Displaying publications 21 - 40 of 42 in total

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  1. Fisher's unique variant in Stocker's type II congenital cystic adenomatoid malformation of the lung: a case report
    Darnal HK, Ibrahim H, Mutum SS
    Malays J Pathol, 2000 Jun;22(1):31-5.
    PMID: 16329535
    An eight-week-old infant presented with dyspnoea two months after an uneventful normal vaginal delivery. Radiologically, a sharply outlined radiolucent area surrounded by atelectasis was seen in the upper lobe of the left lung. A left upper lobectomy was performed with the clinical impression of congenital pulmonary emphysema. The resected specimen displayed multiple cysts 2 to 6 mm in diameter. Microscopically, intracystic papillary mesenchymal ingrowths lined by respiratory epithelium were present. Based on both the gross and microscopical features, a diagnosis of Fisher's variant of type II congenital cystic adenomatoid malformation (CAM) was made. The postoperative follow-up showed excellent recovery and normal development of the child.
    Matched MeSH terms: Pulmonary Emphysema/congenital; Pulmonary Emphysema/diagnosis
  2. The Malaysian experience in the typing of genetic variants of alpha-1-antitrypsin
    Desa NM, Ismail Z, Beran Z, Musa SH
    Southeast Asian J. Trop. Med. Public Health, 1995;26 Suppl 1:311-4.
    PMID: 8629132
    It is known that alpha1-antitrypsin deficiency is associated with emphysema in adults and liver cirrhosis in neonates. The phenotypes PiZZ and PiSZ are considered to be high risk groups. alpha1-antitrypsin deficiency is one of the most common lethal congenital disorders in Europe and the USA, occurring in approximately 1 in 2,000 caucasians of North European descent. Studies in Malaysia have found that the phenotypes PiZ and PiS are present in our population. Out of 950 samples analyzed, it was found that 10 samples were shown to be apparently Z homozygous phenotype. The phenotype is determined by high resolution isoelectrofocusing on an ultra-thin polyacrylamide gel embedded with narrow range Pi phamarlyte. The isoelectrofocused bands are confirmed by immunofixation and the plasma alpha1-antitrypsin levels determined by electroimmunoassay. The abnormal phenotypes are further confirmed by polymerase chain reaction using allele specific oligonucleotides.
    Matched MeSH terms: Emphysema/genetics; Emphysema/epidemiology
  3. Emphysematous pyelonephritis caused by Candida infection
    Kamaliah MD, Bhajan MA, Dzarr GA
    Southeast Asian J. Trop. Med. Public Health, 2005 May;36(3):725-7.
    PMID: 16124446
    We present an interesting and rare case of a diabetic patient who developed extensive unilateral emphysematous pyelonephritis (EPN) which was caused by fungal infection. The diagnosis was confirmed on computed tomography (CT) scan of the abdomen. Repeated urine cultures grew Candida albicans but no other organisms were isolated. The patient remained febrile and unwell despite parenteral broad spectrum antibiotics and antifungal treatment. She underwent nephrectomy and then made a good clinical recovery.
    Matched MeSH terms: Emphysema/diagnosis; Emphysema/drug therapy; Emphysema/microbiology*
  4. Fulltext Spontaneous pneumothorax and pneumomediastinum after a trivial injury: a case report
    Ahmad Faizal Rakawi, Abdul Aziz Marwan, Ummi Nadira Daut
    Malaysian Journal of Medicine and Health Sciences, 2020;16(108):84-86.
    MyJurnal
    Spontaneous pneumothorax and pneumomediastinum is defined as presence of free air or gas in the pleural cav- ity and mediastinal structures respectively. Spontaneous pneumothorax seems to be associated with anatomical abnormalities such as subpleural blebs or bullae, however not for spontaneous pneumomediastinum which may developed without an apparent precipitating cause. Both usually may occur in young healthy adults without serious underlying lung disease. We report a case of spontaneous pneumothorax and pneumomediastinum after a trivial injury. He was initially presented with dyspnea after two weeks of initial trivial trauma. Chest radiograph showed left apical pneumothorax with pneumomediastinum with no evidence of rib fracture. His condition was deemed non-traumatic by surgical colleague, thus admitted to medical ward for observation and eventually discharged well.
    Matched MeSH terms: Mediastinal Emphysema
  5. Fulltext Factitious dermatitis: a non infective cause of subcutaneous emphysema
    Manohar, A., Azhar, M.Z.
    Malaysian Journal of Medicine and Health Sciences, 2012;8(1):69-72.
    MyJurnal
    We report a case of factitious dermatitis in a 17 year female student who presented with recurrent pain .swelling and subcutaneous crepitations of the forearm. A thorough investigation was done. Full blood count, erythrocyte sedimentation rate was normal. Plain radiographs revealed the presence of subcutaneous emphysema. MRI showed similar findings and revealed normal muscles. Colonoscopy and OGDS were normal. except for a small polyp at the gastro-esophageal junction. Based on the clinical findings and lack of correlation with the investigations a diagnosis of factitious subcutaneous emphysema was made.
    Matched MeSH terms: Subcutaneous Emphysema
  6. Fulltext A novel CT-emphysema index/FEV1 approach of phenotyping COPD to predict mortality
    Loh LC, Ong CK, Koo HJ, Lee SM, Lee JS, Oh YM, et al.
    Int J Chron Obstruct Pulmon Dis, 2018;13:2543-2550.
    PMID: 30174423 DOI: 10.2147/COPD.S165898
    Background: COPD-associated mortality was examined using a novel approach of phenotyping COPD based on computed tomography (CT)-emphysema index from quantitative CT (QCT) and post-bronchodilator (BD) forced expiratory volume in 1 second (FEV1) in a local Malaysian cohort.

    Patients and methods: Prospectively collected data of 112 eligible COPD subjects (mean age, 67 years; male, 93%; mean post-BD FEV1, 45.7%) was available for mortality analysis. Median follow-up time was 1,000 days (range, 60-1,400). QCT and clinicodemographic data were collected at study entry. Based on CT-emphysema index and post-BD FEV1% predicted, subjects were categorized into "emphysema-dominant," "airway-dominant," "mild mixed airway-emphysema," and "severe mixed airway-emphysema" diseases.

    Results: Sixteen patients (14.2%) died of COPD-associated causes. There were 29 (25.9%) "mild mixed," 23 (20.5%) "airway-dominant," 15 (13.4%) "emphysema-dominant," and 45 (40.2%) "severe mixed" cases. "Mild mixed" disease was proportionately more in Global Initiative for Chronic Obstructive Lung Disease (GOLD) Group A, while "severe mixed" disease was proportionately more in GOLD Groups B and D. Kaplan-Meier survival estimates showed increased mortality risk with "severe mixed" disease (log rank test, p=0.03) but not with GOLD groups (p=0.08). Univariate Cox proportionate hazard analysis showed that age, body mass index, long-term oxygen therapy, FEV1, forced volume capacity, COPD Assessment Test score, modified Medical Research Council score, St Georges' Respiratory Questionnaire score, CT-emphysema index, and "severe mixed" disease (vs "mild mixed" disease) were associated with mortality. Multivariate Cox analysis showed that age, body mass index, and COPD Assessment Test score remain independently associated with mortality.

    Conclusion: "Severe mixed airway-emphysema" disease may predict COPD-associated mortality. Age, body mass index, and COPD Assessment Test score remain as key mortality risk factors in our cohort.
    Matched MeSH terms: Pulmonary Emphysema/complications; Pulmonary Emphysema/mortality; Pulmonary Emphysema/physiopathology
  7. Fulltext Benign Subcutaneous Emphysema of the Upper Limb: A Case Report
    Rabiul Islam SM, Mamman KG, Pande KC
    Malays Orthop J, 2016 Nov;10(3):39-41.
    PMID: 28553447 DOI: 10.5704/MOJ.1611.002
    Subcutaneous emphysema is the presence of gas or air in the subcutaneous tissue plane. The term is generally used to describe any soft tissue emphysema of the body wall or limbs, it can result from benign causes, most commonly secondary to trauma or from a life-threatening infection by gas gangrene or necrotising fasciitis. A case of subcutaneous emphysema involving the upper limb resulting from a trivial laceration to the elbow is reported and the importance of distinguishing between the two causes of subcutaneous emphysema is highlighted.
    Matched MeSH terms: Subcutaneous Emphysema
  8. Fulltext Bilateral spontaneous persistent open pneumothorax with chylothorax
    Khajotia R, Raman S
    Can Fam Physician, 2012 Jul;58(7):757-60.
    PMID: 22859639
    Matched MeSH terms: Emphysema/diagnosis
  9. Fulltext Emphysematous pyelonephritis in a diabetic patient with pelvic-ureteric stone
    Chan AC, Rohan MJ, Hamid A, Azam A
    Med J Malaysia, 2007 Jun;62(2):166-7.
    PMID: 18705456 MyJurnal
    Emphysematous pyelonephritis is a rare but life threatening infection of kidney that is characterized by gas formation within or around the kidney. We describe a case of emphysematous pyelonephritis as a consequence of inadequately treated pelvic-ureteric stone in a diabetic man and complement this with a brief review of the literature pertaining in particular to the management of this condition.
    Matched MeSH terms: Emphysema/etiology*
  10. Sequelae of traumatic laryngotracheal separation: the need for individualized long term treatment plan
    Mazita A, Sani A
    Auris Nasus Larynx, 2005 Dec;32(4):421-5.
    PMID: 16051456 DOI: 10.1016/j.anl.2005.05.002
    Laryngotracheal separation is a rare variant of laryngeal trauma. However it is life threatening and potentially fatal. Patients with this injury usually succumb at the site of the accident itself. Here we present two cases of laryngotracheal separation of different etiology and of different outcomes. The treatment advocated for laryngotracheal separation is initially airway stabilization followed by formal repair of the transected trachea. However both our cases illustrates that the outcomes can be different and that a long term treatment plan should be individualized to each patient.
    Matched MeSH terms: Subcutaneous Emphysema/etiology
  11. Fulltext Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia - a cross-sectional study
    Chai CS, Mos SB, Ng DL, Goh GM, Su AT, Ibrahim MAB, et al.
    BMC Pulm Med, 2020 Sep 29;20(1):254.
    PMID: 32993591 DOI: 10.1186/s12890-020-01295-4
    BACKGROUND: The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients' health-related quality of life (HRQoL) according to their COPD phenotypes.

    METHODS: This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George's Respiratory Questionnaire for COPD (SGRQ-c).

    RESULTS: Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p 

    Matched MeSH terms: Emphysema; Pulmonary Emphysema
  12. Fulltext Hamman’s syndrome: a rare benign syndrome
    Aida Abdul Rahim, Mohd Taufiq Yahaya1, Siti Nor Farhana Mohd Shafie, Laila Mastura Ahmad Apandi
    Malaysian Journal of Medicine and Health Sciences, 2020;16(1):357-359.
    MyJurnal
    Hamman’s syndrome by definition is spontaneous pneumomediastinum with the exclusion of thoracic trauma or iatrogenic cause. It is rare and is more common in adolescence male. Amongst the risk factors are underlying lung condition such as asthma and interstitial lung disease, drug inhalation and parturient woman. Patient usually pres- ents with sudden onset of shortness of breath and chest pain with subcutaneous emphysema on examination. The diagnosis is confirmed with chest radiograph. The prognosis of Hamman’s syndrome is excellent. Most cases are self-limiting and resolve spontaneously. However, Hamman’s syndrome is a poorly recognised disease due to its rarity. Therefore, the patient may be subjected to misdiagnosis and treatment. This is a case report of Hamman’s syn- drome misdiagnosed and treated as pneumothorax. The objective of this case report is to highlight the importance of differentiating this benign syndrome with life threatening differentials which may have similar clinical presentation. Thus, avoiding unnecessary costly investigation, treatment and invasive procedures.
    Matched MeSH terms: Mediastinal Emphysema; Subcutaneous Emphysema
  13. Fulltext TLR7 promotes smoke-induced experimental lung damage through the activity of mast cell tryptase
    Liu G, Haw TJ, Starkey MR, Philp AM, Pavlidis S, Nalkurthi C, et al.
    Nat Commun, 2023 Nov 14;14(1):7349.
    PMID: 37963864 DOI: 10.1038/s41467-023-42913-z
    Toll-like receptor 7 (TLR7) is known for eliciting immunity against single-stranded RNA viruses, and is increased in both human and cigarette smoke (CS)-induced, experimental chronic obstructive pulmonary disease (COPD). Here we show that the severity of CS-induced emphysema and COPD is reduced in TLR7-deficient mice, while inhalation of imiquimod, a TLR7-agonist, induces emphysema without CS exposure. This imiquimod-induced emphysema is reduced in mice deficient in mast cell protease-6, or when wild-type mice are treated with the mast cell stabilizer, cromolyn. Furthermore, therapeutic treatment with anti-TLR7 monoclonal antibody suppresses CS-induced emphysema, experimental COPD and accumulation of pulmonary mast cells in mice. Lastly, TLR7 mRNA is increased in pre-existing datasets from patients with COPD, while TLR7+ mast cells are increased in COPD lungs and associated with severity of COPD. Our results thus support roles for TLR7 in mediating emphysema and COPD through mast cell activity, and may implicate TLR7 as a potential therapeutic target.
    Matched MeSH terms: Emphysema*
  14. Fulltext Clinical phenotypes of COPD and health-related quality of life: a cross-sectional study
    Chai CS, Liam CK, Pang YK, Ng DL, Tan SB, Wong TS, et al.
    Int J Chron Obstruct Pulmon Dis, 2019 03 01;14:565-573.
    PMID: 30880946 DOI: 10.2147/COPD.S196109
    Introduction: The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes.

    Methods: This was a cross-sectional study of patients with COPD attending the respiratory medicine clinic of University of Malaya Medical Centre from 1 June 2017 to 31 May 2018. Disease-specific HRQoL was assessed by using the COPD Assessment Test (CAT) and St George's Respiratory Questionnaire for COPD (SGRQ-c).

    Results: Of 189 patients, 28.6% were of non-exacerbator phenotype (NON-AE), 18.5% were of exacerbator with emphysema phenotype (AE NON-CB), 39.7% were of exacerbator with chronic bronchitis phenotype (AE CB), and 13.2% had asthma-COPD overlap syndrome phenotype (ACOS). The total CAT and SGRQ-c scores were significantly different between the clinical phenotypes (P<0.001). Patients who were AE CB had significantly higher total CAT score than those with ACOS (P=0.033), AE NON-CB (P=0.001), and NON-AE (P<0.001). Concerning SGRQ-c, patients who were AE CB also had a significantly higher total score than those with AE NON-CB (P=0.001) and NON-AE (P<0.001). However, the total SGRQ-c score of AE CB patients was only marginally higher than those who had ACOS (P=0.187). There was a significant difference in the score of each CAT item (except CAT 7) and SGRQ-c components between clinical phenotypes, with AE CB patients recording the highest score in each of them.

    Conclusion: Patients who were AE CB had significantly poorer HRQoL than other clinical phenotypes and recorded the worst score in each of the CAT items and SGRQ-c components. Therefore, AE CB patients may warrant a different treatment approach that focuses on the exacerbation and chronic bronchitis components.

    Matched MeSH terms: Pulmonary Emphysema/diagnosis*; Pulmonary Emphysema/parasitology; Pulmonary Emphysema/physiopathology; Pulmonary Emphysema/therapy
  15. Fulltext Predicting need for intensive care unit admission in adult emphysematous pyelonephritis patients at emergency departments: comparison of five scoring systems
    Yap XH, Ng CJ, Hsu KH, Chien CY, Goh ZNL, Li CH, et al.
    Sci Rep, 2019 11 12;9(1):16618.
    PMID: 31719593 DOI: 10.1038/s41598-019-52989-7
    This study assesses the performance of National Early Warning Score (NEWS), Quick Sepsis-related Organ Failure Assessment (qSOFA), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) in predicting emphysematous pyelonephritis (EPN) patients' need for intensive care unit (ICU) admission. A retrospective analysis was conducted at four training and research hospitals' emergency departments (EDs) on all EPN adult patients from January 2007 to August 2017. Data extracted were used to calculate raw scores for five physiologic scoring systems. Mann-Whitney U tests and χ2 tests were done for numerical and categorical variables respectively to examine differences between characteristics of ICU and non-ICU patient populations. Predictability of ICU admission was evaluated with AUROC analysis. ICU patients had lower GCS scores, SpO2, platelet counts, and estimated glomerular filtration rate; and higher bands, blood urea nitrogen, creatinine, and incidences of septic shock and nephrectomy. NEWS performed best, with 73.85% accuracy at optimal cut-off of 3. In this multicentre ED EPN series, we recommend using NEWS in early identification of critical EPN patients and advance planning for ICU admission. This would reduce delays in ICU transfer and ultimately improve patient outcomes.
    Matched MeSH terms: Emphysema/complications; Emphysema/diagnosis*
  16. Fulltext Toll-like receptor 2 and 4 have opposing roles in the pathogenesis of cigarette smoke-induced chronic obstructive pulmonary disease
    Haw TJ, Starkey MR, Pavlidis S, Fricker M, Arthurs AL, Nair PM, et al.
    Am. J. Physiol. Lung Cell Mol. Physiol., 2018 02 01;314(2):L298-L317.
    PMID: 29025711 DOI: 10.1152/ajplung.00154.2017
    Chronic obstructive pulmonary disease (COPD) is the third leading cause of morbidity and death and imposes major socioeconomic burdens globally. It is a progressive and disabling condition that severely impairs breathing and lung function. There is a lack of effective treatments for COPD, which is a direct consequence of the poor understanding of the underlying mechanisms involved in driving the pathogenesis of the disease. Toll-like receptor (TLR)2 and TLR4 are implicated in chronic respiratory diseases, including COPD, asthma and pulmonary fibrosis. However, their roles in the pathogenesis of COPD are controversial and conflicting evidence exists. In the current study, we investigated the role of TLR2 and TLR4 using a model of cigarette smoke (CS)-induced experimental COPD that recapitulates the hallmark features of human disease. TLR2, TLR4, and associated coreceptor mRNA expression was increased in the airways in both experimental and human COPD. Compared with wild-type (WT) mice, CS-induced pulmonary inflammation was unaltered in TLR2-deficient ( Tlr2-/-) and TLR4-deficient ( Tlr4-/-) mice. CS-induced airway fibrosis, characterized by increased collagen deposition around small airways, was not altered in Tlr2-/- mice but was attenuated in Tlr4-/- mice compared with CS-exposed WT controls. However, Tlr2-/- mice had increased CS-induced emphysema-like alveolar enlargement, apoptosis, and impaired lung function, while these features were reduced in Tlr4-/- mice compared with CS-exposed WT controls. Taken together, these data highlight the complex roles of TLRs in the pathogenesis of COPD and suggest that activation of TLR2 and/or inhibition of TLR4 may be novel therapeutic strategies for the treatment of COPD.
    Matched MeSH terms: Emphysema/etiology*; Emphysema/pathology
  17. Fulltext Silicone Y-stent insertion under extracorporeal membrane oxygenation (ECMO) in a patient with tracheal tear
    Mohd Esa NY, Faisal M, Vengadesa Pilla S, Abdul Rahaman JA
    BMJ Case Rep, 2020 Dec 22;13(12).
    PMID: 33370965 DOI: 10.1136/bcr-2020-236414
    Tracheal tear after endotracheal intubation is extremely rare. The role of silicone Y-stent in the management of tracheal injury has been documented in the previous studies. However, none of the studies have mentioned the deployment of silicone Y-stent via rigid bronchoscope with the patient solely supported by extracorporeal membrane oxygenation (ECMO) without general anaesthesia delivered via the side port of the rigid bronchoscope. We report a patient who had a tracheal tear due to endotracheal tube migration following a routine video-assisted thoracoscopic surgery sympathectomy, which was successfully managed with silicone Y-stent insertion. Procedure was done while she was undergoing ECMO; hence, no ventilator connection to the side port of the rigid scope was required. This was our first experience in performing Y-stent insertion fully under ECMO, and the patient had a successful recovery.
    Matched MeSH terms: Mediastinal Emphysema/etiology; Mediastinal Emphysema/therapy
  18. Fulltext Vanishing lung syndrome Masquerading as bilateral pneumothorax: A case report
    Muhamad NI, Mohd Nawi SN, Yusoff BM, Ab Halim NA, Mohammad N, Wan Ghazali WS
    Respir Med Case Rep, 2020;31:101276.
    PMID: 33209576 DOI: 10.1016/j.rmcr.2020.101276
    Vanishing lung syndrome (VLS) is a rare condition characterized by giant emphysematous bullae. It is frequently misdiagnosed as pneumothorax. We describe a case of a 30-year-old male who presented with shortness of breath, reduced effort tolerance, and pleuritic chest pain for three months. He was initially diagnosed with bilateral pneumothorax based on clinical examination and chest radiograph findings. However, further imaging with a high resolution computed tomography (HRCT) of the thorax confirmed bilateral giant emphysematous bullae. Our patient subsequently underwent video-assisted thoracoscopic surgery (VATS) and bullectomy. In this report, we discuss the clinical presentations, radiological features, and the management of VLS. We also highlight the differentiating features of VLS from a pneumothorax.
    Matched MeSH terms: Pulmonary Emphysema
  19. Fulltext Technical considerations in the surgical management of external laryngotracheal trauma: surgical outcomes
    Mohd Sayuti, R., Raja Ahmad, R.L.A., Wan Ishlah, L., Kahairi, A., Asha’ari, Z.A., Norie Azilah, K.
    International Medical Journal Malaysia, 2016;15(2):7-12.
    MyJurnal
    Introduction: External laryngotracheal (ELT) trauma is rarely encountered in clinical practice. In most
    circumstances, this injury is overlooked by the primary attending team. Surgical management of ELT trauma
    is complicated, because there is no established management approach for this potentially life-altering, high
    morbidity injury. It is important for this injury to be identified early, as any delay in surgical intervention
    may result in poor airway and phonatory outcomes. The aim of surgical reconstruction is to minimise the
    above debilitating morbidities by restoring the main laryngeal functions as much as possible. Methods: We
    reviewed the outcomes of six surgical interventions for ELT trauma at Tengku Ampuan Afzan Hospital from
    June 2007 to June 2014. Clinical presentations, computed tomography (CT) scans features, intraoperative
    findings, and postoperative outcomes were evaluated. Results: All patients made a good recovery in terms of
    phonation except for one patient who had reduced speech function. After one year, one patient was still
    dependent on a fenestrated tracheostomy. This article describes the surgical reconstruction techniques used
    to achieve these positive outcomes. Stenting is helpful to aid healing and re-epithelialisation. Conclusion:
    Prompt recognition and non-traumatised airway control are essential for addressing laryngotracheal trauma.
    Subcutaneous emphysema is an important hallmark that should alert the attending physician to the
    possibility of ELT trauma. Immediate surgical intervention using appropriate techniques can produce
    favorable patient outcomes.
    Matched MeSH terms: Subcutaneous Emphysema
  20. Fulltext Mesenchymal stem cell-based HSP70 promoter-driven VEGFA induction by resveratrol alleviates elastase-induced emphysema in a mouse model
    Chen YB, Lan YW, Chen LG, Huang TT, Choo KB, Cheng WT, et al.
    Cell Stress Chaperones, 2015 Nov;20(6):979-89.
    PMID: 26243699 DOI: 10.1007/s12192-015-0627-7
    Chronic obstructive pulmonary disease (COPD) is a sustained blockage of the airways due to lung inflammation occurring with chronic bronchitis and/or emphysema. Progression of emphysema may be slowed by vascular endothelial growth factor A (VEGFA), which reduces apoptotic tissue depletion. Previously, authors of the present report demonstrated that cis-resveratrol (c-RSV)-induced heat-shock protein 70 (HSP70) promoter-regulated VEGFA expression promoted neovascularization of genetically modified mesenchymal stem cells (HSP-VEGFA-MSC) in a mouse model of ischemic disease. Here, this same stem cell line was evaluated for its protective capacity to alleviate elastase-induced pulmonary emphysema in mice. Results of this study showed that c-RSV-treatment of HSP-VEGFA-MSC exhibited synergy between HSP70 transcription activity and induced expression of anti-oxidant-related genes when challenged by cigarette smoke extracts. Eight weeks after jugular vein injection of HSP-VEGFA-MSC into mice with elastase-induced pulmonary emphysema followed by c-RSV treatment to induce transgene expression, significant improvement was observed in respiratory functions. Expression of VEGFA, endogenous nuclear factor erythroid 2-related factor (Nrf 2), and manganese superoxide dismutase (MnSOD) was significantly increased in the lung tissues of the c-RSV-treated mice. Histopathologic examination of treated mice revealed gradual but significant abatement of emphysema and restoration of airspace volume. In conclusion, the present investigation demonstrates that c-RSV-regulated VEGFA expression in HSP-VEGFA-MSC significantly improved the therapeutic effects on the treatment of COPD in the mouse, possibly avoiding side effects associated with constitutive VEGFA expression.
    Matched MeSH terms: Emphysema/drug therapy*; Emphysema/metabolism
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