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Introduction: An association between chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis has been observed. However, the incidence of this association is variable. The current use of high-resolution Chest Thoracic (CT) scans in patients with COPD has contributed to its demonstration. It is comorbidity or even an overlap syndrome. The aim of this study is to determine the characteristics of bronchiectasis in patients with COPD at the Annaba University Hospital in Algeria. Subjects and Methods: We prospectively included patients hospitalized at the Annaba University Hospital in Algeria between 1st January, 2013 to 31st December, 2015. All patients were hospitalized for an exacerbation of COPD. One hundred and twelve patients (108 men and 04 women) were enrolled in this study. These patients were classified into two groups: G1 (COPD without bronchiectasis) and G2 (COPD with bronchiectasis). The parameters considered for both the groups were the length of hospitalization, comorbidities as per the Charlson index, number of exacerbations in the previous year, quality of life assessed by the Saint Georges questionnaire, a spirométrie, and C. reactive protein (CRP). The diagnosis of exacerbation, bronchiectasis, and COPD was made. The data collected were statistically analyzed using SPSS/version 16. Parametric data were expressed as mean ± SD, and non-parametric data were expressed as the number and percentage of the total. In all tests, a p-value Results and Discussion: One hundred and twelve patients (108 men and 04 women) were included in the study. The demographic characteristics of the patients were: age (69.49 years ± 8.15), smoking (53.21 ± 48 p/y), and FEV1(42.55 ± 18.90 l/s). Of the 112 cases included, 21 had COPD associated with bronchiectasis (18.75%). This bronchiectasis was of cylindrical type in the majority of patients, i.e., 17 (80.95%), saccular in 03 cases (14.28%), and mixed in only one case (04.77%). Lesions were bilateral in 16 patients (76.19%) and unilateral in 05 patients (23.81%). FEV1 in the COPD group associated with bronchiectasis was more severe (48.7 ± 6 l/s vs. 40.2 ± 3 l/s) (OR=4.3187; 95% C.I =2.6301 - 6.8740; p Conclusion: The diagnosis of bronchiectasis should be more efficient in patients with COPD with a severe respiratory deficit, purulent sputum, accelerated CRP, and deterioration in the quality of life.

Background. Pulmonary actinomycosis (PA) is a rare and ubiquitous bacterial disorder, combining subacute or chronic focal suppuration and an expansive fibrogranulomatous lesion. Lung involvement is rare. The radioclinical manifestations of this infection are polymorphic and confusing. The form revealed by a solitary pulmonary nodule is exceptional and not documented in the literature. Case Presentation. We report a case of a 71-year-old patient, 25-year package smoker, revealed by repeated moderate-abundance hemoptysis with a rare radiological image: in the form of a solitary pulmonary nodule located at the left chest base. The negativity of bacteriological research, endoscopic samples, the failure of treatment of the bleeding by medical and embolization, and at last the suspicion of a neoplasia led us to perform a thoracotomy for diagnostic and therapeutic purposes. This surgery highlighted evidence of filamentous basophilic grains posing the diagnosis of PA. Appropriate treatment allowed a cure without recurrence after 02 years of follow-up. Conclusion. Pulmonary actinomycosis can be revealed by different radiological forms. Pulmonary actinomycosis should be considered in the presence of any solitary lung nodule in order to reduce the morbidity and cost associated with thoracotomy.

Rationale: The Global Burden of Disease program identified smoking and ambient and household air pollution as the main drivers of death and disability from chronic obstructive pulmonary disease (COPD). Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors. Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged ≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a postbronchodilator FEV1-to-FVC ratio less than the lower limit of normal, and the relative risks associated with different risk factors. Local relative risks were estimated using a Bayesian hierarchical model borrowing information from across sites. From these relative risks and the prevalence of risk factors, we estimated local population attributable risks. Measurements and Main Results: The mean prevalence of CAO was 11.2% in men and 8.6% in women. The mean population attributable risk for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index, and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: Although smoking remains the most important risk factor for CAO, in some areas, poor education, low body mass index, and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.

Rationale: Evidence supporting the association of chronic obstructive pulmonary disease or airflow obstruction with use of solid fuels is conflicting and inconsistent. Objectives: To assess the association of airflow obstruction with self-reported use of solid fuels for cooking or heating. Methods: We analyzed 18,554 adults from the BOLD (Burden of Obstructive Lung Disease) study, who had provided acceptable post-bronchodilator spirometry measurements, and information on use of solid fuels. The association of airflow obstruction with use of solid fuels for cooking or heating was assessed by sex, within each site, using regression analysis. Estimates were stratified by national income and meta-analyzed. We performed similar analyses for spirometric restriction, chronic cough, and chronic phlegm. Measurements and Main Results: We found no association between airflow obstruction and use of solid fuels for cooking or heating (odds ratio [OR] for men, 1.20 [95% confidence interval (CI), 0.94–1.53]; OR for women, 0.88 [95% CI, 0.67–1.15]). This was true for low-/middle- and high-income sites. Among never-smokers, there was also no evidence of an association of airflow obstruction with use of solid fuels (OR for men, 1.00 [95% CI, 0.57–1.76]; OR for women, 1.00 [95% CI, 0.76–1.32]). Overall, we found no association of spirometric restriction, chronic cough, or chronic phlegm with the use of solid fuels. However, we found that chronic phlegm was more likely to be reported among female never-smokers and those who had been exposed for 20 years or longer. Conclusions: Airflow obstruction assessed from post-bronchodilator spirometry was not associated with use of solid fuels for cooking or heating.

Introduction La BPCO, maladie chronique dans son evolution, systemique dans ses impacts, handicapante dans ses consequences, destructurante a l’echelle individuelle et communautaire, constitue une preoccupation de sante mondiale, nationale et locale. Ce fait n’aura de cesse de croitre devant l’epidemie tabagique qui reste de rigueur dans les pays en developpement. Malgre le caractere industriel de notre ville, la BPCO demeure meconnue et sous-diagnostiquee, notamment par les medecins de premiers recours. C’est dans ce contexte que nous avons decide de mener une etude dont l’objectif etait d’evaluer la qualite de prise en charge en soins primaires, des patients atteints de BPCO. Methodes Etude prospective transversale interessant 82 medecins generalistes assurant la consultation dans le secteur public et prive de la ville d’Annaba. Resultats L’âge moyen de notre population d’etude etait de 43,8 ans, avec des extremes de 26 et 67 ans. La predominance feminine etait de regle avec un sex-ratio de 0,37. Pour ce qui etait de l’anciennete des praticiens, la duree moyenne d’exercice etait de 15,96 ans. Par ailleurs, 51 medecins inclus dans notre travail exercaient en secteur public. En termes de connaissances et pratiques, la majorite des praticiens generalistes interroges sur la BPCO affirmaient connaitre la definition de cette pathologie mais seuls 6 reconnaissaient la dimension systemique de cette derniere. Le tabac etait communement admis comme principal facteur de risque. La moitie de l’echantillon de l’etude identifiait les signes cliniques de selection des cas suspects de BPCO. Cependant, leurs criteres de confirmation de la BPCO etaient plus radio-cliniques (55 praticiens) que fonctionnels. L’attitude des praticiens variaient entre la demande d’une spirometrie par 12 medecins et l’orientation des patients aux pneumologues par 45 autres. Tous nos participants meconnaissaient les criteres d’evaluation de la gravite de la maladie. Trente-six medecins declaraient participer a la prise en charge therapeutique des patients BPCO dont 30 uniquement dans le cadre de l’urgence. Conclusion Devant l’ampleur du probleme BPCO et l’ecart constate entre le prescrit et le reel en termes de prise en charge de cette pathologie par les praticiens de premiers recours, il est imperatif d’organiser des modules de formation continue centres sur la BPCO en vue d’ameliorer les pratiques professionnelles des medecins generalistes et ainsi optimiser la prise en charge des patients BPCO en nombre croissant.

Introduction Le deficit ventilatoire obstructif non reversible (DVONR) est un element diagnostique fondamental de la bronchopneumopathie chronique obstructive (BPCO). Cette derniere constitue une preoccupation de sante dans le monde. Qu’en est-il a Annaba (Algerie) ? La connaissance de la charge et des determinants de la maladie est le prealable a toute strategie de prise en charge. Les objectifs de notre travail sont de determiner la prevalence du DVONR au niveau d’une commune d’Annaba et de decrire les principaux facteurs de risque. Methodes Enquete transversale descriptive sur un echantillon representatif de la population de la commune âgee de 40 ans et plus selon le protocole de l’enquete Burden of Obstructive Lung Disease (BOLD). Supports : questionnaires (donnees sociodemographiques, facteurs de risque, symptomes respiratoires chroniques) et spirometrie pre et postbronchodilatation avec controle de qualite rigoureux. Definition : nous avons defini le DVONR et son degre de severite selon les criteres GOLD 2007 soit un rapport VEMS/CVF en post-bronchodilatation Resultats Sur 969 individus, 890 avaient des donnees completes. La moyenne d’âge etait de 52,9 ans. Au total, 38,9 % de la population etait ou a ete tabagique. La prevalence du DVONR etait de 8,8 %, et de 6,3 % pour le stade 2 et plus GOLD. Elle etait de 5,9 % chez les non-fumeurs. Presque 80 % des individus porteurs d’une obstruction bronchique persistante n’etaient pas connus pour maladie respiratoire. Conclusion Le DVONR, et par consequent la BPCO, est sous-diagnostique a Annaba. Le tabagisme constitue le principal facteur de risque mais non exclusif. La mise en œuvre d’un plan d’action de sante est un imperatif majeur a une prise en charge efficiente.

Inflammation and epithelial damage of the bronchial mucosa are frequently identified in children with bronchial diseases. Nevertheless, until now the quantitative assessment of the epithelial damage has never been studied in relation to clinical or respiratory function or mucus abnormalities. Bronchial biopsies and brushings were performed in 31 children with recurrent bronchitis and without atopia. The quantitative histologic data were compared with clinical results, the endoscopic appearance of the mucosa, ciliary beating frequency, mucus transport capacity, leukocyte count, and protein concentration in mucus samples. Most of the biopsies (87%) collected in this group of children without recent acute infections showed extensive epithelial damage. A significant correlation was observed between the degree of shedding and edema (p < 0.01). Bronchial epithelial edema was associated with a significantly decreased (p < 0.01) mucus transport rate. Inflammation of the submucosa was significantly correlated with lymphocyte epithelial infiltration (p < 0.01), total mucus protein content (p < 0.01), and local airway inflammation estimated by bronchoscopy. These results demonstrate that children with recurrent bronchitis develop a severe bronchial inflammation associated with an increased mucus protein content and a reduction in the mucociliary function.

We have investigated the effect of both adenosine triphosphate (ATP) and uridine triphosphate (UTP) on the fluid transport, transepithelial electric potential difference (PD), and unidirectional chloride flux when applied apically to cultured human surface respiratory epithelial (HSRE) cells in a double-compartment chamber. The effects of ATP and UTP (both 100 microM) were examined in cells either untreated or pretreated with 100 microM amiloride in lactated Ringer's solution. ATP or UTP was added to the apical solution in a 100 microliters final volume. After a 2-h incubation period, the change in fluid transport was measured by weighing the apical fluid. Compared with control, amiloride blocked the fluid absorption by HSRE cells. The addition of ATP or UTP, either alone or after pretreatment with amiloride, induced a similar and significant increase in the apical fluid and chloride flux (P0.001 and P0.005, respectively). The changes in both fluid transport and chloride flux were accompanied by changes in PD. A blocker for chloride transport, 4,4'-diisothiocyano-2,2'-stilbene disulfonate, at 500 microM significantly blocked the ATP-stimulated fluid transport (P0.05) and chloride flux (P0.01). These results support the hypothesis that extracellular ATP and UTP increase the fluid transport by respiratory epithelial cells and may be useful in the hydration of mucus and respiratory mucosa.

Human surface respiratory epithelial (HSRE) cells from nasal polyps have been cultured within collagen lattices in a serum-free defined medium. Cell growth observed over a period of 12 days showed a population doubling time of 36 h. Under these culture conditions, we observed a contraction of the lattices. Phase-contrast light microscopy and transmission electron microscopy demonstrated that the HSRE cells formed tubular ductlike structures. Lumens formed by HSRE cells were surrounded by cuboidal-shaped polarized cells with numerous ciliated cells, secretory cells, and undifferentiated cells. Epidermal growth factor (EGF) was observed to stimulate the tubule formation and the contraction of the lattices. Videomicroscopic observations and analysis of the ciliary beating frequency (CBF) demonstrated that the cilia were homogeneously distributed on the whole apical surface of the ciliated cells and that their movement was well coordinated, with a CBF similar to that observed in outgrowth cells from cultured human nasal and tracheal epithelia. Immunofluorescent staining of basement membrane components synthesized and secreted by cells revealed the presence of type III collagen around the tubules. Type IV collagen and laminin were present in the cytoplasm and at the periphery of the cells. The biotin-streptavidin-gold immunocytochemical technique with monoclonal anti-mucin antibody showed intracellular localization of mucins in secretory granules of the secretory cells. With the use of substrate gel electrophoresis polyacrylamide gels impregnated with gelatin, collagenase activity was detected in the conditioned medium of the cultured HSRE cells. These results suggest that both three-dimensional collagen gel and soluble factors such as EGF regulate tubule formation by HSRE cells. Moreover, the capacity of the epithelial cells to contract the gel suggests they may be involved in the wound healing process.

Bovine tracheal gland (BTG) cells in culture show an epithelial-fibroblastoid transition after several passages. To investigate these BTG cell phenotype changes, we studied the effects of both the culture medium and passage number on the expression of epithelial cytoskeletal proteins and glandular serous cell markers. We also analyzed the intracellular cAMP level in the basal state and after adrenergic stimulation. Three culture media were used: 1) serum-free defined medium (SFDM); 2) medium supplemented with 2% Ultroser G; and 3) medium supplemented with 10% fetal calf serum (FCS). Using immunofluorescence microscopy, we showed that, in the first 4 passages whatever the culture conditions, BTG cells expressed immunoreactivities to cytokeratin filaments and desmoplakins I and II, whereas vimentin filaments were not detected. After four passages, BTG cells cultured in 10% FCS or 2% Ultroser G became progressively fibroblastoid and showed immunoreactivities to both vimentin and cytokeratin intermediate filaments. No immunoreactivity to vimentin filaments was observed on BTG cells cultured in a SFDM. Using biochemical analysis, we showed that basal levels of cAMP in cultured BTG cells and lysozyme secretion by these cells vary according to the culture medium and passage number. It was higher in BTG cells cultured in a SFDM compared to that recovered from cells cultured in medium supplemented with Ultroser G or FCS. Whatever the culture medium, BTG cells responded to stimulation by isoproterenol. However, the results of stimulation in a SFDM were higher than in Ultroser G or FCS supplemented medium. We conclude that the BTG epithelial cell organization and the regulation of biosynthesis of secretory proteins by these cells in culture depend on both the culture medium and passage number. The maintenance of the epithelial serous phenotype of BTG cells during the first passages (1 to 4) suggests that the study of the regulation of these gland cells should be limited to these early passages.

Human airway lysozyme (HAL) was separated into fractions of distinct molecular forms using a Mono S cation-exchange column on a fast-protein liquid chromatography system. This new and rapid (30 min) purification procedure of human lysozyme enabled the preparation of fractions, highly enriched in different isoenzymes of HAL. Purified HAL from pathological purulent airway secretions, nonpurulent airway secretions, and normal tracheobronchial tissue culture medium was characterized by four, three, and only one enzymatically active molecular forms, respectively. All charge forms (separated or combined) recovered from either purulent or nonpurulent airway secretions or tracheobronchial culture medium exhibited the same apparent molecular weight of 15,000.

Bovine tracheal submucosal gland serous cells were cultured in medium supplemented with either 10% fetal calf serum or 2% Ultroser G, a commercial serum substitute for cell culture. The proteins synthesized and secreted into the culture medium during [35S]methionine pulse, chase and isoproterenol-stimulated periods were analyzed. Marked differences in the patterns of secretory radiolabeled proteins with Mr values ranging from 15000 to 95000 were observed between pulse and chase media of cells cultured in fetal calf serum and Ultroser G. In the presence of Ultroser G, albumin-like protein production was inhibited 95% as compared to cultures incubated with fetal calf serum. A bovine lysozyme-type enzymatic activity was detected only in medium from stimulated cells cultured in Ultroser G. The results suggest that bovine tracheal serous cells synthesize different proteins according to the composition of culture medium and release certain proteins when adrenergically stimulated.

We describe a method for establishing the culture of bovine tracheal submucosal gland (BTG) cells, in which we have also examined the influence of a reconstituted basement membrane matrix derived from the Engelbreth-Holm-Swarm tumor (EHS) on the growth and morphological differentiation of these cells. BTG cells have been isolated by tissue enzymatic digestion using trypsin, deoxyribonuclease I, elastase, hyaluronidase and EGTA for 1 hr at 37 degrees C. Afterwards, cells and tissue were collected by centrifugation and were incubated for 15 min with 15% newborn calf serum to inactivate the proteolytic enzymes. Enzymatic digestion using only trypsin, centrifugation and inactivation steps were repeated three times. Using this protocol, we obtained 15 +/- 4 (X 10(6] cells per g of tracheal submucosa with 72 +/- 2% (n = 5) cell viability. On microscopic observation, isolated cells were mainly composed of serous type glandular cells. Cells were cultured in a 1:1 medium of Dulbecco's Modified Eagle's/Ham's F12 supplemented with 10% fetal calf serum and subcultured in either plastic flasks or flasks coated with EHS matrix. On the plastic, the BTG cells exhibited at confluency an epithelioid appearance. They stained positively with the immunofluorescent anticytokeratin antibody and contained PAS-staining granules. By electron microscopy, lactoferrin, a protein marker specific to the serous cells, was demonstrated immunocytochemically in small secretory vesicles. BTG cells cultured on EHS matrix revealed a significantly increased growth in comparison to those cultured on plastic. In post-confluent culture of BTG cells on EHS matrix, we observed numerous dome-like structures formed by differentiated cells which were joined together around luminal spaces.

Summary Bovine tracheal submucosal gland serous cells were incubated with ( 35 S) methionine. The proteins synthesized and secreted into the culture medium during pulse and chase periods were analyzed. Three major protein bands with apparent molecular weight values of 67 kD, 47 kD and 32 kD were detected by fluorography following SDS-polyacrylamide gel electrophoresis. Based on the molecular weight, immuno-reactive cross reactivity and surface molecular charge characteristics, the labeled Mr 67 kD protein was identified as an albumin-like protein. Our results suggest that albumin found in airway secretions can originate, at least in part, from tracheal gland serous cells.