Reduced inhaler use is safe for infants with bronchiolitis
(Children's Hospital of Philadelphia) Bronchiolitis, a lung infection that is one of the most common reasons for hospitalizations in young children, is most prevalent during the winter months and is usually treated with albuterol delivered via inhalers, despite evidence showing no benefit in most patients. A multidisciplinary team of researchers from Children's Hospital of Philadelphia (CHOP) redesigned the hospital's standard treatment for the infection and reduced albuterol use without compromising care.
Chronic lung allograft dysfunction (CLAD) is the most important reason for poor patient survival after lung transplantation. Of the two CLAD subtypes, restrictive allograft syndrome (RAS) has worse prognosis than bronchiolitis obliterans syndrome (BOS), but only limited information is available on the incidence and clinical effect of CLAD subtype change after CLAD onset. We set out to characterize CLAD subtype development by computed tomography (CT) volumetry after CLAD onset.
Bronchiolitis obliterans syndrome (BOS), the most common form of chronic lung allograft dysfunction (CLAD), and the major limitation to long-term survival after lung transplantation. BOS affects up to 50% of lung transplant recipients within 5 years after transplant, causing significant morbidity and mortality. BOS manifesting early after transplantation shows a poorer prognosis than late ‐onset BOS. There are only few studies assessing treatment efficacy, but only a minority of patients respond to current treatment options.
Airway epithelial injury is thought to be a key event in the pathogenesis of CLAD. We investigated whether markers of epithelial activation and injury in bronchoalveolar lavage (BAL) correlate with CLAD diagnosis and the major CLAD phenotypes: bronchiolitis obliterans syndrome (BOS) vs. restrictive allograft syndrome (RAS) / mixed phenotype.
The objective of the current study was to assess the diagnostic accuracy of FVC≤80% for determining RAS/Mixed in a large center that routinely monito rs both TLC and FVC.
Respiratory tract infection with respiratory syncytial virus (RSV), human metapneumo virus (hMPV) or parainfluenza virus (PIV) are increasingly associated with chronic lung allograft dysfunction in the form of bronchiolitis obliterans syndrome (BOS) in lung transplant recipients (LTR). Ribavirin as treatment option is under debate since its effectiveness is unclear, especially in light of infection severity.
Exosomes are small membrane vesicles that regulate intracellular function and cell-to-cell communication. Our report has shown circulating exosomes are induced during lung allograft rejection (Am J Transplant, 2017; 17:474-484). Rab27, a member of the Rab subfamily of GTPases, is essential for exosome secretion. The aim of this study is to determine the role of Rab27A signaling in human bronchial epithelial cells (BEAS-2B) stimulated with exosomes from human lung transplant recipients (LTxRs) diagnosed with acute rejection, bronchiolitis obliterans syndrome (BOS), or stable.
Bronchiolitis obliterans syndrome (BOS) as a form of chronic lung allograft dysfunction is a limiting factor to the survival of lung transplant recipients. Detection and monitoring of chronic rejection is hampered by a lack of clinically available markers. Particles in exhaled air (PExA) is proposed as a noninvasive means of potentially identifying and observing BOS patients. This pilot study aims to capture the range of exhaled particles expected in human samples and identify possible candidate markers.
Despite immunosuppressive T cell-targeting therapies, the survival rate after LTx remains as low as 50% after 5 years, mainly due to the development of BOS. The T cell centric paradigm is being increasingly challenged in solid organ transplantation. We recently demonstrated in a new mouse model of lymphocytic bronchiolitis (LB) after orthotopic LTx that B cells played a central role in the development of BOS. Alarming experiences from the past strongly suggest that a systemic B cell depletion must be considered with caution if at all.
Bronchiolitis obliterans syndrome (BOS) is associated with poor long-term survival. In its pathogenesis neutrophils (NEU) are recognized as relevant players. Moreover, our group has recently showed that some microRNAs (miRs) may act as pro-fibrotic effectors in the context of BOS highlighting the role of miR21, whose expression was higher in BOS lungs respective to healthy lungs. Our aim was to assess whether activated NEU might contribute to epithelial mesenchymal transition (EMT) through the up regulation of miR21 in lung cells.
Bronchiolitis obliterans (BOS) remains a major cause of death for lung transplant recipients, and mechanisms that drive BOS remain poorly understood. Genetically encoded deficiencies in mitophagy, a specialized autophagy that targets the removal of damaged mitochondria, have been shown to promote Parkinson's disease, but it is unclear if they play a role in other chronic diseases. Recent work has shown that the rs2241880 mutation in the autophagy regulator ATG16L1 leads to protein instability resulting in deficiency of ATG16L1 in monocyte-derived macrophages.