Article
A Breath of Fresh Air / Une boufée d’air frais: Abstracts from the 2012 Canadian Respiratory Conference : April 26 – 28, 2012, Vancouver, British Columbia
2012-01-01
Abstract
The present online supplement highlights the poster abstracts selected for presentation at the 5th Annual Canadian Respiratory Conference (CRC) held in Vancouver, British Columbia, in April 2012. The CRC is a partnership initiative of the Canadian Thoracic Society, Canadian Respiratory Health Professionals, The Lung Association and the Canadian COPD Alliance and has become the premiere national educational and scientific meeting for the respiratory community in Canada. I would like to acknowledge the leadership and expertise of the Scientific Committee, our conference speakers and abstract presenters, all of whom contributed to the delivery of an excellent program. The next Canadian Respiratory Conference will be held in Québec City, Quebec, April 11 to 13, 2012 (www.lung.ca/crc). We look forward to seeing you there! <h4>RATIONALE</h4> Atopic asthmatic individuals respond differently, but reproducibly, to allergen inhalation challenge (AIC). Some individuals develop an isolated early response while others develop isolated late or dual responses. The purpose of this study was to identify proteomic bio-signatures of isolated early and dual responses induced through allergen inhalation challenge. <h4>METHODS:</h4> Eight adult subjects [4 early responders (ERs) and 4 dual responders (DRs)] participated in the AIC. Blood samples were collected prior to and 2h after the inhalation challenge. 16 plasma samples (2 per subject) as well as pooled controls were analyzed using isobaric Tags for Relative and Absolute Quantitation (iTRAQ) mass spectrometry. Data was processed using ProteinPilot™ and summarized using the Protein Group Code Algorithm. Moderated robust regression in R (statistical computing program) was used to determine differentially expressed Protein Groups (PGs) using an FDR cut-off of 15%. Ingenuity Pathway Analysis (IPA) was used to determine biological functions, canonical pathways and networks. <h4>RESULTS:</h4> 28 (10 over-expressed and 18 under-expressed) PGs were found to be differentially expressed when comparing ER and DRs at pre-challenge. Complement proteins were significantly under-expressed in DRs relative to ERs at pre-challenge. Fibronectin (FN1) was differentially expressed between ERs and DRs at both pre- and post-challenge time points. IPA indicated Infectious Disease, Inflammatory Response, Antigen Presentation, Cell-To-Cell Signaling and Interaction and Hematological System Development as the top biological functions. <h4>CONCLUSIONS:</h4> Proteomic analysis has shown significant differences between ERs and DRs prior to and following AIC. Reduced expression of complement proteins in DRs implicates innate immunity in asthmatic responses. FN1 levels suggest differences in the extent of tissue remodeling between ERs and DRs. Thus, the AIC model may improve understanding of molecular mechanisms associated with asthma. <h4>INTRODUCTION</h4> Hairdressers may complain of general (headaches, dizziness) and respiratory (shortness of breath, cough, wheeze) symptoms with exposure to chemicals such as hair bleaches, dyes and styling products. As hairdressers are frequently exposed to chemicals, this suggests a possible association between the hairdressing occupation and asthma. This study aimed to investigate this association through the administration of a questionnaire to a group of hairdressers and a group of retail workers. <h4>METHODS:</h4> We conducted a cross-sectional study in the Edmonton area. Hairdressers and a comparison group of retail workers were chosen by convenience sampling and asked to complete a questionnaire which included questions about respiratory symptoms (and whether symptoms were experienced at work or not at work), family history of asthma, exposure to hair bleaches and dyes, asthma/allergy history and smoking history. Subject demographics including age, gender, education, occupation, years in current occupation were also recorded. <h4>RESULTS:</h4> 55 hairdressers and 52 retail workers participated. The average age of the hairdressers was 29 years, the majority (85%) were female. Hairdressers interviewed had spent a mean of 8.8 years working in the industry. Average age of the retail workers was 23 years, the majority were female (67%). Retail workers had spent an average of 3.2 years in their occupation. There were statistically significant differences with hairdresser reporting more shortness of breath (p=0.04), cough (p<0.01), and dizziness (p<0.01) than retail workers. There were no differences in asthma or allergy history between the two groups. More hairdressers than retail workers reported eczema/dermatitis (p<0.01), but none of the hairdressers reported this developed after starting work in the industry. <h4>CONCLUSIONS:</h4> Significantly more respiratory symptoms were reported by the hairdresser group. There was no significant difference between the groups in reported asthma or allergies, while a difference in the prevalence of eczema/dermatitis may not be work-related. <h4>RATIONALE</h4> The fitness results in Pulmonary Rehabilitation are not always completely achieved. This is the consequence of the subject with COPD characteristics and the available resources. However through our experience we were made to see the improvement in quality of life in our patients. <h4>METHODS:</h4> Between January 2010 and May 2011 we implemented a multidisciplinary Respiratory Rehabilitation Program, designed in three Stages: 1) initial assessments 2) general aerobic endurance, global and segmental strength, and flexibility during 32 sessions under supervised twice a week stimuli; and 3) reassessment. During the program 102 patients were interviewed: 32 patients (31%) completed all 3 stages. Of these patients, 15 (46,87%) were female and 17 (53,12%) were male; 32 (100%) had COPD. According to the GOLD classification, 16 patients (50%) were stage II, 11 (34,37%) stage III and 5 (15,62%) stage IV. Mean age was 66 years [SD ±7,4] and FEV1 was 1.25 l. [SD ±0,57]. Regarding BMI, 5 patients (15,62%) were underweight, 9 patients (28,12%) had normal weight, 10 (31,25%) were overweight and 8 (25%) were obese. <h4>RESULTS:</h4> Patients were reassessed upon completing the 32 sessions. CRQ results showed improvements in all four domains: Dyspnea, 21 patients (65,62%); Fatigue, 26 patients (81,25%); Emotional Function, 21 patients (65,62%) and Mastery 17 patients (53,12). As for the 6MWT, 18 patients (56,25%) achieved the MID (54 mts). Fourteen patients did not: 93% had improved in Fatigue, whereas 50% had improved in Dyspnea; 8 patients had a 6MWT >80% of predicted values per Enright’s formula, 2 had peripheral polyneuropathy affecting the lower limbs and 1 depressive syndrome. <h4>CONCLUSIONS:</h4> According to our experience, compliance improved over the last years (25% in 2004 vs. 31% currently). In our groups, the female population with COPD increased 50% over the last years. Patients are being referred at earlier GOLD stages, probably due to an increased promotion of PR. A review of patients show that over 50% are overweight. The improvement in the Fatigue domain (81,25%) – that implies an improvement in fitness – allows us to infer that the basis training was satisfactory, whereas the results of the 6MWT suggest the specific training was insufficient, although this could be due to the characteristics of this 14-patient population, and also to the fact that bicycles were used instead of treadmills for the GAE training. <h4>BACKGROUND</h4> Several studies have shown that a bacterial microbiome exists below the larynx; however, whether or not fungi reside within the lung microbiome has not been established. In severe COPD, airways are infiltrated with inflammatory immune cells that form tertiary lymphoid organs consistent with adaptive immune responses (NEJM 350:2645-53,2004). To determine whether fungi provide a source of persistent antigens that drive this adaptive immune response in severe COPD, a pilot study using unbiased massively parallel sequencing and quantitative PCR was used to detect fungal DNA. <h4>METHODS:</h4> DNA from peripheral lung tissue from a healthy smoker control (2 samples) and a COPD GOLD 4 patient (5 samples) was analyzed using the 75 based, pair-end tag sequencing (Illumina). Numbers of fungal genomes relative to human genomes were calculated from the respective numbers of reads. Following sequencing, non-smoker (n=8), smoker (n=8), COPD GOLD 4 (n=8), and cystic fibrosis (n=8) lung tissue was quantified for fungal specific ribosomal internal transcribed spacer 1 to 2 DNA by qPCR using A. fumigatus as a reference for the standard curve. Sterile water was used as the negative control. <h4>RESULTS:</h4> Sequence analysis showed an average of 39.7 fungi/1000 human cells was found in the samples from the COPD GOLD 4 individual and 38.9 in those from the smoking individual. Compared to the bacteria in these same samples (Am J Respir Crit Care Med 183; 2011:A1017) the fungi were higher (P < 0.05). qPCR confirmed the presence of fungi in the larger sample group. All sample groups were significantly higher than the negative non-template control (P<0.05). <h4>CONCLUSION:</h4> These preliminary results support the presence of small amounts of fungal DNA within the human lung microbiome and it is possible that foreign antigens derived from this source could provide antigens capable of driving an adaptive immune response in severe COPD.
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Identifiers and source
- Literature Corpus work
- 2beb53c7-f654-5ffa-93fb-15622017952c
- DOI
- 10.1155/2012/934291
- PMCID
- PMC3418102