Name: generation of a chronic obstructive pulmonary disease model in mice by repeated ozone exposure
Uploaded: 2017-08-25T14:00:00
Description: Watch this Scientific Journal Video about Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure at JoVE.com

The authors would like to express gratitude to Mr. Boyin Qin (Shanghai Public Health Clinical Center) for the technical assistance with the &#181;CT evaluation in this protocol.

NOTE: The OE model has been generated and used in previously reported research30,31,32. All animal experiments were approved by the Institutional Animal Care and Use Committee (IACUC) of Shanghai Jiaotong University.
1. Mice
<ol>
	<li>House pathogen-free, 7- to 9-week-old female BALB/c mice in individual ventilated cages in an animal facility under controlled temperature (20 &#176;C) and humidity (4...

In this study, we present a reliable method for generating a new COPD model. Compared to other models (i.e., LPS or PPE models), this OE model recapitulates the pathological process of COPD patients. Because cigarette smoke is the main hazardous material that causes COPD in human patients40, the CS model remains the most popular COPD model41,42. However, the CS model requires a 3- to 12-month R&#38;D period for new drugs. Compared...

It has been estimated that COPD, including emphysema and chronic bronchitis, might be the third leading cause of death in the world in 20201,2. The potential incidence of COPD in a population over 40 years old is estimated to be 12.7% in males and 8.3% in females within the next 40 years3. No medications are currently available to reverse the progressive deterioration in COPD patients4. Reliable animal models of COPD not only demand the imitation of the disease pathological process but also require a short generation period. Current COPD models, including the LPS or a PPE-induced model, can induce emphysema-like symptoms5,6. A single administration or a week-long challenge of LPS or PPE to mice or rats results in marked neutrophilia in the bronchoalveolar lavage fluid (BALF), increases pro-inflammatory mediators (e.g., TNF-&#945; and IL-1&#946;) in the BALF or serum, produces lung parenchymal destruction-enlarged air spaces, and limits airflow5,6,7,8,9,10. However, LPS or PPE are not causes of human COPD and thus do not mimic the pathological process11. A CS-induced model produced a persistent airflow limitation, lung parenchymal destruction, and reduced functional exercise capacity. However, a traditional CS protocol requires at least 3 months to generate a COPD model12,13,14,15. Thus, it is important to generate a new, more efficient animal model that meets the two requirements.
Recently, in addition to cigarette smoking, air pollution and occupational exposure have become more common causes of COPD16,17,18. Ozone, as one of the major pollutants (though not the major component of air pollution), can directly react with the respiratory tract and damage the lung tissue of both children and young adults19,20,21,22,23,24,25. Ozone, as well as other stimulators including LPS, PPE, and CS, are involved in a serious of biochemical pathways of pulmonary oxidative stress and DNA damage and are linked to the initiation and promotion of COPD26,27. Another factor is that the symptoms of some COPD patients deteriorate after being exposed to ozone, indicating that ozone can disrupt lung function18,28,29. Therefore, we generated a new COPD model by repeatedly exposing mice to high concentrations of ozone for 7 weeks; this resulted in airflow defects and lung parenchymal damage similar to those of previous investigations30,31,32. We extended the OE protocol to female mice in this study and successfully reproduced the emphysema observed in male mice in our previous studies30,31,32. Because COPD mortality has decreased in men but increased in women in many countries33, a COPD model in females is needed to study the mechanisms and to develop therapeutic methods for female COPD patients. The applicability of the OE model to all genders lends further support to its use as a COPD model.

<table width="1024">
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		<col />
		<col />
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	<tbody>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">BALB/c mice</td>
			<td style="width:217px;">Slac Laboratory Animal,Shanghai, China</td>
			<td style="width:143px;">N/A</td>
			<td style="width:455px;">7-to-9-week-old female BALB/c mice were used in this study.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Individual ventilated cages</td>
			<td style="width:217px;">Suhang, Shanghai, China</td>
			<td style="width:143px;">Model Number: MU64S7</td>
			<td>The cages were used for housing mice in the animal facility.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Sealing perspex-box</td>
			<td style="width:217px;">Suhang, Shanghai, China</td>
			<td style="width:143px;">N/A</td>
			<td style="width:455px;">The box was used&#160; to contain the ozone generator. Mice were exposed to ozone within the box.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Electric generator</td>
			<td style="width:217px;">Sander Ozoniser, Uetze-Eltze, Germany</td>
			<td style="width:143px;">Model 500&#160;</td>
			<td>The device was used for generating ozone.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Ozone probe</td>
			<td style="width:217px;">ATi Technologies, Ashton-U-Lyne, Greater Manchester, UK</td>
			<td style="width:143px;">Ozone 300</td>
			<td>The device was used for monitoring and controlling the generation of ozone.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Pelltobarbitalum natricum</td>
			<td style="width:217px;">Sigma, St. Louis, MO, USA</td>
			<td style="width:143px;">P3761</td>
			<td style="width:455px;">Mice were anesthetized by intraperitoneal injection of pelltobarbitalum natricum.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Micro-Computed Tomography</td>
			<td style="width:217px;">GE Healthcare, London, ON, Canada</td>
			<td style="width:143px;">RS0800639-0075</td>
			<td>This device was used for acquiring images of the lung.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Micro-view 2.01 ABA software</td>
			<td style="width:217px;">GE Healthcare, London, ON, Canada</td>
			<td style="width:143px;">Micro-view 2.01&#160;</td>
			<td>This device was used for reconstruct the lung and analyze volume, LAA of the lung.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Treadmill machine&#160;</td>
			<td style="width:217px;">Duanshi, Hangzhou, Zhejiang, China</td>
			<td style="width:143px;">DSPT-208</td>
			<td>This machine was usd for fatigue test.</td>
		</tr>
		<tr height="38">
			<td height="38" style="width:211px;height:38px;">Body plethysmograph</td>
			<td style="width:217px;">eSpira&#8482; Forced Manoeuvres System, EMMS, Edinburgh, UK</td>
			<td style="width:143px;">Forced Manoeuvres System</td>
			<td height="80">This device was used to test spirometry pulmonary function.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Ventilator</td>
			<td style="width:217px;">eSpira&#8482; Forced Manoeuvres System, EMMS, Edinburgh, UK</td>
			<td style="width:143px;">Forced Manoeuvres System</td>
			<td height="80">This device was used to test spirometry pulmonary function.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Slide spinner centrifuge</td>
			<td style="width:217px;">Denville Scientific, Holliston, MA, USA</td>
			<td>C1183&#160;</td>
			<td>It was used to spin BALF cells onto slides.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">Wright Staining</td>
			<td style="width:217px;">Hanhong, Shanghai, China</td>
			<td style="width:143px;">RE04000054</td>
			<td>&#160;It was used to staining macrophages, neutrophils in the suspended BALF.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Hemocytometer</td>
			<td style="width:217px;">Hausser Scientific, Horsham, PA, USA</td>
			<td style="width:143px;">4000</td>
			<td>It was used to count cells.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">IL-1&#946;</td>
			<td style="width:217px;">Abcam, Cambridge, MA, USA</td>
			<td style="width:143px;">ab100704</td>
			<td height="63">They were used to test the respective factors in serum.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">IL-10</td>
			<td style="width:217px;">Abcam, Cambridge, MA, USA</td>
			<td style="width:143px;">ab46103</td>
			<td height="63">They were used to test the respective factors in serum.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">TNF-&#945;</td>
			<td style="width:217px;">Abcam, Cambridge, MA, USA</td>
			<td style="width:143px;">ab100747</td>
			<td height="63">They were used to test the respective factors in serum.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">Paraformaldehyde&#160;</td>
			<td style="width:217px;">Sigma, St. Louis, MO, USA</td>
			<td style="width:143px;">P6148</td>
			<td>The lung was inflated by 4% paraformaldehyde.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">Paraffin</td>
			<td style="width:217px;">Hualing, Shanghai, China</td>
			<td style="width:143px;">56#</td>
			<td>It was used to embed the lung.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">Rotary Microtome</td>
			<td style="width:217px;">Leica, Wetzlar,&#160; Hesse, Germany</td>
			<td style="width:143px;">RM2255</td>
			<td>It was used for sectioning the lung.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Hgaematoxylin and Eosin (H&#38;E) staining solution</td>
			<td style="width:217px;">Solarbio, Beijing, China</td>
			<td style="width:143px;">G1120</td>
			<td>H&#38;E staining was done for morphometric analysis.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">Upright bright field microscope</td>
			<td style="width:217px;">Olympus, Center Valley, PA, USA</td>
			<td style="width:143px;">CX41</td>
			<td>It was used to image the H&#38;E staining slides.</td>
		</tr>
		<tr height="21">
			<td height="21" style="width:211px;height:21px;">Adobe Photoshop 12</td>
			<td style="width:217px;">Adobe, San Jose, CA, USA</td>
			<td style="width:143px;">Adobe Photoshop 12</td>
			<td>It was used to count the number of alveoli on the H&#38;E stained images.</td>
		</tr>
		<tr height="42">
			<td height="42" style="width:211px;height:42px;">GraphPad prism 5</td>
			<td style="width:217px;">Graphpad Software Inc., San Diego, CA</td>
			<td style="width:143px;">GraphPad prism 5</td>
			<td>It was used for data analysis and production of figures.</td>
		</tr>
	</tbody>
</table>

generation of a chronic obstructive pulmonary disease model in mice by repeated ozone exposure

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and lung parenchymal destruction. It has a very high incidence in aging populations. The current conventional therapies for COPD focus mainly on symptom-modifying drugs; thus, the development of new therapies is urgently needed. Qualified animal models of COPD could help to characterize the underlying mechanisms and can be used for new drug screening. Current COPD models, such as lipopolysaccharide (LPS) or the porcine pancreatic elastase (PPE)-induced emphysema model, generate COPD-like lesions in the lungs and airways but do not otherwise resemble the pathogenesis of human COPD. A cigarette smoke (CS)-induced model remains one of the most popular because it not only simulates COPD-like lesions in the respiratory system, but it is also based on one of the main hazardous materials that causes COPD in humans. However, the time-consuming and labor-intensive aspects of the CS-induced model dramatically limit its application in new drug screening. In this study, we successfully generated a new COPD model by exposing mice to high levels of ozone. This model demonstrated the following: 1) decreased forced expiratory volume 25, 50, and 75/forced vital capacity (FEV25/FVC, FEV50/FVC, and FEV75/FVC), indicating the deterioration of lung function; 2) enlarged lung alveoli, with lung parenchymal destruction; 3) reduced fatigue time and distance; and 4) increased inflammation. Taken together, these data demonstrate that the ozone exposure (OE) model is a reliable animal model that is similar to humans because ozone overexposure is one of the etiological factors of COPD. Additionally, it only took 6 - 8 weeks, based on our previous work, to create an OE model, whereas it requires 3 - 12 months to induce the cigarette smoke model, indicating that the OE model might be a good choice for COPD research.

Examples of 3D &#181;CT images of each group are displayed in Figure 1a. The ozone-exposed mice had a significantly larger total lung volume (Figure 1a and b) and LAA% (Figure 1c) than did the air-exposed control mice. The lung volume and LAA% remained elevated after six weeks of ozone exposure31,3...

Watch this Scientific Journal Video about Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure at JoVE.com

Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure

This study describes the successful generation of a new chronic obstructive pulmonary disease (COPD) animal model by repeatedly exposing mice to high concentrations of ozone.

Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and lung parenchymal destruction. It has a very high ...

The overall goal of this experiment is to induce chronic obstructive pulmonary disease or C-O-P-D via ozone exposure, O-E in mice. This new OE model can happen in the characterization of the underlying mechanism of COPD and it can be used for the screening of new drugs. The main adavantages of this OE model are that it recapitulates the pathological processes of COPD patients.It can be generated in only six to eight weeks. Demonstrating the procedure with me will be Weijaian Sang, a research fellow in our group. To generate ozone, use an electric generator and a small air blower to blow the air out sealing Perspex box through an air vent pipe connected on the inside and outside of the box using an ozone probe to monitor the concentration of ozone in the box.When the ozone concentration reaches 2.5 parts per million place the mice into the box for 3 hours. At the end of week 7, image the ozone treated animals by micro-computed tomography according to standard protocols. To test the ozone induced changes and functional capacities such as lung fatigue, first warm up the mice at a speed of 10 meters per minute on a treadmill.After 5 minutes, increase the speed to 15 meters per minute for a period of 10 minutes. Continue to increase the speed by five meters per minute for every 30 minutes until the mice can no longer run. Recording the total running distance and running time for each animal as fatigue distance and fatigue time, respectively.To measure the pulmonary function of the ozone exposed animals, place an anesthetized mouse in a body plethysmograph connected to a computer controlled ventilator. Use pressure controlled ventilation to impose an average breathing frequency of a 150 breaths per minute to the anesthetized animal until a regular breathing pattern and a complete expiration at each breathing cycle is obtained. Then record the forced expiratory volume in the first 25, 50, and 75 milliseconds of exhalation rejecting any suboptimal maneuvers.Following terminal anesthesia, use a one millimeter diameter endotracheal tube to lavage the animals two times with one milliliter of PBS per lavage. Pool the retrieved lavage aloquats from each animal for centrifugation and collect the supernatants on liquid nitrogen. Re-suspend the pellets in fresh PPS for counting and equip two holders per mouse with a microscope slide, filter card, and funnel.Add approximately 100 to 125 microliters of the re-suspended cells to each funnel. Load the holders on to a cyto centrifuge and spin the cells on to the slides. Then apply right staining solution to the cells according to the manufacturer's instructions and count 200 cells per mouse under a 400 times magnification.For cardiac blood sampling, collect approximately 500 microliters of blood from the ozone exposed animals via cardiac puncture. And add the blood to 1.5 milliliter tubes on ice. After 30 minutes on ice, centrifuge the blood samples and transfer the serum supernatants into new tubes for storage on liquid nitrogen.The samples can later be thawed for the assessment of serum cytokine expression levels by ELISA according to standard protocols. For lung morphometric analysis, place the first mouse in the supine position after cardiac sampling. Then open up the thoracic cavity and dissect away the platysma and the anterior tracheal muscles to access the tracheal rings.Harvest the lungs and the trachea without separating the heart from the lungs. Next use a PE90 polyethylene tube to connect an endotracheal catheter to a syringe containing 4%power formaldehyde and completely inflate the lungs with approximately 200 microliters of paraformaldehyde. Then place the lungs in a 15 milliliter tube containing 10 milliliters of fresh four percent power formaldehyde for at least four hours.As assessed by microcomputed tomography, ozone exposed mice exhibit a significantly larger total lung volume and percentage of low attenuation area than ambient air exposed control animals. The emphysema phenotype is also evidence by the enlarged lung alveoli and increased mean linear intercepts. Lung function assessment by plethysmograph demonstrates that all the parameters that decrease in ozone exposed mice are consistent with the typical lung functional defects observed in chronic obstructive pulmonary disease patients.Further, ozone exposure significantly decreases the fatigue time and fatigue distance in an exercise tolerance tests. Ozone treated animals also display significant increase in inflammatory cells including macrophages and neutrophils as well as a significant decrease in IL-10 and an increase in IL-1 beta and TNF alpha demonstrating that the ozone exposure model recapitulates human chronic obstructive pulmonary disease like symptoms. Following this procedure on other strains of mice like the C57 BR6 mice can be used to generate this OE model After its development, this technique paves the way for researchers in the field of pulmonary disease to explore the underlying mechanisms of COPD.Don't forget that working with the paraformaldehyde can be hazardous and that precautions such as wearing gloves, safety glasses, and using the solution inside the fume hood should always be taken while working with this reagent.

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Research

JoVE Journal

Medicine

Urinary Bladder Distention Evoked Visceromotor Responses as a Model for Bladder Pain in Mice

Approximately 3-8 million people in the United States suffer from interstitial cystitis/bladder pain syndrome (IC/BPS), a debilitating condition characterized by increased urgency and frequency of urination, as well as nocturia and general pelvic pain, especially upon bladder filling or voiding. Despite years of research, the cause of IC/BPS remains elusive and treatment strategies are unable to provide complete relief to patients. In order to study nervous system contributions to the condition, many animal models have been developed to mimic the pain and symptoms associated with IC/BPS. One such murine model is urinary bladder distension (UBD). In this model, compressed air of a specific pressure is delivered to the bladder of a lightly anesthetized animal over a set period of time. Throughout the procedure, wires in the superior oblique abdominal muscles record electrical activity from the muscle. This activity is known as the visceromotor response (VMR) and is a reliable and reproducible measure of nociception. Here, we describe the steps necessary to perform this technique in mice including surgical manipulations, physiological recording, and data analysis. With the use of this model, the coordination between primary sensory neurons, spinal cord secondary afferents, and higher central nervous system areas involved in bladder pain can be unraveled. This basic science knowledge can then be clinically translated to treat patients suffering from IC/BPS.

Approximately 3-8 million people in the United States suffer from interstitial cystitis/bladder pain syndrome (IC/BPS), a debilitating condition characterized in part by pelvic pain. In order to study nervous system contributions to the condition, a physiological model of urinary bladder pain is used in mice and rats.

Approximately 3-8 million people in the United States suffer from interstitial cystitis/bladder pain syndrome (IC/BPS), a debilitating condition ...

Repeated Orotracheal Intubation in Mice

The literature describes several methods for mouse intubation that either require visualization of the glottis through the oral cavity or incision in the ventral neck for direct confirmation of cannula placement in the trachea. The relative difficulty or the tissue trauma induced to the subject by such procedures can be an impediment to an investigator&#8217;s ability to perform longitudinal studies. This article illustrates a technique in which physical manipulation of the mouse following the use of a depilatory to remove hair from the ventral neck permits transcutaneous visualization of the trachea for orotracheal intubation regardless of degree of skin pigmentation. This method is innocuous to the subject and easily achieved with a limited understanding of murine anatomy. This refined approach facilitates repeated intubation, which may be necessary for monitoring progression of disease or instillation of treatments. Using this method may result in a reduction of the number of animals and technical skill required to measure lung function in mouse models of respiratory disease.

The goal of this article is to describe a refined method of intubation of the laboratory mouse. The method is noninvasive and, therefore, ideal for studies that require serial monitoring of respiratory function and/or instillation of treatments into the lung.

The literature describes several methods for mouse intubation that either require visualization of the glottis through the oral cavity or incision in the ...

A Model of Reverse Vascular Remodeling in Pulmonary Hypertension Due to Left Heart Disease by Aortic Debanding in Rats

Pulmonary hypertension due to left heart disease (PH-LHD) is the most common form of PH, yet its pathophysiology is poorly characterized than pulmonary arterial hypertension (PAH). As a result, approved therapeutic interventions for the treatment or prevention of PH-LHD are missing. Medications used to treat PH in PAH patients are not recommended for treatment of PH-LHD, as reduced pulmonary vascular resistance (PVR) and increased pulmonary blood flow in the presence of increased left-sided filling pressures may cause left heart decompensation and pulmonary edema. New strategies need to be developed to reverse PH in LHD patients. In contrast to PAH, PH-LHD develops due to increased mechanical load caused by congestion of blood into the lung circulation during left heart failure. Clinically, mechanical unloading of the left ventricle (LV) by aortic valve replacement in aortic stenosis patients or by implantation of LV assist devices in end-stage heart failure patients normalizes not only pulmonary arterial and right ventricular (RV) pressures but also PVR, thus providing indirect evidence for reverse remodeling in the pulmonary vasculature. Using an established rat model of PH-LHD due to left heart failure triggered by pressure overload with subsequent development of PH, a model is developed to study the molecular and cellular mechanisms of this physiological reverse remodeling process. Specifically, an aortic debanding surgery was performed, which resulted in reverse remodeling of the LV myocardium and its unloading. In parallel, complete normalization of RV systolic pressure and significant but incomplete reversal of RV hypertrophy was detectable. This model may present a valuable tool to study the mechanisms of physiological reverse remodeling in the pulmonary circulation and the RV, aiming to develop therapeutic strategies for treating PH-LHD and other forms of PH.

The present protocol describes a surgical procedure to remove ascending-aortic banding in a rat model of pulmonary hypertension due to left heart disease. This technique studies endogenous mechanisms of reverse remodeling in the pulmonary circulation and the right heart, thus informing strategies to reverse pulmonary hypertension and/or right ventricular dysfunction.

Pulmonary hypertension due to left heart disease (PH-LHD) is the most common form of PH, yet its pathophysiology is poorly characterized than pulmonary ...

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. Constipation that reduces the quality of life and triggers the risk of diseases is a common concomitant symptom in patients with COPD. Currently, western medical treatment does not achieve the desired results for patients. A high recurrence rate accompanies it, whereas traditional Chinese medicine (TCM) has a long history and rich experience in treating chronic diseases. Both acupoint application and acupoint massage are characteristic therapies of TCM, with minor side effects, high safety, simple operation, and outstanding advantages. They are effective in treating constipation for patients with COPD and are considered an ideal alternative therapy for patients with chronic constipation. The purpose of this article is to introduce the method of acupoint application combined with acupoint massage for the treatment of constipation in patients with COPD, including the selection of points, items, treatment time, and operation procedure.

Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. ...

Acupuncture Stimulation of Ears to Alleviate Sleeping Disorders in COPD Patients

Auricular Acupuncture as a Traditional Chinese Medicine Therapy for Chronic Obstructive Pulmonary Disease Combined with Sleep Disorders

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by persistent and irreversible airflow limitation and chronic respiratory symptoms. It has a wide spectrum of complications, and sleep disorders, as part of it, are common in severe cases, especially in elderly patients. Long-term lack of sleep may lead to the aggravation of the original disease, reducing patients' quality of life. Benzodiazepines are mainly used for symptomatic treatment of COPD combined with sleep disorders. However, such drugs have the side effect of respiratory central inhibition and could probably aggravate hypoxia symptoms. Auricular acupuncture is a special method of treating physical and psychosomatic dysfunctions by stimulating specific points in the ear. This article explains the specific methods of clinical operation of auricular acupuncture in detail, including assessment of patient eligibility, medical devices used, acupuncture points, course of treatment, post-treatment care, responses to emergencies, etc. The Pittsburgh sleep quality index (PSQI) and chronic obstructive pulmonary disease assessment scale (CAT) were used as the observational index of this method. So far, clinical reports have proved that auricular acupuncture has a definite curative effect in the treatment of COPD combined with sleep disorders, and its advantages of simple operation, few adverse reactions are worthy of further study and promotion, which provide a reference for the clinical treatment of such diseases.

Author Spotlight: Utilizing Traditional Chinese Acupuncture of the Ear to Improve Sleep Disorders 

This protocol introduces an effective method to improve the sleep condition of patients with chronic obstructive pulmonary disease and alleviate cough symptoms by using auricular acupuncture techniques to percutaneously stimulate specific acupoints in the patients' ears.

Chronic obstructive pulmonary disease (COPD) is a clinical syndrome characterized by persistent and irreversible airflow limitation and chronic ...

Warm Acupuncture and Moxibustion to Relieve COPD with Abdominal Distension

A Preliminary Study on Warm Acupuncture and Moxibustion for Treating Chronic Obstructive Pulmonary Disease with Abdominal Distension

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute exacerbations, and quality of life in patients with COPD. Warm acupuncture and moxibustion have been shown to be effective in relieving symptoms in patients with COPD combined with abdominal distention. Warm acupuncture and moxibustion are highly effective, easy to perform, and inexpensive forms of traditional Chinese medicine treatments. The standardized practice of warm acupuncture and moxibustion is very important for the treatment of COPD combined with abdominal distension. The specific steps include selecting the appropriate acupoints for needling through syndrome differentiation treatment and selecting moxa sticks of appropriate length for moxibustion for about 30 min after the De-qi. The course of treatment lasts for one week. The following indicators are specifically assessed: the score of the COPD Assessment Test (CAT) and the abdominal distension visual analog scale (VAS). This article will clearly illustrate how to standardize the manipulation of warm acupuncture and moxibustion to relieve COPD combined with abdominal distention.

Author Spotlight: An Effective Traditional Chinese Medicinal Treatment for Chronic Obstructive Pulmonary Disease with Abdominal Distension 

Here, we present a protocol to properly manipulate warm acupuncture and moxibustion for treating chronic obstructive pulmonary disease (COPD) with abdominal distension.

Most patients with COPD have a combination of abdominal distension, which has been shown to adversely affect pulmonary symptoms, frequency of acute ...

Performing Warm Moxibustion on Chronic Obstructive Pulmonary Disease (COPD) Patients with Abdominal Distension

Begin by preparing the required equipment for the procedure, which includes disposable sterile acupuncture needles, moxa sticks, medical sterilization swabs, Iodophor swabs, a lighter and several cardboards. Before proceeding with the patient preparation, wear a medical mask and hat. Then wash hands thoroughly with disinfectant.Once the hands are dried, apply alcohol-based hand sanitizer. Next, measure the patient's blood pressure, heart rate, respiratory rate, and oxygen saturation. Inspect the skin of the desired areas for any signs of damage or infection.If the basic vitals are normal, guide the patient to assume a supine or prone position to expose the acupuncture points. Wipe the skin of the sites to be needled with Iodophor swabs. Following the traditional Chinese medicine theory, select the standardized acupuncture points, or RN-12, or LU-9, or ST-25, or ST-36, or EXP-1, and or BL-13.Stretch out flat the five fingers of the left hand, placing the index and middle fingers on both sides of the stabbing site. Grip the needle handle between the thumb and index finger of the right hand with the end of the middle finger near the needle tip and the finger belly against the needle body. Apply downward pressure with the thumb and index finger while flexing the middle finger to insert the needle.Once positioned, uniformly lift and thrust the needle handle along the acupuncture angle at an appropriate depth and frequency. Then rotate the needle handle forward and backward at an angle of 180 degrees or less until the patient feels Lit the moxa stick from the bottom and place the moxa stick about two to three centimeters from the skin on the acupuncture needle inserted in the acupoint, such that the patient feels a warm sensation and there is redness on the body's surface. Place a cardboard under the moxa stick to prevent the ash from burning the skin and continue treatment until the stick burns out.Using the end of a bamboo swab, gently pick up the burned out moxa stick. Afterward, remove the cardboard from the acupoint and with a medical sterilization swab, apply slight pressure to the needle site. Perform a small twist with the needle, slowly lift it to a subcutaneous level and leave it there briefly before withdrawing it.After removing the needle, using a medical sterilization swab, gently press the puncture site momentarily to avoid bleeding and reduce pain. Inspect all the puncture sites for any sign of bleeding and inquire about the patient's comfort level. Finally, count the needles to ensure all needles are removed from the puncture sites.CAT scores of the observation group, which received warm acupuncture, moxibustion, and basic treatment, and the control group, which received basic treatment with pseudo needling, showed that the scores of both groups after treatment were lower than those before treatment. Moreover, the scores of the observation group were lower than those of the control group. The abdominal distension visual analog score of both groups lowered after treatment as compared to those before treatment.The scores of the observation group were lower than those of the control group.

Auricular Acupuncture for Chronic Obstructive Pulmonary Disease

Traditional Chinese Medicine Ear Point Therapy for Wheezing in COPD Patients

Auricular Acupressure as an Adjuvant Treatment for Wheezing in Stable Chronic Obstructive Pulmonary Disease 

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Due to the restriction of expiratory airflow, it is characterized by emphysematous destruction of the lungs. Shortness of breath is one of the main clinical symptoms. Auricular acupressure is a clinical therapy characteristic of Chinese medicine that treats the disease by compressing ear points. Usually, the seeds of Vaccaria segetalis are used to stimulate ear points, which has the effect of regulating qi and alleviating wheezing. In this paper, we propose this characteristic therapy of traditional Chinese medicine (TCM) for the clinical symptoms of wheezing of lung and kidney qi deficiency type in stable COPD patients. Ear points are selected as the treatment protocol for Lung (CO14), Spleen (CO13), Kidney (CO10), Shen Men (TF4), and Ping Chuan (AT1.2.4i) points. The protocol describes a case study using auricular acupressure for a patient with chronic obstructive pulmonary disease to relieve wheezing symptoms.

Author Spotlight: Efficacy of Auricular Pressure Bean Therapy in Reducing Wheezing Symptoms

This protocol describes an effective therapy using auricular acupressure to relieve wheezing symptoms in stable chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Due to the restriction of expiratory airflow, it is characterized by ...

Advanced Lung Imaging for Disease Detection and Monitoring

Phase-Resolved Functional Lung MRI for Pulmonary Ventilation and Perfusion (V/Q) Assessment

Fourier decomposition is a contrast agent-free 1H MRI method for lung perfusion (Q) and ventilation (V) assessment. After image registration, the time series of each voxel is analyzed with regard to the cardiac and breathing frequency components.
Using a standard 2D spoiled gradient-echo sequence with a temporal resolution of ~300 ms, an image-sorting algorithm was developed to produce phase-resolved functional lung imaging (PREFUL) with an increased temporal resolution. Thus, it is feasible to evaluate regional flow volume loops (FVL) during tidal volume breathing and depict the propagation of the pulse wave during the cardiac cycle. This method can be applied at 1.5T or 3T with standard MR hardware without the necessity for sequence programming, as the described protocol can be implemented with the default SPGRE sequence on most systems.
PREFUL ventilation MRI has been validated using 129Xe and 19F gas imaging with good regional agreement. Perfusion-weighted PREFUL MRI has been validated using SPECT as well as dynamic contrast enhanced (DCE) MRI. PREFUL has been tested in a dual center dual vendor setting and is currently applied in several ongoing multicenter trials. Furthermore, it is feasible across a range of field strengths (0.55T-3T) and different age groups, including newborns.
Quantitative V/Q PREFUL MRI has been used in patients with cystic fibrosis, chronic obstructive pulmonary disease, chronic thromboembolic pulmonary hypertension, and corona virus disease-2019 to quantify disease and monitor treatment change after therapy. Furthermore, PREFUL V/Q imaging has been shown to predict transplant loss due to chronic lung allograft dysfunction in patients after lung transplantation. In summary, PREFUL MRI is a validated technique for quantitative ventilation and pulmonary pulse wave/perfusion imaging for regional pulmonary disease detection, quantification, and treatment monitoring with potential added value to the current clinical routine.

Author Spotlight: Enhancing Diagnostic Strategies and Biomarker Development for Comprehensive Lung Function Analysis

Here, we describe the implementation of phase-resolved functional lung MRI as a contrast-agent-free proton MR technique for the assessment of pulmonary ventilation and perfusion dynamics. Validated and applicable across different field strengths and age groups, it could enhance clinical decision-making in the future by aiding in disease quantification and therapy monitoring.

Fourier decomposition is a contrast agent-free 1H MRI method for lung perfusion (Q) and ventilation (V) assessment. After image registration, the time ...