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L'essentiel de la littérature réçente en Pneumologie

Dans cette rubrique on vous propose une revue de la littérature à travers une sélection d'abstracts d'articles originaux.
On essaiera de vous tenir informé des dernières nouveautés de recherche en matière de Pneumologie. On ne vous fournit que le résumé de l'article et le lien correspondant, pour accéder à l'article en full text vous devez être inscrits à la revue correspondante.
Cliquez ici pour consulter la liste des revues de Pneumologie disponibles en libre accès.



Olodaterol Shows Anti-Fibrotic Efficacy in in vitro and in vivo Models of Pulmonary Fibrosis. Imprimer Envoyer
Samedi, 19 Août 2017 07:07
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Olodaterol Shows Anti-Fibrotic Efficacy in in vitro and in vivo Models of Pulmonary Fibrosis.

Br J Pharmacol. 2017 Aug 15;:

Authors: Herrmann FE, Wollin L, Wirth J, Gantner F, Lämmle B, Wex E

Abstract
BACKGROUND AND PURPOSE: Idiopathic pulmonary fibrosis (IPF) is a fatal respiratory disease characterized by excessive fibroblast activation ultimately leading to scarring of the lungs. Although, the activation of β2 -adrenergic receptors (β2 -AR) has been shown to inhibit pro-fibrotic events primarily in cell lines, the role of β2 -AR agonism has not yet been fully characterized. The aim of our study was to explore the anti-fibrotic activity of the long-acting β2 -AR-agonist olodaterol in primary human lung fibroblasts, and in murine models of pulmonary fibrosis.
EXPERIMENTAL APPROACH: We assessed the activity of olodaterol to inhibit various pro-fibrotic mechanisms, induced by different pro-fibrotic mediators, in primary human lung fibroblasts from control donors (HLF) and patients with IPF (IPF-LF). The in vivo anti-fibrotic activity of olodaterol, given once-daily by inhalation in either a preventive or therapeutic treatment regimen, was explored in murine models of lung fibrosis induced by either bleomycin or the overexpression of TGF-β1.
KEY RESULTS: In both, HLF and IPF-LF, olodaterol attenuated TGF-β-induced expression of α-smooth muscle actin, fibronectin and endothelin-1 (ET-1), FGF- and PDGF-induced motility and proliferation, and TGF-β/ET-1-induced contraction. In vivo olodaterol significantly attenuated the bleomycin-induced increase in lung weight, reduced bronchoalveolar lavage cell counts, inhibited pro-fibrotic mediator release (TGF-ß, MMP-9, TIMP-1) and increased the forced vital capacity, though only with the preventive treatment regimen. In the TGF-β-overexpressing model, olodaterol additionally reduced the Col3A1 mRNA expression.
CONCLUSION AND IMPLICATIONS: In conclusion, olodaterol showed anti-fibrotic properties in primary human lung fibroblasts from control and IPF patients and in murine models of lung fibrosis.

PMID: 28810065 [PubMed - as supplied by publisher]

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Practical Management of Respiratory Comorbidities in Patients with Rheumatoid Arthritis. Imprimer Envoyer
Samedi, 19 Août 2017 07:06
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Practical Management of Respiratory Comorbidities in Patients with Rheumatoid Arthritis.

Rheumatol Ther. 2017 Aug 14;:

Authors: Bluett J, Jani M, Symmons DPM

Abstract
Lung disease is one of the most common causes of extra-articular morbidity and mortality in patients with rheumatoid arthritis (RA). Development of pulmonary manifestations may be due to the systemic disease itself; to serious respiratory adverse events such as pneumonitis and infections secondary to therapy; or to lifestyle habits such as smoking. Rheumatologists often need to make important treatment decisions and plan future care in RA patients with respiratory comorbidities, despite the absence of clear evidence or consensus. In this review we evaluate the clinical assessment and management of RA-associated interstitial lung disease, bronchiectasis, serious (including opportunistic) infection, and smoking-related diseases. We summarize the international recommendations for the management of such conditions where available, refer to published best practice on the basis of scientific literature, and propose practical management suggestions to aid informed decision-making.

PMID: 28808949 [PubMed - as supplied by publisher]

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Serological and morphological prognostic factors in patients with interstitial pneumonia with autoimmune features. Imprimer Envoyer
Samedi, 19 Août 2017 07:06
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Serological and morphological prognostic factors in patients with interstitial pneumonia with autoimmune features.

BMC Pulm Med. 2017 Aug 14;17(1):111

Authors: Ito Y, Arita M, Kumagai S, Takei R, Noyama M, Tokioka F, Nishimura K, Koyama T, Notohara K, Ishida T

Abstract
BACKGROUND: To identify the prognostic factors for survival in patients with interstitial pneumonia with autoimmune features (IPAF) who meet the serological domain of the IPAF criteria.
METHODS: We retrospectively analysed 99 IPAF patients who met the serological domain and were hospitalised at the Respiratory Medicine Unit of Kurashiki Central Hospital from 1999 to 2015. The high-resolution computed tomography findings were usual interstitial pneumonia (UIP; n = 1), non-specific interstitial pneumonia (NSIP; n = 63), NSIP with organizing pneumonia (OP) overlap (n = 15), and OP (n = 20). One patient who had radiological UIP pattern, and met the serological and clinical domains was excluded. The clinical characteristics, radiological findings, administered therapy, and prognosis of the remaining 98 IPAF patients who met the serological and morphological domains were analysed.
RESULTS: The median age of the 98 IPAF patients was 68 years, and 41 (41.8%) of them were men. Twelve (12.2%) of the 98 IPAF patients developed other characteristics and were diagnosed with connective tissue disease (CTD) later during the median follow-up of 4.5 years. Univariate Cox analysis revealed systemic sclerosis (SSc)-specific and SSc-associated antibodies (ANA nucleolar pattern, ANA centromere pattern, anti-ribonucleoprotein and anti-Scl-70) positive IPAF, radiological NSIP pattern, bronchoalveolar lavage fluid lymphocytes >15%, and age as significant prognostic factors for survival. Multivariate Cox analysis revealed radiological NSIP pattern (hazard ratio [HR], 4.48; 95% confidence interval [CI], 1.28-15.77, p = 0.02) and age (HR, 1.07; 95% CI, 1.02-1.11, p = 0.01) were significantly associated with worse survival.
CONCLUSIONS: We confirmed that radiological NSIP pattern and age are poor prognostic factors for the survival of IPAF patients. This study suggested that the autoantibodies that are highly specific for certain connective tissue diseases might be less important for the prognosis of IPAF compared with the radiological-pathological patterns. The relatively high proportion of IPAF patients who developed CTD later suggests the importance of careful observation for evolution to CTD in IPAF.

PMID: 28807021 [PubMed - in process]

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