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BMC Pulmonary Medicine

Subject:
Pulmonary and Respiratory Medicine
Publisher:
BioMed Central —
Springer Journals
ISSN:
Scimago Journal Rank:
66
journal article
Open Access Collection
Eplerenone attenuates pathological pulmonary vascular rather than right ventricular remodeling in pulmonary arterial hypertension

Boehm, Mario; Arnold, Nadine; Braithwaite, Adam; Pickworth, Josephine; Lu, Changwu; Novoyatleva, Tatyana; Kiely, David G.; Grimminger, Friedrich; Ghofrani, Hossein A.; Weissmann, Norbert; Seeger, Werner; Lawrie, Allan; Schermuly, Ralph T.; Kojonazarov, Baktybek

2018 BMC Pulmonary Medicine

doi: 10.1186/s12890-018-0604-xpmid: 29499691

BackgroundAldosterone is a mineralocorticoid hormone critically involved in arterial blood pressure regulation. Although pharmacological aldosterone antagonism reduces mortality and morbidity among patients with severe left-sided heart failure, the contribution of aldosterone to the pathobiology of pulmonary arterial hypertension (PAH) and right ventricular (RV) heart failure is not fully understood.MethodsThe effects of Eplerenone (0.1% Inspra® mixed in chow) on pulmonary vascular and RV remodeling were evaluated in mice with pulmonary hypertension (PH) caused by Sugen5416 injection with concomitant chronic hypoxia (SuHx) and in a second animal model with established RV dysfunction independent from lung remodeling through surgical pulmonary artery banding.ResultsPreventive Eplerenone administration attenuated the development of PH and pathological remodeling of pulmonary arterioles. Therapeutic aldosterone antagonism – starting when RV dysfunction was established - normalized mineralocorticoid receptor gene expression in the right ventricle without direct effects on either RV structure (Cardiomyocyte hypertrophy, Fibrosis) or function (assessed by non-invasive echocardiography along with intra-cardiac pressure volume measurements), but significantly lowered systemic blood pressure.ConclusionsOur data indicate that aldosterone antagonism with Eplerenone attenuates pulmonary vascular rather than RV remodeling in PAH.
journal article
Open Access Collection
Geographic variation in the aetiology, epidemiology and microbiology of bronchiectasis

Chandrasekaran, Ravishankar; Mac Aogáin, Micheál; Chalmers, James; Elborn, Stuart; Chotirmall, Sanjay

2018 BMC Pulmonary Medicine

doi: 10.1186/s12890-018-0638-0pmid: 29788932

Bronchiectasis is a disease associated with chronic progressive and irreversible dilatation of the bronchi and is characterised by chronic infection and associated inflammation. The prevalence of bronchiectasis is age-related and there is some geographical variation in incidence, prevalence and clinical features. Most bronchiectasis is reported to be idiopathic however post-infectious aetiologies dominate across Asia especially secondary to tuberculosis. Most focus to date has been on the study of airway bacteria, both as colonisers and causes of exacerbations. Modern molecular technologies including next generation sequencing (NGS) have become invaluable tools to identify microorganisms directly from sputum and which are difficult to culture using traditional agar based methods. These have provided important insight into our understanding of emerging pathogens in the airways of people with bronchiectasis and the geographical differences that occur. The contribution of the lung microbiome, its ethnic variation, and subsequent roles in disease progression and response to therapy across geographic regions warrant further investigation. This review summarises the known geographical differences in the aetiology, epidemiology and microbiology of bronchiectasis. Further, we highlight the opportunities offered by emerging molecular technologies such as -omics to further dissect out important ethnic differences in the prognosis and management of bronchiectasis.
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