COPD: Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Barriers and Facilitators to Treatment Plan Adoption and Self-Management in People with Chronic Obstructive Pulmonary Disease (COPD): A Systematic Search and Narrative Synthesis.","authors":"Sereena Raju, Judith Dyson, Hannah Harvey, Anwesa Chatterjee, Janelle Kolas, Fiona Cowdell, Dominic L Sykes, Michael G Crooks","doi":"10.1080/15412555.2026.2656201","DOIUrl":"10.1080/15412555.2026.2656201","url":null,"abstract":"<p><strong>Objective: </strong>To review the literature relating to patient barriers and facilitators to self-management in chronic obstructive pulmonary disease.</p><p><strong>Methods: </strong>This review involved a systematic search and narrative synthesis. MEDLINE, CINAHL complete, PsycINFO and the Cochrane database of systematic reviews were systematically searched in March 2025. Search terms related to chronic obstructive pulmonary disease, self-management and potential barriers and facilitators to patient engagement or self-care. We reported according to PRISMA and analysis involved narrative synthesis.</p><p><strong>Findings: </strong>Sixty-three papers were included. Barriers and facilitators to self-management were grouped across the following themes: i) healthcare systems (including time in appointments, treatment use and financial gateways), ii) emotions (incorporating stigma or emotional distress, positive outlook and acceptance of diagnosis or treatment), iii) communication with healthcare professionals (comprising understanding and perceived sufficiency of information, smoking habits, health behaviours and memory, tailoring needs and trust and person-centred care), iv) social factors (including support from family or friends and cultural or social norms) and v) environment (concerning environmental triggers and socioeconomic factors). Within these, challenges and enablers of self-management were encountered. Challenges included a lack of time in appointments, emotional distress and insufficient information from healthcare professionals. Enablers included positive outlook, support from family and friends and person-centred care.</p><p><strong>Conclusions: </strong>This review has identified multiple patient barriers and facilitators to self-management in chronic obstructive pulmonary disease. Future interventions should be tailored to address the barriers whilst building upon the facilitators identified in this review.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2656201"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Reconsidering Post-Discharge Rehabilitation in Frail Older Adults with COPD.","authors":"Paras Saini, Anchal Thakur, Sandeep Pattnaik","doi":"10.1080/15412555.2026.2618984","DOIUrl":"10.1080/15412555.2026.2618984","url":null,"abstract":"","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2618984"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Comorbid Interstitial Lung Abnormalities on Acute Exacerbations of COPD: A Hospital-Based Retrospective Cohort Study.","authors":"Yang Li, Cong Zhou, Wangsheng Yu, Mei Yang, Jian Luo, Xin Chen, Xuemei Liu, Bing Mao, Hongli Jiang, Wei Liu","doi":"10.1080/15412555.2026.2615290","DOIUrl":"10.1080/15412555.2026.2615290","url":null,"abstract":"<p><strong>Objective: </strong>To assess the influence of comorbid interstitial lung abnormalities (ILA), lung fibrosis (LF), and interstitial lung disease (ILD) on clinical characteristics and in-hospital outcomes in acute exacerbations of chronic obstructive pulmonary disease (AECOPD).</p><p><strong>Methods: </strong>In this retrospective cohort study, AECOPD patients were stratified by ILA, LF, or ILD status. Multivariable regression analyzed associations with outcomes, including in-hospital mortality, ICU admission, ventilation use, 30-day readmission, and length of stay (LOS). Subgroup and sensitivity analyses assessed robustness.</p><p><strong>Results: </strong>Among 11,457 AECOPD patients, 33.1% had ILA, 25.9% had LF, and 5.0% had ILD. After multivariable adjustment for potential confounders, the presence of ILA, LF, or ILD was not independently associated with in-hospital mortality (ILA: aOR 0.93, 95% CI 0.75-1.14; LF: aOR 0.87, 95% CI 0.70-1.10; ILD: aOR 1.04, 95% CI 0.70-1.53). All conditions significantly increased ICU admission and noninvasive ventilation use but reduced invasive ventilation use.</p><p><strong>Conclusions: </strong>While not independent mortality predictors, ILA/LF/ILD signify greater disease severity and resource utilization during AECOPD, evidenced by higher ICU needs yet paradoxically lower invasive ventilation, a pattern that might be attributed to distinct pathophysiology and clinical management goals in this complex subgroup. This underscores clinical heterogeneity and necessitates tailored management and goals-of-care discussions for this high-risk subgroup.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2615290"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart Inhaler Parameters for Identifying Clinical Worsening in COPD, Leading Up to an Exacerbation: A Pilot Study.","authors":"Dumiana Chamaon, Marjolein Brusse-Keizer, Sanne H B van Dijk, Sabine Steen, Wendy van Beurden, Anke Lenferink, Job van der Palen","doi":"10.1080/15412555.2026.2715509","DOIUrl":"10.1080/15412555.2026.2715509","url":null,"abstract":"<p><strong>Background: </strong>Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) drive disease progression and morbidity. Early prediction could enable timely intervention and thereby potentially limit the severity of the AECOPD and shorten its course. Smart inhalers measure inhalation parameters that may detect physiological changes preceding AECOPDs.</p><p><strong>Objective: </strong>To explore whether changes in inhalation parameters (inhalation duration, Peak Inspiratory Flow (PIF), inhalation volume) as measured by a smart inhaler (RS01X^TM) can identify clinical worsening leading up to an exacerbation within 14 days preceding an AECOPD.</p><p><strong>Methods: </strong>This single-centre observational pilot study included nine COPD patients using maintenance therapy (LAMA/LABA ± ICS) with the RS01X^TM inhaler for six months. AECOPD were defined based on daily symptom diary data. Trends in inhalation parameters during the 14-day pre-AECOPD window were compared with 14-day control periods without AECOPD using descriptive statistics, visual inspection, slope calculations, and exploratory generalised estimating equations (GEE).</p><p><strong>Results: </strong>During the follow-up period, five AECOPDs occurred in three patients. While PIF (<i>p</i> = .007) showed a clear decline preceding AECOPD, inhalation duration (<i>p</i> = .712) and volume (<i>p</i> = .215) remained stable prior to an AECOPD.</p><p><strong>Conclusion: </strong>Inhalation parameters, particularly PIF, appear promising and may reflect physiological changes associated with AECOPD. However, their use as a standalone predictor is still too early. The heterogeneity of COPD and the explorative design of this study limit their current predictive utility within a 14-day window. Nevertheless, these findings suggest potential for future research, particularly when combined with clinical and contextual data to improve predictive accuracy.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2715509"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ferroptosis-Related Signature Genes and Immune Landscape in Acute Exacerbation of Chronic Obstructive Pulmonary Disease.","authors":"Zhang Yuping, Li Xiangmei, Wang Ruiyang, Zhang Wenbo, Wang Huaqi","doi":"10.1080/15412555.2025.2602632","DOIUrl":"10.1080/15412555.2025.2602632","url":null,"abstract":"<p><p>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is characterized by heightened inflammation and immune dysregulation, yet its underlying molecular mechanisms remain incompletely understood. This study aimed to identify ferroptosis-associated signature genes in AECOPD and to elucidate their immunological implications.</p><p><strong>Methods: </strong>Differentially expressed ferroptosis-related genes(DEGs) were screened from the GSE112165 dataset (GEO, Gene Expression Omnibus database). Key feature genes were identified using an integrated machine learning and network analysis strategy. External validation was conducted using the GSE22148 dataset, six bronchoalveolar lavage fluid (BALF) samples, and 40 clinical sputum samples. Functional enrichment analysis was performed to delineate relevant biological pathways. Immune and stromal cell infiltration differences were quantified using computational deconvolution frameworks, and their correlations with candidate genes were assessed.</p><p><strong>Results: </strong>Two ferroptosis-related signature genes-SCD(Stearoyl-CoA Desaturase) and FABP4(Fatty Acid Binding Protein 4)-were identified as potential diagnostic markers. Their diagnostic performance was further validated in independent datasets. Among them, FABP4 showed significant downregulation in AECOPD, which was consistently confirmed across BALF and sputum samples. Immune infiltration analysis revealed a strong association between FABP4 expression and neutrophil infiltration. Notably, conventional dendritic cells (cDCs) were significantly reduced in AECOPD patients, suggesting a possible link between ferroptosis and impaired antigen presentation.</p><p><strong>Conclusions: </strong>(1) This study is the first to comprehensively demonstrate that decreased FABP4 expression may enhance ferroptosis susceptibility by disrupting lipid metabolism, thereby modulating immune cell recruitment and function in AECOPD.(2) The marked reduction of cDCs suggests that ferroptosis may contribute to dysregulated antigen presentation in AECOPD. Taken together, these findings offer novel mechanistic insights into the interplay between ferroptosis and immune dysfunction in AECOPD and provide a theoretical foundation for the development of targeted diagnostic and therapeutic strategies.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2602632"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upregulation of LncRNA MIR31HG in COPD Correlates with Disease Severity and Facilitates Inflammation via miR-342-3p.","authors":"Jinong Zhao, Yan Zhang, Lijuan Gao, Yiping Tang","doi":"10.1080/15412555.2026.2658219","DOIUrl":"https://doi.org/10.1080/15412555.2026.2658219","url":null,"abstract":"<p><strong>Background: </strong>Long non-coding RNA MIR31HG (lncRNA MIR31HG) plays a well-defined role in tumor progression. However, its roles in chronic obstructive pulmonary disease (COPD) progression remain elusive. This study aimed to investigate the expression level and the physiological role of lncRNA MIR31HG in COPD, and further examine the relationship of the lncRNA MIR31HG and miR-342-3p with disease severity, clinical features, and inflammation levels.</p><p><strong>Methods: </strong>Serum levels of lncRNA MIR31HG and miR-342-3p were measured by RT‑qPCR in healthy controls (HC), patients with stable COPD, and those with acute exacerbation COPD (AECOPD). An <i>in vitro</i> model simulating COPD was created through treatment of Beas-2B cells with 2% cigarette smoke extract (CSE). Cell proliferation and inflammatory cytokines were detected by CCK-8 method and ELISA respectively. The relationship between lncRNA MIR31HG and miR-342-3p was examined using dual luciferase reporter and rescue assays.</p><p><strong>Results: </strong>The expression of lncRNA MIR31HG was up-regulated in COPD patients and CSE-exposed Beas-2B cells. LncRNA MIR31HG positively regulated COPD-related malignant characteristics. The silencing of lncRNA MIR31HG alleviated the slow cell proliferation and inflammation caused by CSE exposure. The expression level of miR-342-3p was more attenuated in COPD patients compared with HC. Assays confirmed that lncRNA MIR31HG participates in cell proliferation and inflammatory response by targeting miR-342-3p.</p><p><strong>Conclusion: </strong>The lncRNA MIR31HG expression was increased in patients with COPD. Its level was positively correlated with disease severity and inflammation but negatively associated with miR-342-3p. LncRNA MIR31HG might be an effective target for COPD distinction and treatment.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2658219"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistency Between Oscillometry and Spirometry in Patients with Suspected or Confirmed COPD or Asthma: Results from a Multi-Center Study in China.","authors":"Hongtao Niu, Xiajun Rong, Min Zhang, Fei Deng, Liang Zhang, Yong Li, Yi Gao, Tim Harrison, Samuel Bardsley, Yuanlin Song, Kewu Huang, Ting Yang, Chen Wang","doi":"10.1080/15412555.2026.2617284","DOIUrl":"10.1080/15412555.2026.2617284","url":null,"abstract":"<p><p>Spirometry is the standard for assessing airflow obstruction but can be challenging and/or time-consuming for patients. Oscillometry offers an effort-independent alternative. This study assessed the consistency between oscillometry and spirometry in Chinese patients with suspected or confirmed chronic obstructive pulmonary disease (COPD) or asthma. This prospective study enrolled patients from 46 Chinese hospitals. All underwent oscillometry with the Ambulatory Lung Diagnosis System followed by spirometry, both before and after salbutamol. The primary outcome was prebronchodilator (pre-BD) test consistency (normal vs. abnormal), evaluated using Cohen's Kappa. Secondary outcomes included the number of attempts to complete each test, post-BD consistency in the COPD group, and BD test consistency overall. From February 8 and August 30, 2024, 801 patients were enrolled; 788 completed both tests and were analyzed (COPD: 197 suspected, 194 confirmed; asthma: 200 suspected, 197 confirmed). Pre-BD results showed moderate test consistency (kappa = 0.4188, 95% CI: 0.3556-0.4820; overall agreement = 70.9%). Overall BD test had only fair agreement (kappa = 0.2722, 95% CI: 0.1870-0.3575; overall agreement = 80.3%) between tests. Post-BD results in the COPD group showed moderate consistency between tests (kappa = 0.4662, 95% CI: 0.3803-0.5521; overall agreement = 73.6%), with a high positive predictive value (87.4%) of abnormal oscillometry for spirometrydefined COPD. For satisfactory results, oscillometry required significantly fewer attempts than spirometry (mean: 8.5 vs. 11.0, <i>p</i> < 0.0001). While oscillometry showed only moderate consistency with spirometry, its high positive predictive value suggests potential as a rule-in test for COPD diagnosis when spirometry is not feasible. An alternative oscillometry-based diagnostic pathway may help improve COPD diagnosis under such circumstances.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov (NCT06172777).</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2617284"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Predictive Model to Determine Probability of Bacterial Aetiology in Acute Exacerbation of COPD: \"Infection Score\" A Prospective Cohort Study.","authors":"Alok Yadav, Suprabha Jha, Saugat Pokhrel, Shubham Raj Dahal, Umesh Pant, Jeena Shrestha, Mukunda Raj Joshi, Adarsh Yadav, Chandra Prasad Acharya","doi":"10.1080/15412555.2026.2639716","DOIUrl":"10.1080/15412555.2026.2639716","url":null,"abstract":"<p><strong>Clinical trial registration number: </strong>Not Applicable.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2639716"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators to Practitioner Identification and Treatment of Patients with Chronic Obstructive Pulmonary Disease (COPD): A Systematic Search and Narrative Synthesis.","authors":"Hannah Harvey, Judith Dyson, Sereena Raju, Janelle Kolas, Anwesa Chatterjee, Dominic Sykes, Fiona Cowdell, Michael G Crooks","doi":"10.1080/15412555.2026.2672707","DOIUrl":"10.1080/15412555.2026.2672707","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) remains underdiagnosed and undertreated despite the availability of clinical guidelines. Variability in care delivery suggests that factors beyond clinical knowledge influence how care is implemented in practice. Understanding the barriers and facilitators shaping healthcare professionals' behaviour is essential to improving COPD identification and management. This review aimed to synthesise evidence on the barriers and facilitators influencing healthcare professionals' ability to identify and manage COPD. A systematic search of CINAHL, MEDLINE, PsycINFO, and the Cochrane Database of Systematic Reviews was conducted to identify studies published between 2015 and 2025. Studies examining healthcare professionals' experiences of COPD identification and management were included. Data were extracted and analysed using narrative synthesis, with barriers and facilitators coded and grouped across stages of care. Sixty-one studies across 28 countries were included. Barriers were reported more frequently than facilitators and were shaped by interacting system, practitioner and patient-level factors. Key barriers included limited time, restricted access to diagnostic and treatment resources, unclear professional roles, and gaps in knowledge and confidence. Facilitators included access to training, supportive organisational structures, multidisciplinary collaboration and clear care pathways. Barriers were often interdependent, with system constraints influencing practitioner behaviour and patient engagement. Barriers to COPD care are multi-level and interconnected, suggesting that single-component interventions are unlikely to be effective. Improving care requires coordinated approaches that address system constraints, support practitioner confidence and role clarity, and strengthen patient engagement. These findings provide a framework for designing interventions responsive to the complexity of real-world COPD care.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2672707"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Mucus Occlusions in Ex-Smokers with and Without COPD.","authors":"Sam Tcherner, Eveline Durom, Joshua Peters, Olivia Gater, Grace Parraga","doi":"10.1080/15412555.2026.2681969","DOIUrl":"10.1080/15412555.2026.2681969","url":null,"abstract":"<p><p>In patients with moderate-to-severe COPD, airway mucus-occlusions correlate with airflow limitation, exacerbation and mortality-risk. However, the clinical relevance of mucus-plugs in milder COPD is not well-understood. We evaluated pulmonary function, six-minute-walk-distance (6MWD), emphysema and airway mucus-plugs at baseline and 31 ± 7 months later (follow-up), in ex-smokers with COPD, and those at risk of COPD, but with normal spirometry. Ninety-three ex-smokers with (<i>n</i> = 54) and without COPD (<i>n</i> = 39) underwent spirometry, plethysmography, the six-minute-walk-test (6MWT),¹²⁹Xe MRI, and CT at a baseline visit and 31 ± 7 months later. Baseline and follow-up FEV₁, FVC, RV/TLC, DL_CO, mucus-score, -count, -volume, -length, airway wall-thickness%, total-airway-count (TAC), relative-area-of-lung-with-attenuation ≤-950 Hounsfield Units (RA₉₅₀), and ¹²⁹Xe MRI ventilation-defect-percent (VDP) were measured. A Sankey plot was generated to follow mucus-plug dynamics at follow-up. At follow-up, there was significantly worse 6MWD, RV/TLC (COPD, <i>p</i> ≤ 0.04), VDP, CT RA₉₅₀, airway WT% and TAC in participants with (<i>p</i> ≤ 0.002) and without COPD (<i>p</i> ≤ 0.03), but there was no change in FEV₁, mucus-score, count, volume or length (all <i>p</i> > 0.07). At baseline, there were 289 plugs in 58 participants; at FU, 94/289 (33%) mucus-plugs persisted and there were 193 new plugs for a total of 287 mucus-plugs (Δmucus-score = 0, <i>p</i> = 0.7; Δmucus-count = -2, <i>p</i> = 0.5). In COPD and participants at-risk for COPD, there was significantly worse airway remodelling, emphysema, gas-trapping, exercise capacity, and ventilation defects. While two thirds of plugs resolved, new plugs, in new locations were observed at follow-up; mucus-count and score did not change. The temporal dynamics of mucus-plugs should be considered when evaluating their clinical relevance in COPD patients.<b>Clinical Trial Registration: </b>www.clinicaltrials.gov NCT02279329.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"23 1","pages":"2681969"},"PeriodicalIF":2.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}