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A probabilistic model of biological ageing of the lungs for analyzing the effects of smoking, asthma and COPD.

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A probabilistic model of biological ageing of the lungs for analyzing the effects of smoking, asthma and COPD.

Respir Res. 2013 May 30;14(1):60

Authors: Chiappa S, Winn J, Vinuela A, Tipney H, Spector TD

Abstract
BACKGROUND: Although a large body of literature is available that describes the effects of factors such as smoking, asthma and COPD on lung function, characterizations over the entire adulthood and analysis of co-occurrence of factors are still rare due to the high number of measurements required for reliable estimation in current approaches. Such a fragmentation, together with the way the effects are expressed, makes it also often difficult to compare results from multiple studies. Furthermore, current approaches consider one type ofmeasurement only or several types separately. METHODS: We propose a probabilistic model that expresses effects on lung function as number of years added to chronological age or, in other words, that estimates the biological age of the lungs. Using biological age as a measure of the effects has the advantage of facilitating the understanding of their severity and comparison of results. In our model, chronological age and other factors affecting the health status of the lungs generate biological age, which in turn generates lung function measurements. This structure enables the use of multiple types of measurement to obtain a more precise estimate of the effects and parameter sharing for characterization over large age ranges and of co-occurrence of factors with little data. We treat the parameters that model smoking habits and lung diseases as random variables to obtain uncertainty in the estimated effects. RESULTS: We use the model to investigate the effects of smoking, asthma and COPD on the TwinsUK Registry. We find that combination of smoking with lung disease(s) has higher effect than smoking or lung disease(s) alone. Furthermore, in smokers, co-occurence of asthma and COPD is more detrimental than asthma or COPD alone. CONCLUSIONS: The proposed model or other models based on a similar approach could be of help in improving the understanding of factors affecting lung function by enabling characterizations over large age ranges and of co-occurrence of factors with little data and the use of multiple types of measurement. The software implementing the model can be downloaded at the first author's webpage.

PMID: 23721360 [PubMed - as supplied by publisher]

Programming of the Lung in Early Life by Bacterial Infections Predisposes to Chronic Respiratory Disease.

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Programming of the Lung in Early Life by Bacterial Infections Predisposes to Chronic Respiratory Disease.

Clin Obstet Gynecol. 2013 May 29;

Authors: Starkey MR, Nguyen DH, Kim RY, Nair PM, Brown AC, Essifie AT, Horvat JC, Hansbro PM

Abstract
There is emerging evidence that chronic respiratory diseases such as asthma and emphysema may originate in early life. Respiratory infections with certain bacterial pathogens such as Chlamydia, Haemophilus influenzae and Streptococcus pneumoniae in early life may promote permanent deleterious changes in immunity, lung structure, and function that predispose to, or increase the severity of chronic respiratory diseases in later life. For example, these infections increase immune responses, which drive subsequent asthma pathogenesis. Targeting the pathways involved with specific inhibitors or agonists may prevent these consequences of early-life infection. Vaccination and immunomodulatory therapies that control the infections and their sequelae may also be efficacious.

PMID: 23722921 [PubMed - as supplied by publisher]

Intermediate filaments of the lung.

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Intermediate filaments of the lung.

Histochem Cell Biol. 2013 Jun 14;

Authors: Yi H, Ku NO

Abstract
Intermediate filaments (IF), a subfamily of the cytoskeletal filaments, provide structural support to cells. Human diseases related to mutations in IF proteins in which their tissue-specific expression is reflected have been found in a broad range of patients. The properties of identified IF mutants are well-studied in vitro in cultured cells and in vivo using transgenic mice expressing IF mutants. However, the association of IF proteins with diseases of the lung is not fully studied yet. Epithelial cells in normal lung express vimentin and various keratins, and the patterns of their expression are altered depending on the progression of the lung diseases. A growing number of studies performed in alveolar epithelial cells demonstrated IF involvement in disease-related aspects including their usefulness as tumor marker, in epithelial-mesenchymal transition and cell migration. However, the lung disease-associated IF functions in animal models are poorly understood, and IF mutations associated with lung diseases in humans have not been reported. In this review, we summarize recent studies that show the significance of IF proteins in lung epithelial cells. Understanding these aspects is an important prerequisite for further investigations on the role of lung IF in animal models and human lung diseases.

PMID: 23765163 [PubMed - as supplied by publisher]

Screening for obstructive sleep apnea: is overnight oximetry the best solution?

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Screening for obstructive sleep apnea: is overnight oximetry the best solution?

Sleep Med. 2013 Jun 8;

Authors: Manuel A

PMID: 23756103 [PubMed - as supplied by publisher]

The morphology of the nasopharyngeal inlet in obstructive sleep apnea.

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Routine flexible optic laryngoscopy (FOL) can visualize the airway from the nasopharynx to the hypopharynx in obstructive sleep apnea (OSA). With the tip of a flexible endoscope at the nasopharyngeal inlet (NPI), we can visualize the morphology of this area.

We evaluated the effect of NPI morphology on OSA severity. Videos were obtained during FOL examinations of the NPI in 83 patients (11 females, 72 males; mean age 42.1 ± 9.5 years) and NPI morphology was examined. Two main morphologies were seen: wide and narrow. The narrow NPI group (n = 45) was further subdivided into kidney-shaped (n = 34), elliptical (n = 6), and circumferential (n = 5) groups. The wide NPI group (n = 38) was subdivided into circumferential (n = 20) and kidney-shaped (n = 18) groups. Mean Respiratory Disturbance Index (RDI) values were 30.38 ± 22.36 and 14.51 ± 13.9 in the narrow and wide groups, respectively. Mean RDI values were 45.32 ± 30.6, 23.74 ± 10.8, and 28.72 ± 21.5 in the narrow circumferential, elliptical, and kidney-shaped groups, respectively. Mean RDI values were 11.58 ± 12.91 and 17.8 ± 14.6 in the wide circumferential and kidney-shaped groups, respectively. RDI values were significantly lower in the wide morphology group (p < 0.0005). NPI morphology might predict OSA during routine FOL examination.

Further analysis of the subgroups supported evidence of narrowing, reflected as higher RDI values.

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