Inflammatory airway features and hypothalamic-pituitary- adrenal axis function in asthmatic rats combined with chronic obstructive pulmonary disease

Background Bronchial asthma （BA） and chronic obstructive pulmonary disease （COPD） are both inflammatory airway diseases with different characteristics. However, there are many patients who suffer from both BA and COPD. This study was to evaluate changes of inflammatory airway features and hypothalamic-pituitary-adrenal （HPA） axis function in asthmatic rats combined with COPD. Methods Brown Norway （BN） rats were used to model These three models were compared and evaluated with the inflammatory airway diseases of BA, COPD and COPD＋BA. respect to clinical symptoms, pulmonary histopathology, airway hyperresponsiveness （AHR）, inflammatory cytokines and HPA axis function. Results The inflammatory airway features and HPA axis function in rats in the COPD＋BA model group were greatly influenced. Rats in this model group showed features of the inflammatory diseases BA and COPD. The expression of inflammatory cytokines in this model group might be up or downregulated when both disease processes are present. The levels of corticotrophin releasing hormone mRNA and corticosterone in this model group were both significantly decreased than those in the control group （P 〈0.05）. Conclusions BN rat can be used as an animal model of COPD＋BA. By evaluating this animal model we found that the features of inflammation in rats in this model group seem to be exaggerated. The HPA axis functions in rats in this model group have been disturbed or impaired, which is prominent at the hypothalamic level.

Interventional pulmonology for chronic inflammatory airway diseases

Chronic inflammatory airway diseases,such as chronic bronchitis,chronic obstructive pulmonary disease,emphysema,and bronchial asthma,pose significant healthcare challenges.Interventional treatments offer promise as valuable complements to the optimal medical therapy recommended by the Global Initiative for Chronic Obstructive Lung Disease guideline and the Global Initiative for Asthma guideline.By directly accessing the airways,these minimally invasive procedures enable precise interventions.They encompass a wide range of techniques including bronchial thermoplasty and targeted lung denervation for both chronic obstructive pulmonary disease and severe asthma,bronchoscopic lung volume reduction(including the use of endobronchial valves,coils,and bronchoscopic thermal vapor ablation),airway bypass and peripheral stent placement for emphysema,bronchial rheoplasty and spray cryotherapy for chronic bronchitis,and other emerging methods.These interventional treatments aim to improve patients’symptoms by reducing lung volume,alleviating hyperinflation,eliminating vagal innervation,disrupting hyperplastic goblet cells and thus reducing excessive mucus secretion,and weakening submucosal smooth muscles.This review highlights the potential advantages of interventional treatments for chronic inflammatory airway diseases and discusses relevant techniques tailored to specific disease subtypes.The overall aim is to assist interventional pulmonologists in selecting the most appropriate techniques for individual patients.