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1.
Med Mal Infect ; 50(4): 332-334, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32243911

RESUMO

BACKGROUND: COVID-19 is a new infectious disease, for which there is currently no treatment. It is therefore necessary to explore biomarkers to determine the extent of lung lesions and disease severity. OBJECTIVE: We aimed to assess the usefulness of CRP levels in the early stage of COVID-19 and to correlate them with lung lesions and severe presentation. METHODS: Confirmed cases of COVID-19 were selected at the Fever Unit in two regions of Guizhou, China. On admission CRP levels were collected, and the diameter of the largest lung lesion was measured in the most severe lung lesion by lung CT scan. Differences in the diameter and CRP levels were compared in the following groups of patients: mild group, moderate group, severe group, and critical group. RESULT: CRP levels and the diameter of the largest lung lesion in the moderate group were higher than those in the mild group (Mann-Whitney test=-2.647, -2.171, P˂0.05), those in the severe group were higher than those in the moderate group (Mann-Whitney test=0.693, -2.177, P˂0.05), and those in the critical group were higher than those in the severe group (Mann-Whitney test=-0.068, -1.549, P˂0.05). The difference was statistically significant. CRP levels were positively correlated with the diameter of lung lesion and severe presentation (correlation coefficient=0.873, 0.734, P˂0.001). CONCLUSION: In the early stage of COVID-19 CRP levels were positively correlated with lung lesions and could reflect disease severity.


Assuntos
Proteína C-Reativa/análise , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Progressão da Doença , Pneumopatias/sangue , Pneumopatias/patologia , Pulmão/patologia , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Adolescente , Adulto , Biomarcadores/sangue , Criança , Pré-Escolar , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Estado Terminal , Feminino , Humanos , Lactente , Pneumopatias/diagnóstico , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Adulto Jovem
2.
BMC Infect Dis ; 19(1): 1055, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842775

RESUMO

BACKGROUND: The risk factors for Mycobacterium avium complex lung disease (MAC-LD) are not well known. We hypothesized that low serum estradiol (E2) levels are related to MAC-LD as most patients with MAC-LD are postmenopausal women. METHODS: This cross-sectional study compared patients with MAC-LD and healthy controls. Study subjects were postmenopausal women aged 65 years or younger. Serum testosterone, dehydroepiandrosterone sulfate (DHEA-S), and E2 levels were measured and categorized as high or low based on median levels. We performed multivariate analysis, receiver operating characteristic (ROC) curve analysis, and age- and body mass index (BMI)-matched subgroup analysis to evaluate the association between low serum E2 levels and MAC-LD. Additionally, using blood samples obtained for other clinical studies, the levels of sex steroid hormones were compared between age- and BMI-matched MAC-LD and bronchiectasis female patients without non-tuberculosis mycobacterial infections (non-NTM BE). RESULTS: Forty-two patients with MAC-LD and 91 healthy controls were included. The median E2 (2.20 pg/mL vs. 15.0 pg/mL, p < 0.001), testosterone (0.230 ng/L vs. 0.250 ng/L, p = 0.005), and DHEA-S (82.5 µg/dL vs. 114.0 µg/dL, p < 0.001) levels were lower in the MAC-LD group than in the control group. Multivariate analysis revealed that low serum E2 (adjusted odds ratio = 34.62, 95% confidence interval = 6.02-199.14) was independently related to MAC-LD, whereas low DHEA-S and testosterone were not. ROC analysis illustrated a strong relationship between low serum E2 levels and MAC-LD (area under the curve = 0.947, 95% confidence interval = 0.899-0.995). Even the age- and BMI-matched subgroup analysis of 17 MAC-LD patients and 17 healthy controls showed lower serum E2 in MAC-LD patients than in healthy controls. Additionally, serum E2 levels of 20 MAC-LD patients were lower than plasma E2 levels of 11 matched non-NTM BE patients (1.79 pg/mL vs. 11.0 pg/mL, p < 0.001). CONCLUSIONS: Low serum E2 levels were strongly related to MAC-LD in postmenopausal women.


Assuntos
Estradiol/sangue , Pneumopatias/sangue , Pneumopatias/microbiologia , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/microbiologia , Índice de Massa Corporal , Bronquiectasia/sangue , Estudos Transversais , Sulfato de Desidroepiandrosterona/sangue , Feminino , Humanos , Japão , Pessoa de Meia-Idade , Análise Multivariada , Pós-Menopausa/fisiologia , Curva ROC , Fatores de Risco , Centros de Atenção Terciária , Testosterona/sangue
3.
Transplant Proc ; 51(6): 2009-2013, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31399181

RESUMO

BACKGROUND: The aim of the study was to investigate the serum concentration of cytokines and biochemical markers of malnutrition in correlation with frailty syndrome in patients qualified for lung transplantation (LTx). METHODS: The study population comprised 31 potential lung recipients, including 18 patients with idiopathic lung disease, 12 patients with chronic obstructive pulmonary disease, and 1 patient with bronchiectasis who qualified for a LTx. Cytokine serum levels were assessed using commercially available enzyme-linked immunosorbent assay kits and the Luminex 200 platform (ProcartaPlex Hu Cytokine/Chemokine Panel 1A 34plex, Invitrogen, Carlsbad, Calif., United States). The patients were also asked to complete a questionnaire, the Clinical Frailty Scale. RESULTS: All patients were found to have higher cytokine concentrations (IL6, IL 2,IL18, IL23, IL 12p70, IL 10, IL 7). No statistically significant differences in the analyzed cytokines were noted when the men's results were compared to those of the women. There were no significant differences between patients who scored 6 vs 7 points on the Canadian Study of Health and Aging Function Scale. In comparing chronic obstructive pulmonary disease to idiopathic lung disease patients, no significant differences were observed in the analyzed cytokine values. Significant correlations were observed between the analyzed cytokines and age of the patients, C-reactive protein, triglycerides, transferrin, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. CONCLUSIONS: Our findings indicate that cytokines may not have a statistically significant effect on the parameters of the frailty syndrome. The results require further investigations on larger study groups. The findings suggest that the analyzed cytokines may play a proinflammatory role in the end stages of lung diseases, but further studies are needed to evaluate whether these cytokines could be used as biomarkers in this group of patients.


Assuntos
Citocinas/sangue , Fragilidade/sangue , Pneumopatias/sangue , Transplante de Pulmão/efeitos adversos , Desnutrição/sangue , Adulto , Biomarcadores/sangue , Proteína C-Reativa/análise , Canadá , HDL-Colesterol , Contraindicações de Procedimentos , Ensaio de Imunoadsorção Enzimática , Feminino , Fragilidade/complicações , Fragilidade/cirurgia , Humanos , Interleucina-10/sangue , Pulmão/fisiopatologia , Pneumopatias/complicações , Pneumopatias/cirurgia , Masculino , Desnutrição/complicações , Desnutrição/cirurgia , Pessoa de Meia-Idade , Seleção de Pacientes , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/cirurgia , Triglicerídeos/sangue , Adulto Jovem
4.
Hum Exp Toxicol ; 38(11): 1227-1234, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31451031

RESUMO

Welders' lung disease refers to mixed exposure to different kinds of metals and chemicals from welding fumes, which affect all parts of the respiratory tract including airways and parenchyma together. This study aimed to investigate the oxidative status in patients with welders' lung (PWL) by means of thiol-disulfide homeostasis and ischemia-modified albumin (IMA) levels. The male welder workers diagnosed with welders' lung disease and healthy individuals were recruited in the study. Plasma levels of disulfide, disulfide/native thiol ratio, disulfide/total thiol ratio, IMA, and catalase (CAT) were determined. Pulmonary function test parameters of both groups were compared. The thiol-disulfide homeostasis parameters of PWL and control group were as follows: disulfide (20.5 ± 6.3 vs. 16.2 ± 3.9 µmol L-1, p < 0.001), disulfide/native thiol (4.36 (1.59) vs. 4.0 (1.64), p = 0.024), and disulfide/total thiol (4.01 (1.34) vs. 3.71 (1.41), p = 0.024). IMA levels in PWL were significantly higher than the control group (1.37 (0.27) mg dL-1 vs. 0.49 (0.61) mg dL-1, p < 0.001), whereas CAT activities were significantly higher in the control group (106.6 (54.5) kU L-1 vs. 78.3 (67.8) kU L-1, p = 0.003). The findings of the present study revealed that oxidative stress plays a key role in the pathogenesis of welders' lung disease. Plasma thiol-disulfide homeostasis and IMA levels might be indicators of oxidative stress in PWL.


Assuntos
Dissulfetos/sangue , Pneumopatias/sangue , Doenças Profissionais/sangue , Estresse Oxidativo , Compostos de Sulfidrila/sangue , Soldagem , Adulto , Biomarcadores/sangue , Homeostase , Humanos , Masculino , Pessoa de Meia-Idade , Albumina Sérica Humana , Adulto Jovem
5.
Analyst ; 144(16): 4813-4819, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31281909

RESUMO

In the clinical diagnosis of tumor, the immunological detection of single tumor markers may lead to errors and missed inspection. Therefore, it is necessary to establish an accurate and effective method for the simultaneous detection of multiple tumor markers. Thus, we developed a time-resolved chemiluminescence immunoassay (TRCLIA) to simultaneously detect carcinoembryonic antigen (CEA) and neuron-specific enolase (NSE) in human serum. Horseradish peroxidase (HRP) and alkaline phosphatase (ALP) were used as the detection probes to label the monoclonal antibodies of CEA and NSE by strain-promoted azide-alkyne cycloaddition (SPAAC), respectively. Based on a sandwich immunoassay, the targets in the samples were captured by antibodies immobilized on the surface of carboxylate-modified polystyrene microspheres (CPSMS) and sandwiched by other antibodies labeled with HRP and ALP. Since HRP and ALP had different dynamic characteristics, the CEA and NSE signals were recorded at 0.5 s and 20 min, respectively, and cross-interference could be avoided effectively. The whole signal detection processes could be completed in 20 min. The linear ranges of CEA and NSE were 0.1-64 ng mL-1 and 0.05-64 ng mL-1 and the limits of detection were 0.085 ng mL-1 and 0.044 ng mL-1 (S/N = 2), respectively. Also, 45 human serum samples obtained from patients having lung disease were tested by TRCLIA and commercial chemiluminescence enzyme-linked immunoassay (CLEIA) kits with good correlation. The correlation coefficients of CEA and NSE were 0.985 and 0.970, respectively. The results demonstrated a novel, effective, reliable and convenient TRCLIA method for the clinical diagnosis of CEA and NSE. The TRCLIA method has the potential to be an effective clinical tool for the early screening of lung cancer and can be applied in clinical diagnosis.


Assuntos
Antígeno Carcinoembrionário/sangue , Técnicas Imunoenzimáticas/métodos , Fosfopiruvato Hidratase/sangue , Fosfatase Alcalina/química , Anticorpos Imobilizados/imunologia , Anticorpos Monoclonais/imunologia , Armoracia/enzimologia , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/imunologia , Antígeno Carcinoembrionário/imunologia , Peroxidase do Rábano Silvestre/química , Humanos , Limite de Detecção , Luminescência , Substâncias Luminescentes/química , Medições Luminescentes/métodos , Luminol/química , Pneumopatias/sangue , Fosfopiruvato Hidratase/imunologia
6.
Int J Mol Sci ; 20(11)2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31146342

RESUMO

As the demand for multi-walled carbon nanotube (MWCNT) incorporation into industrial and biomedical applications increases, so does the potential for unintentional pulmonary MWCNT exposure, particularly among workers during manufacturing. Pulmonary exposure to MWCNTs raises the potential for development of lung inflammation, fibrosis, and cancer among those exposed; however, there are currently no effective biomarkers for detecting lung fibrosis or predicting the risk of lung cancer resulting from MWCNT exposure. To uncover potential mRNAs and miRNAs that could be used as markers of exposure, this study compared in vivo mRNA and miRNA expression in lung tissue and blood of mice exposed to MWCNTs with in vitro mRNA and miRNA expression from a co-culture model of human lung epithelial and microvascular cells, a system previously shown to have a higher overall genome-scale correlation with mRNA expression in mouse lungs than either cell type grown separately. Concordant mRNAs and miRNAs identified by this study could be used to drive future studies confirming human biomarkers of MWCNT exposure. These potential biomarkers could be used to assess overall worker health and predict the occurrence of MWCNT-induced diseases.


Assuntos
Pneumopatias/sangue , Pulmão/metabolismo , MicroRNAs/sangue , Nanotubos de Carbono/toxicidade , RNA Mensageiro/sangue , Animais , Biomarcadores/sangue , Biomarcadores/metabolismo , Linhagem Celular , Células Cultivadas , Humanos , Pulmão/efeitos dos fármacos , Pneumopatias/etiologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs/genética , MicroRNAs/metabolismo , Exposição Ocupacional , RNA Mensageiro/genética , RNA Mensageiro/metabolismo
7.
Anesth Analg ; 128(6): 1208-1216, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31094790

RESUMO

BACKGROUND: Pilot studies applying point-of-care ultrasound (POCUS) in preeclampsia indicate the presence of pulmonary interstitial edema, cerebral edema, and cardiac dysfunction. Laboratory markers of oncotic pressure (albumin) and cardiac dysfunction (brain natriuretic peptide [BNP]) may be abnormal, but the clinical application remains unclear. We investigated the prevalence of pulmonary interstitial syndrome (PIS), cardiac dysfunction, and increased optic nerve sheath diameter (ONSD) in late-onset preeclampsia with severe features. The primary aim was to examine the association between PIS or ONSD and maternal serum albumin level. The secondary aims were to explore the association between cardiac dysfunction and PIS, ONSD, BNP, and serum albumin level and between POCUS-derived parameters and a suspicious or pathological cardiotocograph. METHODS: Ninety-five women were enrolled in this prospective observational cohort study. A POCUS examination of lungs, heart, and ONSD was performed. PIS was defined as a bilateral B-line pattern on lung ultrasound and diastolic dysfunction according to an algorithm of the American Society of Echocardiography. ONSD >5.8 mm was interpreted as compatible with raised intracranial pressure (>20 mm Hg). Serum BNP and albumin levels were also measured. RESULTS: PIS, diastolic dysfunction, systolic dysfunction, and raised left ventricular end-diastolic pressure (LVEDP) were present in 23 (24%), 31 (33%), 9 (10%), and 20 (25%) women, respectively. ONSD was increased in 27 (28%) women. Concerning the primary outcome, there was no association between albumin level and PIS (P = .4) or ONSD (P = .63). With respect to secondary outcomes, there was no association between albumin level and systolic dysfunction (P = .21) or raised LVEDP (P = .44). PIS was associated with diastolic dysfunction (P = .02) and raised LVEDP (P = .009; negative predictive value, 85%). BNP level was associated with systolic (P < .001) and diastolic dysfunction (P = .003) and LVEDP (P = .007). No association was found between POCUS abnormalities and a suspicious/pathological cardiotocograph (P = .07). CONCLUSIONS: PIS, diastolic dysfunction, and increased ONSD were common in preeclampsia with severe features. Cardiac ultrasound abnormalities may be more useful than albumin levels in predicting PIS. The absence of PIS may exclude raised LVEDP. The further clinical relevance of PIS and raised ONSD remains to be established. BNP level was associated with cardiac ultrasound abnormalities. Although this study was not designed to directly influence clinical management, the findings suggest that POCUS may serve as a useful adjunct to clinical examination for the obstetric anesthesiologist managing these complex patients.


Assuntos
Coração/diagnóstico por imagem , Peptídeo Natriurético Encefálico/sangue , Sistemas Automatizados de Assistência Junto ao Leito , Pré-Eclâmpsia/sangue , Albumina Sérica/análise , Ultrassonografia Pré-Natal , Adulto , Algoritmos , Cardiotocografia , Ecocardiografia , Feminino , Cardiopatias Congênitas/sangue , Ventrículos do Coração , Humanos , Incidência , Pressão Intracraniana , Pulmão/diagnóstico por imagem , Pneumopatias/sangue , Variações Dependentes do Observador , Nervo Óptico/patologia , Valor Preditivo dos Testes , Gravidez , Prevalência , Estudos Prospectivos , Disfunção Ventricular Esquerda/fisiopatologia
8.
Dis Markers ; 2019: 8565423, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30944672

RESUMO

Purpose: Sarcoidosis is a systemic granulomatous disease with unknown etiology. Many clinical presentations have been reported, and acute disease needs to be distinguished from subacute and chronic disease. The unpredictable clinical course of the disease prompted us to evaluate the clinical utility of biomarker serum detection in sarcoidosis follow-up. Methods: Serum concentrations of chitotriosidase, ACE, KL-6, and lysozyme were analyzed by different methods in a population of 74 sarcoidosis patients (46 on steroid therapy at sampling) regularly monitored at Siena Sarcoidosis Regional Referral Centre and in a group of controls with the aim of comparing their contribution to clinical management of sarcoidosis patients. Results: KL-6 concentrations were significantly elevated in sarcoidosis patients with lung fibrosis and were significantly correlated with DLco and CPI score, while chitotriosidase was significantly higher in patients with extrapulmonary localizations. With a cut-off value of 303.5 IU/ml, KL-6 showed the best sensitivity (78%), while chitotriosidase reported the best specificity (85%) among the biomarkers. Conclusions: KL-6 is a reliable biomarker of fibrotic lung involvement in sarcoidosis patients. Among biomarkers, KL-6 showed the best sensitivity and serum chitotriosidase the best specificity, even in patients on chronic steroid therapy, and seemed to correlate with extrapulmonary localizations.


Assuntos
Hexosaminidases/sangue , Pneumopatias/sangue , Mucina-1/sangue , Muramidase/sangue , Peptidil Dipeptidase A/sangue , Sarcoidose/sangue , Adulto , Biomarcadores/sangue , Feminino , Hexosaminidases/normas , Humanos , Masculino , Pessoa de Meia-Idade , Muramidase/normas , Peptidil Dipeptidase A/normas , Sensibilidade e Especificidade
9.
PLoS One ; 14(3): e0214324, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30908547

RESUMO

OBJECTIVE: Pneumocystis pneumonia (PCP) is one of the most common opportunistic infections. In systemic autoimmune disease patients receiving immunosuppressive treatments, low lymphocyte count, old age and coexisting lung disease have been known as risk factors for the occurrence of PCP. However, factors relevant to prognosis of PCP have not been fully studied. METHODS: A total of 95 sequential patients who developed PCP during immunosuppressive treatment for systemic autoimmune diseases was identified from five Japanese centres. We retrospectively assessed baseline characteristics, immunosuppressive treatment prior to the onset of PCP, treatment for PCP and survival. Univariate and multivariate analyses were performed to identify prognostic factors. RESULTS: Forty-two deaths (44.2%) were observed in this study. Age at the diagnosis of PCP was higher in non-survivors than in survivors (74 years vs. 64 years, p = 0.008). Non-survivors more frequently had lung involvement than did survivors (47.6% vs. 13.2%, p<0.001). Median lymphocyte count at the diagnosis of PCP was lower in non-survivors than in survivors (499/µl vs. 874/µl, p = 0.002). Multivariate analysis identified lower lymphocyte count, older age and coexisting lung disease at the diagnosis of PCP as independent risk factors for death. Those risk factors for death were similar to the known risk factors for the occurrence of PCP. CONCLUSION: Although PCP can occur even in patients without these risk factors, our data demonstrate that the overall prognosis of PCP in such patients is good. Given that the standard prophylactic treatment against PCP has safety issues, the risk-stratified use of prophylactic treatment may be advisable.


Assuntos
Doenças Autoimunes/tratamento farmacológico , Imunossupressores/uso terapêutico , Pneumopatias/diagnóstico , Infecções Oportunistas/diagnóstico , Pneumonia por Pneumocystis/diagnóstico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doenças Autoimunes/complicações , Doenças Autoimunes/mortalidade , Feminino , Humanos , Japão , Pneumopatias/sangue , Pneumopatias/mortalidade , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Infecções Oportunistas/sangue , Infecções Oportunistas/mortalidade , Pneumonia por Pneumocystis/sangue , Pneumonia por Pneumocystis/mortalidade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
10.
Prog Mol Biol Transl Sci ; 162: 253-264, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30905455

RESUMO

CA199 is a sialic acid containing glycan antigen found in both glycoproteins and glycolipids, which is recognized by monoclonal antibodies generated by hybridoma technology. The increased serum CA199 levels measured by using the monoclonal antibodies have been used as diagnostic or prognostic biomarker for pancreatic cancer. Even though increased serum CA199 levels are also observed in other cancers and noncancer diseases, it is largely unknown if CA199 levels could serve as biomarkers for other diseases as well. Therefore, in our current study, serum CA199 levels from 45,645 patients with 47 clinically defined diseases and 14,783 healthy controls who attended their annual physical examination were collected and measured by the clinical laboratory in the Affiliated Hospital of Qingdao University over the past 5 years. Based on the median, mean, and -Log10p values, we found that patients with pancreatic cancer, lung fibrosis, cirrhosis, liver cancer, hepatitis, and pancreatitis had the highest media and mean serum CA199 levels with statistical significance based on the -Log10p values. Unexpectedly, patients suffering from gout and anemia had significantly low CA199 levels compared to that of the healthy controls. These results showed that serum CA199 levels are not only increased in pancreatic and other cancer patients but also either increased or decreased in noncancer diseases. The overall data indicated that the abnormal serum CA199 level might be an indicator of system malfunction rather than a cancer biomarker in general.


Assuntos
Antígenos Glicosídicos Associados a Tumores/sangue , Hepatopatias/sangue , Pneumopatias/sangue , Estudos de Casos e Controles , Humanos
12.
J Trace Elem Med Biol ; 53: 84-90, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30910213

RESUMO

Nontuberculous mycobacterial (NTM) lung diseases are an emerging cause of pulmonary infection, becoming more common in the clinical setting as incidence of NTM lung diseases steadily increases worldwide. Trace elements are essential micronutrients and are known to play many important roles in infectious diseases. We investigated the concentrations of trace elements in patients with NTM lung disease and compared these values to patients with pulmonary tuberculosis and healthy controls. A case-control study was conducted to evaluate the serum trace element concentrations in 95 patients with NTM lung disease, 97 patients with pulmonary tuberculosis, and 99 healthy control subjects. The serum concentrations of 7 trace elements (cobalt, copper, chromium, manganese, molybdenum, selenium, and zinc) were measured using inductively coupled plasma-mass spectrometry. We also analyzed demographic data, clinical outcomes, and other biochemical parameters. The median serum concentrations of copper and molybdenum were higher in patients with NTM lung disease (109 vs. 91 µg/dL, p < 0.001 and 1.70 vs. 0.96 µg/L, p < 0.001). In contrast, the median serum concentrations of selenium and zinc were significantly lower in patients with NTM lung disease than in healthy controls (105 vs. 115 µg/L, p < 0.001 and 94 vs. 102 µg/dL, p < 0.001). Compared to patients with pulmonary tuberculosis, the serum concentrations of molybdenum and zinc were higher in patients with NTM lung disease, while cobalt and copper concentrations were lower (p < 0.001). Correlations among trace element concentrations were observed (copper and zinc, r = -0.367; cobalt and molybdenum, r = -0.360; selenium and zinc, r = 0.335; and manganese and zinc, r = 0.327, respectively). None of the 7 trace elements were associated with treatment outcomes. Patients with NTM lung disease showed different serum trace element concentrations. Our study indicates that altered trace element status is associated with mycobacterial disease. Further study investigating the clinical significance of individual trace elements and their association with nutritional status in patients with NTM lung disease would be required.


Assuntos
Pneumopatias/sangue , Infecções por Mycobacterium não Tuberculosas/sangue , Oligoelementos/sangue , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão
13.
Orphanet J Rare Dis ; 14(1): 62, 2019 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832705

RESUMO

BACKGROUND: Late-onset Pompe disease (LOPD) is a recessive disease caused by α-glucosidase (GAA) deficiency, leading to progressive muscle weakness and/or respiratory failure in children and adults. Respiratory derangement can be the first indication of LOPD, but the diagnosis may be difficult for pneumologists. We hypothesize that assessing the GAA activity in suspected patients by a dried blood spot (DBS) may help the diagnosis of LOPD in the pneumological setting. POPULATION AND METHODS: We performed a multicenter DBS survey of patients with suspected LOPD according to a predefined clinical algorithm. From February 2015 to December 2017, 140 patients (57 ± 16 yrs., 80 males) were recruited in 19 Italian pneumological units. The DBS test was performed by a drop of blood collected on absorbent paper. Patients with GAA activity < 2.6 µmol/L/h were considered positive. A second DBS test was performed in the patients positive to the first assay. Patients testing positive at the re-test underwent a skeletal muscle biopsy to determine the GAA enzymatic activity. RESULTS: 75 recruited subjects had outpatient access, 65 subjects were admitted for an acute respiratory failure episode. Two patients tested positive in both the first and second DBS test (1.4% prevalence), and the LOPD diagnosis was confirmed through histology, with patients demonstrating a deficient GAA muscle activity (3.6 and 9.1 pmol/min/mg). A further five subjects were positive in the first DBS test but were not confirmed at re-test. The two positive cases were both diagnosed after hospitalization for acute respiratory failure and need of noninvasive ventilation. Most of the recruited patients had reduced maximal respiratory pressures (MIP 50 ± 27% and MEP 55 ± 27% predicted), restrictive pattern (FEV1/FVC 81.3 ± 13.6) and hypoxaemia (PaO2 70.9 ± 14.5 mmHg). Respiratory symptoms were present in all the patients, but only 48.6% of them showed muscle weakness in the pelvic girdle and/or in the scapular girdle (35.7%). CONCLUSIONS: DBS GAA activity test may be a powerful screening tool among pneumologists, particularly in the acute setting. A simple clinical algorithm may aid in the selection of patients on which to administer the DBS test.


Assuntos
Teste em Amostras de Sangue Seco/normas , Doença de Depósito de Glicogênio Tipo II/complicações , Doença de Depósito de Glicogênio Tipo II/diagnóstico , Transtornos de Início Tardio/diagnóstico , Pneumopatias/complicações , Pneumologia/métodos , Adulto , Idoso , Biópsia , Diagnóstico Precoce , Feminino , Doença de Depósito de Glicogênio Tipo II/sangue , Doença de Depósito de Glicogênio Tipo II/enzimologia , Humanos , Itália , Transtornos de Início Tardio/sangue , Transtornos de Início Tardio/enzimologia , Pneumopatias/sangue , Masculino , Pessoa de Meia-Idade , Músculos/enzimologia , Músculos/cirurgia , alfa-Glucosidases/metabolismo
14.
PLoS One ; 14(2): e0212776, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30818375

RESUMO

BACKGROUND: In lymphangioleiomyomatosis (LAM), tuberous sclerosis gene mutations activate the mechanistic target of the rapamycin pathway, resulting in vascular endothelial growth factor-D (VEGF-D) overproduction. While the utility of serum VEGF-D testing for the diagnosis of LAM is outlined in ATS/JRS LAM Guidelines, the assay has not been fully validated for Asian populations. Our aims were to validate serum VEGF-D testing in Japan, by directly comparing measurements in Japan and the U.S., determining the diagnostic cut-off for serum VEGF-D levels among the Japanese women with typical thin walled cystic change on CT, and determining the performance of VEGF-D as a prognostic biomarker. SUBJECTS AND METHODS: We determined serum VEGF-D levels from 108 LAM patients, 14 disease controls, and 51 healthy volunteers from the Japanese population. Measurements of 61 LAM patients were compared to those from the principal VEGF-D laboratory in the U.S at Cincinnati Children's Hospital Medical Center. We correlated baseline serum VEGF-D levels with baseline and longitudinal clinical data to determine how pregnancy, sirolimus or gonadotrophin-releasing hormone (GnRH) agonists influence serum VEGF-D levels. RESULTS: Serum VEGF-D measurements in Japan and the U.S. were very similar. Baseline serum VEGF-D levels effectively distinguished LAM from other diseases and healthy volunteers at a cut-off level of 645 pg/ml and were diagnostically specific at 800 pg/ml, consistent with the recommendations of the ATS/JRS LAM Guidelines. Baseline serum VEGF-D correlated negatively with the DLco baseline % predicted and with the annual decrease in DLco % predicted. There was no significant association between baseline serum VEGF-D level and the outcomes of death or transplant. Serum VEGF-D levels markedly decreased during treatment with sirolimus, but not with GnRH analogues. Serum VEGF-D levels of most LAM patients did not increase over time, and neither pregnancy nor menopause significantly modulated serum VEGF-D levels. CONCLUSIONS: Serum VEGF-D is a useful diagnostic and therapeutic biomarker for LAM. Satisfactory precision and international inter-laboratory agreement of the clinical assay support VEGF-D recommendations in the ATS/JRS LAM Guidelines for the Japanese population.


Assuntos
Pneumopatias/diagnóstico , Linfangioleiomiomatose/diagnóstico , Fator D de Crescimento do Endotélio Vascular/sangue , Adulto , Grupo com Ancestrais do Continente Asiático , Biomarcadores , Feminino , Hormônio Liberador de Gonadotropina/agonistas , Voluntários Saudáveis , Humanos , Japão , Estudos Longitudinais , Pneumopatias/sangue , Pneumopatias/tratamento farmacológico , Linfangioleiomiomatose/sangue , Linfangioleiomiomatose/tratamento farmacológico , Menopausa/sangue , Pessoa de Meia-Idade , Gravidez/sangue , Complicações Neoplásicas na Gravidez/sangue , Complicações Neoplásicas na Gravidez/diagnóstico , Complicações Neoplásicas na Gravidez/tratamento farmacológico , Sirolimo/uso terapêutico , Resultado do Tratamento
15.
Artigo em Inglês | MEDLINE | ID: mdl-30880949

RESUMO

Background: While chronic respiratory diseases are among the leading causes of mortality and morbidity worldwide, little is known about the effect of blood eosinophil levels on lung function trajectories among healthy individuals. Methods: We analyzed data of apparently healthy individuals (n=18,089) recruited for the Tel Aviv Medical Center Inflammation Survey. Blood eosinophil levels were compared between participants with normal and those with abnormal lung function. Multivariate regression was used to assess the OR of forced expiratory volume in 1 second (FEV1) deterioration according to baseline eosinophils in subjects with normal lung function (n=4,141) during a follow-up period of 4 years. Results: Participants with an abnormal, as opposed to a normal, pulmonary function test (PFT) (n=1,832, 10.1%) had significantly higher eosinophil levels, expressed as a percentage or count (2.99%±2.00% compared to 2.67%±1.88% and 0.2210e3/µL±0.163/µL compared to 0.1810e3/µL±0.183/µL, respectively; P<0.001 for both). Among participants with a normal PFT at baseline, those with an eosinophil percentage higher than 4% showed a higher risk for FEV1 decline above 60 mL/year (OR=1.199, 95% CI=1.005-1.431, P=0.044). Conclusion: Our study suggests that higher blood eosinophil levels can predict PFT deterioration even in apparently healthy subjects, implying that these individuals could benefit from frequent lung function evaluation.


Assuntos
Eosinófilos/imunologia , Pneumopatias/diagnóstico , Pulmão/fisiopatologia , Adulto , Estudos de Casos e Controles , Estudos Transversais , Progressão da Doença , Feminino , Volume Expiratório Forçado , Humanos , Israel , Contagem de Leucócitos , Pneumopatias/sangue , Pneumopatias/imunologia , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Espirometria , Fatores de Tempo , Capacidade Vital
16.
Interact Cardiovasc Thorac Surg ; 28(6): 945-952, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30753496

RESUMO

OBJECTIVES: Following lung resection, there is a decrease in the functional capacity and quality of life, which is not fully explained by changes in pulmonary function. Previous work demonstrates that B-type natriuretic peptide (BNP) is associated with short- and long-term complications following lung resection, leading to the suggestion that cardiac dysfunction may contribute to functional deterioration. Our aim was to investigate any relationship between BNP and subjective and objective indices of functional deterioration following lung resection surgery. METHODS: Twenty-seven patients undergoing lung resection had serum BNP measured preoperatively, on postoperative day (POD)1 and POD2, and at 2 months postoperatively. The functional deterioration was assessed using 6-min walk tests and the Medical Research Council dyspnoea scale. 'Deterioration in functional capacity' was defined as either an increase in the Medical Research Council dyspnoea score or a significant decrease in the 6-min walk test distance. RESULTS: BNP increased over time (P < 0.01) and was significantly elevated on POD1 and POD2 (P < 0.02 for both). Seventeen patients demonstrated functional deterioration 2 months postoperatively. At all perioperative time points, BNP was significantly higher in patients showing deterioration (P < 0.05 for all). Preoperative BNP was predictive of functional deterioration at 2 months with an area under the receiver-operating characteristic curve of 0.82 (P = 0.01, 95% confidence interval 0.65-0.99). CONCLUSIONS: This study has demonstrated, using subjective and objective measures, that preoperative BNP is a predictor of functional deterioration following lung resection. BNP may have a role in preoperative risk stratification in this population, allowing therapy in future to be targeted towards high-risk patients with the aim of preventing postoperative cardiac dysfunction. CLINICAL TRIAL REGISTRATION NUMBER: NCT01892800.


Assuntos
Volume Expiratório Forçado/fisiologia , Pneumopatias/cirurgia , Pulmão/fisiopatologia , Peptídeo Natriurético Encefálico/sangue , Pneumonectomia , Caminhada/fisiologia , Idoso , Biomarcadores/sangue , Feminino , Humanos , Pulmão/cirurgia , Pneumopatias/sangue , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Valor Preditivo dos Testes , Período Pré-Operatório , Testes de Função Respiratória
17.
Transfus Med ; 29(1): 55-60, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30779248

RESUMO

BACKGROUND: In ß-thalassemia, there are varying degrees of ineffective haematopoiesis, intermittent haemolysis and iron overload. Excess iron is deposited in organs such as the heart, the liver, the endocrine glands and the lungs. OBJECTIVES: To evaluate the pulmonary functions in asymptomatic beta thalassemic children on regular transfusion therapy and their relation to iron overload. METHODS: The study included 50 transfusion-dependent ß-thalassemic children and 50 apparently healthy children as control. All children had undergone pulmonary function tests (spirometry, lung volumes and diffusion capacities). In addition, test to determine the mean serum ferritin of the last 2 years and pre-transfusion haemoglobin and chest radiograph and echocardiography were performed for the thalassemic children only. RESULTS: A total of 70% of the thalassemic children had diffusion impairment, whereas 34% of them had associated restrictive abnormality. Thalassemic children with serum ferritin >2500 ng mL-1 had significantly lower values of forced vital capacity (FVC), forced expiratory volume at one second (FEV1), peak expiratory flow (PEFR), total lung capacity (TLC) and diffusing capacity of carbon monoxide (DLCO) (P < 0·05). Only diffusion impairment had a significant positive correlation with serum ferritin level. Restrictive impairment had significant positive correlations with age, duration of blood transfusion and serum ferritin level and a significant negative correlation with duration of chelation (P < 0·05). Having a serum ferritin >2500 ng mL-1 was the only predicting factor for diffusion impairment and the strongest predicting factor for restrictive dysfunction. CONCLUSION: Despite being asymptomatic, the majority of thalassemic children in this study suffered from diffusion impairment either alone or in combination with restrictive dysfunction. These pulmonary dysfunctions correlated significantly with body iron stores measured by serum ferritin.


Assuntos
Transfusão de Sangue , Ecocardiografia , Ferritinas/sangue , Pneumopatias , Pulmão , Talassemia beta , Adolescente , Criança , Egito , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/fisiopatologia , Pneumopatias/sangue , Pneumopatias/diagnóstico por imagem , Pneumopatias/terapia , Masculino , Testes de Função Respiratória , Talassemia beta/sangue , Talassemia beta/diagnóstico por imagem , Talassemia beta/fisiopatologia , Talassemia beta/terapia
18.
Pediatr Pulmonol ; 54(5): 610-619, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30672154

RESUMO

BACKGROUND: Surfactant protein D (SP-D) is considered a candidate biomarker for lung integrity and for disease progression. AIM: We determined the level of SP-D in children and adolescents with SCD and assessed its possible relation to pulmonary complications and lung function. METHODS: Serum SP-D levels were assessed in 50 SCD patients compared with 30 healthy controls. High-resolution computerized tomography (HRCT) of the chest was done. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1 ), FEV1 /FVC% and forced expiratory flow rate during 25-75% of expiration (FEF25-75%) were determined. RESULTS: SP-D was significantly higher in SCD patients than controls, particularly patients with sickle cell anemia than those with sickle ß-thalassemia. SP-D levels were significantly associated with increasing severity of interstitial lung disease. The highest SP-D levels were observed among patients with restrictive lung disease followed by mixed type then obstructive lung disease. SP-D was positively correlated to HbS and serum ferritin while negatively correlated to duration of hydroxyurea treatment and parameters of pulmonary functions. ROC curve analysis revealed that SP-D cutoff value 720 ng/mL could significantly detect the presence of abnormal pulmonary function among SCD patients with 82% sensitivity and 88% specificity. Logistic regression analysis showed that SP-D is an independent factor related to abnormal pulmonary function in SCD. CONCLUSIONS: SP-D may be a promising biomarker for screening of SCD patients for risk of later pulmonary complications.


Assuntos
Anemia Falciforme/sangue , Pneumopatias/sangue , Pulmão/fisiopatologia , Proteína D Associada a Surfactante Pulmonar/sangue , Adolescente , Anemia Falciforme/diagnóstico por imagem , Anemia Falciforme/fisiopatologia , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Feminino , Ferritinas/sangue , Volume Expiratório Forçado , Hemoglobina Falciforme/metabolismo , Humanos , Modelos Logísticos , Pulmão/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/fisiopatologia , Doenças Pulmonares Intersticiais/sangue , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/fisiopatologia , Pneumopatias Obstrutivas/sangue , Pneumopatias Obstrutivas/diagnóstico por imagem , Pneumopatias Obstrutivas/fisiopatologia , Masculino , Fluxo Máximo Médio Expiratório , Curva ROC , Testes de Função Respiratória , Tomografia Computadorizada por Raios X , Capacidade Vital
19.
Ecotoxicol Environ Saf ; 168: 102-109, 2019 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-30384157

RESUMO

BACKGROUND: Air pollutant exposure negatively affects human health; however, the molecular mechanisms causing disease remain largely unclear. OBJECTIVES: To explore the effects of respiratory particulate matter (PM2.5) exposure on the serum metabolome and to identify biomarkers for risk assessment of PM2.5 exposure. METHODS: PM2.5 from Nanjing, China, was collected, and its water-soluble extract was subjected to component analysis. BALB/c mice received acute or prolonged exposure to insoluble PM2.5 particles or its water-soluble extract, and lung tissue was submitted to histopathological analyses. Serum samples were collected pre- and post-PM2.5 exposure and analyzed by liquid chromatography/mass spectrometry. RESULTS: Component analysis revealed that metals and inorganic ions were the most abundant components in the soluble PM2.5 samples. Acute exposure to insoluble PM2.5 particles and prolonged exposure to the water-soluble PM2.5 extract both induced severe lung injury, and the lung histopathological scores were significantly associated with PM2.5 exposure. Metabolomics analysis showed that prolonged exposure to the water-soluble PM2.5 extract was associated with statistically significant metabolite changes; the serum concentrations of 30 known metabolites, including metabolites of phospholipids, amino acids and sphingolipids, differed significantly between the control and PM2.5 exposure group. Pathway analysis identified an association of the tricarboxylic acid cycle (TCA) and the phospholipase metabolism pathway with PM2.5 exposure. The most influential metabolites for discriminating between the PM2.5-exposure group serum and the control serum were LysoPE, LysoPC, LGPC, citric acid, PAF C-18, NeuAcalpha2-3Galbeta-Cer, Lyso-PAF C-16, ganglioside GA2, 1-sn-glycero-3-phosphocholine, PC and L-tryptophan. CONCLUSIONS: Respiratory exposure to water-soluble PM2.5 extract has developmental consequences affecting not only the respiratory system but also metabolism.


Assuntos
Poluentes Atmosféricos/sangue , Pulmão/efeitos dos fármacos , Metabolômica , Material Particulado/sangue , Aminoácidos/sangue , Animais , Feminino , Hepatopatias/sangue , Hepatopatias/etiologia , Pulmão/metabolismo , Pneumopatias/sangue , Pneumopatias/induzido quimicamente , Camundongos , Camundongos Endogâmicos BALB C , Estresse Oxidativo/efeitos dos fármacos , Fosfolipídeos/sangue , Medição de Risco , Esfingolipídeos/sangue , Espectrometria de Massas em Tandem
20.
Thorax ; 74(1): 60-68, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30282722

RESUMO

BACKGROUND: The demand for lung transplantation vastly exceeds the availability of donor organs. This translates into long waiting times and high waiting list mortality. We set out to examine factors influencing patient outcomes from the time of listing for lung transplantation in the UK, examining for differences by patient characteristics, lung disease category and transplant centre. METHODS: Data were obtained from the UK Transplant Registry held by NHS Blood and Transplant for adult lung-only registrations between 1January 2004 and 31 March 2014. Pretransplant and post-transplant outcomes were evaluated against lung disease category, blood group and height. RESULTS: Of the 2213 patient registrations, COPD comprised 28.4%, pulmonary fibrosis (PF) 26.2%, cystic fibrosis (CF) 25.4% and other lung pathologies 20.1%. The chance of transplantation after listing differed by the combined effect of disease category and centre (p<0.001). At 3 years postregistration, 78% of patients with COPD were transplanted followed by 61% of patients with CF, 59% of other lung pathology patients and 48% of patients with PF, who also had the highest waiting list mortality (37%). The chance of transplantation also differed by height with taller patients having a greater chance of transplant (HR: 1.03, 95% CI: 1.02 to 1.04, p<0.001). Patients with blood group O had the highest waiting mortality at 3 years postregistration compared with all other blood groups (27% vs 20%, p<0.001). CONCLUSIONS: The way donor lungs were allocated in the UK resulted in discrepancies between the risk profile and probability of lung transplantation. A new donor lung allocation scheme was introduced in 2017 to try to address these shortcomings.


Assuntos
Sistema ABO de Grupos Sanguíneos , Pneumopatias/sangue , Pneumopatias/cirurgia , Transplante de Pulmão/estatística & dados numéricos , Listas de Espera , Aloenxertos/provisão & distribução , Estatura , Fibrose Cística/sangue , Fibrose Cística/cirurgia , Alocação de Recursos para a Atenção à Saúde/métodos , Instalações de Saúde/estatística & dados numéricos , Humanos , Período Pós-Operatório , Período Pré-Operatório , Doença Pulmonar Obstrutiva Crônica/sangue , Doença Pulmonar Obstrutiva Crônica/cirurgia , Fibrose Pulmonar/sangue , Fibrose Pulmonar/cirurgia , Sistema de Registros , Taxa de Sobrevida , Tempo para o Tratamento , Reino Unido/epidemiologia , Listas de Espera/mortalidade
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