Dexmedetomidine for sedation during nonivasive ventilation in acute respiratory syndrome patients
Noninvasive ventilation (NIV) is commonly used to prevent endotracheal intubation in patients with mild to moderate acute respiratory distress syndrome (ARDS). Dexmedetomidine (DEX) provide cooperative sedation, and could be beneficial for patients with ARDS receiving NIV. Aim of this study was to compare DEX with placebo for sedation during NIV.Adults with ARDS due to community aquired pneumonia with PaO2/FiO2 ratio 150-300 mmHg were randomly allocated to receive IV dexmedetomidine (0.2 μg/kg/h titrated every 30 min to 0.7 μg/kg/h to maintain a Richmond sedation agitation score (RASS) of 0 to -2) or placebo up to 72...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Bielka, K., Kuchyn, I. Tags: Noninvasive Ventilatory Support Source Type: research

A multicenter randomized trial for the effectiveness of structured discharge and follow-up protocol on readmission rate in COPD patients receiving LTOT/NIV: one-year interim analysis.
Conclusion: The preliminary results showed that structured discharge and follow up protocol might be a helpful approach for prevention of recurrent admissions in COPD patients with chronic respiratory failure (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Ergan, B., Goktalay, T., Ergun, P., Yilmaz, D., Ocakli, B., Gurgun, A., Demirci, N., Elverisli, F., Yilmazer Ucar, E., Durmaz, A., Gorek Dilektasli, A., Aksoy, E., Elmas, F., Kokturk, N., Aytekin, F., Akgun, M., Ozyilmaz, E., Demirdogen Cetinoglu, E., Aca Tags: Noninvasive Ventilatory Support Source Type: research

The implementation of a psychological support during the adaptation to Non Invasive Ventilation (NIV) in Chronic Obstructive Pulmonary Disease (COPD): a Randomized Controlled Trial
This study aims to investigate the impact of a brief psychological support on acceptance and adherence to NIV in COPD patients.Methods: Eighty-four COPD patients with an indication for NIV were recruited and involved in a two-branch randomised controlled trial, single-blind. The experimental group underwent a psychological support including counselling, relaxation and mindfulness-based exercises and neuropsychological rehabilitation exercises. Controls received standard care and watched educational videos related to the disease’s management. The interventions were delivered at the HD Respiratory Rehabilitation Unit o...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Volpato, E., Pagnini, F., Banfi, P. Tags: Noninvasive Ventilatory Support Source Type: research

Approaching the Non Invasive Ventilation (NIV) in Amyotrophic Lateral Sclerosis (ALS) at home: a Randomized Controlled Trial
Background: Respiratory failure is one of the most common causes of death in ALS patients. Treatment of ALS patients with NIV when FVC
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Volpato, E., D'Ascenzo, S., Montini, A., Paneroni, M., Grilli, S., Vitacca, M., Banfi, P. Tags: Noninvasive Ventilatory Support Source Type: research

Late Breaking Abstract - Exhaled air dispersion during application of CPAP via nasal pillows and oronasal mask versus high flow nasal cannula therapy
Conclusion: Exhaled air dispersion from the patient’s nostrils was limited to 172mm along the sagittal plane when HFNC was delivered at 60L/min. Exhaled air dispersed to 264mm during CPAP via nasal pillows but that from Quattro oronasal mask was negligible. Projected funded by HMRF#15140282, Food & Health Bureau, HK (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hui, D. S. C., Chow, B., Chan, M. Tags: Noninvasive Ventilatory Support Source Type: research

Physical activity in patients with endoscopic lung volume reduction measured with a SenseWear Armband
Conclusions: PAL and sleeping efficiency improves after ELVR with valves in patients with TLVR. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Schotten, L., Oezkan, F., Schwarz, B., Winantea, J., Taube, C., Darwiche, K. Tags: Interventional Pulmonology Source Type: research

Reasons for not receiving interventional therapy in patients with severe emphysema
Background: Endoscopic/surgical interventions may be beneficial in selected emphysema patients. Knowing predictors for successful therapy, rates of treatment failure decreased. Our aim was to evaluate the number of patients eligible for any intervention and exclusion criteria.Methods: Retrospective analysis of 232 consecutive emphysema patients who were considered for interventional therapy in 2016. Reasons for not receiving valve or coil therapy were assessed for all the patients who did not receive any therapy.Results: 50% (116/232) of the patients received any interventional therapy (82% valve therapy, 6% coil therapy, ...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Polke, M., Roetting, M., Sarmand, N., Eberhardt, R., Herth, F., Gompelmann, D. Tags: Interventional Pulmonology Source Type: research

Fissure analisys with StratX software and Chartis system for bronchoscopic lung volume reduction (BLVR) with valves
Background: Collateral ventilation (CV) can be assessed directly with the Chartis System (Pulmonx Inc)[Herth F et al ERJ 2013;41:302–308] or indirectly at computed tomography through visual or computerized methods. We evaluated the agreement between Chartis and StratX (Thirona) in detecting fissure completeness.Methods: Emphysema patients referred for BLVR in 2017 underwent Chartis assessment and StratX analisys to quantify fissure integrity on the basis of a Fissure Completeness Score (FCS). CV was assumed to be absent if FCS>95%, FCS
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Luzzi, V., Innocenti, M., Leoncini, F., Bezzi, M. Tags: Interventional Pulmonology Source Type: research

Pneumothorax after Bronchoscopic Lung Volume Reduction with Endobronchial Valves(EBV-BLVR): Is there any correlation with number of valves?
Purpose: EBV-BLVR has evolved as a minimally invasive therapy for advanced emphysema. Optimal patient selection improves results, but also the likelihood of pneumothorax (pnx). There is, however, little evidence of what its rate could be influenced by. We hypothesized an association with the number of valves used.Aim: to investigate a correlation between the rate of pnx and the number of valves used.Methods: we performed a retrospective evaluation of pnx rate in correlation with number of valves andtreatedlobein all EBV-BLVR procedures from 2015 to 2017 in two referral centers.Results: Overall pnx rate in 99 patientswas 24...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Luzzi, V., Novali, M., Bezzi, M. Tags: Interventional Pulmonology Source Type: research

Is bronchoscopic follow up useful after Bronhoscopic Lung Volume Reduction (BLVR) with endobronchial valves?
Conclusion: Brochoscopy is not needed after BLVR if the patient is asymptomatic unless valve migration/leaking is suspected. It could be useful to re-evaluate patients whose microbiological examination at baseline is positive, but data to support this are poor. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Luzzi, V., Innocenti, M., Romani, S., Leoncini, F., Bezzi, M. Tags: Interventional Pulmonology Source Type: research

Changes in functional capacity after endoscopic lung volume reduction in patients with chronic obstructive lung disease and severe emphysema
Conclusion: Successful ELVR significantly predicts improvements in functional capacity in patients with COPD and severe emphysema. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Geissenberger, F., Bader, S., Faul, C., Schwaiblmair, M., Berghaus, T. Tags: Interventional Pulmonology Source Type: research

Endobronchial valves and spigots in a non-standard indication
Conclusions: EV and spigots in a non-standard indication is an effective and substantially safe method, which can improve and shorten a treatment of the patients, including in those who are ventilator-depended. Next trials should be focused on a standardization and cost-efficacy of the application (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Bartakova, H., Simovic, J., Votruba, J. Tags: Interventional Pulmonology Source Type: research

Altered intercostal muscle structure following successful endobronchial lung volume reduction: a pilot study
Conclusions: Patients with hyperinflation due to severe COPD who respond to EBV insertion exhibit dynamic changes in intercostal muscle thickness on ultrasound measurement. This finding requires replication in a larger cohort of patients. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Wallbridge, P., Hew, M., Parry, S., Hammerschlag, G., Irving, L., Steinfort, D. Tags: Interventional Pulmonology Source Type: research

Efficacy and safety of bronchoscopic lung volume reduction (BLVR) modalities functioning independent of collateral ventilation in advanced emphysema: Systematic review and meta-analysis
Conclusions: BLVR procedures, especially endobronchial coils are found to be effective in management of patients of severe emphysema irrespective of collateral ventilation. However, characterization of patients who would be most benefitted from these procedures is required and effectiveness of these procedures in long run is also to be established. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Dutt, N., Rustagi, N., Singh, S., Shekhar, S., Kuwal, A., Chaudhry, K., Kirubakaran, R. Tags: Interventional Pulmonology Source Type: research

Impact of radiological changes on treatment outcome following endoscopic lung volume reduction with coils (LVRC) in patients with advanced emphysema
Conclusion: In the interim analysis it seems that the radiological changes after LVRC have no impact on the clinical outcome. However further evaluation of a larger patient cohort is needed in order to confirm these results. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Kontogianni, K., Gerovasili, V., Eberhardt, R., Herth, F. J. F., Heussel, C. P., Gompelmann, D. Tags: Interventional Pulmonology Source Type: research

The "Coil Associated Opacity" in endoscopic emphysema treatment. Friend or foe?
The RENEW study was the first to report "Coil Associated Opacity" (CAO) as a specific complication to Endobronchial Coil treatment for severe emphysema. CAO is defined as an opacity occurring in the area around the Coils on chest x-ray, low grade fever
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Perch, M., Johannesen, H. H., Fiehn, A.-M. K., Siemsen, M., Mortensen, J. Tags: Interventional Pulmonology Source Type: research

Computed Tomography Predictors of Pneumothorax and Hemoptysis after Endobronchial Valve Therapy for Emphysema
Conclusions: CT measures predicted pneumothorax/hemoptysis after lobar exclusion with EBV. Future studies should investigate the potential of CT measurements to identify patient with high risk of pneumothorax/hemoptysis before EBV treatment and enable more careful monitoring of these patients after EBV treatment. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Oliveira, D., Kirby, M., Schirm, J., Munhoz Svartman, F., Rodrigues, M., Grynblat, P., Defranchi, H., Caballero Duran, H., Macedo Neto, A. V., Oliveira, H. Tags: Interventional Pulmonology Source Type: research

Five years outcome of Karakoca Resector Balloon dilalation and curetage method in Severe COPD (chronic obstructive pulmonary disease)
Conclusion: These results confirmed our early observations that balloon dilatation and curettage is safe and successful technique for medical treatment-resistant COPD. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Karakoca, Y., Gogus, G., Akduman, S., Erturk, B. Tags: Interventional Pulmonology Source Type: research

Quantitative CT Analysis for Fissure Completeness in Bronchoscopic Lung Volume Reduction
Conclusions: The quantitative analysis of fissure shows that incomplete fissures increased the probability of CV on ChartisTM, while the defect size did not affect the overall rates. CT cannot substitute ChartisTM completely, because TLVR could be achieved even in some patients with relatively large fissure defect, if they showed negative CV on ChartisTM. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Lee, S. W., Shin, S. Y., Park, T. S., Oh, S. Y., Lee, S. M. Tags: Interventional Pulmonology Source Type: research

Removal of diseased emphysematous tissue with bronchoscopic thermal vapor ablation (BTVA)
Conclusion: BTVA typically removes mass of ablated diseased segments and increases mass in healthier segments. Additionally, data from these measurements may result in ways to better identify BTVA responders and continue to improve on good patient outcomes. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Herth, F. J. F., Gompelmann, D., Valipour, A., Snell, G., Grah, C., Witt, C., Hopkins, P., Eberhardt, R., Shah, P. Tags: Interventional Pulmonology Source Type: research

Electromagnetic navigation bronchoscopy: parameters associated with a positive result
Introduction: Peripheral lung lesions are a diagnostic challenge. Electromagnetic navigation bronchoscopy (ENB) is a procedure that facilitates lesion sampling while avoiding more invasive diagnostic methods.Aims and Objective: To define which factors may be associated with a positive result via ENB.Methods: A retrospective study of ENB in 234 consecutive cases, between March 2008 and January 2018, collecting data pertaining to past medical history, chest computed tomography (CT) and positron emission tomography (PET) findings and variables belonging to the bronchoscopy procedure. A descriptive analysis and multiple linear...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Claveria, O., Gonzalez, J., Blanco, A., Seijo, L., Berto, J., Zulueta, J. J. Tags: Interventional Pulmonology Source Type: research

Influence of endoscopic lung volume reduction with valves on the pulmonary gas exchange
In this study we analyse how a complete lobar occlusion effect the overall gas exchange and whether discrepancy of the most diseased lobe in CT-scan and lung perfusion scintigraphy leads to a different outcome.Methods: Data of 34 patients with severe lung emphysema who underwent a complete lobar occlusion with valves between 2015 and 2017 was retrospectively analysed.Results: A significant target lobe volume reduction (TLVR>350ml) was achieved in 22 patients. In 17 patients the most diseased lobe in CT-scan correspond to the lobe with the most reduced perfusion. In these patients FEV1% predicted improved from 31, 7% to 36, 8% (p
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Stiehl, K., Kaid, D., Karpf-Wissel, R., Steveling, H., Taube, C., Winantea, J. Tags: Interventional Pulmonology Source Type: research

Long-term follow-up after endoscopic valve therapy in patients with severe emphysema
Conclusions: Patients treated by valves experienced clinical improvement over one year. Afterwards, benefit gradually declines more likely due to COPD progression; nevertheless, a high proportion of patients are still clinical responders. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Gompelmann, D., Heinhold, T., Bischoff, E., Eberhardt, R., Kontogianni, K., Herth, F. J., Rötting, M. Tags: Interventional Pulmonology Source Type: research

Biomarker measurement in asthma patients receiving biologic therapy: a real-world retrospective study
Conclusion: In the real-world setting, physicians under-utilise biomarkers to assess their patients with severe asthma and help guide selection of biologic therapy. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hanania, N. A., Fang, J., Zhou, L., Ortiz, B., Kavati, A., Jaumont, X., Alvares, L., Cao, H. Tags: Monitoring Airway Disease Source Type: research

Persistent blood eosinophilia and COPD exacerbation risk after ICS withdrawal from triple therapy in the SUNSET study
Conclusions: The direct ICS withdrawal from triple therapy may lead to increased risk of moderate/severe exacerbations in patients with consistently high blood eosinophils at both screening and baseline. Patients without eosinophilia or with intermittent eosinophilia did not present increased exacerbation risk. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hurst, J. R., Kostikas, K., Chapman, K. R., Frent, S.-M., Larbig, M., Fogel, R., Guerin, T., Banerji, D., Patalano, F., Goyal, P., Pfister, P., Wedzicha, J. A. Tags: Monitoring Airway Disease Source Type: research

Increased IL5, IL8 and eosinophils in induced sputum of asthmatics with accelerated FEV1 decline
Introduction: A considerable number of asthmatic patients is characterized with accelerated lung function decline, which is probably a functional reflection of airway remodelling. Risk factors for long term excessive loss of lung function are currently not clearly understood.Objectives: The aim of our study was to evaluate long-term FEV1 decline in patients with controlled asthma, and to discriminate the possible clinical, functional and inflammatory risk factors or biomarkers for accelerated decline (>30ml/year).Methods: We included 33 well-defined patients with mild asthma, and recall them 12 - 15 years after the init...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Marc Malovrh, M., Camlek, L., Skrgat, S., Dezman, M., Kern, I., Korosec, P. Tags: Monitoring Airway Disease Source Type: research

Blood eosinophil count predicts severity of respiratory failure, death and future exacerbations in severe life-threatening asthma
Conclusion: BEC at index SLTA predicts more severe respiratory acidosis, higher risk of death and future exacerbations. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Yii, A., Tay, T. R., Puah, S. H., Lim, H. F., Li, A., Lau, P., Tan, R.-A., Neo, L. P., Koh, M. S. Tags: Monitoring Airway Disease Source Type: research

Relationship between blood eosinophil count and bronchial epithelial gene expression in COPD versus Asthma
In this study, we used a regression transcriptome analysis of bronchial brushings (BB) vs blood EOS level from a COPD cohort (Emphysema vs airway disease (EvA) and from Asthma U-BIOPRED.Aims: To determine if airway gene expression is similar in eosinophilic patients in COPD and Asthma.Methods: A regression analysis determined the relationship between BB gene expression and EOS count in blood. In EvA (n=185) RNA seq was used to characterise RNA expression, in U-BIOPRED (n=95) arrays were used. Differentially expressed genes (DEG's) showing a significant regression coefficient (RC) after FDR correction p
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: George, L., Riley, J., Taylor, A., Bates, S., Wagers, S., Esteve-Codina, A., Artigas, M., Pavlidis, S., Singh, D., Fan-Chung, K., Sterk, P., Brightling, C. Tags: Monitoring Airway Disease Source Type: research

Peripheral eosinophils and mortality in COPD patients over nine years
Introduction: Local and systemic manifestations of COPD are well reported. However, there are few studies that have evaluated the association of peripheral eosinophils and mortality rate over nine years.Objective: Evaluate the association of peripheral eosinophils in the mortality of patients with COPD over nine years.Methods: We followed 110 COPD patients (67% men, 65±9 years) with mild to very severe COPD [forced expiratory volume in one second (FEV1) of 58±25%] during nine years. At the baseline we performed a complete blood count, spirometry, pulse oximetry (SpO2), body composition, dyspnea intensity [Med...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Prudente, R., Mesquita, C., Ferrari, R., Franco, E., Tanni, S. Tags: Monitoring Airway Disease Source Type: research

Blood eosinophilia(BE) and outcomes in patients with acute severe exacerbations of COPD(AECOPD)
Background: Recent studies have shown the usefulness of BE as a biomarker of response to systemic or inhaled corticosteroid therapy. However, little is known whether BE has predictive value of positive clinical outcomes in AECOPD requiring hospitalization.Aim: To evaluate the associations of BE with outcomes of patients with AECOPD.Methods: This was a retrospective observational cohort study, conducted in pulmonology department of Clinical hospital during 2015-2016, including patients hospitalized for severe AECOPD. Subjects were divided into 2 groups: NE, non-eosinophilic (
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Soe, A. K., Kevorkova, M. S., Nuralieva, G. S., Belevskiy, A. S., Avdeev, S. N., Chuchalin, A. G. Tags: Monitoring Airway Disease Source Type: research

Late Breaking Abstract - Protection by budesonide against clinically important deteriorations (CID) in patients with COPD is dependent on blood eosinophil counts (EOS)
Conclusion: The benefit of BUD treatment in reducing risk of CID is dependent on EOS. EOS may be used to identify COPD patients suitable for ICS treatment and studies evaluating ICS treatment effect. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Bafadhel, M., Sing, D., Jenkins, C., Peterson, S., Bengtsson, T., Fageras, M. Tags: Monitoring Airway Disease Source Type: research

Inhibitory effects of mitochondrial TRAP1 on gefitinib-resistancein non-small lung cancer cells
This study was designed to investigate overcoming gefitinib resistance in NSCLC through a mechanism-based approach using gamitrinib variant containing triphenylphosphonium (G-TPP), TRAP1 inhibitor.We developed an in vitro model of acquired resistance to gefitinib. The effects of G-TPP on apoptosis and ROS-dependent mitochondrial dysfunction in HCC827GR cells were examined by annexin V binding assay, MitoSoX, and immunoblot analysis. and we tested the effects of pretreated with NAC or DPI, free radical scavenger. In addition, TRAP1 and antioxidant MnSOD were respectively knocked down or overexpressed to determine its role i...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hwang, K. E., Oh, S. J., Jeong, E. T., Kim, H. R. Tags: Lung Cancer Source Type: research

NTHi-induced inflammation activates the PD-1 immune checkpoint in the tumor microenvironment
Conclusion: Chronic neutrophilic inflammation induced by NTHi activates the PD-1 immune checkpoint in the tumor microenvironment. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Ritzmann, F., Vella, G., Herr, C., Bals, R., Beisswenger, C. Tags: Lung Cancer Source Type: research

ADAM28 deletion in mice impacts lung metastasis formation
ADAM28 expression is upregulated in non-small cell lung carcinoma and correlated with cell proliferation and metastatic dissemination. In addition, ADAM28 is thought to be an important regulator of inflammatory signaling pathways as this protease shed the pro-inflammatory cytokine, pro-TNF-alpha. ADAM28 also interacts with integrins and a P-selectin ligand (PSGL-1) involved in inflammatory cell migration. All these findings suggest that ADAM28 contributes to cancer development and progression.This project aims to characterize the effects of host-derived ADAM28 on lung metastasis formation using an ADAM28-/- mouse model.Lew...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hubeau, C., Gerard, C., Carnet, O., Moser, M., Noël, A., Cataldo, D., Rocks, N. Tags: Lung Cancer Source Type: research

TRAP1 downregulation could overcome gefitinib resistance in NSCLC via EMT reversal
In conclusions, these results suggested that TRAP1 downregulation could overcome gefitinib resistance in NSCLC via EMT reversal in tumor microenvironment. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hwang, K. E., Oh, S. J., Jeong, E. T., Kim, H. R. Tags: Lung Cancer Source Type: research

Long-term objective compliance with a mandibular advancement device and continuous positive airway pressure in moderate obstructive sleep apnea
Conclusion: Objective compliance with MAD and CPAP was comparable and consistent over time. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: De Vries, G. E., Hoekema, A., Claessen, J., Stellingsma, C., Stegenga, B., Kerstjens, H., Wijkstra, P. Tags: Sleep and control of breathing Source Type: research

Mandibular advancement therapy does not reduce inflammatory and metabolic biomarkers in patients with severe OSA: a randomized controlled trial
Rational: Obstructive sleep apnea (OSA) is associated with enhanced vascular inflammation and metabolic dysfunction. Mandibular advancement device (MAD) is an effective treatment for OSA patients with daytime sleepiness but its impact on inflammation and metabolic dysfunction is unknown. This trial investigated the effects of MAD on inflammatory and metabolic markers in patients with OSA.Methods: Patients with severe OSA and no overt cardiovascular disease were randomized to receive 2 months of treatment with either MAD or a sham device. Levels of blood glucose, insulin, high-sensitivity C-reactive protein (hs-CRP), leptin...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Trzepizur, W., Recoquillon, S., Pepin, J.-L., Vielle, B., Bironneau, V., Chouet-Girard, F., Launois, S., Meslier, N., Meurice, J.-C., Nguyen, X.-L., Paris, A., Priou, P., Tamisier, R., Goupil, F., Fleury, B., Gagnadoux, F. Tags: Sleep and control of breathing Source Type: research

Spectral analysis of peri-pharyngeal muscles EMG in patients with OSA and healthy subjects during wakefulness and sleep.
Background: We have recently shown that during sleep, EMG activity of several dilator muscles remained low during flow-limitation–induced respiratory efforts. In contrast, genioglossus (GG) activity rose above the wakefulness level, but failed to ameliorate flow.Goal: We compared centroid EMG frequency (Fc) of dilator muscles during wakefulness and sleep. We hypothesized that left-shift of Fc due to muscle fatigue should worsen overnight, affect GG>other muscles and OSA>healthy subjects. In contrast, a similar shift in all muscles and subjects suggests a sleep-related change in muscle unit synchronization.Metho...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Oliven, A., Cohen, G., Oliven, R., Schwartz, A. Tags: Sleep and control of breathing Source Type: research

Evaluation of upper airway anthropometry by ultrasonography in obstructive sleep apnea patients
Introduction: Anatomical and non-anatomical factors are implicated in repetitive collapse of upper airway (UA) in OSA patients.Aims: To study the anthropometry (static & dynamic) of UA in patients of OSA by US & assess the relation between UA anatomy and severity of OSA.Methods: 30 each of OSA patients, overweight non-OSA persons & healthy individuals with normal BMI, after their polysomnography underwent US measurements of tongue thickness(TT), upper airway length (UAL), lateral pharyngeal wall thickness (LPW) and oropharynx [retropalatal (RP) & retroglossal (RG) levels]. Oropharynx was measured on tidal e...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Govindagoudar, M., Chaudhry, D., Sen, J., Jain, N., Jash, D., Prajapat, B. Tags: Sleep and control of breathing Source Type: research

How lateral airway tissues affect upper airway dimensions with mandibular advancement in obstructive sleep apnoea.
Mandibular advancement increases the lateral dimensions of the nasopharynx via a direct connection between the lateral upper airway and the ramus of the mandible (Brown et al. Sleep 2013;36:397-404). However the mechanical properties of this connection are poorly understood. The aim of this study was to investigate whether a tendinous component influences the mechanical properties of the lateral walls and the effect of mandibular advancement on airway dimensions.Methods: Detailed anatomical MRI of the tissues surrounding the nasopharynx of 101 subjects with obstructive sleep apnoea (OSA) with and without mandibular advance...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Brown, L., Juge, L., Burke, P., Sutherland, K., Cistulli, P., Bilston, L. Tags: Sleep and control of breathing Source Type: research

Ultrasonography of oropharynx and surrounding soft tissues as a screening tool for OSA
Conclusions: Ultrasonography provides a near complete picture of the dynamic changes and collapsibility of the upper airway and can be an effective tool in screening OSA. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Chaudhry, D., Govindagoudar, M., Sen, J., Jain, N., Gupta, M., Prajapat, B., Jash, D. Tags: Sleep and control of breathing Source Type: research

The position of the mandible plays a key role for determining airflow during sleep.
Rationale: Sleep mandibular changes in position (MTP) ar the result of a complex antagonistic interplay between muscles lowering or elevating the mandible. We studied: the causal impact of MTP on inspiratory nasal pressure (INP) and the association between MTP and the surface EMG activities of the jaw antagonistic muscles.Methods: MP,INP and 4 EMG signals (sub-mental muscles and masseters) were extracted from 100 randomly selected fragments including 30 to 150 s before and after one micro-arousal. In each fragment, MTP was automatically located by a customized algorithm. The causal impact of MTP on INP was justified by Bay...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Martinot, J.-B., Le-Dong, N.-N., Melki, B., Cuthbert, V., Denison, S., Borel, J. C., Pepin, J.-L. Tags: Sleep and control of breathing Source Type: research

Late Breaking Abstract - The effectiveness of NAS therapy for the treatment of mild to moderate OSAS
Background: Patients with obstructive sleep apnea syndrome (OSAS) experience subjective symptoms and have an increased risk for several diseases. Continuous positive airway pressure (CPAP) therapy is useful to these symptoms. However, adherence to CPAP therapy often becomes problematic. Although oral appliances are a well-known alternative therapy, user satisfaction is limited. The nasal airway stent (NAS) has attracted much attention as another option to treat OSAS; however, the effectiveness was not well established.Objective: To identify the effects of NAS therapy on patients with mild to moderate OSAS.Patients and meth...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Ohtsuka, K., Fukunaga, K., Baba, R., Haraguchi, M., Shirahama, R., Senoura, H., Miyao, N., Betsuyaku, T. Tags: Sleep and control of breathing Source Type: research

Calcium-sensing receptor as a therapeutic target for pulmonary fibrosis
This study investigates the role of CaSR in lung fibroblast activation and whether CaSR antagonists, calcilytics, attenuate this process.Methods: Human lung fibroblasts were treated with transforming growth factor-β1 (TGF-β1) in the presence or absence of calcilytic for 72 hours. qPCR, immunofluorescence, ELISA, histology and Western blot analyses were used to assess mRNA and protein expression of CaSR and known fibrotic markers.Results: CaSR is increased in human IPF lungs when compared to control. In human lung fibroblasts, mRNA levels of α-smooth muscle actin and collagen 1 were significantly reduced by ...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Wolffs, K., Mansfield, B., Scofield, S., Ward, J. P. T., Corrigan, C. J., Prakash, Y. S., Kemp, P. J. K., Riccardi, D. Tags: Idiopathic interstitial pneumonias Source Type: research

Development of pulmonary fibrosis in conditional Nedd4-2 deficient mice
In this study, we characterized a mouse model with conditional deletion of Nedd4-2 in lung epithelial cells of adult mice. Nedd4-2 is a ubiquitin ligase which is critical for regulation of the epithelial sodium channel ENaC and TGFβ signaling which are known to play an important role in pulmonary inflammatory diseases and fibrosis. To obtain conditional Nedd4-2 deficient mice (Nedd4-2-/-), we crossed mice with Nedd4-2 flanked by lox-P sites (Nedd4-2fl/fl) with mice carrying the reverse tetracycline-dependent transactivator under control of the CCSP-Promoter (CCSP-rtTA2-M2) and mice expressing a PTet responsive Cre rec...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Leitz, D., Duerr, J., Dvornikov, D., Szczygiel, M., Konietzke, P., Rotin, D., Wielpütz, M., Kawabe, H., Beers, M., Klingmüller, U., Mall, M. Tags: Idiopathic interstitial pneumonias Source Type: research

A new Humanized Mouse Model for Idiopathic Pulmonary Fibrosis and Effects of Nintedanib Treatment
Conclusion: This new humanized mouse model resembles IPF better than the commonly used bleomycin model. Nintedanib treatment attenuated pulmonary fibrosis in the humanized mouse model. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Prasse, A., Jäger, B., Plappert, L., Kraus, K., Wollin, L. Tags: Idiopathic interstitial pneumonias Source Type: research

Molecular Markers of Telomere Dysfunction and Senescence are Common Findings in the Usual Interstitial Pneumonia Pattern of Lung Fibrosis
Conclusions: Molecular markers of telomere dysfunction and senescence are pathologically expressed in both IPF and non-IPF UIP lungs. These findings suggest that common molecular drivers may contribute to the pathogenesis of UIP-associated pulmonary fibrosis, regardless of the underlying clinical context. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Lee, J., La, J., Aziz, S., Brownell, R., Jones, K., Green, G., Elicker, B., Golden, J., Matthay, M., Kukreja, J., Collard, H., Wolters, P. Tags: Idiopathic interstitial pneumonias Source Type: research

CHIT1 is a novel therapeutic target in idiopathic pulmonary fibrosis (IPF): anti-fibrotic efficacy of OATD-01, a potent and selective chitinase inhibitor in the mouse model of pulmonary fibrosis
Conclusion: We have demonstrated that expression of CHIT1 is increased in IPF and that inhibition of chitinases with OATD-01 provided significant therapeutic efficacy, comparable to nintedanib, in the bleomycin-induced pulmonary fibrosis model. These data support further development of OATD-01 as a first-in-class therapy for IPF. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Dymek, B., Sklepkiewicz, P., Mlacki, M., Zagozdzon, A., Koralewski, R., Mazur, M., Paplinska-Goryca, M., Nejman-Gryz, P., Proboszcz, M., Gorska, K., Maskey-Warzechowska, M., Przysucha, N., Krenke, R., Golebiowski, A., Dobrzanski, P., Dzwonek, K. Tags: Idiopathic interstitial pneumonias Source Type: research

Synergistic Drug Combination of Nintedanib and Vardenafil Inhibits Fibrosis in AKR-2B Fibroblasts
Idiopathic pulmonary fibrosis (IPF) is an invariably fatal disease characterized by progressive lung parenchymal fibrosis. Two FDA-approved medications exist but have significant side effects and only modest clinical efficacy. Given the multiple molecular pathways involved in IPF, treatment paradigms are shifting to using synergistic combinations of drugs similar to modern cancer treatments. Data from a recent drug screen have shown the PDE5 inhibitor vardenafil attenuates TGF-β mediated fibronectin expression in AKR-2B mouse fibroblasts.We aim to assess for synergistic fibronectin gene suppression using the combinati...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Bourne, M., Kottom, T., Limper, A. Tags: Idiopathic interstitial pneumonias Source Type: research

BAL cell transcriptome predicts survival in IPF and can be used to gauge and model treatment effects interfering with the TGF-beta pathway
Introduction: Idiopathic pulmonary fibrosis (IPF) is a fatal disease with a variable course. Current prediction models of mortality which are based on clinical and physiological parameters have modest value in predicting survival. In addition there is little information whether changes in molecular pathways in the alveolar compartment are indicative of disease progression.Methods: BAL cells were harvested from 212 IPF patients at three different European tertiary referral centers: Freiburg (Germany), Siena (Italy) and Leuven (Belgium) between 2006-2014. Furthermore, BAL cells from 20 IPF patients were cultured in vitro w/w...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Prasse, A., Carleo, A., Jaeger, B., Schupp, J., Rottoli, P., Wuyts, W., Kaminski, N. Tags: Idiopathic interstitial pneumonias Source Type: research