• 제목/요약/키워드: Chronic Airway Diseases

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Changes of Sputum Matrix Metalloproteinases and Tissue Inhibitor of Matrix Metalloproteinase-1 by Antibiotic Treatment in Acute Exacerbation of Chronic Bronchitis (만성 기관지염의 급성 악화에서 항생제 투여에 의한 유도객담 내 Matrix metalloproteinase와 Tissue inhibitor of matrix metalloproteinase의 변화)

  • Yoon, Hyoung-Kyu;Ahn, Joong-Hyun;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.420-430
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    • 2002
  • Background : Excessive extracellular matrix (ECM) deposition by airway inflammation is presumed to play an important role in the pathogenesis of worsening airflow obstruction (Ed- acceptable three-word noun) seen during acute exacerbations of chronic bronchitis. Although many proteases can cleave ECM molecules, matrix metalloproteinases (MMPs) and their inhibitors are likely to be the physiologically relevant mediators of ECM degradation. Objectives ; The purpose of this study was to demonstrate that antibiotic treatment can change airway MMPs and TIMP-1 concentrations/levels by controlling airway inflammation in acute exacerbation of chronic bronchitis. Methods : We studied 40 patients, all of whom had an acute exacerbation of chronic bronchitis. The patients were treated with two different antibiotics, moxifloxacin and clarithromycin, in a double-blind manner for 7 days. Sputum samples were induced and collected before and after antibiotic therapy. We measured the sputum concentration of MMP-1,-9, TIMP-1, IL-8 and secretory leukocyte proteinase inhibitor (SLPI) in sputum supernatants by ELISA method. Results : There was no difference after antibiotic treatment in the sputum concentrations of MMP-1,-9, TIMP-1, IL-8 and SLPI between the patients treated with moxifloxacin and those treated with clarithromycin. But the sputum concentrations of TIMP-1, and SLPI, and the TIMP-1/MMP-1 ratio were significantly reduced by the antibiotic therapy. There were significant positive correlations between sputum TIMP-1 levels and IL-8 levels (p<0.01, r=0.751), and between the sputum TIMP-1/MMP-1 ratio and IL-8 levels (p<0.01, r=0.752). The sputum SLPI levels were significantly elevated by antibiotic treatment and were negatively correlated with sputum TIMP-1 levels (p<0.01, r=-0.496) and TIMP-1/MMP-1 levels (p<0.01, r=-0.456). Conclusion : The study shows that the worsening of airway inflammation in acute exacerbation of chronic bronchitis is associated with an imbalance between the concentrations/levels of TIMP-1 and MMPs. Antibiotic treatment can prevent progression of airway narrowing in acute exacerbation of chronic bronchitis by modulation of the protease and anti-protease imbalance.

Association between the use of electronic cigarettes and the prevalence of chronic rhinosinusitis and allergic rhinitis: a nationwide cross-sectional study

  • M.-S. Rha;H.-J. Cho;J.-H. Yoon;C.-H. Kim
    • Journal of Rhinology
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    • v.60 no.1
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    • pp.20-28
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    • 2022
  • Background: Whether the use of electronic cigarettes (ECs) is associated with upper airway diseases, including chronic rhinosinusitis (CRS) and allergic rhinitis (AR), remains unclear. Methods: We analyzed data from the nationwide cross-sectional surveys: the Korea National Health and Nutrition Examination Survey VI (2013-2015), VII (2016-2018), and VIII (2019). Logistic regression analysis was performed to assess the association between EC use and CRS or AR. Results: Among a total of 38,413 participants, 6.4% were former EC users and 2.5% were current EC users. Former EC users and current EC showed a significantly increased OR for CRS or AR compared with never EC users. In the subgroup analysis, the "current CC (conventional cigarette)-current EC" and the "current CC-formal EC" group had a significantly higher OR for CRS or AR than the "current CC-never EC" group. In addition, former CC smokers who currently use ECs showed a significantly higher OR for AR than former CC smokers without EC use. Conclusions: EC use is significantly associated with a high prevalence of CRS and AR in the adult population. These results indicate that the use of ECs may increase the risk of upper airway disease.

Overlap Syndrome:Obstructive Sleep Apnea-Hypopnea Syndrome in Patients with Chronic Obstructive Pulmonary Disease (중첩증후군:만성 폐쇄성 폐질환을 가 진 폐쇄성 수면무호흡-저호흡 증후군)

  • Choi, Young-Mi
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.67-70
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    • 2008
  • Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.

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Asthma-COPD Overlap Syndrome: What We Know and What We Don't

  • Sin, Don D.
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.1
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    • pp.11-20
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    • 2017
  • Approximately one in four patients with chronic obstructive pulmonary disease (COPD) have asthmatic features consisting of wheezing, airway hyper-responsiveness or atopy. The Global initiative for Asthma/Globalinitiative for chronic Obstructive Lung Disease committee recently labelled these patients as having asthma-COPD overlap syndrome or ACOS. ACOS also encompasses patients with asthma, ${\geq}40$ years of age, who have been cigarette smokers (more than 5-10 pack years) or have had significant biomass exposure, and demonstrate persistent airflow limitation defined as a post-bronchodilator forced expiratory volume in 1 second ($FEV_1$)/forced vital capacity of <70%. Data over the past 30 years indicate that patients with ACOS have greater burden of symptoms including dyspnea and cough and show higher risk of COPD exacerbations and hospitalizations than those with pure COPD or pure asthma. Patients with ACOS also have increased risk of rapid $FEV_1$ decline and COPD mortality. Paradoxically, experimental evidence to support therapeutic decisions in ACOS patients is lacking because traditionally, patients with ACOS have been systematically excluded from therapeutic COPD and asthma trials to maintain homogeneity of the study population. In this study, we summarize the current understanding of ACOS, focusing on definitions, epidemiology and patient prognosis.

Suppressive Effect of Carnosol on Ovalbumin-Induced Allergic Asthma

  • Lee, Jung-Eun;Im, Dong-Soon
    • Biomolecules & Therapeutics
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    • v.29 no.1
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    • pp.58-63
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    • 2021
  • Asthma is a chronic obstructive lung disease characterized by recurrent episodes of bronchoconstriction and wheezing. Conventional asthma treatment involves the suppression of airway inflammation or improving airway flow. Rosmarinus officialis, also known as rosemary, is a Mediterranean plant that is used for the treatment of inflammatory diseases. Carnosol, a diterpenoid found in rosemary extracts, has been known to exhibit anti-inflammatory, anti-tumor, and anti-oxidant effects. The effect of carnosol on allergic responses has not been tested yet. The effect of carnosol on a murine allergic asthma model were investigated. Carnosol inhibited the degranulation of RBL-2H3 mast cells. Carnosol treatment inhibited the increase in the number of eosinophils in the bronchoalveolar lavage fluids (BALF) of mice treated with ovalbumin. Carnosol treatment also inhibited inflammatory responses and mucin production in histologic studies. Carnosol treatment inhibited the increases of IL-4 and IL-13 cytokines expression in both BALF and the lungs. These results suggest that carnosol may have a potential for allergic asthma therapy.

Recent Advances in the Development of Novel Drug Candidates for Regulating the Secretion of Pulmonary Mucus

  • Li, Xin;Jin, Fengri;Lee, Hyun Jae;Lee, Choong Jae
    • Biomolecules & Therapeutics
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    • v.28 no.4
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    • pp.293-301
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    • 2020
  • Hypersecretion of pulmonary mucus is a major pathophysiological feature in allergic and inflammatory respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD). Overproduction and/or oversecretion of mucus cause the airway obstruction and the colonization of pathogenic microbes. Developing a novel pharmacological agent to regulate the production and/or secretion of pulmonary mucus can be a useful strategy for the effective management of pathologic hypersecretion of mucus observed in COPD and asthma. Thus, in the present review, we tried to give an overview of the conventional pharmacotherapy for mucus-hypersecretory diseases and recent research results on searching for the novel candidate agents for controlling of pulmonary mucus hypersecretion, aiming to shed light on the potential efficacious pharmacotherapy of mucus-hypersecretory diseases.

Correlation between Telomere Length and Chronic Obstructive Pulmonary Disease-Related Phenotypes: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort

  • Moon, Da Hye;Kim, Jeeyoung;Lim, Myoung Nam;Bak, So Hyen;Kim, Woo Jin
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.3
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    • pp.188-199
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    • 2021
  • Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.

Clinical Significance of Airway Resistance Curve by the Body Plethysmograph (Body Plethysmograph를 이용한 Airway Resistance Curve의 임상적 의의)

  • Cheon, Seon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.218-225
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    • 1995
  • Background: Airway resistance(Raw) is measured with the body plethysmograph by displaying the relationship between airflow and alveolar pressure($V/P_A$). If the resistance curve on $V/P_A$ tracing is curved or looped, the estimation of Raw is difficult. This study was designed to examine wheather there is any correlation between the shape of resistance curve and the clinical status and the pulmonary function of patients. Methods: The 146 pulmonary disease patients with increased Raw were included in this study. The shapes of resistance curves on $V/P_A$ tracing with body plethysmograph during quiet breathing were analyzed and compared with pulmonary function. Results: The results were as follows ; 1) The shapes of resistance curves were summarized in 5 categories; type 1: linear, type 2: ovoid, type 3: sigmoid, type 4: scoop, type 5: paisley. The type 3 except 1 case, type 4 and type 5 were found to have loop mainly in expiratory phase. 2) Although the shapes of resistance curves were not typical for specific disease, the resistance curves of acute disease tended to belong to type 1 or 2 and those of chronic airflow obstruction tended to belong to type 3, 4 or 5. But resistance curves of bronchial asthma and destructive lung with tuberculosis showed all types in proportion to degree of airflow obstruction or destruction of parenchyme. 3) In the cases of resistance curves going to type 5 rather than type 1 and those with looping, airflow obstuction tended to be severe and airway resistance and residual volume tended to increase. Conclusions: Analysis of resistance curve on $V/P_A$ tracing measuring airway resistance is helpful for judging degree of airflow obstruction and air trapping. Although the shape of resistance curve is not typical for specific disease, there is a close association between looping and airway obstruction.

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Respiratory protective effects of Korean Red Ginseng in a mouse model of particulate matter 4-induced airway inflammation

  • Won-Kyung Yang;Sung-Won Kim;Soo Hyun Youn;Sun Hee Hyun;Chang-Kyun Han;Yang-Chun Park;Young-Cheol Lee;Seung-Hyung Kim
    • Journal of Ginseng Research
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    • v.47 no.1
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    • pp.81-88
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    • 2023
  • Background: Air pollution has led to an increased exposure of all living organisms to fine dust. Therefore, research efforts are being made to devise preventive and therapeutic remedies against fine dust-induced chronic diseases. Methods: Research of the respiratory protective effects of KRG extract in a particulate matter (PM; aerodynamic diameter of <4 ㎛) plus diesel exhaust particle (DEP) (PM4+D)-induced airway inflammation model. Nitric oxide production, expression of pro-inflammatory mediators and cytokines, and IRAK-1, TAK-1, and MAPK pathways were examined in PM4-stimulated MH-S cells. BALB/c mice exposed to PM4+D mixture by intranasal tracheal injection three times a day for 12 days at 3 day intervals and KRGE were administered orally for 12 days. Histological of lung and trachea, and immune cell subtype analyses were performed. Expression of pro-inflammatory mediators and cytokines in bronchoalveolar lavage fluid (BALF) and lung were measured. Immunohistofluorescence staining for IRAK-1 localization in lung were also evaluated. Results: KRGE inhibited the production of nitric oxide, the expression of pro-inflammatory mediators and cytokines, and expression and phosphorylation of all downstream factors of NF-κB, including IRAK-1 and MAPK/AP1 pathway in PM4-stimulated MH-S cells. KRGE suppressed inflammatory cell infiltration and number of immune cells, histopathologic damage, and inflammatory symptoms in the BALF and lungs induced by PM4+D; these included increased alveolar wall thickness, accumulation of collagen fibers, and TNF-α, MIP2, CXCL-1, IL-1α, and IL-17 cytokine release. Moreover, PM4 participates induce alveolar macrophage death and interleukin-1α release by associating with IRAK-1 localization was also potently inhibited by KRGE in the lungs of PM4+D-induced airway inflammation model. KRGE suppresses airway inflammatory responses, including granulocyte infiltration into the airway, by regulating the expression of chemokines and inflammatory cytokines via inhibition of IRAK-1 and MAPK pathway. Conclusion: Our results indicate the potential of KRGE to serve as an effective therapeutic agent against airway inflammation and respiratory diseases.

Effects of Platycodi Radix ethanol extract on ovalbumin-induced allergic responses in mice (난알부민 유도 알레르기 면역반응에 대한 길경(桔梗)에탄올추출물의 효능 연구)

  • Jung, Jin Ki;Kang, Seok Yong;Kim, Jinwoong;Lee, Sang Kook;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.27 no.6
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    • pp.123-129
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    • 2012
  • Objectives : Allergy has been described as an inflammatory with hypersensitivity resulting from seasonal or perennial responses to specific allergens. The root of Platycodon grandiflorum (Jacq.) A. DC.(Platycodi Radix; Campanulaceae) has been traditionally used to treat chronic diseases such as bronchitis, asthma, pulmonary tuberculosis, inflammation and hyperlipidemia. In this study, we examined the effect of 70% ethanol extract of Platycodi Radix (PR-E) on ovalbumin (OVA)-induced airway inflammation in mice. Methods : Mice were sensitized and challenged by OVA inhalation to induced chronic airway inflammation, and then were intragastrically administered PR-E extract at doses of 50 and 200 mg/kg/day from days 21 to 30 consecutively. The levels of allergic mediators such as histamine, OVA-specific immunoglobulin (Ig) E, and cytokines such as IL-4 and IFN-${\gamma}$ were measured in the sera of mice by ELISA. The histological change of lung tissue was observed by hematoxylin and eosin (H&E) staining. Results : PR-E extract significantly decreased the serum levels of histamine, OVA-specific IgE, and Th2 cytokine, IL-4 compared with those in the OVA-induced group. PE-E extract significantly increased the serum level of Th1 cytokine, IFN-${\gamma}$. Based on lung histopathological studies, inflammatory cell infiltration and mucus hypersecretion were inhibited by PE-E extract administration compared to that in the OVA-induced group. Conclusions : These findings indicate that PE-E extract may be useful as an adjuvant therapy for the treatment of bronchial asthma.