Distribution and outcomes of a phenotype-based approach to guide COPD management: Results from the CHAIN cohort

Rationale: The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes. Objective: We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes. Methods: We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes. Results: Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%); ACOS, 125 (15.0%); FEE, 38 (4.6%); and FECB, 99 (11.9%); additionally 19 (2.3%) COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p<0.05). The FECB phenotype had the highest CAT score (17.1±8.2, p<0.05 compared to the other phenotypes). Frequent exacerbator groups (FEE and FECB) were receiving more pharmacological treatment at baseline, and also experienced more exacerbations the year after (all p<0.05) with no differences in one-year mortality. Most of NE (93%) and half of exacerbators were stable after one year. Conclusions: There is an uneven distribution of COPD phenotypes in stable COPD patients, with significant differences in demographics, patient-centered outcomes and health care resources use

The menthol receptor TRPM8 is the principal detector of environmental cold

Sensory nerve fibres can detect changes in temperature over a remarkably wide range, a process that has been proposed to involve direct activation of thermosensitive excitatory transient receptor potential (TRP) ion channels. One such channel--TRP melastatin 8 (TRPM8) or cold and menthol receptor 1 (CMR1)--is activated by chemical cooling agents (such as menthol) or when ambient temperatures drop below approximately 26 degrees C, suggesting that it mediates the detection of cold thermal stimuli by primary afferent sensory neurons. However, some studies have questioned the contribution of TRPM8 to cold detection or proposed that other excitatory or inhibitory channels are more critical to this sensory modality in vivo. Here we show that cultured sensory neurons and intact sensory nerve fibres from TRPM8-deficient mice exhibit profoundly diminished responses to cold. These animals also show clear behavioural deficits in their ability to discriminate between cold and warm surfaces, or to respond to evaporative cooling. At the same time, TRPM8 mutant mice are not completely insensitive to cold as they avoid contact with surfaces below 10 degrees C, albeit with reduced efficiency. Thus, our findings demonstrate an essential and predominant role for TRPM8 in thermosensation over a wide range of cold temperatures, validating the hypothesis that TRP channels are the principal sensors of thermal stimuli in the peripheral nervous system

Ação de quitosana sobre o desenvolvimento de Plasmopara viticola e Elsinoe ampelina, in vitro e em videiras cv. Isabel Chitosan action on Plasmopara viticola and Elsinoe ampelina development in vitro and in grapevines cv. Isabel

Este trabalho teve como objetivos avaliar o efeito da quitosana no controle dos fungos Plasmopara viticola e Elsinoe ampelina, agentes causais do míldio e da antracnose da videira, respectivamente. As concentrações de 0, 20, 40, 80 e 160 mg L-1 de quitosana foram utilizadas nos seguintes experimentos: testes de crescimento micelial, de germinação de esporos e ensaio em condições de campo. Para os dois últimos ensaios, adicionou-se tratamentos padrões com mancozeb e calda bordalesa. Verificou-se redução no crescimento micelial de E. ampelina sendo que a maior concentração de quitosana (160 mg L-1) reduziu em 57% o desenvolvimento do fungo, 192 horas após incubação. Nos testes de germinação, a dose de 160 mg L-1 de quitosana reduziu a germinação de esporos de E. ampelina em aproximadamente 98% e de P. viticola em 60%, não diferindo dos tratamentos com calda bordalesa e mancozeb. Nos ensaios a campo as maiores doses de quitosana (80 e 160 mg L-1) apresentaram um decréscimo na severidade de antracnose entre 93 e 81%. Para o míldio, a concentração de 160 mg L-1 apresentou um decréscimo de aproximadamente 81%. Baseando-se nestes resultados, pode-se concluir que a quitosana tem um grande potencial no controle do míldio e da antracnose da videira.<br>This work aimed to evaluate the effect of chitosan on the control of fungi Elsinoe ampelina and Plasmopara viticola, the causal agents of downy mildew and anthracnose in grapevines, respectively. The concentrations of 0, 20, 40, 80 and 160 mg L-1 chitosan were used in the following trials: mycelial growth, spore germination, and experiment in field conditions. For the last two trials standard treatments with mancozeb and bordeax mixture were added. There was a reduction in E. ampelina mycelial growth and the highest chitosan concentration (160 mg L-1) decreased by 57% the fungus development at 192 hours after incubation. In the germination tests, the concentration of 160 mg L-1 chitosan reduced spore germination in E. ampelina by approximately 98% and P. viticola by 60%, not differing from the treatments with bordeaux mixture and mancozeb. In the field trial the highest chitosan concentrations (80 and 160 mg L-1) decreased anthracnose severity between 93 and 81%. For downy mildew, the concentration of 160 mg L-1 decreased the disease by approximately 81%. Based on these results, chitosan has a great potential for the control of downy mildew and anthracnose in grapevines