Nano-based theranostics for chronic obstructive lung diseases: challenges and therapeutic potential.

Expert Opin Drug Deliv. 2011 Jun 28;

Authors: Vij N

The major challenges in the delivery and therapeutic efficacy of nano-delivery systems in chronic obstructive airway conditions are airway defense, severe inflammation and mucous hypersecretion. Chronic airway inflammation and mucous hypersecretion are hallmarks of chronic obstructive airway diseases, including asthma, COPD (chronic obstructive pulmonary disease) and CF (cystic fibrosis). Distinct etiologies drive inflammation and mucous hypersecretion in these diseases, which are further induced by infection or components of cigarette smoke. Controlling chronic inflammation is at the root of treatments such as corticosteroids, antibiotics or other available drugs, which pose the challenge of sustained delivery of drugs to target cells or tissues. In spite of the wide application of nano-based drug delivery systems, very few are tested to date. Targeted nanoparticle-mediated sustained drug delivery is required to control inflammatory cell chemotaxis, fibrosis, protease-mediated chronic emphysema and/or chronic lung obstruction in COPD. Moreover, targeted epithelial delivery is indispensable for correcting the underlying defects in CF and targeted inflammatory cell delivery for controlling other chronic inflammatory lung diseases. We propose that the design and development of nano-based targeted theranostic vehicles with therapeutic, imaging and airway-defense penetrating capability, will be invaluable for treating chronic obstructive lung diseases. This paper discusses a novel nano-theranostic strategy that we are currently evaluating to treat the underlying cause of CF and COPD lung disease.

PMID: 21711085 [PubMed - as supplied by publisher]

Airflow limitation, lung volumes and systemic inflammation in a general population.

Eur Respir J. 2011 Jun 30;

Authors: Gläser S, Ittermann T, Koch B, Völzke H, Wallaschofski H, Nauck M, Warnke C, Vogelmeier C, Schulz H, Felix SB, Ewert R, Schäper C

Although several levels of evidence suggested an association of systemic inflammation and spirometric lung volumes, data addressing the potential interrelationship between airflow limitation and inflammatory markers are sparse and remain controversial. Potential associations between high-sensitive C-reactive protein, fibrinogen and lung function were investigated in 1466 individuals, aged 25-85 years, representing a general population. Within this cross-sectional population based study data on bodyplethysmography, spirometry, helium dilution and diffusing capacity for carbon monoxide were analysed. After adjustment for potential confounding factors such as smoking, obesity and cardiorespiratory fitness, there was an inverse association of high-sensitive C-reactive protein with forced expiratory and static lung volumes. Neither in apparently healthy nor in the entire population inflammation was associated with airflow limitation in central airways. In smokers only, higher high-sensitive C-reactive protein and fibrinogen were associated with an impaired diffusing capacity. This study shows that higher levels of high-sensitive C-reactive protein are associated with decreased lung volumes in a general population over a wide age range. A consistent interrelationship of central airflow limitation and inflammation was not verifiable. Smoking is related to an impaired diffusing capacity in association to an increase in systemic inflammation.

PMID: 21719491 [PubMed - as supplied by publisher]

Malignancy and Specific Allergen Immunotherapy: The Results of a Case Series.

Int Arch Allergy Immunol. 2011 Jun 29;156(3):313-319

Authors: Wöhrl S, Kinaciyan T, Jalili A, Stingl G, Moritz KB

Background: Specific immunotherapy with allergen is the only causative treatment for IgE-mediated allergies such as stinging insect allergy or hay fever and works by the induction of blocking antibodies and regulatory T lymphocytes. Objective: Does a hypothetical obstruction of tumor surveillance presupposing the induction of regulatory T cells really justify detaining immunotherapy to oncologic patients as suggested by recent guidelines? Methods: We report 6 patients (4 female, 2 male) suffering or having suffered from stage 1 cancer (4 melanomas, 1 lung cancer, 1 breast cancer) and concomitant IgE-mediated allergy. Four of them had a history of severe anaphylactic reactions to the insect yellow jacket, the 5th suffered from allergic rhinoconjunctivitis to dust mites, and the 6th to grass/rye pollen. Results: Between 2004 and 2010, subcutaneous immunotherapy was safely performed in 5 patients without signs of tumor reactivation. The cancer in 2 of them was diagnosed immediately after specific immunotherapy had been initiated and in another 2 the active cancer phase had already finished years before; the 5th suffered from a relapse around the time of the initiation of immunotherapy. At the time of the writing of the manuscript, 4 of them had already concluded 3 years of treatment, another one almost 1 year. The melanoma in the 6th patient was diagnosed 5 months after reaching the maintenance dose. Immunotherapy with grass/rye pollen was aborted in this patient based on current guidelines. Conclusions: Specific immunotherapy was safely administered in patients suffering concomitantly from IgE-mediated allergy and lower stage cancer.

PMID: 21720177 [PubMed - as supplied by publisher]

Computer-assisted detection of infectious lung diseases: A review.

Comput Med Imaging Graph. 2011 Jun 29;

Authors: Bağcı U, Bray M, Caban J, Yao J, Mollura DJ

Respiratory tract infections are a leading cause of death and disability worldwide. Although radiology serves as a primary diagnostic method for assessing respiratory tract infections, visual analysis of chest radiographs and computed tomography (CT) scans is restricted by low specificity for causal infectious organisms and a limited capacity to assess severity and predict patient outcomes. These limitations suggest that computer-assisted detection (CAD) could make a valuable contribution to the management of respiratory tract infections by assisting in the early recognition of pulmonary parenchymal lesions, providing quantitative measures of disease severity and assessing the response to therapy. In this paper, we review the most common radiographic and CT features of respiratory tract infections, discuss the challenges of defining and measuring these disorders with CAD, and propose some strategies to address these challenges.

PMID: 21723090 [PubMed - as supplied by publisher]