scholarly journals Eosinophils as a Biomarker in Asthma and COPD

2020 ◽  
Author(s):  
Jose Carlos Herrera Garcia
Keyword(s):  
Differential Diagnosis ◽  
Lung Function ◽  
Laboratory Test ◽  
Airway Remodeling ◽  
Rapid Development ◽  
Targeted Treatment ◽  
Systemic Diseases ◽  
Subsequent Test ◽  
Direct Activation ◽  
Inflammatory Conditions

Asthma and COPD are two diseases related to eosinophils. But at present, we do not know with certainty how much these cells participate in these diseases, beyond that the treatment of the underlying cause produces the resolution of eosinophilia in a “reactive” way. Eosinophil-related diseases are a spectrum of systemic diseases such as Asthma and COPD in pneumology area. Under inflammatory conditions, the number of circulating eosinophils or tissues can increase dramatically, with rapid development of eosinophilia and we can obtain in a simple laboratory test. In general, the number of eosinophils in the blood can provide useful information and considering the differential diagnosis and for the subsequent test of patients presenting with eosinophilia. The treatment of eosinophilia currently in number of 300 cells in which is the criteria and the target to be treat. The best known and most used of all treatments for diseases related to eosinophils are corticosteroids, which decrease circulating and tissue eosinophils in a few hours, through mechanisms that include the direct activation of eosinophil program death. Targeted treatment against eosinophils could improve airway remodeling through mechanisms that are not fully known, and their effects on lung function are variable and decreasing symptoms in patients.

scholarly journals FSTL1 aggravates cigarette smoke-induced airway inflammation and airway remodeling by regulating autophagy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Liu ◽  
Jiawei Xu ◽  
Tian Liu ◽  
Jinxiang Wu ◽  
Jiping Zhao ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Inflammation ◽  
Cigarette Smoke ◽  
Airway Remodeling ◽  
Critical Factor ◽  
Lavage Fluid ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Impaired Lung Function

Abstract Background Cigarette smoke (CS) is a major risk factor for Chronic Obstructive Pulmonary Disease (COPD). Follistatin-like protein 1 (FSTL1), a critical factor during embryogenesis particularly in respiratory lung development, is a novel mediator related to inflammation and tissue remodeling. We tried to investigate the role of FSTL1 in CS-induced autophagy dysregulation, airway inflammation and remodeling. Methods Serum and lung specimens were obtained from COPD patients and controls. Adult female wild-type (WT) mice, FSTL1± mice and FSTL1flox/+ mice were exposed to room air or chronic CS. Additionally, 3-methyladenine (3-MA), an inhibitor of autophagy, was applied in CS-exposed WT mice. The lung tissues and serum from patients and murine models were tested for FSTL1 and autophagy-associated protein expression by ELISA, western blotting and immunohistochemical. Autophagosome were observed using electron microscope technology. LTB4, IL-8 and TNF-α in bronchoalveolar lavage fluid of mice were examined using ELISA. Airway remodeling and lung function were also assessed. Results Both FSTL1 and autophagy biomarkers increased in COPD patients and CS-exposed WT mice. Autophagy activation was upregulated in CS-exposed mice accompanied by airway remodeling and airway inflammation. FSTL1± mice showed a lower level of CS-induced autophagy compared with the control mice. FSTL1± mice can also resist CS-induced inflammatory response, airway remodeling and impaired lung function. CS-exposed WT mice with 3-MA pretreatment have a similar manifestation with CS-exposed FSTL1± mice. Conclusions FSTL1 promotes CS-induced COPD by modulating autophagy, therefore targeting FSTL1 and autophagy may shed light on treating cigarette smoke-induced COPD.

scholarly journals Dynamic evolution of emphysema and airway remodeling in two mouse models of COPD

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yue Yang ◽  
Tingting Di ◽  
Zixiao Zhang ◽  
Jiaxin Liu ◽  
Congli Fu ◽  
...  
Keyword(s):  
Lung Function ◽  
Mouse Models ◽  
Lung Tissue ◽  
Airway Remodeling ◽  
Exposed Group ◽  
The Body ◽  
Mouse Lung ◽  
Control Group ◽  
Suitable Model ◽  
Exposure Method

Abstract Background Establishment of a mouse model is important for investigating the mechanism of chronic obstructive pulmonary disease (COPD). In this study, we observed and compared the evolution of the pathology in two mouse models of COPD induced by cigarette smoke (CS) exposure alone or in combination with lipopolysaccharide (LPS). Methods One hundred eight wild-type C57BL/6 mice were equally divided into three groups: the (1) control group, (2) CS-exposed group (CS group), and (3) CS + LPS-exposed group (CS + LPS group). The body weight of the mice was recorded, and noninvasive lung function tests were performed monthly. Inflammation was evaluated by counting the number of inflammatory cells in bronchoalveolar lavage fluid and measuring the expression of the IL-6 mRNA in mouse lung tissue. Changes in pathology were assessed by performing hematoxylin and eosin and Masson staining of lung tissue sections. Results The two treatments induced emphysema and airway remodeling and decreased lung function. Emphysema was induced after 1 month of exposure to CS or CS + LPS, while airway remodeling was induced after 2 months of exposure to CS + LPS and 3 months of exposure to CS. Moreover, the mice in the CS + LPS group exhibited more severe inflammation and airway remodeling than the mice in the CS group, but the two treatments induced similar levels of emphysema. Conclusion Compared with the single CS exposure method, the CS + LPS exposure method is a more suitable model of COPD in airway remodeling research. Conversely, the CS exposure method is a more suitable model of COPD for emphysema research due to its simple operation.

Systemic Diseases Associated with Nasal Symptoms

1987 ◽  
Vol 1 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Guy A. Settipane
Keyword(s):  
Differential Diagnosis ◽  
Fungal Infections ◽  
Systemic Disease ◽  
Systemic Diseases ◽  
Proper Treatment ◽  
Csf Rhinorrhea ◽  
Nasal Symptoms ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Careful History

Many systemic diseases are associated with nasal symptoms, Rhinitis associated with asthma is probably the most common with leprosy and fungal infections being the rarest. A careful history and nasal examination in a patient with rhinitis may lead to the discovery of more significant systemic diseases. Proper treatment of systemic disease will often cure or improve the associated rhinitis. Similarly, appropriate treatment of the rhinitis/sinusitis may reduce systemic complaints such as asthma. At times, identification of the cause of rhinitis as in CSF rhinorrhea, Wegeners’ syndrome, etc., alerts one to a life-threatening entity. Thus, it is apparent that the nose is an excellent mirror of some systemic diseases and identifying and understanding the differential diagnosis of nasal symptoms may be a tremendous help in diagnosing the disease and treating the whole patient.

Persistent airflow obstruction in inner-city children with asthma

2021 ◽  
Vol 42 (4) ◽  
pp. 310-316
Author(s):  
Kenny Y. Kwong ◽  
Yang Z. Lu ◽  
Emilio Jauregui ◽  
Lyne Scott
Keyword(s):  
Lung Function ◽  
Inner City ◽  
Airway Remodeling ◽  
Airflow Obstruction ◽  
Later Life ◽  
Forced Expiratory Volume ◽  
Initial Visit ◽  
Asthma Care ◽  
Increased Risk ◽  
Children With Asthma

Background: Airway remodeling has been shown to be persistent in patients with asthma despite treatment with controller medications. Patients with early airflow obstruction may continue to experience poor lung function despite treatment. Objectives: To determine whether early airflow obstruction in inner-city children with asthma persists despite guideline-based asthma care. Methods: In a retrospective study that used a cohort of inner-city children with asthma treated by using an asthma-specific disease management system, the patients were stratified into “low” or “high” lung function groups at the time of the initial visit (high, forced expiratory volume in the first second of expiration [FEV1] % predicted and FEV1/forced vital capacity [FVC] ≥ 80%; and low, FEV1% predicted and FEV1/FVC < 80%). These patients then received National Heart, Lung, and Blood Institute guideline‐based asthma treatment at regular follow-up intervals with spirometry performed at these visits as part of regular care. FEV1% predicted and FEV1/FVC were followed up for up to 10 years for both the high and low cohorts. Results: Over 10 years, the patients initially in the “high” group maintained FEV1% predicted and FEV1/FVC at values similar to the initial visit (94 to 96% and 87 to 89%, respectively), whereas those in the low group had only slight increases of FEV1% predicted and FEV1/FVC over the same time (77 to 82% and 78 to 82%, respectively). Low FEV1% predicted and FEV1/FVC at the time of the first visit was significantly associated with an increased risk of low values of these lung functions over the next 3‐5 years despite treatment. African American ethnicity and male gender were also associated with lower lung function over time. Conclusion: Early airflow obstruction in inner city children asthma is associated with poor lung function in later life despite guideline-based asthma care. Current asthma therapy may not affect pathways and leads to airway remodeling in children with asthma.

scholarly journals Aproximación Diagnóstica De Las Enfermedades Sistémicas De Los Pacientes Con Signos Y Lesiones Oculares Atendidos En La Consulta Externa Del Hospital Veterinario De Animales De Compañía De La Universidad De San Carlos De Guatemala

2021 ◽  
pp. 1-5
Author(s):  
Laparra-Galindo Julia Patricia ◽  
Mendez-Valenzuela Carlos Roberto
Keyword(s):  
Differential Diagnosis ◽  
Descriptive Analysis ◽  
Systemic Diseases ◽  
Inclusion Criteria ◽  
Eye Examination ◽  
The University ◽  
San Carlos ◽  
University Of San Carlos ◽  
Veterinary Hospital ◽  
Ocular Signs

The goal of this article is to show the most frequent types of differential diagnoses of systemic diseases in canines with ocular signs and lesions. For this purpose, a retrospective study was conducted on 510 medical records from patients of the Companion Animal Veterinary Hospital (HVAC) of the University of San Carlos (USAC) of Guatemala, from August to November 2017. The inclusion criteria were: canine species, having a differential diagnosis established list of possible systemic diseases and an eye examination by specialist. Through a descriptive analysis of the data, it was established that, of the 510 canines examined, 212 (42%) presented signs and ocular alterations, of these there were 550 differential diagnosis, which were categorized using the acronym DAMNIT V; from which it was determined that 40% are infectious / inflammatory, neoplasic (19%) followed by metabolic processes (13%), allergic / autoimmune (10%), degenerative (7%), idiopathic (5%), traumatic / toxic 4% and finally vascular (2%).

scholarly journals IgG4-associated disease in differential diagnosis of inflammatory orbitopathy

2019 ◽  
Vol 65 (5) ◽  
pp. 367-372
Author(s):  
Yaroslav O. Grusha ◽  
Dilyara S. Ismailova ◽  
Natalya Yu. Sviridenko ◽  
Pavel I. Novikov ◽  
Alla M. Kovrigina
Keyword(s):  
Differential Diagnosis ◽  
Gold Standard ◽  
Granulomatosis With Polyangiitis ◽  
Plasma Cells ◽  
Eye Disease ◽  
Systemic Diseases ◽  
Long Period ◽  
Inappropriate Treatment ◽  
Systemic Inflammatory Disease ◽  
Systemic Process

IgG4-associated disease (IgG4-RD) is a systemic inflammatory disease characterized by tumorlike sclerosing masses in different organs. Differential diagnosis in orbital IgG4-RD includes majority of conditions, such as thyroid eye disease (TED), sarcoidosis, granulomatosis with polyangiitis, idiopatic orbital inflammation, limphoproliferative diseases and others. A case of IgG4-RD with different organs involvement and complicated differential diagnosis is presented. This case demonstrates very uncommon manifestation of IgG4-RD, when orbital involvement was very similar with TED. Systemic process was not recognized during a long period of time and diagnosis of IgG4-RD was established only after biopsy of abnormally increased lacrimal gland. Differential diagnosis included other systemic diseases, first of all sarcoidosis, GPA, and lymphoma. Biopsy results were consistent with the gold standard of diagnosis, e. g. more than 40% of plasma cells were IgG4 positive. This case demonstrates the necessity of orbital biopsy before starting immunosuppression to avoid inappropriate treatment strategy.

scholarly journals Necrotizing leukocytoclastic vasculitis mimicking necrotizing fasciitis: a case report

2016 ◽  
Vol 2 (3) ◽  
pp. 193
Author(s):  
Mehmet Salih Soylemez ◽  
Korhan Ozkan ◽  
Bulent Kılıc ◽  
Samet Erinc ◽  
Irfan Esenkaya ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Laboratory Test ◽  
Necrotizing Fasciitis ◽  
Immunofluorescence Microscopy ◽  
Leukocytoclastic Vasculitis ◽  
Maculopapular Rash ◽  
Skin Manifestation ◽  
Biopsy Specimens ◽  
Common Skin

<p>There are several subtypes of necrotizing leukocytoclastic vasculitis, which are classified according to their morphological features in biopsy specimens using immunofluorescence microscopy. Necrotizing leukocytoclastic vasculitis is limited to the skin, predominantly that of the lower extremities, and usually spares the palms and soles. The most common skin manifestation is palpable purpura. Other skin manifestations include maculopapular rash, bullae, papules, nodules, ulcers and livedo reticularis. There is no specific laboratory test to determine the diagnosis. There are various diseases presenting with these nonspecific symptoms, and a rapid differential diagnosis must be conducted, because the appropriate differentiation and diagnosis markedly influence the treatment strategy and survival of patients. In this study, we report a case of necrotizing leukocytoclastic vasculitis<strong> </strong>presenting with internal organ involvement and symptoms of necrotizing fasciitis, with emphasis on the clinical differentiation.</p>

THE FLUORESCENT ANTITOXIN TEST FOR THE IMMEDIATE DIAGNOSIS OF DIPHTHERIA

PEDIATRICS ◽  
1961 ◽  
Vol 27 (2) ◽  
pp. 214-218
Author(s):  
Jo Anne Whitaker ◽  
John D. Nelson ◽  
Chester W. Fink
Keyword(s):  
Differential Diagnosis ◽  
Laboratory Test ◽  
Clinical Judgment ◽  
Poor Quality ◽  
Fluorescent Staining ◽  
The Poor ◽  
Diphtheria Antitoxin ◽  
Early Case ◽  
The One

The recent increase in the incidence of diphtheria in our area stimulated the search for a reliable laboratory test for the immediate differential diagnosis of diphtheritic and non-diphtheritic membranous tonsillitis. Fluorescein-conjugated diphtheria antitoxin proved to be highly specific for staining toxigenic C. diphtheriae. Eight of nine patients with proved diphtheria had fluorescent organisms on a smear of exudate. The failure in the one case is attributed to the poor quality of the specimen obtained. An early case of diphtheria was detected by examination of family contacts of one of the patients in this series. The conjugated antitoxin does not result in fluorescent staining of nontoxigenic diphtheria bacilli on of other bacteria commonly found in the nasopharyngeal tract. Fluorescent staining of cultures suggests that only a small proportion of the potentially toxigenic diphtheria organisms are actually producing toxin at a given moment. The fluorescent antitoxin test can be performed within 1 hour. A positive result of the test is an absolute indication for antitoxin therapy. With a negative result the physician must still rely on his clinical judgment and cultural and virulence tests.

Posterior Scleritis: Clinic, Diagnosis, and Treatment

10.37783/243 ◽  
2021 ◽  
pp. 71-76
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Intraocular Inflammation ◽  
Systemic Diseases ◽  
Aggressive Treatment ◽  
Resonance Imaging ◽  
Posterior Scleritis ◽  
Ocular Disorders

Posterior scleritis is a painful inflammatory disease that affects the sclera behind the ora serrata. Although it can be seen at any age, it is mostly seen over the age of 40 and mostly affects women. It is usually unilateral. The most common symptoms are periocular pain and loss of vision. It is often idiopathic but it may be associated with systemic diseases such as rheumatologic and autoimmune illnesses. Because of its variable clinical features, the differential diagnosis should be done with orbital or intraocular inflammation and ocular tumors. B-mode ultrasonography (USG), computed tomography, and magnetic resonance imaging are helpful in diagnosis. Posterior scleritis should be kept in mind in all inflammatory and painful ocular disorders without a significant etiology. With the correct diagnosis, appropriate and aggressive treatment, it is possible to recover and protect vision.

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