Featuring Characteristics of Chronic Obstructive Pulmonary Disease, Procalcitonin and Lower Tract Infections and Inert Gas Studies

Abstract

The last issue of BRN Reviews for the current year sets out two first-class observational studies devoted to the complexities of the natural history of chronic obstructive pulmonary disease (COPD). The first refers to SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS), a multicentre, cohort study of nearly 3000 never-smokers and ever-smokers with and without COPD. This outstanding work is reviewed by Wassim W Labaki, from University of Michigan (Ann Ar­ bor, MI) together with two distinguished members of the Global Initiative for Obstructive Lung Disease (GOLD) Science Committee, FJ Mar­ tinez, from Weill Cornell Medical College (New York, NY), and MeiLan K Han, from the same university as the first author, who leads the publication, a talented worldwide COPD researcher. This huge observational study focuses on the natural history of COPD, funded by the United States (US) National Institutes of Health (NIH), and represents a milestone in the effort to further phenotype the challenging complexity and heterogeneity of COPD. Indeed, SPIROMICS has gener ated significant knowledge on the clinical phe notypes of COPD through the identification of distinct subgroups and the investigation of various chest and imaging biomarkers. Through the description of the major findings achieved by SPIROMICS, the reader is invited to pay special attention to table 2 that includes a very thorough summary of the strengths and shortcomings of the study. I will give just one example, that one of on exposures. It is observed that second-hand smoke exposure and ever-use of e-cigarettes are associated with a higher burden of respiratory symptoms in subjects with COPD; however, a lot of work on long-term effects of e-cigarette use on respiratory health, lung function and clinical effects in individuals with COPD remains to be investigated.