Risk of Motor Vehicle Accidents in Obstructive Sleep Apnea: Comparative Analysis of CPAP Versus Surgery.

Objective: To compare the incidence of motor vehicle accidents (MVAs) among patients with obstructive sleep apnea (OSA) undergoing continuous positive airway pressure (CPAP) therapy and sleep surgery.

Study Design: Retrospective cohort study using the TriNetX national clinical database.

Setting: Analysis of a nationwide patient cohort.

Vitronectin regulates lung tissue remodeling and emphysema in chronic obstructive pulmonary disease.

Vitronectin (VTN) is an important extracellular matrix protein in tissue remodeling, but its role in COPD is unknown. We show that VTN regulates tissue remodeling through urokinase plasminogen activator (uPA) signaling pathway in COPD. In human COPD airways and bronchoepithelial cells and the airways of mice with cigarette smoke (CS)-induced experimental COPD, VTN protein was not changed, but downstream uPA signaling was altered (increased plasminogen activator inhibitor-1, uPAR) that induced collagen and airway remodeling.

Improved Annotation of Asthma Gene Variants with Cell Type Deconvolution of Nasal and Lung Expression-Quantitative Trait Loci.

Asthma is a genetically complex inflammatory airway disease associated with over 200 Single nucleotide polymorphisms (SNPs). However, the functional effects of many asthma-associated SNPs in lung and airway epithelial samples are unknown. Here, we aimed to conduct expression quantitative trait loci (eQTL) analysis using a meta-analysis of nasal and lung samples.

COPD Airway Epithelial Cell-derived Extracellular Vesicles Spread Cellular Senescence via MicroRNA-34a.

Chronic obstructive pulmonary disease (COPD) is associated with the acceleration of lung aging, and the accumulation of senescent cells in lung tissue. MicroRNA (miR)-34a induces senescence by suppressing the anti-aging molecule, sirtuin-1 (SIRT1). Senescent cells spread senescence to neighbouring and distant cells, favouring COPD progression and its comorbidities.

Time course of hospitalizations in patients with heart failure and chronic obstructive pulmonary disease around sleep-disordered-breathing diagnosis.

Purpose: In heart failure (HF) and chronic obstructive pulmonary disease (COPD) populations, sleep-disordered breathing (SDB) is associated with impaired health outcomes. We evaluated whether in patients with HF, concomitant HF and COPD or COPD, the number of hospitalizations would be reduced in the year after testing for SDB with and without treatment initiation compared to the year before.

Methods: We performed a multicentre retrospective study of 390 consecutive sleep-clinic patients who had a primary diagnosis of chronic HF, HF and COPD or COPD and a secondary diagnosis of SDB.

CPAP Therapy for OSA and Its Impact on Various Cardiovascular Disorders.

Obstructive sleep apnea (OSA), a highly prevalent and serious disorder with significant complications, causes considerable daytime and nighttime symptoms as well as long-term consequences and is yet an underdiagnosed and inadequately treated condition. Patients with OSA undergo frequent awakenings during the sleep cycle and find it impossible to get restorative sleep. Individuals are extremely fatigued, sleepy, and irritable throughout the day.

A randomized, crossover trial of one night of oxygen therapy for obstructive sleep apnea in patients with fibrotic interstitial lung disease.

Background And Objective: There is no satisfactory treatment for obstructive sleep apnea (OSA) in patients with interstitial lung disease (ILD) because of poor tolerance of positive airway pressure (PAP) therapy. Supplemental oxygen therapy has been shown to reduce hypoxemia and is well tolerated in patients with ILD. However, little is known about the effect of nocturnal oxygen supplementation (NOS) on OSA in patients with ILD.

Association Between Positive Airway Pressure Therapy and Healthcare Costs Among Older Adults with Comorbid Obstructive Sleep Apnea and Common Chronic Conditions: An Actuarial Analysis.

Study Objectives: To determine the association between adherence to positive airway pressure and healthcare costs among a national sample of older adults with comorbid OSA and common chronic conditions.

Methods: Our data source was a random sample of Medicare administrative claims for years 2016-2019. Inclusion criteria included age >65 years and new diagnosis of OSA.

L-shaped association between leisure-time physical activity and depressive symptoms in individuals with chronic inflammatory airway disease: Data from the NHANES (2007-2018).

Background: Chronic inflammatory airway diseases (CIAD) are well-known risk factors for depression symptoms. There exists a complex interplay between leisure-time physical activity (LTPA) and depressive symptoms. However, the relationship between LTPA duration and depressive symptoms in CIAD patients remains unclear.

TSLP acts on regulatory T cells to maintain their identity and limit allergic inflammation.

Thymic stromal lymphopoietin (TSLP) is a type I cytokine that promotes allergic responses and mediates type 2 immunity. A balance between effector T cells (T), which drive the immune response, and regulatory T cells (T), which suppress the response, is required for proper immune homeostasis. Here, we report that TSLP differentially acts on T versus T to balance type 2 immunity.

Epigenetic Inhibitors Differentially Impact TGF-β1 Signaling Cascades in COPD Airway Smooth Muscle Cells.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive and incurable airflow obstruction and chronic inflammation. Both TGF-β1 and CXCL8 have been well described as fundamental to COPD progression. DNA methylation and histone acetylation, which are well-understood epigenetic mechanisms regulating gene expression, are associated with COPD progression.

Association between asthma and cardiovascular disease: evidence from the national health and nutrition examination survey 1999-2018.

Background: Cardiovascular disease(CVD) remains a significant global challenge. Asthma, which is characterized by airway hyperresponsiveness and reversible and limited airflow, plays an important role in cardiovascular diseases. This study aimed to investigate the association between asthma and CVD.

The Role of WNT5a and TGF-β1 in Airway Remodelling and Severe Asthma.

Background: Airway remodelling is a feature of severe asthma with airway epithelial damage observed frequently. We evaluated the role of WNT5a and TGF-β in asthmatic airway biopsies and in sputum and bronchial brushings assessed their role in remodelling.

Methods: WNT5a and TGF-β protein expression were assessed in the lamina propria epithelium of people with asthma (GINA 1-3, n-8 and GINA 4-5, n-14) and healthy subjects (n-9), alongside relevant remodelling markers.

Mechanistic modelling of allergen-induced airways disease in early life.

Asthma affects approximately 300 million individuals worldwide and the onset predominantly arises in childhood. Children are exposed to multiple environmental irritants, such as viruses and allergens, that are common triggers for asthma onset, whilst their immune systems are developing in early life. Understanding the impact of allergen exposures on the developing immune system and resulting alterations in lung function in early life will help prevent the onset and progression of allergic asthma in children.

Seasonal effect of PM exposure in patients with COPD: a multicentre panel study.

: Exposure to particulate matter <2.5 μm (PM) is linked to chronic obstructive pulmonary disease (COPD), but most studies lack individual PM measurements. Seasonal variation and their impact on clinical outcomes remain understudied.

Anti-IL-4Ra therapy is superior to other biologic classes in treating allergic bronchopulmonary aspergillosis.

Background: Allergic bronchopulmonary aspergillosis (ABPA) is a disease resulting from an overactive type 2 response to . Initial studies suggest that asthma biologics can effectively treat ABPA, but it is unclear which biologic class is superior.

Objective: We sought to compare the effectiveness of asthma biologics in the treatment of ABPA.

Use of STOP-BANG Questionnaire to Predict Postoperative Respiratory Complications after Bariatric Surgery.

Background: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder associated with multisystem organ involvement. The STOP-BANG questionnaire is a short and valid questionnaire used to screen OSA. This study aimed to investigate the ability of the STOP-BANG questionnaire to predict postoperative OSA- related respiratory complications in patients undergoing bariatric surgery.

Social inequalities in childhood asthma.

Asthma is a complex, heterogeneous condition, broadly characterized by chronic airway inflammation with variable expiratory airflow limitation, but with several subtypes underpinned by different (although likely overlapping) pathological mechanisms. It is one of the most common chronic diseases of childhood and represents a significant cost for healthcare systems and affected families. Evidence suggests that a disproportionate proportion of this burden falls on families from disadvantaged socioeconomic circumstances (SECs).

The epithelial era of asthma research: knowledge gaps and future direction for patient care.

The Epithelial Science Expert Group convened on 18-19 October 2023, in Naples, Italy, to discuss the current understanding of the fundamental role of the airway epithelium in asthma and other respiratory diseases and to explore the future direction of patient care. This review summarises the key concepts and research questions that were raised. As an introduction to the epithelial era of research, the evolution of asthma management throughout the ages was discussed and the role of the epithelium as an immune-functioning organ was elucidated.

The Role of Trace Elements in COPD: Pathogenetic Mechanisms and Therapeutic Potential of Zinc, Iron, Magnesium, Selenium, Manganese, Copper, and Calcium.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive, inflammatory airway disorder characterized by a gradual decline in lung function and increased oxidative stress. Both oxidative stress and inflammation are central to its pathophysiology, with trace elements such as zinc, copper, iron, manganese, magnesium, selenium, and calcium playing key roles in various cellular processes.

Objective: This article reviews the role of trace elements in COPD, focusing on their involvement in disease pathogenesis and their therapeutic potential.

Coaching inexperienced clinicians before a high stakes medical procedure: randomized clinical trial.

Objective: To assess whether training provided to an inexperienced clinician just before performing a high stakes procedure can improve procedural care quality, measuring the first attempt success rate of trainees performing infant orotracheal intubation.

Design: Randomized clinical trial.

Setting: Single center, quaternary children's hospital in Boston, MA, USA.

Prevalence and Clinical Correlates of Radiologically Detected Coronary Artery Disease in COPD: A Cross-Sectional Observational Study.

Rationale: Unrecognised coronary artery disease (CAD) may contribute to adverse outcomes in chronic obstructive pulmonary disease (COPD). Improved identification of at-risk groups could inform better preventative care. We aimed to evaluate the burden and relationships of radiologically detectable CAD in COPD, establish frequency of occult disease, and examine potential cardiovascular screening methods.

The Bronchodilator and Anti-Inflammatory Effect of Long-Acting Muscarinic Antagonists in Asthma: An EAACI Position Paper.

As cholinergic innervation is a major contributor to increased vagal tone and mucus secretion, inhaled long-acting muscarinic antagonists (LAMA) are a pillar for the treatment of chronic obstructive pulmonary disease and asthma. By blocking the muscarinic receptors expressed in the lung, LAMA improve lung function and reduce exacerbations in asthma patients who remained poorly controlled despite treatment with inhaled corticosteroids and long-acting β2 agonists. Asthma guidelines recommend LAMA as a third controller to be added on before the initiation of biologicals.

Contextual factors influencing bubble continuous positive airway pressure implementation for paediatric respiratory distress in low-income and middle-income countries: a realist review.

Background: Bubble continuous positive airway pressure (bCPAP) is a low-cost, non-invasive respiratory support therapy for children with respiratory distress, but its effectiveness is dependent on the context. We aimed to understand contextual factors influencing bCPAP implementation for children aged 1-59 months in low-income and middle-income countries (LMICs) and to develop a theory explaining how these factors influence implementation outcomes.

Methods: In this realist review, we generated an initial programme theory comprising candidate context-mechanism-outcome configurations (CMOCs) via review of key references and team discussion.