A new tidal breathing measurement device detects bronchial obstruction during methacholine challenge test.

PURPOSE: Bronchial hyperresponsiveness (BHR), a hallmark of bronchial asthma, is typically diagnosed through a methacholine inhalation test followed by spirometry, known as the methacholine challenge test (MCT). While spirometry relies on proper patients' cooperation and precise execution of forced breathing maneuvers, we conducted a comparative analysis with the portable nanomaterial-based sensing device, SenseGuard™, to non-intrusively assess tidal breathing parameters. MATERIALS AND METHODS: In this prospective study, 37 adult participants with suspected asthma underwent sequential spirometry and SenseGuard™ measurements after inhaling increasing methacholine doses. RESULTS: Among the 37 participants, 18 were MCT responders, 17 were non-responders and 2 were excluded due to uninterpretable data. The MCT responders exhibited a significant lung function difference when comparing the change from baseline to maximum response. This was evident through a notable decrease in forced expiratory volume in 1 â€‹s (FEV1) levels in spirometry, as well as in prominent changes in tidal breathing parameters as assessed by SenseGuard™, including the expiratory pause time (Trest) to total breath time (Ttot) ratio, and the expiratory time (Tex) to Ttot ratio. Notably, the ratios Trest/Ttot (∗p â€‹= â€‹0.02), Tex/Ttot (∗p â€‹= â€‹0.002), and inspiratory time (Tin) to Tex (∗p â€‹= â€‹0.04) identified MCT responders distinctly, corresponding to spirometry (∗p â€‹< â€‹0.0001). CONCLUSIONS: This study demonstrates that tidal breathing assessment using SenseGuard™ device reliably detects clinically relevant changes of respiratory parameter during the MCT. It effectively distinguishes between responders and non-responders, with strong agreement to conventional spirometry-measured FEV1. This technology holds promise for monitoring clinical respiratory changes in bronchial asthma patients pending further studies.

Changes in tidal breathing biomarkers as indicators of treatment response in AECOPD patients in an acute care setting.

PURPOSE: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a complication of COPD that typically necessitates intensified treatment and hospitalization. It is linked to higher morbidity, mortality and healthcare spending. Assessment of therapy response for AECOPD is difficult due to the variability of symptoms and limitations in current measures. Hence, there is a need for new biomarkers to aid in the management of AECOPD in acute care settings. MATERIALS AND METHODS: Fifteen hospitalized AECOPD patients (GOLD 3-4) were enrolled in this study. Treatment response was assessed daily through clinical evaluations and by monitoring tidal breathing biomarkers (respiratory rate [RR], expiratory time [Tex], inspiratory time [Tin], expiratory pause [Trst], total breath time [Ttot]), using a novel, wearable nanosensor-based device (SenseGuard™). RESULTS: Patients who showed significant clinical improvement had substantial changes in ΔTex/Ttot (+14%), ΔTrst/Ttot (-18%), and ΔTin/Tex (+0.09), whereas patients who showed mild or no clinical improvement had smaller changes (+5%, +3%, and -0.03, respectively). Linear regression between change in physician's assessment score and the median change in tidal breathing parameters was significant for Tin/Tex (R2 â€‹= â€‹0.449, ∗p â€‹= â€‹0.017), Tex/Ttot (R2 â€‹= â€‹0.556, ∗p â€‹= â€‹0.005) and Trst/Ttot (R2 â€‹= â€‹0.446, ∗p â€‹= â€‹0.018), while no significant regression was observed for RR, Tin/(Trst â€‹+ â€‹Tex) and Tin/Ttot. CONCLUSIONS: Our study demonstrates the potential of the SenseGuard™ to monitor treatment response in AECOPD patients by measuring changes in tidal breathing biomarkers, which were shown to be associated with significant changes in the patients' respiratory condition as evaluated by physicians. However, further large-scale clinical studies are needed to confirm these findings.

Neuronal Activity in the Sciatic Nerve Is Accompanied by Immediate Cytoskeletal Changes.

Mechanical events and alterations in neuronal morphology that accompany neuronal activity have been observed for decades. However, no clear neurophysiological role, nor an agreed molecular mechanism relating these events to the electrochemical process, has been found. Here we hypothesized that intense, yet physiological, electrical activity in neurons triggers cytoskeletal depolymerization. We excited the sciatic nerve of anesthetized mice with repetitive electric pulses (5, 10, and 100 Hz) for 1 and 2 min and immediately fixed the excised nerves. We then scanned the excised nerves with high-resolution transmission electron microscopy, and quantified cytoskeletal changes in the resulting micrographs. We demonstrate that excitation with a stimulation frequency that is within the physiological regime is accompanied by a significant reduction in the density of cytoskeletal proteins relative to the baseline values recorded in control nerves. After 10 Hz stimulation with durations of 1 and 2 min, neurofilaments density dropped to 55.8 and 51.1% of the baseline median values, respectively. In the same experiments, microtubules density dropped to 23.7 and 38.5% of the baseline median values, respectively. These changes were also accompanied by a reduction in the cytoskeleton-to-cytoplasm contrast that we attribute to the presence of depolymerized electron-dense molecules in the lumen. Thus, we demonstrate with an in vivo model a link between electrical activity and immediate cytoskeleton rearrangement at the nano-scale. We suggest that this cytoskeletal plasticity reduces cellular stiffness and allows cellular homeostasis, maintenance of neuronal morphology and that it facilitates in later stages growth of the neuronal projections.