of mortality worldwide. Despite much development in the area of drug development, currently there are no effective medicines available for the treatment of this disease. An imbalance in the protease: Antiprotease ratio in the COPD lung remains an important aspect of COPD pathophysiology and several studies have shown the efficacy of antiprotease therapy in both in vitro and in vivo COPD models. However more in-depth studies will be required to validate the efficacy of lead drug molecules targeting these proteases. This review discusses the current status of protease-directed drugs used for treating COPD and explores the future prospects of utilizing the potential of antiprotease-based therapeutics as a treatment for this disease. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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21 pages, 1093 KiB

Open AccessFeature PaperReview

Idiopathic Pulmonary Fibrosis (IPF): An Overview

by Shaney L. Barratt^1,2,*

, Andrew Creamer¹, Conal Hayton³ and Nazia Chaudhuri³

¹ Bristol Interstitial Lung Disease Service, North Bristol NHS Trust, Bristol BS10 5NB, UK

² Academic Respiratory Unit, University of Bristol, Bristol BS16 1QY, UK

³ North West Interstitial Lung Disease Unit, Manchester University NHS Foundation Trust, Wythenshawe, Manchester M23 9LT, UK

J. Clin. Med. 2018, 7(8), 201; https://doi.org/10.3390/jcm7080201 - 6 Aug 2018

Cited by 275 | Viewed by 27806

Abstract

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterised by chronic, progressive scarring of the lungs and the pathological hallmark of usual interstitial pneumonia. Current paradigms suggest alveolar epithelial cell damage is a key initiating factor. Globally, incidence of the disease is [...] Read more.

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterised by chronic, progressive scarring of the lungs and the pathological hallmark of usual interstitial pneumonia. Current paradigms suggest alveolar epithelial cell damage is a key initiating factor. Globally, incidence of the disease is rising, with associated high morbidity, mortality, and economic healthcare burden. Diagnosis relies on a multidisciplinary team approach with exclusion of other causes of interstitial lung disease. Over recent years, two novel antifibrotic therapies, pirfenidone and nintedanib, have been developed, providing treatment options for many patients with IPF, with several other agents in early clinical trials. Current efforts are directed at identifying key biomarkers that may direct more customized patient-centred healthcare to improve outcomes for these patients in the future. Full article

(This article belongs to the Special Issue Lung Disease on COPD, Asthma, Bronchiectasis, Lung Cancer Screening, IPF)

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