Vol 3-1 Commentary

Commentary on "Effect of Humidified Noninvasive Ventilation on the Development of Facial Skin Breakdown"

Jaber Saud Alqahtani1, 2*

1Respiratory Care Department, Prince Sultan Military College of Health Sciences – Dhahran, Saudi Arabia

2Respiratory Medicine, University College London, London, United Kingdom

DOI: 10.29245/2689-999X/2018/1.1147 View / Download Pdf
Vol 3-1 Review Article

The Relation between Ambient Temperature and Asthma Exacerbation in Children: A Systematic Review

Hamid Reza Shoraka1,3, Moslem Taheri Soodejani1, Omid Abobakri1, Narges Khanjani2*

1Dept. of Epidemiology and Biostatistics, Kerman University of Medical Sciences, Kerman, Iran

2Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran

3Vector-borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran

Background: Asthma is one of the most common chronic non-communicable diseases which is seen more in the developed than developing countries of the world. Recurrence and exacerbations of the disease are common among patients and often lead to hospitalization and therapeutic interventions. Ambient air temperature might be related to the relapse of asthma. This review was conducted to investigate the relation between ambient temperature and exacerbations of asthma in children.

Methods: Related articles were searched in PubMed, Web of Science, Science Direct, and Scopus databases with appropriate keywords and no specific limitation on October 1, 2018. Initially, the relevance of the articles was examined using the title and abstract. Out of 2633 articles, 23 articles were eligible according to the inclusion and exclusion criteria.

Results: Fourteen studies had reported inverse relations; and showed as the temperature dropped, the number of asthma attacks increased in children. Nine papers observed a relation between hot weather and asthma attacks, 3 studies reported a relation between temperature differences and asthma attacks, and two studies did not show any relation. Some studies suggested the increased incidence of asthma in the 5-14 year old age group was associated with the start of the school year and probably due to the spread of viral diseases, not temperature changes.

Conclusion: Extreme temperatures are likely to cause exacerbation of childhood asthma.

DOI: 10.29245/2689-999X/2018/1.1146 View / Download Pdf
Vol 3-1 Summary
Vol 3-1 Mini Review

Lgr6: From Stemness to Cancer Progression

Emanuela Cortesi, Juan-Jose Ventura*

Translational Cell and Tissue Research, Dept. of Imaging and Pathology, KU Leuven, Belgium

Lung cancer is the leading cause of cancer-related deaths worldwide with poor prognosis, mainly due to the delay in the diagnosis. Adenocarcinoma, a subtype of non-small cell lung cancer, has the highest incidence and significant recurrence rates. Experimental and clinical researches suggested that the presence of cancer stem cells could support the development, malignization and resistance of lung cancer. Unfortunately, our knowledge in the field is still limited.

Here we report our findings regarding a cell population expressing LGR6, an epithelial stem cell marker. Under the pressure of a fine regulated p38? MAPK/mir-17-92 axis, LGR6+ stem cells produce differentiated bronchioalveolar cells, in the normal lung.

LGR6 is enriched in tumour cells during adenocarcinoma progression. Similar to normal stem cells, LGR6+ cancer cells show self-renewal and differentiation capacities, alongside with a higher oncogenic potential. Our studies suggest a disruption in the p38? MAPK/mir-17-92 network, that enhances Wnt pathway activity, could be responsible for the selection of malignant LGR6+ tumour cells. These results support the existence of a cell population with stem-like characteristics and strong oncogenic potential. This population could be useful for predictive diagnosis and a novel target for improved and more effective therapies against metastases and recurrences of lung adenocarcinomas.

DOI: 10.29245/2689-999X/2018/1.1144 View / Download Pdf
Vol 3-1 Review

Fluticasone Furoate: A Once Daily Preparation in Patients with Persistent Asthma

Paul A. Lilburn1*, Henry Ainge-Allen1, Paul S. Thomas1,2

1Department of Respiratory Medicine, Prince of Wales’ Hospital

2Prince of Wales’ Clinical School and Mechanisms of Disease and Translational Research, University of New South Wales, NSW, Faculty of Medicine, University of New South Wales, NSW, Australia

Asthma affects approximately 240 million people worldwide. It is characterised by an allergic pattern of smooth muscle constriction and airway inflammation, and if chronic, the inflammation can lead to structural changes and fixed airflow obstruction. Bronchodilators relieve the bronchoconstriction, while inhaled corticosteroids reduce the airway inflammation. This paper reviews fluticasone furoate (FF), a novel inhaled corticosteroid with 24-hour duration of action. It is a synthetic fluorinated corticosteroid with agonist activity at the glucocorticoid receptor (GRE). It is reported to have a fast association and slow dissociation from the GRE compared to other ICSs. FF has been found to have a greater lung retention time than all other ICS preparations which may contribute to the extended duration of anti-inflammatory action. FF has extensive first pass hepatic metabolism resulting in a low gastrointestinal bioavailability which is consistent with the findings for other ICS preparations. FF, however, will pass from the lung into the systemic circulation and therefore an adverse profile similar to all ICS is likely, but long term data are needed.

FF has demonstrated treatment efficacy for asthma between 100μg and 200μg alone, but in combination with the long-acting beta agonist, vilanterol (FF/VIL 200μg/50μg OD) there were further improvements in lung function relative to monotherapy. There is an increased risk of pneumonia identified in patients with airways disease in associated with ICS preparations and surveillance will be required to determine if this also applies to FF. Once daily therapy, such as FF, may improve compliance and could hopefully be translated into further improvements in asthma-related outcomes.

DOI: 10.29245/2689-999X/2018/1.1143 View / Download Pdf