Nebulized platelet-derived extracellular vesicles attenuate chronic cigarette smoke-induced murine emphysema.

Chronic obstructive pulmonary disease (COPD) is a prevalent lung disease usually resulting from cigarette smoking (CS). Cigarette smoking induces oxidative stress, which causes inflammation and alveolar epithelial cell apoptosis and represents a compelling therapeutic target for COPD. Purified human platelet-derived exosome product (PEP) is endowed with antioxidant enzymes and immunomodulatory molecules that mediate tissue repair. In this study, a murine model of CS-induced emphysema was used to determine whether nebulized PEP can influence the development of CS-induced emphysema through the mitigation of oxidative stress and inflammation in the lung. Nebulization of PEP effectively delivered the PEP vesicles into the alveolar region, with evidence of their uptake by type I and type II alveolar epithelial cells and macrophages. Lung function testing and morphometric assessment showed a significant attenuation of CS-induced emphysema in mice treated with nebulized PEP thrice weekly for 4 weeks. Whole lung immuno-oncology RNA sequencing analysis revealed that PEP suppressed several CS-induced cell injuries and inflammatory pathways. Validation of inflammatory cytokines and apoptotic protein expression on the lung tissue revealed that mice treated with PEP had significantly lower levels of S100A8/A9 expressing macrophages, higher levels of CD4+/FOXP3+ Treg cells, and reduced NF-κB activation, inflammatory cytokine production, and apoptotic proteins expression. Further validation using in vitro cell culture showed that pretreatment of alveolar epithelial cells with PEP significantly attenuated CS extract-induced apoptotic cell death. These data show that nebulization of exosomes like PEP can effectively deliver exosome cargo into the lung, mitigate CS-induced emphysema in mice, and suppress oxidative lung injury, inflammation, and apoptotic alveolar epithelial cell death.

Smoking-Related Interstitial Lung Diseases.

Smoking-related interstitial lung diseases (ILDs) are a group of heterogeneous, diffuse pulmonary parenchymal disease processes associated with tobacco exposure. These disorders include pulmonary Langerhans cell histiocytosis, respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, acute eosinophilic pneumonia, and combined pulmonary fibrosis and emphysema. This review summarizes the current evidence of pathogenesis, clinical manifestations, diagnostic approach, prognosis, and treatment modalities for these diseases. We also discuss the interstitial lung abnormalities incidentally detected in radiologic studies and smoking-related fibrosis identified on lung biopsies.

Lack of nutrient declarations and low nutritional quality of pre-packaged foods sold in Guatemalan supermarkets.

OBJECTIVE: To assess the presence of nutrition declarations and nutritional quality in pre-packaged food products sold in Guatemala. DESIGN: We photographed nutrition labels of pre-packaged foods. We extracted information about declaration of energy, total/saturated/trans-fats, total/added sugars and Na content (critical nutrients). We classified all products according to their degree of processing (NOVA classification) and nutritional quality (PAHO and WHO-Europe nutrient profile models). SETTING: Pre-packaged foods for sale in seven supermarkets in Guatemala City. PARTICIPANTS: This study did not involve human subjects. RESULTS: We assessed 3459 pre-packaged foods, including 80 % ultra-processed, 7 % processed and 13 % unprocessed/minimally processed foods or culinary ingredients. Nutritional information was available in 3021 products (87·3 %). Energy content was declared in 87·0 %; total fats in 86·1 %; saturated fats in 81·5 %; trans-fats in 48·9 %; total sugars in 70·3 %; added sugars in 0·5 % and Na/salt in 85·5 % of products. Insufficient nutrient information made impossible to assess nutritional quality in 36·6 and 17·1 % of products with the PAHO and WHO-Europe models, respectively. Using PAHO and WHO nutrient profiles, we found that 66·2 and 50 % of food products did not meet the model's nutritional criteria. CONCLUSIONS: A high proportion of pre-packaged foods with nutritional information available in Guatemalan supermarkets do not meet the nutritional criteria recommended by WHO and PAHO. Furthermore, a high proportion of products did not declare critical nutrients and many did not even provide any nutritional information. National regulations should consider making critical nutrient declarations (including trans-fats and sugars) mandatory for all products.

Demencia en enfermos renales crónicos mayores de 55 años en Guatemala: prevalencia y factores asociados / Dementia in patients with chronic kidney disease older than 55 years in Guatemala: prevalence and associated factors

La demencia es un desorden que se caracteriza por un deterioro progresivo que limita la funcionalidad del individuo. Se han postulado varios factores de riesgo independientes para su desarrollo, entre ellos la enfermedad renal crónica. Se realizó un estudio transversal en 328 participantes mayores de 55 años, para determinar la prevalencia de demencia y los factores asociados en pacientes con enfermedad renal crónica. La función cognitiva de los participantes fue evaluada con la prueba cognitiva Montreal y el cuestionario de actividad funcional de Pfeffer. Se obtuvieron datos acerca de comorbilidades, valores de hemoglobina, creatinina sérica, índice de masa corporal y presión arterial. Se realizó un análisis descriptivo de la muestra, estimación de la de prevalencia de demencia y determinación de la asociación de factores de riesgo con el desarrollo de demencia por medio de regresión logística. El 16.6% de los sujetos fueron clasificados con demencia, IC 95% [12.82, 21.11] y 47.0% con deterioro cognitivo leve, IC 95% [41.54, 52.51]. Se encontró asociación positiva entre demencia y edad (OR 1.10, IC 95% [1.05, 1.15], p < .001), diabetes (OR 3.25, IC 95% [1.62, 6.50], p = .001), y antecedente de trauma craneoencefálico (OR 3.28, IC 95% [1.18, 9.09], p = .022). La asociación fue negativa con hemoglobina (OR 0.71, IC 95% [0.58, 0.88], p = .002) y tabaquismo (OR 0.31, IC 95% [0.13, 0.78], p = .012).

Dementia is a disorder characterized by progressive cognitive impairment, which limits the functionality of the affected individuals. Several independent risk factors have been postulated for its development, including chronic kidney disease. A cross-sectional design was performed in 328 subjects over 55 years old to determine the prevalence of dementia and associated risk factors in patients with chronic kidney disease. Two tests were administered to evaluate cognitive function: Montreal Cognitive Assessment and Pfeffer Functional Activities Questionnaire. Data of comorbidities, hemoglobin, serum creatinine, body mass index and blood pressure was collected. A descriptive analysis of the sample was performed, prevalence of dementia was estimated and associated factors were analyzed with a logistic regression model. 16.6% of subjects were classified as demented, whereas 47.0% had mild cognitive impairment. Significant association was found between: dementia and age (OR 1.10 CI 95% [1.05,1.15], p< .001), hemoglobin (OR .71 [.58, .88], p=.002, diabetes (OR 3.25 [1.62,6.50], p=.001), smoking (OR .31 [.13,.78], p=.012) and traumatic brain injury (OR 3.28 [1.18, 9.09], p=.022).