Background and Objectives: Studies have tried to establish a relationship between Obstructive Sleep Apnea syndrome (OSA) and smoking but data still remain controversial. We aimed: 1. To evaluate the relationship between smoking and OSA; 2. To explore potential differences according to gender, and 3. To analyze the prevalence of cardiovascular disease (CVD) co-morbidities according to gender and smoking status. Materials and Methods: This retrospective study included 3791 (70.6% males) adult patients who visited a Sleep Clinic. All participants underwent nocturnal polysomnography. Daytime somnolence and insomnia were assessed by using the Epworth Sleepiness Scale (ESS) and the Athens Insomnia Scale (AIS). Ever-smokers completed the Fagerstrom Test for Nicotine Dependence (FTND). Results: OSA was confirmed in 72.1% of participants with 62.2% suffering from moderate-to-severe disease. The number of cigarettes/day, Pack/Years, and FTND were significantly higher in patients with more severe OSA. The prevalence of current smokers was higher in those without OSA or with mild disease, whereas the prevalence of former smokers was higher in moderate and severe OSA. In univariate analysis, current smokers were found to be 1.2 times more likely to have OSA compared with never and former smokers combined and former smokers 1.49 times more likely compared with never smokers. In the multiple regression analysis, after adjusting for BMI, gender, age and number of alcoholic drinks per week, smoking was not found to be significantly associated with OSA. In gender stratified multivariate analyses, no significant associations were observed. CVD co-morbidities were more frequent in more severe OSA. Hypertension, coronary disease and diabetes were more prevalent in former smokers with AHI ≥ 15, compared with current smokers, especially in men. Conclusions: Even if an independent effect of smoking on OSA was not found, the number of cigarettes/day, Pack/Years, and FTND were higher in patients with more severe OSA with more prevalent CVD co-morbidities.

Adiponutrin (patatin-like phospholipase domain-containing 3; PNPLA3), encoded in humans by the PNPLA3 gene, is a protein associated with lipid droplet and endoplasmic reticulum membranes, where it is apparently involved in fatty acid redistribution between triglycerides and phospholipids. A common polymorphism of PNPLA3 (I148M, rs738409), linked to increased PNPLA3 presence on lipid droplets, is a strong genetic determinant of non-alcoholic fatty liver disease (NAFLD) and of its progression. P-glycoprotein (Pgp, MDR1—multidrug resistance protein 1, ABCB1—ATP-binding cassette sub-family B member 1), encoded by the ABCB1 gene, is another membrane protein implicated in lipid homeostasis and steatosis. In the past, common ABCB1 polymorphisms have been associated with the distribution of serum lipids but not with fatty acids (FA) profiles. Similarly, data on the effect of PNPLA3 I148M polymorphism on blood FAs are scarce. In this study, a gas chromatography-flame ionization detection (GC-FID) method was optimized, allowing us to analyze twenty FAs (C14: 0, C15: 0, C15: 1, C16: 0, C16: 1, C17: 0, C17: 1, C18: 0, C18: 1cis, C18: 2cis, C20: 0, C20: 1n9, C20: 2, C20: 3n6, C20: 4n6, C20: 5, C23: 0, C24: 0, C24: 1 and C22: 6) in whole blood, based on the indirect determination of the fatty acids methyl esters (FAMES), in 62 hyperlipidemic patients and 42 normolipidemic controls. FA concentrations were then compared between the different genotypes of the rs738409 and rs2032582 (ABCB1 G2677T) polymorphisms, within and between the hyperlipidemic and normolipidemic groups. The rs738409 polymorphism appears to exert a significant effect on the distribution of blood fatty acids, in a lipidemic and fatty acid saturation state-depending manner. The effect of rs2032582 was less pronounced, but the polymorphism did appear to affect the relative distribution of blood fatty acids between hyperlipidemic patients and normolipidemic controls.

This study investigated whether specific sulfatase modifying factor-1 (SUMF1) SNPs—previously linked to lung function—are associated with COPD progression and response to inhaled corticosteroid (ICS) treatment, specifically budesonide, given that SUMF1 expression is altered in COPD and its variants linked to increased disease risk. A subgroup of 165 COPD patients from the HISTORIC study were genotyped for two common SUMF1 SNPs, rs11915920 and rs793391. Patients first underwent a six-week run-in phase with open-label triple inhaled therapy (LAMA/LABA/ICS), then were randomized to receive either LAMA/LABA/placebo or LAMA/LABA/ICS for 12 months. Associations between SNPs, baseline characteristics, and response to ICS—based on FEV₁ change over 12 months—were evaluated. Heterozygotes (TG) for the rs793391 polymorphism treated with LAMA/LABA/ICS showed a significant and clinically meaningful FEV₁ improvement compared to the placebo group. This was supported by improved patient-reported outcomes, with lower SGRQ and CAT scores and a clinically relevant increase in General Health Questionnaire scores. These findings suggest that rs793391 may be linked to both COPD progression and ICS response and could contribute to more personalized treatment strategies in COPD.

Introduction:Pseudomonas aeruginosa is a major cause of morbidity and mortality in cystic fibrosis (CF) patients. Fluoroquinolones serve as the only available oral anti-pseudomonal antibiotic with advantages arising from their pharmacodynamic properties. Prulifloxacin, the pro-drug of ulifloxacin, has reported to show high anti-pseudomonal in vitro potency but there are few available data in CF patients. Aim: To compare the in vitro activity of ulifloxacin (ULI), ciprofloxacin (CIP) and levofloxacin (LEV) against P.aeruginosa strains in a Greek CF population. Methods: A total of 37 P. aeruginosa mucoid or non mucoid strains were collected from CF patients of any age and disease severity in 2 CF centers of Northern Greece during routine visits over the year 2018. Isolates included 33 sputum specimens and 4 pharyngeal swabs. Species’ identification and susceptibility testing were performed using the VITEK2 automated system and the E-test method accordingly. Susceptibility rates for CIP and LEV were calculated according to 2019 EUCAST breakpoints. Breakpoints for ULI are not reported; susceptibility was defined by a minimum inhibitory concentration (MIC) assessed by studies. MIC₅₀ and MIC₉₀ were calculated for each agent. Results: Overall, 18 of 37 isolates were susceptible to all agents and 11 were multiple resistant. ULI displayed a MIC range of 0.125-8, CIP 0.05-12 and LEV 0.25-12 mg/L. MIC₅₀ and MIC₉₀ were 0.38 and 4 for CIP, 0.44 and 4 for ULI ,and 1 and 6 mg/L for LEV respectively. Conclusion: ULI showed similar but not higher in vitro potency than CIP while LEV demonstrated the lowest against the isolates studied. These results do not necessarily reflect in vivo efficacy.

Aim: To compare the concordance of Bronchodilation Reversibility Testing (BDR) according to the two ERS/ATS definitions (2005 vs 2021) in a cohort of Greek adult and pediatric asthma patients. Methods: Consecutive, anonymized data recorded during 2022-2023 in one paediatric and one adult asthma outpatient clinic of a tertiary hospital of Northern Greece were retrospectively analysed. Patients with a first-time referral for a bronchodilator test were included. Chi-square test was utilised for group comparisons of BDR 2005 vs BDR 2021 tests in both cohorts. Results: Data were available for 274 patients, 190 adults and 84 children, aged 4.3 to 80 years old. Out of 170 BDR2021 negative (−) patients, 11 (6.5%) were BDR2005 positive (+). Of 174 (63.5%) who were BDR2005-, 15 (8.6%) were BDR2021+ (p<0.001). Dividing into subgroups, 65 (34%) adults and 24 (29%) children were BDR+ by both definitions. The two criteria led to discordant results in 13% and 7.9% of children and adults, respectively. More tests were classified as BDR+ using the 2021 criteria compared to 2005 in adults (n = 80/190, 42 % vs. 65/190, 34%; p =0.01) while the opposite trend was observed in children (n= 24/84, 29% vs. 35/84, 42%; p<0.001) (Table). Conclusions: In our cohort, the 2021 recommendation for BDR interpretation led to a small but significant reclassification in the number of BDR+ tests, with discrepancies assessed between adult and children group. Larger population data are needed. erj;64/suppl_68/PA2595/TB1 T1 TB1 Total Sample (N=274) Adults (n= 190) Children (n=84) BDR2021+% BDR2021-% BDR2021+ % BDR2021- % BDR2021+% BDR2021-% BDR2005+% 32.5 4 34 0 29 13 BDR2005- % 5.5 58 8 58 0 58 Total% 38 62 42 58 29 71