Vagotomy influences the lung response to adrenergic agonists and muscarinic antagonists

Lourenço, Luiz Otávio; Lopes, Ana Carolina Ramos; Zavan, Bruno; Soncini, Roseli

doi:10.1016/j.resp.2019.103358

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…The pathways leading to ASM contraction are complex so there are several potential steps that can be altered and lead to hypercontractility. Neural control has been shown through animal models to be implicated in AHR ( Shore et al, 1985 ; Wagner and Jacoby, 1999 ; Lourenço et al, 2020 ; Nie et al, 2020 ) but a similar connection has not been proven in humans ( Sterk et al, 1985 ). Thus, the focus on possible mechanisms to explain abnormal ASM behaviour remains on post-synaptic processes such as the interaction of acetylcholine and M 3 receptors at the neuromuscular junction ( Ouedraogo and Roux, 2003 ) and following pathways that become activated downstream.…”

Section: Signalling Pathwaysmentioning

confidence: 99%

Airway smooth muscle function in asthma

2022

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Known to have affected around 340 million people across the world in 2018, asthma is a prevalent chronic inflammatory disease of the airways. The symptoms such as wheezing, dyspnea, chest tightness, and cough reflect episodes of reversible airway obstruction. Asthma is a heterogeneous disease that varies in clinical presentation, severity, and pathobiology, but consistently features airway hyperresponsiveness (AHR)—excessive airway narrowing due to an exaggerated response of the airways to various stimuli. Airway smooth muscle (ASM) is the major effector of exaggerated airway narrowing and AHR and many factors may contribute to its altered function in asthma. These include genetic predispositions, early life exposure to viruses, pollutants and allergens that lead to chronic exposure to inflammatory cells and mediators, altered innervation, airway structural cell remodeling, and airway mechanical stress. Early studies aiming to address the dysfunctional nature of ASM in the etiology and pathogenesis of asthma have been inconclusive due to the methodological limitations in assessing the intrapulmonary airways, the site of asthma. The study of the trachealis, although convenient, has been misleading as it has shown no alterations in asthma and it is not as exposed to inflammatory cells as intrapulmonary ASM. Furthermore, the cartilage rings offer protection against stress and strain of repeated contractions. More recent strategies that allow for the isolation of viable intrapulmonary ASM tissue reveal significant mechanical differences between asthmatic and non-asthmatic tissues. This review will thus summarize the latest techniques used to study ASM mechanics within its environment and in isolation, identify the potential causes of the discrepancy between the ASM of the extra- and intrapulmonary airways, and address future directions that may lead to an improved understanding of ASM hypercontractility in asthma.

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Section: Signalling Pathwaysmentioning

confidence: 99%

Airway smooth muscle function in asthma

2022

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Pulmonary vagus nerve transection for chronic cough after video-assisted lobectomy: a randomized controlled trial

Zhang,

Ge,

Sun

et al. 2023

International Journal of Surgery

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Background: Chronic cough is common after lobectomy. Vagus nerves are part of the cough reflex. Accordingly, transection of the pulmonary branches of vagus nerve may prevent chronic cough. And there are no clear recommendations on the management of the pulmonary branches of vagus in any thoracic surgery guidelines. Methods: This is a single-center, randomized controlled trial. Adult patients undergoing elective video-assisted thoracoscopic lobectomy and lymphadenectomy were randomized at a 1:1 ratio to undergo a sham procedure (control group) or transection of the pulmonary branches of the vagus nerve that innervate the bronchial stump plus the caudal-most large pulmonary branch of the vagus nerve. The primary outcome was the rate of chronic cough, as assessed at three months after surgery in the intent-to-treat population. Results: Between February 1, 2020 and August 1, 2020, 116 patients (59.6 ± 10.1 y of age; 45 men) were randomized (58 in each group). All patients received designated intervention. The rate of chronic cough at 3 months was 19.0% (11/58) in the vagotomy group versus 41.4% (24/58) in the control group (OR=0.332, 95% CI: 0.143-0.767; P=0.009). In the 108 patients with two-year assessment, the rate of persistent cough was 12.7% (7/55) in the control and 1.9% (1/53) in the vagotomy group (P=0.032). The 2 groups did not differ in postoperative complications and key measures of pulmonary function, e.g., maximal voluntary ventilation, diffusing capacity of the lungs for carbon monoxide and forced expiratory volume. Conclusion: Transecting the pulmonary branches of vagus nerve that innervate the bronchial stump plus the caudal-most large pulmonary branch decreased the rate of chronic cough without affecting pulmonary function in patients undergoing video-assisted lobectomy and lymphadenectomy.

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Vagotomy influences the lung response to adrenergic agonists and muscarinic antagonists

Cited by 2 publications

References 25 publications

Airway smooth muscle function in asthma

Airway smooth muscle function in asthma

Pulmonary vagus nerve transection for chronic cough after video-assisted lobectomy: a randomized controlled trial

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