Background: Chronic Obstructive Pulmonary Disease (COPD) exhibits some phenotypic differences between patients with biomass smoke inhalation (COPD-B) and tobacco smoking (COPD-T). COPD-B is characterized by less emphysema but more airway disease and vascular pulmonary remodeling, which are related to mast cells in lung tissues in COPD-T. Our objective was to describe the differences between the number of mast cells in COPD-B and COPD-T patients. Methods: A cross-sectional study was conducted on lung tissue resections for suspected cancer obtained between 2014 and 2021 from patients with documented COPD due to wood smoke or tobacco exposure. Histological samples were analyzed for mast cell count, CD34+ expression, and structural changes in lung tissue and pulmonary circulation. Results: A total of 20 histological samples were analyzed, with significant differences found in mast cell count [median 8 (p25-75, 5–11) vs. 2 (p75-25, 0–6), p = 0.016] and severe peribronchiolar fibrosis (60% vs. 10%, p = 0.04) between COPD-B and COPD-T patients. A positive correlation [Spearman rho = 0.879 (95% CI 0.71–0.96), p < 0.001] was observed between mast cell count and a gradual increase in pulmonary artery diameter. Conclusions: These preliminary findings suggest histological differences and the presence of mast cells between COPD-B and COPD-T, which should be confirmed in a larger number of samples and patients.

Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by local and systemic inflammation independently of the risk factor; during the exacerbations, such inflammation is accentuated and amplified. A practical inflammatory marker and one with an applicable predictive value in the follow-up has been sought. FeNO has shown an excellent performance in that respect within the context of asthma and has also been studied in tobacco-smoke COPD (COPD-TS). In Biomass-smoke COPD (COPD-BS), this, to our knowledge, has not been evaluated. Objective: To measure FeNO levels in patients with COPD-BS and to compare these with those of patients with stable COPD-TS and in healthy controls. Methods: Transversal, observational, descriptive, comparative, and analytical study. A total of 57 patients, including 23 with COPD-BS, 17 with COPD-TS, and 17 healthy control subjects. The measurement of FeNO was carried out on all of these by means of the on-line chemiluminescence technique; the values were expressed in parts per billion (ppb) for their analysis. Results: It was observed that the FeNO values were similar between COPD-BS and COPD-TS and were significantly different between the healthy and stable COPD (both groups). No correlation was found between pulmonary function and symptoms with FeNO in any of the groups. Conclusions: The level of FeNO in stable COPD is found to be increased in a similar manner in COPD-BS and COPD-TS, with a significant difference on comparing it with that of the healthy subjects.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), is a global health threat with the potential to cause severe disease manifestations in the lungs. Although clinical descriptions of COVID-19 are currently available, the factors distinguishing SARS-CoV-2 from other respiratory viruses are unknown. Here, we compared the clinical, histopathological, and immunological characteristics of patients with COVID-19 and pandemic influenza A(H1N1). We observed a higher frequency of respiratory symptoms, increased tissue injury markers, a histological pattern of alveolar pneumonia, and higher levels of IL-1RA, TNF-α, CCL3, G-CSF, APRIL, sTNF-R1, sTNF-R2, sCD30, and sCD163 in influenza patients. Conversely, dry cough, gastrointestinal symptoms, interstitial lung pathology, increased Th1 (IL-12, IFN-γ) and Th2 (IL-4, IL-5, IL-10, IL-13) cytokine levels, along with IL-1β, IL-6, CCL11, VEGF, TWEAK, TSLP, MMP-1, and MMP-3, were observed in COVID-19 cases. We demonstrated the diagnostic potential of some clinical and immune factors to differentiate COVID-19 from pandemic influenza A(H1N1). Our data suggest that SARS-CoV-2 induces a dysbalanced polyfunctional inflammatory response that is different from the immune response against influenza. These findings might be relevant for the upcoming 2020-2021 influenza season, which is projected to be historically unique due to its convergence with COVID-19.

Background: COPD ranks as the third leading global cause of mortality. Despite the widespread use of the BODE index and its variants for mortality prediction, their accuracy may be affected by factors like ethnicity, altitude and regional disparities. This study aimed to assess a new altitude-adapted prognostic index in COPD patients at moderate altitudes compared with the BODE and other mortality predictors.Methods: We evaluated the performance of BODE and other standard prognostic indexes in an exploratory cohort of COPD patients using Cox proportional hazards models. Additionally, we developed a new risk-weighted prognostics model. We assessed its performance utilising receiver operating characteristic curves and compared it with BODE index variants. The indices were validated in a second cohort. The mean follow-up period in both cohorts was 7 years.Results: In the exploratory cohort (n=416), COPD patients had a 77% 5-year survival rate. eBODE exhibited superior predictive capacity (HR 1.22, 95% CI 1.11–1.34, p<0.05). Prognostic models included oxygen saturation measured by pulse oximetry <90%, body mass index, 6-min walk test (6MWT) and current smoking as primary relevant risks (BOSEA-90), with the second model excluding 6MWT (BOSA-90). BOSEA-90 predicted a major risk per point (HR 1.41, 95% CI 1.31–1.51, p0.75) compared to other indices (AUC <0.70, p<0.001). The validation cohort (n=436) confirmed effectiveness in differentiating mild and very severe cases.Conclusions: The BODE prognostic index and its variants effectively predicted mortality, and the newly proposed BOSEA-90 and BOSA-90 indices demonstrated appropriate performance for a group of COPD patients at moderate altitude.

Chronic Obstructive Pulmonary Disease (COPD) is a disease characterized by local and systemic inflammation independently of the risk factor; during the exacerbations, such inflammation is accentuated and amplified. A practical inflammatory marker and one with an applicable predictive value in the follow-up has been sought. FeNO has shown an excellent performance in that respect within the context of asthma and has also been studied in tobacco-smoke COPD (COPD-TS). In Biomass-smoke COPD (COPD-BS), this, to our knowledge, has not been evaluated. Objective: To measure FeNO levels in patients with COPD-BS and to compare these with those of patients with stable COPD-TS and in healthy controls. Methods: Transversal, observational, descriptive, comparative, and analytical study. A total of 57 patients, including 23 with COPD-BS, 17 with COPD-TS, and 17 healthy control subjects. The measurement of FeNO was carried out on all of these by means of the on-line chemiluminescence technique; the values were expressed in parts per billion (ppb) for their analysis. Results: It was observed that the FeNO values were similar between COPD-BS and COPD-TS and were significantly different between the healthy and stable COPD (both groups). No correlation was found between pulmonary function and symptoms with FeNO in any of the groups. Conclusions: The level of FeNO in stable COPD is found to be increased in a similar manner in COPD-BS and COPD-TS, with a significant difference on comparing it with that of the healthy subjects.

Las bolsas de nicotina (BN) han incursionado en el mercado nacional. Su composición incluye celulosa, aromatizantes, ácidos reguladores y sales de nicotina que se disuelven en la boca y se absorben en las encías y mucosa. El consumo de BN se asocia con el desarrollo de la adicción a la nicotina y con la aparición de lesiones en la cavidad bucal. Asimismo, se ha descrito un posible incremento en el riesgo de cáncer asociado con nitrosaminas en estos productos, junto con efectos adversos a largo plazo por la exposición a la nicotina como problemas metabólicos, inflamación crónica y deterioro cognitivo. En este contexto, considerando su creciente popularidad, las BN podrían constituir un riesgo relevante para la salud pública, particularmente en adolescentes y adultos jóvenes, al actuar como una vía de inicio hacia la adicción a la nicotina y por favorecer la renormalización de su consumo, incluyendo el de cigarrillos normales.