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Radiological abnormalities following bronchial thermoplasty: is the pathophysiology understood?
We read with great interest the correspondence by J.N.S. d'Hooghe and colleagues focusing on the pathophysiology of early transient radiological abnormalities following bronchial thermoplasty (BT). In line with our previous report [1], they have reported transient radiological opacities in all treated lobes of 12 BT-treated patients and in an adjacent untreated lobe in 31% of cases [2]. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Debray, M.-P., Dombret, M.-C., Pretolani, M., Thabut, G., Alavoine, L., Brillet, P.-Y., Taille, C., Khalil, A., Chanez, P., Aubier, M. Tags: Original Articles: Correspondence Source Type: research

Malaria and the development of pulmonary fibrosis
Sorry for the bait-and-switch. This is not a review about the role of parasitic infections and lung scarring. Instead, the manuscript by Sack et al. [1] in this issue of the European Respiratory Journal gives us the opportunity to consider the relationship between air pollution, or "bad air" (the literal translation of the contracted Italian words mala aria), and the development of, and progression from, early stages of pulmonary fibrosis. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Miller, E. R., Hunninghake, G. M. Tags: Interstitial and orphan lung disease Editorials Source Type: research

Ten principles for climate, environment and respiratory health
While not a meteorological fact, it is nonetheless commonly believed that every cloud has a silver lining. It seems they may also have a developed sense of irony as within days of announcing plans to pull the United States out of the United Nations Framework Convention on Climate Change (UNFCCC) Paris Agreement, President Trump moved to show his climate credentials by proposing to cover his Mexican border wall with solar panels. Despite such changes, The Lancet has noted that the response to the cloud of climate change could offer "...the greatest global health opportunity of the 21st century..." [1]. After all, ...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Barry, M., Annesi-Maesano, I. Tags: Epidemiology, occupational and environmental lung disease Editorials Source Type: research

Asthma control and action plans
We would like to thank I. Amirav and M.T. Newhouse for their correspondence in response to our recent paper, "An evidence-based, point-of-care tool to guide completion of asthma action plans in practice" [1]. They raise an important issue surrounding confusion between the concepts of poor baseline asthma control and acute changes in symptoms that merit activation of the "yellow zone" of the asthma action plan (AAP). Although, contrary to their contention, this discussion does not affect the objective or outcome of our analysis, which was to provide a practical, evidence-based guide to populating th...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Kouri, A., Boulet, L.-P., Kaplan, A., Gupta, S. Tags: Asthma and allergy Original Articles: Correspondence Source Type: research

Age should not be a barrier for pulmonary endarterectomy in carefully selected patients
Pulmonary endarterectomy (PEA) is the treatment of choice in operable chronic thromboembolic pulmonary hypertension (CTEPH) with excellent long-term outcomes [1]. It is a complex surgical procedure requiring cardiopulmonary bypass and removal of obstructive thromboembolic material during periods of deep hypothermic circulatory arrest [1]. We have observed an increase in the number of older CTEPH patients referred for consideration of PEA, which is consistent with other cardiothoracic surgeries. The UK population is ageing with a projected 3% increase in subjects aged>85 years in the next 20 years [2]. This may...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Newnham, M., Hernandez-Sanchez, J., Dunning, J., Ng, C., Tsui, S., Bunclark, K., Sheares, K., Taboada, D., Toshner, M., Pepke-Zaba, J., Jenkins, D., Cannon, J. Tags: Pulmonary vascular disease Original Articles: Research letters Source Type: research

Care pathways for the selection of a biologic in severe asthma
Patients with severe asthma generally benefit from consultations with an asthma specialist to optimise their management, which may include the potential initiation of biologic agents that have made a breakthrough in the treatment of severe disease. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Bousquet, J., Brusselle, G., Buhl, R., Busse, W. W., Cruz, A. A., Djukanovic, R., Domingo, C., Hanania, N. A., Humbert, M., Menzies Gow, A., Phipatanakul, W., Wahn, U., Wechsler, M. E. Tags: Asthma and allergy Editorials Source Type: research

Asthma control and action plans
Kouri et al. [1] in Canada have developed a tool to guide completion of asthma action plans (AAPs). In their rationale, they suggest that "fewer than 25% of patients receive an AAP, partly due to prescribers' inability to complete ‘yellow zone’ instructions (how to intensify therapy for acute loss of control)". The authors "reviewed recent asthma guidelines and adult studies addressing acute loss of asthma control" and "developed evidence-based rules for yellow zone therapy and operational guidelines to maximise adherence and minimise errors". (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Amirav, I., Newhouse, M. T. Tags: Asthma and allergy Original Articles: Correspondence Source Type: research

Fluoroquinolone resistance in multidrug-resistant Mycobacterium tuberculosis independent of fluoroquinolone use
During the 1990s, multidrug-resistant tuberculosis (MDR-TB), resistant to at least isoniazid and rifampin, emerged as a great threat to global tuberculosis (TB) control [1]. For most MDR-TB patients, the World Health Organization (WHO) recommends a treatment regimen including second-line anti-TB drugs [2]. One of the most effective second-line drugs is fluoroquinolone [3]. During the treatment, MDR-TB may develop resistance to fluoroquinolone, or even become extensively drug-resistant (XDR-TB), which is resistant to both fluoroquinolone and at least one of three injectable second-line drugs [4]. The main genetic mechanism ...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Che, Y., Song, Q., Yang, T., Ping, G., Yu, M. Tags: Respiratory infections and tuberculosis Original Articles: Research letters Source Type: research

Radiological abnormalities following bronchial thermoplasty: is the pathophysiology understood?
We read with great interest the paper by Debray et al. [1] reporting on early radiological lung abnormalities on computed tomography (CT) of the chest after bronchial thermoplasty (BT). The described findings in 13 patients are in line with our observations in 12 patients with severe asthma treated with BT in the TASMA trial (www.clinicaltrials.gov identifier number NCT02225392). Transient radiological abnormalities were seen after all 36 BT procedures, predominantly consisting of peribronchial consolidations with ground-glass opacities (figure 1a and c), partial occlusions/filling of bronchial lumen and atelectasis. Furth...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: d'Hooghe, J. N. S., Bonta, P. I., van den Berk, I. A. H., Annema, J. T. Tags: Original Articles: Correspondence Source Type: research

Novel magnetic resonance technique for functional imaging of cystic fibrosis lung disease
We examined the correlation between functional MRI, performed without administration of contrast agent, and lung clearance index (LCI) from nitrogen multiple-breath washout (N2-MBW). 40 children with CF (median (range) age 12.0 (6–18) years) and 12 healthy age-matched controls underwent functional and structural MRI and lung function tests on the same day. Functional MRI provided semiquantitative measures of perfusion (RQ) and ventilation (RFV) impairment as percentages of affected lung volume. Morphological MRI was evaluated using CF-specific scores. LCI measured global ventilation inhomogeneity. MRI detected f...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Nyilas, S., Bauman, G., Sommer, G., Stranzinger, E., Pusterla, O., Frey, U., Korten, I., Singer, F., Casaulta, C., Bieri, O., Latzin, P. Tags: CF and non-CF bronchiectasis Original Articles: Cystic fibrosis Source Type: research

Asthma phenotypes: do cough and wheeze predict exacerbations in persistent asthma?
Little is known of the long-term symptom profile in uncontrolled asthma and whether symptoms can predict distinct phenotypes. The primary objective of these analyses was to assess diurnal profile of cough and wheeze in an uncontrolled asthma population. Secondary outcomes were to examine how these symptom profiles influence response to treatment. Twice-daily electronically recorded data from 1701 patients were examined in relation to the population demographics. Reliever treatment with salbutamol was then compared with extra-fine beclometasone/formoterol maintenance and reliever therapy (MART). Exacerbation frequency was t...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Morjaria, J. B., Rigby, A. S., Morice, A. H. Tags: Asthma and allergy Original Articles: Asthma Source Type: research

ERS statement on obstructive sleep disordered breathing in 1- to 23-month-old children
The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1–23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present. SDB...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Kaditis, A. G., Alonso Alvarez, M. L., Boudewyns, A., Abel, F., Alexopoulos, E. I., Ersu, R., Joosten, K., Larramona, H., Miano, S., Narang, I., Tan, H.-L., Trang, H., Tsaoussoglou, M., Vandenbussche, N., Villa, M. P., Van Waardenburg, D., Weber, S., Verh Tags: Sleep medicine, Paediatric pulmonology Original Articles: ERS statement Source Type: research

Phenotypes of symptomatic airways disease in China and New Zealand
It is uncertain whether phenotypes of asthma and chronic obstructive pulmonary disease (COPD) vary between populations with different genetic and environmental characteristics. Here, our objective was to compare the phenotypes of airways disease in two separate populations. This was a cross-sectional observational study in adult populations from New Zealand and China. Participants aged 40–75 years who reported wheeze and breathlessness in the last 12 months were randomly selected from the general population and underwent detailed characterisation. Complete data for cluster analysis were available for 345 pa...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Fingleton, J., Huang, K., Weatherall, M., Guo, Y., Ivanov, S., Bruijnzeel, P., Zhang, H., Wang, W., Beasley, R., Wang, C., for the NZ-China Study Group Tags: Original Articles: Airways disease Source Type: research

Outcomes in coronary artery disease patients with sleepy obstructive sleep apnoea on CPAP
This study was a parallel observational arm of the RICCADSA randomised controlled trial, conducted in Sweden between 2005 and 2013. Patients with revascularised CAD and OSA (apnoea–hypopnoea index (AHI) ≥15 events·h–1) with daytime sleepiness (Epworth Sleepiness Scale score ≥10) were offered continuous positive airway pressure (CPAP) (n=155); CAD patients with no OSA (AHI
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Peker, Y., Thunström, E., Glantz, H., Wegscheider, K., Eulenburg, C. Tags: Sleep medicine Original Articles: Sleep Source Type: research

Air pollution and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis (MESA) air-lung study
We studied whether ambient air pollution is associated with interstitial lung abnormalities (ILAs) and high attenuation areas (HAAs), which are qualitative and quantitative measurements of subclinical interstitial lung disease (ILD) on computed tomography (CT). We performed analyses of community-based dwellers enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) study. We used cohort-specific spatio-temporal models to estimate ambient pollution (fine particulate matter (PM2.5), nitrogen oxides (NOx), nitrogen dioxide (NO2) and ozone (O3)) at each home. A total of 5495 participants underwent serial assessment of HAA...
Source: European Respiratory Journal - December 7, 2017 Category: Respiratory Medicine Authors: Sack, C., Vedal, S., Sheppard, L., Raghu, G., Barr, R. G., Podolanczuk, A., Doney, B., Hoffman, E. A., Gassett, A., Hinckley-Stukovsky, K., Williams, K., Kawut, S., Lederer, D. J., Kaufman, J. D. Tags: Epidemiology, occupational and environmental lung disease, Interstitial and orphan lung disease Original Articles: Air pollution and interstitial lung diseases Source Type: research

Fluctuation Dynamics of Clinical Markers in Asthmatic and Healthy Subjects Challenged with Rhinovirus
Clinical biomarkers can improve asthma diagnosis and phenotyping, aiding disease monitoring and prediction of outcomes. Such biomarkers are dynamic, changing over time from clinically controlled states to loss of control (LOC)/exacerbations in asthma as opposed to static single time point cross sectional snapshots.Aims: To compare temporal fluctuations in lung function between asthmatic and healthy volunteers before and after destabilization by RhinoVirus (RV) challenge.Methods: It is a prospective observational follow up study for 3 months in 12 asthmatic and 12 healthy subjects. The first 2 months is the stable phase fol...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Sinha, A., Binbin, X., Leoni, V., Delgado Eckert, E., Frey, U., Lutter, R., Sterk, P. J. Tags: Allergy and immunology Source Type: research

What predicts a deterioration of generic and disease-specific health-related quality of life in COPD? First longitudinal results of the COSYCONET cohort
Conclusion: Knowledge about factors predicting change in HRQL helps to identify subgroups of patients with special needs for care. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Wacker, M. E., Jörres, R. A., Schulz, H., Karrasch, S., Koch, A., Leidl, R., Watz, H., Vogelmeier, C., Holle, R. Tags: Clinical Problems COPD Source Type: research

Mortality after an acute exacerbation of COPD (AECOPD): findings from the National COPD Audit Programme
The National COPD Audit Programme ran a secondary care audit between February and April 2014, aiming to capture all hospital admissions for AECOPD in this window.Aims: To investigate 30 and 90 day mortality rates following hospital admission for AECOPD.Methods: The audit obtained permission to collect patient identifiers. These were used to link the English audit cohort records to an externally available source of mortality data, held by the Office of National Statistics. Comparison was made against earlier audit data for 90-day mortality.Results: Data from 12594 English patients were analysed.Mortality within 90 days of a...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Stone, R., Holzhauer-Barrie, J., Lowe, D., McMillan, V., Saleem Khan, M., Roberts, M. Tags: Clinical Problems COPD Source Type: research

Using Gold Standard Framework Criteria in COPD: Empowering Patients to make Choices about End of Life Care
Conclusions: The majority of patients admitted with COPD to a respiratory ward meet GSF criteria and have a poor prognosis. We found that an MDT approach using GSF criteria to predict mortality at 12 months was accurate. Comparing deaths out of hospital (35%) to a pre project audit (18%) has demonstrated that by working in this way and initiating discussions about advanced care planning around the time of admission, resulted in a reduction in deaths in hospital. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Gudur, S., O'Brien, F., Salem, A., Hasan, I., Hussain, N., Corcoran, C., Emery, S., Walker-Frost, Z., Fletcher, A., Marsden, P. Tags: Clinical Problems COPD Source Type: research

Elevated systemic biomarkers and persistent anxiety and depression in smokers with and without COPD: An analysis of the SPIROMICS cohort
We examined 1543 smokers with and without COPD and divided them into groups based on the Hospital Anxiety and Depression Scale (HADS), defining Persistent Anxiety (PA+) as HADS-A≥8 at baseline and year 1 (n=222), and Persistent Depression (PD+) as HADS-D≥8 at baseline and year 1 (n=137). We analyzed selected baseline biomarkers, divided them into quartiles and compared the percentages in the upper quartile (referred to as "high") between groups (PA+ vs. PA- and PD+ vs. PD-) with Chi squared tests.Preliminary Results: The PA+ group had greater percentages of high CBC (30.3 vs. 22.7%, p=0.014), CRP (30.6 vs. ...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Kim, V., Zhao, H., Armstrong, H., O'Neal, W., Bailey, K., Rennard, S., Barr, R. G., Criner, G., Lovasi, G., Morrison, M. Tags: Clinical Problems COPD Source Type: research

A real world experience of COPD exacerbations and possible association with Bronchiectasis in a medium size teaching hospital in the northwest of England
Admissions due to COPD exacerbations is an issue. A distinct Chronic Obstructive Pulmonary Disease (COPD) phenotype associated with Bronchiectasis is important for therapeutic reasons (1). These patients have greater levels of bronchial inflammation, colonisation of the bronchial mucosa with potentially pathogenic microorganisms (PPM) and a longer duration of acute infectious exacerbations (2). They may possibly have a worse prognosis (2). However the prevalence in COPD varies from 4%-50% (2, 3).Our aim was to identify the recurrent exacerbations for possible interventions and also correlate with Bronchiectasis. We retrosp...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Singh, H., Khan, S., Murrell, J. Tags: Clinical Problems COPD Source Type: research

High CAT score predicts lung parenchymal damage in COPD
COPD Assessment Test (CAT) is a measure of impact of COPD on a patient’s health status. We measured CAT score in 94 Chinese patients with a confirmed diagnosis of stable COPD (GOLD criteria). Age ranged 43-86 years, smoking pack years 0-104, and post-bronchodilatation FEV1/FVC under treatment 25-80%. CAT was compared to ventilation and perfusion tomography with Technegas™ (V/P SPECT*), diffusion capacity (DLCO) and FEV1, FVC and FEV1/FVC. Obstructive bronchitis was classified by penetration of Technegas™ to periphery and quantified to estimate % of missing lung function in relation to total lung volume. E...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Bajc, M., Wang, J., Chen, Y., Lindqvist, A. E., He, X. Y. Tags: Clinical Problems COPD Source Type: research

Use of the Daily PROactive instrument to evaluate physical activity in patients with COPD: results from ACTIVATE
Conclusion: AB/FF 400/12 µg significantly improved D-PPAC scores vs PBO at Week 4. BI did not augment these improvements. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Garcia Aymerich, J., Watz, H., Beeh, K. M., Paggiaro, P., Moya, M., Notari, M., Jarreta, D., Garcia Gil, E., Troosters, T. Tags: Clinical Problems COPD Source Type: research

Carbon monoxide transfer factor (DL,CO), age and gender add to the BODE index to predict survival in COPD patients
The BODE index is an important tool to predict survival in patients with COPD. Some data suggest that diffusion indices are related to survival, with COPD patients with a lower DL, CO having a worse survival. We are however unaware of any data examining the added value of DL, CO on top of the BODE index to predict survival in COPD.The BODE index was assessed as a routine in COPD patients followed in a tertiary care hospital with a lung transplantation (LTx) program. The files of 470 consecutive patients with a BODE index assessment in stable state were reviewed for DL, CO measurement (n = 436) at the time or within 3 month...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Marchand, E., Pirard, L. Tags: Clinical Problems COPD Source Type: research

Blood eosinophil (EOS) count, exacerbation rate and response to roflumilast in patients with severe COPD
Introduction: Studies suggest that high blood EOS count may be a marker of increased exacerbation risk in COPD patients (pts) with a history of exacerbations. We investigated the effect of blood EOS count on the efficacy of roflumilast (ROF) on COPD exacerbation rate.Methods: A post-hoc analysis was performed on two trials (REACT [NCT01329029], RE2SPOND [NCT01443845]) in which pts with severe COPD and ≥2 exacerbations in the previous year were randomised to ROF 500μg od or placebo (PBO) added to ICS/LABA±LAMA for 52 weeks. Primary endpoint was rate of moderate or severe COPD exacerbations/pt/year. Exacerbation...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Martinez, F. J., Rabe, K., Calverley, P., Fabbri, L., Sethi, S., Pizzichini, E., McIvor, A., Anzueto, A., Alagappan, V., Siddiqui, S., Reisner, C., Purkayastha, D., Roman, J., Rennard, S. Tags: Clinical Problems COPD Source Type: research

MISSION COPD: A novel model of integrated multidisciplinary COPD care that demonstrates significant reductions in unscheduled health care usage
Introduction: The MISSION COPD project delivered a one-stop carousel model of integrated COPD care to patients in Wessex in Autumn 2015.Methods: Patients were identified using the GRASP tool. Patients were subdivided in to a "case cohort" where no diagnosis was documented but COPD was suspected, and a "care cohort" where there was a pre-existing diagnosis. Data on healthcare usage for 12 months before the clinic and 6 months after (annualised to 12 months) were used to assess the efficacy of the clinic model.Results: 108 patients were reviewed, with 98 being included in the research project. Complete fo...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Lanning, E., Longstaff, J., Roberts, C., Jones, T., Neville, D., Storrar, W., Green, B., Brown, T., Chauhan, A. Tags: Clinical Problems COPD Source Type: research

Evaluation of roflumilast in COPD patients in a real-world European setting: results from the PROFILE EU study
Conclusions: These results suggest that the use of ROF in standard clinical practice may reduce the frequency of COPD exacerbations. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Vogelmeier, C., Tzanakis, N., Lassan, S., Genofre, E., Ding, B., Horton, J., Bakke, P. Tags: Clinical Problems COPD Source Type: research

Role of non-cystic fibrosis bronchiectasis in hospitalized patients with acute exacerbation of COPD
Conclusion: After elimination of confounding factors, our study demonstrates that the presence of NCFB does not influence the risk of death in a long-term follow-up. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Crisafulli, E., Guerrero, M., Ielpo, A., Huerta, A., Gabarrus, A., Soler, N., Chetta, A., Torres, A. Tags: Clinical Problems COPD Source Type: research

Determining SGRQ and TDI responder rates across the duration of clinical trials: Results from tiotropium + olodaterol in COPD
Conclusion: Analysing SGRQ and TDI responders using AUC and mean values allows investigation over a longer period of time and may be a better way to define responders than using only a single timepoint. The results consistently show an improved response of T+O compared to its mono-components. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Derom, E., Watz, H., Grönke, L., Voss, F., Buhl, R. Tags: Clinical Problems COPD Source Type: research

Validation of the GOLD 2017 classification in predicting exacerbations and mortality in COPD patients
Conclusions: The GOLD 2017 classification performed well by identifying individuals at risk of exacerbations, but its predictive ability for mortality was poor among COPD patients. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Chen, C.-Z., Hua, T.-H., Han, M.-Z., Tsai, S.-H., Hsiue, T.-R. Tags: Clinical Problems COPD Source Type: research

Population-based analysis of COPD patients in Catalonia: implications for case management
Conclusions: The predictive models stress the explanatory role of the covariate multimorbidity. The results highly encourage further developments fostering interoperability between health registries and electronic health records to enhance clinical risk prediction. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Baltaxe, E., Roca, J., Vela, E., Tenyi, A., Cano, I., Monterde, D., Claries, M., Garcia-Altes, A., Hernandez, C., Escarrabill, J. Tags: Clinical Problems COPD Source Type: research

Impact of comorbid bronchiectasis on COPD patients
According to the GOLD Guidelines, bronchiectasis (BE) is one of the comorbidities of COPD. It seems to have an important impact on the natural history of COPD.Aims: To determine the impact of coexistent bronchiectasis on COPD outcomes.Methods: A retrospective single-centre study of COPD patients with Bronchiectasis revealed by chest computed tomography. We compared 2 groups of patients: G1: COPD patients with BE (84 cases, 20%); G2: no BE at CTscan (339 cases, 80%). Clinical, functional and bacteriologic features were analyzed.Results: The study included 423 COPD patients (mean age 65+/-11 years, 97% males). No significant...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Ben Saad, A., Joobeur, S., Fahem, N., Cheikh Mhamed, S., Mribah, H., Rouatbi, N., El Kamel, A. Tags: Clinical Problems COPD Source Type: research

Clinical effect of different pneumococcal vaccination schedules in patients with chronic obstructive pulmonary disease (COPD): long-term follow-up results
Conclusion: After a 4-year follow-up the best effect of the vaccine was observed in the PCV13/PPV23 group. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Protasov, A., Kostinov, M., Zhestkov, A. Tags: Clinical Problems COPD Source Type: research

The allelic frequency for S and Z mutations in the SERPINA1 gene in NSCLC patients from Poland
Conclusions: The frequency of Pi*S and Pi*Z alleles in NSCLC patients differ noticeably from the general Polish population (Pi*Z 13.7/1000 and Pi*S 7.6/1000): the frequency of Pi*Z allele is lower whereas the frequency of Pi*S is higher. The NSCLC patients who carry AATD allele do not present reduced AAT concentration in blood as compared to the reference values from population studies. The study is on-going. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Komorowski, M., Szpechcinski, A., Debek, E., Duk, K., Zdral, A., Florczuk, M., Rudzinski, P., Kupis, W., Zaleska, J., Langfort, R., Orlowski, T., Roszkowski-Sliz, K., Chorostowska-Wynimko, J. Tags: Molecular Pathology and Functional Genomics Source Type: research

p.Leu747Pro mutation leads to misdiagnosis in EGFR mutation assessment - first Caucasian NSCLC patients reported
Epidermal growth factor receptor (EGFR) mutation assessment is essential for targeted therapy of non-small cell lung cancer (NSCLC) as predictive biomarker of the response to EGFR tyrosine kinase inhibitors (TKI).There is a number of well-known mutations in EGFR gene. Still infrequent or complex aberrations are also observed. p.Leu747Pro is one of rare mutations which might be misdiagnosed by commercial real-time PCR kits for EGFR mutation analysis. It is an inhibiting mutation. Importantly, it might be confused with an activating deletion in exon 19 of EGFR gene.The aim of the study was to assess the occurrence of p.Leu74...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Duk, K., Skronska, P., Skronski, M., Zdral, A., Chorostowska-Wynimko, J. Tags: Molecular Pathology and Functional Genomics Source Type: research

Transcriptomic profiling reveals M1-high tumour associated macrophages that orchestrate the adaptive Anti-tumour response in human lung cancer
We describe a novel set of M1high TAMs that simultaneously activate M1 and M2 signatures. M1high TAMs strongly activate antigen-presenting genes and express high levels of T-cell chemoattractants (CXCL9, 10 and 11), associating with a higher infiltration of anti-tumour CD8+ T-cells and a better clinical outcome. AIM2 and IL1beta levels are increased in M1high TAMs, indicating a direct involvement in pyroptosis and clearance of cancer cells. We provide a unique transcriptomic resource of TAMs in lung cancer and propose that TAMs can be used to improve immunotherapy due to a novel and pivotal role for M1high TAMs in orchestr...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Garrido-Martin, E. M., Ottensmeier, C., Vijayanand, P., Sanchez-Elsner, T. Tags: Molecular Pathology and Functional Genomics Source Type: research

Expression of Her-2/neu and Bcl-2 in patients with non-small cell lung cancer
The aim of this study: was to evaluate the expression of protein products of HER-2/neu and Bcl-2 in patients with non-small cell lung carcinoma (NSCLC), and to assess their clinicopathological and prognostic significance.Methods: HER-2/neu and Bcl-2 were investigated immunohistochemically using tumor semples obtained from 87 NSCLC patients. The immunohistochemical study was performed on formalin-fixed, paraffin-embedded sections using LCAB immunoperoxidase method with specific monoclonal antibody for HER-s/neu and Bcl-2.Results: The overall expression of HER-2/neu and Bcl-2 in 87 patients with NSCLC was 25,2% and 21,3% res...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Ilievska Poposka, B., Petrusevska, G. Tags: Molecular Pathology and Functional Genomics Source Type: research

Characterization of cultured primary/metastatic lung cancer cells obtained by percutaneous puncture
Conclusions: Primary culture of human lung tumor cells obtained by percutaneous puncture can be successfully achieved with the method described. These primary cultures of cancer cells showed rearrangements of chromosomes and change in their complement chromosomic typical of tumoral cells. Aditionally, Fluorescence in situ Hybridization analysis showed that three cultures showed amplification for EGFR. Finally the expression profiles of the CK7, Napsin A, TTF-1 and P63 genes allowed in most cases to confirm the tumor phenotype of the samples. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Rojas Moreno, A., Canas Arboleda, A., Herreno, A., Fernandez, M. J., Mejia, J. A., Moreno Nino, O. M., Rey, L., Bustos, F., Montecino, M. Tags: Molecular Pathology and Functional Genomics Source Type: research

A metabolite of prostaglandin D2, 15-deoxy-?12,14-prostaglandin J2 (15d-PGJ2), in exhaled breath condensate (EBC) of asthma patients
Conclusion: The content of 15d-PGJ2 in EBC is higher than 11β-PGF2α, as found earlier, thus making it more preferable for the estimation of the level of unstable PGD2 in EBC.Supported by Russian Science Foundation (grant No.14-25-00019). (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Perelman, J. M., Nekrasov, E. V., Prikhodko, A. G., Makarova, G. A. Tags: Molecular Pathology and Functional Genomics Source Type: research

The role of glucocorticoid receptor {alpha} and {beta} isoforms in exacerbations of asthma, COPD, and ACOS
Background: Glucocorticoid receptor (GR) β is a well-known antagonist of GR α and it may cause a steroid resistance (SR) in patients with chronic inflammatory or oncological diseases. However, the role of GR α and β in non-SR patients is not determined.Aim: to evaluate GR α, β expression and its clinical role in exacerbations of asthma, COPD, and ACOS.Materials and Methods: The levels of GR α, β mRNAs were measured by real-time PCR in 89 subjects aged 63.4±10.7, namely 22 exacerbated BA, 21 exacerbated COPD, 26 exacerbated ACOS, and 20 controls. DNA samples from all patien...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Belash, V., Mironova, Z., Trofimov, V., Vsevolodskaia, E., Zaraiski, M., Sazanov, A., Ulitina, A., Pchelina, S. Tags: Molecular Pathology and Functional Genomics Source Type: research

Association between pentanucleotide repeat polymorphism in NOS2 promoter and asthma exacerbations
Introduction: Polymorphisms of inducible nitric oxide synthase (NOS2) gene is related to fractional exhaled nitric oxide (FeNO) level in steroid-naive patients with asthma, but its association with treatment outcomes remains unclear.Aims and objectives: We investigated the association of NOS2 polymorphism with exacerbations in patients with asthma.Methods: NOS2 pentanucleotide repeat (CCTTT)n polymorphisms were genotyped in 136 patients with moderate/severe asthma. Cross-sectionally, we evaluated NOS2 mRNA expression levels in peripheral blood mononuclear cells, FeNO levels, white blood cell counts and lung function. Exace...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Hirai, K., Shirai, T., Suzuki, M., Tsuji, D., Inoue, K., Itoh, K. Tags: Molecular Pathology and Functional Genomics Source Type: research

Clustering of patients with bronchial asthma with regard to the genotypes for Bcl1 polymorphism in the glucocorticoid receptor gene
Conclusions: Cluster analysis of BA patients with regard to the genotypes of VcI1 polymorphism demonstrated 3 different BA subphenotypes that differed from each other in sex, BA course and control, values of respiratory function, BMI and inflammatory markers. These can contribute to individual approach to diagnostics and treatment of BA in the future. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Kmyta, V., Prystupa, L. Tags: Molecular Pathology and Functional Genomics Source Type: research

Transcriptional factors F???3,?-Maf, GATA3 and T-bet in different variants of bronchial asthma
Predominance of Th-cells populations has been previously shown in patients with differtentvariants of bronchial asthma. To investigate cross-talk interactions between lymphocyte transcriptional factors Foxp3, c-Maf, GATA3 and T-bet we evaluated blood samples of 47 healthy volunteers and 82 patients with bronchial asthma. mRNA expression of Fop3, c-Maf, GATA3 and T-bet was measured by RT-PCR, the levels of associated cytokines were analyzed by ready-to-use ELISA kits. We revealed high levels of GATA3, c-Maf, IL-4, IL-13 and IgE in patients with allergic bronchial asthma. On the contrary, in non-allergic bronchial asthma T-b...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Eremeeva, A., Sorokina, L., Mineev, V., Nyoma, M., Trofimov, V. Tags: Molecular Pathology and Functional Genomics Source Type: research

A hypothesis driven approach investigating the interleukin-6 pathway in UBIOPRED severe asthma patients
In this study, we investigated whether sputum IL-6 pathway activity is aberrant in a subgroup of asthma patients and is associated with particular clinical characteristics. We used a hypothesis driven analysis by investigating sputum transcriptomics (n=77), sputum and blood proteomics and clinical data from UBIOPRED consortium severe asthma cohort. As asthma is a heterogeneous disease, we used a clustering approach to identify subgroups of patients using genes correlated with IL6R sputum mRNA.The analysis identified two subgroups with high (n=33) and low (n=28) IL6R expression. Mean IL6R expression level in the high IL6R group was 2.8-fold (p
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Turan, N., Bates, S., Edwards, M., Shaw, D. E., Chung, K. F., James, A., Loza, M. J., Van Oosterhout, A. J., UBIOPRED study group Tags: Molecular Pathology and Functional Genomics Source Type: research

Distinctive gene signature of allergen-specific CD4+T cells in allergic patients
Allergic patients display abnormal immune responses to harmless antigens, including abnormal Th2 polarization and induction of allergen-specific T and B cells, resulting in development of allergy instead of tolerance. Allergen-specific immunotherapy (AIT) is currently the only causative treatment of allergic disorders. Yet, understanding of the underlying differences in allergen-specific responses between allergy and tolerance is lacking. We investigated whole-genome transcriptomics of circulating birch and grass specific CD4+ T cells in patients before and during AIT, as well in non-allergic healthy controls. Detailed imm...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Sokolowska, M., Boonpiyathad, T., Eljaszewicz, A., Castro Giner, F., Ruchti, F., Globinska, A., Ruckert, B., Dreher, A., Radzikowska, U., Morita, H., Jansen, K., Rinaldi, A., Gschwend, A., Meyer, N., Helbling, A., Negoias, S., Hool, S.-L., Borner, U., Kwo Tags: Molecular Pathology and Functional Genomics Source Type: research

Urinary metabolomics-based molecular sub-phenotyping of the U-BIOPRED asthma cohort
Introduction: Asthma is heterogeneous disease consisting of multiple sub-phenotypes that are poorly definedAim: To investigate the utility of the urinary metabolome to identify sub-phenotypes of severe asthma via molecular phenotypingMethods: Spot urine was collected from healthy controls (HC, n=108), mild-to-moderate asthmatics (MMA, n=87), severe asthmatics (SA); including both non-smokers (SAns, n=310) and smokers (SAs, n=108) from the U-BIOPRED cohort (Shaw et al, Eur Respir J. 2015; 46:1308). Metabolomics data were acquired using liquid chromatography coupled to mass spectrometry. Data were analysed using Principal Co...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Wheelock, C., Naz, S., Reinke, S., Chaleckis, R., Schofield, J., Skipp, P., Bigler, J., Loza, M., Baribaud, F., Bakke, P., Caruso, M., Chanez, P., Fowler, S., Horvath, K., Krug, N., Montuschi, P., Sanak, M., Sandstrom, T., Shaw, D., Chung, F., Djukanovic, Tags: Molecular Pathology and Functional Genomics Source Type: research

Late Breaking Abstract - The "one airway, one disease" concept at the light of Th2 inflammation
Conclusions: Nasal and bronchial epithelia display distinct transcriptional signatures. In AR group, but not in R group, nasal cells can be used as bronchial surrogates to assess Th2 inflammation. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Giovannini-Chami, L., Paquet, A., Sanfiorenzo, C., Pons, N., Cazareth, J., Magnone, V., Le Brigand, K., Chevalier, B., Julia, V., Leroy, S., Marquette, C.-H., Barbry, P., Marcet, B. Tags: Molecular Pathology and Functional Genomics Source Type: research

Propolis reverts cigarette smoke-induced emphysema through macrophage alternative activation
Emphysema is an incurable and progressive disease, and cigarette smoke (CS) is the main risk factor. Natural extracts have shown antioxidant and anti-inflammatory properties that can prevent acute lung inflammation and emphysema, but there are almost no reports in literature about therapeutics approaches to emphysema. We hypothesized if supplementation with propolis would repair lung damage in emphysema caused by CS exposure. C57BL/6 mice were exposed to 60 days of CS and then treated or not with propolis extract orally for more 60 days. Histological analysis revealed significant improvement in lung histoarchiteture, with ...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Deus, M., Barroso, M., Cavalieri, I., Gitirana, L. d. B., Fautrel, A., Lagente, V., Schmidt, M., Porto, L. C., Souza, B. R. d., Valenca, S. d. S. Tags: Mechanisms of Lung Injury and Repair Source Type: research

Different microenvironment stimuli results in distinct patterns of macrophages polarization comparing elastase- and cigarette smoke - induced models of emphysema
Rationale: Depending on microenvironment stimuli, macrophages can be polarized into M1("classical") or M2 ("alternative")phenotypes.Aim:To verify M1 and M2 phenotypes in the CS- and elastase- induced models.Methods: Mice were submitted to CS exposure (CS Group)and the Control group were maintained in ambient air for 3 months or animals received elastase instillation (50 μL;0,667UI)(PPE Group) and their control received saline solution(Sal Group) and euthanized at the 28th day. In lungs, real-time PCR were performed to evaluate M1-(CXCL9, CXCL10, IL-12b) and M2-(FIZZ-1, ARG-1)genes expression, M2- (IL...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Benini Kohler, J., Cervilha, D. A. B., Ito, J. T., Moreira, A. R., Santana, F. R., Farias, T. M., Alonso- Vale, M. I. C., Prado, C. M., Arruda Martins, M., Lopes, F. D. T. Q. S., Franca, L. E. Tags: Mechanisms of Lung Injury and Repair Source Type: research

The protective effects of thymoquinone on lung damage developed by cigarette smoke
This study aims to investigate the preventive and curative effects of TQ on lung damage created by cigarette smoke on rats. Fifty adult male Wistar albino rats were included in this study. Thirty subjects were randomized to exposure to tobacco smoke every day for 3 months. Intraperitoneal(IP) TQ was administered every day to ten subjects to investigate the protective effects of TQ, and on the last 21 days to ten subjects to investigate the curative effect. Ten subjects received IP saline for last 21 days. Ten subjects were enrolled as control group. Ten controls received IP TQ for last 10 days. Close circuit cage apparatus...
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: yetkin, N. A., Büyükoglan, H., Sönmez, M. F., Tutar, N., Yilmaz, I., Gulmez, I. Tags: Mechanisms of Lung Injury and Repair Source Type: research