Effects of para-toluenesulfonamide intratumoral injection on non-small cell lung carcinoma with severe central airway obstruction: A multi-center, non-randomized, single-arm, open-label trial.

BACKGROUND: Severe malignant airway obstruction (SMAO) is a life-threatening form of non-small cell lung carcinoma (NSCLC). OBJECTIVES: To determine the efficacy and safety of para-toluenesulfonamide (PTS) intratumoral injection in NSCLC-SMAO. METHODS: Ninety patients with NSCLC-SAO received repeated courses of PTS intratumoral injection until tumor sizes had reduced by 50% or greater. Primary endpoint was objective alleviation rate, assessed by chest computed tomography (CT) and bronchoscopy, at day 7 and 30 following final dosing. Secondary endpoints included airway obstruction, spirometry, quality-of-life and survival time. RESULTS: In full-analysis set (N=88), using RECIST criteria, PTS treatment resulted in a significant objective alleviation rate [chest CT: 59.1% (95%CI: 48.1%-69.5%), bronchoscopy: 48.9% (95%CI: 38.1%-59.8%) at day 7; chest CT: 43.2% (95%CI: 32.7%-54.2%), bronchoscopy: 29.6% (95%CI: 20.3%-40.2%) at day 30]. There was a remarkable increase in FVC (mean difference: 0.35 liters, 95%CI: 0.16-0.53 liters), FEV1 (mean difference: 0.27 liters, 95%CI: 0.07-0.48 liters), Baseline Dyspnea Index (mean difference: 64.8%, 95%CI: 53.9-74.7%) and Functional Assessment of Cancer Therapy-Lung Cancer Subscale (mean difference: 6·9, 95%CI: 3.8-9.9) at day 7 post-treatment. We noted significantly reduced prevalence of atelectasis (by 42.9%) and Eastern Cooperative Oncology Group physical performance scale (mean difference: 7.2, 95%CI: 3.9-10.5). Median survival time was 394 days in full-analysis set and 460 days in per-protocol set. Adverse events were reported in 64.0% of subjects. Seven severe adverse events (7.9%) were reported, of which three led to death (drug-related in one case). CONCLUSION: PTS intratumoral injection is effective and well tolerated for palliative therapy of NSCLC-SMAO.

Association between interleukin-17a gene polymorphisms and asthma risk: a meta-analysis.

BACKGROUND: Interleukin-17A (IL-17A), a proinflammatory cytokine, plays an important role in the pathogenesis of asthma. Considerable research has assessed the association between IL-17A polymorphisms and asthma risk, but the results are inconsistent. OBJECTIVE: This meta-analysis was carried out to make a more precise estimation of the relationship between IL-17A polymorphisms and asthma risk. METHODS: The PUBMED, MEDLINE, EMBASE, Chinese National Knowledge Infrastructure and Wan Fang databases were searched systemically on December 12, 2014 and data were extracted from eligible studies by two independent reviewers. Meta-analysis, sub-group analysis, sensitivity analysis and publication bias assessments were all done using Stata 12.1 software. RESULTS: The IL-17A -737C/T polymorphism and IL-17A -197G/A polymorphism were included in the analysis with seven case-control studies. Asthma patients (n = 2882) and healthy controls (n = 2093) were included. The IL17A -737C/T polymorphism was found to have a significantly protective effect on asthma in the allele model (OR = 0.86, 95% CI 0.78-0.96, P = 0.007), dominant model (OR = 0.76, 95% CI 0.65-0.88, P <0.001) and heterozygous model (OR = 0.75, 95% CI 0.64-0.88, P < 0.001) in the overall analysis. Stratified by ethnicity and age, the effects were also significant in the Asian population and in children. However, for IL-17A -197G/A, no significant association was revealed either in the overall analysis in the ethnicity-special subgroup analysis. CONCLUSIONS: The IL-17A -737C/T polymorphism is likely to contribute to protection against asthma, while the IL-17A -197G/A polymorphism may not be associated with asthma susceptibility.

Cerebral anatomical changes in female asthma patients with and without depression compared to healthy controls and patients with depression.

BACKGROUND: Population-based studies have demonstrated that asthma patients with depression symptoms are more likely to have poor asthma control and worse asthma outcomes. However, the underlying mechanism of the relationship between asthma and depression is still unclear. The present study aimed to examine the cerebral anatomical changes in female asthma patients with and without depression. METHODS: Using structural magnetic resonance imaging (MRI) and a voxel-based morphometry technique, the primary effects of and the interaction between asthma and depression were analyzed. The cerebral gray matter volume (GMV) was compared between the groups. Correlation analyses between the GMV value of the brain regions and the clinical parameters were completed. RESULTS: The interaction effect of asthma and depression was found on the right superior temporal gyrus (STG) and the left middle temporal gyrus. Patients with both asthma and depression showed less GMV in the right STG, the bilateral precuneus, and the right superior frontal gyrus compared to patients with asthma only. The GMV of the right STG showed a decrement form among the asthma only group, healthy controls and asthma plus depression group. In patients with asthma and depression, the volume of the right STG was positively correlated with PD20 (r = 0.714, p = 0.047) and negatively correlated with the nocturnal awakening score in the Asthma Control Test (r = -0.061, p = 0.038). CONCLUSION: Current findings provided convergent evidence to support the critical role of the right STG in the brain mechanism that mediates asthma and depression.