Advanced nanomedicines and immunotherapeutics to treat respiratory diseases especially COVID-19 induced thrombosis

Immunotherapy and associated immune regulation strategies gained huge attraction in order to be utilized for treatment and prevention of respiratory diseases.Engineering specifically nanomedicines can be used to regulate host immunity in lungs in the case of respiratory diseases including coronavirus disease 2019(COVID-19)infection.COVID-19 causes pulmonary embolisms,thus new therapeutic options are required to target thrombosis,as conventional treatment options are either not effective due to the complexity of the immunethrombosis pathophysiology.In this review,we discuss regulation of immune response in respiratory diseases especially COVID-19.We further discuss thrombosis and provide an overview of some antithrombotic nanoparticles,which can be used to develop nanomedicine against thrombo-inflammation induced by COVID-19 and other respiratory infectious diseases.We also elaborate the importance of immunomodulatory nanomedicines that can block pro-inflammatory signalling pathways,and thus can be recommended to treat respiratory infectious diseases.

Impact of Environmental Factors on Respiratory Diseases in Fuxin City and Its Prediction

Based on the daily data of visits for respiratory diseases in two grade A hospitals as well as meteorological factors and air pollution in Fuxin City from December 1, 2020 to November 31, 2021, PCA and RBF neural network were used to study the effects of meteorological factors and air pollution on respiratory diseases and predict them. The results showed that the number of daily visits was the largest in winter(accounting for 62.5%), followed by spring(15.2%), and it was the smallest in autumn(only 6.9%). The correlation between the number of daily visits and meteorological factors was higher than that of air pollution factors, and the correlation with temperature and ozone was the highest. The response coefficient of daily visits to each factor increased first and then decreased within 9 d, and the peak was 4-5 d behind. RBF and PCA-RBF neural network models were established to predict the number of daily visits, and the accuracy was 86.3% and 95.2%, respectively.

Analysis of Relationship between Meteorological Conditions and Respiratory Diseases in Xuzhou

Based on daily data of influenza-like cases from four sentinel hospitals as well as meteorological data in Xuzhou from October 2005 to May 2011, number of patients with respiratory diseases in Xuzhou was analyzed, and then relationship between meteorological factors and number of patients with respiratory diseases was discussed. The prediction model of number of patients with respiratory diseases in each month was established to forecast number of patients with respiratory diseases using meteorological data. The results show that people suffered from respiratory diseases more frequently in January and from June to September in Xuzhou. Meteorological factors correlated highly with number of patients with re- spiratory diseases are different due to the difference in climatic characteristics among various seasons. The prediction model could obtain good effect.

Advances in Single Nucleotide Polymorphisms of Vitamin D Metabolic Pathway Genes and Respiratory Diseases

Vitamin D is a fat-soluble vitamin.It is an essential vitamin for human body.It has a classical effect on regulating calcium and phosphorus metabolism.Participate in cellular and humoral immune processes by regulating the growth,differentiation and metabolism of immune cells.A large number of studies in recent years have shown that vitamin D deficiency increases the incidence of respiratory diseases.Respiratory diseases mainly include bronchial asthma,chronic obstructive pulmonary disease,tuberculosis,acute upper respiratory tract infection and pneumonia.Vitamin D metabolic pathway genes play a very important regulatory role in the transformation of vitamin D into active vitamin D,including CYP2R1,CYP27B1,CYP24A1,VDBP,VDR five genes.Genetic polymorphism of genes is the molecular basis of individual differences and disease development.Therefore,this paper summarizes the research on single nucleotide polymorphism of vitamin D metabolic pathway gene and respiratory diseases.In order to provide a new idea for future treatment.

Association between Air Cane Field Burning Pollution and Respiratory Diseases:A Bayesian Approach

Respiratory diseases and air pollution are the goals of many scientific works, but studies of the relations between these diseases and cane field burning pollution are still not well studied in the literature. In this work, we consider the times between days of extrapolations of the number of daily hospitalizations due to respiratory diseases as our data. To analyze this data set, we introduce different statistical models related to burning focus pollution and their relations with the counting of hospitalizations due to respiratory diseases. Under a Bayesian approach and with the help of the free available WinBUGS software, we get posterior summaries of interest using standard MCMC (Markov Chain Monte Carlo) methods.

Nutraceutical support for respiratory diseases

Respiratory diseases have been a major health concern for human beings since several decades.Soothing the irritated nasal passages and airways had been a mutual necessity in multiple ancient cultures.In ancient China,herbs were largely used to help deal with cough and reduce mucus,thereby maintaining respiratory health.In India,knowledge of herb-related remedies passed down through generations.In the human society,freshly prepared herb ointments,including air-dried herbs,and boiled herbal soups have had a long history of combining botanical nutrients with local cuisine.Although the use of herbs and natural products from plants(NPFPs)has been primarily cited in reviews based on modern respiratory diseases,the concept of soothing and alleviating disease progression or reducing mucus production has been highly valued.Nevertheless,only a few herbs could directly disrupt the irreversible fibrotic progression.On the other hand,natural products from animals(NPFAs)have more potential in disrupting procollagen or extracellular matrix deposition.Due to these reasons,NPFAs could be considered as important functional foods for patients with respiratory diseases.In this article,we provide a review of both NPFAs and NPFPs that are adjuvant to respiratory health.

Home-Nebulized Inhaled Glucocorticoid Therapy in Pediatric Respiratory Diseases

Objective:To evaluate the therapeutic effect of home-nebulized inhaled glucocorticoid therapy in pediatric respiratory diseases.Methods:60 cases of children with respiratory diseases admitted between October 2022 and October 2023 were selected as study subjects and randomly divided into the control group and the observation group,30 cases each.The control group was provided with conventional treatment only,while the observation group was provided with home-nebulized inhalation glucocorticosteroid treatment,and the treatment effects,clinical symptom relief time,disease recurrence rate,and treatment satisfaction of the children’s families were recorded and compared between the two groups.Results:A comparison of the two groups in terms of gender and age showed that the differences were not statistically significant(P>0.05).In terms of clinical efficacy,the total effective rate of the observation group was 90.00%,which was significantly higher than that of the control group of 66.67%(P<0.05).Compared with the control group,the disappearance time of the clinical symptoms of the observed group was significantly shortened(P<0.05).In addition,the satisfaction scores of the families of the children in the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Home-nebulized inhalation glucocorticoid therapy shows significant clinical efficacy in pediatric respiratory diseases,significantly reduces the time of disappearance of clinical symptoms,and improves the satisfaction of patients’families,which provides an effective treatment option for children.

Using Network Pharmacology and Molecular Docking Tools to Investigate the Potential Mechanism of Ephedra-Gypsum in the Treatment of Respiratory Diseases

Objective:The objective of this study was to investigate the potential mechanisms of ephedra-gypsum in the treatment ofrespiratory diseases(RDs)using network pharmacology and molecular docking techniques.Materials and Methods:The TCMSP and UniProt databases were used to mine the active components and targets of ephedra-gypsum,and the targets of RD were screened using the Online Mendelian Inheritance in Man(OMIM)and GeneCards databases.The protein-protein interaction network graph was created using the drug-disease intersection targets in the STRING database.The network diagram was analyzed using Cytoscape 3.9.1's topology function.The gene ontology(GO)and KEGG enrichment analyses were performed using the DAVID platform.Molecular docking bioactivity validation of the main active components and core targets was performed using AutoDock and PyMOL software.Results:Twenty-four compounds were screened,and 113 drug-disease targets overlapped.In total,358 biological processes,67 molecular functions,38 cellular components of GO,and 139 pathways were identified.Molecular docking analysis demonstrated the strong binding ability of tumor protein 53(TP53)-luteolin.Conclusion:The core components of ephedra-gypsum,such as quercetin,luteolin,kaempferol,and CaSO_(4)·2H_(2)O,act on key targets,such as tumor necrosis factor(TNF),interleukin-6(IL-6),TP53,and IL-1β through cytokine-mediated signaling pathways,infiammatory responses,cell proliferation,and apoptosis.This could be useful for the treatment of RD.

Ambient Nitrogen Dioxide and Hospitalizations of Full-Spectrum Respiratory Diseases:A National Case-Crossover Study

Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.

Association of emergency room visits for respiratory diseases with sources of ambient PM2.5

Previous studies have reported associations of short-term exposure to different sources of ambient fine particulate matter(PM2.5)and increased mortality or hospitalizations for respiratory diseases.Few studies,however,have focused on the short-term effects of source-specific PM2.5 on emergency room visits(ERVs)of respiratory diseases.Source apportionment for PM2.5 was performed with Positive Matrix Factorization(PMF)and generalized additive model was applied to estimate associations between source-specific PM2.5 and respiratory disease ERVs.The association of PM2.5 and total respiratory ERVs was found on lag4(RR=1.011,95%CI:1.002,1.020)per interquartile range(76μg/m3)increase.We found PM2.5 to be significantly associated with asthma,bronchitis and chronic obstructive pulmonary disease(COPD)ERVs,with the strongest effects on lag5(RR=1.072,95%CI:1.024,1.119),lag4(RR=1.104,95%CI:1.032,1.176)and lag3(RR=1.091,95%CI:1.047,1.135),respectively.The estimated effects of PM2.5 changed little after adjusting for different air pollutants.Six primary PM2.5 sources were identified using PMF analysis,including dust/soil(6.7%),industry emission(4.5%),secondary aerosols(30.3%),metal processing(3.2%),coal combustion(37.5%)and traffic-related source(17.8%).Some of the sources were identified to have effects on ERVs of total respiratory diseases(dust/soil,secondary aerosols,metal processing,coal combustion and traffic-related source),bronchitis ERVs(dust/soil)and COPD ERVs(traffic-related source,industry emission and secondary aerosols).Different sources of PM2.5 contribute to increased risk of respiratory ERVs to different extents,which may provide potential implications for the decision making of air quality related policies,rational emission control and public health welfare.

Correlation Analysis for the Attack of Respiratory Diseases and Meteorological Factors

Objective：To investigate the relationship between respiratory diseases onset and the meteorological factors in the same period and in a specific environment.Methods：By using the data of daily incidence of respiratory diseases obtained from Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from January 1, 1998 to December 31,2007,and the data of 16 items of meteorological factors（such as the average,maximum, and minimum temperatures,etc.,including meteorological factors derived） obtained from the Beijing Municipal Meteorological Observatory,mathematical statistical methods were applied to achieve the non-linear correlation analysis,or the correlation test,between the incidence of respiratory diseases and the time-related meteorological factors.Results：The simple correlation coefficients of the relationship between the incidence of respiratory diseases and 9 meteorological elements,including the average values of temperature,maximum temperature,minimum temperature,degree of comfort,precipitation,vapor pressure,low cloud cover,change of vapor pressure,and change of wind speed,were all greater than 0.8286,in which one of the relationship between the incidence of respiratory diseases and the maximum temperature is as high as 0.9670.Statistical tests showed RRα=0.05 and FFα=0.05.Conclusions：The incidence of respiratory diseases was closely correlated to meteorological factors,such as air temperature,vapor pressure,precipitation,wind speed,etc.To a certain extent,this conclusion confirmed the scientificity and objectivity of the theory of five evolutive phases and six climatic factors（Wu Yun Liu Qi,五运六气） in Huang Di Nei Jing（黄帝内经,The Yellow Emperor＇s Canon of Internal Medicine）.

Development of community health service-oriented computer-assisted information system for diagnosis and treatment of respiratory diseases

Objective:Community health services are an emerging trend.We have found in practice that diagnosis and treatment of respiratory diseases in the community are distinct.The respiratory department’s daily work involves a number of outpatient registration items and a vast workload.The routine manual operation is inefficient and it is not convenient to make effective statistical analysis of the outpatient data to identify the risk factors closely related to diseases.Therefore,it is imperative to process the outpatient information of patients with respiratory diseases effectively and efficiently in a unified manner by means of computer technology.Methods:The design and realization of the Community Health Service-oriented computerassisted Information System for Diagnosis and Treatment of Respiratory Diseases(CHS-DTRD)was completed as part of the community intervention study on bronchial asthma that was carried out jointly by the Nanjing First Hospital Affiliated to Nanjing Medical University and the Hospital of Nanjing University of Science&Technology,and based on 2 years of experience and the needs of an overall analysis.Results:The computer-assisted information system for diagnosis and treatment was developed using Java Server Page(JSP)technology and introducing the advanced Asynchronous JavaScript XML(AJAX)technique and MS-SQL Server was used in the background database.CHS-DTRD was composed of eight functional modules(outpatient data maintenance,outpatient appointment,intelligent analysis for disease risk factors,query and statistics,data dictionary maintenance,database manipulation,access control,and system configuration).CHS-DTRD featured a friendly interface,convenient operation,and stability and reliability.Conclusion:Community health-oriented diagnosis and treatment of respiratory diseases is simple,programmable,and intuitive,thus the workload of physicians is significantly reduced and the work efficiency is improved.This system facilitates an intelligent analysis of disease risk factors using data mining technology,and provides physicians with suggestions on intelligent analysis for diagnosis of disease and conclusion of disease causes.

Changes in Life Expectancy of Respiratory Diseases from Attaining Daily PM_(2.5) Standard in China: A Nationwide Observational Study

Although exposure to air pollution increases the risk of premature mortality and years of life lost(YLL),the effects of daily air quality improvement to the life expectancy of respiratory diseases remained unclear.We applied a generalized additive model(GAM)to assess the associations between daily PM_(2.5) exposure and YLL from respiratory diseases in 96 Chinese cities during 2013–2016.We further estimated the avoidable YLL,potential gains in life expectancy,and the attributable fraction by assuming dailyPM_(2.5) concentration decrease to the air quality standards of China and World Health Organization.Regional and national results were generated by random-effects meta-analysis.A total of 861,494 total respiratory diseases and 586,962 chronic obstructive pulmonary disease(COPD)caused death from 96 Chinese cities were recorded during study period.Each 10 mg/m3 increase of PM_(2.5) in 3-day moving average(lag02)was associated with 0.16(95%CI:0.08,0.24)years increment in life expectancy from total respiratory diseases.The highest effect was observed in Southwest region with 0.42(95%CI:0.22,0.62)years increase in life expectancy.By attaining the WHO's Air Quality Guidelines,we estimated that an average of 782.09(95%CI:438.29,1125.89)YLLs caused by total respiratory death in each city could be avoided,which corresponded to 1.15%(95%CI:0.67%,1.64%)of the overall YLLs,and 0.12(95%CI:0.07,0.17)years increment in life expectancy.The results of COPD were generally consistent with total respiratory diseases.Our findings indicate that reduction in daily PM_(2.5) concentrations might lead to longer life expectancy from respiratory death.

Mechanisms of immune regulation for acupuncture on chronic respiratory diseases

Chronic respiratory diseases(CRDs)are among the most common noncommunicable diseases globally,with high morbidity and mortality rates.Acupuncture,a treatment method derived from Traditional Chinese Medicine,has been shown to be effective at treating CRDs,with little risk of adverse effects.Scientific research on the mechanisms underlying the effects of acupuncture,especially,its immune regulatory function,has rapidly advanced in recent years.Herein,the diverse immune regulatory mechanisms underlying the beneficial effects of acupuncture are summarized from the perspectives of innate immunity,adaptive immunity,and neuroimmunity.A better understanding of these mechanisms will ultimately provide a scientific basis for the clinical use of acupuncture for the treatment of CRDs.

Global Alliance against Chronic Respiratory Diseases symposium on air pollution:overview and highlights

A 1-day symposium before the annual meeting of the Global Alliance against Chronic Respiratory Diseases,gathered authorities and researchers from around the world to discuss the impact of air pollution on human and planetary health.Air quality is a high priority for Global Alliance against Chronic Respiratory Diseases and China,the host country.This article presents a summary,commentary,and amplification of the 17 presentations.Air pollution is closely linked with global warming and harms most body systems even at levels below international standards.Information about the genetic,cellular,and metabolic effects of exposure to air pollution is important for better understanding of individual responses and even potential therapeutic mediation.Reducing air pollution at its source leads to prompt and important benefits and should be the first priority for political and public action.

Strengthen national action for the prevention and control of chronic respiratory diseases

Chronic respiratory diseases are chronic diseases of the airways and other structures of the lung.Some of the most common are asthma,chronic obstructive pulmonary disease （COPD）,respiratory allergies,occupational lung diseases and pulmonary hypertension.Hundreds of millions of people suffer every day from chronic respiratory diseases.COPD is one of the most representative chronic respiratory diseases.A population-based,cross-sectional survey of COPD conducted between 2003 and 2004 showed that the overall prevalence of the disease in people aged above 40 years was 8.2%,1 which would result in a COPD patient population of over 43 million.

Recent advances in lung-on-a-chip technology for modeling respiratory disease

Tissue engineering approaches,including those to functional lung tissues,are finely honed by the inclusion of upgraded devices that mimic biophysical and biochemical features in vivo.Perfusion culture is one of these essential biophysical characteristics enabled by the introduction of microfluidic devices in recent years.This review links the importance of dynamic culture for in vitro maintenance of functional lung cells to the modeling of respiratory disease.We identify and discuss different parameters for fabricating the requisite microfluidic models for lung cells,as well as their application in modeling lung diseases caused by external factors such as smoking and pollution.The possibility of creating a multi-organ-on-a-chip to establish a more physiologically relevant model is highlighted.Overall,the focus is on different prospects for the in vitro modeling approach and for lungs-on-a-chip for developing advanced,reliable technology to analyze the pathophysiology of respiratory diseases and screen potential treatments.

Recent progress of respiratory inhalation drug delivery systems

With the influence of many factors such as the aging of the population,the younger smokers,and the serious air pollution,the incidence of chronic respiratory diseases is increasing year by year.In the treatment of respiratory diseases,clinical intervention is still mainly based on drug control of pulmonary symptoms.However,systemic drugs have disadvantages such as many adverse reactions and severe systemic side effects.In recent years,the research and development of local drug delivery systems for the respiratory tract has brought new changes to the treatment of respiratory diseases.Locally delivered drugs can directly act on the airways and have the characteristics of fast onset,good curative effect and small side effects.It is a simple,efficient and safe treatment method,which has a very significant effect,and has become a hot topic of current research and promotion.This paper briefly reviews the development track and latest research progress of respiratory local drug delivery systems at home and abroad,in order to provide reference for clinical workers in drug selection and application.

Effect of exposure to ambient PM2.5 pollution on the risk of respiratory tract diseases： a meta-analysis of cohort studies

The International Agency for Research on Cancer and the World Health Organization have designated airborne particulates, including particulates of median aerodynamic diameter 〈 2.5 gm （PM2.5）, as Group 1 carcinogens. It has not been determined, however, whether exposure to ambient PM2.5 is associated with an increase in respiratory related diseases. This meta-analysis assessed the association between exposure to ambient fine particulate matter （PM2.5） and the risk of respiratory tract diseases, using relevant articles extracted from PubMed, Web of Science, and Embase. In results, of the 1,126 articles originally identified, 35 （3.1%） were included in this meta-analysis. PM2.5 was found to be associated with respiratory tract diseases. After subdivision by age group, respiratory tract disease, and continent, PM2.5 was strongly associated with respiratory tract diseases in children, in persons with cough, lower respiratory illness, and wheezing, and in individuals from North America, Europe, and Asia. The risk of respiratory tract diseases was greater for exposure to traffic-related than non-traffic-related air pollution. In children, the pooled relative risk （RR） represented significant increases in wheezing （8.2%）, cough （7.5%）, and lower respiratory illness （15.3%）. The pooled RRs in children were 1.091 （95%CI： 1.049, 1.135） for exposure to 〈 25 gg/m3 PM2.5, and 1.126 （95%CI： 1.067, l. 190） for exposure to 〉 25 gg/m3 PM2.5. In conclusion, exposure to ambient PM2.5 was significantly associated with the development of respiratory tract diseases, especially in children exposed to high concentrations of PM2.5.

The Weather Temperature and Air Pollution Interaction and Its Effect on Hospital Admissions due to Respiratory System Diseases in Western China

Air pollution has ever become a global major public health problem.Previous studies showed that air pollution is associated with excessive mortality and morbidity of respiratory disease[1-2].The extreme weather temperature can impact human health and the thermal stresses can lead not only to direct deaths and illnesses,but also to aggravation of respiratory disease[3-4].Though the independent