#Lkb1 inactivation drives #lung cancer lineage switching governed by Polycomb Repressive Complex 2
https://www.nature.com/articles/ncomms14922
Adenosquamous lung tumours, which are extremely poor prognosis, may result from cellular plasticity. Here, we demonstrate lineage switching of KRAS+ lung adenocarcinomas (ADC) to squamous cell carcinoma (SCC) through deletion of Lkb1 (Stk11) in autochthonous and transplant models. Using FACS-isolated populations, we demonstrate that bronchioalveolar stem cells and club cells are the likely cells-of-origin for SCC transitioned tumours. These findings shed light on the epigenetics and cellular origins of lineage-specific lung tumours
https://www.nature.com/articles/ncomms14922
Adenosquamous lung tumours, which are extremely poor prognosis, may result from cellular plasticity. Here, we demonstrate lineage switching of KRAS+ lung adenocarcinomas (ADC) to squamous cell carcinoma (SCC) through deletion of Lkb1 (Stk11) in autochthonous and transplant models. Using FACS-isolated populations, we demonstrate that bronchioalveolar stem cells and club cells are the likely cells-of-origin for SCC transitioned tumours. These findings shed light on the epigenetics and cellular origins of lineage-specific lung tumours
Nature Communications
Lkb1 inactivation drives lung cancer lineage switching governed by Polycomb Repressive Complex 2
The mechanisms that govern the transdifferentiation of lung adenocarcinomas (ADC) to squamous cell carcinoma (SCC) are not fully understood. Here, the authors show that EZH2 loss exacerbates the transdifferentiation of ADCs to SCCs as a result of chromatin…
Systemic Therapy for Stage IV Non–Small-Cell #Lung #Cancer Update
http://www.asco.org/practice-guidelines/quality-guidelines/guidelines/lung-cancer?etcid=39522617&etrid=1061710211&linkid=asco.org%2fpractice-guidelines%2fquality-guidelines%2fguidelines%2flung-cancer%23%2f10201#/10201
Recommendations
New or revised recommendations include the following. Regarding first-line treatment for patients with non–squamous cell carcinoma or squamous cell carcinoma (without positive markers, eg, EGFR/ALK/ROS1), if the patient has high programmed death ligand 1 (PD-L1) expression, pembrolizumab should be used alone; if the patient has low PD-L1 expression, clinicians should offer standard chemotherapy. All other clinical scenarios follow 2015 recommendations. Regarding second-line treatment in patients who received first-line chemotherapy, without prior immune checkpoint therapy, if NSCLC tumor is positive for PD-L1 expression, clinicians should use singleagent nivolumab, pembrolizumab, or atezolizumab; if tumor has negative or unknown PD-L1 expression, clinicians should use nivolumab or atezolizumab. All immune checkpoint therapy is recommended alone plus in the absence of contraindications. For patients who received a prior firstline immune checkpoint inhibitor, clinicians should offer standard chemotherapy. For patients who cannot receive immune checkpoint inhibitor after chemotherapy, docetaxel is recommended; in patients with nonsquamous NSCLC, pemetrexed is recommended. In patients with a sensitizing EGFR mutation, disease progression after first-line epidermal growth factor receptor tyrosine kinase inhibitor therapy, and T790M mutation, osimertinib is recommended; if NSCLC lacks the T790M mutation, then chemotherapy is recommended. Patients with ROS1 gene rearrangement without prior crizotinib may be offered crizotinib, or if they previously received crizotinib, they may be offered chemotherapy
http://www.asco.org/practice-guidelines/quality-guidelines/guidelines/lung-cancer?etcid=39522617&etrid=1061710211&linkid=asco.org%2fpractice-guidelines%2fquality-guidelines%2fguidelines%2flung-cancer%23%2f10201#/10201
Recommendations
New or revised recommendations include the following. Regarding first-line treatment for patients with non–squamous cell carcinoma or squamous cell carcinoma (without positive markers, eg, EGFR/ALK/ROS1), if the patient has high programmed death ligand 1 (PD-L1) expression, pembrolizumab should be used alone; if the patient has low PD-L1 expression, clinicians should offer standard chemotherapy. All other clinical scenarios follow 2015 recommendations. Regarding second-line treatment in patients who received first-line chemotherapy, without prior immune checkpoint therapy, if NSCLC tumor is positive for PD-L1 expression, clinicians should use singleagent nivolumab, pembrolizumab, or atezolizumab; if tumor has negative or unknown PD-L1 expression, clinicians should use nivolumab or atezolizumab. All immune checkpoint therapy is recommended alone plus in the absence of contraindications. For patients who received a prior firstline immune checkpoint inhibitor, clinicians should offer standard chemotherapy. For patients who cannot receive immune checkpoint inhibitor after chemotherapy, docetaxel is recommended; in patients with nonsquamous NSCLC, pemetrexed is recommended. In patients with a sensitizing EGFR mutation, disease progression after first-line epidermal growth factor receptor tyrosine kinase inhibitor therapy, and T790M mutation, osimertinib is recommended; if NSCLC lacks the T790M mutation, then chemotherapy is recommended. Patients with ROS1 gene rearrangement without prior crizotinib may be offered crizotinib, or if they previously received crizotinib, they may be offered chemotherapy
Elemental #Sulfur Use and Associations with Pediatric #Lung Function and Respiratory Symptoms in an Agricultural Community (California, USA)
https://ehp.niehs.nih.gov/ehp528/
Elemental sulfur, “the oldest of all pesticides,” is the most heavily used agricultural pesticide in California and Europe. Sulfur is considered relatively safe and is used in both conventional and organic farming systems.
Adverse respiratory effects have been reported in applicators and animals..
Adverse associations with respiratory outcomes were found for sulfur applications within 0.5- and 1-km radii. Specifically, asthma medication usage and respiratory symptoms increased OR=3.51; 95% confidence interval (CI): 1.50, 8.23, p=0.004; OR=2.09; 95% CI: 1.27, 3.46, p=0.004, respectively and FEV1 decreased (β=−0.143; 95% CI: −0.248, −0.039, p=0.008) per 10-fold increase in the estimated amount of sulfur used within 1 km of child residence during the year prior to pulmonary evaluation.
CONCLUSIONS:
This study suggests that elemental sulfur use, allowed in both organic and conventional farming, in close proximity to residential areas, may adversely affect children’s respiratory health
https://ehp.niehs.nih.gov/ehp528/
Elemental sulfur, “the oldest of all pesticides,” is the most heavily used agricultural pesticide in California and Europe. Sulfur is considered relatively safe and is used in both conventional and organic farming systems.
Adverse respiratory effects have been reported in applicators and animals..
Adverse associations with respiratory outcomes were found for sulfur applications within 0.5- and 1-km radii. Specifically, asthma medication usage and respiratory symptoms increased OR=3.51; 95% confidence interval (CI): 1.50, 8.23, p=0.004; OR=2.09; 95% CI: 1.27, 3.46, p=0.004, respectively and FEV1 decreased (β=−0.143; 95% CI: −0.248, −0.039, p=0.008) per 10-fold increase in the estimated amount of sulfur used within 1 km of child residence during the year prior to pulmonary evaluation.
CONCLUSIONS:
This study suggests that elemental sulfur use, allowed in both organic and conventional farming, in close proximity to residential areas, may adversely affect children’s respiratory health
Long-Term, Supplemental, One-Carbon Metabolism–Related Vitamin #B Use in Relation to #Lung Cancer Risk in the Vitamins and Lifestyle (VITAL) Cohort
http://ascopubs.org/doi/abs/10.1200/JCO.2017.72.7735
Use of supplemental vitamins B6, folate, and B12 was not associated with lung cancer risk among women. In contrast, use of vitamin B6 and B12 from individual supplement sources, but not from multivitamins, was associated with a 30% to 40% increase in lung cancer risk among men. When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers. For vitamin B6 and B12, the risk was even higher among men who were smoking at baseline. In addition, the B6 and B12 associations were apparent in all histologic types except adenocarcinoma, which is the type less related to smoking.
Conclusion
This sex- and source-specific association provides further evidence that vitamin B supplements are not chemopreventive for lung cancer and may be harmful
http://ascopubs.org/doi/abs/10.1200/JCO.2017.72.7735
Use of supplemental vitamins B6, folate, and B12 was not associated with lung cancer risk among women. In contrast, use of vitamin B6 and B12 from individual supplement sources, but not from multivitamins, was associated with a 30% to 40% increase in lung cancer risk among men. When the 10-year average supplement dose was evaluated, there was an almost two-fold increase in lung cancer risk among men in the highest categories of vitamin B6 (> 20 mg/d; hazard ratio, 1.82; 95% CI, 1.25 to 2.65) and B12 (> 55µg/d; hazard ratio, 1.98; 95% CI, 1.32 to 2.97) compared with nonusers. For vitamin B6 and B12, the risk was even higher among men who were smoking at baseline. In addition, the B6 and B12 associations were apparent in all histologic types except adenocarcinoma, which is the type less related to smoking.
Conclusion
This sex- and source-specific association provides further evidence that vitamin B supplements are not chemopreventive for lung cancer and may be harmful
Dietary #antioxidants and 10-year #lung function decline in adults from the ECRHS survey
http://erj.ersjournals.com/content/50/6/1602286
In 2002, adults from three participating countries of the European Community Respiratory Health Survey (ECRHS) answered a questionnaire and underwent spirometry (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)), which were repeated 10 years later. Dietary intake was estimated at baseline with food frequency questionnaires (FFQ). Associations between annual lung function decline (mL) and diet (tertiles) were examined with multivariable analyses. Simes’ procedure was applied to control for multiple testing.
A total of 680 individuals (baseline mean age 43.8±6.6 years) were included. A per-tertile increase in apple and banana intake was associated with a 3.59 mL·year−1 (95% CI 0.40, 7.68) and 3.69 mL·year−1 (95% CI 0.25, 7.14) slower decline in FEV1 and FVC, respectively. Tomato intake was also associated with a slower decline in FVC (4.5 mL·year−1; 95% CI 1.28, 8.02). Only the association with tomato intake remained statistically significant after the Simes’ procedure was performed. Subgroup analyses showed that apple, banana and tomato intake were all associated with a slower decline in FVC in ex-smokers.
Intake of fruits and tomatoes might delay lung function decline in adults, particularly in ex-smokers.
http://erj.ersjournals.com/content/50/6/1602286
In 2002, adults from three participating countries of the European Community Respiratory Health Survey (ECRHS) answered a questionnaire and underwent spirometry (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)), which were repeated 10 years later. Dietary intake was estimated at baseline with food frequency questionnaires (FFQ). Associations between annual lung function decline (mL) and diet (tertiles) were examined with multivariable analyses. Simes’ procedure was applied to control for multiple testing.
A total of 680 individuals (baseline mean age 43.8±6.6 years) were included. A per-tertile increase in apple and banana intake was associated with a 3.59 mL·year−1 (95% CI 0.40, 7.68) and 3.69 mL·year−1 (95% CI 0.25, 7.14) slower decline in FEV1 and FVC, respectively. Tomato intake was also associated with a slower decline in FVC (4.5 mL·year−1; 95% CI 1.28, 8.02). Only the association with tomato intake remained statistically significant after the Simes’ procedure was performed. Subgroup analyses showed that apple, banana and tomato intake were all associated with a slower decline in FVC in ex-smokers.
Intake of fruits and tomatoes might delay lung function decline in adults, particularly in ex-smokers.
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A Validated Clinical Risk Prediction Model for #Lung Cancer in #Smokers of All Ages and Exposure Types: A HUNT Study
https://www.sciencedirect.com/science/article/pii/S2352396418301142?via%3Dihub
Highlights
•
Applying this risk model in adults, screening 22% of ever-smokers would identify 81·85% of all lung cancers within 6 years.
•
Two novel highly significant factors were identified, periodical daily cough, and hours of daily indoors exposure to smoke.
•
The HUNT Lung Cancer Model is an accurate risk predictor useful in prospective screening studies for lung cancer.
Our final HUNT Lung Cancer Model included age, pack-years, smoking intensity, years since smoking cessation, body mass index, daily cough, and hours of daily indoors exposure to smoke. External validation showed a 0·879 concordance index (95% CI 0·866–0·891) with an area under the curve of 0·87 (95% CI 0·85–0·89) within 6 years. Only 22% of ever-smokers would need screening to identify 81·85% of all lung cancers within 6 years.
Our model of seven variables is simple, accurate, and useful for screening selection
A Validated Clinical Risk Prediction Model for #Lung Cancer in #Smokers of All Ages and Exposure Types: A HUNT Study
https://www.sciencedirect.com/science/article/pii/S2352396418301142?via%3Dihub
Highlights
•
Applying this risk model in adults, screening 22% of ever-smokers would identify 81·85% of all lung cancers within 6 years.
•
Two novel highly significant factors were identified, periodical daily cough, and hours of daily indoors exposure to smoke.
•
The HUNT Lung Cancer Model is an accurate risk predictor useful in prospective screening studies for lung cancer.
Our final HUNT Lung Cancer Model included age, pack-years, smoking intensity, years since smoking cessation, body mass index, daily cough, and hours of daily indoors exposure to smoke. External validation showed a 0·879 concordance index (95% CI 0·866–0·891) with an area under the curve of 0·87 (95% CI 0·85–0·89) within 6 years. Only 22% of ever-smokers would need screening to identify 81·85% of all lung cancers within 6 years.
Our model of seven variables is simple, accurate, and useful for screening selection
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FDA approves a new antibacterial drug to treat a serious #lung disease using a novel pathway to spur innovation
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm622048.htm
The U.S. Food and Drug Administration today approved a new drug, Arikayce (amikacin liposome inhalation suspension), for the treatment of lung disease caused by a group of bacteria, Mycobacterium avium complex ( #MAC ) in a limited population of patients with the disease who do not respond to conventional treatment (refractory disease).
MAC is a type of nontuberculous mycobacteria (NTM) commonly found in water and soil. Symptoms of disease in patients with MAC include persistent cough, fatigue, weight loss, night sweats, and occasionally shortness of breath and coughing up of blood.
"As bacteria continue to grow impervious to currently available antibiotics, we need to encourage the development of drugs that can treat resistant infections. That means utilizing novel tools intended to streamline development and encourage investment into these important endeavors," said FDA Commissioner Scott Gottlieb, M.D. "This approval is the first time a drug is being approved under the Limited Population Pathway for Antibacterial and Antifungal Drugs, and it marks an important policy milestone..."
FDA approves a new antibacterial drug to treat a serious #lung disease using a novel pathway to spur innovation
https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm622048.htm
The U.S. Food and Drug Administration today approved a new drug, Arikayce (amikacin liposome inhalation suspension), for the treatment of lung disease caused by a group of bacteria, Mycobacterium avium complex ( #MAC ) in a limited population of patients with the disease who do not respond to conventional treatment (refractory disease).
MAC is a type of nontuberculous mycobacteria (NTM) commonly found in water and soil. Symptoms of disease in patients with MAC include persistent cough, fatigue, weight loss, night sweats, and occasionally shortness of breath and coughing up of blood.
"As bacteria continue to grow impervious to currently available antibiotics, we need to encourage the development of drugs that can treat resistant infections. That means utilizing novel tools intended to streamline development and encourage investment into these important endeavors," said FDA Commissioner Scott Gottlieb, M.D. "This approval is the first time a drug is being approved under the Limited Population Pathway for Antibacterial and Antifungal Drugs, and it marks an important policy milestone..."
U.S. Food and Drug Administration
FDA approves a new antibacterial drug to treat a serious lung disease using a novel pathway to spur innovation
The FDA approved the first antibacterial drug under the Limited Population Pathway for Antibacterial and Antifungal Drugs (LPAD). LPAD was created by Congress to spur development of drugs targeting serious infections in limited patient populations with unmet…
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Development and Validation of a Multivariable #Lung Cancer Risk Prediction Model That Includes Low-Dose Computed #Tomography Screening Results
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726714
Incident lung cancers occurring 1 to 4 years after the third screen (202 LSS and 96 ACRIN). Predictors included scores from the validated PLCOm2012 risk model and Lung CT Screening Reporting & Data System (Lung-RADS) screening results.
In ACRIN validation data, the model that included PLCOm2012 scores and screening results (PLCO2012results) demonstrated significantly greater discrimination (area under the curve, 0.761; 95% CI, 0.716-0.799) than when screening results were excluded (PLCOm2012) (area under the curve, 0.687; 95% CI, 0.645-0.728) (P < .001). In ACRIN validation data, PLCO2012results demonstrated good calibration. Individuals who had initial negative scans but elevated PLCOm2012 six-year risks of at least 2.6% did not have risks decline below the 1.5% screening eligibility criterion when subsequent screens were negative.
Conclusions and Relevance According to this analysis, some individuals with elevated risk scores who have negative initial screens remain at elevated risks, warranting annual screening. Positive screens seem to increase baseline risk scores and may identify high-risk individuals for continued screening and enrollment into clinical trials
Development and Validation of a Multivariable #Lung Cancer Risk Prediction Model That Includes Low-Dose Computed #Tomography Screening Results
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726714
Incident lung cancers occurring 1 to 4 years after the third screen (202 LSS and 96 ACRIN). Predictors included scores from the validated PLCOm2012 risk model and Lung CT Screening Reporting & Data System (Lung-RADS) screening results.
In ACRIN validation data, the model that included PLCOm2012 scores and screening results (PLCO2012results) demonstrated significantly greater discrimination (area under the curve, 0.761; 95% CI, 0.716-0.799) than when screening results were excluded (PLCOm2012) (area under the curve, 0.687; 95% CI, 0.645-0.728) (P < .001). In ACRIN validation data, PLCO2012results demonstrated good calibration. Individuals who had initial negative scans but elevated PLCOm2012 six-year risks of at least 2.6% did not have risks decline below the 1.5% screening eligibility criterion when subsequent screens were negative.
Conclusions and Relevance According to this analysis, some individuals with elevated risk scores who have negative initial screens remain at elevated risks, warranting annual screening. Positive screens seem to increase baseline risk scores and may identify high-risk individuals for continued screening and enrollment into clinical trials
Jamanetwork
Multivariable Lung Cancer Risk Prediction Model Including CT Screening Results
This secondary analysis of data from the National Lung Screening Trial develops and validates a risk prediction model that incorporates low-dose computed tomography (CT) screening results for patients being screened for lung cancer.
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Association of Long-term Use of Low-Dose #Aspirin as Chemoprevention With Risk of #Lung Cancer
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726712
The duration of low-dose aspirin use was none for 10 987 417 participants (84.7%), 1 to 2 years for 750 992 participants (5.8%), 3 to 4 years for 506 945 participants (3.9%), 5 to 6 years for 371 062 participants (2.9%), 7 to 8 years for 240 528 participants (1.9%), and 9 years for 112 456 participants (0.9%). Compared with no aspirin use, 5 to 6 years (adjusted hazard ratio, 0.96 [95% CI, 0.92-0.99]), 7 to 8 years (adjusted hazard ratio, 0.94 [95% CI, 0.90-0.99]), and 9 years (adjusted hazard ratio, 0.89 [95% CI, 0.84-0.94]) of aspirin use were significantly associated with reduced lung cancer risk. After stratified analysis, a significant reduction of lung cancer risk was observed among people aged 65 years or older and among people without diabetes.
Conclusions and Relevance Although the use of low-dose aspirin for more than 5 years was associated with decreased risk of lung cancer, particularly among elderly participants and among people without diabetes, the observed effect size was quite modest. Future prospective studies are needed to determine whether there is a causal association.
Association of Long-term Use of Low-Dose #Aspirin as Chemoprevention With Risk of #Lung Cancer
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726712
The duration of low-dose aspirin use was none for 10 987 417 participants (84.7%), 1 to 2 years for 750 992 participants (5.8%), 3 to 4 years for 506 945 participants (3.9%), 5 to 6 years for 371 062 participants (2.9%), 7 to 8 years for 240 528 participants (1.9%), and 9 years for 112 456 participants (0.9%). Compared with no aspirin use, 5 to 6 years (adjusted hazard ratio, 0.96 [95% CI, 0.92-0.99]), 7 to 8 years (adjusted hazard ratio, 0.94 [95% CI, 0.90-0.99]), and 9 years (adjusted hazard ratio, 0.89 [95% CI, 0.84-0.94]) of aspirin use were significantly associated with reduced lung cancer risk. After stratified analysis, a significant reduction of lung cancer risk was observed among people aged 65 years or older and among people without diabetes.
Conclusions and Relevance Although the use of low-dose aspirin for more than 5 years was associated with decreased risk of lung cancer, particularly among elderly participants and among people without diabetes, the observed effect size was quite modest. Future prospective studies are needed to determine whether there is a causal association.
Jamanetwork
Risk of Lung Cancer With Long-term Use of Low-Dose Aspirin as Chemoprevention
This nationwide, population-based cohort study uses data from the Korean National Health Information Database to assess whether an association exists between low-dose aspirin use and lung cancer risk and to identify specific subgroups that may benefit most…
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State investigating death from severe #lung illness linked to #vaping
https://www.oregon.gov/oha/ERD/Pages/State-Investigating-Death-Severe-Lung-Illness-Link-Vaping.aspx
The Oregon Health Authority is investigating the recent death of an individual who had severe respiratory illness following use of an e-cigarette, which is also known as a vaping device.
Investigators at the OHA Public Health Division say they received reports that the individual, who died in July, had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary. OHA officials say the individual’s symptoms were consistent with those of more than 200 similar cases in a national cluster of respiratory illness, mostly affecting teenagers and young adults, in at least 25 states...
State investigating death from severe #lung illness linked to #vaping
https://www.oregon.gov/oha/ERD/Pages/State-Investigating-Death-Severe-Lung-Illness-Link-Vaping.aspx
The Oregon Health Authority is investigating the recent death of an individual who had severe respiratory illness following use of an e-cigarette, which is also known as a vaping device.
Investigators at the OHA Public Health Division say they received reports that the individual, who died in July, had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary. OHA officials say the individual’s symptoms were consistent with those of more than 200 similar cases in a national cluster of respiratory illness, mostly affecting teenagers and young adults, in at least 25 states...
www.oregon.gov
Oregon Health Authority : State investigating death from severe lung illness linked to vaping : External Relations Division : State…
oregon health authority State investigating death from severe lung illness linked to vaping
Clinical presentation, treatment, and short-term outcomes of #lung injury associated with e-cigarettes or #vaping: a prospective observational cohort study
33 (55%) of 60 were admitted to an intensive care unit (ICU). 53 (88%) of 60 patients presented with constitutional symptoms, 59 (98%) with respiratory symptoms, and 54 (90%) with gastrointestinal symptoms. 54 (90%) of 60 were given antibiotics and 57 (95%) were given steroids. Six (10%) of 60 patients were readmitted to an ICU or hospital within 2 weeks, three (50%) of whom had relapsed with vaping or e-cigarette use. Of 26 patients who were followed up within 2 weeks, despite clinical and radiographic improvement in all, many had residual abnormalities on chest radiographs (ten [67%] of 15) and pulmonary function tests (six [67%] of nine). Two patients died and lung injury associated with e-cigarettes or vaping was thought to be a contributing factor, but not the cause of death, for both.
Interpretation
Lung injury associated with e-cigarettes or vaping is an emerging illness associated with severe lung injury and constitutional and gastrointestinal symptoms. Increased awareness has led to identification of a broad spectrum of severity of illness in patients who were treated with antibiotics and steroids. Despite improvement, at short-term follow-up many patients had residual abnormalities. Lung injury associated with e-cigarettes or vaping remains a clinical diagnosis with symptoms that overlap infectious and other lung diseases. Maintaining a high index of suspicion for this disease is important as work continues in understanding the cause or causes, optimal therapy, and long-term outcomes of these patients.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32679-0/fulltext
33 (55%) of 60 were admitted to an intensive care unit (ICU). 53 (88%) of 60 patients presented with constitutional symptoms, 59 (98%) with respiratory symptoms, and 54 (90%) with gastrointestinal symptoms. 54 (90%) of 60 were given antibiotics and 57 (95%) were given steroids. Six (10%) of 60 patients were readmitted to an ICU or hospital within 2 weeks, three (50%) of whom had relapsed with vaping or e-cigarette use. Of 26 patients who were followed up within 2 weeks, despite clinical and radiographic improvement in all, many had residual abnormalities on chest radiographs (ten [67%] of 15) and pulmonary function tests (six [67%] of nine). Two patients died and lung injury associated with e-cigarettes or vaping was thought to be a contributing factor, but not the cause of death, for both.
Interpretation
Lung injury associated with e-cigarettes or vaping is an emerging illness associated with severe lung injury and constitutional and gastrointestinal symptoms. Increased awareness has led to identification of a broad spectrum of severity of illness in patients who were treated with antibiotics and steroids. Despite improvement, at short-term follow-up many patients had residual abnormalities. Lung injury associated with e-cigarettes or vaping remains a clinical diagnosis with symptoms that overlap infectious and other lung diseases. Maintaining a high index of suspicion for this disease is important as work continues in understanding the cause or causes, optimal therapy, and long-term outcomes of these patients.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32679-0/fulltext
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#C-reactive protein mediates the association between leisure-time physical #activity and #lung function in middle-aged and older adults
Although previous studies have reported the benefits of physical activity (PA) to lung function in middle-aged and older adults, the biological mechanisms are still unclear..
..Multiple linear regression models suggested that higher PA was associated with lower levels of CRP (β = − 0.048, P = 0.002 for moderate PA; β = − 0.108, P < 0.001 for high PA). CRP negatively correlated with FEV1 (β = − 0.180, P < 0.001) and FVC (β = − 0.181, P < 0.001). Higher levels of PA were associated with better FEV1 (β = 0.085, P < 0.001 for moderate PA; β = 0.150, P < 0.001 for high PA) and FVC (β = 0.131, P < 0.001 for moderate PA; β = 0.211, P < 0.001 for high PA)..
The association between PA and lung function is mediated by CRP, suggesting that this association may be partially explained by an inflammation-related biological mechanism. This finding highlights the possible importance of PA in systemic inflammation and lung function, thus, middle-aged and older adults should be encouraged to enhance PA levels.
https://bit.ly/2Re1GX9
#C-reactive protein mediates the association between leisure-time physical #activity and #lung function in middle-aged and older adults
Although previous studies have reported the benefits of physical activity (PA) to lung function in middle-aged and older adults, the biological mechanisms are still unclear..
..Multiple linear regression models suggested that higher PA was associated with lower levels of CRP (β = − 0.048, P = 0.002 for moderate PA; β = − 0.108, P < 0.001 for high PA). CRP negatively correlated with FEV1 (β = − 0.180, P < 0.001) and FVC (β = − 0.181, P < 0.001). Higher levels of PA were associated with better FEV1 (β = 0.085, P < 0.001 for moderate PA; β = 0.150, P < 0.001 for high PA) and FVC (β = 0.131, P < 0.001 for moderate PA; β = 0.211, P < 0.001 for high PA)..
The association between PA and lung function is mediated by CRP, suggesting that this association may be partially explained by an inflammation-related biological mechanism. This finding highlights the possible importance of PA in systemic inflammation and lung function, thus, middle-aged and older adults should be encouraged to enhance PA levels.
https://bit.ly/2Re1GX9
BMC Public Health
C-reactive protein mediates the association between leisure-time physical activity and lung function in middle-aged and older adults
Although previous studies have reported the benefits of physical activity (PA) to lung function in middle-aged and older adults, the biological mechanisms are still unclear. This study aimed to assess the extent to which C-reactive protein (CRP) mediates…
Electronic-#cigarette smoke induces #lung adenocarcinoma and #bladder urothelial hyperplasia in mice
Electronic-cigarettes (E-cigs) are marketed as a safe alternative to tobacco to deliver the stimulant nicotine, and their use is gaining in popularity, particularly among the younger population. We recently showed that mice exposed to short-term (12 wk) E-cig smoke (ECS) sustained extensive DNA damage in lungs, heart, and bladder mucosa and diminished DNA repair in lungs..
..We found that mice exposed to ECS for 54 wk developed lung adenocarcinomas (9 of 40 mice, 22.5%) and bladder urothelial hyperplasia (23 of 40 mice, 57.5%). These lesions were extremely rare in mice exposed to vehicle control or filtered air. Current observations that ECS induces lung adenocarcinomas and bladder urothelial hyperplasia, combined with our previous findings that ECS induces DNA damage in the lungs and bladder and inhibits DNA repair in lung tissues, implicate ECS as a lung and potential bladder carcinogen in mice. While it is well established that tobacco smoke poses a huge threat to human health, whether ECS poses any threat to humans is not yet known and warrants careful investigation.
https://bit.ly/35TzTAE
Electronic-cigarettes (E-cigs) are marketed as a safe alternative to tobacco to deliver the stimulant nicotine, and their use is gaining in popularity, particularly among the younger population. We recently showed that mice exposed to short-term (12 wk) E-cig smoke (ECS) sustained extensive DNA damage in lungs, heart, and bladder mucosa and diminished DNA repair in lungs..
..We found that mice exposed to ECS for 54 wk developed lung adenocarcinomas (9 of 40 mice, 22.5%) and bladder urothelial hyperplasia (23 of 40 mice, 57.5%). These lesions were extremely rare in mice exposed to vehicle control or filtered air. Current observations that ECS induces lung adenocarcinomas and bladder urothelial hyperplasia, combined with our previous findings that ECS induces DNA damage in the lungs and bladder and inhibits DNA repair in lung tissues, implicate ECS as a lung and potential bladder carcinogen in mice. While it is well established that tobacco smoke poses a huge threat to human health, whether ECS poses any threat to humans is not yet known and warrants careful investigation.
https://bit.ly/35TzTAE
PNAS
Electronic-cigarette smoke induces lung adenocarcinoma and bladder urothelial hyperplasia in mice
Electronic-cigarette smoke (ECS) is designed to deliver nicotine, and its use is gaining popularity. Previously, we found that ECS induces DNA damage and inhibits DNA repair in the mouse lungs and bladder urothelium. Nicotine induces the same types of DNA…
Interstitial #lung abnormalities and the clinical course in patients with #COPD
https://2medical.news/2020/09/06/interstitial-lung-abnormalities-and-the-clinical-course-in-patients-with-copd/
The presence and progression of interstitial lung abnormalities (ILA) is known to be associated with a decline of lung function and increased risk of mortality. Research question We aimed to elucidate the clinical course according to ILA in patients with chronic obstructive pulmonary disease (COPD).. ..Of 363 patients with COPD, 44 and 103 patients had equivocal and definite ILA, respectively. Patients with ILA were significantly …
https://2medical.news/2020/09/06/interstitial-lung-abnormalities-and-the-clinical-course-in-patients-with-copd/
The presence and progression of interstitial lung abnormalities (ILA) is known to be associated with a decline of lung function and increased risk of mortality. Research question We aimed to elucidate the clinical course according to ILA in patients with chronic obstructive pulmonary disease (COPD).. ..Of 363 patients with COPD, 44 and 103 patients had equivocal and definite ILA, respectively. Patients with ILA were significantly …
Chest x-ray findings and temporal #lung changes in patients with #COVID-19 pneumonia
https://2medical.news/2020/09/23/chest-x-ray-findings-and-temporal-lung-changes-in-patients-with-covid-19-pneumonia/
Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.. ..A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed …
https://2medical.news/2020/09/23/chest-x-ray-findings-and-temporal-lung-changes-in-patients-with-covid-19-pneumonia/
Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.. ..A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed …
Home #Oxygen Therapy for Adults with Chronic #Lung Disease. An Official American Thoracic Society Clinical Practice Guideline
https://2medical.news/2020/11/21/home-oxygen-therapy-for-adults-with-chronic-lung-disease-an-official-american-thoracic-society-clinical-practice-guideline/
Evidence-based guidelines are needed for effective delivery of home oxygen therapy to appropriate patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). Methods: The multidisciplinary panel created six research questions using a modified Delphi approach. A systematic review of the literature was completed, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations: The panel …
https://2medical.news/2020/11/21/home-oxygen-therapy-for-adults-with-chronic-lung-disease-an-official-american-thoracic-society-clinical-practice-guideline/
Evidence-based guidelines are needed for effective delivery of home oxygen therapy to appropriate patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). Methods: The multidisciplinary panel created six research questions using a modified Delphi approach. A systematic review of the literature was completed, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to formulate clinical recommendations. Recommendations: The panel …
Distinct developmental pathways from blood #monocytes generate human #lung macrophage diversity
https://2medical.news/2021/01/06/distinct-developmental-pathways-from-blood-monocytes-generate-human-lung-macrophage-diversity/
The study of human macrophages and their ontogeny is an important unresolved issue. Here, we use a humanized mouse model expressing human cytokines to dissect the development of lung macrophages from human hematopoiesis in vivo. Human CD34+ hematopoietic stem and progenitor cells (HSPCs) generated three macrophage populations, occupying separate anatomical niches in the lung. Intravascular cell labeling, cell transplantation, and fate-mapping studies established that classical …
https://2medical.news/2021/01/06/distinct-developmental-pathways-from-blood-monocytes-generate-human-lung-macrophage-diversity/
The study of human macrophages and their ontogeny is an important unresolved issue. Here, we use a humanized mouse model expressing human cytokines to dissect the development of lung macrophages from human hematopoiesis in vivo. Human CD34+ hematopoietic stem and progenitor cells (HSPCs) generated three macrophage populations, occupying separate anatomical niches in the lung. Intravascular cell labeling, cell transplantation, and fate-mapping studies established that classical …
Calculated indices of volatile organic compounds (VOCs) in exhalation for #lung #cancer screening and early detection
https://2medical.news/2021/02/17/calculated-indices-of-volatile-organic-compounds-vocs-in-exhalation-for-lung-cancer-screening-and-early-detection/
Breath analysis is a promising noninvasive technique that offers a wide range of opportunities to facilitate early diagnosis of lung cancer (LC). Method Exhaled breath samples of 352 subjects including 160 with lung cancer (LC), 70 with benign pulmonary nodule (BPN) and 122 healthy controls (HC) were analyzed through thermal desorption coupled with gas chromatography-mass spectrometry (TD-GC–MS) to obtain the metabolic information from volatile organic …
https://2medical.news/2021/02/17/calculated-indices-of-volatile-organic-compounds-vocs-in-exhalation-for-lung-cancer-screening-and-early-detection/
Breath analysis is a promising noninvasive technique that offers a wide range of opportunities to facilitate early diagnosis of lung cancer (LC). Method Exhaled breath samples of 352 subjects including 160 with lung cancer (LC), 70 with benign pulmonary nodule (BPN) and 122 healthy controls (HC) were analyzed through thermal desorption coupled with gas chromatography-mass spectrometry (TD-GC–MS) to obtain the metabolic information from volatile organic …
Broadened Eligibility for #Lung #Cancer Screening Challenges and Uncertainty for Implementation and Equity
https://2medical.news/2021/03/10/broadened-eligibility-for-lung-cancer-screening-challenges-and-uncertainty-for-implementation-and-equity/
In 2013, the US Preventive Services Task Force (USPSTF) recommended annual lung cancer screening with low-dose computed tomography (CT) in US adults aged 55 to 80 years who currently smoke or formerly smoked with a 30 pack-year history, and for those who formerly smoked, quitting within the past 15 years (grade “B” recommendation).1 In this issue of JAMA, the USPSTF updates this recommendation, proposing 2 …
https://2medical.news/2021/03/10/broadened-eligibility-for-lung-cancer-screening-challenges-and-uncertainty-for-implementation-and-equity/
In 2013, the US Preventive Services Task Force (USPSTF) recommended annual lung cancer screening with low-dose computed tomography (CT) in US adults aged 55 to 80 years who currently smoke or formerly smoked with a 30 pack-year history, and for those who formerly smoked, quitting within the past 15 years (grade “B” recommendation).1 In this issue of JAMA, the USPSTF updates this recommendation, proposing 2 …
Adherence to the #low-fat diet pattern reduces the risk of #lung cancer in American adults aged 55 years and above: a prospective cohort study
https://2medical.news/2024/05/31/adherence-to-the-low-fat-diet-pattern-reduces-the-risk-of-lung-cancer-in-american-adults-aged-55-years-and-above-a-prospective-cohort-study/
https://2medical.news/2024/05/31/adherence-to-the-low-fat-diet-pattern-reduces-the-risk-of-lung-cancer-in-american-adults-aged-55-years-and-above-a-prospective-cohort-study/
2Medical.News
Adherence to the #low-fat diet pattern reduces the risk of #lung cancer in American adults aged 55 years and above: a prospective…
ObjectivesThere is little evidence on the association between low-fat dietary patterns and lung cancer risk among middle-aged and older adults. To fill this gap, we comprehensively investigated the…