Slaapstoornis Wetenschap

Sleep in PTSD: Conceptual model and novel directions in brain-based research and interventions.

Curr Opin Psychol. 2017 Apr;14:84-89

Authors: Germain A, McKeon AB, Campbell RL

Abstract
Peri-traumatic sleep disturbances are growingly recognized as biologically-relevant and modifiable predisposing, precipitating, and perpetuating factors in posttraumatic stress disorder (PTSD). The exponential growth of the literature on sleep in PTSD over the last two decades has stimulated a paradigm shift in the conceptualization of the relationship between sleep and PTSD. A conceptual framework that captures this paradigm shift is offered. New research on existing and promising sleep-focused treatments for augmenting PTSD treatment outcomes is then summarized. New findings on the neurobiological correlates and underpinnings of the relationship between sleep and PTSD are also discussed. Informed by these recent findings and foundational literature, opportunities for innovation in clinical and experimental research are proposed.

PMID: 28813325 [PubMed]

American Thoracic Society/National Heart, Lung, and Blood Institute Asthma-Chronic Obstructive Pulmonary Disease Overlap Workshop Report.

Am J Respir Crit Care Med. 2017 Aug 01;196(3):375-381

Authors: Woodruff PG, van den Berge M, Boucher RC, Brightling C, Burchard EG, Christenson SA, Han MK, Holtzman MJ, Kraft M, Lynch DA, Martinez FD, Reddel HK, Sin DD, Washko GR, Wenzel SE, Punturieri A, Freemer MM, Wise RA

Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic obstructive lung diseases with an associated high burden of disease. Asthma, which is often allergic in origin, frequently begins in infancy or childhood with variable airflow obstruction and intermittent wheezing, cough, and dyspnea. Patients with COPD, in contrast, are usually current or former smokers who present after the age of 40 years with symptoms (often persistent) including dyspnea and a productive cough. On the basis of age and smoking history, it is often easy to distinguish between asthma and COPD. However, some patients have features compatible with both diseases. Because clinical studies typically exclude these patients, their underlying disease mechanisms and appropriate treatment remain largely uncertain. To explore the status of and opportunities for research in this area, the NHLBI, in partnership with the American Thoracic Society, convened a workshop of investigators in San Francisco, California on May 14, 2016. At the workshop, current understanding of asthma-COPD overlap was discussed among clinicians, pathologists, radiologists, epidemiologists, and investigators with expertise in asthma and COPD. They considered knowledge gaps in our understanding of asthma-COPD overlap and identified strategies and research priorities that will advance its understanding. This report summarizes those discussions.

PMID: 28636425 [PubMed - indexed for MEDLINE]

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Human Metapneumovirus Infection in Chronic Obstructive Pulmonary Disease: Impact of Glucocorticosteroids and Interferon.

J Infect Dis. 2017 May 15;215(10):1536-1545

Authors: Kan-O K, Ramirez R, MacDonald MI, Rolph M, Rudd PA, Spann KM, Mahalingam S, Bardin PG, Thomas BJ

Abstract
Background.: Human metapneumovirus (hMPV) infection is implicated in exacerbations of asthma and chronic obstructive pulmonary disease (COPD). Research into the pathogenesis of infection is restricted to animal models, and information about hMPV replication and inflammatory and immune responses in human disease is limited.
Methods.: Human primary bronchial epithelial cells (PBECs) from healthy and asthmatic subjects and those with COPD were infected with hMPV, with or without glucocorticosteroid (GCS) exposure. Viral replication, inflammatory and immune responses, and apoptosis were analyzed. We also determined whether adjuvant interferon (IFN) can blunt hMPV infection in vitro and in a murine model.
Results.: hMPV infected human PBECs and viral replication was enhanced in cells from patients with COPD. The virus induced gene expression of IFN-stimulated gene 56 (ISG56) and IFN-β, as well as IFN-γ-inducible protein 10 (IP-10) and regulated on activation, normal T cell expressed and secreted (RANTES), and more so in cells from patients with COPD. GCS exposure enhanced hMPV replication despite increased IFN expression. Augmented virus replication associated with GCS was mediated by reduced apoptosis via induction of antiapoptotic genes. Adjuvant IFN treatment suppressed hMPV replication in PBECs and reduced hMPV viral titers and inflammation in vivo.
Conclusions.: hMPV infects human PBECs, eliciting innate and inflammatory responses. Replication is enhanced by GCS and adjuvant IFN is an effective treatment, restricting virus replication and proinflammatory consequences of hMPV infections.

PMID: 28379462 [PubMed - indexed for MEDLINE]

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Legionnaire's Disease and Influenza.

Infect Dis Clin North Am. 2017 Mar;31(1):137-153

Authors: Magira EE, Zakynthinos S

Abstract
Legionella pneumophila and influenza types A and B viruses can cause either community-acquired pneumonia with respiratory failure, or Legionella infection could attribute to influenza infection with potentially fatal prognosis. Copathogenesis between pandemic influenza and bacteria is characterized by complex interactions between coinfecting pathogens and the host. Understanding the underlying reason of the emersion of the secondary bacterial infection during an influenza infection is challenging. The dual infection has an impact on viral control and may delay viral clearance. Effective vaccines and antiviral therapy are crucial to increase resistance toward influenza, decrease the prevalence of influenza, and possibly interrupt the potential secondary bacterial infections.

PMID: 28159173 [PubMed - indexed for MEDLINE]

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Morbidity and mortality of childhood- and adolescent-onset epilepsy: A controlled national study.

Epilepsy Behav. 2017 Jan;66:80-85

Authors: Jennum P, Pickering L, Christensen J, Ibsen R, Kjellberg J

Abstract
PURPOSE: Epilepsy is associated with significant morbidities and mortality. We aimed to evaluate the 30-year morbidities and mortality in a national group of patients after a first diagnosis of epilepsy.
METHODS: From the Danish National Patient Registry (NPR), in total, 3123 patients with epilepsy aged 0-5years and 5018 patients aged 6-20years diagnosed in 1998-2002 were identified and compared with, respectively, 6246 and 10,036 persons matched for age, gender, and place of living with randomly chosen citizens from the Danish Civil Registration System Statistics. In the NPR, all morbidities in the following 30years were grouped into major WHO disease classes.
KEY FINDINGS: Patients with epilepsy had significantly higher rates of comorbidities including almost all health-related comorbidities compared with controls. Mortality rates were elevated: the hazard ratio (5%; 95% CI) was 14.46 (11.8; 17.7, p<0.001) and 5.58 (4.9; 6.4, P<0.001) for patients aged 0-5years and 6-20years at first diagnosis of epilepsy, respectively.
SIGNIFICANCE: Epilepsy is associated with significant comorbidities and mortality including all health care domains, especially among persons who were young at the onset of epilepsy.

PMID: 28038391 [PubMed - indexed for MEDLINE]