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Wendt CH, Bowler RP, Demorest C, Hastie A, Labaki WW, Chen M, Carmella SG, Hecht SS. Levels of Urinary Mercapturic Acids of Acrolein, Methacrolein, Crotonaldehyde, and Methyl Vinyl Ketone in Relationship to Chronic Obstructive Pulmonary Disease in Cigarette Smokers of the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS). Chem Res Toxicol 2023. [PMID: 37725788 DOI: 10.1021/acs.chemrestox.3c00197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Cigarette smoking is an established cause of chronic obstructive pulmonary disease (COPD). Numerous studies implicate acrolein, which occurs in relatively high concentrations in cigarette smoke and reacts readily with proteins, as one causative factor for COPD in smokers. Far less is known about the possible roles in COPD of the related α,β-unsaturated carbonyl compounds of cigarette smoke crotonaldehyde, methacrolein, and methyl vinyl ketone. In the study reported here, we analyzed mercapturic acids of these α,β-unsaturated compounds in the urine of 413 confirmed cigarette smokers in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS)─202 with COPD and 211 without COPD. The mercapturic acids analyzed were 3-hydroxypropyl mercapturic acid (3-HPMA) from acrolein, 3-hydroxy-1-methylpropyl mercapturic acid (HMPMA-1) from crotonaldehyde, 3-hydroxy-2-methylpropyl mercapturic acid (HMPMA-2) from methacrolein, and 3-hydroxy-3-methylpropyl mercapturic acid (HMPMA-3) from methyl vinyl ketone. In models adjusting for age, sex, race, pack years of tobacco use, and BMI, all four mercapturic acids were increased in individuals with COPD but not significantly. Stratified by the GOLD status, there were increased levels of the metabolites associated with GOLD 3-4 compared to that with GOLD 0, with the methacrolein metabolite HMPMA-2 reaching statistical significance (adjusted odds ratio 1.23 [95% CI: 1.00-1.53]). These results highlight the possible role of methacrolein, which has previously received little attention in this regard, as a causative factor in COPD in cigarette smokers.
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Affiliation(s)
- Chris H Wendt
- University of Minnesota, Minneapolis, Minnesota 55455, United States
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota 55417, United States
| | | | - Connor Demorest
- University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Annette Hastie
- Wake Forest University School of Medicine, Winston Salem, North Carolina 27101-4135, United States
| | - Wassim W Labaki
- University of Michigan, Ann Arbor, Michigan 48109-1382, United States
| | - Menglan Chen
- University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Steven G Carmella
- University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Stephen S Hecht
- University of Minnesota, Minneapolis, Minnesota 55455, United States
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Guo Y, Bai J, Zhang X, Jin Q, Liu Y, Yu C. Secular Trends of Mortality and Years of Life Lost Due to Chronic Obstructive Pulmonary Disease in Wuhan, China from 2010 to 2019: Age-Period-Cohort Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10685. [PMID: 36078400 PMCID: PMC9518558 DOI: 10.3390/ijerph191710685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) has been an important public health issue in China. This study aimed to analyze the temporal trends in mortality and years of life lost (YLL) from COPD, and explore the effects of age, period, and cohort in Wuhan, China from 2010 to 2019. METHODS Data were collected from the cause of death surveillance system in Wuhan. Age-standardized mortality rate (ASMR), age-standardized YLL rate (ASYR) and the estimated annual percent changes (EAPC) were calculated to evaluate the temporal trends. The age-period-cohort (APC) model was adopted to estimate the age, period, and cohort effects. RESULTS From 2010 to 2019, COPD accounted for 26,051.15 deaths and 394,659.58 person years YLL in Wuhan. Recently, the death burden of COPD in Wuhan has somewhat improved, especially after 2015, with declining trends in ASMR and ASYR. Additionally, the ASMR and ASYR of COPD was higher in males. And these of males showed the overall upward trends, with EAPCs of 1.06 (0.13, 2.00) and 1.21 (0.12, 2.31), respectively, while females showed downward trends since 2010. According to APC model, the age effect of COPD increased with age, and the cohort risk ratios (RRs) followed the overall downward trends. Period RRs for the Wuhan population generally tended to rise and then fall, with females showing a clear downward trend after 2015, while period RRs for males maintained an upward trend throughout the study period. CONCLUSIONS Recently, the death burden from COPD in Wuhan has improved, especially after 2015, with improvements in ASMR, ASYR and period RRs. Sex differences still exist. COPD posed a greater threat to the elderly, especially males. Public health managers should continue to execute more targeted programs to lessen the death burden of COPD in Wuhan.
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Affiliation(s)
- Yan Guo
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Jianjun Bai
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xiaoxia Zhang
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Qiman Jin
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Yijun Liu
- Wuhan Center for Disease Control and Prevention, Wuhan 430022, China
| | - Chuanhua Yu
- School of Public Health, Wuhan University, Wuhan 430071, China
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Choudhary I, Vo T, Paudel K, Wen X, Gupta R, Kesimer M, Patial S, Saini Y. Vesicular and extravesicular protein analyses from the airspaces of ozone-exposed mice revealed signatures associated with mucoinflammatory lung disease. Sci Rep 2021; 11:23203. [PMID: 34853335 PMCID: PMC8636509 DOI: 10.1038/s41598-021-02256-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 11/08/2021] [Indexed: 12/16/2022] Open
Abstract
Lung epithelial lining fluid (ELF) harbors a variety of proteins that influence homeostatic and stress responses in the airspaces. Exosomes, nano-sized extracellular vesicles, contain many proteins that vary in abundance and composition based on the prevailing conditions. Ozone causes inflammatory responses in the airspaces of experimental animals and humans. However, the exosomal protein signatures contained within the ELF from ozone-exposed lung airspaces remain poorly characterized. To explore this, we hypothesized that ozone triggers the release of exosome-bound inflammatory proteins from various cells that reflect mucoobstructive lung disease. Accordingly, we repetitively exposed adult male and female C57BL/6 mice to HEPA-filtered air (air) or 0.8 ppm ozone (4 h per day) for 14 days (five consecutive days of exposure, 2 days of rest, five consecutive days of exposure, 2 days of rest, four consecutive days of exposure). Exosome-bound proteomic signatures, as well as the levels of soluble inflammatory mediators in the bronchoalveolar lavage fluid (BALF), were determined 12-16 h after the last exposure. Principal component analyses of the exosome-bound proteome revealed a clear distinction between air-exposed and ozone-exposed mice, as well as between ozone-exposed males and ozone-exposed females. In addition to 575 proteins that were enriched in both sexes upon ozone exposure, 243 and 326 proteins were enriched uniquely in ozone-exposed males and females, respectively. Ingenuity pathway analyses on enriched proteins between ozone- and air-exposed mice revealed enrichment of pro-inflammatory pathways. More specifically, macrophage activation-related proteins were enriched in exosomes from ozone-exposed mice. Cytokine analyses on the BALF revealed elevated levels of G-CSF, KC, IP-10, IL-6, and IL-5 in ozone-exposed mice. Finally, the histopathological assessment revealed significantly enhanced intracellular localization of mucoinflammatory proteins including MUC5B and FIZZ1 in ozone-exposed mice in a cell-specific manner indicating the cellular sources of the proteins that are ferried in the exosomes upon ozone-induced lung injury. Collectively, this study identified exosomal, secretory, and cell-specific proteins and biological pathways following repetitive exposure of mice to ozone.
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Affiliation(s)
- Ishita Choudhary
- grid.64337.350000 0001 0662 7451Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, 1909 Skip Bertman Drive, Baton Rouge, LA 70803 USA
| | - Thao Vo
- grid.64337.350000 0001 0662 7451Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, 1909 Skip Bertman Drive, Baton Rouge, LA 70803 USA
| | - Kshitiz Paudel
- grid.64337.350000 0001 0662 7451Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, 1909 Skip Bertman Drive, Baton Rouge, LA 70803 USA
| | - Xue Wen
- grid.64337.350000 0001 0662 7451Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803 USA
| | - Richa Gupta
- grid.10698.360000000122483208Department of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, NC 27510 USA
| | - Mehmet Kesimer
- grid.10698.360000000122483208Department of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, NC 27510 USA
| | - Sonika Patial
- grid.64337.350000 0001 0662 7451Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, 1909 Skip Bertman Drive, Baton Rouge, LA 70803 USA
| | - Yogesh Saini
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, 1909 Skip Bertman Drive, Baton Rouge, LA, 70803, USA.
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Lefebvre P, Staels B. Hepatic sexual dimorphism - implications for non-alcoholic fatty liver disease. Nat Rev Endocrinol 2021; 17:662-670. [PMID: 34417588 DOI: 10.1038/s41574-021-00538-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 12/14/2022]
Abstract
The liver is often thought of as a single functional unit, but both its structural and functional architecture make it highly multivalent and adaptable. In any given physiological situation, the liver can maintain metabolic homeostasis, conduct appropriate inflammatory responses, carry out endobiotic and xenobiotic transformation and synthesis reactions, as well as store and release multiple bioactive molecules. Moreover, the liver is a very resilient organ. This resilience means that chronic liver diseases can go unnoticed for decades, yet culminate in life-threatening clinical complications once the adaptive capacity of the liver is overwhelmed. Non-alcoholic fatty liver disease (NAFLD) predisposes individuals to cirrhosis and increases liver-related and cardiovascular disease-related mortality. This Review discusses the accumulating evidence of sexual dimorphism in NAFLD, which is currently rarely considered in preclinical and clinical studies. Increased awareness of the mechanistic causes of hepatic sexual dimorphism could lead to improved understanding of the biological processes that are dysregulated in NAFLD, to the identification of relevant therapeutic targets and to improved risk stratification of patients with NAFLD undergoing therapeutic intervention.
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Affiliation(s)
- Philippe Lefebvre
- Université Lille, INSERM, CHU Lille, Institut Pasteur de Lille, Lille, France.
| | - Bart Staels
- Université Lille, INSERM, CHU Lille, Institut Pasteur de Lille, Lille, France
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Michalovic E, Jensen D, Dandurand RJ, Saad N, Ezer N, Moullec G, Smith BM, Bourbeau J, Sweet SN. Description of Participation in Daily and Social Activities for Individuals with COPD. COPD 2020; 17:543-556. [PMID: 32811208 DOI: 10.1080/15412555.2020.1798373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study described the participation in daily and social activities and the perceived barriers and facilitators to participation of individuals with chronic obstructive pulmonary disease (COPD). Individuals, recruited from outpatient clinics, responded to a survey on their participation in, and barriers and facilitators towards, 26 daily and social activities, divided into 3 categories: (1) physical activity and movement (PAM); (2) self-care; and (3) social engagement. For each activity, chi-square analyses were used to examine participation differences by individuals': quartiles of airflow obstruction [percent predicted forced expiratory volume in 1 second (FEV1%predicted)] and breathlessness burden and exacerbation risk. Of the 200 participants (47% women; mean ± standard deviation age = 68 ± 9 years), most wanted to increase their participation in PAM activities (range 21-75%) and significant differences were found in 5/10 PAM activities for individuals' breathlessness burden and exacerbation risk (e.g., more individuals than expected in group A (modified Medical Research Council breathlessness score <2 and 0-1 exacerbations in past 12 months) participated in regular exercise as much as they wanted (χ(9)2=20.43, Cramer's V=.23)). Regardless of the degree of airflow obstruction or breathlessness burden and exacerbation risk, the most common barrier to participation was breathlessness (p<.001, η2p=.86) and the most common facilitator was engaging as part of their routine (p<.001, η2p=.75). Individuals with COPD want to increase their participation in daily and social activities but are limited by breathlessness. Strategies to alleviate breathlessness should be identified/prioritized and incorporated into individuals' daily routines to meet their self-reported participation objectives in daily and social activities.
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Affiliation(s)
- Emilie Michalovic
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, Faculty of Education, McGill University, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
| | - Dennis Jensen
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, Faculty of Education, McGill University, Montreal, Quebec, Canada
| | - Ronald J Dandurand
- CIUSSS de l'Ouest-de-l'île-de-Montréal, Montreal, Quebec, Canada.,Department of Medicine, Respiratory Division, McGill University, Montreal, Quebec, Canada
| | - Nathalie Saad
- Department of Medicine, Respiratory Division, McGill University, Montreal, Quebec, Canada
| | - Nicole Ezer
- Department of Medicine, Respiratory Division, McGill University, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute McGill University, Health Centre, McGill University, Montreal, Quebec, Canada
| | - Gregory Moullec
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.,Research Center of the Centre Intégré Universitaire de Santé Et De Services Sociaux du Nord-de-l'Île de Montréal, Montreal, Quebec, Canada
| | - Benjamin M Smith
- Department of Medicine, Respiratory Division, McGill University, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute McGill University, Health Centre, McGill University, Montreal, Quebec, Canada.,Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Jean Bourbeau
- Department of Medicine, Respiratory Division, McGill University, Montreal, Quebec, Canada.,Respiratory Epidemiology and Clinical Research Unit, Research Institute McGill University, Health Centre, McGill University, Montreal, Quebec, Canada
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, Faculty of Education, McGill University, Montreal, Quebec, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada
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Kim J, Lee CH, Lee MG, Shin KC, Yoo KH, Lim SY, Na JO, Yoo CG, Jung KS, Lee SD. Acute Exacerbation According to GOLD 2017 Categories in Patients with Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2019; 55:414-420. [PMID: 30922610 DOI: 10.1016/j.arbres.2019.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 01/20/2019] [Accepted: 02/10/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION The association between GOLD categorizations and future exacerbations has not been fully investigated. This study elucidates whether the GOLD 2017 classification is associated with different future exacerbation risk in patients with chronic obstructive pulmonary disease (COPD) compared with the previous GOLD categorization. Another objective was to investigate the impacts of the symptoms and FEV1 on the predicted future exacerbation independently of previous exacerbation history. METHODS We analyzed patients from three prospective COPD cohorts (SNUH, KOCOSS, and KOLD) and evaluated the risk of moderate to severe exacerbation among different models, including GOLD grade (FEV1), GOLD 2011, and GOLD 2017. RESULTS In total, 611 COPD patients were included (36 from SNUH, 257 from KOCOSS, and 318 from KOLD). GOLD 2017 classification, excluding FEV1% for categorization criteria, showed no differences in future exacerbation risk compared with GOLD grade and GOLD 2011 based on c-statistics. Among those with no frequent exacerbation history and FEV1 ≥50%, the group with more symptoms was significantly associated with future exacerbations than the group with less symptoms. A lower FEV1 (FEV1 <50%) was not associated with a higher future exacerbation risk than a higher FEV1 (FEV1 ≥50%), regardless of prior exacerbation history and symptom group. CONCLUSION The GOLD 2017 classification was not different from GOLD grade and GOLD 2011 regarding the association with future exacerbation risk, and there were no significant differences in exacerbation risk according to FEV1%. This suggests that FEV1 might not be an important factor in future exacerbation risk. These results partly support the GOLD 2017 assessment tool.
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Affiliation(s)
- Joohae Kim
- Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Myung-Goo Lee
- Division of Pulmonary, Allergy & Critical Care Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Kyeong-Cheol Shin
- Division of Pulmonology and Allergy, Regional Center for Respiratory Disease, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Kwang Ha Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ju Ock Na
- Department of Pulmonary Medicine, Soonchunhyang University Cheonan Hospital, Cheonan-si, Republic of Korea
| | - Chul-Gyu Yoo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Suck Jung
- Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University Medical School, Anyang, Republic of Korea
| | - Sang-Do Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Sánchez-Muñoz G, Lopez-de-Andrés A, Hernández-Barrera V, Jiménez-García R, Pedraza-Serrano F, Puente-Maestu L, de Miguel-Díez J. Bronchiectasis in patients hospitalized with acute exacerbation of COPD in Spain: Influence on mortality, hospital stay, and hospital costs (2006-2014) according to gender. PLoS One 2019; 14:e0211222. [PMID: 30682190 PMCID: PMC6347366 DOI: 10.1371/journal.pone.0211222] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 01/09/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The objectives of this study were to analyze the characteristics of male and female patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) during 2006-2014 according to the presence or absence of bronchiectasis and to study the factors associated with in-hospital mortality (IHM) in patients hospitalized with AE-COPD and concomitant bronchiectasis. METHODS We used the Spanish National Hospital Database to analyze patients admitted with AE-COPD as their primary diagnosis. Patients included in the study were stratified according to the presence or absence of bronchiectasis as their secondary diagnosis. RESULTS We identified 386,646 admissions for AE-COPD, of which 19,679 (5.09%) involved patients with concomitant bronchiectasis. When patients with and without bronchiectasis were compared, we observed that the incidence of infection by Pseudomonas aeruginosa was substantially higher in the former, as were the mean stay, cost, and percentage of readmissions, although IHM and comorbidity were lower. The course of patients with AE-COPD and bronchiectasis was characterized by a gradual increase in prevalence and mean age among men and no differences in prevalence or lower mean age in women. Mortality was 4.24% and 5.02% in patients with and without bronchiectasis, respectively, although significance was lost after a multivariate adjustment (OR 0.94; 95% CI, 0.88-1.01). The factors associated with IHM were older age, higher comorbidity, isolation of P. aeruginosa, mechanical ventilation and readmission. CONCLUSIONS The prevalence of admission with AE-COPD and bronchiectasis increased in men but not in women during the study period. In patients hospitalized with AE-COPD, we did not find differences in mortality when comparing the presence and absence of bronchiectasis. The analysis of temporal trends revealed a significant reduction in mortality from 2006 to 2014 in male patients with COPD and concomitant bronchiectasis, but not among women. It is important to consider the factors associated with IHM such as age, comorbidity, isolation of P. aeruginosa, mechanical ventilation and readmission to better identify those patients who are at greater risk of dying during hospitalization.
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Affiliation(s)
- Gema Sánchez-Muñoz
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Ana Lopez-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit. Health Sciences Faculty. Rey Juan Carlos University, Alcorcón, Madrid, Spain
- * E-mail:
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit. Health Sciences Faculty. Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit. Health Sciences Faculty. Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Fernando Pedraza-Serrano
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Luis Puente-Maestu
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Javier de Miguel-Díez
- Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
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Nelson AJ, Roy SK, Warren K, Janike K, Thiele GM, Mikuls TR, Romberger DJ, Wang D, Swanson B, Poole JA. Sex differences impact the lung-bone inflammatory response to repetitive inhalant lipopolysaccharide exposures in mice. J Immunotoxicol 2018; 15:73-81. [PMID: 29648480 DOI: 10.1080/1547691x.2018.1460425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Skeletal health consequences associated with inflammatory diseases of the airways significantly contribute to morbidity. Sex differences have been described independently for lung and bone diseases. Repetitive inhalant exposure to lipopolysaccharide (LPS) induces bone loss and deterioration in male mice, but comparison effects in females are unknown. Using an intranasal inhalation exposure model, 8-week-old C57BL/6 male and female mice were treated daily with LPS (100 ng) or saline for 3 weeks. Bronchoalveolar lavage fluids, lung tissues, tibias, bone marrow cells, and blood were collected. LPS-induced airway neutrophil influx, interleukin (IL)-6 and neutrophil chemoattractant levels, and bronchiolar inflammation were exaggerated in male animals as compared to female mice. Trabecular bone micro-CT imaging and analysis of the proximal tibia were conducted. Inhalant LPS exposures lead to deterioration of bone quality only in male mice (not females) marked by decreased bone mineral density, bone volume/tissue volume ratio, trabecular thickness and number, and increased bone surface-to-bone volume ratio. Serum pentraxin-2 levels were modulated by sex differences and LPS exposure. In proof-of-concept studies, ovarectomized female mice demonstrated LPS-induced bone deterioration, and estradiol supplementation of ovarectomized female mice and control male mice protected against LPS-induced bone deterioration findings. Collectively, sex-specific differences exist in LPS-induced airway inflammatory consequences with significant differences found in bone quantity and quality parameters. Male mice demonstrated susceptibility to bone loss and female animals were protected, which was modulated by estrogen. Therefore, sex differences influence the biologic response in the lung-bone inflammatory axis in response to inhalant LPS exposures.
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Affiliation(s)
- Amy J Nelson
- a Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA
| | - Shyamal K Roy
- b Obstetrics and Gynecology Department , University of Nebraska Medical Center , Omaha , NE , USA
| | - Kristi Warren
- a Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA
| | - Katherine Janike
- a Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA.,c Rheumatology Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA
| | - Geoffrey M Thiele
- c Rheumatology Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA.,d Veterans Affairs Nebraska-Western Iowa Health Care System , Omaha , NE , USA
| | - Ted R Mikuls
- c Rheumatology Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA.,d Veterans Affairs Nebraska-Western Iowa Health Care System , Omaha , NE , USA
| | - Debra J Romberger
- a Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA.,d Veterans Affairs Nebraska-Western Iowa Health Care System , Omaha , NE , USA
| | - Dong Wang
- e Department of Pharmaceutical Sciences , University of Nebraska Medical Center , Omaha , NE , USA
| | - Benjamin Swanson
- f Department of Pathology and Microbiology , University of Nebraska Medical Center , Omaha , NE , USA
| | - Jill A Poole
- a Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine , University of Nebraska Medical Center , Omaha , NE , USA
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Nicolini A, Barbagelata E, Tagliabue E, Colombo D, Monacelli F, Braido F. Gender differences in chronic obstructive pulmonary diseases: a narrative review. Panminerva Med 2018; 60:192-199. [DOI: 10.23736/s0031-0808.18.03463-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Jia G, Lu M, Wu R, Chen Y, Yao W. Gender difference on the knowledge, attitude, and practice of COPD diagnosis and treatment: a national, multicenter, cross-sectional survey in China. Int J Chron Obstruct Pulmon Dis 2018; 13:3269-3280. [PMID: 30349232 PMCID: PMC6188108 DOI: 10.2147/copd.s176173] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the gender difference in knowledge, attitude, and practice of COPD diagnosis and treatment in China. PATIENTS AND METHODS A nationwide, multicenter, cross-sectional questionnaire study was carried out to investigate patients' understanding and experience of COPD between September 2007 and December 2008. RESULTS Two thousand and seventy-two patients were recruited from eleven centers. The final effective questionnaires were those of 1,698 cases, of which 32% were female. Women were younger, had higher body mass index, were more never smokers, and had lesser pack-years (all P<0.01). More women had under elementary education level and monthly income <1,000 RMB (about 160 USD) (all P<0.01). Women had higher ratio of FEV1/FVC (54.1±10.9 vs 50.2±11.5), FEV1% (50.0±19.1 vs 45.4±29.0), and lower short form-36 mental component summary (57.5±26.8 vs 61.3±25.0) (all P<0.01). Fewer women reported severe exacerbation (defined as an acute worsening of respiratory symptoms that results in patient's hospitalization) in the previous year (44.5% vs 51.6%, P<0.05). More women reported that they never heard of COPD before (67.0% vs 59.0%, P<0.01). Less women reported that physician had to tell them they had emphysema (50.5% vs 60.4%) or COPD (31.9% vs 37.9%). Less women had pulmonary function test (PFT) done before (65.2% vs 70.4%, P<0.05). More women reported that they would not repeat PFT annually (91.7% vs 87.6%, P<0.05) and did not know the PFT results (78.6% vs 73.1%, P<0.05). More women reported not having had pulmonary rehabilitation before (87.8% vs 83.6%, P<0.05). Fewer women reported knowing that COPD should be given combined therapy (38.3% vs 44.5%) and long-term treatment (46.1% vs 51.9%) (all P<0.05). CONCLUSION Male and female patients had different experiences on COPD diagnosis and treatment. Physicians should pay more attention to patients' education on COPD, especially of women.
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Affiliation(s)
- Guohua Jia
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China, ;
| | - Ming Lu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China, ;
| | - Rui Wu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China, ;
| | - Yahong Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China, ;
| | - Wanzhen Yao
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China, ;
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Dominelli PB, Ripoll JG, Cross TJ, Baker SE, Wiggins CC, Welch BT, Joyner MJ. Sex differences in large conducting airway anatomy. J Appl Physiol (1985) 2018; 125:960-965. [PMID: 30024341 DOI: 10.1152/japplphysiol.00440.2018] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Airway luminal area is the major determinant of resistance to airflow in the tracheobronchial tree. Women may have smaller central conducting airways than men; however, previous evidence is confounded by an indirect assessment of airway geometry and by subjects with prior smoking history. The purpose of this study was to examine the effect of sex on airway size in healthy nonsmokers. Using low-dose high-resolution computed tomography, we retrospectively assessed airway luminal area in healthy men ( n = 51) and women ( n = 73) of varying ages (19-86 yr). Subjects with a positive smoking history, cardiopulmonary disease, or a body mass index > 40 kg/m2 were excluded. Luminal areas of the trachea, right and left main bronchus, bronchus intermediate, left and right upper lobes, and the left lower lobe were analyzed at three discrete points. The luminal areas of the conducting airways were ~26%-35% smaller in women. The trachea had the largest differences in luminal area between men and women (298 ± 47 vs. 195 ± 28 mm2 or 35% smaller for men and women, respectively), whereas the left lower lobe had the smallest differences (57 ± 15 vs. 42 ± 9 mm2 or 26% smaller for men and women, respectively). When a subset of subjects was matched for height, the sex differences in airway luminal area persisted, with women being ~20%-30% smaller. With all subjects, there were modest relationships between height and airway luminal area ( r = 0.73-0.53, P < 0.05). Although there was considerable overlap between sexes, the luminal areas of the large conducting airways were smaller in healthy women than in men. NEW & NOTEWORTHY Previous evidence for sex differences in airway size has been confounded by indirect measures and/or cohorts with significant smoking histories or pathologies. We found that central airways in healthy women were significantly smaller (~26%-35%) than men. The significant sex-difference in airway size was attenuated (20%-30% smaller) but preserved in a subset of subjects matched for height. Over a range of ages, healthy women have smaller central airways than men.
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Affiliation(s)
| | - Juan G Ripoll
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Troy J Cross
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Sarah E Baker
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Chad C Wiggins
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
| | - Brian T Welch
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Tsiligianni I, Mezzi K, Fucile S, Kostikas K, Shen S, Banerji D, Fogel R. Response to Indacaterol/Glycopyrronium (IND/GLY) by Sex in Patients with COPD: A Pooled Analysis from the IGNITE Program. COPD 2017; 14:375-381. [DOI: 10.1080/15412555.2017.1324837] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ioanna Tsiligianni
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Crete, Greece
| | | | | | | | - Steven Shen
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Donald Banerji
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Robert Fogel
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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13
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Köktürk N, Gürgün A, Şen E, Kocabaş A, Polatlı M, Naycı SA, Çöplü L, Tellioğlu E, Elmas F, Erdinç E. The View of the Turkish Thoracic Society on the Report of the GOLD 2017 Global Strategy for the Diagnosis, Management, and Prevention of COPD. Turk Thorac J 2017; 18:57-64. [PMID: 29404162 DOI: 10.5152/turkthoracj.2017.060417] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 03/25/2017] [Indexed: 01/07/2023]
Abstract
Since the Global Initiative for Obstructive Lung Disease (GOLD) published its first guidelines on chronic obstructive pulmonary disease (COPD) in 2001, much has changed till 2017. Previous versions of GOLD guidelines mentioned the forced expiratory volume in one second (FEV1)-based approach for staging and treatment modalities. Since 2011, a composite multi-dimensional approach has been introduced to cover various aspects of the disease. Unfortunately, this approach was not found to be correlated with mortality as well as the FEV1-based approach, despite the fact that it was better for estimating exacerbation rates. Although this assessment tool has been considered as a big step in personalized medicine, the system was rather complex to use in daily practice. In 2017, GOLD introduced a major revision in many aspects of the disease. This mainly includes a revised assessment tool and treatment algorithm. This new ABCD algorithm has excluded spirometry for guiding pharmacological therapy. Treatment recommendations are mainly based on symptoms and exacerbation rates. Escalation and de-escalation strategies have been proposed for the first time. The spirometric measurement has only been retained to confirm the diagnosis and lead to nonpharmacological therapies. In this report, the Turkish Thoracic Society COPD assembly aimed to summarize and give an insight to the Turkish interpretation of GOLD 2017.
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Affiliation(s)
- Nurdan Köktürk
- Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Alev Gürgün
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Elif Şen
- Department of Pulmonary Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ali Kocabaş
- Department of Pulmonary Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Mehmet Polatlı
- Department of Pulmonary Medicine, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Sibel Atış Naycı
- Department of Pulmonary Medicine, Mersin University School of Medicine, Mersin, Turkey
| | - Lütfi Çöplü
- Department of Pulmonary Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Emel Tellioğlu
- Department of Pulmonary Medicine, Health Sciences University, İzmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Funda Elmas
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
| | - Ertürk Erdinç
- Department of Pulmonary Medicine, Ege University School of Medicine, İzmir, Turkey
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