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Metabolic abnormalities caused by the accumulation of human, environmental, genetic and lifestyle variables can be found in diabetes mellitus (DM). An increase in blood glucose carried on by a reduction in insulin production can also result in DM. Insulin resistance often occurs as a result of obesity and a lack of physical activity and aging. Telang flower extract (Clitoria ternatea L.) is reported to have several qualities such as being able to treat DM, chronic bronchitis, goiter, mucosal disorders and leprosy. This study's objective was to elucidate anti-dibetic effect of C. ternatea extract (CTE) in rats with diabetic complications related to dyslipidemia. Rats suffering from diabetes will be examined after being given oral doses of Simvastatin 0.9 mg/kg BW, Glibenclamide 0.45 mg/kg BW, and 200, 400, and 800 mg/kg BW CTE, model induced by streptozotocin. The expression of the insulin gene (INS-1) was investigated by qRTPCR, Tumor Necrosis Factor-α (TNF-α), and Interleukin-1β (IL-1β) pancreatic DM rats model using the Immunohistochemistry (IHC) test. Both descriptive and quantitative data were acquired for the data. After utilizing ANOVA to evaluate quantitative data, the Tukey post hoc test was used to analyze the data, the expression of TNF-α and IL-1β was found to decrease while INS-1 expression increased in response to CTE. This effect was attributed to the modulation of TNF-α, IL-1β, and INS-1 expression. These findings suggest that CTE possesses antidiabetic properties. [ABSTRACT FROM AUTHOR]

Excessive water consumption is an extremely rare and potential asthma risk factor with very few cases reported in the literature. Common triggers of asthma include genetic factors, smoking, allergens, and viral respiratory infections. The adult patient with asthma reportedly drank too much water and was unable to get relief from his asthma while hospitalized. The patient's asthma was better controlled with the use of diuretics and control of the patient's fluid intake and output. This case explores asthma induced by excessive drinking of water. [ABSTRACT FROM AUTHOR]

Background: The association between obesity and respiratory diseases has been confirmed. However, few studies have reported the relationship between obesity and the risk and mortality of chronic inflammatory airway disease (CIAD). The aim of this study was to reveal the association between obesity and the risk of CIAD, and mortality in patients with CIAD. Methods: The study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2013 to 2018 among adults aged 20 years and above. All participants were grouped according to body mass index (BMI) and waist circumference (WC) levels to study the relationship between obesity and CIAD. Multivariate logistic regression analysis was utilized to examine the connection between CIAD and obesity in a cross-sectional study. The association between obesity and all-cause mortality in individuals with CIAD was examined using multiple cox regression models and smooth curve fitting in a prospective cohort study. Results: When stratified based on BMI in comparison to the normal weight group, the ORs with 95%CIs of CIAD for underweight and obesity were 1.39 (1.01–1.93) and 1.42 (1.27–1.58), respectively. The OR with 95%CI of CIAD for obesity was 1.20 (1.09–1.31) when stratified according to WC. Additionally, underweight was associated with a higher mortality (HR = 2.44, 95% CI = 1.31–4.55), whereas overweight (HR = 0.58,95% CI = 0.39–0.87) and obesity (HR = 0.59,95% CI = 0.4–0.87) were associated with a lower mortality (P for trend < 0.05). There was a non-linear association between BMI and all-cause mortality (P for non-linear = 0.001). An analysis of a segmentation regression model between BMI and all-cause mortality revealed a BMI turning point value of 32.4 kg/m2. The mortality of CIAD patients was lowest when BMI was 32.4 kg/m2. When BMI ≤ 32.4 kg/m2, BMI was inversely associated with all-cause mortality in patients with CIAD (HR: 0.92, 95%CI:0.88–0.97). However, when BMI > 32.4 kg/m2, there was no association between BMI and all-cause mortality (HR:1.02, 95%CI:0.97–1.06). Conclusion: Compared to normal weight, underweight and obesity were associated with the increased risk of CIAD. Underweight was associated with increased all-cause mortality, while overweight was associated with reduced all-cause mortality. There was a non-linear association between BMI and all-cause mortality in patients with CIAD. The all-cause mortality was lowest when BMI was 32.4 kg/m2. [ABSTRACT FROM AUTHOR]

Background: Invasive fungal disease (IFD) is a frequent complication in pediatric lung transplant recipients, occurring in up to 12% of patients in the first year. Risk factors for infection include impaired lung defenses and intense immunosuppressive regimens. While most IFD occurs from Aspergillus, other fungal conidia are continuously inhaled, and infections with fungi on a spectrum of human pathogenicity can occur. Case Report: We report a case of a 17‐year‐old lung transplant recipient in whom Irpex lacteus and Rhodotorula species were identified during surveillance bronchoscopy. She was asymptomatic and deemed to be colonized by Irpex lacteus and Rhodotorula species following transplant. 2 years after transplantation, she developed a fever, respiratory symptoms, abnormal lung imaging, and histological evidence of acute and chronic bronchitis on transbronchial biopsy. After developing symptoms concerning for a pulmonary infection and graft dysfunction, she was treated for a presumed IFD. Unfortunately, further diagnostic testing could not be performed at this time given her tenuous clinical status. Despite the initiation of antifungal therapy, her graft function continued to decline resulting in a second lung transplantation. Conclusions: This case raises the concern for IFD in lung transplant recipients from Irpex species. Further investigation is needed to understand the pathogenicity of this organism, reduce the incidence and mortality of IFD in lung transplant recipients, and refine the approach to diagnosis and manage the colonization and isolation of rare, atypical fungal pathogens in immunocompromised hosts. [ABSTRACT FROM AUTHOR]

The complex nature of chronic bronchitis (CB) and changing definitions have contributed to challenges in understanding its aetiology and burden. In children, CB is characterised by persistent airway inflammation often linked to bacterial infections and is therefore termed "protracted bacterial bronchitis" (PBB). Longitudinal studies suggest that CB in childhood persists into adulthood in a subgroup. It can also be associated with future chronic respiratory diseases including asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD). Adult CB is traditionally associated with smoking, occupational exposures, and lower socioeconomic status. The interplay between risk factors, childhood CB, adult CB, and other chronic respiratory diseases is intricate, requiring comprehensive longitudinal studies for a clearer understanding of the natural history of CB across the lifespan. Such longitudinal studies have been scarce to date given the logistic challenges of maintaining them over time. In this review, we summarise current evidence on the evolution of the definitions, pathophysiology, risk factors, and consequences of childhood and adulthood chronic bronchitis. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of paeoniflorin on Th17, Treg cell subsets and lung function in rats with chronic bronchitis （CB）, so as to enrich its pharmacological effects. Methods: CB model was established by compound induction in SD rats, and SD rats were randomly divided into CB group （normal saline）, low-dose paeoniflorin group （50 mg/kg）, medium-dose paeoniflorin group（ 100 mg/kg）, high-dose paeoniflorin group（ 200 mg/kg） and Helao group（ positive control, Helao oral liquid）, with 10 rats in each group; another 10 rats in the control group （normal saline） were given 2 ml/100 g corresponding drugs by gavage after modeling. After administration, the general conditions of rats were observed and the lung function and blood gas were analyzed; the morphology of lung tissue was observed by HE staining; the lung CD4+T, CD8+T, Th17（ CD4+IL-17+T） and Treg（ CD4+CD25+Foxp3+T） cells were detected by flow cytometry; the levels of IL-10, IL-22 and IL-17 in the lung were detected by ELISA. Results: In CB group, the activity of rats were slow, the color of hair were dim, the body were curled up, accompanied with cough and moist nasal cavity, the above symptoms and injuries were alleviated in different degrees in paeoniflorin groups and Helao group, and the high dose group was the least. Compared with control group, the airway resistance, arterial partial pressure of carbon dioxide （PaCO2）, IL-17, IL-22 levels, CD4+T, CD8+T, Th17 cells, Th17/Treg, CD4+T/CD8+T were higher in CB group, arterial partial pressure of oxygen （PaO2）, IL-10 and Treg cells were lower （all P<0.05）; compared with CB group, the airway resistance, PaCO2, IL-17, IL-22 levels, CD4+T, CD8+T, Th17 cells, Th17/Treg, CD4+T/CD8+T in low-, medium- and high-dose paeoniflorin groups decreased in turn, PaO2, IL-10 and Treg cells increased in turn （all P<0.05）; there was no significant difference in airway resistance and the other above indexes between the medium-dose paeoniflorin group and Helao group （P>0.05）. Conclusion: Paeoniflorin can regulate the activation of T lymphocytes, reduce the differentiation of Th17 cells, increase the differentiation of Treg cells, and reduce the inflammatory level and lung injury in CB rats. [ABSTRACT FROM AUTHOR]

The study aimed to assess associations between chronic diseases and incident and persistent depressive symptoms (DSs) in a cohort study of ageing adults in South Africa. Participants in the baseline survey (in 2014/2015) were 5,059 persons (≥40 years) and at follow-up 4,176 (in 2018/2019). DSs were measured with the Center for Epidemiological Studies Depression scale. Logistic regression was used to estimate the associations between chronic conditions and incident and persistent DS. The prevalence of DS at baseline was 15.5%, incident DS (without DS and/or PTSD at baseline) was 25.1% and persistent DS (DS at both baseline and follow-up) was 4.8%. In unadjusted logistic regression analysis, diabetes had higher odds of incident DS. Participants with baseline heart attack/stroke/angina, dyslipidemia, tuberculosis, chronic bronchitis, kidney disease and three or more chronic conditions had a higher probability of persistent DS. In conclusion, of the eight chronic conditions evaluated, only diabetes (in unadjusted analysis) was associated with incident DS, and five chronic conditions (heart attack/stroke/angina, dyslipidaemia, tuberculosis, chronic bronchitis and kidney disease) and three or more chronic conditions were associated with persistent DS. [ABSTRACT FROM AUTHOR]

Background: Cameroon is a tuberculosis (TB) burden country with a 12% positivity among TB presumptive cases. Of the presumptive cases with a negative TB test, some are infected with Non-tuberculous Mycobacteria (NTM). However, the diagnosis of NTM infections remains difficult due to the lack of tools in many laboratories, particularly in resource limited laboratories and remote setting. The present study was undertaken to determine NTM profile and associated comorbidities among TB presumptive people. Methods: A retrospective study was conducted from December 2018 to December 2019 in the Tuberculosis-National Reference Laboratory (TB-NRL) for Bacteriological analysis of samples and Jamot Hospital of Yaounde (JHY) for clinical evaluation of confirmed NTM patients. We included in this study data of 5267 TB presumptive people previously diagnosed using three consecutive samples and having culture and SD Bioline results with or without Microscopy and reverse hybridization-based Line Probe Assay(LPA) results. The data on co-morbidities or history of people infected with NTM were then collected from the three participants with available clinical data. Results: We collected data of 5267 presumptive TB people. Among them, 3436 (65.24%), have a positive culture with 3200 (60.75%) isolates belong to Mycobacterium tuberculosis Complex (MBTC) and 236 (4.48%) to NTM. Our results showed that, 123 (52.11%) NTM were isolated from people with negative microscopy and 113 (47.88%) from people with positive microscopy. Among the 236 NTM, 108 (45.8%) isolates were identified using LPA. M. fortuitum was the most represented species (32.41%) followed by M. intracellulare (19.44%). Sputum had the highest proportion of NTM (56%), followed by bronchial aspirations (31%). The extra-pulmonary samples presented lower proportions of isolates compared to pulmonary samples. Some patients affected with NTM presented comorbidities as HIV infection, Pulmonary tuberculosis, Type 2 diabetes, Chronic bronchitis and Alveolar pneumonia. Conclusions: Our study showed the presence of NTM strains among presumptive TB people with a predominance of M. fortuitum and M. intracellulare. It is important to implement a surveillance system of NTM in TB burden country and also to develop a point-of-care test for NTM identification in limited-resource settings. [ABSTRACT FROM AUTHOR]

Simple Summary: Lung cancer is one of the deadliest cancers worldwide, and the prognosis is poor. The disease is potentially curable if detected at an early stage, but currently, the only widely implemented screening tool is low-dose computed tomography. Biomarkers such as methylated tumor DNA may be used for the early detection of lung cancer, and sputum is an appealing, non-invasive sample type. With this systematic review and meta-analysis, we aimed to identify all studies evaluating the quantitative methylation of tumor DNA in sputum samples for lung cancer detection. A systematic overview of all the available evidence may highlight areas of improvement as well as certain high-performing genes to prioritize in future studies. Lung cancer is the leading cause of cancer-related mortality worldwide. Early diagnosis is pivotal for the prognosis. There is a notable overlap between lung cancer and chronic bronchitis, and the potential use of methylated tumor DNA in sputum as a biomarker for lung cancer detection is appealing. This systematic review and meta-analysis followed the PRISMA 2020 statement. A comprehensive search was conducted in Embase, Medline, Web of Science, and the Cochrane Library, using these search strings: Lung cancer, sputum, and methylated tumor DNA. A total of 15 studies met the eligibility criteria. Studies predominantly utilized a case–control design, with sensitivity ranging from 10 to 93% and specificity from 8 to 100%. A meta-analysis of all genes across studies resulted in a summary sensitivity of 54.3% (95% CI 49.4–59.2%) and specificity of 79.7% (95% CI 75.0–83.7%). Notably, two less explored genes (TAC1, SOX17) demonstrated sensitivity levels surpassing 85%. The study's findings highlight substantial variations in the sensitivity and specificity of methylated tumor DNA in sputum for lung cancer detection. Challenges in reproducibility could stem from differences in tumor site, sample acquisition, extraction methods, and methylation measurement techniques. This meta-analysis provides a foundation for prioritizing high-performing genes, calling for a standardization and refinement of methodologies before potential application in clinical trials. [ABSTRACT FROM AUTHOR]

Aims: Tobacco smoking has been identified as the most important risk factor of chronic bronchitis. The aim of this study was to assess the contribution of smoking to the trends in prevalence of chronic bronchitis among men and women in Finland. Methods: For this purpose, we analysed questionnaires included in national FINRISK and FinHealth studies conducted between 1972 and 2017 in 5-year intervals. A total of 26,475 men and 28,684 women aged 30–59 years were included in the analysis. In addition to smoking, age and socioeconomic status were used as risk factors in the logistic regression model. Results: Smoking in Finland has declined from 51% to 23% in men between 1972 and 2017. In women, it increased from 11% in 1972 to 23% in 2002, with a following decrease to 16% in 2017. The prevalence of chronic bronchitis has generally followed the trend of smoking. The population attributable risk was 60% in men and 49% in women. A decrease in chronic bronchitis was observed in male never-smokers. Conclusions: Smoking is currently declining in Finland in both men and women. As result, the prevalence of chronic bronchitis is declining and it is approaching baseline independent of smoking. The decrease in never-smokers has yet to be explained. [ABSTRACT FROM AUTHOR]

Background: Chronic bronchitis is a form of COPD (chronic obstructive pulmonary disease) depicting a cough of >3 months and recurring over two years. Studies on chronic bronchitis are primary and assessed only older subjects. Aim: The present study was aimed at the identification of risk factors linked with chronic bronchitis in adult Indian subjects visiting medical care for respiratory diseases. Methods: The present study assessed 78 subjects and a questionnaire was used to assess nutritional, environmental, and seasonal factors, family history, individual factors, and demographic data. The majority of the subjects were male in the age range of 21-35 years residing in rural areas. The study also had a control group where the majority of subjects were from urban residences. Results: It was seen that asthma was the most common and prevalent disease associated with the subjects having chronic bronchitis diagnosed with asthma along with chronic bronchitis. Various associated risk factors with chronic bronchitis were identified including family history, pertussis, pneumonia, pulmonary obstruction, asthma, hay fever, spring sensitivity, dust sensitivity, respiratory sensitivity, exposure to secondhand smoke, smoking, and residency. Conclusion: The present study focuses on healthy eating habits, physical fitness, and smoking cessation to prevent chronic bronchitis in affected subjects. The results of the present study are vital for healthcare professionals in India to implement and design effective management and prevention strategies for chronic bronchitis. [ABSTRACT FROM AUTHOR]

Context • The identification of a patient’s constitution in Traditional Chinese Medicine (TCM) allows physicians to understand his or her risk for different diseases, forecast the mechanism of disease development, and direct treatment strategies, such as herbs and/or acupuncture. However, very few large-scale clinical trials have occurred on the relationships of the TCM constitution to lifestyles and diseases. Objective • The study intended investigate the complex and systematic relationship between the TCM constitution and lifestyles to provide solutions for adjusting unbalanced constitutions and maintaining a balanced constitution and health state among people of various lifestyles in Jilin, China. Design • The research team conducted a randomized crosssectional survey. Setting • The study took place in Jilin Province in China. Participants • Participants were 1755 residents of Jilin Province in China, 794 men and 961 women, between September 2006 and February 2013. Outcome Measures • The research team: (1) collected participants’ data using a basic informational and lifestyle questionnaire and the Constitution in Chinese Medicine Questionnaire (CCMQ); (2) used descriptive analysis to illustrate demographic characteristics and the distribution of TCM constitutions; (3) conducted multivariate logistic regressions to explore potential factors influencing the Deficiency, Excess, Gentleness, and Special-diathesis constitutions. Results • Approximately one-half of participants in Jilin, China had an unbalanced constitution and one-third had Deficiency constitutions. Lifestyles and disease histories were significant influencing factors for the unbalanced constitutions. Of the 1755 participants, 757 had the Gentleness constitution (43.1%); the remaining participants had unbalanced constitutions, including 501 with a Deficiency constitution (28.6%), 423 with an Excess constitution (24.1%), and 74 with a Special-Diathesis constitution (4.2%). Regarding the influencing factors, the Deficiency constitutions were significantly related to lifestyle factors— especially gender, age, exercise, and diet: (21) the Qi-deficiency constitution was significantly related to excessive exercise and chronic bronchia; (2) the Yang-deficiency constitution was significantly related to female gender and prefer to hot food; and (3) the Yin-deficiency constitution was significantly related to age, from 46 to ≥66, and the barbecue diet. The Excess constitutions were related to medical histories: (1) the Phlegm-dampness and Blood-stasis constitutions were both significantly related to cardiocerebrovascular disease and hyperlipidemia; (2) the Dampnessheat constitution was significantly related to liver disease and osteoporosis; (3) the Qi-depression constitution was significantly related to liver disease and chronic bronchia. The Gentleness constitution was significantly related to a greasy diet, and the Special-diathesis constitution was significantly related to allergies. Conclusions • The identification of TCM constitutions would be beneficial to early identification of potential risk factors and could contribute to the creation of more comprehensive guidelines for health organizations. Controlling the factors influencing the TCM constitutions and using health management plans based on the TCM constitution could help people with unbalanced constitutions to adjust their lifestyles and improve their health. [ABSTRACT FROM AUTHOR]

Patients living with chronic bronchitis (CB) suffer from physical limitations and poor quality of life. In general, treatment options that directly address the mucus hypersecretion component of CB are quite limited. Chronic airway inflammation and the associated hypersecretion and cough that are pathognomonic for CB generally result from long-term exposure to airway irritants such as tobacco use and other environmental insults. This, in turn, results in an increase in the quantity and change in composition of the airway mucosa as a consequence of altered goblet cells, club cells, and submucosal glands. Pulsed electric fields (PEFs) provide a method for eradicating the cellular constituents of tissue with limited impact on the stromal proteins. Preclinical evidence in porcine airways demonstrated that particular PEF waveforms allowed for salutary remodeling of the epithelial and submucosal airway tissue layers and appeared to foster rapid regeneration and recovery of the tissue. Therefore, a therapeutic opportunity might exist whereby the application of a specific form of PEF may result in a reduction of the cellular secretory constituents of the airway while also reducing airway mucosal inflammation. This review discusses the use of such PEF to address the underlying disease processes in CB including challenges around device design, dosing, and appropriate delivery methods. Further, we outline considerations for the transition to human airways along with a brief examination of the initial work treating CB patients, suggesting that the therapy is well tolerated with limited adverse events. [ABSTRACT FROM AUTHOR]

Background: Feline lower airway disease (FLAD) is frequently associated with radiographic abnormalities. Objectives: To evaluate whether radiographic changes in cats with naturally occurring FLAD improve with treatment and if radiographic changes correlate with clinical signs. Animals: Twenty‐four client‐owned cats newly diagnosed with FLAD, based on medical history, typical clinical signs, radiographic findings, and examination of bronchoalveolar lavage fluid, were included in the prospective study. Methods: At 2 examination time points (days 0 and 60), an owner questionnaire, clinical examination, and thoracic radiography were carried out. Information from the questionnaire and clinical examination were evaluated on the basis of a 12‐point clinical score. Radiographs were assessed using a 10‐point radiographic score. Individual treatment was given to all cats over the study period, based on severity of the disease and compliance of the cat. Clinical and radiographic scores were compared statistically for both examination time points and evaluated for correlation. Results: All cats showed radiographic abnormalities at initial presentation. In addition to significant improvement in clinical variables, the total radiographic score improved significantly (P =.01) during the study period, with significant improvement in the severity of bronchial (P =.01) and interstitial lung pattern (P =.04). Improvement of the clinical and radiographic score was not correlated. Conclusion and Clinical Importance: In addition to clinical signs, repeated radiographic examination can be used as a diagnostic tool to evaluate treatment response in cats with FLAD. [ABSTRACT FROM AUTHOR]

Ganoderma is the dried fruiting bodiy of Ganoderma lucidum (Leyss.ex Fr.) Karst. or Ganoderma sinense Zhao, Xu et Zhang, belonging to the family Polyporaceae, which grows mainly in tropical, subtropical, and temperate regions. As a traditional Chinese medicine, Ganoderma has been used in China for more than 2000 years because of its medicinal properties, such as relieving cough and asthma, providing nourishment, and strengthening. Currently, more than 470 natural compounds have been obtained from the fungus, mainly including terpenoids, steroids, alkaloids, phenols, and other types of compounds. Modern pharmacological studies have shown that Ganoderma has antitumor, anti-inflammatory, hypoglycemic, hypolipidemic, and immunomodulatory effects. It is mainly used in clinical practice for the treatment of Diabetic Nephropathy and malignant tumors, with few side effects and high safety. This paper reviews the progress of research on its chemical composition, pharmacological effects, and clinical applications, with the goal of providing a basis for the better development and utilization of Ganoderma. [ABSTRACT FROM AUTHOR]

COPD is a heterogeneous disease, and its acute exacerbation is a major prognostic factor. We used cluster analysis to predict COPD exacerbation due to subtypes of mild–moderate airflow limitation. In all, 924 patients from the Korea COPD Subgroup Study cohort, with a forced expiratory volume (FEV1) ≥ 50% and documented age, body mass index (BMI), smoking status, smoking pack-years, COPD assessment test (CAT) score, predicted post-bronchodilator FEV1, were enrolled. Four groups, putative chronic bronchitis (n = 224), emphysema (n = 235), young smokers (n = 248), and near normal (n = 217), were identified. The chronic bronchitis group had the highest BMI, and the one with emphysema had the oldest age, lowest BMI, and highest smoking pack-years. The young smokers group had the youngest age and the highest proportion of current smokers. The near-normal group had the highest proportion of never-smokers and near-normal lung function. When compared with the near-normal group, the emphysema group had a higher risk of acute exacerbation (OR: 1.93, 95% CI: 1.29–2.88). However, multiple logistic regression showed that chronic bronchitis (OR: 2.887, 95% CI: 1.065–8.192), predicted functional residual capacity (OR: 1.023, 95% CI: 1.007–1.040), fibrinogen (OR: 1.004, 95% CI: 1.001–1.008), and gastroesophageal reflux disease were independent predictors of exacerbation (OR: 2.646, 95% CI: 1.142–6.181). The exacerbation-susceptible subtypes require more aggressive prevention strategies. [ABSTRACT FROM AUTHOR]

Simple Summary: To date, the etiology of feline chronic inflammatory bronchial disease, including feline asthma, chronic bronchitis, and mixed inflammatory forms, has not extensively been investigated. By measuring allergen-specific immunoglobulin E from the serum of cats with different types of inflammatory bronchial disease and healthy cats, we aimed to obtain information on serum reactions to environmental allergens. No significant differences were found in the number of positive immunoglobulin E-reactions between affected and healthy cats. Significantly, more cats with mixed airway inflammation reacted to mites. Sensitization to environmental allergens can be detected in healthy and diseased cats. Therefore, positive reactions must always be interpreted in the context of clinical signs and environmental conditions. The etiology of feline inflammatory bronchial disease is poorly understood. This study compares the degree of allergen-specific serum IgE responses between cats with feline asthma, chronic bronchitis, mixed inflammation, and clinically healthy cats (HCs). The retrospective case–control study used serum from eighteen cats with eosinophilic inflammation (EI), ten with neutrophilic inflammation (NI), six with mixed inflammation (MI), and fourteen HCs. Affected cats were categorized into groups based on bronchoalveolar lavage cytology. The measurement of IgE for 34 different allergens including fungal organisms, weeds, grasses, trees, mites, and insects was performed using an indirect ELISA. Positive reactions to allergens were detected in the serum of 17/18 cats with EI, 8/10 with NI, 6/6 with MI, and 11/14 HCs (p = 0.364). When overall positive reactions were compared between groups, cats with MI (p = <0.01) had significantly more positive reactions against mite allergens than HCs. Blood eosinophils inversely correlated with the absolute amount of allergen-specific serum IgE expressed in ELISA absorbance units (EAs) (p = 0.014). Sensitization against dust mites seems to be more prevalent in cats with MI. However, positive IgE reactions can be observed in healthy and diseased cats, and, therefore, need to be interpreted in the light of clinical findings and environmental conditions of individual patients. [ABSTRACT FROM AUTHOR]

AIM: To investigate the effect of scutellarin combined with polydatin on pulmonary and bronchial injury induced by lipopolysaccharide （LPS） combined with smoking in rats and its mechanism. METHODS: Male SD rats were randomly divided into control group, model group, Huangqin Jingye-Huzhang decoction （5 g/kg） group, scutellarin （40 mg/kg） group, polydatin （60 mg/kg） group, scutellarin+polydatin （20 mg/kg+30 mg/kg, 40 mg/kg+60 mg/kg and 80 mg/kg+120 mg/kg） groups, and Guilong Kechuanning tablet （1 g/kg） group, with 10 rats each group. Chronic bronchitis model was established in 90 rats. The levels of interleukin-1β（ IL-1β）, IL-6, IL-17A, IL-10 and tumor necrosis factor-α （TNF-α） in bronchoalveolar lavage fluid （BALF） and serum were measured by ELISA, and the levels of superoxide dismutase （SOD） and malondialdehyde （MDA） in lung tissues were detected using kits. Protein content and cell counts in BALF were determined. Wet/dry（ W/D） mass ratio of the right lung was estimated, and HE staining was used to observe the pathological changes of pulmonary and bronchial tissues and score the lung tissue injury. The mRNA expression of phosphatidylinositol 3-kinase （PI3K）, protein kinase B （PKB/AKT） and mammalian target of rapamycin （mTOR） was detected by RT-qPCR. The protein levels of p-PI3K, PI3K, p-AKT, AKT, p-mTOR and mTOR were detected by Western blot. RESULTS: Compared with control group, the levels of IL-1β, IL-6, protein, leukocytes and neutrophils in BALF, the levels of IL-17A and TNF-α in serum, the content of MDA in lung tissues and the W/D mass ratio of the right lung in model group were significantly increased （P<0. 01）, while the content of IL-10 in serum and the activity of SOD in lung tissue were significantly decreased（ P<0. 01）. The protein levels of p-PI3K, p-AKT and p-mTOR were significantly up-regulated （P<0. 01）. Compared with model group, the levels of IL-1β, IL-6, protein, white blood cells and neutrophils in BALF, the levels of IL-17A and TNF-α in serum, the content of MDA in lung tissues and the W/D mass ratio of the right lung in scutellarin+polydatin （20 mg/kg+30 mg/kg, 40 mg/kg+60 mg/kg and 80 mg/kg+120 mg/kg） groups were significantly lower than those in model group（ P<0. 01 or P<0. 05）, while the content of IL-10 in serum and the activity of SOD in lung tissue were significantly increased （P<0. 01）. The pulmonary and bronchial inflammatory response was alleviated, and the injury was obviously attenuated. The protein levels of p-PI3K, p-AKT and p-mTOR were significantly down-regulated （P<0. 01）. CONCLUSION: Scutellarin combined with polydatin protects pulmonary and bronchial tissues against the injury induced by LPS combined with smoking in rats. The mechanism may be related to inhibiting the activation of PI3K/AKT/mTOR pathway, reducing oxidative stress and inhibiting inflammatory factors such as IL-17A, TNF-α, IL-1β and IL-6. [ABSTRACT FROM AUTHOR]

Occupational exposure to cotton dust is still an important cause of respiratory problems in textile workers particularly in less developed countries like Egypt. Evaluate respiratory symptoms and diseases, and pulmonary function pattern among Egyptian textile workers. Cross sectional comparative study was conducted from December 2019 to September 2020 in a textile factory in Egypt; 364 male workers (184 cotton dust exposed workers, and 180 unexposed workers) were included. Participants were subjected to an interviewing questionnaire, British Medical Research Council questionnaire, anthropometric measurements, pulmonary function tests, and byssinosis grading format. Descriptive and analytic statistics were conducted. Chronic cough, phlegm production, and shortness of breath grade I, II and III were more reported in cotton dust exposed workers than unexposed workers (P<0.01, P<0.01, and P=0.02, respectively). Prevalence of chronic bronchitis was significantly higher among cotton dust exposed workers (12%) than unexposed workers (3.9%) (P<0.01). The mean percent predicted values of lung function indices reflecting large-1irway function (VC, FVC, FEV1, FEV1%, PEFR, and FEF75) were significantly lower in cotton dust exposed workers (P<0.01). Prevalence of byssinosis was 22.8%. Workers with byssinosis had significantly higher prevalence of respiratory symptoms, chronic bronchitis, cross-shift reduction in PEFR and significant decrease in mean percent predicted values of FVC, FEV1, PEFR, FEF75, and FEF50 than workers without byssinosis. This study revealed a substantial association between cotton dust exposure at work and respiratory symptoms and morbidity. Regular measurement of cross shift change in PEFR is recommended among exposed workers for early diagnosis of byssinosis. [ABSTRACT FROM AUTHOR]

Smoking has been associated with an increased risk of asthma, lung cancer, cardiovascular diseases, chronic bronchitis, and a massive amount of oxidative stress. The present study was undertaken to determine the modulatory effects of Holi Basil/Tulsi, (Ocimum sanctum) leaf extract on cigarette smoke-induced pulmonary damage in mice. Cigarette smoke (CS) inhalation increased the levels of pulmonary lipid peroxidation, and reactive oxygen species and decreased the levels of glutathione. Histoarchitectural alterations and enhanced tissue lactate dehydrogenase (LDH) activity in pulmonary tissue was distinctly indicative of damage. Enhanced mucin production was also observed through mucicarmine and Alcian Blue-Periodic Acid Schiff (PAS) staining. Increased expression of MUC5AC was also observed. Alterations in the lung were also evident through FTIR studies. Administration of Ocimum sanctum leaf extract (80 mg/kg b.w) to CS exposed mice ameliorated these alterations to a greater extent. These findings are suggestive of the fact that Ocimum sanctum leaf extract effectively modulated CS-induced deleterious effects on pulmonary tissue. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, is now the third cause of death worldwide, and COVID-19 infection has been reported as an exacerbation factor of them. In this study, we report that the intratracheal administration of the keratan sulfate-based disaccharide L4 mitigates the symptoms of elastase-induced emphysema in a mouse model. To know the molecular mechanisms, we performed a functional analysis of a C-type lectin receptor, langerin, a molecule that binds L4. Using mouse BMDCs (bone marrow-derived dendritic cells) as langerin-expressing cells, we observed the downregulation of IL-6 and TNFa and the upregulation of IL-10 after incubation with L4. We also identified CapG (a macrophage-capping protein) as a possible molecule that binds langerin by immunoprecipitation combined with a mass spectrometry analysis. We identified a portion of the CapG that was localized in the nucleus and binds to the promoter region of IL-6 and the TNFa gene in BMDCs, suggesting that CapG suppresses the gene expression of IL-6 and TNFa as an inhibitory transcriptional factor. To examine the effects of L4 in vivo, we also generated langerin-knockout mice by means of genome editing technology. In an emphysema mouse model, the administration of L4 did not mitigate the symptoms of emphysema as well as the inflammatory state of the lung in the langerin-knockout mice. These data suggest that the anti-inflammatory effect of L4 through the langerin-CapG axis represents a potential therapeutic target for the treatment of emphysema and COPD. [ABSTRACT FROM AUTHOR]

Interventional pneumology (IP) has rapidly developed over the past 120 years, evolving from a diagnostic procedure to a therapeutic option for lung diseases. IP techniques such as endobronchial ultrasound and cryobiopsy have revolutionized the diagnosis and staging of lung diseases. Additionally, IP procedures have shown promise in treating conditions such as chronic obstructive pulmonary disease (COPD) and severe asthma. However, the acceptance of IP by payers and the lack of training structures for new developments remain challenges. Overall, IP is expected to become increasingly recognized and offer effective diagnostic and therapeutic methods for lung patients. [Extracted from the article]

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and its global health burden is increasing. COPD is characterized by emphysema, mucus hypersecretion, and persistent lung inflammation, and clinically by chronic airflow obstruction and symptoms of dyspnea, cough, and fatigue in patients. A cluster of pathologies including chronic bronchitis, emphysema, asthma, and cardiovascular disease in the form of hypertension and atherosclerosis variably coexist in COPD patients. Underlying causes for COPD include primarily tobacco use but may also be driven by exposure to air pollutants, biomass burning, and workplace related fumes and chemicals. While no single animal model might mimic all features of human COPD, a wide variety of published models have collectively helped to improve our understanding of disease processes involved in the genesis and persistence of COPD. In this review, the pathogenesis and associated risk factors of COPD are examined in different mammalian models of the disease. Each animal model included in this review is exclusively created by tobacco smoke (TS) exposure. As animal models continue to aid in defining the pathobiological mechanisms of and possible novel therapeutic interventions for COPD, the advantages and disadvantages of each animal model are discussed. [ABSTRACT FROM AUTHOR]

Background & Objectives: Chronic Obstructive Pulmonary Disease (COPD) is the illness with airflow obstruction caused by emphysema, chronic bronchitis, or a combination of both the disorders. It is the third leading cause of death worldwide. Between 20 and 40% of all COPD patients across the globe are never smokers. The primary objective of this study was to evaluate Pulmonary Function Tests (PFTs) in non-smoker COPD patients and compare their results with normal healthy subjects. The study also intended to check the variations in lung function of COPD patients living in urban & rural areas. Materials & Methods: The study was conducted by performing PFTs in 50 non-smoker COPD patients (28 from urban & 22 from rural areas) & comparing them with 50 non-smoker healthy subjects of same age group excluding ex-smokers. Various parameters of PFTs like FVC, FEV1, FEV1/FVC, PEFR & MVV were assessed & compared. For statistical data analysis unpaired t-Test was applied. Results: The mean values of PFT parameters such as FVC, FEV1, FEV1/FVC, PEFR & MVV are very significantly differed between COPD patients & healthy subjects (p<0.01). Although the data is not statistically significant between total COPD patients, urban & rural COPD patients, mean values of above PFT parameters are higher in total COPD patients than urban while higher in rural compared to total COPD patients (p>0.05). The mean values of above PFT parameters are not significant statistically between urban & rural COPD patients (p>0.05). Conclusion: The study indicates that as compared to normal subjects, in patients of COPD there is great reduction in mean values for FVC, FEV1, PEFR, FEV1/FVC%, & MVV irrespective of their residing location which is suggestive of an increase air way obstruction with reduced values of various PFT parameters. The study also shows that there is no significant difference in mean values of various parameters between urban & rural areas. [ABSTRACT FROM AUTHOR]

Background: COPD exacerbation is characterized by both airway and systemic inflammation. The present study aimed to investigate the relationship between serum levels of some inflammatory biomarkers and the phenotypes of COPD exacerbation. Materials and Methods: This study includes known COPD patients, presenting to a hospital with acute exacerbation of COPD. Serum levels of CRP, ESR, CBC, TNF-a, IL-8, and IL-6 were measured at the time of admission. According to the previously done HRCT, the patients were divided into two groups including emphysema and chronic bronchitis. Levels of serum biomarkers were compared in the two groups. The relationships between biomarkers and duration of hospitalization were assessed too. Results: Comparison of quantitative CRP levels, WBC, and platelet counts did not show a statistically significant difference between emphysema and chronic bronchitis but it was significantly higher than control subjects. Although not statistically significant, ESR level was higher in emphysema. TNF-alpha was 6.0±1.5 ng / ml and 1.5 ng / ml in the emphysema and chronic bronchitis groups, respectively. TNF-a had no significant difference compared to the groups. Although higher than the control group, IL-6 and IL-8 did not show significant differences between emphysema and chronic bronchitis. The two groups did not statistically differ in terms of hospital stay but patients with higher serum TNF-a tended to have longer hospitalization and ICU admission. Conclusion: The present study showed predictably higher inflammatory biomarkers in COPD exacerbation but no significant difference between the two phenotypes of COPD and these two entities could not be discriminated based on inflammatory bio-factors. [ABSTRACT FROM AUTHOR]

COPD is a condition characterized by chronic airflow obstruction resulting from chronic bronchitis, emphysema, or both. The clinical picture is usually progressive with respiratory symptoms such as exertional dyspnea and chronic cough. For many years, spirometry was used to establish a diagnosis of COPD. Recent advancements in imaging techniques allow quantitative and qualitative analysis of the lung parenchyma as well as related airways and vascular and extrapulmonary manifestations of COPD. These imaging methods may allow prognostication of disease and shed light on the efficacy of pharmacologic and nonpharmacologic interventions. This is the first of a two-part series of articles on the usefulness of imaging methods in COPD, and it highlights useful information that clinicians can obtain from these imaging studies to make more accurate diagnosis and therapeutic decisions. [ABSTRACT FROM AUTHOR]

Silver nanoparticles (AgNPs) occupy a major part in biomedicine due to their unique physicochemical and biological properties including anti-microbial and anti-cancer activity. Evolvulus alsinoides (EA), commonly known as "Dwarf morning glory", is a flowering plant with unique medicinal properties. This plant is reported for its therapeutic significance in chronic bronchitis, asthma and even possesses higher pharmacological properties. In this study, we have reported the synthesis and biological properties of quercetin functionalized biogenic silver nanoparticles (Qur-EA-AgNPs). AgNPs were synthesized using EA Leaf extract and functionalized with Quercetin. Qur-EA-AgNPs were characterized using various techniques and their biocompatibility was investigated. The UV-Visible spectrum of EA-AgNPs revealed a maximum absorbance at 428 nm and quercetin functionalization results in a shift towards 390 nm. The intense peak in the Fourier-transform infrared spectroscopy (FTIR) spectra revealed the quercetin functionalization on EA-AgNPs. Scanning electron microscope (SEM) results confirmed the spherical morphology of quercetin-functionalized AgNPs with a size range around 20 nm which was further confirmed by High resolution transmission electron microscope (HRTEM). Energy Dispersive X-ray (EDX) spectrum evidenced the presence of Ag, C and O. Hemocompatibility of Qur-EA-AgNPs was confirmed from hemolytic assay showing < 5% hemolysis. Moreover, Annexin V PI assay on Qur-EA-AgNPs treated peripheral blood mononuclear cells (PBMCs) showed 78.58 % viability significantly which is comparable with the control cells and its biocompatible nature was proved. In the current study, quercetin-functionalized biogenic silver nanoparticles using E. alsinoides leaf extract have been fabricated and characterized using various techniques. TEM micrograph of functionalized nanoparticles revealed spherical-shaped particles. EDX analysis showed a major elemental composition of silver, carbon and oxygen. The particles are biocompatible towards PBMCs and the erythrocytes. [ABSTRACT FROM AUTHOR]

It has long been recognized that harmful inhaled workplace exposures can contribute to the development of chronic obstructive pulmonary disease (COPD). This article, intended for the clinician, summarizes some of this evidence and some areas of controversy. Current estimates based on pooled epidemiological analyses of population-based studies identify that approximately 14% of the burden of COPD (and 13% of the burden of chronic bronchitis) is attributable to such exposures. In addition to these approaches, various studies implicate specific exposures as contributing. Certain of these relating to cadmium, coal, and respirable crystalline silica are discussed in more detail. Despite this amassed evidence to date supporting associations between COPD and workplace exposures, there have been surprisingly few studies that have attempted to assess the attribution by experts of an occupational cause in cases of COPD. One study, using hypothetical cases of COPD, noted that while expert physicians were willing to make such an occupational link, this was only likely in cases with light smoking histories and a priori defined heavy occupational exposures. Relatively recent data relating to computed tomography (CT) scan appearances may give the clinician a further guide. Several studies from populations have now linked potentially harmful occupational exposures specifically with the presence of emphysema on CT scanning. It will be of interest to see if this finding, along with other clinical attributes of cases such as smoking and family histories, exclusion of asthma, genetic data, and the nature of workplace exposures, will increase the future diagnosis by clinicians of occupational COPD. In the interim, while better diagnostic approaches are developed, we suggest that consideration of an occupational cause is an important part of the clinical investigation of cases of COPD. Finally, we suggest that evidence-based workplace preventive strategies for occupational COPD should be informed by knowledge of which exposures are most important to reduce, and whether and when intervention to reduce exposure at an individual worker level is warranted. [ABSTRACT FROM AUTHOR]

The objectives of the present investigation were to formulate and evaluate medicated oral jellies containing Ambroxol HCl, which is the most used mucolytic agent in the treatment of chronic bronchitis and formulate and evaluate medicated oral jellies containing Ibuprofen which is recognized as a nonsteroidal anti-inflammatory drug. Medicated jellies with Amb or Ibu contain the following gelling agents: gelatin (Gel), sodium alginate (Alg), pectin (Pec). Prior to jellies preparation, a compatibility study was performed for each moist binary mixture between Ibu or Amb, with each medicated jelly preparation component. Active substances, moist binary mixtures, and medicated jellies were analyzed using FTIR-UATR and thermogravimetry (TGA). [ABSTRACT FROM AUTHOR]

Cigarette smoke (CS)-induced oxidative stress drives the pathogenesis of respiratory diseases, in which the activation and accumulation of reactive oxygen species (ROS) play an important role. Ferroptosis, a regulated cell death induced by Fe2+-dependent, lipid peroxidation, and ROS, is closely related to CS-induced airway injury disease, but its mechanism remains unclear. We found that bronchial epithelial ferroptosis and expression of iNOS in smoking patients were significantly higher than that in non-smokers. The iNOS, induced by CS exposure, was involved in bronchial epithelial cell ferroptosis, whereas genetic depletion or pharmacologic inactivation of iNOS attenuated the CS-induced ferroptosis and mitochondrial dysfunction. Our mechanistic studies found that SIRT3 directly bound to and negatively regulated iNOS to mediate ferroptosis. Moreover, we found that the Nrf-2/SIRT3 signal was deactivated by cigarette smoke extract (CSE)-induced ROS. Collectively, these results linked CS to human bronchial epithelial cell ferroptosis through ROS deactivation of the Nrf-2/SIRT3 signal to promote iNOS expression. Our study provides new insights into the pathogenesis of CS-induced tracheal injury diseases such as chronic bronchitis, emphysema, and chronic obstructive pulmonary disease. • Human lung tissues are used to confirm that cigarette smoke induces ferroptosis in bronchial epithelium. • ROS is a key factor in the bronchial epithelium ferroptosis caused by cigarette smoke. • Activation of Nrf-2/SIRT3 inhibits ferroptosis in the bronchial epithelium. • Inactivating iNOS inhibits ferroptosis in the bronchial epithelium. • SIRT3 binds directly to iNOS and inhibits its expression and activity. [ABSTRACT FROM AUTHOR]

Background: Chronic airflow obstruction (CAO) is a chronic lung condition that interferes with normal breathing. In common practice, CAO includes chronic obstructive pulmonary disease (COPD), asthma, chronic bronchitis, and emphysema. The present study was planned to be carried out in a tertiary care center to evaluate the profile of patients with chronic airflow obstruction with an aim to establish a cause-effect relationship between various disorders with chronic airflow obstruction. Aims and Objectives: The aim of the study was to find out the prevalence of different respiratory diseases among patients diagnosed as cases of chronic airflow obstruction and to evaluate the clinical and demographic profile of patients to find out risk factors and their role in etiology of chronic obstructive airflow. Materials and Methods: We studied demographic details of the patients, smoking history, biomass exposure, and tubercular history. All the patients were clinically examined and were subjected to pulmonary function assessment. The diagnosis of the patients was made on the basis of clinical features and outcome of spirometry. COPD was graded depending on post-bronchodilator FEV1% predicted as (GOLD, 2022). Results: Among patients with chronic airway obstruction, the number of patients diagnosed as COPD was highest (68%) followed by bronchial asthma (19%) and bronchectasis (13%). Among COPD population, 48% were smokers and 20% were non-smokers. Age of patients with bronchial asthma was significantly lower than that of other groups. In the present study, proportion of males diagnosed as COPD (NS) was significantly lower (P<0.001) as compared to other groups. Conclusion: The findings in the present study highlighted that different types of CAO can affect a wide variety of population groups and share a number of risk factors; however, some demographic and clinical factors help in understanding the specific risks and type of disorder. A Change in environmental conditions and lifestyle can change the spectrum of CAO disorders. [ABSTRACT FROM AUTHOR]

Chronic Obstructive Pulmonary Disease (COPD) is a highly prevalent and morbid disease marked by irreversible structural changes in the lungs. Bronchoscopic therapies have significantly expanded the treatment armamentarium for patients with persistent symptoms by reducing the physiologic detriments of hyperinflation in a less invasive fashion than surgical lung volume reduction. The spectrum of bronchoscopic techniques to reduce hyperinflation includes endobronchial valves, coils, thermal ablation, and biologic sealants. Other therapies focus on reducing parasympathetic tone and mucus hypersecretion and include targeted lung denervation, bronchial rheoplasty, and cryospray techniques. In this article, we will review the variety of techniques for bronchoscopic lung volume reduction, both established and investigational, along with their respective benefits and complications and will briefly review other investigational therapies for COPD. [ABSTRACT FROM AUTHOR]

Introduction: Most household cleaners contain chlorine, an irritating chemical commonly used to purify water. The inhalation of chlorine causes chemical pneumonitis and the treatment of inhalation injuries from this chemical is difficult due to the lack of evidence and human studies. We will discuss a case of a man, who developed chemical pneumonitis after being exposed to chlorine fumes while cleaning swimming pool. Case Presentation: A 30-year-old man showed up after being exposed to 33% hydrochloric fumes at work and developed coughing, sore throat, and dyspnea immediately. He received initial treatment at nearby clinic and referred to the emergency department. In emergency department, he was in respiratory distress. His respiratory rate was 28 breaths per minute and oxygen saturation was 81% with a 15 L/min non-rebreathing mask. Lung auscultation showed crepitation in both lower zones with expiratory rhonchi. Noninvasive ventilation support was initiated with continuous nebulization of salbutamol, ipratropium bromide, and sodium bicarbonate. His initial blood gases showed type 1 respiratory failure. He was then intubated for severe acute respiratory distress syndrome. The patient was then admitted to the intensive care unit for further treatment and discharged after 18 days of hospitalization. Conclusion: Acute exposure to chemical irritants can cause asthma exacerbation, chronic bronchitis, bronchial hypersensitivity, and ARDS. There are no biomarkers for the inhalation of HCL gas. Medical history, clinical symptoms, and radiographic findings are decisive factors in the diagnosis. Treatment usually focuses on supportive care such as oxygen therapy, broncholytic therapy, and sodium bicarbonate, inhaled or systemic corticosteroids. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) affects 210 million people worldwide and kills > 4 million people every year, accounting for around 9% of total deaths. Ninety percent of these deaths occur in low- and middle-income countries. It is projected to be the 3rd leading cause of death by 2030. Its chronic nature causes disruption of normal social roles, reduced workability, and poses massive burden on direct and indirect costs. According to the World Health Organization report, the prevalence of COPD ranges between 4% and 20% in the Indian adults. Aim & Objective: 1 Study risk factors, clinical profile of bronchitis and emphysema 2. Study the Association of chronic bronchitis and emphysema with various factors Methods: Study design: Prospective Observational Study. Study setting: Medicine ward tertiary care centre. Study duration: 2 years. Study population: The study population included all the cases with chronic bronchitis, emphysema admitted at a tertiary care center. Sample size: 200 Results: majority of study participants belongs to the age group of 51-60 years e.g 67 cases (33.50%) followed by 41-50 years 54 (27%), 48 (24%) cases found in 31-40 years age group and 31 (15.50%) cases was found in 18-30 years age group. majority of study participants were males contributing 138 (69%) and Females 62 (31%). majority of cases associated with HTN 61 (30.50%) followed by Asthma 47 (23.50%), 28 cases found no associated comorbidity, 27 cases had a history of DM, Anxiety found in 12 (6%) and Rhinitis found in 17 (8.50%). There is statistically highly significant association between age and Chronic Bronchitis. There is statistically significant association between Emphysema with gender. Conclusions: High prevalence of COPD was found in males. Majority of cases found with Chronic Bronchitis. There is statistically highly significant association between age and Chronic Bronchitis. There is statistically significant association between Emphysema with gender [ABSTRACT FROM AUTHOR]

Background: Both chronic bronchitis and emphysema are part of COPD. Having a productive cough at least three times a week for more than two years is diagnostic of chronic bronchitis. Methods: Outpatients and inpatients at the Department of Pulmonology, Shadan Institute of Medical Sciences, Hyderabad, Telangana, India, were the subjects of a prospective research conducted between June 2021 to May 2022. The research involves sixty participants. Results: However, a diagnosis of COPD requires the use of spirometry. The effects of COPD on one's health and quality of life can be measured using a CAT score. Even in a rural situation where most COPD patients do not have access to spirometry, both the 6MWT and the CAT score may be employed. Conclusion: The results of this study suggest that the 6-minute walk test can replace the FEV1 as a means of measuring COPD severity. Spirometry is not required in order to determine the severity of COPD every time. [ABSTRACT FROM AUTHOR]

Introduction Diaphragm is considered a key point in the prognosis of acute chronic obstructive pulmonary disease (COPD) exacerbations. Diaphragmatic performance is an issue that is not fully studied in different COPD phenotypes. Aim To assess diaphragmatic performance by chest ultrasound (US) in patients with two COPD phenotypes admitted to respiratory ICU with an acute exacerbation and to assess its relation to outcome. Patients and methods US assessment of diaphragm position, excursion, inspiratory time, velocity, thickening fraction, and excursion-time (E-T) index was done for 100 patients with COPD with two phenotypes, that is, chronic bronchitis (CB) and emphysema (E), who were admitted at the respiratory ICU of Abbassia Chest Hospital. Assessment was done for all patients within 24h of admission. Primary end point was the need for mechanical ventilation (MV) and secondary end point was discharge or ICU mortality. Results Position of the diaphragm was at the –six to eight intercostal space, with mean of 7.114±0.404, in the E group and at the –five to seven intercostal space, with a mean of 5.946±0.524, in the CB group, with P value less than 0.001. There was a higher velocity in E (3.324±1.151cm/s) compared with CB (2.757±1.023cm/s), with P=0.011, and a higher expiratory thickness in CB (3.312±0.806) versus E (2.584±0.786mm), with P value less than 0.001. Regarding the need for MV, 62 (62%) cases required MV (nine noninvasive mechanical ventilation and 53 invasive mechanical ventilation). The need for MV was higher in E compared with CB group (35/50 cases, 70%, and 27/50 cases, 54%, respectively; P<0.001). There was a significant shorter inspiratory time and a lower E-T index in both phenotypes among patients who required MV (P=0.007 and 0.045, respectively). The cutoff value of the inspiratory time and the E-T index in predicting the need to MV was less than 0.65s and less than 1cm/s, respectively. Conclusion US assessment of the diaphragm during acute COPD exacerbations may help anticipate the need for MV. The need of MV was related to a shorter inspiratory time (cutoff point <0.65s) and a lower E-T index (cutoff point <1cm/s). There was no difference between CB and E phenotypes in this aspect. [ABSTRACT FROM AUTHOR]

Background: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory pulmonary disorder with systemic inflammatory manifestations. This study aims to identify the profile of systemic inflammatory markers in the different phenotypes of COPD to help predict the disease and identify suitable treatment options. Materials and Methods: A prospective observational study was conducted on 92 patients with COPD admitted to Victoria Hospital, Bangalore between August 2021 to December 2021. Levels of C-reactive protein (CRP), Serum Creatinine, Erythrocyte Sedimentation Rate (ESR), Absolute Lymphocyte Count (ALC), Absolute Eosinophil Count (AEC), and Lactate Dehydrogenase (LDH) were measured within 48 hours of presentation. Results: Significantly higher levels of CRP were found in frequent exacerbator emphysema and chronic bronchitis phenotypes (p=0.001). The frequent exacerbator emphysema phenotype had significantly higher levels of LDH (p=0.001) and serum creatinine (p=0.001). Not surprisingly, absolute eosinophil counts were significantly raised in the overlap COPD-Asthma phenotype (p=0.001). Conclusion: Raised serum CRP levels in the frequent exacerbator phenotypes of emphysema and chronic bronchitis suggest a possible inflammatory response to an infective etiology. Raised LDH levels in frequent exacerbator emphysema phenotype could signify underlying lung parenchymal destruction. Systemic inflammation and oxidative stress can lead to skeletal muscle injury and atrophy in COPD patients. This may explain the raised serum creatinine levels in frequent exacerbator emphysema phenotype. Eosinophilia seen in Overlap COPD-Asthma phenotype is suggestive of type 2 inflammation of the airways with better response to steroids. [ABSTRACT FROM AUTHOR]

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of death worldwide and has a large impact on a patient's quality of life due to its wide range of symptoms and comorbidities. There are known to be different phenotypes in COPD with various extents on the burden of the disease and its prognosis. Chronic bronchitis with persistent cough and mucus production is regarded as one of the main symptoms of COPD with tremendous effects on subjectively reported symptom burden and frequency of exacerbations. Exacerbations in turn are known to have an impact on disease progression and increase health care costs. Modern bronchoscopic treatment options are currently under investigation targeting the problem of chronic bronchitis and frequent exacerbations. This review summarizes the existing literature about these modern interventional treatment options and provides perspectives on upcoming studies. [ABSTRACT FROM AUTHOR]

This study aimed to identify the risk factors associated with chronic bronchitis among patients seeking medical attention for respiratory conditions in Al-Najaf Al-Ashraf city, Iraq. The study employed a case-control design and recruited 134 participants using convenient sampling. Data was collected using a questionnaire consisting of four parts which included demographic characteristics, individual factors, family history, and seasonal, environmental, and nutritional factors. The majority of participants were males aged between 21 and 35 years, with 71.8% of the study group residing in rural areas and 66.3% of the control group living in urban areas. We found that asthma was the most prevalent associated disease among chronic bronchitis patients, with 64.1% reporting it. The risk factors associated with chronic bronchitis were residency, smoking, exposure to secondhand smoke, respiratory sensitivity, dust sensitivity, spring sensitivity, hay fever, asthma, pulmonary obstruction, pneumonia, pertussis, and family history. The study highlights the need for smoking cessation, physical fitness, and healthy eating habits to prevent chronic bronchitis. The findings of this study are important for healthcare professionals in Iraq to design and implement effective prevention and management strategies for chronic bronchitis. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated the incidence of respiratory diseases based on anatomical sites or the relationship between breed and these diseases. Objective: The objective of this study was to investigate the prevalence of canine respiratory diseases among dogs in Japan, with relationship to the breed. Methods: We retrospectively reviewed the medical records of dogs with respiratory symptoms and calculated the odds ratio (OR) to evaluate the relationship between breed and disease. Results: A total of 1050 dogs with respiratory symptoms were included in this study. Miniature dachshunds were the most common breed affected by respiratory diseases. Among tracheobronchial diseases, there was a significant association between some small breeds and tracheobronchial collapse, miniature dachshunds (OR: 4.44, 8.43, 95% confidence interval [CI]: 3.17–6.22, 4.33–16.0) and chronic bronchitis and bronchiectasis. Among nasal diseases, miniature dachshunds (OR: 27.2, 95% CI: 16.8–44.8) and golden retrievers (OR: 21.0, 95% CI: 6.43–69.3) were the most affected by non‐infectious rhinitis and nasal aspergillosis, respectively. Brachycephalic obstructive airway syndrome was the most common disease among pharyngeal and laryngeal diseases, with a relationship with breed being found in some brachycephalic breeds, and Pomeranians (OR: 2.7, 95% CI: 1.42–5.17). Conclusions: Respiratory diseases in dogs are strongly correlated with popular breeds in Japan. Miniature dachshunds, in particular, are associated with many respiratory diseases, which may differ from international reports. Thus, this result may help in the early detection, prevention, treatment, and elucidation of the pathophysiology of canine respiratory diseases. [ABSTRACT FROM AUTHOR]

Recent research has shown that people who suffer from chronic obstructive pulmonary disease (COPD) have a greater propensity to contract and develop tuberculosis (TB) than the general population. Not only is the hazard ratio for contracting active tuberculosis triple that of the general population for those with COPD, but that the probability of death from any cause during the first year was double that of the tuberculosis population as a whole. This observation suggests that patients with COPD are less likely to progress to latent tuberculosis infection (LTBI) and are more likely to develop active tuberculosis than the general population. While similar susceptibility rates to TB are known to occur in populations with other ailments of the lung, particularly HIV, emphysema or asthma, patients with COPD (both emphysema and chronic bronchitis) are statistically more at risk for the disease. To examine the comorbidity effects of COPD on tuberculosis disease and granuloma formation, the process by which Mycobacterium tuberculosis (Mtb) is either contained or disseminates, we used a multi-scale model that integrates pathophysiological and immunopathological aspects of COPD and TB. Depicting chronic obstructive pulmonary disease smoker and non-smoker populations, we integrate agent-based models (ABM) of cellular immune response, physiological models of pulmonary capacity for COPD smoker/non-smoker, systems biology models of macrophage immune response to Mtb, and metabolic models to capture intracellular and extracellular Mtb metabolism and proliferation. We use our model to investigate key drivers of disease outcomes of clearance, granulomabased containment, and disseminated disease in individuals with COPD and TB for smoking and non-smoking populations. [ABSTRACT FROM AUTHOR]

Among individuals with chronic respiratory conditions, transitions between patterns of tobacco product use are not well understood. This study examines how transitions, including quitting altogether, differ over time between those who do and do not have chronic respiratory conditions. Data from youth and adult participants of the longitudinal Population Assessment of Tobacco and Health Study (2013–2018) were analyzed. Youth aged 12–17 years were included if they had aged into the adult sample by Wave 4. Stratified polytomous regression models built under a first-order Markov assumption modeled the probability of transitioning between different states/patterns of tobacco product use (exclusive current E-cigarette use, exclusive current combustible tobacco product use, current dual use of combustible products and E-cigarettes, and no current tobacco product use) at each wave. Marginal transition probabilities were computed as a function of ever or past-year diagnosis of a respiratory condition (separately for asthma and a composite variable representing chronic bronchitis, emphysema, and/or chronic obstructive pulmonary disease). Analyses were conducted in 2020–2021. Most individuals, regardless of respiratory condition, maintained the same pattern of tobacco use between waves. Exclusive combustible tobacco product users, including those with or without a respiratory condition, were not likely to become exclusive E-cigarette users or to quit using tobacco entirely. Although combustible tobacco use negatively impacts the management and prognosis of respiratory illnesses, combustible tobacco users who were recently diagnosed with a chronic respiratory condition were not likely to quit using tobacco. Efforts to encourage and support cessation in this medically vulnerable population should be increased. [ABSTRACT FROM AUTHOR]

Bai He Gu Jin Tang is one of the most commonly used herbal formulas to treat dry chronic cough from Lung and Kidney Yin Deficiencies. Deficiency of these two organs can develop from internal causes (chronic disease, chronic medication) or from external causes (exogenous Heat pathogen, dry/hot environment). This formula is effective for both conditions. Common conditions for which Bai He Gu Jin Tang may be used in veterinary medicine include: acute and chronic bronchitis from a variety of causes including aging, recovery from pneumonia/heartworm disease/kennel cough, chronic drug therapy, asthma, upper respiratory tract infection, spontaneous pneumothorax and cancer of the nose and lungs. In China, herbal medicine is commonly used to treat lung cancer in humans with Bai He Gu Jin Tang as one of the most commonly used herbal formulas. The mechanism of anti-neoplastic activity was investigated with positive results drawing the conclusion that the herbal formula inhibits lung cancer growth and represents a potential integrative treatment for lung cancer. Human clinical trials have also demonstrated the utility of the herbal formula (90% effective) for patients with chronic cough characterized by dryness and heat and successful treatment of pneumonia in humans when compared to conventional therapy. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a debilitating lung disease characterised by airflow limitation, chronic bronchitis, emphysema and airway remodelling. Cigarette smoke is considered the primary risk factor for the development of COPD; however, genetic factors, host responses and infection also play an important role. Accumulating evidence highlights a role for iron dyshomeostasis and cellular iron accumulation in the lung as a key contributing factor in the development and pathogenesis of COPD. Recent studies have also shown that mitochondria, the central players in cellular iron utilisation, are dysfunctional in respiratory cells in individuals with COPD, with alterations in mitochondrial bioenergetics and dynamics driving disease progression. Understanding the molecular mechanisms underlying the dysfunction of mitochondria and cellular iron metabolism in the lung may unveil potential novel investigational avenues and therapeutic targets to aid in the treatment of COPD. [ABSTRACT FROM AUTHOR]

It is well known that air pollution has a negative impact on human health. Research has shown an increasing trend in hospital admissions due to respiratory and heart diseases during and after consecutive days of high or even medium air pollution levels. The objective of this paper is to provide quantitative and qualitative data concerning the impact of long-term air pollution on the health of residents living in the Greater Athens Area (GAA). More accurately, the prevalence of bronchitis in children and the incidence of chronic bronchitis cases in adults due to particulate matter exposure are estimated utilizing the AirQ+ model. For this purpose, daily average concentrations of particulate matter with an aerodynamic diameter less than or equal to 10 μm (PM10) from five different locations within the GAA, covering the period 2001–2020, are used. The results show a significant correlation between PM10 concentrations and adverse health effects (R2 = 0.9). Interestingly, there were more cases of children suffering from bronchitis disease than cases of adults. In addition, it was observed that the unhealthiest areas in the GAA are the center of Athens city (mean annual PM10 concentration in 2019: 36 μgr/m3), as well as suburban areas (Lykovrissi and Marousi: mean annual PM10 concentrations in 2019 were 27 μgr/m3 and 28 μgr/m3, respectively). Finally, a decreasing trend for both PM10 concentrations and the prevalence of chronic bronchitis across the GAA was observed through the examined 20 years, which was significantly higher over the period 2010–2020. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is characterized by chronic bronchitis and emphysema, and current drug treatments target its symptoms. Thus, the development of a therapeutic drug to repair alveolar destruction is urgently needed. Our previous research revealed that the synthetic retinoic acid Am80 (1.0 mg/kg) showed a repairing effect on collapsed alveoli in a mouse model of elastase-induced emphysema. However, a further reduction in the dose is desirable to facilitate the development of a powder inhalation formulation for clinical application. We, therefore, focused on SS-OP to deliver Am80 efficiently. As a result, 0.01 mg/kg of Am80-encapsulated SS-OP nanoparticles repaired collapsed alveoli and improved the respiratory function in the mouse model of elastase induced emphysema. The results suggested that, with the use of SS-OP, the Am80 dose could be reduced. This could contribute to the development of a powder inhalation system as a curative medicine for COPD. [ABSTRACT FROM AUTHOR]

OBJECTIVE To describe the current standard of care among specialists for the routine diagnostic evaluation and medical management of stable tracheal collapse in dogs. identifying gaps between practice and scientific evidence to facilitate the development of future prospective studies. A secondary objective was to describe the perceived incidence of selected comorbid disorders in dogs with tracheal collapse and the diagnostic tests performed to evaluate for those disorders. SAMPLE 180 veterinary specialists in 22 countries. PROCEDURES An electronic survey was sent to 4 specialty listservs to target diplomates. Respondents completed multiple-choice and free-response questions related to the diagnostic evaluation and treatment of a theoretical stable dog with suspected tracheal collapse. RESULTS Most respondents routinely utilized radiography, tracheobronchoscopy, and fluoroscopy to diagnose tracheal collapse and performed airway sampling, sedated airway examination, and echocardiograms to rule out comorbidities. The most frequently perceived comorbid disorders included chronic bronchitis, bronchomalacia, and myxomatous mitral valve disease. Respondents most often prescribed opioid antitussives, glucocorticoids, anxiolytics, and antibiotics as treatments. Less frequently, they utilized bronchodilators and nonopioid medications for cough. CLINICAL RELEVANCE Despite a lack of published guidelines, specialists have similar approaches in their diagnostic and therapeutic approach to a stable dog with suspected tracheal collapse and believe evaluating for comorbid disorders is important. A description of a typical diagnostic approach and knowledge of realistic treatment goals will assist the general practitioner managing dogs with stable tracheal collapse. Additionally, gaps between current practices established via this survey and data supporting those practices exist, specifically concerning the use of antibiotics and nonopioid medications for cough, representing areas for further study. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. In addition to chronic bronchitis and emphysema, patients often develop at least mild pulmonary hypertension (PH). We previously demonstrated that inhibition of inducible nitric oxide synthase (iNOS) prevents and reverses emphysema and PH in mice. Interestingly, strong iNOS upregulation was found in alveolar epithelial type II cells (AECII) in emphysematous murine lungs, and peroxynitrite, which can be formed from iNOS-derived NO, was shown to induce AECII apoptosis in vitro. However, the specific cell type(s) that drive(s) iNOS-dependent lung regeneration in emphysema/PH has (have) not been identified yet. Aim: we tested whether iNOS knockout in AECII affects established elastase-induced emphysema in mice. Methods: four weeks after a single intratracheal instillation of porcine pancreatic elastase for the induction of emphysema and PH, we induced iNOS knockout in AECII in mice, and gave an additional twelve weeks for the potential recovery. Results: iNOS knockout in AECII did not reduce elastase-induced functional and structural lung changes such as increased lung compliance, decreased mean linear intercept and increased airspace, decreased right ventricular function, increased right ventricular systolic pressure and increased pulmonary vascular muscularization. In vitro, iNOS inhibition did not reduce apoptosis of AECII following exposure to a noxious stimulus. Conclusion: taken together, our data demonstrate that iNOS deletion in AECII is not sufficient for the regeneration of emphysematous murine lungs, and suggest that iNOS expression in pulmonary vascular or stromal cells might be critically important in this regard. [ABSTRACT FROM AUTHOR]

Abelmoschus manihot (A. manihot) is a flowering plant belong to the Malvaceae family that has been used traditionally in Oman to cure bronchitis, wound and toothache. Therefore, the goal of this present study is to prepare the various crude extracts from the fruits of the plant to identify the phytochemical constituents by using Gas Chromatography-Mass Spectrometry (GC-MS) and antibacterial activity by disc diffusion method. The powder of the fruits was extracted with methanol by using maceration method for 24 to 48 hours and then the extract was filtered by using Buchner apparatus. The methanol was removed under reduced pressure and the methanol crude residue was dissolved in a mixture of alcohol-water solution and successively fractionated with hexane, chloroform, ethyl acetate, and butanol to give the corresponding fractions. All solvents were removed from under reduced pressure and the crude various extracts was used to determined their antibacterial activity against Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), Proteus vulgaris (P. vulgaris), Streptococcus pneumoniae (S. pneumoniae), and Staphylococcus aureus (S. aureus) using the disc diffusion method. In addition, the phytochemicals of each extract were identified by using GC-MS. The results showed that among the extracts hexane and water extracts had the highest antibacterial activity with the range of inhibition zone 0-10.6 mm against the applied bacterial strains. The primary phytochemicals found in the extracts were unsaturated fatty acids, terpenoids derivatives, normal and aromatic hydrocarbons, alkaloid, and flavonoids derivatives. In conclusion, the best antibacterial activity extract of the selected plant could be used for the development of antibacterial agents. [ABSTRACT FROM AUTHOR]

INTRODUCTION Diabetes mellitus is defined as the increase in blood glucose level resulting from defects in insulin secretion, insulin action, or both. The present study was conducted to evaluate anti-diabetic activity of Justicia adhatoda (Linn.) leaves extract in diabetic Wistar rats. Justicia adhatoda, commonly known as vasaka is rich in phytochemicals like alkaloids, saponins, steroids, flavonoids and glycosides. It is used in asthma, jaundice, wound healing, typhus fever, cough, chronic bronchitis and inflamma- tory swellings treatment. MATERIAL AND METHODS The extract was obtained by maceration process with the use of methanol as solvent. 30 Wistar rats of 150-250 gm were used taken as study animal. Diabetes was induced by single intraperitoneal injection of Alloxan 150 mg/kg body weight. The methan- olic extract of low dose (50 mg/kg) and high dose (100 mg/kg) were given orally for anti-diabetic activity. The standard drug glimepiride 0.5 mg/kg body weight was used. RESULTS The extract treated 50mg/kg and 100mg/kg showed significant p<0.01 reduction in blood glucose level while the standard 0.5 mg/kg showed less significant p<0.05. The standard and extract showed less significant p<0.05 body weight recovery in compar- ison to negative control group. The extract 50 mg/kg, 100 mg/kg and standard showed significant p<0.01 improvement in food intake when compared to negative control group. The extract 100 mg/kg treatment showed significant p<0.01, highly significant p<0.001 improvement in water intake on 1st, 2nd and 3rd week respectively when compared to negative control group. CONCLUSION The present study concludes that the extract possesses potent and significant anti-diabetic activity of Justicia adhatoda leaves. [ABSTRACT FROM AUTHOR]