Prolidase could be considered a sign of inflammation associated with cigarette smoking.

Objectives: Smoking causes inflammation, thickening, and narrowing of the airways. This inflammatory process is a reaction to free radicals and oxidants. Smoking affects collagen metabolism and tissue remodeling. Prolidase enzyme hydrolyzes iminodipeptides with hydroxyproline and C terminal proline. It plays a crucial role in the metabolism of collagen and the remodeling of the matrix. The present study aims to reveal the association of prolidase with inflammation caused by smoking and to compare serum prolidase levels with oxidative-antioxidative status in healthy individuals. Methods: A total of 76 participants (38 smokers and 38 nonsmokers) were involved in the present study. Serum cotinine levels were measured to show the exposure to nicotine in tobacco smoke by using the competitive inhibition enzyme immunoassay method. Serum prolidase, total oxidant status (TOS), and total antioxidant status (TAS) were determined by the enzyme-linked immunosorbent (ELISA) method, respectively. The correlation between smoking, serum prolidase levels, TOS, and TAS was investigated. Results: TAS and serum prolidase levels of smokers were considerably lower than those in non-smokers (p < 0.001, p = 0.012 respectively). However, no differences were observed in TOS between the two groups. There was no statistically significant correlation between serum prolidase levels, TAS, and TOS. Moreover, no relationship was observed between respiratory function parameters and serum prolidase levels. Conclusion: To the best of our knowledge, the present study is the first study to demonstrate the role of prolidase in smoking-related inflammation. The results achieved in the present study suggest that smoking creates an imbalance in the oxidant-antioxidant activity. Smoking decreases prolidase levels, leading to decreased collagen turnover. Chronic pulmonary disease might be related to this decrease in collagen turnover.

Mounier-Kuhn syndrome (tracheobronchomegaly): An analysis of eleven cases.

BACKGROUND AND AIM: Mounier-Kuhn syndrome (MKS) is a congenital disorder characterized by tracheobronchomegaly resulting from the absence of elastic fibers in the trachea and main bronchi or atrophy and thinning of the smooth muscle layer. In this syndrome, dead space associated with tracheobronchomegaly increases and discharge of secretions decreases because of ineffective coughing. The most common complications are recurrent lower respiratory tract infections and bronchiectasis. We examined the clinical characteristics, radiological features, and related complications of patients with MKS. METHODS: The cases were obtained between September 2007 and November 2015. Computed tomography scans of the chest were used to diagnose tracheobronchomegaly. RESULTS: All cases (a total of 11) were males with a mean age of 63 ± 13 (range, 38-80) years. The mean diameter of the trachea was 31.53 ± 2.99 mm; the mean transverse diameter was 31.69 ± 3.10 mm and the mean sagittal diameter was 31.36 ± 3.01 mm. Complaints at the time of presentation included chronic cough, purulent sputum, dyspnea, and hemoptysis. There were recurrent pulmonary infections in seven cases, bronchiectasis in six, and tracheal diverticulum in four at the time of diagnosis. CONCLUSIONS: In this article, 11 cases with various rarely seen complications are presented and evaluated in the light of current literature. We recommend that if chronic cough, recurrent pulmonary infections, and bronchiectasis seen in a patient, MKS should be kept in mind.

Endobronchial hamartoma.

Pulmonary hamartoma is a benign lung neoplasm and it comprises 6% of solitary pulmonary nodules. Two clinical types have been defined according to its location: intraparenchymal (90%) and endobronchial (10%). We report on a case of endobronchial hamartoma resected with electrocautery by a flexible bronchoscope (FB). A 57-year-old male patient was admitted to our clinic because of worsening dyspnea. The patient had been smoking 1 pack per day for 37 years. A solid smooth lesion with calcification, located in the distal part of the left main bronchus and partially obstructing the lumen of bronchus, was detected at computerized tomography. A mass lesion that moved with coughing was observed during FB. The polypoid mass was arising from the anterior wall of the left main bronchus. Punch biopsies were taken from the polypoid lesion and a diagnosis of bronchial papilloma was made after histopathologic examination. The patient underwent endobronchial electrosurgery and the lesion was excised using FB. Pathologic evaluation revealed it to be a cartilagenous hamartoma. In conclusion, endobronchial hamartomas are benign neoplasms of the tracheobronchial tree. Endoscopic treatment with flexible bronchoscopic electrocautery is safe and less invasive in experienced hands. Therefore, it should be considered as the primary treatment approach in selected cases.