Premature lung aging and cellular senescence in the pathogenesis of idiopathic pulmonary fibrosis and COPD/emphysema.

Transl Res. 2013 Jul 2;

Authors: Chilosi M, Carloni A, Rossi A, Poletti V

Abstract
Different anatomic and physiological changes occur in the lung of aging people that can affect pulmonary functions and different pulmonary diseases heterogeneously, including deadly diseases such as chronic obstructive pulmonary disease (COPD)/emphysema and idiopathic pulmonary fibrosis (IPF), and can be related to an acceleration of the aging process. The individual genetic background, as well as the exposure to a variety of toxic substances (cigarette smoke in primis) can contribute significantly to accelerating pulmonary senescence. Premature aging can impair lung function by different ways: by interfering specifically with tissue repair mechanisms after damage, thus perturbing the correct crosstalk between mesenchymal and epithelial components; by inducing systemic and/or local alteration of the immune system, thus impairing the complex mechanisms of lung defense against infections; and by stimulating a local and/or systemic inflammatory condition (inflammaging). According to recently proposed pathogenic models in COPD and IPF, premature cellular senescence likely affects distinct progenitors cells, leading to stem cell exhaustion. Mesenchymal stem cells in COPD, alveolar epithelial precursors in IPF. In this review, the large amount of data supporting this pathogenic view are discussed, with emphasis on the possible molecular and cellular mechanisms leading to the severe parenchymal remodeling that characterizes, in different ways, these deadly diseases.

PMID: 23831269 [PubMed - as supplied by publisher]

Identification of occupational exposures among patients with lung cancer.

Bull Cancer. 2013 Jul 5;

Authors: Cellier C, Charbotel B, Carretier J, Rebattu P, Fayette J, Pérol M, Claude L, Philip T, Fervers B

Abstract
Despite the rising number of lung cancers recognized as occupational disease, occupational lung cancers are still under-reported. To improve the recognition of occupational lung cancer, we implemented at the Léon-Bérard Cancer Centre, a questionnaire-based process to identify occupational exposures in these patients and improve compensation. Between January 2010 and December 2011, 91 lung cancer patients responded to a questionnaire. An "occupational cancer" consultation was proposed to patients reporting exposure to carcinogens or jobs with risk of exposure. Fifty-one patients were seen in consultation (34 following the questionnaire and 17 directly addressed by the oncologist). A suspicion of high or average imputability was identified in 31 (60.8%) patients and a compensation process seemed possible for 27 (61.4%). Asbestos was the most common carcinogen identified. Among 17 compensation processes engaged, 12 succeeded and one is ongoing. The complexity of the administrative process seems to be an obstacle for patients and perpetuates inequality. The implementation of our approach increased the identification and the compensation of occupational lung cancer. Our approach responds to the objectives of the National Cancer Plan and helps to improve the overall care of patients with cancer. This approach has been awarded by the national label in 2011 "Year of the patients and their rights".

PMID: 23831888 [PubMed - as supplied by publisher]

Conclusions: This theory driven self-management lifestyle physical activity intervention is designed to reach patients unable to complete center-based pulmonary rehabilitation. Results will advance knowledge and methods for dissemination of a potentially cost-effective program for patients with COPD. (Source: Contemporary Clinical Trials)

Conclusions: It is both feasible and safe to perform VATS lobectomy on patients with unexpected N2 NSCLC. VATS provides better survival rates for those patients with just one station of metastatic mediastinal lymph nodes. (Source: Annals of Thoracic Medicine)