UNASSIGNED: The autonomic nerves in the lungs and the intercostal and phrenic nerves are important for respiratory movements. This study investigated the effects of electroacupuncture (EA) stimulation via the sympathetic nerve on maximal respiratory mouth pressure.
UNASSIGNED: This prospective, single-center, randomized crossover study was conducted in Teikyo Heisei University, Japan. The subjects were 17 healthy adults (15 men and 2 women), who were randomly assigned to untreated and EA groups in a crossover trial with a 2-week washout period. Initially, respiratory mouth pressure was tested in both groups. After 5 minutes of rest, either a 5-minute rest or an EA stimulus was delivered, followed by 5 minutes of rest. EA was delivered near the cervical ganglia at the level of the sixth cervical vertebra on the left side. The EA stimulus was set to 2 Hz, and the stimulation intensity was set to a level so that no pain would be felt by the volunteers. Nasal-skin temperature was measured during rest or EA stimulation. Thereafter, respiratory mouth pressure was tested again in both groups.
UNASSIGNED: The EA group had a significant reductions in nasal-skin temperature during the intervention and a significant increase in inspiratory and expiratory respiratory mouth pressure after the intervention, compared to the nonstimulated group.
UNASSIGNED: The 2-Hz EA stimulation via the sympathetic nerve activated the sympathetic nerves and suppressed respiratory mouth pressure weakness. Future studies are needed to evaluate EA\'s effectiveness for treating bronchial stenosis and respiratory weakness.

Objective: The autonomic nervous system is involved in the regulation of airway smooth muscle. This study examined the effect of acupuncture stimulation in the vicinity of the cervical-sympathetic ganglion on respiratory function in humans. Materials and Methods: Twenty-four healthy adults (19 males and 5 females) were randomly assigned to a no-treatment group, a leave-needle group, and an electroacupuncture (EA) group in a crossover trial. In all groups, respiratory function was initially tested. In both acupuncture groups, after 5 minutes of rest, a 5-minute acupuncture stimulus was delivered, followed by 5 minutes of rest. Thereafter, respiratory function was again tested in all groups. Acupuncture was delivered in the vicinity of the cervical ganglia at the height of the sixth cervical vertebra on the left side and the vertebral artery node; the EA stimulus was set to 2 Hz, and the stimulation intensity was set to a level at which no pain was felt by the participants. Results: The EA group had significant increases in peak expiratory flow (PEF) and vital capacity (VC) after the intervention, compared to before intervention. Additionally, the EA group had significant increases in these parameters, compared to the no-treatment group. Conclusions: These results indicated that stimulation with 2-Hz EA in the vicinity of the cervical-sympathetic trunk causes an increase in PEF and VC, and increased bronchial dilation.

Rationale: Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma targeting airway smooth muscle (ASM). Observational studies have shown ASM mass reduction after BT, but appropriate control groups are lacking. Furthermore, as treatment response is variable, identifying optimal candidates for BT treatment is important.Objectives: First, to assess the effect of BT on ASM mass, and second, to identify patient characteristics that correlate with BT response.Methods: Patients with severe asthma (n = 40) were randomized to immediate (n = 20) or delayed (n = 20) BT treatment. Before randomization, clinical, functional, blood, and airway biopsy data were collected. In the delayed control group, reassessment, including biopsies, was performed after 6 months of standard clinical care, followed by BT. In both groups, post-BT data including biopsies were obtained after 6 months. ASM mass (% positive desmin or α-smooth muscle actin area in the total biopsy) was calculated with automated digital analysis software. Associations between baseline characteristics and Asthma Control Questionnaire and Asthma Quality of Life Questionnaire (AQLQ) improvement were explored.Measurements and Main Results: Median ASM mass decreased by >50% in the immediate BT group (n = 17) versus no change in the delayed control group (n = 19) (P = 0.0004). In the immediate group, Asthma Control Questionnaire scores improved with -0.79 (interquartile range [IQR], -1.61 to 0.02) compared with 0.09 (IQR, -0.25 to 1.17) in the delayed group (P = 0.006). AQLQ scores improved with 0.83 (IQR, -0.15 to 1.69) versus -0.02 (IQR, -0.77 to 0.75) (P = 0.04). Treatment response in the total group (n = 35) was positively associated with serum IgE and eosinophils but not with baseline ASM mass.Conclusions: ASM mass significantly decreases after BT when compared with a randomized non-BT-treated control group. Treatment response was associated with serum IgE and eosinophil levels but not with ASM mass.

Preclinical research suggests a role of Glucagon Like Peptide-1 Receptors (GLP-1R) on the regulation of human bronchial tone. We investigated the effect of GLP-1R agonists on lung function of Type 2 Diabetes Mellitus (T2DM) population without co-existing chronic obstructive respiratory disorders.
This was a prospective cohort study that examined change in lung function measurements over two years of T2DM patients (n = 32) treated with metformin monotherapy (control cohort), metformin plus GLP-1R agonists (GLP-1R agonists cohort), or metformin plus insulin (insulin cohort).
After 24 months of treatment, the forced expiratory volume in 1 s (FEV1) significantly (p < 0.05) increased from baseline in the GLP-1R agonists cohort (218 ml [95%CI 88-246]), but not in the control and insulin cohorts (94 ml [95%CI -28 - 216] and 26 ml [95%CI -174 - 226], respectively; p > 0.05 vs. baseline). The average increase in FEV1 in the GLP-1R agonists cohort was significantly greater than that in the control and insulin cohorts (delta: 110 ml [95%CI 18-202] and 177 ml [95%CI 85-270], respectively, p < 0.05). The forced vital capacity (FVC) also increased significantly more in the GLP-1R agonists cohort than in the control and insulin cohorts (overall delta FVC: 183 ml [95%CI 72-295], p < 0.05). The maximal expiratory flow at 50-75% significantly (p < 0.05) improved from baseline in the GLP-1R agonists cohort, but not in the control and insulin cohorts (p > 0.05).
Our preliminary results suggest a potential new therapeutic perspective to treat airway disorders with GLP-1R agonists.

The factors altering the bronchodilatory response to a deep inspiration (DI) in asthma are important to decipher. In this in vitro study, we investigated the effect of changing the duration between DIs on the rate of force recovery post-DI in guinea pig bronchi. The airway smooth muscle (ASM) within the main bronchi were submitted to length oscillation that simulated tidal breathing in different contractile states during 2, 5, 10 or 30min prior to a larger length excursion that simulated a DI. The contractile states of ASM were determined by adding either methacholine or isoproterenol. Irrespective of the contractile state, the duration between DIs neither affected the measured force during length oscillation nor the bronchodilator effect of DI. Contrastingly, the rate of force recovery post-DI in contracted state increased as the duration between DIs decreased. Similar results were obtained with contracted parenchymal strips. These findings suggest that changing the duration between DIs may alter the rate of ASM force recovery post-DI and thereby affect the rate of renarrowing and the duration of the respiratory relief afforded by DI.

BACKGROUND: Chronic cough involves airway remodeling associated with cough reflex hypersensitivity. Whether cough itself induces these features remains unknown.
METHODS: Guinea pigs were assigned to receive treatment with citric acid (CA), saline (SA), or CA+dextromethorphan (DEX). All animals were exposed to 0.5M CA on days 1 and 22. On days 4-20, the CA and CA+DEX groups were exposed to CA, and the SA group to saline thrice weekly, during which the CA+DEX group was administered DEX pretreatment to inhibit cough. The number of coughs was counted during each 10-min CA or SA exposure. Terbutaline premedication was started to prevent bronchoconstriction. Bronchoalveolar lavage and pathology were examined on day 25. Average cough number for 10 CA exposures was examined as \"cough index\" in the CA group, which was divided into frequent (cough index>5) and infrequent (<5) cough subgroups for lavage and pathology analysis.
RESULTS: The number of coughs significantly increased in the CA group from day 13 onwards. In the CA+DEX and SA groups, the number of coughs did not differ between days 1 and 22, while average number of coughs during days 4-20 was significantly lower than at days 1 and 22. Bronchoalveolar cell profiles were similar among the four groups. The smooth muscle area of small airways was significantly greater in the frequent-cough subgroup than in the other groups (in which it was similar), and highly correlated with cough index in CA group.
CONCLUSIONS: Repeated cough induces airway smooth muscle remodeling associated with cough reflex hypersensitivity.