Soluble CD93 as a Novel Biomarker in Asthma Exacerbation

Asthma research is shifting from studying symptoms and lung functions to the narrow-focus cellular profiles protein analysis, biomarkers, and genetic markers. The transmembrane glycoprotein CD93 is involved in endothelial cell migration, angiogenesis, leukocytes extravasation, apoptosis, innate immunity and inflammation. Relationships between the serum level of soluble CD93 (sCD93) and acute myocardial infarction/premature MI/inflammatory arthritis/skin sclerosis have recently been reported. We hypothesized that sCD93 would be elevated during the acute phase of asthma. We measured the serum level of sCD93 in 57 patients with asthma exacerbation and 57 age-and gender-matched healthy controls. Additionally, sCD93 was reassessed at the time of discharge from the hospital. Clinical characteristics and peak expiratory flow (PEF) of the patients were assessed. The primary outcome was the comparison of serum level of sCD93 between asthmatics and healthy subjects. The sCD93 values ranged from 128 to 789 ng/mL in asthmatics (345.83±115.81) and from 31 to 289 ng/mL in control subjects (169.46±62.43). The difference between the 2 groups was statistically significant (P<0.001). The association between sCD93 and asthma remained significant after adjusting for age, sex, and BMI. The differences between asthmatics and controls remained significant on the last day of hospital stay. The association between sCD93 and PEF was not significant. In conclusion, the serum level of soluble CD93 is increased in patients with asthma exacerbation. It also showed that serum levels of sCD93 decreased with treatment of asthma attack. The clinical usefulness of determination of sCD93 as a biomarker of asthma requires further studies.

First presentation of a case of pulmonary alveolar microlithiasis with spontaneous pneumothorax

Pulmonary Alveolar Microlithiasis [PAM] is a rare disease of unknown origin. It is characterized by the presence of small calculi within the alveolar spaces, and has various clinical manifestations. Some patients may be asymptomatic for a long period of time with subsequent occurrence of dyspnea, dry cough, chest pain, and eventually, respiratory failure. Recurrent spontaneous pneumothorax episodes are a late complication of the disease. We report the case of an alveolar microlithiasis episode in a 42-year-old male, admitted to Tohid Hospital, Iran, whose first clinical presentation was symptoms of pneumothorax. He was admitted with sudden onset dyspnea and right-sided pleuretic chest pain. Following treatment of pneumothorax after chest tube placement, the pulmonary function revealed normal indices, and chest radiograph demonstrated diffuse confluence of dense micronodular infiltrate. High-resolution computerized tomography scan showed diffuse ground glass attenuation and calcifications along the interlobular septa and subpleural regions. Transbronchial lung biopsy confirmed the diagnosis of PAM

[Low dose oral theophylline effects on HS-CRP in stable COPD patients]

Low dose theophylline may have some anti-inflammatory effects on COPD patients. This study was conducted to determine the effect of oral low dose theophylline on serum CRP level in patients with stable COPD. In this double blind randomized clinical trail study, 50 patients [25 in experimental and 25 in placebo group] were enrolled into the study by randomized blocking method. Serum HS-CRP using ELISA method was measured before and after the study. Data was analyzed using t-test and paired t-test. There was no significant difference in gender, age, smoking and spirometry variables before study between two groups. Serum HS-CRP level remained the same between two groups before and after the intervention. More studies with large sample size needed to find anti-inflammatory effect of theophylline on macrophages and neutrophils and their derivative inflammatory materials in COPD patients

Anthracosis and anthracofibrosis

To define the clinical, radiographic, and bronchoscopic features, and to describe the occupations of the largest group of patients with anthracosis. All patients who underwent flexible bronchoscopy at 2 Iranian hospitals [Imam Hospital [Tehran], and Tohid Hospital [Sanandaj]], Iran, between April 1982 and June 2006 were considered for inclusion in the study. The demographic data, clinical, and radiographic findings of anthracotic and anthracofibrotic patients were recorded. Of the 14300 patients, 487 cases of simple anthracosis, and 291 of anthracofibrosis were found. A total of 98.4% female patients were housewives, and 86.4% lived in rural areas. Of the male patients, 40.6% were farmers, 29.6% were manual workers, and 7.5% were miners. Of these, 96% of patients had abnormal chest radiography. On bronchoscopic examination, bilateral bronchial involvement was found in 62.5% of the patients. The condition was confined to the trachea in 0.38% of patients, the bronchi involved were the main bronchus in 37%, the lobar bronchi in 83.2%, and segmental bronchi in 35%. Bronchial narrowing and obstruction was observed in 37.4% of the patients. Anthracosis and anthracofibrosis are neglected conditions that are a common finding on routine bronchoscopic examination. Given the demographic findings, and a review of other reports from developing countries, exposure to combustion of biomass fuel in rural areas is a possible risk factor

Prevalence of asthma and rhinitis in bakery workers in the city of Sanandaj, Iran

Baker's asthma is one of the most common forms of occupational asthma. This study was conducted to determine prevalence of asthma and rhinitis among bakery workers in the city of Sanandaj, the provincial center of Kurdistan province in the west of Iran in the in Summer 2006. In this study 776 bread bakery workers were included. These subjects were selected randomly among 1620 bakery workers. The diagnosis of asthma was based on a medical history of episodic symptoms of cough, chest tightness, and dyspnea and spirometry. Airflow obstruction was determined with spirometry, the definition of airflow obstruction which was used in this study was an FEV1/FVC ratio<0.8, and FEV1 or FVC increases of>/=12 percent and at least 200mL after using a short-acting inhaled beta2-agonist. Rhinitis was diagnosed by typical history of work related symptoms. Analyses were performed on 776 subjects [all were men] without missing data for asthma and rhinitis. All of subjects were male with mean age of 33.69 +/- 11.09 years. Mean duration of bakery working for these subjects was 13.91 +/- 9.37 years. Prevalence of asthma at the time of study was 11.9%. 93 subjects were diagnosed as asthma with history, physical and spirometry findings. 31 [33.3%] of asthmatic workers were diagnosed as asthma previously and 62 [66.6%] workers were known as new asthmatic patients which were diagnosed in this study program. The prevalence of rhinitis was [9.9%]. Subjects with asthma had longer history of working at bakery than others [P=0.001]. Asthma prevalence among these bakery workers that were included in our study was similar and in some instances the prevalence was lower than other studies