Background:Pulmonary fibrosis(PF)is a refractory disease with limited treatment options.This study investigates the potential anti-PF effects of the herbal formula Yiqi Huatan Sanjie(YQHTSJ)administered via nebulized ...Background:Pulmonary fibrosis(PF)is a refractory disease with limited treatment options.This study investigates the potential anti-PF effects of the herbal formula Yiqi Huatan Sanjie(YQHTSJ)administered via nebulized inhalation,exploring its underlying mechanisms.Methods:The anti-fibrotic properties of nebulized YQHTSJ were assessed using a bleomycin(BLM)-induced PF mouse model.RNA sequencing identified differentially expressed genes(DEGs),and subsequent gene enrichment analysis,along with transcription factor(TF)prediction,revealed YQHTSJ-regulated DEGs.Active components and targets of YQHTSJ were retrieved from the HERB database,leading to the identification of key TFs interacting with DEGs.Quercetin,a constituent of YQHTSJ,was evaluated for its effects on transforming growth factor-β1-induced myofibroblast activation and BLM-induced PF.The direct binding interaction between quercetin and the key TF Jun proto-oncogene(JUN)was confirmed through molecular docking studies and the cellular thermal shift assay(CETSA)experiments.Results:Nebulized YQHTSJ was found to significantly inhibit PF and inflammation in the mouse model.RNA sequencing identified 135 DEGs regulated by YQHTSJ,and 27 key TFs associated with these DEGs were predicted.Among YQHTSJ’s potential targets,41 were identified as TFs,with six-JUN,Fos proto-oncogene,MYC proto-oncogene,RELA proto-oncogene,nuclear factor kappa B subunit 1,and peroxisome proliferator activated receptor alpha-recognized as key TFs targeted by YQHTSJ.Molecular docking and CETSA experiments confirmed that quercetin directly targets JUN protein and inhibits its phosphorylation,thereby contributing to the suppression of myofibroblast activation and PF.Conclusion:The potential mechanisms of YQHTSJ and its component quercetin in combating PF may involve the regulation of critical TFs like JUN and the suppression of pathogenic gene expression.展开更多
The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.An...The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.Another eight mice are exposed to indoor air to be served as a control group.Lung tissue and blood are collected after euthanizing the animals.The results show that lactate dehydrogenase（LDH）activity increases in all experimental groups.Alanine aminotransferase（ALT）activity and blood urea nitrogen（BUN）levels are increased in the group exposed to TiO2 aerosols for 28 d,and creatinine（Cr）levels are increased in 14 d and 28 d samples（P0.05）.No obvious changes are observed in other serum indexes.Lungs of mice exposed to 28 d exposure show significant but moderate increase in pulmonary inflammation,and many TiO2 particles are found in the interstitium of pulmonary alveoli.展开更多
In order to remove efficiently haled-particles emissions from coal combustions, a new way was used to put forward the process of agglomeration and the atomization was produced by the nozzle and then sprayed into the ...In order to remove efficiently haled-particles emissions from coal combustions, a new way was used to put forward the process of agglomeration and the atomization was produced by the nozzle and then sprayed into the flue before precipitation devices of power station boiler in order to make inhaled-particles agglomerate into bigger particles, which can be easily removed but not change existing running conditions of boiler. According to this idea, a model is set up to study agglomeration rate and effect forces between fly ash inhaled-particles and atomized agglomerator particles. The developed agglomeration rate was expressed by relative particle number decreasing speed per unit volume. The result showed that viscosity force and flow resistance force give main influences on agglomeration effect of inhaled-particles, while springiness force and gravity have little effect on agglomeration effect of theirs. Factors influencing the agglomeration rate and effect forces are studied, including agglomerator concentration, agglomerator flux and agglomerator density, atomized-particles diameters and inhaled-particles diameter and so on.展开更多
Pneumocystis pneumonia(PCP) is a life-threatening infection in immunocompromised patients. It is relatively uncommon in patients with lung cancer. We report a case of PCP in a 59-year-old man with a past medical histo...Pneumocystis pneumonia(PCP) is a life-threatening infection in immunocompromised patients. It is relatively uncommon in patients with lung cancer. We report a case of PCP in a 59-year-old man with a past medical history of chronic obstructive pulmonary disease treated with formoterol and a moderate daily dose of inhaled budesonide. He had also advanced stage non-small lung cancer treated with concurrent chemo-radiation with a cisplatin-etoposide containing regimen. The diagnosis of PCP was suspected based on the context of rapidly increasing dyspnea, lymphopenia and the imaging findings. Polymerase chain reaction testing on an induced sputum specimen was positive for Pneumocystis jirovecii. The patient was treated with oral trimethoprim-sulfamethoxazole and systemic corticotherapy and had showed clinical and radiological improvement. Six months after the PCP diagnosis, he developed a malignant pleural effusion and expired on hospice care. Through this case, we remind the importance of screening for PCP in lung cancer patients under chemotherapeutic regimens and with increasing dyspnea. In addition, we alert to the fact that long-term inhaled corticosteroids may be a risk factor for PCP in patients with lung cancer. Despite intensive treatment, the mortality of PCP remains high, hence the importance of chemoprophylaxis should be considered.展开更多
It is well known that the safety and efficacy profile of an inhaled cortocosteroid(ICS) is influenced by the pharmacokinetic properties and associated pharmacodynamic effects of the drug. Freely circulating,protein un...It is well known that the safety and efficacy profile of an inhaled cortocosteroid(ICS) is influenced by the pharmacokinetic properties and associated pharmacodynamic effects of the drug. Freely circulating,protein unbound, and active ICS can cause systemic adverse effects. Therefore, a detailed investigation of drug-protein interaction could be of great interest to understand the pharmacokinetic behaviour of corticosteroids and for the design of new analogues with effective pharmacological properties. In the present work, the interaction between some corticosteroids and human serum albumin(HSA) has been studied by spectroscopic approaches. UV–Vis spectroscopy confirmed that all the investigated corticosteroids can bind to HSA forming a protein-drug complex. The intrinsic fluorescence of HSA was quenched by all the investigated drugs, which was rationalized in terms of a static quenching mechanism. The thermodynamic parameters determined by the Van't Hoff analysis of the binding constants(negative ΔH and ΔS values) clearly indicate thathydrogen bonds and van der Waals forces play a major role in the binding process between albumin and betamethasone, flunisolide and prednisolone, while hydrophobic forces may play a major role in stabilizing albumin-triamcinolone complexes.展开更多
AIM To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome(ARDS).METHODS Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeti...AIM To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome(ARDS).METHODS Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of i NO(20 ppm) or nebulized epoprostenol(10 μg/mL) was done in all patients. Thereafter, inhaled milrinone(1 mg/mL) alone followed by inhaled milrinone in association with inhaled nitric oxide(iN O) was administered. A jet nebulization device synchronized with the mechanical ventilation was use to administrate the epoprostenol and the milrinone. Hemodynamic measurements and partial pressure of arterial oxygen(PaO_2) were recorded before and after each inhaled therapyadministration.RESULTS The majority of ARDS were of pulmonary cause(n = 13) and pneumonia(n = 7) was the leading underlying initial disease. Other pulmonary causes of ARDS were: Post cardiopulmonary bypass(n = 2), smoke inhalation injury(n = 1), thoracic trauma and pulmonary contusions(n = 2) and aspiration(n = 1). Two patients had an extra pulmonary cause of ARDS: A polytrauma patient and an intra-abdominal abscess Inhaled nitric oxide, epoprostenol, inhaled milrinone and the combination of inhaled milrinone and i NO had no impact on systemic hemodynamics. No significant adverse events related to study medications were observed. The median increase of PaO 2 from baseline was 8.8 mmH g [interquartile range(IQR) = 16.3], 6.0 mm Hg(IQR = 18.4), 6 mm Hg(IQR = 15.8) and 9.2 mm Hg(IQR = 20.2) respectively with i NO, epoprostenol, inhaled milrinone, and i NO added to milrinone. Only i NO and the combination of inhaled milrinone and i NO had a statistically significant effect on PaO 2. CONCLUSION When comparing the effects of inhaled NO, milrinone and epoprostenol, only NO significantly improved oxygenation. Inhaled milrinone appeared safe but failed to improve oxygenation in ARDS.展开更多
Type 2 diabetes continues to place a major burden on the health care system of the United States and worldwide. Type 2 diabetes involves two major defects: decreased insulin production from the pancreas and increased ...Type 2 diabetes continues to place a major burden on the health care system of the United States and worldwide. Type 2 diabetes involves two major defects: decreased insulin production from the pancreas and increased insulin resistance. Many patients with type 2 diabetes have decreased insulin production which requires exogenous insulin therapy in order to manage their disease. Despite this need, there is often a reluctance to initiate insulin therapy from both providers and patients. One reason for this reluctance may be a fear of needles or of administering injections. Delivering insulin through the lungs has been studied for decades, with the first inhaled insulin product coming to market in 2006. This product’s launch was considered unsuccessful, and the product was discontinued by the manufacturer the following year. A new inhaled insulin, Technosphere? insulin, was approved for use in type 1 and type 2 diabetes in 2014. This product was shown superior to placebo and non-inferior to a premixed bi-phasic subcutaneous insulin in patients with type 2 diabetes, and may offer an alternative to patients who are averse to giving subcutaneous injections.展开更多
Coronavirus disease 2019(COVID-19)related acute respiratory distress syndrome(ARDS)is a severe complication of infection with severe acute respiratory syndrome coronavirus 2,and the primary cause of death in the curre...Coronavirus disease 2019(COVID-19)related acute respiratory distress syndrome(ARDS)is a severe complication of infection with severe acute respiratory syndrome coronavirus 2,and the primary cause of death in the current pandemic.Critically ill patients often undergo extracorporeal membrane oxygenation(ECMO)therapy as the last resort over an extended period.ECMO therapy requires sedation of the patient,which is usually achieved by intravenous administration of sedatives.The shortage of intravenous sedative drugs due to the ongoing pandemic,and attempts to improve treatment outcome for COVID-19 patients,drove the application of inhaled sedation as a promising alternative for sedation during ECMO therapy.Administration of volatile anesthetics requires an appropriate delivery.Commercially available ones are the anesthetic gas reflection systems AnaConDa®and MIRUSTM,and each should be combined with a gas scavenging system.In this review,we describe respiratory management in COVID-19 patients and the procedures for inhaled sedation during ECMO therapy of COVID-19 related ARDS.We focus particularly on the technical details of administration of volatile anesthetics.Furthermore,we describe the advantages of inhaled sedation and volatile anesthetics,and we discuss the limitations as well as the requirements for safe application in the clinical setting.展开更多
The therapeutic potential of small nucleic acids such as small interfering RNA(siRNA) to treat lung diseases has been successfully demonstrated in many in vivo studies. A major barrier to their clinical application is...The therapeutic potential of small nucleic acids such as small interfering RNA(siRNA) to treat lung diseases has been successfully demonstrated in many in vivo studies. A major barrier to their clinical application is the lack of a safe and efficient inhaled formulation.In this study, spray freeze drying was employed to prepare dry powder of small nucleic acids.Mannitol and herring sperm DNA were used as bulking agent and model of small nucleic acid therapeutics, respectively. Formulations containing different solute concentration and DNA concentration were produced. The scanning electron microscope(SEM) images showed that the porosity of the particles increased as the solute concentration decreased. Powders prepared with solute concentration of 5% w/v were found to maintain a balance between porosity and robustness. Increasing concentration of DNA improved the aerosol performance of the formulation. The dry powder formulation containing 2% w/w DNA had a median diameter of 12.5 μm, and the aerosol performance study using next generation impactor(NGI) showed an emitted fraction(EF) and fine particle fraction(FPF) of 91% and 28% respectively. This formulation(5% w/v solute concentration and 2% w/w nucleic acid) was adopted subsequently to produce siRNA powder. The gel retardation and liquid chromatography assays showed that the siRNA remained intact after spray freeze drying even in the absence of delivery vector. The siRNA powder formulation exhibited a high EF of 92.4%and a modest FPF of around 20%. Further exploration of this technology to optimise inhaled siRNA powder formulation is warranted.展开更多
Orally inhaled drug products(OIPs),such as corticosteroids and bronchodilators,are at the forefront of asthma and chronic obstructive pulmonary disease treatments,two diseases that afflict worldwide populations.Introd...Orally inhaled drug products(OIPs),such as corticosteroids and bronchodilators,are at the forefront of asthma and chronic obstructive pulmonary disease treatments,two diseases that afflict worldwide populations.Introducing generics of these products is essential,as the pricing of these medications remain a barrier to adequate patient care.Currently,there is no consensus between regulatory bodies as to the bioequivalence and equivalence requirements of OIPs that are intended for local action in the lungs.This manuscript critically reviews these requirements and presents future directions for clinicians,scientists,and regulators to consider to optimize the development and approval of OIPs.展开更多
There are a large number of smokers who want to quit smoking but have failed in their attempts to do so,with many having been unsuccessful at quitting multiple times over their lifetime.The existing marketed nicotine ...There are a large number of smokers who want to quit smoking but have failed in their attempts to do so,with many having been unsuccessful at quitting multiple times over their lifetime.The existing marketed nicotine replacement therapies(NRT)have only marginal effectiveness and none provide a comparable physiological response to that derived from cigarette smoking;that is,rapid absorption of nicotine from the lung leading to peak levels of nicotine in the bloodstream to target the receptors in the brain.Instead,existing NRTs produce a slower and delayed rise in nicotine blood levels which is less effective at reducing the craving sensations.Published data for electronic cigarettes show that they typically deliver nicotine with a profile closer to that for nicotine patches,with a slow rise that can take 30–60 min,or longer,to reach the same peak nicotine concentration that is produced in less than 3 min from a single cigarette.A number of attempts have been made to develop an inhaled product which would deliver the nicotine through the lung and mimic the physiological response from smoking,but many of them produced intolerable aversive reactions or delivered an ineffective dose.This paper discusses examples of the potential for the recent inhaled nicotine products in development to be effective as NRTs,but is not meant to be a comprehensive review.展开更多
Distribution of Sm and Ce in mice was investigated after inhalation exposure to their oxide particles of 5 μm diameter and 15 mg/m3.Sm and Ce were mainly distributed in lung,their concentrations decreased with passin...Distribution of Sm and Ce in mice was investigated after inhalation exposure to their oxide particles of 5 μm diameter and 15 mg/m3.Sm and Ce were mainly distributed in lung,their concentrations decreased with passing time,and their concentrations in lung were correlated with exposure periods.Concentrations of Ce were lower than that of Sm in each point.Sm was also distributed in the other organs and bone but Ce was scarcely detected.These results suggest that the behaviors of Sm and Ce inhaled were different,although their chemical properties are similar.展开更多
To evaluate the acute lung toxicity and the effect on serum biochemical indexes of inhaled TiO2 nanotubes , healthy and adult Kunming mice are exposed to aerosols of TiO2nanotubes in a sealed chamber , the concentrati...To evaluate the acute lung toxicity and the effect on serum biochemical indexes of inhaled TiO2 nanotubes , healthy and adult Kunming mice are exposed to aerosols of TiO2nanotubes in a sealed chamber , the concentration of which is 250mg / m 3 while another group of mice are exposed to room air only served as control.The blood , alveolar lavaged fluid and lungs of the mice are collected and examined after exposed for 7 , 14and 28d , respectively.The serum analysis shows that glucose ( Glu ) values with 7dexposure , alanine aminotransferase ( ALT ) and aspartate aminotransferase ( AST ) activities with 28dinhalation , and total bile acid ( TBA ) values with 7 , 28d as well as the creatine kinase ( CK ) levels with 28dexposure are significantly different from those of controls ( P< 0.05 ) .The pathological findings exhibit that more TiO 2 nanotubes are found in the interstitium of pulmonary alveoli with the experimental time prolonged.The results suggest that TiO 2 nanotubes do produce adverse responses to the lung and serum biochemical indexes of mice.Moreover , the responses become severer with the exposed-time prolonged.展开更多
Inhaled formulations are promising for pulmonary and systemic non-pulmonary diseases.Functional engineered particles including drugs and drug-loaded nanocarriers have been anticipated because they can improve drug del...Inhaled formulations are promising for pulmonary and systemic non-pulmonary diseases.Functional engineered particles including drugs and drug-loaded nanocarriers have been anticipated because they can improve drug delivery efficacy against target sites in the lungs or blood.In this review,unique spray nozzles(e.g.,four-fluid spray nozzle and twosolution mixing type nozzle)for the preparation of nanocomposite particles which mean microparticles containing drug nanoparticles are described.These nozzles can produce nanocomposite particles in one-step and their spray drying system is suitable for scalingup.Nanocomposite particles are useful in improving drug absorption and delivery efficacy against alveolar macrophages.In addition,recent studies on several pulmonary diseases(tuberculosis,lung cancer,cystic fibrosis,pneumonia,vaccine and others)and related inhaled formulations were also reviewed.展开更多
Objective:To evaluate the effect of inhaled aromatherapy on complications in patients undergoing hemodialysis.Methods:We search the PubMed,Web of Science,Cochrane Library,Embase and China Biomedical Literature Databas...Objective:To evaluate the effect of inhaled aromatherapy on complications in patients undergoing hemodialysis.Methods:We search the PubMed,Web of Science,Cochrane Library,Embase and China Biomedical Literature Database from their inception to December,2019 to collect randomized controlled trials about the effects of inhaled aromatherapy on hemodialysis complications.Literatures screening,data extraction and risk of bias assessment for the included studies were conducted by two reviewers independently.We summarized all findings with qualitative analysis.Results:A total of 15 studies with 967 participants were included in the systematic review.Inhaled aromatherapy can reduce anxiety,depression,arteriovenous fistula puncture pain,stress and fatigue,and improve the quality of sleep and perceived well-being in hemodialysis patients.Conclusion:Inhaled aromatherapy had certain effects on complications in hemodialysis patients,which can be used as a simple and convenient treatment,but further research was needed to determine standardized implementation procedures and standards.展开更多
The aim of the present study was to establish the mechanism of the allergy aggravation effect. Our previous study showed that soluble ZnO nanoparticles caused allergy aggravation, but insoluble TiO<sub>2</sub...The aim of the present study was to establish the mechanism of the allergy aggravation effect. Our previous study showed that soluble ZnO nanoparticles caused allergy aggravation, but insoluble TiO<sub>2</sub> and SiO<sub>2</sub> nanoparticles did not induce an allergic response. Metal ion release is associated with the cytotoxicity of manufactured nanoparticles;however, the role of metal ion release in allergy aggravation remains to be elucidated. Therefore, we examined the allergy aggravation potential of several soluble manufactured nanoparticles (ZnO, CuO, NiO, MgO, and CaCO<sub>3</sub>). These nanoparticles were administered to mouse lungs by pharyngeal aspiration and subsequently, the mice inhaled ovalbumin (OVA). We also compared the properties of soluble NiO nanoparticles with insoluble micro-scale NiO particles. NiO nanoparticles markedly increased the levels of OVAspecific immunoglobulin (Ig) E but micro-scale NiO particles did not. Among the nanoparticles (ZnO, CuO, MgO, and CaCO<sub>3</sub>), ZnO induced increase of OVA-specific IgE level. CuO showed tendency to increase OVA-specific IgE;however, no significant difference was observed. Additionally, ZnO and NiO nanoparticles enhanced expression of a gene related to inflammation (Cxcl2), heavy metal detox (metallothionein 2), and oxidative stress (heme oxygenase-1). Gene expression of arginase1, which is enhanced by T helper 2 cytokine, was remarkably enhanced in mice administered ZnO and NiO particles. These effects were not observed in mice administered MgO and CaCO<sub>3</sub> nanoparticles. In conclusion, the solubility and type of metal ion released from the nanoparticles influence the allergy aggravation effect. The results showed that the release of Zn<sup>2+</sup> and Ni<sup>2+</sup> aggravated the allergic reaction.展开更多
Inhaled preparation is a common drug type in modern clinical practice. Because of its unique nature, it can be used by inhalation. It has the advantages that conventional oral or injection drugs do not have, and has b...Inhaled preparation is a common drug type in modern clinical practice. Because of its unique nature, it can be used by inhalation. It has the advantages that conventional oral or injection drugs do not have, and has been paid more attention in medical research. This paper analyzes the common classification of inhalation preparations, and analyzes the future development direction of inhalation preparations.展开更多
Objective:To evaluate the therapeutic effect of home-nebulized inhaled glucocorticoid therapy in pediatric respiratory diseases.Methods:60 cases of children with respiratory diseases admitted between October 2022 and ...Objective:To evaluate the therapeutic effect of home-nebulized inhaled glucocorticoid therapy in pediatric respiratory diseases.Methods:60 cases of children with respiratory diseases admitted between October 2022 and October 2023 were selected as study subjects and randomly divided into the control group and the observation group,30 cases each.The control group was provided with conventional treatment only,while the observation group was provided with home-nebulized inhalation glucocorticosteroid treatment,and the treatment effects,clinical symptom relief time,disease recurrence rate,and treatment satisfaction of the children’s families were recorded and compared between the two groups.Results:A comparison of the two groups in terms of gender and age showed that the differences were not statistically significant(P>0.05).In terms of clinical efficacy,the total effective rate of the observation group was 90.00%,which was significantly higher than that of the control group of 66.67%(P<0.05).Compared with the control group,the disappearance time of the clinical symptoms of the observed group was significantly shortened(P<0.05).In addition,the satisfaction scores of the families of the children in the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Home-nebulized inhalation glucocorticoid therapy shows significant clinical efficacy in pediatric respiratory diseases,significantly reduces the time of disappearance of clinical symptoms,and improves the satisfaction of patients’families,which provides an effective treatment option for children.展开更多
The issue of microplastic(MPs)pollution has received increased attention in recent years.Studies have indicated that inhalation of microplastics may result in the cardiovascular harm.However,the specific mechanism rem...The issue of microplastic(MPs)pollution has received increased attention in recent years.Studies have indicated that inhalation of microplastics may result in the cardiovascular harm.However,the specific mechanism remains to be elucidated.In this study,5μm polystyrene microplastics(PS-MPs)were employed to construct in vivo and in vitro exposure models to investigate the potential mechanisms of microplastic-induced cardiac fibrosis.In vivo model of respiratory exposure to MPs,echocardiography observed a decrease in systolic-diastolic function of the mouse heart,and myocardial tissue showed significant mitochondrial morphological abnormalities and myocardial fibrosis.In vitro models also revealed upregulation of fibrosis indicators in human cardiomyocytes AC16 cells.Transcriptome and RT-qPCR assay exposed that ferroptosis-related pathways were significantly gath-ered in the MPs group,with decreased expression of ferroptosis related genes SLC7A11 and GPX4.Liproxstatin-1(Lip-1),a ferroptosis inhibitor,significantly ameliorated MPs-induced cardiomyocyte fibrosis and ferroptosis.We further demonstrated that inhibition of hypoxia-inducible factor𝛼(HIF-𝛼)and oxidative stress ameliorated PS-MPs-induced cardiomyocyte ferroptosis,and thus upregulation of the HIF pathway and oxidative stress may be the upstream mechanism of MPs-induced ferroptosis in myocardial fibrosis.Above all,our study demonstrated that MPs exposure resulted in cardiac fibrosis via the HIF-ROS-SLC7A11/GPX4 signaling pathway.展开更多
Objective To evaluate the effect of inhaled corticosteroids on airway remodeling in patients with mild asthma.Methods In this single-arm,open-label,singlecenter,prospective exploratory study,we enrolled patientswithmi...Objective To evaluate the effect of inhaled corticosteroids on airway remodeling in patients with mild asthma.Methods In this single-arm,open-label,singlecenter,prospective exploratory study,we enrolled patientswithmildasthma from January 2019 to December 2020 at the First Affiliated Hospita1l of Guangdong Pharmaceutical University.A total of 15 patients with mild asthma were included in this study.There were 6 males and 9 females.The age was(38.6±11.5)years.Fluticasone propionate inhalation aerosol(125μg)was administered twice daily for 12 months.Pulmonary function tests,high-resolution chest CT,asthma control test(ACT)questionnaires were performed before and after treatment.Airway mucosal biopsies and bronchoalveolarlavage fluid were obtained by bronchoscopy of the right lower lobe to evaluate the airway inflammatory condition.Airway lumen area(Ai),airway wall thickness(Aw%)measured by CT,and the thickness of airway epithelium,basement membrane and smooth muscle measured by pathology were analyzed to evaluate the effect of inhaled corticosteroid on airway remodeling.Pearson or Spearman correlation were used to analyze the correlation among the improvement in lung function,ACT score and the improvement of airway remodeling.Results The Ai at 3,4,5,and 6^(th)generation of bronchi was increased by 7.5%,14.4%,4.1%,and 22.8%,respectively;The Aw%was decreased by 6.1%,6.7%,6.5%,and 7%,respectively(all P<0.05).The average area of airway smooth muscle was 13.3%±8.7%at baseline,and was 11.67%at the 12th month(interquartile range 9%),but the change was not significant(Z=-0.63,P=0.539).The thickness of the basement membrane decreased from(5.19±1.75)μm to(3.83±1.15)μm at the 12th month(Z=-2.38,P=0.019).The thickness of the epithelium decreased from(78.60±13.12)μm to(59.32±11.97)μmat12month(t=4.20,P<0.001).Changes in Aw%,epithelial and basement membrane thickness at the 12th month were correlated with the improvement in ACT score(all P<O.05).Conclusion Regular inhalation of corticosteroids for 12 months in patients with mild asthma results in reduced airway remodeling,as evidenced by a decrease in the thickness of airway wall,airway mucosal epithelium and basementmembraneT.heimprovement of airway remodeling is significantly associated with the improvement of asthma ACT score.A scientific rationale for inhaled corticosteroids in mild asthma on airway remodeling is provided at the level of morphology and structure.展开更多
基金supported by the Guangdong Basic and Applied Basic Research Foundation under Grant(2023A1515011243)National Natural Science Foundation of China under Grant(82004141)+2 种基金Bao’an Traditional Chinese Medicine Development Foundation under Grant(2022KJCX-ZJZL-11)Science,Technology,and Innovation Commission of Shenzhen Municipality under Grant(JCYJ20190808160407500)Shenzhen Bao’an Traditional Chinese Medicine Hospital Research Program under Grant(BAZYY20220701).
文摘Background:Pulmonary fibrosis(PF)is a refractory disease with limited treatment options.This study investigates the potential anti-PF effects of the herbal formula Yiqi Huatan Sanjie(YQHTSJ)administered via nebulized inhalation,exploring its underlying mechanisms.Methods:The anti-fibrotic properties of nebulized YQHTSJ were assessed using a bleomycin(BLM)-induced PF mouse model.RNA sequencing identified differentially expressed genes(DEGs),and subsequent gene enrichment analysis,along with transcription factor(TF)prediction,revealed YQHTSJ-regulated DEGs.Active components and targets of YQHTSJ were retrieved from the HERB database,leading to the identification of key TFs interacting with DEGs.Quercetin,a constituent of YQHTSJ,was evaluated for its effects on transforming growth factor-β1-induced myofibroblast activation and BLM-induced PF.The direct binding interaction between quercetin and the key TF Jun proto-oncogene(JUN)was confirmed through molecular docking studies and the cellular thermal shift assay(CETSA)experiments.Results:Nebulized YQHTSJ was found to significantly inhibit PF and inflammation in the mouse model.RNA sequencing identified 135 DEGs regulated by YQHTSJ,and 27 key TFs associated with these DEGs were predicted.Among YQHTSJ’s potential targets,41 were identified as TFs,with six-JUN,Fos proto-oncogene,MYC proto-oncogene,RELA proto-oncogene,nuclear factor kappa B subunit 1,and peroxisome proliferator activated receptor alpha-recognized as key TFs targeted by YQHTSJ.Molecular docking and CETSA experiments confirmed that quercetin directly targets JUN protein and inhibits its phosphorylation,thereby contributing to the suppression of myofibroblast activation and PF.Conclusion:The potential mechanisms of YQHTSJ and its component quercetin in combating PF may involve the regulation of critical TFs like JUN and the suppression of pathogenic gene expression.
文摘The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.Another eight mice are exposed to indoor air to be served as a control group.Lung tissue and blood are collected after euthanizing the animals.The results show that lactate dehydrogenase（LDH）activity increases in all experimental groups.Alanine aminotransferase（ALT）activity and blood urea nitrogen（BUN）levels are increased in the group exposed to TiO2 aerosols for 28 d,and creatinine（Cr）levels are increased in 14 d and 28 d samples（P0.05）.No obvious changes are observed in other serum indexes.Lungs of mice exposed to 28 d exposure show significant but moderate increase in pulmonary inflammation,and many TiO2 particles are found in the interstitium of pulmonary alveoli.
文摘In order to remove efficiently haled-particles emissions from coal combustions, a new way was used to put forward the process of agglomeration and the atomization was produced by the nozzle and then sprayed into the flue before precipitation devices of power station boiler in order to make inhaled-particles agglomerate into bigger particles, which can be easily removed but not change existing running conditions of boiler. According to this idea, a model is set up to study agglomeration rate and effect forces between fly ash inhaled-particles and atomized agglomerator particles. The developed agglomeration rate was expressed by relative particle number decreasing speed per unit volume. The result showed that viscosity force and flow resistance force give main influences on agglomeration effect of inhaled-particles, while springiness force and gravity have little effect on agglomeration effect of theirs. Factors influencing the agglomeration rate and effect forces are studied, including agglomerator concentration, agglomerator flux and agglomerator density, atomized-particles diameters and inhaled-particles diameter and so on.
文摘Pneumocystis pneumonia(PCP) is a life-threatening infection in immunocompromised patients. It is relatively uncommon in patients with lung cancer. We report a case of PCP in a 59-year-old man with a past medical history of chronic obstructive pulmonary disease treated with formoterol and a moderate daily dose of inhaled budesonide. He had also advanced stage non-small lung cancer treated with concurrent chemo-radiation with a cisplatin-etoposide containing regimen. The diagnosis of PCP was suspected based on the context of rapidly increasing dyspnea, lymphopenia and the imaging findings. Polymerase chain reaction testing on an induced sputum specimen was positive for Pneumocystis jirovecii. The patient was treated with oral trimethoprim-sulfamethoxazole and systemic corticotherapy and had showed clinical and radiological improvement. Six months after the PCP diagnosis, he developed a malignant pleural effusion and expired on hospice care. Through this case, we remind the importance of screening for PCP in lung cancer patients under chemotherapeutic regimens and with increasing dyspnea. In addition, we alert to the fact that long-term inhaled corticosteroids may be a risk factor for PCP in patients with lung cancer. Despite intensive treatment, the mortality of PCP remains high, hence the importance of chemoprophylaxis should be considered.
基金supported by a grant from the University of Torino(Ricerca Locale ex-60%,Bando 2015)
文摘It is well known that the safety and efficacy profile of an inhaled cortocosteroid(ICS) is influenced by the pharmacokinetic properties and associated pharmacodynamic effects of the drug. Freely circulating,protein unbound, and active ICS can cause systemic adverse effects. Therefore, a detailed investigation of drug-protein interaction could be of great interest to understand the pharmacokinetic behaviour of corticosteroids and for the design of new analogues with effective pharmacological properties. In the present work, the interaction between some corticosteroids and human serum albumin(HSA) has been studied by spectroscopic approaches. UV–Vis spectroscopy confirmed that all the investigated corticosteroids can bind to HSA forming a protein-drug complex. The intrinsic fluorescence of HSA was quenched by all the investigated drugs, which was rationalized in terms of a static quenching mechanism. The thermodynamic parameters determined by the Van't Hoff analysis of the binding constants(negative ΔH and ΔS values) clearly indicate thathydrogen bonds and van der Waals forces play a major role in the binding process between albumin and betamethasone, flunisolide and prednisolone, while hydrophobic forces may play a major role in stabilizing albumin-triamcinolone complexes.
文摘AIM To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome(ARDS).METHODS Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of i NO(20 ppm) or nebulized epoprostenol(10 μg/mL) was done in all patients. Thereafter, inhaled milrinone(1 mg/mL) alone followed by inhaled milrinone in association with inhaled nitric oxide(iN O) was administered. A jet nebulization device synchronized with the mechanical ventilation was use to administrate the epoprostenol and the milrinone. Hemodynamic measurements and partial pressure of arterial oxygen(PaO_2) were recorded before and after each inhaled therapyadministration.RESULTS The majority of ARDS were of pulmonary cause(n = 13) and pneumonia(n = 7) was the leading underlying initial disease. Other pulmonary causes of ARDS were: Post cardiopulmonary bypass(n = 2), smoke inhalation injury(n = 1), thoracic trauma and pulmonary contusions(n = 2) and aspiration(n = 1). Two patients had an extra pulmonary cause of ARDS: A polytrauma patient and an intra-abdominal abscess Inhaled nitric oxide, epoprostenol, inhaled milrinone and the combination of inhaled milrinone and i NO had no impact on systemic hemodynamics. No significant adverse events related to study medications were observed. The median increase of PaO 2 from baseline was 8.8 mmH g [interquartile range(IQR) = 16.3], 6.0 mm Hg(IQR = 18.4), 6 mm Hg(IQR = 15.8) and 9.2 mm Hg(IQR = 20.2) respectively with i NO, epoprostenol, inhaled milrinone, and i NO added to milrinone. Only i NO and the combination of inhaled milrinone and i NO had a statistically significant effect on PaO 2. CONCLUSION When comparing the effects of inhaled NO, milrinone and epoprostenol, only NO significantly improved oxygenation. Inhaled milrinone appeared safe but failed to improve oxygenation in ARDS.
文摘Type 2 diabetes continues to place a major burden on the health care system of the United States and worldwide. Type 2 diabetes involves two major defects: decreased insulin production from the pancreas and increased insulin resistance. Many patients with type 2 diabetes have decreased insulin production which requires exogenous insulin therapy in order to manage their disease. Despite this need, there is often a reluctance to initiate insulin therapy from both providers and patients. One reason for this reluctance may be a fear of needles or of administering injections. Delivering insulin through the lungs has been studied for decades, with the first inhaled insulin product coming to market in 2006. This product’s launch was considered unsuccessful, and the product was discontinued by the manufacturer the following year. A new inhaled insulin, Technosphere? insulin, was approved for use in type 1 and type 2 diabetes in 2014. This product was shown superior to placebo and non-inferior to a premixed bi-phasic subcutaneous insulin in patients with type 2 diabetes, and may offer an alternative to patients who are averse to giving subcutaneous injections.
文摘Coronavirus disease 2019(COVID-19)related acute respiratory distress syndrome(ARDS)is a severe complication of infection with severe acute respiratory syndrome coronavirus 2,and the primary cause of death in the current pandemic.Critically ill patients often undergo extracorporeal membrane oxygenation(ECMO)therapy as the last resort over an extended period.ECMO therapy requires sedation of the patient,which is usually achieved by intravenous administration of sedatives.The shortage of intravenous sedative drugs due to the ongoing pandemic,and attempts to improve treatment outcome for COVID-19 patients,drove the application of inhaled sedation as a promising alternative for sedation during ECMO therapy.Administration of volatile anesthetics requires an appropriate delivery.Commercially available ones are the anesthetic gas reflection systems AnaConDa®and MIRUSTM,and each should be combined with a gas scavenging system.In this review,we describe respiratory management in COVID-19 patients and the procedures for inhaled sedation during ECMO therapy of COVID-19 related ARDS.We focus particularly on the technical details of administration of volatile anesthetics.Furthermore,we describe the advantages of inhaled sedation and volatile anesthetics,and we discuss the limitations as well as the requirements for safe application in the clinical setting.
基金funded by the Health and Medical Research Fund, Hong Kong (15140962)Research Grant Council, Hong Kong (17110414)
文摘The therapeutic potential of small nucleic acids such as small interfering RNA(siRNA) to treat lung diseases has been successfully demonstrated in many in vivo studies. A major barrier to their clinical application is the lack of a safe and efficient inhaled formulation.In this study, spray freeze drying was employed to prepare dry powder of small nucleic acids.Mannitol and herring sperm DNA were used as bulking agent and model of small nucleic acid therapeutics, respectively. Formulations containing different solute concentration and DNA concentration were produced. The scanning electron microscope(SEM) images showed that the porosity of the particles increased as the solute concentration decreased. Powders prepared with solute concentration of 5% w/v were found to maintain a balance between porosity and robustness. Increasing concentration of DNA improved the aerosol performance of the formulation. The dry powder formulation containing 2% w/w DNA had a median diameter of 12.5 μm, and the aerosol performance study using next generation impactor(NGI) showed an emitted fraction(EF) and fine particle fraction(FPF) of 91% and 28% respectively. This formulation(5% w/v solute concentration and 2% w/w nucleic acid) was adopted subsequently to produce siRNA powder. The gel retardation and liquid chromatography assays showed that the siRNA remained intact after spray freeze drying even in the absence of delivery vector. The siRNA powder formulation exhibited a high EF of 92.4%and a modest FPF of around 20%. Further exploration of this technology to optimise inhaled siRNA powder formulation is warranted.
文摘Orally inhaled drug products(OIPs),such as corticosteroids and bronchodilators,are at the forefront of asthma and chronic obstructive pulmonary disease treatments,two diseases that afflict worldwide populations.Introducing generics of these products is essential,as the pricing of these medications remain a barrier to adequate patient care.Currently,there is no consensus between regulatory bodies as to the bioequivalence and equivalence requirements of OIPs that are intended for local action in the lungs.This manuscript critically reviews these requirements and presents future directions for clinicians,scientists,and regulators to consider to optimize the development and approval of OIPs.
文摘There are a large number of smokers who want to quit smoking but have failed in their attempts to do so,with many having been unsuccessful at quitting multiple times over their lifetime.The existing marketed nicotine replacement therapies(NRT)have only marginal effectiveness and none provide a comparable physiological response to that derived from cigarette smoking;that is,rapid absorption of nicotine from the lung leading to peak levels of nicotine in the bloodstream to target the receptors in the brain.Instead,existing NRTs produce a slower and delayed rise in nicotine blood levels which is less effective at reducing the craving sensations.Published data for electronic cigarettes show that they typically deliver nicotine with a profile closer to that for nicotine patches,with a slow rise that can take 30–60 min,or longer,to reach the same peak nicotine concentration that is produced in less than 3 min from a single cigarette.A number of attempts have been made to develop an inhaled product which would deliver the nicotine through the lung and mimic the physiological response from smoking,but many of them produced intolerable aversive reactions or delivered an ineffective dose.This paper discusses examples of the potential for the recent inhaled nicotine products in development to be effective as NRTs,but is not meant to be a comprehensive review.
基金Project partially supported by the Grant-in-Aid for Scientific Research (c)21590665,JSPS,Japan
文摘Distribution of Sm and Ce in mice was investigated after inhalation exposure to their oxide particles of 5 μm diameter and 15 mg/m3.Sm and Ce were mainly distributed in lung,their concentrations decreased with passing time,and their concentrations in lung were correlated with exposure periods.Concentrations of Ce were lower than that of Sm in each point.Sm was also distributed in the other organs and bone but Ce was scarcely detected.These results suggest that the behaviors of Sm and Ce inhaled were different,although their chemical properties are similar.
基金Supported by the Ford University Research Projectthe "Peak of Six Major Human Resources Plan" of Jiangsu Province
文摘To evaluate the acute lung toxicity and the effect on serum biochemical indexes of inhaled TiO2 nanotubes , healthy and adult Kunming mice are exposed to aerosols of TiO2nanotubes in a sealed chamber , the concentration of which is 250mg / m 3 while another group of mice are exposed to room air only served as control.The blood , alveolar lavaged fluid and lungs of the mice are collected and examined after exposed for 7 , 14and 28d , respectively.The serum analysis shows that glucose ( Glu ) values with 7dexposure , alanine aminotransferase ( ALT ) and aspartate aminotransferase ( AST ) activities with 28dinhalation , and total bile acid ( TBA ) values with 7 , 28d as well as the creatine kinase ( CK ) levels with 28dexposure are significantly different from those of controls ( P< 0.05 ) .The pathological findings exhibit that more TiO 2 nanotubes are found in the interstitium of pulmonary alveoli with the experimental time prolonged.The results suggest that TiO 2 nanotubes do produce adverse responses to the lung and serum biochemical indexes of mice.Moreover , the responses become severer with the exposed-time prolonged.
文摘Inhaled formulations are promising for pulmonary and systemic non-pulmonary diseases.Functional engineered particles including drugs and drug-loaded nanocarriers have been anticipated because they can improve drug delivery efficacy against target sites in the lungs or blood.In this review,unique spray nozzles(e.g.,four-fluid spray nozzle and twosolution mixing type nozzle)for the preparation of nanocomposite particles which mean microparticles containing drug nanoparticles are described.These nozzles can produce nanocomposite particles in one-step and their spray drying system is suitable for scalingup.Nanocomposite particles are useful in improving drug absorption and delivery efficacy against alveolar macrophages.In addition,recent studies on several pulmonary diseases(tuberculosis,lung cancer,cystic fibrosis,pneumonia,vaccine and others)and related inhaled formulations were also reviewed.
文摘Objective:To evaluate the effect of inhaled aromatherapy on complications in patients undergoing hemodialysis.Methods:We search the PubMed,Web of Science,Cochrane Library,Embase and China Biomedical Literature Database from their inception to December,2019 to collect randomized controlled trials about the effects of inhaled aromatherapy on hemodialysis complications.Literatures screening,data extraction and risk of bias assessment for the included studies were conducted by two reviewers independently.We summarized all findings with qualitative analysis.Results:A total of 15 studies with 967 participants were included in the systematic review.Inhaled aromatherapy can reduce anxiety,depression,arteriovenous fistula puncture pain,stress and fatigue,and improve the quality of sleep and perceived well-being in hemodialysis patients.Conclusion:Inhaled aromatherapy had certain effects on complications in hemodialysis patients,which can be used as a simple and convenient treatment,but further research was needed to determine standardized implementation procedures and standards.
文摘The aim of the present study was to establish the mechanism of the allergy aggravation effect. Our previous study showed that soluble ZnO nanoparticles caused allergy aggravation, but insoluble TiO<sub>2</sub> and SiO<sub>2</sub> nanoparticles did not induce an allergic response. Metal ion release is associated with the cytotoxicity of manufactured nanoparticles;however, the role of metal ion release in allergy aggravation remains to be elucidated. Therefore, we examined the allergy aggravation potential of several soluble manufactured nanoparticles (ZnO, CuO, NiO, MgO, and CaCO<sub>3</sub>). These nanoparticles were administered to mouse lungs by pharyngeal aspiration and subsequently, the mice inhaled ovalbumin (OVA). We also compared the properties of soluble NiO nanoparticles with insoluble micro-scale NiO particles. NiO nanoparticles markedly increased the levels of OVAspecific immunoglobulin (Ig) E but micro-scale NiO particles did not. Among the nanoparticles (ZnO, CuO, MgO, and CaCO<sub>3</sub>), ZnO induced increase of OVA-specific IgE level. CuO showed tendency to increase OVA-specific IgE;however, no significant difference was observed. Additionally, ZnO and NiO nanoparticles enhanced expression of a gene related to inflammation (Cxcl2), heavy metal detox (metallothionein 2), and oxidative stress (heme oxygenase-1). Gene expression of arginase1, which is enhanced by T helper 2 cytokine, was remarkably enhanced in mice administered ZnO and NiO particles. These effects were not observed in mice administered MgO and CaCO<sub>3</sub> nanoparticles. In conclusion, the solubility and type of metal ion released from the nanoparticles influence the allergy aggravation effect. The results showed that the release of Zn<sup>2+</sup> and Ni<sup>2+</sup> aggravated the allergic reaction.
文摘Inhaled preparation is a common drug type in modern clinical practice. Because of its unique nature, it can be used by inhalation. It has the advantages that conventional oral or injection drugs do not have, and has been paid more attention in medical research. This paper analyzes the common classification of inhalation preparations, and analyzes the future development direction of inhalation preparations.
文摘Objective:To evaluate the therapeutic effect of home-nebulized inhaled glucocorticoid therapy in pediatric respiratory diseases.Methods:60 cases of children with respiratory diseases admitted between October 2022 and October 2023 were selected as study subjects and randomly divided into the control group and the observation group,30 cases each.The control group was provided with conventional treatment only,while the observation group was provided with home-nebulized inhalation glucocorticosteroid treatment,and the treatment effects,clinical symptom relief time,disease recurrence rate,and treatment satisfaction of the children’s families were recorded and compared between the two groups.Results:A comparison of the two groups in terms of gender and age showed that the differences were not statistically significant(P>0.05).In terms of clinical efficacy,the total effective rate of the observation group was 90.00%,which was significantly higher than that of the control group of 66.67%(P<0.05).Compared with the control group,the disappearance time of the clinical symptoms of the observed group was significantly shortened(P<0.05).In addition,the satisfaction scores of the families of the children in the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Home-nebulized inhalation glucocorticoid therapy shows significant clinical efficacy in pediatric respiratory diseases,significantly reduces the time of disappearance of clinical symptoms,and improves the satisfaction of patients’families,which provides an effective treatment option for children.
基金supported by the National Natural Science Foundation of China(No.82073520).
文摘The issue of microplastic(MPs)pollution has received increased attention in recent years.Studies have indicated that inhalation of microplastics may result in the cardiovascular harm.However,the specific mechanism remains to be elucidated.In this study,5μm polystyrene microplastics(PS-MPs)were employed to construct in vivo and in vitro exposure models to investigate the potential mechanisms of microplastic-induced cardiac fibrosis.In vivo model of respiratory exposure to MPs,echocardiography observed a decrease in systolic-diastolic function of the mouse heart,and myocardial tissue showed significant mitochondrial morphological abnormalities and myocardial fibrosis.In vitro models also revealed upregulation of fibrosis indicators in human cardiomyocytes AC16 cells.Transcriptome and RT-qPCR assay exposed that ferroptosis-related pathways were significantly gath-ered in the MPs group,with decreased expression of ferroptosis related genes SLC7A11 and GPX4.Liproxstatin-1(Lip-1),a ferroptosis inhibitor,significantly ameliorated MPs-induced cardiomyocyte fibrosis and ferroptosis.We further demonstrated that inhibition of hypoxia-inducible factor𝛼(HIF-𝛼)and oxidative stress ameliorated PS-MPs-induced cardiomyocyte ferroptosis,and thus upregulation of the HIF pathway and oxidative stress may be the upstream mechanism of MPs-induced ferroptosis in myocardial fibrosis.Above all,our study demonstrated that MPs exposure resulted in cardiac fibrosis via the HIF-ROS-SLC7A11/GPX4 signaling pathway.
文摘Objective To evaluate the effect of inhaled corticosteroids on airway remodeling in patients with mild asthma.Methods In this single-arm,open-label,singlecenter,prospective exploratory study,we enrolled patientswithmildasthma from January 2019 to December 2020 at the First Affiliated Hospita1l of Guangdong Pharmaceutical University.A total of 15 patients with mild asthma were included in this study.There were 6 males and 9 females.The age was(38.6±11.5)years.Fluticasone propionate inhalation aerosol(125μg)was administered twice daily for 12 months.Pulmonary function tests,high-resolution chest CT,asthma control test(ACT)questionnaires were performed before and after treatment.Airway mucosal biopsies and bronchoalveolarlavage fluid were obtained by bronchoscopy of the right lower lobe to evaluate the airway inflammatory condition.Airway lumen area(Ai),airway wall thickness(Aw%)measured by CT,and the thickness of airway epithelium,basement membrane and smooth muscle measured by pathology were analyzed to evaluate the effect of inhaled corticosteroid on airway remodeling.Pearson or Spearman correlation were used to analyze the correlation among the improvement in lung function,ACT score and the improvement of airway remodeling.Results The Ai at 3,4,5,and 6^(th)generation of bronchi was increased by 7.5%,14.4%,4.1%,and 22.8%,respectively;The Aw%was decreased by 6.1%,6.7%,6.5%,and 7%,respectively(all P<0.05).The average area of airway smooth muscle was 13.3%±8.7%at baseline,and was 11.67%at the 12th month(interquartile range 9%),but the change was not significant(Z=-0.63,P=0.539).The thickness of the basement membrane decreased from(5.19±1.75)μm to(3.83±1.15)μm at the 12th month(Z=-2.38,P=0.019).The thickness of the epithelium decreased from(78.60±13.12)μm to(59.32±11.97)μmat12month(t=4.20,P<0.001).Changes in Aw%,epithelial and basement membrane thickness at the 12th month were correlated with the improvement in ACT score(all P<O.05).Conclusion Regular inhalation of corticosteroids for 12 months in patients with mild asthma results in reduced airway remodeling,as evidenced by a decrease in the thickness of airway wall,airway mucosal epithelium and basementmembraneT.heimprovement of airway remodeling is significantly associated with the improvement of asthma ACT score.A scientific rationale for inhaled corticosteroids in mild asthma on airway remodeling is provided at the level of morphology and structure.
