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Inhaled endotoxin in healthy human subjects: a dose-related study on systemic effects and peripheral CD4+ and CD8+ T cells

Loh LC, Vyas B, Kanabar V, Kemeny DM, O'Connor BJ

Respir Med, 2006 Mar;100(3):519-28.
PMID: 16039108

Inhaled endotoxin or lipopolysaccharide (LPS) is implicated in the pathogenesis of pulmonary diseases. We investigated the inhalation effects of two different doses of LPS in healthy human subjects.
Fulltext Ethnic differences in anthropometry among adult Singaporean Chinese, Malays and Indians, and their effects on lung volumes

Yap WS, Chan CC, Chan SP, Wang YT

Respir Med, 2001 Apr;95(4):297-304.
PMID: 11316113

When standing height (StndHt) cannot be assessed, arm span (AS) or sitting height (SitHt) has been used as surrogate variables for prediction of StndHt in adult caucasians and blacks. We examined (1) the relationship between StndHt, AS and SitHt among adult Chinese, Malays and Indians; and (2) whether anthropometry could explain the ethnic differences in lung volumes (as StndHt-adjusted lung volumes are known to differ significantly: Chinese > Malays > Indians). We recruited 1250 consecutive outpatients aged 20-90 years. Prediction equations of StndHt (with AS, SitHt, weight, age as predictors) for each subgroup of race and sex were formulated with multiple linear regressions. Equations with both AS and SitHt as predictors had the best goodness of fit (SEE = 2.37-2.85 cm, adjusted R2 = 0.67-0.87), as compared to equations with either AS (SEE = 3.00-3.91 cm, adjusted R2 = 0.58-0.80) or SitHt alone (SEE = 3.48-4.00 cm, adjusted R2 = 0.45-0.76). GLM general factorial analyses found that age- and weight-adjusted SitHt-to-StndHt ratios differed significantly among Chinese (0.539), Malays (0.529) and Indians (0.518). This paralleled the ethnic differences in lung volumes. The equations with both AS and SitHt as predictors provide the most accurate estimate of StndHt. Ethnic differences in upper body segment length may explain in part the lung volume differences.
Study site: Respiratory clinic, Tan Tock Seng Hospital, Singapore
Ethnic differences in normal spirometric lung function of Malaysian children

Azizi BH, Henry RL

Respir Med, 1994 May;88(5):349-56.
PMID: 8036303

Spirometric recordings of 1098 Malaysian children who were free of respiratory symptoms were examined by least square regression analysis of log-transformed lung function data. Ethnic differences were observed in FVC, FEV1, and FEF25-75 independent of father's education, exposure to passive smoking, wood stove, kerosene stove and mosquito repellents, family history of chest illness and history of allergy, after adjusting for standing height, age and sex. Exposure to kerosene stove was significantly associated with reduced FVC and FEV1 indicating that environmental factors may impair lung function in symptomless children. Prediction equations were derived for each ethnic group and sex. Comparison with data from the literature showed that Malaysian children had lower lung function values than Caucasian children. Generally, Chinese children had higher FEV1, FVC and FEF25-75 than Malay and Indian children. Indian children consistently had the lowest lung function values. Since these ethnic differences were independent of environmental and other host factors, anthropometric variations could be an explanation.
Fulltext Use of corticosteroids in asthma and COPD patients with or without COVID-19

Hasan SS, Capstick T, Zaidi STR, Kow CS, Merchant HA

Respir Med, 2020 05 26;170:106045.
PMID: 32843175 DOI: 10.1016/j.rmed.2020.106045

The potential detrimental effects of steroids on the immune system to fight viral infections had always been a concern for patients on long term steroids in chronic conditions. A recent warning from WHO on systemic corticosteroid use amid COVID-19 raised suspicion among public and healthcare professionals regarding the safety of steroid use during the SARS-CoV-2 pandemic. The corticosteroids (inhaled and oral) are commonly prescribed in the management of asthma and COPD patients and any unsolicited changes in medications use may lead to potentially severe exacerbations and may risk patient lives. This article provides a critical review of clinical evidence and offers a detailed discussion on the safety and efficacy of corticosteroids in asthma and COPD patients, both with and without COVID-19.
Comment on "A novel approach of using educational pharmaceutical pictogram for improving inhaler techniques in patients with asthma"

Muneswarao J, Hassali MA, Verma AK

Respir Med, 2018 12;145:241-242.
PMID: 30266530 DOI: 10.1016/j.rmed.2018.09.012
Fulltext Does baricitinib reduce mortality and disease progression in SARS-CoV-2 virus infected patients? A systematic review and meta analysis

Manoharan S, Ying LY

Respir Med, 2022 Oct;202:106986.
PMID: 36150282 DOI: 10.1016/j.rmed.2022.106986

BACKGROUND: There are conflicting reports on the results of several of the latest clinical trials related to the use of baricitinib in the management of COVID-19 patients. The aim of the current systematic review and meta-analysis was to evaluate the efficacy of baricitinib in COVID-19 patients.
METHODS: Databases like ScienceDirect, PubMed/Medline, Publons, Google Scholar and other sources like ClinicalTrials.gov, Cochrane, medRxiv, Research Square and reference lists were thoroughly searched.
RESULTS: Fifteen (15) articles which met the inclusion criteria were qualitatively and quantitatively analysed. Based on Cochrane and Newcastle-Ottawa Scale (NOS) risk of bias (RoB) analyses, 14/15 articles are grouped as high-quality. Meta-analyses revealed that randomised control trials (RCTs) and non-randomised control trials (nRCTs) statistically significantly reduced the mortality rate in COVID-19 patients, with a risk ratio (RR) in the fixed-effect model was RR = 0.64 [95% CI: 0.51 to 0.79; p
Safety and efficacy of Ensifentrine in COPD: A Systemic Review and Meta-analysis

Yappalparvi A, Balaraman AK, Padmapriya G, Gaidhane S, Kaur I, Lal M, et al.

Respir Med, 2024 Nov 16.
PMID: 39557208 DOI: 10.1016/j.rmed.2024.107863

BACKGROUND: Chronic obstructive pulmonary disease (COPD) significantly impacts global health due to persistent airflow limitation and inflammation. Despite standard therapies, symptoms persist. Ensifentrine, targeting both bronchoconstriction and inflammation as a dual phosphodiesterase 3 and 4 inhibitor, offers a promising therapeutic advancement for COPD management. This meta-analysis evaluates the safety and efficacy of ensifentrine in improving lung function, dyspnea, and quality of life in COPD patients.
METHODS: We searched PubMed, Embase, and Web of Science through August 2024 for randomized controlled trials evaluating ensifentrine in COPD patients over a minimum of four weeks. Data extraction and screening utilized Knowledge software, and meta-analyses were performed using R v4.4 with a random-effects model.
RESULTS: From 206 studies identified, four met our inclusion criteria. Ensifentrine improved FEV1 significantly at a dose of 3 mg (LS mean difference: 40.90 mL; 95% CI: 19.65-62.15). It also improved dyspnea as measured by the Transition Dyspnea Index (TDI) (LS mean difference: 0.91; 95% CI: 0.61-1.21) and quality of life according to the St. George's Respiratory Questionnaire-C (SGRQ-C) scores (LS mean difference: -1.92; 95% CI: -3.28 to -0.55). Safety profiles were comparable between the ensifentrine and placebo groups, with no significant increase in treatment-emergent adverse events (TEAEs) (RR: 1.02; 95% CI: 0.94-1.10).
CONCLUSION: Ensifentrine significantly enhances lung function, reduces dyspnea, and improves quality of life in COPD patients, especially at a 3 mg dose. These benefits, coupled with a stable safety profile, support its use as an adjunctive therapy in COPD management.