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Jörres RA, Buess C, Piecyk A, Thompson B, Stanojevic S, Magnussen H. The total-breath method yields higher values of DLCO and TLC than the conventional method. BMC Pulm Med 2024; 24:127. [PMID: 38475751 PMCID: PMC10936061 DOI: 10.1186/s12890-024-02932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The 2017 ATS/ERS technical standard for measuring the single-breath diffusing capacity (DLCO) proposed the "rapid-gas-analyzer" (RGA) or, equivalently, "total-breath" (TB) method for the determination of total lung capacity (TLC). In this study, we compared DLCO and TLC values estimated using the TB and conventional method, and how estimated TLC using these two methods compared to that determined by body plethysmography. METHOD A total of 95 people with COPD (GOLD grades 1-4) and 23 healthy subjects were studied using the EasyOne Pro (ndd Medical Technologies, Switzerland) and Master Screen Body (Vyaire Medical, Höchberg, Germany). RESULTS On average the TB method resulted in higher values of DLCO (mean ± SD Δ = 0.469 ± 0.267; 95%CI: 0.420; 0.517 mmol*min-1*kPa-1) and TLC (Δ = 0.495 ± 0.371; 95%CI: 0.427; 0.562 L) compared with the conventional method. In healthy subjects the ratio between TB and conventional DLCO was close to one. TLC estimated using both methods was lower than that determined by plethysmography. The difference was smaller for the TB method (Δ = 1.064 ± 0.740; 95%CI: 0.929; 1.199 L) compared with the conventional method (Δ = 1.558 ± 0.940; 95%CI: 1.387; 1.739 L). TLC from body plethysmography could be estimated as a function of TB TLC and FEV1 Z-Score with an accuracy (normalized root mean square difference) of 9.1%. CONCLUSION The total-breath method yielded higher values of DLCO and TLC than the conventional analysis, especially in subjects with COPD. TLC from the total-breath method can also be used to estimate plethysmographic TLC with better accuracy than the conventional method. The study is registered under clinicaltrial.gov NCT04531293.
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Affiliation(s)
- Rudolf A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Ziemssenstraße 5, Munich, 80336, Germany.
| | | | | | - Bruce Thompson
- Melbourne School of Health Science, The University of Melbourne, Victoria, Australia
| | - Sanja Stanojevic
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | - Helgo Magnussen
- Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, Germany
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2
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Ojha M, Smith NJ, Devine AJ, Joshi R, Goodman EM, Fan Q, Schuman R, Porollo A, Wells JM, Tiwary E, Batie MR, Gray J, Deshmukh H, Borchers MT, Ammerman SA, Varisco BM. Anti-CELA1 antibody KF4 prevents emphysema by inhibiting stretch-mediated remodeling. JCI Insight 2024; 9:e169189. [PMID: 38193533 PMCID: PMC10906462 DOI: 10.1172/jci.insight.169189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 11/17/2023] [Indexed: 01/10/2024] Open
Abstract
There are no therapies to prevent emphysema progression. Chymotrypsin-like elastase 1 (CELA1) is a serine protease that binds and cleaves lung elastin in a stretch-dependent manner and is required for emphysema in a murine antisense oligonucleotide model of α-1 antitrypsin (AAT) deficiency. This study tested whether CELA1 is important in strain-mediated lung matrix destruction in non-AAT-deficient emphysema and the efficacy of CELA1 neutralization. Airspace simplification was quantified after administration of tracheal porcine pancreatic elastase (PPE), after 8 months of cigarette smoke (CS) exposure, and in aging. In all 3 models, Cela1-/- mice had less emphysema and preserved lung elastin despite increased lung immune cells. A CELA1-neutralizing antibody was developed (KF4), and it inhibited stretch-inducible lung elastase in ex vivo mouse and human lung and immunoprecipitated CELA1 from human lung. In mice, systemically administered KF4 penetrated lung tissue in a dose-dependent manner and 5 mg/kg weekly prevented emphysema in the PPE model with both pre- and postinjury initiation and in the CS model. KF4 did not increase lung immune cells. CELA1-mediated lung matrix remodeling in response to strain is an important contributor to postnatal airspace simplification, and we believe that KF4 could be developed as a lung matrix-stabilizing therapy in emphysema.
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Affiliation(s)
- Mohit Ojha
- Lincoln Medical Center and Mental Health Center, New York, New York, USA
| | - Noah J. Smith
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Andrew J. Devine
- Heritage College of Osteopathic Medicine, Ohio University, Athens Ohio, USA
| | - Rashika Joshi
- Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Emily M. Goodman
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Qiang Fan
- Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Richard Schuman
- Antibody and Immunoassay Consultants, Rockville, Maryland, USA
| | - Aleksey Porollo
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Center for Autoimmune Genomics and Etiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - J. Michael Wells
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- UAB Lung Health Center, Birmingham, Alabama, USA
| | - Ekta Tiwary
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- UAB Lung Health Center, Birmingham, Alabama, USA
| | | | - Jerilyn Gray
- Perinatal Institute, Center for Perinatal Immunity, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Hitesh Deshmukh
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Perinatal Institute, Center for Perinatal Immunity, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Michael T. Borchers
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Pulmonary and Critical Care Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | | | - Brian M. Varisco
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children’s Research Institute, Little Rock, Arkansas, USA
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3
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Jarenbäck L, Frantz S, Weidner J, Ankerst J, Nihlén U, Bjermer L, Wollmer P, Tufvesson E. Single-nucleotide polymorphisms in the sulfatase-modifying factor 1 gene are associated with lung function and COPD. ERJ Open Res 2022; 8:00668-2021. [PMID: 35586453 PMCID: PMC9108960 DOI: 10.1183/23120541.00668-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/17/2022] [Indexed: 11/05/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in various genes have been shown to associate with COPD, suggesting a role in disease pathogenesis. Sulfatase modifying factor (SUMF1) is a key modifier in connective tissue remodelling, and we have shown previously that several SNPs in SUMF1 are associated with COPD. The aim of this study was to investigate the association between SUMF1 SNPs and advanced lung function characteristics. Never-, former and current smokers with (n=154) or without (n=405) COPD were genotyped for 21 SNPs in SUMF1 and underwent spirometry, body plethysmography, diffusing capacity of the lung for carbon monoxide (D LCO) measurement and impulse oscillometry. Four SNPs (rs793391, rs12634248, rs2819590 and rs304092) showed a significantly decreased odds ratio of having COPD when heterozygous for the variance allele, together with a lower forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) ratio and an impaired peripheral resistance and reactance. Moreover, individuals homozygous for the variance allele of rs3864051 exhibited a strong association to COPD, a lower FEV1/FVC, FEV1 and D LCO, and an impaired peripheral resistance and reactance. Other SNPs (rs4685744, rs2819562, rs2819561 and rs11915920) were instead associated with impaired lung volumes and exhibited a lower FVC, total lung capacity and alveolar volume, in individuals having the variance allele. Several SNPs in the SUMF1 gene are shown to be associated with COPD and impaired lung function. These genetic variants of SUMF1 may cause a deficient sulfation balance in the extracellular matrix of the lung tissue, thereby contributing to the development of COPD.
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Affiliation(s)
- Linnea Jarenbäck
- Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Sophia Frantz
- Dept of Translational Science, Clinical Physiology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Julie Weidner
- Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Jaro Ankerst
- Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Ulf Nihlén
- Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Leif Bjermer
- Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Per Wollmer
- Dept of Translational Science, Clinical Physiology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ellen Tufvesson
- Dept of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
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Levy I, Szarek E, Maria AG, Starrost M, De La Luz Sierra M, Faucz FR, Stratakis CA. A phosphodiesterase 11 (Pde11a) knockout mouse expressed functional but reduced Pde11a: Phenotype and impact on adrenocortical function. Mol Cell Endocrinol 2021; 520:111071. [PMID: 33127481 PMCID: PMC7771190 DOI: 10.1016/j.mce.2020.111071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 01/23/2023]
Abstract
Phosphodiesterases catalyze the hydrolysis of cyclic nucleotides and maintain physiologic levels of intracellular concentrations of cyclic adenosine and guanosine mono-phosphate (cAMP and cGMP, respectively). Increased cAMP signaling has been associated with adrenocortical tumors and Cushing syndrome. Genetic defects in phosphodiesterase 11A (PDE11A) may lead to increased cAMP signaling and have been found to predispose to the development of adrenocortical, prostate, and testicular tumors. A previously reported Pde11a knockout (Pde11a-/-) mouse line was studied and found to express PDE11A mRNA and protein still, albeit at reduced levels; functional studies in various tissues showed increased cAMP levels and reduced PDE11A activity. Since patients with PDE11A defects and Cushing syndrome have PDE11A haploinsufficiency, it was particularly pertinent to study this hypomorphic mouse line. Indeed, Pde11a-/- mice failed to suppress corticosterone secretion in response to low dose dexamethasone, and in addition exhibited adrenal subcapsular hyperplasia with predominant fetal-like features in the inner adrenal cortex, mimicking other mouse models of increased cAMP signaling in the adrenal cortex. We conclude that a previously reported Pde11a-/- mouse showed continuing expression and function of PDE11A in most tissues. Nevertheless, Pde11a partial inactivation in mice led to an adrenocortical phenotype that was consistent with what we see in patients with PDE11A haploinsufficiency.
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Affiliation(s)
- Isaac Levy
- Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA; Endocrine and Diabetes Unit. Edmond and Lily Safra Children's Hospital, Tel-Hashomer. Ramat Gan. Sackler School of Medicine, Ramat-aviv, Israel
| | - Eva Szarek
- Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Andrea Gutierrez Maria
- Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Matthew Starrost
- Division of Veterinary Resources, National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Maria De La Luz Sierra
- Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA
| | - Fabio R Faucz
- Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA.
| | - Constantine A Stratakis
- Section on Endocrinology & Genetics (SEGEN), Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 20892, USA.
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5
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Talaminos-Barroso A, Roa-Romero LM, Ortega-Ruiz F, Cejudo-Ramos P, Márquez-Martín E, Reina-Tosina J. Effects of genetics and altitude on lung function. Clin Respir J 2020; 15:247-256. [PMID: 33112470 DOI: 10.1111/crj.13300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/11/2020] [Accepted: 10/23/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this work is to present a review on the impact of genetics and altitude on lung function from classic and recent studies. DATA SOURCE A systematic search has been carried out in different databases of scientific studies, using keywords related to lung volumes, spirometry, altitude and genetics. RESULTS The results of this work have been structured into three parts. First, the relationship between genes and lung function. Next, a review of the genetic predispositions related to respiratory adaptation of people who inhabit high-altitude regions for millennia. Finally, temporary effects and long-term acclimatisation on respiratory physiology at high altitude are presented. CONCLUSIONS The works focused on the influence of genetics and altitude on lung function are currently of interest in terms of studying the interactions between genetic, epigenetic and environmental factors in the configuration of the pathophysiological adaptation patterns.
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Affiliation(s)
| | | | - Francisco Ortega-Ruiz
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocio, Seville, Spain.,Spanish Networking Center on Biomedical Research, Area of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Pilar Cejudo-Ramos
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocio, Seville, Spain.,Spanish Networking Center on Biomedical Research, Area of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Eduardo Márquez-Martín
- Medical-Surgical Unit of Respiratory Diseases, University Hospital Virgen del Rocio, Seville, Spain
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6
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Alter P, Baker JR, Dauletbaev N, Donnelly LE, Pistenmaa C, Schmeck B, Washko G, Vogelmeier CF. Update in Chronic Obstructive Pulmonary Disease 2019. Am J Respir Crit Care Med 2020; 202:348-355. [PMID: 32407642 PMCID: PMC8054880 DOI: 10.1164/rccm.202002-0370up] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Peter Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL)
| | - Jonathan R. Baker
- Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Nurlan Dauletbaev
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL),Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada,Faculty of Medicine and Healthcare, al-Farabi Kazakh National University, Almaty, Kazakhstan; and
| | - Louise E. Donnelly
- Airway Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Carrie Pistenmaa
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Bernd Schmeck
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL),Institute for Lung Research, Member of the DZL and of the German Center of Infection Research (DZIF), and,Center for Synthetic Microbiology (SYNMIKRO), Philipps University of Marburg, Marburg, Germany
| | - George Washko
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Claus F. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL)
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7
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Niu H, Niu W, Yu T, Dong F, Huang K, Duan R, Qumu S, Lu M, Li Y, Yang T, Wang C. Association of RAGE gene multiple variants with the risk for COPD and asthma in northern Han Chinese. Aging (Albany NY) 2020; 11:3220-3237. [PMID: 31141790 PMCID: PMC6555453 DOI: 10.18632/aging.101975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/12/2019] [Indexed: 12/17/2022]
Abstract
Clinical and experimental data have shown that the receptor for advanced glycation end products (RAGE) is implicated in the pathogenesis of respiratory disorders. In this study, we genotyped five widely-evaluated variants in RAGE gene, aiming to assess their association with the risk for chronic obstructive pulmonary disease (COPD) and asthma in northern Han Chinese. Genotypes were determined in 105 COPD patients, 242 asthma patients and 527 controls. In single-locus analysis, there was significant difference in the genotype distributions of rs1800624 between COPD patients and controls (p=0.022), and the genotype and allele distributions of rs1800625 differed significantly (p=0.040 and 0.016) between asthma patients and controls. Haplotype analysis revealed that haplotype T-A-G-T (allele order: rs1800625, rs1800624, rs2070600, rs184003) was significantly associated with a reduced COPD risk (OR=0.32, 95% CI: 0.06-0.60), and haplotype T-A-A-G was significantly associated with a reduced asthma risk (OR=0.19, 95% CI: 0.04-0.96). Further haplotype-phenotype analysis showed that high- and low-density lipoprotein cholesterol and blood urea nitrogen were significant mediators for COPD (psim=0.041, 0.043 and 0.030, respectively), and total cholesterol was a significant mediator for asthma (psim=0.009). Taken together, our findings indicate that RAGE gene is a promising candidate for COPD and asthma, and importantly both disorders are genetically heterogeneous.
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Affiliation(s)
- Hongtao Niu
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Tao Yu
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Feng Dong
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Ke Huang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Ruirui Duan
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Shiwei Qumu
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Minya Lu
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
| | - Yong Li
- National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China.,Clinical Diagnosis Department of Respiratory Diseases Center, China-Japan Friendship Hospital, Beijing 100029, China
| | - Ting Yang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China.,Clinical Diagnosis Department of Respiratory Diseases Center, China-Japan Friendship Hospital, Beijing 100029, China
| | - Chen Wang
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.,National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing 100029, China
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