Adiponectin inhibits the activation of lung fibroblasts and pulmonary fibrosis by regulating the nuclear factor kappa B (NF-κB) pathway.

Idiopathic pulmonary fibrosis (IPF) is a common pulmonary interstitial disease with a high mortality rate. Adiponectin (APN) is reportedly an effective therapy for fibrosis-related diseases. This study aimed to investigate the potential effects of APN on IPF. Male BALB/c mice were injected with bleomycin (BLM) and treated with different doses of APN (0.1, 0.25, and 0.5 mg/kg). The body weights of the mice were recorded. Immunohistochemical, hematoxylin and eosin, and Masson staining were performed to evaluate pulmonary histopathological changes. Enzyme-linked immunosorbent assay (ELISA) and western blotting were performed to assess tissue inflammation. The human lung fibroblasts HELF were stimulated with TGF-ß1 and treated with different doses of APN (2.5, 5, and 10 µg/ml). Cell proliferation, inflammation, and fibrosis were determined by MTT assay, EdU assay, colony formation assay, ELISA, and western blotting. APN significantly attenuated BLM-induced body weight loss, alveolar destruction, and collagen fiber accumulation in mice (p < 0.05). APN decreased the expression of α-SMA and collagen I and reduced the concentration of TNF-α, IL-6, IL-1ß, and IL-18 in lung tissues (p < 0.05). In TGF-ß1-treated HELF cells, cell proliferation and colony formation were inhibited by APN (p < 0.05). Additionally, the expression of α-SMA, collagen I, and pro-inflammatory cytokines were suppressed by APN (p < 0.05). APN inhibited the phosphorylation of IκB and nuclear translocation of p65. In conclusion, these findings suggest that APN is an effective agent for controlling IPF progression. The antifibrotic effects of APN might be mediated via inhibiting the NF-κB signaling pathway.

Evaluation factors of pulmonary embolism severity and prognosis.

Management of pulmonary embolism (PE) is still unclear. We summarized 16 kinds of evaluation factors of PE severity and prognosis, and we analyzed the single and joint value for short-term and long-term prognosis. Among them, biomarkers such as brain natriuretic peptide or N-terminal probrain natriuretic peptide, troponin, and heart-type fatty acid-binding protein are the best indicators of PE severity and short-term prognosis. They might replace imaging detections in evaluating PE severity. But the positive predictive value of all the biomarkers is low, and we need to improve each value through joint detection. The PE severity index and simplified PE severity index are more suitable for evaluating the overall risk and long-term prognosis. They could be used as complements of indicators of the PE severity, especially in identifying low-risk group. Integrated risk stratification and strategies of management should be established based on the 2 aspects mentioned previously.

[The value of simplified pulmonary embolism severity index and biomarkers in evaluating pulmonary embolism prognosis].

OBJECTIVE: To evaluate the value of simplified pulmonary embolism severity index (sPESI) , brain natriuretic peptide (BNP) and high-sensitivity troponin I (hs-TnI) in predicting the short-term and long-term prognosis of patients with acute pulmonary embolism. METHODS: We collected the clinical data of 162 consecutive patients with acute pulmonary embolism in The First Affiliated Hospital of Dalian Medical University from January of 2010 to September of 2012. Hospital death, shock, mechanical ventilation and cardiopulmonary resuscitation were defined as the primary endpoints while death within 38 months as the secondary endpoint. The correlations between sPESI,BNP and hs-TnI, and the primary and secondary endpoints in the overall cohort and hemodynamically stable subgroup were analyzed respectively. RESULTS: BNP, hs-TnI and sPESI were independent predictors in multivariate regression of the primary endpoints in the overall cohort. The area under ROC curve and the risk odds ratio of them were 0.87, 8.16;0.91, 6.09 and 0.78 , 14.07 respectively.Only BNP and sPESI were independent predictors in multivariate regression of the primary endpoints in hemodynamically stable subgroup.Only sPESI was an independent risk factor in COX regression of the secondary endpoint. The combination of BNP and hs-TnI further improved the positive predictive value (44.4%), while the negative predictive value was unaffected(97.8%). There was no adverse event in patients with low score of sPESI and single-positive or negative combination of BNP and hs-TnI. CONCLUSION: sPESI could reflect overall risk of pulmonary embolism.It had a high value in the evaluation of pulmonary embolism prognosis, especially for long-term prognosis.It should be integrated into the risk stratification strategy of pulmonary embolism.In the evaluation of short-term prognosis, BNP and hs-TnI were the best indicators, and the combination of BNP, hs-TnI and sPESI could further improve the prognostic value.