Molecular mechanisms and cellular process in signal transduction pathway related to air pollutants in obstructive lung diseases:A mini-review

Exposure to air pollutants such as PM_(10),PM_(2.5),PM_(0.1),O_(3),CO,NO2,and SO_(2),and biological pollutants are important factors causing the evolution and furtherance of obstructive lung diseases(OLD),including asthma and chronic obstructive pulmonary disease(COPD).Asthma is the most frequent chronic inflammatory airway disease,characterized by breathlessness,wheezing,chest tightness,and cough,together with the presence of exaggerated expiratory airflow fluctuation that varies over time.COPD is a heterogeneous lung condition characterized by chronic respiratory symptoms such as dyspnea,cough,expectoration,and/or exacerbations due to abnormalities of the airways and/or alveoli that cause persistent,often progressive,airflow obstruction.Understanding the molecular mechanisms and cellular processes based on the development of OLD on exposure to air pollutants will provide insights into the solution of pathogenesis,prevention,and treatment of these conditions.The molecular mechanisms and cellular process involved in signal transduction pathway plays a role in the binding of extracellular signaling molecules and ligands to receptors placed on the cell surface or on the inner side cell that trigger inflammation that occurs,especially when something important enters the cell to bring into a cascade response.This binding then alters the cell metabolism,shape,and gene expression in the airway.This review aimed to reveal the effect of air pollutants on the molecular mechanisms and cellular processes involved in the signal transduction pathways in OLD.

Research progress of red blood cell distribution width in diagnosis and treatment of lung diseases and prognosis

Lung disease is the disease of the lung itself or lung manifestations of other diseases,including COPD,PTE,CAP,etc.In recent years,the incidence rate has been increased year after year.Many of these diseases have hidden onset and complicated causes.Therefore,accurate diagnosis and treatment are very important.Studies have shown that RDW is closely linked to the diagnosis and treatment of lung diseases.This article analyzes the research on RDW and lung diseases at home and abroad,and briefly summarizes the diagnosis,severity and clinical prognosis of lung diseases by RDW,hoping to provide useful clues and reliable basis for clinical workers,to provide assistance for further application research of RDW in lung diseases.

Acupoint selection rules for acupoint application in lung diseases in the post-epidemic era

Objective:To summarize the rules of acupoint selection of acupoint application to prevent and treat lung diseases under the background the post-epidemic era using data-mining technology.Method:The CNKI,Wanfang database,and VIP database were searched for clinical study articles on lung diseases treated by acupoint application published in the past 5 years.Data-eligible papers were extracted to establish a database of acupoint application for lung disease using Microsoft Excel 2019,with the goal of analyzing the frequency of acupoints,acupoint-meridian association,acupoint-location association,specific acupoint frequency,and cluster analysis.Association rules,consisting of acupoints with an application frequency of≥10,were devised by the Apriori algorithm to explore the correlation between acupoint groups and to analyze the rules of the compatibility of acupoint prescriptions.Results:A total of 229 eligible papers met our inclusion criteria.Forty-seven acupoints were applied,for a total frequency of acupoints of 1,035 times.Among these,acupoints for lung diseases were primarily distributed in the back-and-waist and chest-and-abdomen areas.From the analysis of the association rules,we obtained four groups of acupoint association rules based on acupoint clusters with a frequency≥10 and found that Feishu(BL 13),Tiantu(CV 22),Dazhui(GV 14),Dingchuan(EX-B1),and Danzhong(CV 17)constitute the core acupoints of prescriptions for clinical acupoint application to prevent and treat lung diseases.Conclusion:It is clearly shown that the core acupoints are relatively concentrated and that the selected acupoints were mainly locally selected,which could be a matching reference for the long-term prevention and treatment of lung diseases,including COVID-19.

Automated Classification of Lung Diseases in Computed Tomography Images Using a Wavelet Based Convolutional Neural Network

Recently, convolutional neural networks (CNNs) have been utilized in medical imaging research field and have successfully shown their ability in image classification and detection. In this paper we used a CNN combined with a wavelet transform approach for classifying a dataset of 448 lung CT images into 4 categories, e.g. lung adenocarcinoma, lung squamous cell carcinoma, metastatic lung cancer, and normal. The key difference between the commonly-used CNNs and the presented method is that in this method, we adopt the use of redundant wavelet coefficients at level 1 as inputs to the CNN, instead of using original images. One of the main advantages of the proposed method is that it is not necessary to extract regions of interest from original images. The wavelet coefficients of the entire image are used as inputs to the CNN. We compare the classification performance of the proposed method to that of an existing CNN classifier and a CNN-based support vector machine classifier. The experimental results show that the proposed method outperforms the other two methods and achieve the highest overall accuracy of 91.9%. It demonstrates the potential for use in classification of lung diseases in CT images.

The Differences of Interstitial Lung Diseases in High-Resolution Computerized Tomography and Pulmonary Function Test among Different Connective Tissue Diseases, and the Correlated Factors

Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.

Increased Levels of Hyaluronic Acid in Bronchoalveolar Lavage from Patients with Interstitial Lung Diseases, Relationship with Lung Function and Inflammatory Cells Recruitment

Purpose: Interstitial Lung Diseases (ILD) are characterized by inflammation and fibrosis. It described the role of hyaluronic acid (HA) as an immune-regulator. It is not known if HA contributes to the recruitment of inflammatory cells associated with ILD. If this hypothesis was correct, then concentrations of HA in bronchoalveolar lavage (BAL) should correlate with the severity of ILD. Methods: We collected BAL from 22 ILD patients and 15 control subjects. We determined HA and cytokine levels by ELISA. In vitro chemotaxis assays were performed by using a transwell system. Results: We found that ILD patients showed a significant increase in HA, IL-6 levels and the amount of cells in BAL compared to control subjects. We detected a significant positive correlation between HA and IL-6 levels (r = 0.53 and p In vitro, HA induced migration of macrophages and monocytes through a CD44-dependent process. BAL from patients with ILD stimulated macro-phage migration and this was abrogated by hyaluronidase. Conclusions: Our results support the hypothesis that HA contributes to the recruitment of monocytes towards the alveolar space, leading to exacerbation of lung inflammation in ILD patients.

Psychological and Social Health Status of Patients with Lung Diseases in Jordan

Objective: The study aims to investigate the psychosocial health status of patients with pulmonary diseases in Jordan. Methods: A cross-sectional survey using 230 patients diagnosed with lung diseases from six major hospitals in Jordan used to collect data in regards to depressive symptoms, psychological distress, coping, life satisfaction, and perceived social support. Data were collected from Jan 2013 to May 2013. Results: About 50% of the patients reported moderate levels of ability to effectively cope with life situations, life satisfaction, psychological distress, and perceived social support from family, friends and others. About 29% of the patients reported that they had moderate to severe depressive symptoms. Depressive symptoms had significant and negative correlation with life satisfaction and perceived social support (r = ﹣0.21 to ﹣0.39, p β = 2.72, p = 0.007), marital status (β = 2.63, p = 0.009), and life satisfaction (β = ﹣4.54, p ≤ 0.001) were the significant predictors of depressive symptoms. Conclusion: Health professionals need to screening for psychological disturbances for their patients. There should be integration between early detection of psychological disturbances and implementation of effective treatment plans.

Non-Invasive Early Diagnosis of Obstructive Lung Diseases Leveraging Machine Learning Algorithms

Lungs are a vital human body organ,and different Obstructive Lung Diseases(OLD)such as asthma,bronchitis,or lung cancer are caused by shortcomings within the lungs.Therefore,early diagnosis of OLD is crucial for such patients suffering from OLD since,after early diagnosis,breathing exercises and medical precautions can effectively improve their health state.A secure non-invasive early diagnosis of OLD is a primordial need,and in this context,digital image processing supported by Artificial Intelligence(AI)techniques is reliable and widely used in the medical field,especially for improving early disease diagnosis.Hence,this article presents an AIbased non-invasive and secured diagnosis for OLD using physiological and iris features.This research work implements different machine-learning-based techniques which classify various subjects,which are healthy and effective patients.The iris features include gray-level run-length matrix-based features,gray-level co-occurrence matrix,and statistical features.These features are extracted from iris images.Additionally,ten different classifiers and voting techniques,including hard and soft voting,are implemented and tested,and their performances are evaluated using several parameters,which are precision,accuracy,specificity,F-score,and sensitivity.Based on the statistical analysis,it is concluded that the proposed approach offers promising techniques for the non-invasive early diagnosis of OLD with an accuracy of 97.6%.

Transbronchial Lung Cryobiopsy in the Diagnosis of Interstitial Lung Diseases. Looking at the Holy Grail or Another Misleading Diagnostic Approach?

Interstitial lung diseases (ILD’s) are a group of heterogenous chronic, ferociously progressive lung diseases. The aetiology of the aforementioned diseases is not always recognisable. The diagnosis of these dismal diseases is a vivid challenge for the physicians. Through the intervening years different diagnostic algorithms have been implemented towards more accurate outcome. Different types of ILD’s demand diverse diagnostic approaches. In the latest years a novel diagnostic mini invasive approach seems to gain continuously terrain towards the diagnosis of ILD’s. Transbronchial cryobiopsy may be the Holy Grail in the diagnosis of these diseases or a misleading diagnostic tool in this challenging field.

Interstitial Lung Diseases Associated with Connective Tissue Pathologies: Radiologic Features

Introduction: The high resolution computed tomography (HRCT) is an important part in the diagnostic approach of interstitial lung disease (ILD) associated with connective tissue diseases (CTD) by providing detailed information on the elementary lesion and the radiological pattern of ILD. Aim: to point out the role of HRCT in the diagnosis of ILD associated with CTD (ILD-CTD). Methods: A Retrospective descriptive study was conducted between 2008 and 2017. Data of 24 patients presenting ILD-CTD were collected. A review of HRCT was performed by a radiologist without knowledge of the CTD. Results: Predominant elementary lesion of ILD associated with dermatomyositis (9 cases) was ground glass opacity (n = 9) followed by consolidation (n = 6). Non Specific Interstitial Pneumonia (NSIP) was the most reported pattern (5 cases). Ground glass opacity was also the predominant elementary lesion for the 2 cases of scleroderma and in Sj&#246gren’s syndrome (4 cases/5). NSIP was the predominant radiological presentation in these two CTD. Lymphoid interstitial pneumonia revealed Sj&#246gren’s syndrome in one case. In rheumatoid arthritis (6 cases), the elementary HRCT lesions were irregular interlobular septal thickening (n = 4) and honeycombing (n = 4) consistent with Usual Interstitial Pneumonia (UIP) in 2 cases. Similarly UIP has been described for the 2 patients with lupus and mixed connective tissue disease. Conclusion: HRCT plays an important role in the management of ILD-CTD. Description of the HRCT elementary lesions and the radiological pattern of ILD can be helpful for CTD’s diagnosis.

Resveratrol extracted from Chinese herbal medicines: A novel therapeutic strategy for lung diseases

Lung diseases and their related complications represent a critical source of morbidity and mortality globally and have become a research focus in recent years.There are plenty of hazards that threaten the health of lung by exposure to external environmental stimuli,such as dust,cigarette smoke,PM2.5,air pollution and pathogen infection.These risks lead to the impairment of lung function and subsequent lung diseases including pneumonia,chronic obstructive pulmonary disease(COPD),asthma and idiopathic pulmonary fibrosis(IPF).Compared with antibiotics and corticosteroids therapies,traditional Chinese medicine prescriptions are more effective with fewer side effects.A considerable variety of bioactive ingredients have been extracted and identified from Chinese herbal medicines and are used for the treatment of different lung diseases,including resveratrol.Increasing studies have reported promising therapeutic effects of resveratrol against lung diseases by inhibiting oxidative stress,inflammation,aging,fibrosis and cancer both in vitro and in vivo.In this review,the recent progress in the studies of lungprotective effects and underlying mechanisms of resveratrol and also highlight the potency of resveratrol and traditional Chinese prescriptions containing resveratrol as promising therapeutic options were summarized for the treatment of lung and respiratory diseases.

Recent applications and strategies in nanotechnology for lung diseases

Lung diseases,including COVID-19 and lung cancers,is a huge threat to human health.However,for the treatment and diagnosis of various lung diseases,such as pneumonia,asthma,cancer,and pulmonary tuberculosis,are becoming increasingly challenging.Currently,several types of treatments and/or diagnostic methods are used to treat lung diseases;however,the occurrence of adverse reactions to chemotherapy,drug-resistant bacteria,side effects that can be significantly toxic,and poor drug delivery necessitates the development of more promising treatments.Nanotechnology,as an emerging technology,has been extensively studied in medicine.Several studies have shown that nano-delivery systems can significantly enhance the targeting of drug delivery.When compared to traditional delivery methods,several nanoparticle delivery strategies are used to improve the detection methods and drug treatment efficacy.Transporting nanoparticles to the lungs,loading appropriate therapeutic drugs,and the incorporation of intelligent functions to overcome various lung barriers have broad prospects as they can aid in locating target tissues and can enhance the therapeutic effect while minimizing systemic side effects.In addition,as a new and highly contagious respiratory infection disease,COVID-19 is spreading worldwide.However,there is no specific drug for COVID-19.Clinical trials are being conducted in several countries to develop antiviral drugs or vaccines.In recent years,nanotechnology has provided a feasible platform for improving the diagnosis and treatment of diseases,nanotechnology-based strategies may have broad prospects in the diagnosis and treatment of COVID-19.This article reviews the latest developments in nanotechnology drug delivery strategies in the lungs in recent years and studies the clinical application value of nanomedicine in the drug delivery strategy pertaining to the lung.

Role of extracellular vesicles in lung diseases

Extracellular vesicles(EVs)are anuclear particles composed of lipid bilayers that contain nucleic acids,proteins,lipids,and organelles.EVs act as an important mediator of cell-to-cell communication by transmitting biological signals or components,including lipids,proteins,messenger RNAs,DNA,microRNAs,organelles,etc,to nearby or distant target cells to activate and regulate the function and phenotype of target cells.Under physiological conditions,EVs play an essential role in maintaining the homeostasis of the pulmonary milieu but they can also be involved in promoting the pathogenesis and progression of various respiratory diseases including chronic obstructive pulmonary disease,asthma,acute lung injury/acute respiratory distress syndrome,idiopathic pulmonary fibrosis(IPF),and pulmonary artery hypertension.In addition,in multiple preclinical studies,EVs derived from mesenchymal stem cells(EVs)have shown promising therapeutic effects on reducing and repairing lung injuries.Furthermore,in recent years,researchers have explored different methods for modifying EVs or enhancing EVs-mediated drug delivery to produce more targeted and beneficial effects.This article will review the characteristics and biogenesis of EVs and their role in lung homeostasis and various acute and chronic lung diseases and the potential therapeutic application of EVs in the field of clinical medicine.

Primary biliary cholangitis presenting with granulomatous lung disease misdiagnosed as lung cancer:A case report

BACKGROUND There are few cases of pulmonary granulomatous changes secondary to primary biliary cirrhosis(PBC).No case of granulomatous lung disease secondary to PBC misdiagnosed as lung cancer had been reported.CASE SUMMARY A middle-aged woman presented with lung nodules and was misdiagnosed with lung cancer by positron emission tomography/computed tomography.She underwent left lobectomy,and the pathology of the nodules showed granulomatous inflammation,which was then treated with antibiotics.However,a new nodule appeared.Further investigation with lung biopsy and liver serology led to the diagnosis of PBC,and chest computed tomography indicated significant reduction in the pulmonary nodule by treatment with methylprednisolone and ursodeoxycholic acid.CONCLUSION Diagnosis of pulmonary nodules requires integrating various clinical data to avoid unnecessary pulmonary lobectomy.

Application of Lung Ultrasonography in the Diagnosis of Childhood Lung Diseases

INTRODUCTION Lung diseases are the most common conditions in newborn infants and children and are also the primary causes of death in children younger than 5 years old.[1] Therefore,accurate and timely diagnosis is extremely important in order to enable efficient treatment and improve the prognosis of patients with lung diseases.In the past,the diagnosis of lung disease mainly depended on chest radiography （CR） and/or computed tomography （CT）.

Fine particulate matter (PM2.5):The culprit for chronic lung diseases in China

Air pollution is a world public health problem. Particulate matter (PM), a mix of solid and liquid particles in the air, becomes an increasing concern in the social and economic development of China. For decades, epidemiological studies have confirmed the association between fine particle pollutants and respiratory diseases. It has been reported in different populations that increased fine particulate matter (PM2.5) concentrations cause elevated susceptibility to respiratory diseases, including acute respiratory distress, asthma, chronic obstructive pulmonary disease, and lung cancer. This review will discuss the pathophysiology of PM2.5 in res-piratory diseases, which are helpful for the prevention of air pollution and treatment of respiratory tract inflammatory diseases.

Spatial patterns and effects of air pollution and meteorological factors on hospitalization for chronic lung diseases in Beijing, China

Chronic obstructive pulmonary disease(COPD), lung cancer(LC) and tuberculosis(TB) are common chronic lung diseases that generate a large disease burden and significant health care resource use in China. The aim of this study was to quantify spatial patterns and effects of air pollution and meteorological factors on hospitalization of COPD, LC and TB in Beijing. Daily counts of hospitalization for 2010 were obtained from the Beijing Urban Employees Basic Medical Insurance(UEBMI) system.Bayesian hierarchical Poisson regression models were applied to identify spatial patterns of hospitalization for COPD, LC and TB at the district level and explore associations with inhalable particulate matter(aerodynamic diameter <10 μm, PM10), sulfur dioxide(SO2), nitrogen dioxide(NO2), mean temperature and relative humidity. There were 18,882, 14,295 and 2,940 counts of hospitalizations for COPD, LC and TB respectively, in Beijing in 2010. Clusters of high relative risk were in different locations for the three diseases. The effect of relative humidity on COPD hospitalization was most significant with a relative risk(RR) of 1.070(95%CI: 1.054, 1.086) per one percent increase. For lung cancer hospitalization, exposure to ambient SO2 was associated with a RR of 1.034(95%CI: 1.011, 1.058) per μg m–3 increase. For tuberculosis, the effect of mean temperature was significant with a RR of 1.107(95%CI: 1.038, 1.180) per °C increase. Risk factors and spatial patterns were different for hospitalization of non-infectious and infectious chronic lung disease in Beijing. Even over a short time period(one year), associations were apparent with air pollution and meteorological factors.

The roles of exosomal miRNAs and lncRNAs in lung diseases

An increasing number of studies have reported that exosomes released from various cells can serve as mediators of information exchange between different cells.With further exploration of exosome content,a more accurate molecular mechanism involved in the process of cell-to-cell communication has been revealed;specifically,microRNAs(miRNAs)and long noncoding RNAs(lncRNAs)are shuttled by exosomes.In addition,exosomal miRNAs and lncRNAs may play vital roles in the pathogenesis of several respiratory diseases,such as chronic obstructive pulmonary disease(COPD),lung cancer,and asthma.Consequently,exosomal miRNAs and lncRNAs show promise as diagnostic biomarkers and therapeutic targets in several lung diseases.This review will summarize recent knowledge about the roles of exosomal miRNAs and lncRNAs in lung diseases,which has shed light on the discovery of novel diagnostic methods and treatments for these disorders.Because there is almost no published literature about exosomal lncRNAs in COPD,asthma,interstitial lung disease,or tuberculosis,we summarize the roles of exosomal lncRNAs only in lung cancer in the second section.This may inspire some new ideas for researchers who are interested in whether lncRNAs shuttled by exosomes may play roles in other lung diseases.

Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis

Background:Clinically amyopathic dermatomyositis(CADM)is a unique sub-type of idiopathic inflammatory myopathies with a high prevalence of interstitial lung disease(ILD).Poor prognosis of the patients was strongly associated with rapid progressive ILD.The aim of this study was to identify risk factors for prediction of different types of ILD in CADM.Methods:In this study,data of 108 inpatients with CADM were collected,including 87 with ILD.The baseline clinical data and laboratory parameters,including myositis-specific and associated antibodies and tumor-associated antigens were analyzed to identify risk factors for acute or subacute interstitial pneumonitis(A/SIP)and chronic interstitial pneumonitis(CIP).Results:In 87 patients with CADM-ILD,39(36.1%)were A/SIP,and 48(44.4%)were CIP.There were 22(20.4%)patients with asymptomatic ILD who were detected by routine high resolution computed tomography.Cytokeratin-19 fragment(CYFRA21-1)was significantly higher in CADM-ILD than that in CADM patients without ILD;carcinoembryonic antigen and neuron-specific enolase were significantly elevated in A/SIP than that in CIP.Patients with A/SIP had a higher positive rate of anti-melanoma differentiation-associated gene 5(MDA5),while patients with CIP had a higher positive rate of anti PL-12 and anti-Ro-52.Logistic regression analysis indicated that elevation of CYFRA21-1 was a risk factor for ILD,higher titer of anti-MDA5 indicated increased likelihood for A/SIP,and higher titer of anti-Ro-52 was also clearly associated with CIP.Conclusions:This study indicated that the prevalence of ILD was high in CADM.Asymptomatic ILD has been previously underestimated.Anti-MDA5 was a risk factor for the presence of A/SIP,and CYFRA21-1 was a risk factor for ILD.

Heart and lung, a dangerous liaison-Tako-tsubo cardiomyopathy and respiratory diseases: A systematic review

AIM: To investigate the possible association between Tako-tsubo cardiomyopathy(TTC)-a reversible clini-cal condition mimicking an acute myocardial infarction characterized by multifactorial pathophysiologic mecha-nisms- and respiratory system diseases. METHODS: We systematically searched PubMed and EMBASE medical information sources, to identify the different triggering causes, limiting our search to ar-ticles in English. The search keywords were: "tako-tsubo cardiomyopathy", "takotsubo", "takotsubo cardiomyopa-thy", "broken heart syndrome", "stress-induced cardio-myopathy", "apical ballooning syndrome", and "ampulla cardiomyopathy in combination with respiratory dis-eases, lung, pulmonary disease. For each kind of dis-ease, we registered: author, year and country of study, patient sex, age, concurring situation, and outcome. RESULTS: Out of a total of 1725 articles found, we se-lected 37 papers reporting a total of 38 patients. As ex-pected, most patients were women(81.6%), mean age was 65 ± 10 years. Outcome was favorable in 100% of cases, and all the patients have been discharged un-eventfully in a few days. CONCLUSION: An association between respiratory diseases and TTC is likely to exist. Patients with severe respiratory diseases, due to the high dosages of β2-agonists used or to the need of invasive procedures, are highly exposed to the risk of developing TTC.