Lack of association between increased mitochondrial DNA4977 deletion and ATP levels of sputum cells from chronic obstructive pulmonary disease patients versus healthy smokers.

In this study we looked at smokers with and without chronic obstructive pulmonary disease (COPD) patients in order to evaluate the incidence of 4977 base pair (bp) mtDNA (mtDNA4977) deletion and mtDNA copy number in sputum cells and in peripheral blood leukocytes (PBLs) in relation to mitochondrial function and oxidative stress status. Twenty-five COPD patients who were current smokers, 22 smokers and 23 healthy nonsmokers (for only PBLs studies) participated in this study. The 4977-bp deletion was detected in all examined samples within 40 cyles of PCR amplification, using a quantitative real time PCR. The frequency of the mtDNA4977 was significantly higher in the sputum cells of patients with COPD compared to smokers without COPD (p < 0.0001). This difference was not observed in PBLs. Levels of cellular oxidative stress were significantly higher in the sputum cells of subjects with COPD than in the smoker group. However, mtDNA copy number, mitochondrial membrane potential (ΔΨm) and cellular ATP levels in PBLs and sputum cells were not significantly different between the studied groups. The Pearson analysis revealed no correlations between the accumulation of mtDNA4977, and intracellular ATP content and ΔΨm values of the sputum cells, although there was a positive correlation between the increase in the percentage of deleted mtDNA4977 and the levels of cellular oxidative stress in COPD patients (r = 0.80, p < 0.0001). Our studies may suggest that the accumulation of mtDNA4977 in the sputum cells of smokers with COPD does not seem to have an important impact on mitochondrial dysfunction in relation to ATP production and ΔΨm when compared to those of healthy smokers.

The respiratory effects of occupational polypropylene flock exposure.

The present study evaluated the possible effects of exposure to polypropylene flock on respiratory health and serum cytokines in a cross-sectional study of workers from a plant in Turkey. A total of 50 polypropylene flocking workers were compared to a control group of 45 subjects. All subjects filled out a respiratory questionnaire and underwent a physical examination, a chest radiograph and pulmonary function testing, including single breath carbon monoxide diffusing capacity (DL,CO). Serum interleukin-8 (IL-8) and tumour necrosis factor-alpha (TNF-alpha) were measured. Additionally, high resolution computed tomography (HRCT) of the chest was performed in 10 exposed workers with low DL,CO. Work-related respiratory symptoms were reported in 26% of the exposed subjects and in 13.3% of the controls. Logistic regression analysis showed that the risk of respiratory symptoms increased 3.6 fold in polypropylene flocking workers when compared to controls. Parameters of the study group, including per cent predicted: forced vital capacity, forced expiratory volume in one second, forced mid-expiratory flow 25-75% and DL,CO, were significantly lower than in controls. Multivariate analyses showed that being a polypropylene flocking worker was a predictive factor for impairment of pulmonary function. Serum IL-8 and TNF-alpha levels were increased in the study group compared with the controls. HRCT revealed peribronchial thickening and diffuse ground glass attenuation in some subjects. The present study suggests the presence of subtle or the beginning of interstitial lung disease in these polypropylene flocking workers.

Sensitization to horse hair, symptoms and lung function in grooms.

OBJECTIVE: This study aimed to investigate the rate of occupational sensitization to horse hair in grooms and whether occupational exposure to horse hair increases respiratory and allergic symptoms and affects lung function in grooms or not. METHODS: This is a cross-sectional study. Two hundred grooms were randomly selected among 1000 grooms working in Veliefendi Hippodrome of Istanbul. One hundred and twenty-five subjects agreed to enter the study. Ninety-two workers who worked in the different parts of this hippodrome enrolled as the control group. A detailed questionnaire including respiratory and allergic symptoms was filled in, physical examination, skin prick tests and pulmonary function tests were performed. RESULTS: Sensitization to horse hair was 12.8% in grooms and 4.3% in controls. The difference was statistically significant (P = 0.0035). Asthma was found in 14.4% of the grooms and 5.4% of the controls, allergic rhinitis in 42.4% of the grooms and 18.4% of the controls, allergic conjunctivitis in 35.2% of the grooms and 15.2% of the controls, and allergic skin diseases in 32.8% of the grooms and 13% of the controls. The differences were statistically significant (P = 0.043, P = 0.0002, P = 0.001 and P = 0.0008, respectively). The means of FEV1, FEV1/FVC and FVC parameters were significantly lower in the groom group (P = 0.006, P = 0.001 and P = 0.003, respectively). In the multivariate analysis, being in the groom group and working years were found to be predictive factors for impairments of lung function (P < 0.001 and P = 0.002, respectively). CONCLUSION: Occupational exposure to horse increases the sensitization to horse hair, induces asthma and allergic symptoms and also impairs lung functions.

Sensitization to sunflower pollen and lung functions in sunflower processing workers.

BACKGROUND: This study aimed to investigate whether exposure to sunflower pollen (Helianthus annuus) increases both sensitization and respiratory symptoms, and whether or not it affects lung functions in sunflower processing workers. METHODS: The largest sunflower processing factories in the Thrace region of Turkey participated in this study. Workers from the units directly exposed to sunflower seed enrolled as the study group (n = 102) and workers who were not directly exposed to Helianthus annuus pollen (n = 102) were the control group. Detailed questionnaires covering respiratory and allergic symptoms were completed, and skin prick tests and lung function tests were performed. RESULTS: We found a very high rate (23.5%) of sensitization to Helianthus annuus in the study group compared to the controls (P<0.001). Logistic regression analysis showed that the risk of sensitization to H. annuus was increased 4.7-fold (odds ratio = 4.17, 95%) confidence interval = 1.3-16.7) if subjects were exposed to sunflower pollen in the workplace. While asthmatic symptoms and allergic skin diseases were not different between the two groups, workers in the study group had a higher rate of allergic rhinitis and conjunctivitis (P<0.05). We found that pulmonary function was significantly impaired in the study group (P<0.01). Using a multivariate analysis model, inclusion in the study group was found to be a predictive factor for impairment of lung function (P=0.002). CONCLUSIONS: We conclude that sunflower pollen has high allergenic potential, especially when there is close contact, and exposure to sunflower pollen in the workplace can result in impairment in lung function.

Serum IgA and secretory IgA levels in bronchial lavages from patients with a variety of respiratory diseases.

The secretory immunoglobulin A (IgA) system plays an important role in the protection of epithelial surfaces. The aim of this study was to evaluate whether the measurement of the primary airway Ig (sIgA) concentration in bronchial washings is clinically useful in patients with airway epithelial injury or inflammation. We measured serum IgA levels and sIgA concentrations in the bronchial lavages of patients with chronic bronchitis (n = 10), bronchiectasis (n = 15), lung cancer (n = 15) and in healthy control subjects (n = 10). Absolute sIgA levels of bronchial lavage fluids in the chronic bronchitis, bronchiectasis and lung cancer groups were higher than the controls, but there was no significant difference between the groups. sIgA/ml recovered bronchial fluid ratios were similar in the all groups. Standardisation of samples by means of albumin concentration ratios (sIgA/alb) showed that the bronchial lavages of the patients with lung cancer, chronic bronchitis and bronchiectasis were generally similar and demonstrated a significantly decreased sIgA/alb ratio compared to that of control subjects (p = 0.001, p < 0.05 and p < 0.05). sIgA/alb ratios in bronchial lavages recovered from involved lung of the patients with lung cancer and bronchiectasis were lower as compared to uninvolved lung (p < 0.001 and p < 0.05). There was no significant difference in serum IgA levels between all groups. As a result, although our findings seem partly to confirm the hypothesis that local bronchial IgA secretion is impaired in areas of bronchial epithelial injury or inflammation, we thought that sIgA would be useless as a marker of respiratory epithelial injury or inflammation in patients with chronic bronchitis, bronchiectasis and lung cancer.

Effects of heparin on hypertonic potassium chloride-induced bronchoconstriction.

BACKGROUND: Changes in bronchial osmolarity is a well-known factor for bronchoconstricion. Recenty, nonisotonic aerosols have begun to be used for the assessment of bronchial hyperreactivity. Hypertonic KCl can cause bronchoconstriction even in non-symptomatic asthmatic patients. OBJECTIVE: To evaluate the protective role of heparin on hypertonic KCl-induced bronchospasm in asthma. METHODS: Thirty-eight asthmatic patients were included in this double-blind, placebo-controlled study. On day 1 of the study, after performing the respiratory function test (RFT), patients had inhaled KCl 10% and RFTs were done after 20 minutes. On day 2 of the study, after the basal RFT, 18 patents inhaled NaCl 0.9% 0.2 mLkg solution. After the completion of this procedure, patients waited for 20 minutes and inhaled KCl 10% 10 mL, and RFTs were repeated 20 minutes later. The second group consisted of 20patients who inhaled heparn 1,000 units/kg after the RFTs were performed. Twenty minutes later, they inhaled KCl 10% and waited for 20 minutes. Finally, RFTs were done and compared with those from the other group. RESULTS: In the control group, forced expiratory volume in one second (FEV1) decreased 17.4% on day 1 and 16.4% on day 2. In the heparin-treated group, FEV1 decreased 18.6% on day 1, but almost no change occurred after this group was treated with heparin before inhalation of hypertonic KCl on day 2. CONCLUSIONS: Heparin was found to be highly protective against hypertonic KCl induced bronchospasm in bronchial asthma.

Characteristics and compliance of patients receiving long-term oxygen therapy (LTOT) in Turkey.

Compliance is often poor in patients receiving long-term oxygen therapy (LTOT). We assessed some characteristics of LTOT patients and factors associated with non-effective use of LTOT in Turkey. A questionnaire was sent to 1100 patients who purchased their oxygen equipment between January 1995 and September 1999 from the largest oxygen company in Turkey. The questionnaire included items about daily duration of oxygen therapy, home situation, lifestyle, education level of the patient, smoking habits and side effects of oxygen therapy. In addition, patients were asked whether supplementary medical and technical education on oxygen therapy was explained to them. 379 patients responded. The patients had been receiving LTOT for 24.3 +/- 13 months. The mean duration of oxygen therapy was 9 +/- 6.8 hours/day. Only 28.2% of the patients managed to receive oxygen therapy for 15 h or more daily. 33.2% of the patients were told to use oxygen only when they had difficulty in breathing. 6.9% of the patients continued to smoke and 8.7% of the patients had complaints related to oxygen therapy. Logistic regression analysis identified that the likelihood of achieving effective oxygen therapy increased 4.5 fold (p < 0.001) when the physician gave pre-treatment education to the patient about the therapy, and effective use increased 3.8 fold (p < 0.002) when the patients were closely followed-up by the physician. We conclude that pre-treatment education of the patient about the therapy and close follow-up by the physician may increase the compliance rate to LTOT.

Plasma thrombomodulin levels in lung cancer patients.

BACKGROUND: Thrombomodulin (TM) is a glycoprotein and besides its anticoagulant property it is accepted as an onco developmental antigen. Considering these properties we hypothesised that active TMB might have a role in cancer cell behaviour. METHODS: We measured serum TMB levels by the enzyme immunoassay method in 40 patients with lung cancer and 20 healthy subjects. RESULTS: TMB levels were found as 54.6 +/- 11.5 in controls and 60.9 +/- 31.2 ng/ml in lung cancer patients TM levels were 59.4 +/- 24.2 ng/ml in 24 epidermoid carcinoma patients, 65 +/- 50.2 ng/ml in 10 small cell carcinoma patients and 60 +/- 18.4 ng/ml in 6 adenocarcinoma patients. Patients with stage 4 and distant metastasis had a value of 65 +/- 33.9 ng/ml. No significant differences were found between healthy subjects and cancer patients. Also the differences between 3 groups of patients were insignificant. CONCLUSIONS: It was concluded that serum TMB levels could not be accepted as a tumour marker in lung cancer patients.

Determination of the etiological organism during acute exacerbations of COPD and efficacy of azithromycin, ampicillin-sulbactam, ciprofloxacin and cefaclor. Turkish Thoracic Society COPD Working Group.

Acute exacerbations, most of which are due to lower respiratory tract infections, cause great morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD) and most of these are due to lower respiratory tract infections. The aim of this study was to determine the causative organism and the effects of azithromycin, ampicillin sulbactam (sultamicillin), ciprofloxacin and cefaclor monohydrate therapy in COPD. One hundred and six patients with COPD in acute exacerbation were randomized into four groups for empiric antibiotic treatment following lung function tests and sputum examination. The most common strains isolated from sputum were Haemophilus influenzae (30.8%), Streptoccocus pneumoniae (12%) and Moraxella catarrhalis (7.7%). Azithromycin, sultamicillin, ciprofloxacin and cefaclor monohydrate were found to be effective in treating COPD exacerbations.

The relationship between serum ACE activity and total IgE levels in patients with bronchial asthma.

Pulmonary endothelium takes part in the metabolization of some products such as prostaglandins, norepinefrine, serotonin, bradikinin and angiotensin I. Angiotensin I is the substrate for Angiotensin Converting Enzyme (ACE). It is known that greatest production site of ACE is the pulmonary endothelium. A lot of studies have been done for determining the levels of ACE in various lung diseases. It has been observed that serum ACE activity is increased in granulomatous diseases such as sarcoidosis and berylliosis. In patients with bronchial carcinoma, serum ACE activity is found to be decreased. There are some papers about the significant changes in serum ACE activities in asthmatic patients. We determined the activity of ACE and total IgE levels at the serum of 40 asthmatic patients and 20 healthy subjects. Among 40 patients 20 of them were mild asthmatic and they developed symptoms only during the attacks. The remainder 20 patients were chronic asthmatics and all the time they had the symptoms of dyspnea, wheezing and coughing. Serum ACE activity was found 25.5 +/- 11.77 U in the control group, 22.8 +/- 8.04 U in mild asthmatic group and 16.6 +/- 6.13 U in chronic asthmatic group. When compared with control group serum ACE levels found to be significantly decreased in chronic asthmatic group. Also a weak but significant correlation was found between serum total IgE levels and ACE activity in the chronic asthmatic group. These findings suggest that there is a relation between ACE and Total IgE production.