Alejandra Cañas

Background: DNA methylation alterations represent a key epigenetic mechanism linking environmental exposures to disease pathogenesis. The present study aimed to identify differentially methylated genes and shared biological processes associated with lung cancer (LuCa), chronic obstructive pulmonary disease (COPD) and tobacco exposure. Methods: A comprehensive literature search was performed in PubMed to identify studies evaluating DNA methylation in LuCa, COPD and smoking-related models. A total of 117 articles were selected, including 83 studies on lung cancer, 18 on COPD and 16 on smoking exposure. Genes exhibiting statistically significant methylation changes relative to controls were extracted from each study. To provide additional support for these findings, differential methylation signatures were further evaluated using The Cancer Genome Atlas (TCGA) lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) datasets. Functional and transcription factor motif enrichment analyses were subsequently conducted to identify shared biological pathways and regulatory mechanisms. Results: In total, 324 genes displaying altered methylation patterns across these conditions were identified. Seven tumor suppressor genes (CDKN2A, CDH13, MGMT, MIR137, DAPK1, RARB, and RASSF1A) consistently exhibited hypermethylation in both lung cancer and in association with smoking exposure. In addition, AHRR hypomethylation emerged as a shared epigenetic hallmark across all three conditions. TCGA-based analyses confirmed several of these methylation patterns and revealed subtype-specific methylation profiles associated with smoking history. Functional enrichment highlighted common biological processes and signaling pathways, particularly those related to transcriptional regulation, apoptosis and cancer-associated pathways. Conclusions: These results provide an integrative overview of shared DNA methylation alterations associated with smoking exposure, COPD, and lung cancer, and suggest potential DNA methylation candidates that may be relevant for future biomarker development and mechanistic studies.

Las complicaciones pulmonares en pacientes con neoplasias hematológicas representan un desafío significativo en la práctica clínica y pueden presentarse hasta en un 60 % de estos pacientes. Su origen puede ser infeccioso o no infeccioso, generando morbilidad y mortalidad en esta población ya vulnerable. En este contexto, el uso de la broncoscopia flexible se ha consolidado como una herramienta diagnóstica esencial, permitiendo la obtención de muestras microbiológicas, histológicas y citológicas que son fundamentales para el diagnóstico oportuno y manejo adecuado de las infecciones bacterianas, virales y fúngicas. Un aporte muy valioso de la broncoscopia en este contexto es la evaluación de complicaciones no infecciosas como la toxicidad por quimioterapia o la enfermedad de injerto contra huésped (EICH), además del monitoreo de la respuesta al tratamiento y recaídas, ayudando a ajustar las estrategias terapéuticas.

Fine particulate matter (PM2.5), an atmospheric pollutant that settles deep in the respiratory tract, is highly harmful to human health. Despite its well-known impact on lung function and its ability to exacerbate asthma, the molecular basis of this effect is not fully understood. This integrated transcriptomic and epigenomic data analysis from publicly available datasets aimed to determine the impact of PM2.5 exposure and its association with asthma in human airway epithelial cells. Differential gene expression and binding analyses identified 349 common differentially expressed genes and genes associated with differentially enriched H3K27ac regions in both conditions. Co-expression network analysis revealed three preserved modules (Protein Folding, Cell Migration, and Hypoxia Response) significantly correlated with PM2.5 exposure and preserved in asthma networks. Pathways dysregulated in both conditions included epithelial function, hypoxia response, interleukin-17 and TNF signaling, and immune/inflammatory processes. Hub genes like TGFB2, EFNA5, and PFKFB3 were implicated in airway remodeling, cell migration, and hypoxia-induced glycolysis. These findings elucidate common altered expression patterns and processes between PM2.5 exposure and asthma, helping to understand their molecular connection. This provides guidance for future research to utilize them as potential biomarkers or therapeutic targets and generates evidence supporting the need for implementing effective air quality management strategies.

Introduction: Lung cancer is the third cause of cancer worldwide of 2,200,000 and a mortality of approximately 35%. Diagnosis by a multidisciplinary team has become the most effective tool for early treatment. This is linked to the use of immunohistochemistry and immunomarkers that in the last decade have allowed us to strengthen the diagnosis and have involved target-directed therapies. Objective: To define by common agreement of experts, considerations for diagnostic quality and the use of biomarkers in lung cancer in Colombia. Methods: A formal consensus of experts, mixed type (Delphi/Nominal), was carried out with the participation of oncopathologists, pathologists, pulmonologists and chest surgeons by ASOCOLPAT. A group of questions and answers were graded, which were discussed in a nominal session. The information was consolidated in Excel and analyzed in STATA 14. Results: 12 questions and answers were structured and rated, addressing the following aspects: pathological diagnosis of lung cancer, description of the clinical centers, and some administrative and logistical issues in each region of Colombia. Conclusions: The consensus of experts defined 12 considerations by common agreement, for guidance in the pathological diagnosis of lung cancer, hoping to homogenize both medical and administrative aspects in order to generate an effective result and timely treatment.

Introduction: Lung cancer is the third cause of cancer worldwide of 2,200,000 and a mortality of approximately 35%. Diagnosis by a multidisciplinary team has become the most effective tool for early treatment. This is linked to the use of immunohistochemistry and immunomarkers that in the last decade have allowed us to strengthen the diagnosis and have involved target-directed therapies. Objective: To define by common agreement of experts, considerations for diagnostic quality and the use of biomarkers in lung cancer in Colombia. Methods: A formal consensus of experts, mixed type (Delphi/Nominal), was carried out with the participation of oncopathologists, pathologists, pulmonologists and chest surgeons by ASOCOLPAT. A group of questions and answers were graded, which were discussed in a nominal session. The information was consolidated in Excel and analyzed in STATA 14. Results: 12 questions and answers were structured and rated, addressing the following aspects: pathological diagnosis of lung cancer, description of the clinical centers, and some administrative and logistical issues in each region of Colombia. Conclusions: The consensus of experts defined 12 considerations by common agreement, for guidance in the pathological diagnosis of lung cancer, hoping to homogenize both medical and administrative aspects in order to generate an effective result and timely treatment.

International air quality indexes (AQIs) are derived from air pollution and are essential global tools for mitigating diseases such as asthma, as they are used to reduce exposure to triggers. The aim of this article is to systematically review the global literature on the use of AQIs in asthma-related studies. To evaluate the importance of the variables considered, a citation frequency index (Q) was used. The results suggest that the most frequently reported air pollutants related to asthma are PM (Q3) > NO₂ (Q3) > O₃ (Q3) > CO (Q3) > NO (Q3) > SO₂ (Q3). In addition, climate variables play a relevant role in asthma research. Temperature (Q4) emerged as the most relevant climate variable, followed by atmospheric pressure (Q3) > wind direction (Q3) > solar radiation (Q3) > precipitation (Q3) > wind speed (Q3). AQIs, specifically the U.S.EPA Air Quality Index and the Air Quality Health Index, are directly associated with air pollution and the prevalence, severity and exacerbation of asthma. The findings also suggest that climate change presents additional challenges in relation to asthma by influencing the environmental conditions that affect the disease. Finally, this study provides a comprehensive view of the relationships among air quality, air pollutants and asthma and highlights the need for further research in this field to develop public health policies and environmental regulations.

Background:Evidence-based practice (EBP) is a systematic approach to professional practice using the best available evidence to make informed clinical decisions in healthcare. It is necessary to measure and identify strengths and opportunities for improvement. Objective: To assess the knowledge and application of EBP in respiratory health professionals in Latin America. Methods: A cross-sectional study was conducted. The questionnaire was distributed online to health professionals in Latin American countries. Demographic data, professional characteristics, EBP training, and questionnaire responses were collected. Descriptive and inferential statistical analyses were performed. Results: A total of 448 respiratory health professionals participated in the study. Responses were obtained from 17 countries where the majority were female, with an average age of 42. Participants included physicians, physiotherapists, nurses, respiratory therapists, speech therapists, and occupational therapists. Overall scores indicated moderate to high levels of EBP knowledge and application. However, variations were observed in different dimensions. Factors such as EBP training, reading scientific articles, and professional characteristics were associated with higher scores. Barriers to implementing EBP were identified mostly related to institutional support. Conclusions: This study provides information on the knowledge and implementation of EBP in respiratory health professionals in Latin America. Although the overall levels of knowledge and application of EBP were moderate to high, there are options for improvement, especially in addressing barriers to implementation.

Background: Lung cancer is the leading cause of cancer death worldwide. It has been reported that genetic and epigenetic factors play a crucial role in the onset and evolution of lung cancer. Previous reports have shown that essential transcription factors in embryonic development contribute to this pathology. Runt-related transcription factor (RUNX) proteins belong to a family of master regulators of embryonic developmental programs. Specifically, RUNX2 is the master transcription factor (TF) of osteoblastic differentiation, and it can be involved in pathological conditions such as prostate, thyroid, and lung cancer by regulating apoptosis and mesenchymal–epithelial transition processes. In this paper, we identified TALAM1 (Metastasis Associated Lung Adenocarcinoma Transcript 1) as a genetic target of the RUNX2 TF in lung cancer and then performed functional validation of the main findings. Methods: We performed ChIP-seq analysis of tumor samples from a patient diagnosed with lung adenocarcinoma to evaluate the target genes of the RUNX2 TF. In addition, we performed shRNA-mediated knockdown of RUNX2 in this lung adenocarcinoma cell line to confirm the regulatory role of RUNX2 in TALAM1 expression. Results: We observed RUNX2 overexpression in cell lines and primary cultured lung cancer cells. Interestingly, we found that lncRNA TALAM1 was a target of RUNX2 and that RUNX2 exerted a negative regulatory effect on TALAM1 transcription.

Objective: We evaluated the discriminatory ability of variations in lymphocyte, D-dimer, C-reactive protein (CRP), and lactate dehydrogenase (LDH) serum levels at 48 to 72 hours of hospitalization compared with baseline measurements to predict unfavorable clinical outcomes in patients with COVID-19. Methods: We analyzed diagnostic test results based on a retrospective cohort to determine the ability of variations (gradients or ratios) in patients’ lymphocyte, D-dimer, CRP, and LDH serum levels taken 48 to 72 hours after hospital admission to predict adverse outcomes such as death, mechanical ventilation, or intensive care unit (ICU) admission developing. Results: Among 810 patients (56.1% men, age 61.6 ± 16.2 years), 37.5% had at least one adverse outcome; 28.2% required ICU admission, 26.5% required mechanical ventilation, and 19.4% died during hospitalization. In comparing baseline measurements with measurements at 48 to 72 hours, D-dimer, lymphocyte delta, LDH, and CRP had similar discriminatory ability (area under the receiver operating characteristic curve [AUC] 0.57 vs. 0.56, 0.53 vs. 0.57, 0.64 vs. 0.66, and 0.62 vs. 0.65, respectively). Conclusions: Measuring serum risk markers upon hospital admission can be used to evaluate risk of adverse outcomes in hospitalized patients with COVID-19. Repeating these measurements at 48 to 72 hours does not improve discriminatory ability.

Revisión narrativa sobre la tamización de cáncer de pulmón abarcando su evolución, sus beneficios, efectos adversos, las barreras a la implementación, cómo funcionan los programas de tamización y recomendaciones mirando al futuro de los programas de tamización.