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Sun D, Wang Y, Wang J, Dilixiati N, Ye Q. Inflammation mediates the association between furan exposure and the prevalence and mortality of chronic obstructive pulmonary disease: National Health and Nutrition Examination Survey 2013-2018. BMC Public Health 2024; 24:1046. [PMID: 38622557 PMCID: PMC11020888 DOI: 10.1186/s12889-024-18442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Although extensive research has established associations between chronic obstructive pulmonary disease (COPD) and environmental pollutants, the connection between furan and COPD remains unclear. This study aimed to explore the association between furan and COPD while investigating potential mechanisms. METHODS The study involved 7,482 adults from the National Health and Nutrition Examination Survey 2013-2018. Exposure to furan was assessed using blood furan levels. Participants were categorized into five groups based on quartiles of log10-transformed blood furan levels. Logistic regression and restricted cubic spline regression models were used to assess the association between furan exposure and COPD risk. Mediating analysis was performed to assess the contribution of inflammation to the effects of furan exposure on COPD prevalence. Cox regression was used to assess the association between furan exposure and the prognosis of COPD. RESULTS Participants with COPD exhibited higher blood furan levels compared to those without COPD (P < 0.001). Log10-transformed blood furan levels were independently associated with an increased COPD risk after adjusting for all covariates (Q5 vs. Q1: OR = 4.47, 95% CI = 1.58-12.66, P = 0.006, P for trend = 0.001). Inflammatory cells such as monocytes, neutrophils, and basophils were identified as mediators in the relationship between furan exposure and COPD prevalence, with mediated proportions of 8.73%, 20.90%, and 10.94%, respectively (all P < 0.05). Moreover, multivariate Cox regression analysis revealed a positive correlation between log10-transformed blood furan levels and respiratory mortality in COPD patients (HR = 41.00, 95% CI = 3.70-460.00, P = 0.003). CONCLUSIONS Exposure to furan demonstrates a positive correlation with both the prevalence and respiratory mortality of COPD, with inflammation identified as a crucial mediator in this relationship.
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Affiliation(s)
- Di Sun
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, 100020, Beijing, China
| | - Yuanying Wang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, 100020, Beijing, China
| | - Jingwei Wang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, 100020, Beijing, China
| | - Nafeisa Dilixiati
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, 100020, Beijing, China
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, 100020, Beijing, China.
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de Biase MS, Massip F, Wei TT, Giorgi FM, Stark R, Stone A, Gladwell A, O'Reilly M, Schütte D, de Santiago I, Meyer KB, Markowetz F, Ponder BAJ, Rintoul RC, Schwarz RF. Smoking-associated gene expression alterations in nasal epithelium reveal immune impairment linked to lung cancer risk. Genome Med 2024; 16:54. [PMID: 38589970 PMCID: PMC11000304 DOI: 10.1186/s13073-024-01317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer-related death in the world. In contrast to many other cancers, a direct connection to modifiable lifestyle risk in the form of tobacco smoke has long been established. More than 50% of all smoking-related lung cancers occur in former smokers, 40% of which occur more than 15 years after smoking cessation. Despite extensive research, the molecular processes for persistent lung cancer risk remain unclear. We thus set out to examine whether risk stratification in the clinic and in the general population can be improved upon by the addition of genetic data and to explore the mechanisms of the persisting risk in former smokers. METHODS We analysed transcriptomic data from accessible airway tissues of 487 subjects, including healthy volunteers and clinic patients of different smoking statuses. We developed a computational model to assess smoking-associated gene expression changes and their reversibility after smoking is stopped, comparing healthy subjects to clinic patients with and without lung cancer. RESULTS We find persistent smoking-associated immune alterations to be a hallmark of the clinic patients. Integrating previous GWAS data using a transcriptional network approach, we demonstrate that the same immune- and interferon-related pathways are strongly enriched for genes linked to known genetic risk factors, demonstrating a causal relationship between immune alteration and lung cancer risk. Finally, we used accessible airway transcriptomic data to derive a non-invasive lung cancer risk classifier. CONCLUSIONS Our results provide initial evidence for germline-mediated personalized smoke injury response and risk in the general population, with potential implications for managing long-term lung cancer incidence and mortality.
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Affiliation(s)
- Maria Stella de Biase
- Berlin Institute of Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Hannoversche Strasse 28, 10115, Berlin, Germany.
| | - Florian Massip
- Berlin Institute of Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Hannoversche Strasse 28, 10115, Berlin, Germany.
- MINES Paris, PSL University, CBIO-Centre for Computational Biology, 60 bd Saint Michel, 75006, Paris, France.
- Institut Curie, Cedex, Paris, France.
- INSERM, U900, Cedex, Paris, France.
| | - Tzu-Ting Wei
- Berlin Institute of Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Hannoversche Strasse 28, 10115, Berlin, Germany
- Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Federico M Giorgi
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK
- Present Address: Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Rory Stark
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK
| | - Amanda Stone
- Papworth Trials Unit Collaboration, Department of Oncology, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, CB2 0AY, UK
| | - Amy Gladwell
- Papworth Trials Unit Collaboration, Department of Oncology, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, CB2 0AY, UK
| | - Martin O'Reilly
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK
- Present Address: MRC Toxicology Unit, Tennis Court Road, Cambridge, CB2 1QR, UK
| | - Daniel Schütte
- Institute for Computational Cancer Biology (ICCB), Center for Integrated Oncology (CIO), Cancer Research Center Cologne Essen (CCCE), Faculty of Medicine and University Hospital Cologne, University of Cologne, Am Weyertal 115C, Gebäude 74, 50931, Cologne, Germany
| | - Ines de Santiago
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK
- Present Address: e-therapeutics plc, 17 Blenheim Office Park, Long Hanborough, OX29 8LN, UK
| | - Kerstin B Meyer
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK
- Present Address: The Wellcome Sanger Institute, Hinxton, CB10 1SA, UK
| | - Florian Markowetz
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK
| | - Bruce A J Ponder
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK.
| | - Robert C Rintoul
- Cancer Research UK Cambridge Institute, University of Cambridge, Robinson Way, Cambridge, CB2 0AY, UK.
- Papworth Trials Unit Collaboration, Department of Oncology, Royal Papworth Hospital NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, CB2 0AY, UK.
- Department of Oncology, Early Cancer Institute, University of Cambridge, Cambridge, CB2 0XZ, UK.
| | - Roland F Schwarz
- Berlin Institute of Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Hannoversche Strasse 28, 10115, Berlin, Germany.
- BIFOLD - Berlin Institute for the Foundations of Learning and Data, Berlin, Germany.
- Institute for Computational Cancer Biology (ICCB), Center for Integrated Oncology (CIO), Cancer Research Center Cologne Essen (CCCE), Faculty of Medicine and University Hospital Cologne, University of Cologne, Am Weyertal 115C, Gebäude 74, 50931, Cologne, Germany.
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Paudel KR, Clarence DD, Panth N, Manandhar B, De Rubis G, Devkota HP, Gupta G, Zacconi FC, Williams KA, Pont LG, Singh SK, Warkiani ME, Adams J, MacLoughlin R, Oliver BG, Chellappan DK, Hansbro PM, Dua K. Zerumbone liquid crystalline nanoparticles protect against oxidative stress, inflammation and senescence induced by cigarette smoke extract in vitro. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:2465-2483. [PMID: 37851060 PMCID: PMC10933165 DOI: 10.1007/s00210-023-02760-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/28/2023] [Indexed: 10/19/2023]
Abstract
The purpose of this study was to evaluate the potential of zerumbone-loaded liquid crystalline nanoparticles (ZER-LCNs) in the protection of broncho-epithelial cells and alveolar macrophages against oxidative stress, inflammation and senescence induced by cigarette smoke extract in vitro. The effect of the treatment of ZER-LCNs on in vitro cell models of cigarette smoke extract (CSE)-treated mouse RAW264.7 and human BCi-NS1.1 basal epithelial cell lines was evaluated for their anti-inflammatory, antioxidant and anti-senescence activities using colorimetric and fluorescence-based assays, fluorescence imaging, RT-qPCR and proteome profiler kit. The ZER-LCNs successfully reduced the expression of pro-inflammatory markers including Il-6, Il-1β and Tnf-α, as well as the production of nitric oxide in RAW 264.7 cells. Additionally, ZER-LCNs successfully inhibited oxidative stress through reduction of reactive oxygen species (ROS) levels and regulation of genes, namely GPX2 and GCLC in BCi-NS1.1 cells. Anti-senescence activity of ZER-LCNs was also observed in BCi-NS1.1 cells, with significant reductions in the expression of SIRT1, CDKN1A and CDKN2A. This study demonstrates strong in vitro anti-inflammatory, antioxidative and anti-senescence activities of ZER-LCNs paving the path for this formulation to be translated into a promising therapeutic agent for chronic respiratory inflammatory conditions including COPD and asthma.
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Affiliation(s)
- Keshav Raj Paudel
- Centre of Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, 2007, Australia
| | - Dvya Delilaa Clarence
- School of Postgraduate Studies, International Medical University (IMU), 57000, Kuala Lumpur, Malaysia
| | - Nisha Panth
- Centre of Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, 2007, Australia
| | - Bikash Manandhar
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Gabriele De Rubis
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Hari Prasad Devkota
- Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto City, Kumamoto, 862-0973, Japan
- Program for Leading Graduate Schools, Health Life Science: Interdisciplinary and Glocal Oriented (HIGO) Program, 5-1 Oe-honmachi, Chuo-ku, Kumamoto, 862-0973, Japan
| | - Gaurav Gupta
- Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 602105, India
- School of Pharmacy, Graphic Era Hill University, Dehradun, Uttarakhand, 248007, India
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura, Mahal Road, Jaipur, 302017, India
| | - Flavia C Zacconi
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, 7820436, Santiago, Macul, Chile
- Centro de Investigación en Nanotecnología y Materiales Avanzados, CIEN-UC, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, 7820436, Santiago, Chile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Kylie A Williams
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Lisa G Pont
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Sachin Kumar Singh
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, 2007, Australia
- School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi GT Road, Phagwara, Punjab, 144411, India
| | - Majid Ebrahimi Warkiani
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, 2007, Australia
- Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Jon Adams
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Ronan MacLoughlin
- Aerogen, IDA Business Park, Dangan, Galway, H91 HE94, Ireland
- School of Pharmacy & Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, D02 YN77, Ireland
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, D02 PN40, Ireland
| | - Brian G Oliver
- Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
- School of Life Sciences, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Philip Michael Hansbro
- Centre of Inflammation, Centenary Institute and University of Technology Sydney, Faculty of Science, School of Life Sciences, Sydney, NSW, 2007, Australia.
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia.
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
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Chen X, Zhu T, Wang Q, Wang T, Chen W, Yao Y, Xu Y, Qiu X. Higher temperature and humidity exacerbate pollutant-associated lung dysfunction in the elderly. ENVIRONMENTAL RESEARCH 2024; 245:118039. [PMID: 38147919 DOI: 10.1016/j.envres.2023.118039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 12/28/2023]
Abstract
RATIONALE Air pollution and extreme temperature and humidity are risk factors for lung dysfunction, but their interactions are not clearly understood. OBJECTIVES To assess the impact of exposure to air pollutants and meteorological factors on lung function, and the contribution of their interaction to the overall effect. METHODS The peak expiratory flow rates of 135 participants were repeatedly measured during up to four visits. Two weeks before each visit, the concentrations of gaseous pollutants and 19 fine particle components, and the temperature and relative humidity, were continuously monitored in the community where they lived. A Bayesian Kernel machine regression model was used to explore the non-linear exposure-response relationships of the peak expiratory flow rate with pollutant exposure and meteorological factors, and their interactions. MEASUREMENTS AND MAIN RESULTS Increased temperature and relative humidity could exacerbate pollutant-associated decline in the peak expiratory flow rate, although their associations with lung dysfunction disappeared after adjustment for pollutant exposure. For example, declines of peak expiratory flow rate associated with interquartile range increase of 3-day cadmium exposure were -0.03 and -0.07 units, when temperature was at 0.1 and 19.5 °C, respectively. Decreased temperature were associated with declines of peak expiratory flow rate after adjustment for pollutant exposure, and had interaction with pollutant exposure on lung dysfunction. CONCLUSIONS High temperature, low temperature, and high humidity were all high-risk factors for lung dysfunction, and their interactions with pollutant levels contributed greatly to the overall effects.
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Affiliation(s)
- Xi Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China; Hebei Technology Innovation Center of Human Settlement in Green Building, Shenzhen Institute of Building Research Co., Ltd., Xiongan, 071700, China
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China.
| | - Qi Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China
| | - Teng Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China
| | - Yuan Yao
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China
| | - Yifan Xu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China
| | - Xinghua Qiu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing, 100871, China
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Meng M, Zhang WW, Chen SF, Wang DR, Zhou CH. Therapeutic utility of human umbilical cord-derived mesenchymal stem cells-based approaches in pulmonary diseases: Recent advancements and prospects. World J Stem Cells 2024; 16:70-88. [PMID: 38455096 PMCID: PMC10915951 DOI: 10.4252/wjsc.v16.i2.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024] Open
Abstract
Pulmonary diseases across all ages threaten millions of people and have emerged as one of the major public health issues worldwide. For diverse disease conditions, the currently available approaches are focused on alleviating clinical symptoms and delaying disease progression but have not shown significant therapeutic effects in patients with lung diseases. Human umbilical cord-derived mesenchymal stem cells (UC-MSCs) isolated from the human UC have the capacity for self-renewal and multilineage differentiation. Moreover, in recent years, these cells have been demonstrated to have unique advantages in the treatment of lung diseases. We searched the Public Clinical Trial Database and found 55 clinical trials involving UC-MSC therapy for pulmonary diseases, including coronavirus disease 2019, acute respiratory distress syndrome, bronchopulmonary dysplasia, chronic obstructive pulmonary disease, and pulmonary fibrosis. In this review, we summarize the characteristics of these registered clinical trials and relevant published results and explore in depth the challenges and opportunitiesfaced in clinical application. Moreover, the underlying molecular mechanisms involved in UC-MSC-based therapy for pulmonary diseases are also analyzed in depth. In brief, this comprehensive review and detailed analysis of these clinical trials can be expected to provide a scientific reference for future large-scale clinical application.
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Affiliation(s)
- Min Meng
- Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
| | - Wei-Wei Zhang
- Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
| | - Shuang-Feng Chen
- Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
| | - Da-Rui Wang
- Department of Clinical Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China
| | - Chang-Hui Zhou
- Department of Central Laboratory, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China.
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Godoy R, Benavent Núñez M, Cruz J, López Yepes G, Parralejo Jiménez A, Callejas FJ, Izquierdo JL. Smokers and risk of hospital death by COVID calculated with SAVANA's natural language processing in the Castilla-La Mancha area. Rev Clin Esp 2024; 224:34-42. [PMID: 38142978 DOI: 10.1016/j.rceng.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/26/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION During the COVID pandemic, it was speculated that patients with the virus who were smoking-related might have a lower likelihood of disease exacerbation or death. To assess whether there is an association between smoking and risk of in-hospital mortality, SAVANA's big data and Natural Language Processing (NLP) technology is used. METHOD A retrospective, observational, non-interventional cohort study was conducted based on real-life data extracted from medical records throughout Castilla La Mancha using Natural Language Processing and Artificial Intelligence techniques developed by SAVANA. The study covered the entire population of this region with Electronic Medical Records in SESCAM presenting with a diagnosis of COVID from March 1, 2020 to February 28, 2021. RESULTS Smokers had a significantly higher percentage of cardiovascular risk factors (hypertension, dyslipidemia and diabetes), COPD, asthma, IDP, IC, CVD, PTE, cancer in general and lung cancer in particular, bronchiectasis, heart failure and a history of pneumonia (p < 0.0001).Former smokers, current smokers and non-smokers have a significant age difference. As for in-hospital deaths, they were more frequent in the case of ex-smokers, followed by smokers and then non-smokers (p < 0.0001). CONCLUSION There is an increased risk of dying in hospital in SARS-COV2-infected patients who are active smokers or have smoked in the past.
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Affiliation(s)
- R Godoy
- Servicio de Neumología del Complejo Hospitalario Universitario de Albacete, Spain.
| | | | - J Cruz
- Servicio de Neumología del Complejo Hospitalario Universitario de Albacete, Spain
| | | | | | - F J Callejas
- Servicio de Neumología del Complejo Hospitalario Universitario de Albacete, Spain
| | - J L Izquierdo
- Servicio de Neumología, Hospital Universitario de Guadalajara, Spain
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Bunæs-Næss H, Kvæl LAH, Nilsson BB, Heywood S, Heiberg KE. Aquatic high-intensity interval training (HIIT) may be similarly effective to land-based HIIT in improving exercise capacity in people with chronic conditions: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2023; 9:e001639. [PMID: 38022764 PMCID: PMC10649609 DOI: 10.1136/bmjsem-2023-001639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/19/2023] Open
Abstract
Objective To investigate the effect of aquatic high-intensity interval training (AHIIT) on exercise capacity in people with chronic conditions. Design Systematic review and meta-analysis. Participants Adults (age ≥18 years) with any chronic conditions (long duration, continuing health problems). Data sources The databases Medline, EMBASE, CINAHL, SPORTSDiscus, PEDro and The Cochrane Library were searched from inception to 11 August 2023. Eligibility criteria Randomised or non-randomised controlled trials of adults reporting one or more chronic conditions were included, comparing the effect of AHIIT with a non-exercising control group, land-based high-intensity interval training (LBHIIT) or aquatic moderate-intensity continuous training (AMICT). Results Eighteen trials with 868 participants with chronic musculoskeletal, respiratory, cardiovascular, metabolic or neurological conditions were included. Adherence to AHIIT was high, ranging from 84% to 100%. There was moderate certainty in evidence according to the Grading of Recommendations Assessment, Development and Evaluation system for a moderate beneficial effect on exercise capacity standardised mean differences (SMD) 0.78 (95% CI 0.48 to 1.08), p<0.00001) of AHIIT compared with a non-exercising control group. There was moderate certainty in evidence for no difference of effects on exercise capacity (SMD 0.28 (95% CI -0.04 to 0.60), p=0.08) of AHIIT compared with LBHIIT. There was moderate certainty in evidence for small effect on exercise capacity (SMD 0.45 (95% CI 0.10 to 0.80), p=0.01) of AHIIT compared with AMICT. Conclusion There are beneficial effects of AHIIT on exercise capacity in people with a range of chronic conditions. AHIIT has similar effects on exercise capacity as LBHIIT and may represent an alternative for people unable to perform LBHIIT. PROSPERO registration number CRD42022289001.
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Affiliation(s)
- Heidi Bunæs-Næss
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Linda Aimée Hartford Kvæl
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Centre for Welfare and Labour Research, Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Birgitta Blakstad Nilsson
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Division of Medicine, Department of Clinical Services, Oslo University Hospital, Oslo, Norway
| | - Sophie Heywood
- Department of Physiotherapy, St Vincent's Hospital, St Vincent's Health Australia Ltd Fitzroy, Fitzroy, Victoria, Australia
- Department of Physiotherapy, University of Melbourne VCCC, Parkville, Victoria, Australia
| | - Kristi Elisabeth Heiberg
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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Miravitlles M, Kostikas K, Bizymi N, Tzanakis N. A Novel Figure and Algorithm for the Gold ABE Classification. Arch Bronconeumol 2023; 59:702-704. [PMID: 37355409 DOI: 10.1016/j.arbres.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/26/2023]
Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d́Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | | | - Nikoletta Bizymi
- Department of Respiratory Medicine, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Greece
| | - Nikolaos Tzanakis
- Department of Respiratory Medicine, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Greece
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Linden DA, Guo-Parke H, McKelvey MC, Einarsson GG, Lee AJ, Fairley DJ, Brown V, Lundy G, Campbell C, Logan D, McFarland M, Singh D, McAuley DF, Taggart CC, Kidney JC. Valaciclovir for Epstein-Barr Virus Suppression in Moderate-to-Severe COPD: A Randomized Double-Blind Placebo-Controlled Trial. Chest 2023; 164:625-636. [PMID: 37011709 PMCID: PMC10808072 DOI: 10.1016/j.chest.2023.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/25/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Epstein-Barr virus (EBV) frequently is measured at high levels in COPD using sputum quantitative polymerase chain reaction, whereas airway immunohistochemistry analysis has shown EBV detection to be common in severe disease. RESEARCH QUESTION Is valaciclovir safe and effective for EBV suppression in COPD? STUDY DESIGN AND METHODS The Epstein-Barr Virus Suppression in COPD (EViSCO) trial was a randomized double-blind placebo-controlled trial conducted at the Mater Hospital Belfast, Northern Ireland. Eligible patients had stable moderate-to-severe COPD and sputum EBV (measured using quantitative polymerase chain reaction) and were assigned randomly (1:1) to valaciclovir (1 g tid) or matching placebo for 8 weeks. The primary efficacy outcome was sputum EBV suppression (defined as ≥ 90% sputum viral load reduction) at week 8. The primary safety outcome was the incidence of serious adverse reactions. Secondary outcome measures were FEV1 and drug tolerability. Exploratory outcomes included changes in quality of life, sputum cell counts, and cytokines. RESULTS From November 2, 2018, through March 12, 2020, 84 patients were assigned randomly (n = 43 to valaciclovir). Eighty-one patients completed trial follow-up and were included in the intention-to-treat analysis of the primary outcome. A greater number of participants in the valaciclovir group achieved EBV suppression (n = 36 [87.8%] vs n = 17 [42.5%]; P < .001). Valaciclovir was associated with a significant reduction in sputum EBV titer compared with placebo (-90,404 copies/mL [interquartile range, -298,000 to -15,200 copies/mL] vs -3,940 copies/mL [interquartile range, -114,400 to 50,150 copies/mL]; P = .002). A statistically nonsignificant 24-mL numerical FEV1 increase was shown in the valaciclovir group (difference, -44 mL [95% CI, -150 to 62 mL]; P = .41). However, a reduction in sputum white cell count was noted in the valaciclovir group compared with the placebo group (difference, 2.89 [95% CI, 1.5 × 106-7.4 × 106]; P = .003). INTERPRETATION Valaciclovir is safe and effective for EBV suppression in COPD and may attenuate the sputum inflammatory cell infiltrate. The findings from the current study provide support for a larger trial to evaluate long-term clinical outcomes. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT03699904; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Dermot A Linden
- Mater Hospital Belfast, Belfast Health and Social Care Trus, Belfast, Northern Ireland; Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland.
| | - Hong Guo-Parke
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland
| | - Michael C McKelvey
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland
| | - Gisli G Einarsson
- Halo Research Group, School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland
| | - Andrew J Lee
- Halo Research Group, School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland
| | - Derek J Fairley
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Vanessa Brown
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland
| | - Gavin Lundy
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland
| | | | - Danielle Logan
- Northern Ireland Clinical Trials Unit, Belfast, Northern Ireland
| | | | - Dave Singh
- Division of Infection and Immunity, University of Manchester, Manchester, England
| | - Daniel F McAuley
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland; Royal Victoria Hospital, Belfast, Northern Ireland
| | - Clifford C Taggart
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Sciences, Belfast, Northern Ireland
| | - Joseph C Kidney
- Mater Hospital Belfast, Belfast Health and Social Care Trus, Belfast, Northern Ireland
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10
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Krishnan S, Tan WC, Farias R, Aaron SD, Benedetti A, Chapman KR, Hernandez P, Maltais F, Marciniuk DD, O'Donnell DE, Sin DD, Walker B, Bourbeau J. Impaired Spirometry and COPD Increase the Risk of Cardiovascular Disease: A Canadian Cohort Study. Chest 2023; 164:637-649. [PMID: 36871842 DOI: 10.1016/j.chest.2023.02.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Individuals with COPD and preserved ratio impaired spirometry (PRISm) findings in clinical settings have an increased risk of cardiovascular disease (CVD). RESEARCH QUESTION Do individuals with mild to moderate or worse COPD and PRISm findings in community settings have a higher prevalence and incidence of CVD compared with individuals with normal spirometry findings? Can CVD risk scores be improved when impaired spirometry is added? STUDY DESIGN AND METHODS The analysis was embedded in the Canadian Cohort Obstructive Lung Disease (CanCOLD). Prevalence of CVD (ischemic heart disease [IHD] and heart failure [HF]) and their incidence over 6.3 years were compared between groups with impaired and normal spirometry findings using logistic regression and Cox models, respectively, adjusting for covariables. Discrimination of the pooled cohort equations (PCE) and Framingham risk score (FRS) in predicting CVD were assessed with and without impaired spirometry. RESULTS Participants (n = 1,561) included 726 people with normal spirometry findings and 835 people with impaired spirometry findings (COPD Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage 1 disease, n = 408; GOLD stage ≥ 2, n = 331; PRISm findings, n = 96). Rates of undiagnosed COPD were 84% in GOLD stage 1 and 58% in GOLD stage ≥ 2 groups. Prevalence of CVD (IHD or HF) was significantly higher among individuals with impaired spirometry findings and COPD compared with those with normal spirometry findings, with ORs of 1.66 (95% CI, 1.13-2.43; P = .01∗) (∗ indicates statistical significane with P < .05) and 1.55 (95% CI, 1.04-2.31; P = .033∗), respectively. Prevalence of CVD was significantly higher in participants having PRISm findings and COPD GOLD stage ≥ 2, but not GOLD stage 1. CVD incidence was significantly higher, with hazard ratios of 2.07 (95% CI, 1.10-3.91; P = .024∗) for the impaired spirometry group and 2.09 (95% CI, 1.10-3.98; P = .024∗) for the COPD group compared to individuals with normal spirometry findings. The difference was significantly higher among individuals with COPD GOLD stage ≥ 2, but not GOLD stage 1. The discrimination for predicting CVD was low and limited when impaired spirometry findings were added to either risk score. INTERPRETATION Individuals with impaired spirometry findings, especially those with moderate or worse COPD and PRISm findings, have increased comorbid CVD compared with their peers with normal spirometry findings, and having COPD increases the risk of CVD developing.
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Affiliation(s)
- Suurya Krishnan
- Respiratory Epidemiology and Clinical Research Unit, Center of Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, ON Canada
| | - Wan C Tan
- Center for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - Raquel Farias
- Respiratory Epidemiology and Clinical Research Unit, Center of Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, ON Canada
| | - Shawn D Aaron
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Andrea Benedetti
- Respiratory Epidemiology and Clinical Research Unit, Center of Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, ON Canada
| | - Kenneth R Chapman
- Toronto General Hospital Research Institute, University of Toronto, Toronto, ON, Canada
| | - Paul Hernandez
- Division of Respirology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - François Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Darcy D Marciniuk
- Respiratory Research Center, University of Saskatchewan, Saskatoon, SK, Canada
| | - Denis E O'Donnell
- Division of Respiratory and Critical Care Medicine, Queens University, Kingston, ON, Canada
| | - Don D Sin
- Center for Heart Lung Innovation, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - Brandie Walker
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jean Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Center of Outcome Research and Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, ON Canada.
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11
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Liu X, Jiao X, Gong X, Nie Q, Li Y, Zhen G, Cheng M, He J, Yuan Y, Yang Y. Prevalence, Risk Factor and Clinical Characteristics of Venous Thrombus Embolism in Patients with Acute Exacerbation of COPD: A Prospective Multicenter Study. Int J Chron Obstruct Pulmon Dis 2023; 18:907-917. [PMID: 37223656 PMCID: PMC10202142 DOI: 10.2147/copd.s410954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/29/2023] [Indexed: 05/25/2023] Open
Abstract
Background and Objective The prevalence of venous thrombus embolism (VTE) in patients with chronic obstructive pulmonary disease (COPD) is higher than in patients without COPD. Owing to the similarity of clinical symptoms between PE and acute exacerbation COPD (AECOPD), PE is likely to be overlooked or underdiagnosed in patients with AECOPD. The aim of the study was to investigate the prevalence, risk factor, clinical characteristics, and prognostic impact of VTE in patients with AECOPD. Methods This multicenter, prospective, cohort study was conducted in 11 research centers of China. Data on the baseline characteristics, VTE-related risk factors, clinical symptoms, laboratory examination results, computed tomography pulmonary angiography (CTPA) and lower limb venous ultrasound of AECOPD patients were collected. Patients were followed up for 1 year. Results A total of 1580 AECOPD patients were included in the study. The mean (SD) age was 70.4 (9.9) years and 195 (26%) patients were women. The prevalence of VTE was 24.5% (387/1580) and PE was 16.8% (266/1580). VTE patients were older; had higher BMI; and longer course of COPD than non-VTE patients. The history of VTE, cor pulmonale, less purulent sputum, increased respiratory rate, higher D-dimer, and higher NT-proBNP/BNP were independently associated with VTE in hospitalized patients with AECOPD. The mortality at 1-year was higher in patients with VTE than patients without VTE (12.9% vs 4.5%, p<0.01). There was no significant difference in the prognosis of patients with PE in segmental or subsegmental arteries and in main pulmonary arteries or lobar arteries (P>0.05). Conclusion VTE is common in COPD patients and is associated with poor prognosis. Patients with PE at different locations had poorer prognosis than patients without PE. It is necessary to perform active screening strategy for VTE in AECOPD patients with risk factors.
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Affiliation(s)
- Xia Liu
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
- Department of Respiratory and Critical Care Medicine, Capital Medical University Daxing Teaching Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaojing Jiao
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Xiaowei Gong
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Qingrong Nie
- Department of Respiratory and Critical Care Medicine, Beijing Fangshan District Liangxiang Hospital, Beijing, People’s Republic of China
| | - Yang Li
- Department of Respiratory and Critical Care Medicine, Capital Medical University Daxing Teaching Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Guohua Zhen
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Mengyu Cheng
- Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, People’s Republic of China
| | - Jianguo He
- Department of Cardiovascular Medicine, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Yadong Yuan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
| | - Yuanhua Yang
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China
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12
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Levi N, Papismadov N, Majewska J, Roitman L, Wigoda N, Eilam R, Tsoory M, Rotkopf R, Ovadya Y, Akiva H, Regev O, Krizhanovsky V. p21 facilitates chronic lung inflammation via epithelial and endothelial cells. Aging (Albany NY) 2023; 15:2395-2417. [PMID: 36996500 PMCID: PMC10120903 DOI: 10.18632/aging.204622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/17/2023] [Indexed: 04/01/2023]
Abstract
Cellular senescence is a stable state of cell cycle arrest that regulates tissue integrity and protects the organism from tumorigenesis. However, the accumulation of senescent cells during aging contributes to age-related pathologies. One such pathology is chronic lung inflammation. p21 (CDKN1A) regulates cellular senescence via inhibition of cyclin-dependent kinases (CDKs). However, its role in chronic lung inflammation and functional impact on chronic lung disease, where senescent cells accumulate, is less understood. To elucidate the role of p21 in chronic lung inflammation, we subjected p21 knockout (p21-/-) mice to repetitive inhalations of lipopolysaccharide (LPS), an exposure that leads to chronic bronchitis and accumulation of senescent cells. p21 knockout led to a reduced presence of senescent cells, alleviated the pathological manifestations of chronic lung inflammation, and improved the fitness of the mice. The expression profiling of the lung cells revealed that resident epithelial and endothelial cells, but not immune cells, play a significant role in mediating the p21-dependent inflammatory response following chronic LPS exposure. Our results implicate p21 as a critical regulator of chronic bronchitis and a driver of chronic airway inflammation and lung destruction.
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Affiliation(s)
- Naama Levi
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Nurit Papismadov
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Julia Majewska
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Lior Roitman
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Noa Wigoda
- Department of Life Sciences Core Facilities, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Raya Eilam
- Department of Veterinary Resources, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Michael Tsoory
- Department of Veterinary Resources, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Ron Rotkopf
- Department of Life Sciences Core Facilities, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Yossi Ovadya
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Hagay Akiva
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Ofer Regev
- Department of Immunology, The Weizmann Institute of Science, Rehovot 7610001, Israel
| | - Valery Krizhanovsky
- Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot 7610001, Israel
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13
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Suarez-Dono J, Novo-Veleiro I, Gude-Sampedro F, Marinho R, Xavier-Pires S, Rocha D, Araújo-Correia J, Moreira C, Beires F, Pérez D, David F, Vasco-Barreto J, Del Corral-Beamonte E, Piñeiro-Fernández JC, Casariego-Vales E, Diez-Manglano J, Pose-Reino A. Atrial fibrillation as a new prognosis factor in chronic patients after hospitalization: the CHRONIBERIA index. Sci Rep 2023; 13:4068. [PMID: 36906719 PMCID: PMC10008559 DOI: 10.1038/s41598-023-30610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/27/2023] [Indexed: 03/13/2023] Open
Abstract
A collaborative project in different areas of Spain and Portugal was designed to find out the variables that influence the mortality after discharge and develop a prognostic model adapted to the current healthcare needs of chronic patients in an internal medicine ward. Inclusion criteria were being admitted to an Internal Medicine department and at least one chronic disease. Patients' physical dependence was measured through Barthel index (BI). Pfeiffer test (PT) was used to establish cognitive status. We conducted logistic regression and Cox proportional hazard models to analyze the influence of those variables on one-year mortality. We also developed an external validation once decided the variables included in the index. We enrolled 1406 patients. Mean age was 79.5 (SD = 11.5) and females were 56.5%. After the follow-up period, 514 patients (36.6%) died. Five variables were identified as significantly associated with 1 year mortality: age, being male, lower BI punctuation, neoplasia and atrial fibrillation. A model with such variables was created to estimate one-year mortality risk, leading to the CHRONIBERIA. A ROC curve was made to determine the reliability of this index when applied to the global sample. An AUC of 0.72 (0.7-0.75) was obtained. The external validation of the index was successful and showed an AUC of 0.73 (0.67-0.79). Atrial fibrillation along with an advanced age, being male, low BI score, or an active neoplasia in chronic patients could be critical to identify high risk multiple chronic conditions patients. Together, these variables constitute the new CHRONIBERIA index.
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Affiliation(s)
- Javier Suarez-Dono
- Internal Medicine Department, Complexo Hospitalario Universitario de Santiago de Compostela y Barbanza, School of Medicine, University of Santiago de Compostela, Rua da Choupana S/N, 15706, Santiago de Compostela. A Coruña, Spain
| | - Ignacio Novo-Veleiro
- Internal Medicine Department, Complexo Hospitalario Universitario de Santiago de Compostela y Barbanza, School of Medicine, University of Santiago de Compostela, Rua da Choupana S/N, 15706, Santiago de Compostela. A Coruña, Spain.
| | - Francisco Gude-Sampedro
- Epidemiology Unit, Complexo Hospitalario Universitario de Santiago de Compostela y Barbanza, School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ricardo Marinho
- Internal Medicine Department, Santo António Hospital - Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal
| | - Sara Xavier-Pires
- Internal Medicine Department, Santo António Hospital - Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal
| | - Diana Rocha
- Internal Medicine Department, Santo António Hospital - Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal
| | - João Araújo-Correia
- Internal Medicine Department, Santo António Hospital - Centro Hospitalar e Universitário do Porto (CHUP), Porto, Portugal.,Multidisciplinary Biomedical Research Unit (UMIB), Abel Salazar Biomedical Science Institute (ICBAS), Porto, Portugal
| | - Cecília Moreira
- Internal Medicine Service, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Francisca Beires
- Internal Medicine Service, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Danay Pérez
- Internal Medicine Service, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Filipa David
- Internal Medicine Service, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - J Vasco-Barreto
- Internal Medicine Service, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal.,Abel Salazar Biomedical Science Institute (ICBAS), Porto, Portugal
| | - Esther Del Corral-Beamonte
- Internal Medicine Department. Hospital Royo Villanova, School of Medicine, University of Zaragoza, Zaragoza, Spain
| | | | | | - Jesús Diez-Manglano
- Internal Medicine Department. Hospital Royo Villanova, School of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Antonio Pose-Reino
- Internal Medicine Department, Complexo Hospitalario Universitario de Santiago de Compostela y Barbanza, School of Medicine, University of Santiago de Compostela, Rua da Choupana S/N, 15706, Santiago de Compostela. A Coruña, Spain.
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14
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Agarwood Oil Nanoemulsion Attenuates Cigarette Smoke-Induced Inflammation and Oxidative Stress Markers in BCi-NS1.1 Airway Epithelial Cells. Nutrients 2023; 15:nu15041019. [PMID: 36839377 PMCID: PMC9959783 DOI: 10.3390/nu15041019] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is an irreversible inflammatory respiratory disease characterized by frequent exacerbations and symptoms such as cough and wheezing that lead to irreversible airway damage and hyperresponsiveness. The primary risk factor for COPD is chronic cigarette smoke exposure, which promotes oxidative stress and a general pro-inflammatory condition by stimulating pro-oxidant and pro-inflammatory pathways and, simultaneously, inactivating anti-inflammatory and antioxidant detoxification pathways. These events cause progressive damage resulting in impaired cell function and disease progression. Treatments available for COPD are generally aimed at reducing the symptoms of exacerbation. Failure to regulate oxidative stress and inflammation results in lung damage. In the quest for innovative treatment strategies, phytochemicals, and complex plant extracts such as agarwood essential oil are promising sources of molecules with antioxidant and anti-inflammatory activity. However, their clinical use is limited by issues such as low solubility and poor pharmacokinetic properties. These can be overcome by encapsulating the therapeutic molecules using advanced drug delivery systems such as polymeric nanosystems and nanoemulsions. In this study, agarwood oil nanoemulsion (agarwood-NE) was formulated and tested for its antioxidant and anti-inflammatory potential in cigarette smoke extract (CSE)-treated BCi-NS1.1 airway basal epithelial cells. The findings suggest successful counteractivity of agarwood-NE against CSE-mediated pro-inflammatory effects by reducing the expression of the pro-inflammatory cytokines IL-1α, IL-1β, IL-8, and GDF-15. In addition, agarwood-NE induced the expression of the anti-inflammatory mediators IL-10, IL-18BP, TFF3, GH, VDBP, relaxin-2, IFN-γ, and PDGF. Furthermore, agarwood-NE also induced the expression of antioxidant genes such as GCLC and GSTP1, simultaneously activating the PI3K pro-survival signalling pathway. This study provides proof of the dual anti-inflammatory and antioxidant activity of agarwood-NE, highlighting its enormous potential for COPD treatment.
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15
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Jorde I, Schreiber J, Stegemann-Koniszewski S. The Role of Staphylococcus aureus and Its Toxins in the Pathogenesis of Allergic Asthma. Int J Mol Sci 2022; 24:ijms24010654. [PMID: 36614093 PMCID: PMC9820472 DOI: 10.3390/ijms24010654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 01/01/2023] Open
Abstract
Bronchial asthma is one of the most common chronic diseases worldwide and affects more than 300 million patients. Allergic asthma affects the majority of asthmatic children as well as approximately 50% of adult asthmatics. It is characterized by a Th2-mediated immune response against aeroallergens. Many aspects of the overall pathophysiology are known, while the underlying mechanisms and predisposing factors remain largely elusive today. Over the last decade, respiratory colonization with Staphylococcus aureus (S. aureus), a Gram-positive facultative bacterial pathogen, came into focus as a risk factor for the development of atopic respiratory diseases. More than 30% of the world’s population is constantly colonized with S. aureus in their nasopharynx. This colonization is mostly asymptomatic, but in immunocompromised patients, it can lead to serious complications including pneumonia, sepsis, or even death. S. aureus is known for its ability to produce a wide range of proteins including toxins, serine-protease-like proteins, and protein A. In this review, we provide an overview of the current knowledge about the pathophysiology of allergic asthma and to what extent it can be affected by different toxins produced by S. aureus. Intensifying this knowledge might lead to new preventive strategies for atopic respiratory diseases.
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16
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Wei S, Lu R, Zhang Z, Wang F, Tan H, Wang X, Ma J, Zhang Y, Deng N, Chen J. MRI-assessed diaphragmatic function can predict frequent acute exacerbation of COPD: a prospective observational study based on telehealth-based monitoring system. BMC Pulm Med 2022; 22:438. [PMID: 36424599 PMCID: PMC9685983 DOI: 10.1186/s12890-022-02254-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have considerably high mortality and re-hospitalisation rate. Diaphragmatic dysfunction (DD) is common in COPD patients. However, whether diaphragmatic dysfunction is related to acute exacerbation is yet to be elucidated. This study aimed to evaluate the diaphragm function by magnetic resonance imaging (MRI) in COPD patients and assess whether the impact of DD may help predict AECOPD. METHODS 20 healthy adult volunteers and 80 COPD patients were enrolled. The diaphragms function parameters were accessed by MRI. Patients were guided to start self-management by the Telehealth-based monitoring system following the enrolment. Events of acute exacerbation of COPD were recorded by the system and confirmed by healthcare providers. Binary univariate and multivariate logistic regression analyses were performed to investigate the factors associated with the frequency of AECOPD. Receiver operating characteristic (ROC) curves were further used to assess the value of prediction indexes. RESULTS Fifty-nine COPD patients completed a one-year follow-up based on the Telehealth-based monitoring system. The clinical outcomes showed that the diaphragm function parameters at the end of maximal breathing were lower in the COPD group than in the healthy control group (P < 0.05). ANOVA showed significant differences among Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages for diaphragm function parameters, including chest wall motion, lung area, upper-lower diameter, and the diaphragm thickening fraction at the end of maximal breathing (P < 0.05). Moreover, significant differences in diaphragm function parameters were observed between patients with infrequent AECOPD (n = 28) and frequent AECOPD (n = 31) based on the frequency of AECOPD (P < 0.05). The diaphragm thickening fraction and the chest wall motion were associated with AECOPD after adjusting for age, sex, BMI, and lung functions, and the combination of predictions showed better accuracy in predicting the frequency of AECOPD. CONCLUSIONS In COPD patients, diaphragm function parameters correlate with the severity of airflow limitation. The diaphragm thickening fraction and the chest wall motion were associated with the frequency of AECOPD and can predict it.
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Affiliation(s)
- Shuoshuo Wei
- grid.413385.80000 0004 1799 1445Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yongan Lane, Xingqing District, Yinchuan, 750004 Ningxia China ,grid.412194.b0000 0004 1761 9803Ningxia Medical University, Yinchuan, 750004 Ningxia China
| | - Rong Lu
- grid.413385.80000 0004 1799 1445Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yongan Lane, Xingqing District, Yinchuan, 750004 Ningxia China ,Department of Pulmonary Medicine, People’s Hospital of Wuzhong, Wuzhong, 751100 Ningxia China
| | - Zhengping Zhang
- grid.413385.80000 0004 1799 1445Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, 750004 Ningxia China
| | - Faxuan Wang
- grid.412194.b0000 0004 1761 9803Ningxia Medical University, Yinchuan, 750004 Ningxia China ,grid.412194.b0000 0004 1761 9803School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Hai Tan
- grid.413385.80000 0004 1799 1445Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yongan Lane, Xingqing District, Yinchuan, 750004 Ningxia China
| | - Xiaohong Wang
- grid.413385.80000 0004 1799 1445Department of Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, 750004 Ningxia China
| | - Jinlan Ma
- grid.413385.80000 0004 1799 1445Department of Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, 750004 Ningxia China
| | - Yating Zhang
- grid.413385.80000 0004 1799 1445Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yongan Lane, Xingqing District, Yinchuan, 750004 Ningxia China
| | - Ning Deng
- grid.13402.340000 0004 1759 700XMinistry of Education Key Laboratory of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, 38 Zheda Road, Hangzhou, 310027 Zhejiang China
| | - Juan Chen
- grid.413385.80000 0004 1799 1445Department of Pulmonary and Critical Care Medicine, General Hospital of Ningxia Medical University, Yongan Lane, Xingqing District, Yinchuan, 750004 Ningxia China
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17
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Miravitlles M, Soler-Cataluña JJ, Soriano JB, García-Río F, de Lucas P, Alfageme I, Casanova C, Rodríguez González-Moro JM, Sánchez G, Ancochea J, Cosío BG. Respiratory symptoms and their determinants in the general Spanish population: changes over 20 years. ERJ Open Res 2022; 8:00067-2022. [PMID: 36382234 PMCID: PMC9661281 DOI: 10.1183/23120541.00067-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background Few large epidemiological studies have analysed the prevalence of respiratory symptoms and their determinants in the general adult population. We investigated the prevalence and determinants of respiratory symptoms and compared their prevalence with that of two previous studies conducted in 1999 and 2009. Method EPISCAN II was a multicentre, cross-sectional, population-based epidemiological study in individuals older than 40 years. Results A total of 9092 individuals were included. Up to 47.5% reported at least one respiratory symptom, being more frequent in women than in men (49.4% versus 45.5%, p=0.0002) and with wheezing being the most frequent (33.7%) followed by dyspnoea (26.8%). The presence of any symptom was associated with female sex, higher body mass index (BMI), lower forced expiratory volume in 1 s (FEV1 % pred), reduced physical activity, a higher Charlson index and the presence of anxiety and depression. Smoking was also significantly associated with having at least one respiratory symptom in a dose–response fashion (OR: 1.415, 1.916, 2.192 and 2.987 for 0–10, 10–20, 20–30 and >30 pack-years, respectively, all p<0.0001). The prevalence of symptoms remained quite similar over the last 20 years (wheezing 40%, 36% and 33.7% and dyspnoea 10.4%, 9.9% and 13.1% in 1999, 2009 and 2019, respectively). Conclusions Approximately half of the adult Spanish population have respiratory symptoms and this prevalence has remained quite stable over the last 20 years. Smoking remains the main factor associated with respiratory symptoms, but female sex, comorbidities, high BMI and low FEV1 and low physical activity are also significantly associated with respiratory symptoms. Approximately half of the adult Spanish population has some respiratory symptoms and this prevalence has remained quite stable over the last 20 yearshttps://bit.ly/37uGRT7
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Huang X, Yin W, Shen M, Wang X, Ren T, Wang L, Liu M, Guo Y. Contributions of Emphysema and Functional Small Airway Disease on Intrapulmonary Vascular Volume in COPD. Int J Chron Obstruct Pulmon Dis 2022; 17:1951-1961. [PMID: 36045693 PMCID: PMC9423118 DOI: 10.2147/copd.s368974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Previous studies have demonstrated that there is a certain correlation between emphysema and changes in pulmonary small blood vessels in patients with chronic obstructive pulmonary disease (COPD), but most of them were limited to the investigation of the inspiratory phase. The emphysema indicators need to be further optimized. Based on the parametric response mapping (PRM) method, this study aimed to investigate the effect of emphysema and functional small airway disease on intrapulmonary vascular volume (IPVV). Methods This retrospective study enrolled 63 healthy subjects and 47 COPD patients, who underwent both inspiratory and expiratory CT scans of the chest and pulmonary function tests (PFTs). Inspiratory and expiratory IPVV were measured by using an automatic pulmonary vessels integration segmentation approach, the ratio of emphysema volume (Emph%), functional small airway disease volume (fsAD%), and normal areas volume (Normal%) were quantified by the PRM method for biphasic CT scans. The participants were grouped according to PFTs. Analysis of variance (ANOVA) and Kruskal–Wallis H-test were used to analyze the differences in indicators between different groups. Then, Spearman’s rank correlation coefficients were used to analyze the correlation between Emph%, fsAD%, Normal%, PFTs, and IPVV. Finally, multiple linear regression was applied to analyze the effects of Emph% and fsAD% on IPVV. Results Differences were found in age, body mass index (BMI), smoking index, FEV1%, FEV1/forced vital capacity (FVC), expiratory IPVV, IPVV relative value, IPVV difference value, Emph%, fsAD%, and Normal% between the groups (P<0.05). A strong correlation was established between the outcomes of PFTs and quantitative CT indexes. Finally, the effect of Emph% was more significant than that of fsAD% on expiratory IPVV, IPVV difference value, and IPVV relative value. Conclusion IPVV may have a potential value in assessing COPD severity and is significantly affected by emphysema.
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Affiliation(s)
- Xiaoqi Huang
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Weiling Yin
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Min Shen
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Xionghui Wang
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Tao Ren
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Lei Wang
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
| | - Min Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Youmin Guo
- Department of Radiology, Yan'an University Affiliated Hospital, Yan'an, People's Republic of China
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19
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Su KC, Ko HK, Hsiao YH, Chou KT, Chen YW, Yu WK, Pan SW, Feng JY, Perng DW. Fractional Exhaled Nitric Oxide Guided-Therapy in Chronic Obstructive Pulmonary Disease: A Stratified, Randomized, Controlled Trial. Arch Bronconeumol 2022; 58:601-610. [PMID: 35312525 DOI: 10.1016/j.arbres.2021.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/21/2021] [Accepted: 11/15/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) with eosinophilic airway inflammation represents a distinct phenotype that might respond to treatment with inhaled corticosteroids. Fractional exhaled nitric oxide (FENO) might predict eosinophilic inflammation and guide treatment option. We hypothesized that COPD patients with different baseline levels of FENO might have differentiated response to treatment with salmeterol/fluticasone (SFC) or tiotropium (TIO). METHODS This open-label, randomized-controlled trial enrolled treatment-naïve COPD patients who were stratified into high- (≥23.5ppb) and low-FENO group, followed by 12-week treatment with SFC or TIO. A linear mixed model with repeated measures was applied to analyze the changes in FENO (primary outcome), COPD assessment test (CAT) score, FEV1, and parameters in induced sputum and blood after treatment. RESULTS 134 patients were divided into 4 subgroups: low-FENO/SFC (n=30), low-FENO/TIO (n=29), high-FENO/SFC (n=37), and high-FENO/TIO (n=38). At baseline, FENO 23.5ppb clearly differentiated between eosinophilic and non-eosinophilic inflammation groups based on the eosinophils in induced sputum and blood. FENO significantly correlated with sputum and blood eosinophils at baseline. High-FENO/SFC (vs. high-FENO/TIO) subgroup had significant reduction in FENO and sputum inflammation profiles (including eosinophils, macrophages, matrix metalloproteinase-9, and interlukin-8) after treatment. These differences were not replicated between low-FENO/SFC and low-FENO/TIO subgroups. The improvement in CAT and FEV1 after treatment was indiscriminate between SFC and TIO in the low- and high-FENO groups. CONCLUSION High baseline FENO can serve as an indicator of eosinophilic airway inflammation in COPD patients who may respond favorably to treatment with inhaled corticosteroids/long-acting β2-agonists. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT02546349.
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Affiliation(s)
- Kang-Cheng Su
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; Center of Sleep Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Hsin-Kuo Ko
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Yi-Han Hsiao
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; Center of Sleep Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Kun-Ta Chou
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; Center of Sleep Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Yen-Wen Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Wen-Kuang Yu
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Sheng-Wei Pan
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC
| | - Diahn-Warng Perng
- Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City 11217, Taiwan, ROC; School of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, Taiwan, ROC.
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20
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Arellano-Orden E, Calero Acuña C, Sánchez-López V, López Ramírez C, Otero-Candelera R, Marín-Hinojosa C, López Campos J. Cellular mechanisms involved in the pathogenesis of airway remodeling in chronic lung disease. Eur Clin Respir J 2022; 9:2097377. [PMID: 35832729 PMCID: PMC9272929 DOI: 10.1080/20018525.2022.2097377] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- E. Arellano-Orden
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C. Calero Acuña
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - V. Sánchez-López
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C. López Ramírez
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - R. Otero-Candelera
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - C. Marín-Hinojosa
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jl López Campos
- Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de SevillaUnidad Médico Quirúrgica de Enfermedades Respiratorias,Quirúrgica, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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21
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Joean O, Welte T. Vaccination and modern management of chronic obstructive pulmonary disease - a narrative review. Expert Rev Respir Med 2022; 16:605-614. [PMID: 35713962 DOI: 10.1080/17476348.2022.2092099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) carries a tremendous societal and individual burden, posing significant challenges for public health systems worldwide due to its high morbidity and mortality. Due to aging and multimorbidity but also in the wake of important progress in deciphering the heterogeneous disease endotypes, an individualized approach to the prevention and management of COPD is necessary. AREAS COVERED This article tackles relevant immunization strategies that are available or still under development with a focus on the latest evidence but also controversies around different regional immunization approaches. Further, we present the crossover between chronic lung inflammation and lung microbiome disturbance as well as its role in delineating COPD endotypes. Moreover, the article attempts to underline endotype-specific treatment approaches. Lastly, we highlight non-pharmacologic prevention and management programs in view of the challenges and opportunities of the COVID-19 era. EXPERT OPINION Despite the remaining challenges, personalized medicine has the potential to offer tailored approaches to prevention and therapy and promises to improve the care of patients living with COPD.
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Affiliation(s)
- Oana Joean
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease, Member of the German Center for Lung Research, Hannover, Germany
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22
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Granell-Gil M, Murcia-Anaya M, Sevilla S, Martínez-Plumed R, Biosca-Pérez E, Cózar-Bernal F, Garutti I, Gallart L, Ubierna-Ferreras B, Sukia-Zilbeti I, Gálvez-Muñoz C, Delgado-Roel M, Mínguez L, Bermejo S, Valencia O, Real M, Unzueta C, Ferrando C, Sánchez F, González S, Ruiz-Villén C, Lluch A, Hernández A, Hernández-Beslmeisl J, Vives M, Vicente R. Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy). REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2022; 69:266-301. [PMID: 35610172 DOI: 10.1016/j.redare.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/19/2021] [Indexed: 06/15/2023]
Abstract
The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.
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Affiliation(s)
- M Granell-Gil
- Sección en Anestesiología, Reanimación y T. Dolor, Consorcio Hospital General Universitario de Valencia, Profesor Contratado Doctor en Anestesiología, Universitat de València, Valencia, Spain
| | - M Murcia-Anaya
- Anestesiología, Reanimación y T. Dolor, Unidad de Cuidados Intensivos, Hospital IMED Valencia, Valencia, Spain.
| | - S Sevilla
- Sociedad de Cirugía Torácica, Complejo Hospitalario Universitario de Jaén, Jaén, Spain
| | - R Martínez-Plumed
- Anestesiología, Reanimación y T. Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - E Biosca-Pérez
- Anestesiología, Reanimación y T. Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - F Cózar-Bernal
- Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - I Garutti
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - L Gallart
- Anestesiología, Reanimación y T. Dolor, Hospital del Mar de Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - I Sukia-Zilbeti
- Fisioterapia, Hospital Universitario Donostia de San Sebastián, Spain
| | - C Gálvez-Muñoz
- Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, Spain
| | - M Delgado-Roel
- Cirugía Torácica, Complejo Hospitalario Universitario La Coruña, La Coruña, Spain
| | - L Mínguez
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario La Fe de Valencia, Valencia, Spain
| | - S Bermejo
- Anestesiología, Reanimación y T. Dolor, Hospital del Mar de Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - O Valencia
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Doce de Octubre de Madrid, Madrid, Spain
| | - M Real
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Doce de Octubre de Madrid, Madrid, Spain
| | - C Unzueta
- Anestesiología, Reanimación y T. Dolor, Hospital Sant Pau de Barcelona, Barcelona, Spain
| | - C Ferrando
- Anestesiología, Reanimación y T. Dolor, Hospital Clínic Universitari de Barcelona, Barcelona, Spain
| | - F Sánchez
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario de la Ribera de Alzira, Valencia, Spain
| | - S González
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Donostia de San Sebastián, Spain
| | - C Ruiz-Villén
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - A Lluch
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario La Fe de Valencia, Valencia, Spain
| | - A Hernández
- Anestesiología, Reanimación y T. Dolor, Grupo Policlínica de Ibiza, Ibiza, Spain
| | - J Hernández-Beslmeisl
- Anestesiología, Reanimación y T. Dolor, Complejo Hospitalario Universitario de Canarias, Canarias, Spain
| | - M Vives
- Anestesiología, Reanimación y T. Dolor, Hospital Universitari Dr. Josep Trueta de Girona, Girona, Spain
| | - R Vicente
- Sección de Anestesia Cardiaca, Vascular y Torácica, SEDAR, Anestesiología, Reanimación y T. Dolor, Hospital Universitario La Fe de Valencia, Universitat de València, Valencia, Spain
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Chronic obstructive pulmonary disease and atherosclerosis: common mechanisms and novel therapeutics. Clin Sci (Lond) 2022; 136:405-423. [PMID: 35319068 PMCID: PMC8968302 DOI: 10.1042/cs20210835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 03/07/2022] [Indexed: 12/17/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) and atherosclerosis are chronic irreversible diseases, that share a number of common causative factors including cigarette smoking. Atherosclerosis drastically impairs blood flow and oxygen availability to tissues, leading to life-threatening outcomes including myocardial infarction (MI) and stroke. Patients with COPD are most likely to die as a result of a cardiovascular event, with 30% of all COPD-related deaths being attributed to cardiovascular disease (CVD). Both atherosclerosis and COPD involve significant local (i.e. lung, vasculature) and systemic inflammation and oxidative stress, of which current pharmacological treatments have limited efficacy, hence the urgency for the development of novel life-saving therapeutics. Currently these diseases must be treated individually, with no therapies available that can effectively reduce the likelihood of comorbid CVD other than cessation of cigarette smoking. In this review, the important mechanisms that drive atherosclerosis and CVD in people with COPD are explained and we propose that modulation of both the oxidative stress and the inflammatory burden will provide a novel therapeutic strategy to treat both the pulmonary and systemic manifestations related to these diseases.
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Lung function impairment in relation to cognition and vascular brain lesions: the Rotterdam Study. J Neurol 2022; 269:4141-4153. [PMID: 35267082 DOI: 10.1007/s00415-022-11027-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the association of chronic obstructive pulmonary disease (COPD) and Preserved Ratio Impaired Spirometry (PRISm) with cognitive performance and presence of vascular brain lesions (VBL). METHODS We determined both cross-sectional and longitudinal association of lung function impairment with cognition, as well as cross-sectional association of lung function impairment with VBL, in the general population. Between 2009 and 2014 we included 3,941 participants from the Rotterdam Study with spirometry tests, brain MRI scans and cognition tests, of whom 1815 had follow-up data on cognition. RESULTS Our finding indicated that cross-sectionally, participants with PRISm or COPD GOLD2-4 had a worse global cognitive performance. We did not find differences in cognition over time between those with normal spirometry versus those with lung function impairment. In addition, PRISm and COPD GOLD2-4 were associated with a higher prevalence of lacunar infarcts compared to normal spirometry. CONCLUSIONS This study suggests that persons with COPD GOLD2-4 or restrictive lung function, defined as PRISm, are characterized by poorer global cognitive function and a higher prevalence of lacunar infarcts.
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25
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Baos S, Cremades-Jimeno L, López-Ramos M, de Pedro MÁ, Uriarte SA, Sastre J, González-Mangado N, Rodríguez-Nieto MJ, Peces-Barba G, Cárdaba B. Expression of Macrophage Scavenger Receptor (MSR1) in Peripheral Blood Cells from Patients with Different Respiratory Diseases: Beyond Monocytes. J Clin Med 2022; 11:jcm11051439. [PMID: 35268530 PMCID: PMC8910889 DOI: 10.3390/jcm11051439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Macrophage scavenger receptor 1 (MSR1) has mostly been described in macrophages, but we previously found a significant gene expression increase in peripheral blood mononuclear cells (PBMCs) of asthmatic patients. Objective: To confirm those results and to define its cellular origin in PBMCs. Methods: Four groups of subjects were studied: healthy controls (C), nonallergic asthmatic (NA), allergic asthmatic (AA), and chronic obstructive pulmonary disease (COPD) patients. RNA was extracted from PBMCs. MSR1 gene expression was analyzed by RT-qPCR. The presence of MSR1 on the cellular surface of PBMC cellular subtypes was analyzed by confocal microscopy and flow cytometry. Results: MSR1 gene expression was significantly increased in the three clinical conditions compared to the healthy control group, with substantial variations according to disease type and severity. MSR1 expression on T cells (CD4+ and CD8+), B cells, and monocytes was confirmed by confocal microscopy and flow cytometry. In all clinical groups, the four immune cell subtypes studied expressed MSR1, with a greater expression on B lymphocytes and monocytes, exhibiting differences according to disease and severity. Conclusions: This is the first description of MSR1’s presence on lymphocytes’ surfaces and reinforces the potential role of MSR1 as a player in asthma and COPD.
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Affiliation(s)
- Selene Baos
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - Lucía Cremades-Jimeno
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - María López-Ramos
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - María Ángeles de Pedro
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - Silvia A. Uriarte
- Allergy Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain; (S.A.U.); (J.S.)
| | - Joaquín Sastre
- Allergy Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain; (S.A.U.); (J.S.)
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
| | - Nicolás González-Mangado
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Pulmonology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - María Jesús Rodríguez-Nieto
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Pulmonology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Germán Peces-Barba
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Pulmonology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Blanca Cárdaba
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Correspondence:
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Margaroli C, Madison MC, Viera L, Russell DW, Gaggar A, Genschmer KR, Blalock JE. A novel in vivo model for extracellular vesicle-induced emphysema. JCI Insight 2022; 7:153560. [PMID: 35077395 PMCID: PMC8876451 DOI: 10.1172/jci.insight.153560] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/19/2022] [Indexed: 11/17/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a debilitating chronic disease and the third-leading cause of mortality worldwide. It is characterized by airway neutrophilia, promoting tissue injury through release of toxic mediators and proteases. Recently, it has been shown that neutrophil-derived extracellular vesicles (EVs) from lungs of patients with COPD can cause a neutrophil elastase–dependent (NE-dependent) COPD-like disease upon transfer to mouse airways. However, in vivo preclinical models elucidating the impact of EVs on disease are lacking, delaying opportunities for therapeutic testing. Here, we developed an in vivo preclinical mouse model of lung EV–induced COPD. EVs from in vivo LPS-activated mouse neutrophils induced COPD-like disease in naive recipients through an α-1 antitrypsin–resistant, NE-dependent mechanism. Together, these results show a key pathogenic and mechanistic role for neutrophil-derived EVs in a mouse model of COPD. Broadly, the in vivo model described herein could be leveraged to develop targeted therapies for severe lung disease.
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Affiliation(s)
- Camilla Margaroli
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology, and
| | - Matthew C. Madison
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology, and
| | - Liliana Viera
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
| | - Derek W. Russell
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology, and
| | - Amit Gaggar
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology, and
- Lung Health Center and Gregory Fleming James Cystic Fibrosis Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Birmingham VA Medical Center, Birmingham, Alabama, USA
| | - Kristopher R. Genschmer
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Program in Protease and Matrix Biology, and
| | - J. Edwin Blalock
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
- Lung Health Center and Gregory Fleming James Cystic Fibrosis Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Wallick C, To TM, Korom S, Masters H, Hanania NA, Moawad D. Impact of influenza infection on the short- and long-term health of patients with chronic obstructive pulmonary disease. J Med Econ 2022; 25:930-939. [PMID: 35837794 DOI: 10.1080/13696998.2022.2098630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Influenza is a common cause of acute respiratory infection that leads to exacerbation of underlying chronic obstructive pulmonary disease (COPD). To elucidate the short- and long-term effects of influenza in patients with COPD, we examined health care resource utilization (HRU) and costs up to 13 months following influenza infection. METHODS We conducted a retrospective cohort study using U.S. insurance claims data from MarketScan. Patients with an influenza diagnosis during the 2012-2014 influenza seasons and continuous enrollment in a health plan from 12 months before to 13 months after the index influenza diagnosis were identified and propensity score-matched 1:5 to controls without evidence of influenza. COPD- and pneumonia-related outcomes were assessed over 13 months following influenza diagnosis. RESULTS COPD-associated outcomes after diagnosis were significantly worse in patients with influenza (n = 7,087) vs. controls (n = 35,435) during the first month (exacerbation: 16.1 vs. 3.4%; outpatient visits: 57.1 vs. 35.2%; emergency department (ED) visits: 10.5 vs. 1.8%; and inpatient visits: 5.6 vs. 0.7%) and months 2-13 (exacerbation: 25.1 vs. 21.1%; outpatient visits: 86.1 vs. 85.8%; ED visits: 20.0 vs. 15.7%; and inpatient visits: 6.5 vs. 5.3%). COPD- and pneumonia-associated costs for months 1 and 2-13 were higher in patients with influenza. LIMITATIONS The study was subject to a residual imbalance between cohorts despite propensity score matching. The use of diagnostic codes to select patients and identify complications could introduce inaccuracies in estimating events. CONCLUSIONS HRU and costs were higher in COPD patients with influenza during the first month and over the entire year following infection. This suggests influenza has an impact on respiratory health in patients with COPD that lasts beyond the acute infection.
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Affiliation(s)
| | - Tu My To
- Genentech, Inc., South San Francisco, CA, USA
| | | | | | - Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA
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Zuo X, Lou P, Zhu Y, Chen B, Zhu X, Chen P, Dong Z, Zhu X, Li T, Zhang P. Effects of expressive art therapy on health status of patients with chronic obstructive pulmonary disease: a community-based cluster randomized controlled trial. Ther Adv Respir Dis 2022; 16:17534666221111876. [PMID: 35850588 PMCID: PMC9340361 DOI: 10.1177/17534666221111876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background and objective: This study was performed to investigate the effect of expressive art therapy
(EAT) on the health status of patients with chronic obstructive pulmonary
disease (COPD). Methods: This community-based cluster randomized controlled trial involved patients
with COPD from 16 communities in China. Participants received either EAT
plus usual care (UC) or UC only. General practitioners were trained in EAT
before the intervention. The primary outcomes were depression and anxiety
symptoms, measured with the Hospital Anxiety and Depression Scale (HADS) and
expressed as the HADS score for depression or anxiety (HADS-D or HADS-A,
respectively). The secondary outcomes were the quality of life and dyspnoea,
measured with the COPD assessment test (CAT). Dyspnoea was assessed using
the modified Medical Research Council (mMRC) dyspnoea scale. Lung function
was expressed as the forced expiratory volume in 1 s as a percentage of the
predicted value [FEV1 (% pred)]. Outcome data were collected from
all participants at baseline, 2 and 6 months. Results: In total, 360 participants with COPD and comorbid depression were included in
the analysis with the control group of 181 receiving UC only and the
intervention group of 179 receiving EAT plus UC. The EAT group showed
significantly greater improvement in the HADS-D and HADS-A scores than the
UC group at 2 months (p < 0.0001 and
p < 0.001, respectively) and 6 months
(p < 0.001 for both). The CAT and mMRC scores were
significantly lower in the EAT group than in the UC group at 2 and 6 months
(p < 0.001 for all). The FEV1 (% pred)
was significantly higher in the EAT group than in the UC group at 6 months
(p < 0.01). Conclusion: General practitioners can deliver EAT interventions. EAT can effectively
reduce anxiety and depression symptoms and dyspnoea, improve quality of life
and improve the pulmonary function of patients with COPD.
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Affiliation(s)
- Xiaowei Zuo
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Peian Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Yanan Zhu
- Department of Respiratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Bi Chen
- Department of Respiratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xianghua Zhu
- Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, China
| | - Peipei Chen
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Zongmei Dong
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Xuan Zhu
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Ting Li
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Pan Zhang
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, 142 West Erhuan Road, Xuzhou 221006, China
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Marín-Hinojosa C, Eraso CC, Sanchez-Lopez V, Hernández LC, Otero-Candelera R, Lopez-Campos JL. Nutriepigenomics and chronic obstructive pulmonary disease: potential role of dietary and epigenetics factors in disease development and management. Am J Clin Nutr 2021; 114:1894-1906. [PMID: 34477827 DOI: 10.1093/ajcn/nqab267] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
Over recent decades, a number of studies have revealed the possible role of different types of diets, as well as the nutritional elements they are made up of, in the pathogenesis of chronic obstructive pulmonary disease (COPD). To date, dietary factors have been identified to play a role in the prevention of COPD, with evidence from antioxidant nutrients, vitamins, and fiber intake. Additionally, certain dietary patterns such as the Mediterranean diet, together with other Western diets, provide evidence of the influence on COPD development, promoting lung health through nutritional approaches, and giving us an opportunity for intervention. The effect of diet on COPD is conveyed by 3 mechanisms: regulation of inflammation, oxidative stress, and carbon dioxide produced/oxygen intake. Current advances have begun to highlight the possible role of diet in modifying gene expression in certain individuals that predisposes them to COPD through epigenetic modifications. The relation between dietary intake and epigenetic factors has therefore outlined nutriepigenomics as a possible missing link in the relation between environmental exposure to smoke and the appearance of a subsequent chronic bronchial obstruction. This review summarizes the evidence regarding the influence of dietary patterns and nutrients and epigenetic regulatory mechanisms on COPD development and prevention with the aim of encouraging clinical research on the impact of dietary modifications on COPD-related clinical outcomes. This review highlights the importance of proposing and carrying out future studies focused on the modulating effects of certain nutrients on epigenetic changes in patients with specific COPD phenotypes (bronchiectasis, emphysema, asthma/COPD, chronic bronchitis), and their individual responses to cigarette smoking, environmental pollution, or other noxious particles. The objectives of these future studies must be directed to the development of novel therapeutic approaches and personalized management of COPD.
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Affiliation(s)
- Carmen Marín-Hinojosa
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Candelaria Caballero Eraso
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Veronica Sanchez-Lopez
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Carrasco Hernández
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Remedios Otero-Candelera
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Alcázar-Navarrete B, Díaz-Lopez JM, García-Flores P, Ortega-Antelo M, Aguilar-Cruz I, Ruiz-Rodríguez O, Santiago-Diaz P, Romero Palacios PJ. T2 Biomarkers as Predictors of Exacerbations of Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2021; 58:595-600. [PMID: 35312535 DOI: 10.1016/j.arbres.2021.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Type 2 (T2) biomarkers such as blood eosinophil count (BEC) and FeNO have been related to a higher risk of exacerbations in COPD. It is unknown whether combining these biomarkers could be useful in forecasting COPD exacerbations. METHODS COPD patients were enrolled in this prospective, multicenter, observational study and followed up for 1 year, during which BEC were analysed at baseline (V0) while FeNO analyses were performed at baseline (V0), 6 months (V1) and 12 months (V2). The risk of moderate or severe exacerbation during follow up was assessed by Cox regression analysis, and the predictive capacity of both measurements was assessed by ROC curves and the DeLong test. Statistical significance was assumed at P<.05. RESULTS Of the 322 COPD patients initially recruited, 287 were followed up. At baseline, 28.0% were active smokers, and experienced moderate airflow limitation (mean FEV1 56.4%±17.0% predicted). Patients with at least one elevated T2 biomarker (n=125, 42.5%) were at increased risk of COPD exacerbation (HR 1.75, 95% CI 1.25-2.45, P=.001) and of shorter time to first COPD exacerbation. There was no difference between BEC and FeNO regarding the predictive capacity for moderate to severe exacerbation (AUC 0.584 vs 0.576, P=.183) but FeNO predicted severe episodes more accurately than BEC (AUC 0.607 vs 0.539, P<.05). Combining the two biomarkers enhanced the detection of moderate and severe COPD exacerbations. CONCLUSIONS Both eosinophil count and FeNO have limited utility for predicting COPD exacerbations. Combining these T2 biomarkers could enhance the detection of future COPD exacerbations.
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Affiliation(s)
- Bernardino Alcázar-Navarrete
- Respiratory Department, HU Virgen de las Nieves, Granada, Spain; Facultad de Medicina, Universidad de Granada, Granada, Spain; Centro de Investigación Biomédica en red Enfermedades Respiratorias (CIBERES), Spain.
| | | | | | | | | | - Oliverio Ruiz-Rodríguez
- Respiratory Department, AIG de Medicina, Hospital de Alta Resolución de Loja, Agencia Sanitaria Hospital de Poniente, Loja, Granada, Spain
| | - Pablo Santiago-Diaz
- Cardiology Department, AIG de Medicina, Hospital de Alta Resolución de Loja, Agencia Sanitaria Hospital de Poniente, Loja, Granada, Spain
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31
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Sistani F, Reed RM, Shah CH, Zafari Z. Trends in Medicaid spending on inhalers in the United States, 2012-2018. J Manag Care Spec Pharm 2021; 27:1744-1749. [PMID: 34818085 PMCID: PMC10391144 DOI: 10.18553/jmcp.2021.27.12.1744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma are common respiratory diseases that impose a significant economic burden on Medicaid. Inhalers are the mainstay treatment for relieving symptoms and improving outcomes for COPD and asthma patients. OBJECTIVE: To describe the total spending and trends of Medicaid expenditures on inhalers between 2012 and 2018 in the United States. METHODS: We analyzed the deidentified data from the Medicaid Drug Spending Dashboard and utilization datasets from 2012 to 2018. We identified 9 classes of inhalers and described the Medicaid total spending on and relative annual changes for those inhalers. We also described the spending on available generic inhalers and compared the Medicaid spending by manufacturers during this time frame. RESULTS: Medicaid spent $26.2 billion on inhalers from 2012 to 2018. This spending increased by $2.5 billion (120%) over this time frame. During this specified period, the highest Medicaid spending was on the group of inhaled corticosteroid (ICS)-containing inhalers ($14.9 billion). Within this group, the inhaler class of ICS/long-acting beta-2 adrenoceptor agonists contributed to the highest Medicaid spending (53%), with a growth of 607% between 2012 and 2018. Of the $26.2 billion that Medicaid spent on inhalers, $35.5 million (less than 0.01%) was spent on 2 generic inhalers: fluticasone propionate with salmeterol and levalbuterol tartrate hydrofluoroalkane. CONCLUSIONS: Between 2012 and 2018, on average, $3.5 billion per year was spent by Medicaid on inhalers. Decreasing the price of inhalers by introducing more generic inhalers in the market can potentially reduce the cost burden on Medicaid. DISCLOSURES: This study was funded by the American Foundation for Pharmaceutical Education (AFPE). The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. The authors declare no conflicts of interest.
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Affiliation(s)
- Farideh Sistani
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore
| | - Robert M Reed
- Associate Professor of Medicine, University of Maryland School of Medicine, Baltimore
| | - Chintal H Shah
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore
| | - Zafar Zafari
- Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore
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Lin S, Ma Z, Huang Y, Sun Y, Yi H. Chronic obstructive pulmonary disease is characterized by reduced levels and defective suppressive function of regulatory B cells in peripheral blood. Mol Immunol 2021; 141:87-93. [PMID: 34837778 DOI: 10.1016/j.molimm.2021.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/17/2021] [Accepted: 11/07/2021] [Indexed: 01/02/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by a progressive, persistent immune response to cigarette smoke, and it has been suggested that immune dysregulation is involved in its pathogenesis. A subset of regulatory B cells (Bregs) with high levels of the surface markers CD24 and CD38 (CD24hiCD38hi) has previously been shown to exert an immunosuppressive function. This study investigated the levels and activity of CD24hiCD38hi Bregs in stable COPD (sCOPD). Testing the peripheral blood from 65 patients with sCOPD and 39 control subjects for CD24hiCD38hi Breg subsets by flow cytometry showed that the patients with sCOPD had significantly lower levels of CD24hiCD38hi Bregs and IL-10+ B cells. The patients with sCOPD had lower serum interleukin-10 levels than the controls. The patients with most severe sCOPD had the lowest levels of CD24hiCD38hi Bregs. Spearman correlation analysis showed that the levels of CD24hiCD38hi Bregs in the patients with sCOPD positively correlated with serum interleukin-10 concentrations but not with levels of C-reactive protein. Compared to healthy controls, functional studies showed that Breg cells from patients with sCOPD exhibit a decreased suppressive function. We conclude that sCOPD is characterized by the exhaustion of CD24hiCD38hi regulatory B cells compartment. Therefore, CD24hiCD38hi Bregs may contribute to the pathogenesis of sCOPD.
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Affiliation(s)
- Shan Lin
- Central Laboratory, The First Hospital of Jilin University, Changchun, Jilin, 130031, China; Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, Jilin, 130031, China.
| | - Zhanchuan Ma
- Central Laboratory, The First Hospital of Jilin University, Changchun, Jilin, 130031, China.
| | - Yuanping Huang
- Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, Jilin, 130031, China.
| | - Yu Sun
- Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, Jilin, 130031, China.
| | - Huanfa Yi
- Central Laboratory, The First Hospital of Jilin University, Changchun, Jilin, 130031, China.
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Feng Q, Yu YZ, Meng QH. Blocking tumor necrosis factor-α delays progression of chronic obstructive pulmonary disease in rats through inhibiting MAPK signaling pathway and activating SOCS3/TRAF1. Exp Ther Med 2021; 22:1311. [PMID: 34630665 PMCID: PMC8461615 DOI: 10.3892/etm.2021.10746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/25/2021] [Indexed: 01/04/2023] Open
Abstract
The present study was conducted in order to study the detailed molecular mechanism of tumor necrosis factor (TNF)-α in chronic obstructive pulmonary disease (COPD). The rats were treated with cigarette smoke (CS) and lipopolysaccharide (LPS) to establish the COPD model. Next, the changes in lung injury in COPD rats with TNF-α knockdown was tested. Meanwhile, the regulation of TNF-α on MAPK pathway and its downstream molecules (SOCS3/TRAF1) was determined by western blotting. On this basis, the activation of MAPK and inhibition of SOCS3/TRAF1 was also examined. Subsequently, the lung function was tested with the plethysmograph, the cells of bronchoalveolar lavage fluid was counted and classified. Furthermore, lung tissue sections were stained with hematoxylin and eosin to verify whether the treatment of MAPK pathway and downstream molecules affected the effect of TNF-α knockdown on COPD. The present study showed that TNF-α knockdown could alleviate the decrease in the function and inflammatory injury of the lungs of rats with COPD. Western blot analysis verified that TNF-α knockdown could inhibit the activation of MAPK pathway and increase the expression of SOCS3/TRAF1. The following experimental results showed that the relief of lung injury caused by TNF-α knockdown could be deteriorated by activating MAPK pathway. It was also found that the symptom of COPD was decreased following transfection with sh-TNF-α but worsened by SOCS3/TRAF1 knockdown. Overall, TNF-α knockdown inhibited the activation of MAPK pathway and increased the expression of SOCS3/TRAF1, thus delaying the process of COPD.
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Affiliation(s)
- Qiong Feng
- Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Jianghan University, Wuhan, Hubei 430015, P.R. China
| | - Yan-Zi Yu
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Jianghan University, Wuhan, Hubei 430015, P.R. China
| | - Qing-Hua Meng
- Department of Pulmonary and Critical Care Medicine, The Affiliated Hospital of Jianghan University, Wuhan, Hubei 430015, P.R. China
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García García MDC, Hernández Borge J, García García GM, Márquez Pérez FL. Supervivencia en pacientes con EPOC en tratamiento con oxigenoterapia continua domiciliaria. OPEN RESPIRATORY ARCHIVES 2021. [PMID: 37496844 PMCID: PMC10369520 DOI: 10.1016/j.opresp.2021.100119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Introduction Continuous home oxygen therapy (CHOT), along with smoking cessation, is the first treatment that has been shown to increase the survival of patients with chronic obstructive pulmonary disease (COPD) and chronic hypoxemia. Objective To determine survival in a cohort of COPD patients receiving CHOT and to analyze the main causes and risk factors associated with their mortality. Methods Prospective study of a cohort of COPD patients receiving CHOT. Numerous variables, including survival and cause of death at the end of follow-up, were collected. Results A total of 409 COPD patients receiving CHOT were included (85.6% men; mean age: 71.27 ± 9.74 years). Mean time of CHOT follow-up was 5.86 ± 3.24 years and median survival was 6 years (95% CI: 5.47-6.53). Mortality at the end of follow-up was 75.8%, the leading cause of death being respiratory (36.9%). Longer survival was significantly associated with lower age, correct CHOT compliance, absence of exacerbations in the previous year, use of long-acting anticholinergics (LAMA), less severe COPD, presence of sleep apnea-hypopnea syndrome/obesity hypoventilation syndrome (SAHS/SHO), absence of malignant disease, heart disease, cerebrovascular disease, and kidney disease. Conclusions The survival of COPD patients receiving CHOT was very long. The main causes of mortality were respiratory (36.9%). Independent predictors of mortality were age, presence of exacerbations in the previous year, previous diagnosis of cancer, and presence of cerebrovascular and renal disease.
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Impact of preoperative comorbidities on postoperative complication rate and outcome in surgically resected non-small cell lung cancer patients. Gen Thorac Cardiovasc Surg 2021; 70:248-256. [PMID: 34554366 PMCID: PMC8881261 DOI: 10.1007/s11748-021-01710-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 09/10/2021] [Indexed: 11/14/2022]
Abstract
Objective This study aimed to analyze whether comorbidities impact postoperative complication rate or survival after anatomical lung resection for non-small cell lung cancer (NSCLC). Methods A retrospective analysis of 1219 patients who underwent NSCLC resection between 2000 and 2015 was performed. Analyzed comorbidities included chronic obstructive lung disease (COPD), hypertension, coronary artery disease (CAD), peripheral artery disease, myocardial infarction history, diabetes mellitus, renal insufficiency and other malignancies. Results Most patients (78.9%) had comorbidities, most commonly hypertension (34.1%) followed by COPD (26.4%) and other malignancies (19%). The overall complication rate was 38.6% (26.4% pulmonary; 14.8% cardiac; and 3.0% gastrointestinal). Hypertension (odds ratio (OR) = 1.492, p = 0.031) was associated with more cardiac complications. Heavy smoking (OR = 1.008, p = 0.003) and low body mass index (BMI) (OR = 0.932, p < 0.001) affected the pulmonary complication rate significantly. None of the included comorbidities affected the overall complication rate or the survival negatively. However, the patient characteristics of advanced age (p < 0.001), low BMI (p = 0.008), and low FEV1 (p = 0.008) affected the overall complication rate as well as survival (each p < 0.001). Conclusion Advanced age, low BMI, and low FEV1 were predictive of greater complication risk and shorter long-term survival in patients who underwent NSCLC resection. Cardiac complications were associated with hypertension and CAD, whereas pulmonary complications were associated with a high pack year count.
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Lu J, Xie L, Sun S. The inhibitor miR-21 regulates macrophage polarization in an experimental model of chronic obstructive pulmonary disease. Tob Induc Dis 2021; 19:69. [PMID: 34539308 PMCID: PMC8409097 DOI: 10.18332/tid/140095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION In chronic obstructive pulmonary disease (COPD), macrophages play an indispensable role. In the lung tissues of COPD patients and smokers, macrophages can be observed to polarize towards M2 phenotype. The molecular mechanism of this process is unclear, and it has not been fully elucidated in COPD. METHODS We bought laboratory animals [C57BL/6 and miR-21-/- C57BL/6(F1)] from the Jackson Laboratory. The model of COPD mice was established by cigarette smoke (CS) exposure combined with intraperitoneal injection of cigarette smoke extract (CSE). RT-PCR detected the expression levels of inflammatory factors and markers associated with M1 and M2 macrophages. The ratio of M2 macrophages to M1 macrophages was detected by immunohistochemical staining. RESULTS The level of miR-21 was increased in RAW264.7 cells intervened by CSE and in lung tissue and bone marrow-derived macrophages (BMDMs) from COPD mice. CSE can gradually over time increase the level of miR-21. The proportion of M2 macrophages to M1 macrophages had a positive correlation with miR-21. Knockdowning miR-21 can reduce lung tissue damage. CSE also increased the levels of related inflammatory factors and markers associated with M2 macrophages, and an miR-21 inhibitor can reverse this conversion. CONCLUSIONS We confirmed that CSE can lead to macrophage transformation to the M2 phenotype and an increase in the expression level of miR-21. Knockdown of the miR-21 gene could inhibit the transformation of macrophages to the M2 phenotype in COPD.
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Affiliation(s)
- JunJuan Lu
- Department of Respiratory Medicine, The Third XiangYa Hospital of Central South University, Changsha, People's Republic of China
| | - LiHua Xie
- Department of Respiratory Medicine, The Third XiangYa Hospital of Central South University, Changsha, People's Republic of China
| | - ShengHua Sun
- Department of Respiratory Medicine, The Third XiangYa Hospital of Central South University, Changsha, People's Republic of China
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Cosío BG, Shafiek H, Verdú J, Fiorentino F, Valera JL, Martínez R, Romero S, Ramón L, Toledo-Pons N, Sala E. Implementation of an Integrated Care Model for Frequent-Exacerbator COPD Patients: A Controlled Prospective Study. Arch Bronconeumol 2021; 57:577-583. [PMID: 35698933 DOI: 10.1016/j.arbr.2021.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/25/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Frequent-exacerbator COPD (fe-COPD) associated with frequent hospital admissions have high morbidity, mortality and use of health resources. These patients should be managed in personalized integrated care models (ICM). Accordingly, we aimed to evaluate the long-term effectiveness of a fe-COPD ICM on emergency room (ER) visits, hospital admissions, days of hospitalization, mortality and improvement of health status. METHODS Prospective-controlled study with analysis of a cohort of fe-COPD patients assigned to ICM and followed-up for maximally 7 years that were compared to a parallel cohort who received standard care. All patients had a confirmed diagnosis of COPD with a history of ≥2 hospital admissions due to exacerbations in the year before enrollment. The change in CAT score and mMRC dyspnea scale, hospital admissions, ER visits, days of hospitalization, and mortality were analyzed. RESULTS 141 patients included in the ICM were compared to 132 patients who received standard care. The ICM reduced hospitalizations by 38.2% and ER visits by 69.7%, with reduction of hospitalizations for COPD exacerbation, ER visits and days of hospitalization (p<0.05) compared to standard care. Further, health status improved among the ICM group after 1 year of follow-up (p=0.001), effect sustained over 3 years. However, mortality was not different between groups (p=0.117). Last follow-up CAT score>17 was the strongest independent risk factor for mortality and hospitalization among ICM patients. CONCLUSIONS An ICM for fe-COPD patients effectively decreases ER and hospital admissions and improves health status, but not mortality.
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Affiliation(s)
- Borja G Cosío
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain; CIBERES, Instituto de Salud Carlos III, Madrid, Spain.
| | - Hanaa Shafiek
- Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Javier Verdú
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain
| | - Federico Fiorentino
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain
| | - Jose Luis Valera
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain; CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Martínez
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain
| | - Susana Romero
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain
| | - Lluisa Ramón
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain
| | - Nuria Toledo-Pons
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain
| | - Ernest Sala
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa, Spain; CIBERES, Instituto de Salud Carlos III, Madrid, Spain
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López-Campos JL, Calle Rubio M, Izquierdo Alonso JL, Fernández-Villar A, Abascal-Bolado B, Alcázar B, García-Río F, Peces-Barba G, Serra Batlles J, Martínez Garcerán JJ, Riesco Miranda JA, Figueira-Gonçalves JM, Soler-Cataluña JJ, Temprano M, Ortega Ruiz F, Santos Pérez S, Álvarez Martínez CJ. Forum COPD working group consensus on the diagnosis, treatment and follow-up of COPD. Arch Bronconeumol 2021; 57:596-599. [PMID: 35702916 DOI: 10.1016/j.arbr.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 06/15/2023]
Affiliation(s)
- José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Myriam Calle Rubio
- Departamento de Medicina, Universidad Complutense de Madrid, Hospital Clínico de San Carlos, Madrid, Spain
| | - José Luis Izquierdo Alonso
- Departamento de Medicina y Especialidades, Universidad de Alcalá, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Alberto Fernández-Villar
- Hospital Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Spain
| | | | - Bernardino Alcázar
- Servicio de Neumología, AIG de Medicina, Hospital de Alta Resolución de Loja, Granada, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Germán Peces-Barba
- Hospital Universitario Fundación Jiménez Díaz, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | | | | | | | - Francisco Ortega Ruiz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Salud Santos Pérez
- Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
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Carrasco Hernández L, Caballero Eraso C, Abad Arranz M, Márquez Martín E, Calero Acuña C, Lopez-Campos JL. Time-based Register and Analysis of COPD Endpoints (TRACE) Project: Methodology and Workflow. Arch Bronconeumol 2021:S0300-2896(20)30515-9. [PMID: 33317892 DOI: 10.1016/j.arbres.2020.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/25/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Carrasco Hernández
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain
| | - Candela Caballero Eraso
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - María Abad Arranz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain
| | - Eduardo Márquez Martín
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain
| | - Carmen Calero Acuña
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
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Carrasco Hernández L, Caballero Eraso C, Abad Arranz M, Márquez Martín E, Calero Acuña C, Lopez-Campos JL. Time-based Register and Analysis of COPD Endpoints (TRACE) Project: Methodology and Workflow. Arch Bronconeumol 2021; 57:593-594. [PMID: 35698941 DOI: 10.1016/j.arbr.2020.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/16/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Laura Carrasco Hernández
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain
| | - Candela Caballero Eraso
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - María Abad Arranz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain
| | - Eduardo Márquez Martín
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain
| | - Carmen Calero Acuña
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
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Kotlyarov S, Kotlyarova A. Bioinformatic Analysis of ABCA1 Gene Expression in Smoking and Chronic Obstructive Pulmonary Disease. MEMBRANES 2021; 11:674. [PMID: 34564491 PMCID: PMC8464760 DOI: 10.3390/membranes11090674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022]
Abstract
Smoking is a key modifiable risk factor for developing the chronic obstructive pulmonary disease (COPD). When smoking, many processes, including the reverse transport of cholesterol mediated by the ATP binding cassette transporter A1 (ABCA1) protein are disrupted in the lungs. Changes in the cholesterol content in the lipid rafts of plasma membranes can modulate the function of transmembrane proteins localized in them. It is believed that this mechanism participates in increasing the inflammation in COPD. METHODS Bioinformatic analysis of datasets from Gene Expression Omnibus (GEO) was carried out. Gene expression data from datasets of alveolar macrophages and the epithelium of the respiratory tract in smokers and COPD patients compared with non-smokers were used for the analysis. To evaluate differentially expressed genes, bioinformatic analysis was performed in comparison groups using the limma package in R (v. 4.0.2), and the GEO2R and Phantasus tools (v. 1.11.0). RESULTS The conducted bioinformatic analysis showed changes in the expression of the ABCA1 gene associated with smoking. In the alveolar macrophages of smokers, the expression levels of ABCA1 were lower than in non-smokers. At the same time, in most of the airway epithelial datasets, gene expression did not show any difference between the groups of smokers and non-smokers. In addition, it was shown that the expression of ABCA1 in the epithelial cells of the trachea and large bronchi is higher than in small bronchi. CONCLUSIONS The conducted bioinformatic analysis showed that smoking can influence the expression of the ABCA1 gene, thereby modulating lipid transport processes in macrophages, which are part of the mechanisms of inflammation development.
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Affiliation(s)
- Stanislav Kotlyarov
- Department of Nursing, Ryazan State Medical University, 390026 Ryazan, Russia
| | - Anna Kotlyarova
- Department of Pharmacology and Pharmacy, Ryazan State Medical University, 390026 Ryazan, Russia;
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Andelius DK, Hilberg O, Ibsen R, Løkke A. National Epidemiological Case-Control Study of Pharmacological Smoking Cessation Treatment in Danish Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2021; 16:2433-2443. [PMID: 34465989 PMCID: PMC8402988 DOI: 10.2147/copd.s317118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that is mainly caused by smoking, and most patients with COPD are either former or current smokers. The optimal way to slow down disease progression and reduce overall mortality is for patients to stop smoking. Patients with COPD are known to have lower socio-economic status and to be more nicotine-dependent than most other smokers and therefore face difficulties when attempting to quit smoking. Pharmacological smoking cessation treatment is known to be the most effective. However, the extent to which this treatment is actually offered to Danish smokers with COPD is unknown. Aim The aim of this study was to investigate if patients with COPD were more likely to redeem a prescription for smoking cessation medication compared with matched controls. Materials and Methods The study was designed as a registry-based, non-interventional case-control study. All Danish patients with COPD (ICD-10-code J 44 chronic obstructive pulmonary disease) diagnosed between 2009 and 2015 were included (130,797 cases). Controls (252,216) were matched on age, gender and geography. Primary outcome was the number of redeemed prescriptions for smoking cessation medication. Results We found that 12% of patients with COPD redeemed a prescription for smoking cessation medication during the eight-year study period. The odds ratio (OR) for redeeming a prescription on smoking cessation medicine was OR 6.22 for patients with COPD compared with their matched controls. We also found that patients with COPD were more likely to redeem smoking cessation medication if they were younger, female or single. Conclusion There is substantial room for improvement with respect to pharmacological smoking cessation treatment in Danish patients with COPD. In-depth knowledge of factors contributing to the patients choice of smoking cessation treatment might allow for more personalized guidance of patients with COPD.
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Affiliation(s)
- Dea Kejlberg Andelius
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Hilberg
- Department of Medicine, Vejle, Little Belt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Anders Løkke
- Department of Medicine, Vejle, Little Belt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Wang Y. Effects of Doxofylline Combined with Ceftazidime on Clinical Efficacy, Drug Safety, and Prognosis in Patients with Chronic Obstructive Pulmonary Disease Complicated with Infection. Med Sci Monit 2021; 27:e930494. [PMID: 34404757 PMCID: PMC8381755 DOI: 10.12659/msm.930494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to investigate the effects of doxofylline combined with ceftazidime on clinical efficacy, drug safety, and prognosis in patients with COPD complicated with infection. Material/Methods A total of 450 patients admitted to the Inner Mongolia BaoGang Hospital for treatment of COPD from January 2017 to December 2019 were selected to participate. All patients were randomly divided into control and observation groups, with 225 patients in each group. In addition, patients with COPD in the remission stage were matched by sex and age for a blank control group. The control group was treated with doxofylline, and the observation group was treated with ceftazidime and doxofylline. No drug intervention was given to the blank control group. Short-term efficacy, pulmonary ventilation function, patient quality of life, peripheral blood TNF-α and PGDF-B levels, and adverse drug reactions were observed. Results The effective treatment rate in the observation group was 96.89%, which was significantly higher than that in the control group (84.00%). Measures of pulmonary ventilation function and patient quality of life in the observation group were significantly higher than those in the control group. Levels of TNF-α and PDGF-B in the observation group were significantly lower than those in the control group. There were no significant differences in the above indicators between the blank control group and the observation group. Conclusions Doxofylline combined with ceftazidime effectively treated patients with COPD complicated with infection. These results provide a reference for clinical treatment.
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Affiliation(s)
- Ying Wang
- Department of Geriatric, Inner Mongolia BaoGang Hospital, Baotou, Inner Mongolia, China (mainland)
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Schwarz SB, Mathes T, Majorski DS, Wollsching-Strobel M, Kroppen D, Magnet FS, Windisch W. Living conditions and autonomy levels in COPD patients receiving non-invasive ventilation: impact on health related quality of life. BMC Pulm Med 2021; 21:255. [PMID: 34344338 PMCID: PMC8330117 DOI: 10.1186/s12890-021-01621-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/07/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Research on health-related quality of life (HRQL) has become increasingly important in recent decades. However, the impact of both living conditions and the level of autonomy impairments on HRQL in COPD patients receiving non-invasive ventilation (NIV) is still unclear. METHODS The Severe Respiratory Insufficiency Questionnaire (SRI) was used to measure HRQL in a prospective cohort of COPD patients in whom home NIV was already established. Data on sociodemographics, clinical characteristics and standardized levels of autonomy impairment were evaluated. A multiple linear regression analysis was performed to identify the factors associated with a reduced HRQL. RESULTS A total of 137 patients (67.0 ± 7.8 years, 45% female) were assessed. The mean SRI Summary Score was 54.1 ± 16.9 (95%CI: 51.1-57.1; N = 127). Regular ambulatory care was provided in 76% of patients, but only 37% underwent pulmonary rehabilitation. Overall, 69% of patients lived with family members, while 31% lived alone (family situation). Autonomy impairment levels were most serious in 3%, serious in 14%, and significant in 29% of patients, while 54% had no impairments at all. Of note, higher levels of autonomy impairment were markedly associated with lower SRI scores (regression coefficient - 6.5 ± 1.1 per level; P < 0.001). In contrast, family situation (0.2 ± 3.0; P = 0.959), ambulatory care by a respiratory specialist (1.7 ± 3.6; P = 0.638), and pulmonary rehabilitation (- 0.8 ± 3.1; P = 0.802) did not appear to influence HRQL. Possible subgroup effects were evident for the factors "impaired autonomy" and "living in a nursing home" (P = 0.016). CONCLUSION A higher level of autonomy impairment has been identified as the major determinant of reduced HRQL in COPD-patients receiving long-term NIV, particularly in those living in a nursing home. Trial Registration German Clinical Trials Register (DRKS00008759).
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Affiliation(s)
- Sarah Bettina Schwarz
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine , Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Tim Mathes
- Institute for Research in Operative Medicine, Faculty of Health - School of Medicine, Witten/Herdecke University, Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Daniel Sebastian Majorski
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine , Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Maximilian Wollsching-Strobel
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine , Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Doreen Kroppen
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine , Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Friederike Sophie Magnet
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine , Ostmerheimer Strasse 200, 51109, Cologne, Germany
| | - Wolfram Windisch
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine , Ostmerheimer Strasse 200, 51109, Cologne, Germany.
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Almadana Pacheco V, Benito Bernáldez C, Gómez-Bastero Fernández AP, Muñiz Rodríguez AM, López Gutiérrez Y, Valido Morales AS. Influence of climatic variables on chronic obstructive pulmonary disease patient attendance to a pulmonary rehabilitation program. THE CLINICAL RESPIRATORY JOURNAL 2021; 15:878-884. [PMID: 33848400 DOI: 10.1111/crj.13376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Implementing adherence to pulmonary rehabilitation (PR) programs is key to obtaining the best results. The objective of our study was to evaluate the influence of weather conditions (humidity, temperature, and precipitation) on attendance to a PR program in chronic obstructive pulmonary disease (COPD) patients. METHODS This prospective observational study, carried out in Seville (Spain), included COPD patients who participated in a 36-session outpatient mixed (strength and endurance) training program for 12 weeks. The program included educational sessions as well. The attendance at the program scheduled sessions during 1 year was evaluated in relation to the meteorological conditions of relative humidity in percentage (%), temperature in degree centigrade (°C), and precipitation in millimeters (mm) according to the data from the State Meteorological Agency (AEMET) and the meteorological center of La Rinconada. RESULTS A total of 81 COPD patients who underwent 2903 sessions were analyzed. The annual average attendance of the program was 78.6%. No differences were found in the attendance to the program depending on the climatic conditions evaluated throughout the year. CONCLUSIONS In a specific geographical area such as Seville, meteorological conditions are not a determining factor of attendance to the PR program for COPD patients.
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Affiliation(s)
| | | | | | | | - Yolanda López Gutiérrez
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Virgen Macarena, Sevilla, Spain
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Spielmanns M, Tamm M, Schildge S, Valipour A. Swiss Experience in Therapy With Dual Bronchodilation in Chronic Obstructive Pulmonary Disease in Relation to Self-Reported Physical Functionality. J Clin Med Res 2021; 13:392-402. [PMID: 34394782 PMCID: PMC8336944 DOI: 10.14740/jocmr4542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/30/2021] [Indexed: 12/29/2022] Open
Abstract
Background Medical therapy in chronic obstructive pulmonary disease (COPD) usually includes inhaled dual bronchodilation leading not only to an improvement in symptoms but also to an increase in physical performance. However, it remains unknown whether responder rates to dual bronchodilation differ between the Swiss subgroup in comparison to participants of other European countries. Methods The non-interventional OTIVACTO trial investigated changes in self-reported physical functioning in COPD patients treated with tiotropium/olodaterol 5/5 µg fixed dose combination for 6 weeks. The cut-off between responder and non-responder was defined as a minimum increase of 10 points using the 10-question physical functioning questionnaire (PF-10) score. We searched for patterns of the responder patient group and compared the results of the whole dataset with the subgroup of Swiss participants. Results Compared to the total cohort (n = 7,608), the Swiss participants (n = 94) were predominantly > 65 years of age and had significantly more comorbidities. There were no significant differences according to COPD stage, smoking status, exacerbation rate in the last 12 months and modified Medical Research Council questionnaire (mMRC) score between the total cohort and the Swiss collective. There were no significant differences between the Swiss subgroup and the total cohort with regard to response to the medication in the PF-10 score. In the intragroup comparison, patients with high mMRC score showed significantly higher values in the PF-10 in both groups. The number of exacerbations had no influence on the PF-10 score in the Swiss subgroup but in the total cohort. Conclusion In terms of age and number of comorbidities, significant differences were found between the overall patient population and the Swiss participants, having no influence on the success of the medication. The patients suffering from increased dyspnea benefited most from tiotropium/olodaterol treatment (Clinical Trials Registry NCT02720757).
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Affiliation(s)
- Marc Spielmanns
- Pulmonary Medicine, Zuercher RehaZentren Klinik Wald, Switzerland.,Faculty of Health, Department of Pneumology, University of Witten/Herdecke, Germany
| | - Michael Tamm
- Lung Centre/Pneumology Department, University Hospital Basel, Basel, Switzerland
| | | | - Arschang Valipour
- Department of Respiratory and Critical Care Medicine, Karl-Landsteiner-Institute for Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
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Granell-Gil M, Murcia-Anaya M, Sevilla S, Martínez-Plumed R, Biosca-Pérez E, Cózar-Bernal F, Garutti I, Gallart L, Ubierna-Ferreras B, Sukia-Zilbeti I, Gálvez-Muñoz C, Delgado-Roel M, Mínguez L, Bermejo S, Valencia O, Real M, Unzueta C, Ferrando C, Sánchez F, González S, Ruiz-Villén C, Lluch A, Hernández A, Hernández-Beslmeisl J, Vives M, Vicente R. Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy). REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2021; 69:S0034-9356(21)00129-8. [PMID: 34330548 DOI: 10.1016/j.redar.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/09/2021] [Accepted: 03/19/2021] [Indexed: 10/20/2022]
Abstract
The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.
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Affiliation(s)
- M Granell-Gil
- Sección en Anestesiología, Reanimación y T. Dolor, Consorcio Hospital General Universitario de Valencia, Profesor Contratado Doctor en Anestesiología, Universitat de València, Valencia, España
| | - M Murcia-Anaya
- Anestesiología, Reanimación y T. Dolor, Unidad de Cuidados Intensivos, Hospital IMED Valencia, Valencia, España.
| | - S Sevilla
- Sociedad de Cirugía Torácica, Complejo Hospitalario Universitario de Jaén, Jaén, España
| | - R Martínez-Plumed
- Anestesiología, Reanimación y T. Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - E Biosca-Pérez
- Anestesiología, Reanimación y T. Dolor, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - F Cózar-Bernal
- Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - I Garutti
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Gregorio Marañón, Madrid, España
| | - L Gallart
- Anestesiología, Reanimación y T. Dolor, Hospital del Mar de Barcelona, Universitat Autònoma de Barcelona, Barcelona, España
| | | | - I Sukia-Zilbeti
- Fisioterapia, Hospital Universitario Donostia, San Sebastián, España
| | - C Gálvez-Muñoz
- Cirugía Torácica, Hospital General Universitario de Alicante, Alicante, España
| | - M Delgado-Roel
- Cirugía Torácica, Complejo Hospitalario Universitario La Coruña, La Coruña, España
| | - L Mínguez
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario La Fe de Valencia, Valencia, España
| | - S Bermejo
- Anestesiología, Reanimación y T. Dolor, Hospital del Mar de Barcelona, Universitat Autònoma de Barcelona, Barcelona, España
| | - O Valencia
- Anestesiología, Reanimación y T. Dolor. Hospital Universitario Doce de Octubre de Madrid, Madrid, España
| | - M Real
- Anestesiología, Reanimación y T. Dolor. Hospital Universitario Doce de Octubre de Madrid, Madrid, España
| | - C Unzueta
- Anestesiología, Reanimación y T. Dolor. Hospital Sant Pau de Barcelona, Barcelona, España
| | - C Ferrando
- Anestesiología, Reanimación y T. Dolor. Hospital Clínic Universitari de Barcelona, Barcelona, España
| | - F Sánchez
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario de la Ribera de Alzira, Valencia, España
| | - S González
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Donostia de San Sebastián, España
| | - C Ruiz-Villén
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario Reina Sofía de Córdoba, Córdoba, España
| | - A Lluch
- Anestesiología, Reanimación y T. Dolor, Hospital Universitario La Fe de Valencia, Valencia, España
| | - A Hernández
- Anestesiología, Reanimación y T. Dolor, Grupo Policlínica de Ibiza, Ibiza, España
| | - J Hernández-Beslmeisl
- Anestesiología, Reanimación y T. Dolor, Complejo Hospitalario Universitario de Canarias, Canarias, España
| | - M Vives
- Anestesiología, Reanimación y T. Dolor, Hospital Universitari Dr. Josep Trueta de Girona, Girona, España
| | - R Vicente
- Sección de Anestesia Cardiaca, Vascular y Torácica, SEDAR, Anestesiología, Reanimación y T. Dolor. Hospital Universitario La Fe de Valencia, Universitat de València, Valencia, España
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Tang M, Long Y, Liu S, Yue X, Shi T. Prevalence of Cardiovascular Events and Their Risk Factors in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Overlap Syndrome. Front Cardiovasc Med 2021; 8:694806. [PMID: 34336955 PMCID: PMC8318267 DOI: 10.3389/fcvm.2021.694806] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/21/2021] [Indexed: 12/25/2022] Open
Abstract
Rationale: Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) have been identified as independent risk factors for cardiovascular diseases. However, the impact of COPD and OSA overlap syndrome (OS) on cardiovascular outcomes remains to be elucidated. Objective: To determine the prevalence of cardiovascular events and their risk factors in OS patients. Methods: Seventy-four patients who had OS between January 2015 and July 2020 were retrospectively enrolled, and 222 COPD-only patients and 222 OSA-only patients were pair-matched for age and sex from the same period and served as the OS-free control group. The prevalence rates of coronary heart disease (CHD), arrhythmia, heart failure, and pulmonary arterial hypertension (PAH) were compared among the three groups, and multivariable logistic regression models were used to screen the risk factors for specific cardiovascular events. Results: OS patients had higher prevalence rates of heart failure (10.8 vs. 0.5 and 1.4%, respectively) and PAH (31.1 vs. 4.5 and 17.1%, respectively) than those with OSA alone or COPD alone (all P < 0.01). The CHD prevalence was also significantly higher in the OS group than in the COPD-alone group (25.7 vs. 11.7%, P < 0.01). There was no significant difference in the prevalence of arrhythmia among the three groups (20.3, 22.5, and 13.1%, respectively, P > 0.05). In OS patients, risk factors for CHD included hypertension, diabetes, body mass index, lactate dehydrogenase level, and tidal volume; risk factors for heart failure included diabetes, partial pressure of oxygen, partial pressure of carbon dioxide, maximum ventilatory volume, and neutrophilic granulocyte percentage; and risk factors for PAH included minimum nocturnal oxygen saturation, partial pressure of carbon dioxide, and brain natriuretic peptide and lactate dehydrogenase levels. Conclusions: OS patients have a higher prevalence of cardiovascular events, which is associated with hypoxemia, hypercapnia, and impaired lung function in these patients.
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Affiliation(s)
- Manyun Tang
- Arrhythmia Unit, Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yunxiang Long
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shihong Liu
- East Unit, Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Yue
- Department of Cardiology, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States
| | - Tao Shi
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Yi E, Zhang J, Zheng M, Zhang Y, Liang C, Hao B, Hong W, Lin B, Pu J, Lin Z, Huang P, Li B, Zhou Y, Ran P. Long noncoding RNA IL6-AS1 is highly expressed in chronic obstructive pulmonary disease and is associated with interleukin 6 by targeting miR-149-5p and early B-cell factor 1. Clin Transl Med 2021; 11:e479. [PMID: 34323408 PMCID: PMC8288003 DOI: 10.1002/ctm2.479] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/09/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022] Open
Abstract
Chronic obstructive pulmonary disease is a complex condition with multiple etiologies, including inflammation. We identified a novel long noncoding RNA (lncRNA), interleukin 6 antisense RNA 1 (IL6-AS1), which is upregulated in this disease and is associated with airway inflammation. We found that IL6-AS1 promotes the expression of inflammatory factors, especially interleukin (IL) 6. Mechanistically, cytoplasmic IL6-AS1 acts as an endogenous sponge by competitively binding to the microRNA miR-149-5p to stabilize IL-6 mRNA. Nuclear IL6-AS1 promotes IL-6 transcription by recruiting early B-cell factor 1 to the IL-6 promoter, which increases the methylation of the H3K4 histone and acetylation of the H3K27 histone. We propose a model of lncRNA expression in both the nucleus and cytoplasm that exerts similar effects through differing mechanisms, and IL6-AS1 probably increases inflammation via multiple pathways.
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Affiliation(s)
- Erkang Yi
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Jiahuan Zhang
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Mengning Zheng
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Yi Zhang
- GMU‐GIBH Joint School of Life SciencesGuangzhou Medical UniversityGuangzhouGuangdong510000China
| | - Chunxiao Liang
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Binwei Hao
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Wei Hong
- GMU‐GIBH Joint School of Life SciencesGuangzhou Medical UniversityGuangzhouGuangdong510000China
| | - Biting Lin
- GMU‐GIBH Joint School of Life SciencesGuangzhou Medical UniversityGuangzhouGuangdong510000China
| | - Jinding Pu
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Zhiwei Lin
- GMU‐GIBH Joint School of Life SciencesGuangzhou Medical UniversityGuangzhouGuangdong510000China
| | - Peiyu Huang
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Bing Li
- GMU‐GIBH Joint School of Life SciencesGuangzhou Medical UniversityGuangzhouGuangdong510000China
| | - Yumin Zhou
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
| | - Pixin Ran
- National Center for Respiratory MedicineState Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical University151 Yanjiang Xi RoadGuangzhouGuangdong510000China
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Identification of Macrophage Polarization-Related Genes as Biomarkers of Chronic Obstructive Pulmonary Disease Based on Bioinformatics Analyses. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9921012. [PMID: 34250093 PMCID: PMC8238569 DOI: 10.1155/2021/9921012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/04/2021] [Indexed: 12/15/2022]
Abstract
Objectives Chronic obstructive pulmonary disease (COPD) is characterized by lung inflammation and remodeling. Macrophage polarization is associated with inflammation and tissue remodeling, as well as immunity. Therefore, this study attempts to investigate the diagnostic value and regulatory mechanism of macrophage polarization-related genes for COPD by bioinformatics analysis and to provide a new theoretical basis for experimental research. Methods The raw gene expression profile dataset (GSE124180) was collected from the Gene Expression Omnibus (GEO) database. Next, a weighted gene coexpression network analysis (WGCNA) was conducted to screen macrophage polarization-related genes. The differentially expressed genes (DEGs) between the COPD and normal samples were generated using DESeq2 v3.11 and overlapped with the macrophage polarization-related genes. Moreover, functional annotations of overlapped genes were conducted by Database for Annotation, Visualization and Integrated Discovery (DAVID) Bioinformatics Resource. The immune-related genes were selected, and their correlation with the differential immune cells was analyzed by Pearson. Finally, receiver operating characteristic (ROC) curves were used to verify the diagnostic value of genes. Results A total of 4922 coexpressed genes related to macrophage polarization were overlapped with the 203 DEGs between the COPD and normal samples, obtaining 25 genes related to COPD and macrophage polarization. GEM, S100B, and GZMA of them participated in the immune response, which were considered the candidate biomarkers. GEM and S100B were significantly correlated with marker genes of B cells which had a significant difference between the COPD and normal samples. Moreover, GEM was highly associated with the genes in the PI3K/Akt/GSK3β signaling pathway, regulation of actin cytoskeleton, and calcium signaling pathway based on a Pearson correlation analysis of the candidate genes and the genes in the B cell receptor signaling pathway. PPI network analysis also indicated that GEM might participate in the regulation of the PI3K/Akt/GSK3β signaling pathway. The ROC curve showed that GEM possessed an excellent accuracy in distinguishing COPD from normal samples. Conclusions The data provide a transcriptome-based evidence that GEM is related to COPD and macrophage polarization likely contributes to COPD diagnosis. At the same time, it is hoped that in-depth functional mining can provide new ideas for exploring the COPD pathogenesis.
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