Combined use of rheology and portable low-field NMR in cystic fibrosis patients.

Published on Nov 1, 2021in Respiratory Medicine3.415
· DOI :10.1016/J.RMED.2021.106623
Michela Abrami14
Estimated H-index: 14
(UniTS: University of Trieste),
Massimo Maschio8
Estimated H-index: 8
(UniTS: University of Trieste)
+ 9 AuthorsBarbara Ruaro20
Estimated H-index: 20
Source
Abstract
Abstract null null Background null As most cystic fibrosis (CF) patients progress to respiratory failure, lung functionality assessment is pivotal. We previously developed a test that indirectly monitors airways (inflammation/functional test) by measuring the spin-spin relaxation time (T2m) of the water hydrogens present in CF sputum. Here the T2m significance in the monitoring of CF lung disease was further investigated by studying the correlation of T2m with: 1) sputum viscoelasticity, 2) mucociliary clearability index (MCI)/cough clearability index (CCI) and 3) sputum average mesh-size. null null null Methods null Sputum samples from 25 consenting CF subjects were analyzed by rheology tests (elastic modulus G and zero shear viscosity η0) and Low Field Nuclear Magnetic (LF-NMR) resonance (T2m). MCI/CCI were calculated from the rheological parameters. The average mesh-size (ξ) of the sputum structure was then evaluated by rheology/LF-NMR, together with FEV1 for each patient. null null null Results null There was an inverse correlation between G and η0 versus T2m, indicating that a worsening of the lung condition (T2m-FEV1 drop) is paralleled by an increase in sputum viscoelasticity (G and η0) favoring mucus stasis/inflammation. A direct correlation was also observed between T2m and MCI/CCI, showing that T2m provides information as to airway mucus clearing. Moreover, there was a direct correlation between T2m and the average sputum mesh size (ξ). null null null Conclusions null We demonstrated a correlation between T2m (measured in CF patient's sputum) and the sputum viscoelasticity/average mesh-size and with MCI/CCI, parameters related to airway mucus clearing. Thus, the present data strengthen the potential of our test to provide indirect monitoring of airway disease course in CF patients as T2m depends on mucus solid concentration and nanostructure.
References45
Newest
Bronchial diseases are characterised by the weak efficiency of mucus transport through the lower airways, leading in some cases to the muco-obstruction of bronchi. It has been hypothesised that this loss of clearance results from alterations in the mucus rheology, which are reflected in sputum samples collected from patients, making sputum rheology a possible biophysical marker of these diseases and their evolution. However, previous rheological studies have focused on quasi-static viscoelastic ...
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#1Michela Abrami (UniTS: University of Trieste)H-Index: 14
#2Massimo MaschioH-Index: 8
Last. Mario Grassi (UniTS: University of Trieste)H-Index: 43
view all 15 authors...
PURPOSE: To develop a novel approach to monitor lung ventilation/inflammation in cystic fibrosis (CF) patients. Lung assessment in CF patients is relevant given that most patients succumb to respiratory failure. Respiratory functional tests (forced expiratory volume in the first second; FEV1 ) and inflammatory markers are used to test pulmonary ventilation/inflammation, respectively. However, FEV1 is effort dependent and might be uncomfortable for CF patients. Furthermore, inflammatory marker de...
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#1Vivian Y. Lin (UAB: University of Alabama at Birmingham)H-Index: 7
#2Niroop Kaza (UAB: University of Alabama at Birmingham)H-Index: 10
Last. Steven M. Rowe (UAB: University of Alabama at Birmingham)H-Index: 63
view all 13 authors...
The mechanisms by which cigarette smoking impairs airway mucus clearance are not well understood. We recently established a ferret model of cigarette smoke-induced chronic obstructive pulmonary disease (COPD) exhibiting chronic bronchitis. We investigated the effects of cigarette smoke on mucociliary transport (MCT). Adult ferrets were exposed to cigarette smoke for 6 months, with in vivo mucociliary clearance (MCC) measured by Tc-labeled DTPA (Tc-DTPA) retention. Excised tracheae were imaged wi...
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#1Michela AbramiH-Index: 14
#2Paolo MarizzaH-Index: 8
Last. Mario GrassiH-Index: 43
view all 10 authors...
Background: The new concepts of personalized and precision medicine require the design of more and more refined delivery systems. In this frame, hydrogels can play a very important role as they represent the best surrogate of soft living tissues for what concerns rheological properties. Thus, this paper focusses on a global theoretical approach able to describe how hydrogel polymeric networks can affect the release kinetics of drugs characterized by different sizes. The attention is focused on a...
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#4Judith A. Voynow (Boston Children's Hospital)H-Index: 28
Background Cystic fibrosis (CF) airway secretions are abnormal, contributing to decreased clearance and a cycle of infection and inflammation. CF sputum properties may predict disease progression. We hypothesized that sputum viscoelasticity and clearance abnormalities would inversely correlate with pulmonary function during exacerbation and that sputum properties would return to baseline after therapy. Methods We collected sputa longitudinally from 13 subjects with CF with moderate to severe lun...
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#1Michela AbramiH-Index: 14
Last. Mario Grassi (UniTS: University of Trieste)H-Index: 43
view all 11 authors...
Purpose Development of a reliable, simple method to monitor lung condition in cystic fibrosis (CF) patients. Lung functionality assessment in CF patients is relevant, as most of them still die of respiratory failure. In lung mucus (sputum) of CF patients, components such as proteins, biopolymers, DNA, bacteria, and mucin are pathologically increased. As lung functionality is related to the amount of the pathological components in the sputum, their determination can help clinicians in monitoring ...
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#1Michaela Abrami (UniTS: University of Trieste)H-Index: 1
#2Gianluca Chiarappa (UniTS: University of Trieste)H-Index: 6
Last. Mario GrassiH-Index: 43
view all 6 authors...
The focus of this paper is on the theoretical interpretation of Low Field Nuclear Magnetic Resonance (LF-NMR) data regarding hydrogels architecture and on the most interesting applications of LF-NMR presented by this research group at the 6 th IAPC Symposium held in Zagreb (HR) on September 2017. Particular attention is devoted to the determination of the mesh size distribution of gels polymeric network and the determination of the pore size distribution of microporous systems such as scaffolds,...
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#1Gregg A. DuncanH-Index: 13
#2James JungH-Index: 2
Last. Jung Soo SukH-Index: 35
view all 8 authors...
The stasis of mucus secretions in the lungs of cystic fibrosis (CF) patients leads to recurrent infections and pulmonary exacerbations, resulting in decreased survival. Prior studies have assessed the biochemical and biophysical features of airway mucus in individuals with CF. However, these measurements are unable to probe mucus structure on microscopic length scales relevant to key players in the progression of CF-related lung disease, namely, viruses, bacteria, and neutrophils. In this study,...
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#1Mariateresa Stigliani (UNISA: University of Salerno)H-Index: 6
#2Michele Dario Manniello (UNISA: University of Salerno)H-Index: 6
Last. Paola Russo (UNISA: University of Salerno)H-Index: 24
view all 11 authors...
Abstract Background: Cystic fibrosis (CF) is characterized by a thick, sticky mucus responsible for both airway obstruction and resistance to drug diffusion, reducing the effectiveness of drug delivery to the lung. Studies of drug–mucus interaction may be a crucial step in therapeutic management of CF. In the present research, the effect of a saline solution of sodium bicarbonate (100 mM) on sputum viscosity and the permeation properties of ketoprofen lysinate (Klys) from a previously developed ...
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Mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator undermine many host defense systems by inhibiting the function of airway-surface liquid, causing flaws in mucociliary transport, and compromising other lung-protection mechanisms.
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