Tongyao Sun, Jun Wang, Min Zheng, Chengsen Cai, Jianjian Yu, Lina Fu, Lei Duan
{"title":"Assessment of the Relationship Between Genetic Determinants of Obesity, Unhealthy Eating Habits and Chronic Obstructive Pulmonary Disease: A Mendelian Randomisation Study.","authors":"Tongyao Sun, Jun Wang, Min Zheng, Chengsen Cai, Jianjian Yu, Lina Fu, Lei Duan","doi":"10.1080/15412555.2024.2309236","DOIUrl":"10.1080/15412555.2024.2309236","url":null,"abstract":"<p><p><b>Background:</b> Clinical studies have shown that the onset and exacerbation of chronic obstructive pulmonary disease (COPD) are related to obesity and dietary behaviours, but the genetic relationship between them is not clear.<b>Aims:</b> To investigate the relationship between the genetic determinants of obesity, dietary habits (alcohol consumption, intake of sweets, salt intake) and COPD.<b>Methods:</b> Exposure and outcome datasets were obtained from the IEU Open GWAS project. The exposure dataset includes dietary habits (Salt added to food, Sweets intake, Alcohol consumption), obesity level (represented by body mass index (BMI) and body fat percentage (BFP) data sets.). The outcome dataset includes COPD and acute COPD admissions. The collected data were imported into the RStudio software and conducted Mendelian randomisation analysis. Additionally, heterogeneity and horizontal pleiotropy tests were conducted on the data to ensure the veracity of the results.<b>Results:</b> The results showed that BMI was positively correlated with the risk of acute COPD admission (OR = 1.74, 95% CI 1.39-2.18) and COPD (OR = 1.81, 95%CI 1.41-2.33). In addition, BFP was also a risk factor for COPD (OR = 1.98, 95% CI 1.42-2.77) and acute exacerbation of COPD admission (OR = 1.99, 95%CI 1.43-2.77). The increase of salt, sugar and alcohol consumption will not increase the risk of COPD and the risk of hospitalisation due to COPD.<b>Conclusion:</b> Therefore, we should strengthen the guidance of diet and living habits of obese patients. For patients with heavier weight and higher body fat rate, they should be instructed to lose weight and fat to prevent the occurrence of COPD. For obese patients with COPD, more attention should be paid to prevent the occurrence of acute exacerbation of COPD in advance.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2309236"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139721973","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":"EQ-5D Based Utility Values for Adults with Chronic Obstructive Pulmonary Disease: A Systematic Review, Meta-Analysis, and Meta-Regression.","authors":"Natasha Salant, Syed Mohiuddin, Yuanyuan Zhang, Lynda Ayiku, Kusal Lokuge, Paul Jacklin, Lesley Owen","doi":"10.1080/15412555.2024.2385358","DOIUrl":"10.1080/15412555.2024.2385358","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a common lung disease that negatively affects health-related quality of life (QoL). Utility values, which measure QoL by weighting health states with societal preferences, are required for the cost-utility models that drive economic evaluations and policy decisions. Moayeri et al. published a systematic review and meta-analysis of utilities (EQ-5D) in COPD in June 2016. The current study investigated changes in mean utilities in more recent studies thereafter, exploring heterogeneity in utilities across diverse clinical and study characteristics. Systematic searches of databases, such as MEDLINE and Embase were undertaken from 1 July 2015 until 20 May 2024. A random-effects meta-analysis of utilities (EQ-5D) was performed which addressed inter-study heterogeneity and subgroup analyses. The pooled general mean (95% CI) utility value was 0.761 (0.726-0.795) from 43 studies, whereas Moayeri et al. reported 0.673 (0.653-0.693) from 32 studies. This improvement in mean utilities could be due to increased awareness, early detection, and better medical interventions over the past decade, but demonstrates that a general utility value should be approached with caution given significant heterogeneity. Four meta-regressions were performed on each subgroup: region, method of elicitation, reported comorbidities, and disease stage; of which, method of elicitation, disease stage, and region were found to be significant moderators of utilities. It is, therefore, important to use meta-analysed utilities for cost-utility analyses that reflect the context and patient population of the model. Moreover, these results provide additional evidence for the precision and sensitivity of EQ-5D-5L over EQ-5D-3L.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2385358"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854967","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":"Real World Study on the Reasons for eScalation or de-Escalation of Inhaled ThEraPies in COPD Patients: the STEPINCOPD Multicenter Observational Study.","authors":"Argyris Tzouvelekis, Christos Kyriakopoulos, Irini Gerogianni, Aggeliki Rapti, Vasileios Michailidis, Andreas Dimoulis, Despina Papakosta, Paschalis Steiropoulos, Panagiota Styliara, Konstantinos Kostikas, Athena Gogali","doi":"10.1080/15412555.2024.2427755","DOIUrl":"10.1080/15412555.2024.2427755","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on the reasons for escalation or de-escalation of COPD inhaled therapies in routine clinical practice, especially after the follow-up pharmacological treatment guidance on the 2019 GOLD report and the 2020 ERS guideline on ICS withdrawal.</p><p><strong>Methods: </strong>The STEPINCOPD study was a 12-week, two-visit, prospective observational study that aimed to describe the reasons for change of inhaled therapies, in accordance with GOLD recommendations 2021. Only patients that had a recent change in their inhaled medication were enrolled. Moreover, we investigated associations between physicians' and patients' characteristics and adherence to GOLD recommendations.</p><p><strong>Results: </strong>1429 patients were enrolled from 146 centers (138 private practice and 8 hospitals) throughout Greece. At enrollment, the most frequent reasons for treatment change were lack of clinical (78.9%) or spirometric (49.5%) response to previous treatment, change in CAT score (45.1%), and mMRC score (28.2%). At the follow-up visit, most common reasons were lack of clinical response to previous treatment (71.4%), COPD exacerbations (59.5%), changes in CAT score (52.4%), lack of spirometric response (42.9%) and lower respiratory tract infections (31%). We observed high adherence to the GOLD 2021 recommendations (81.6% at enrollment and 92.9% at follow-up). Physicians' age and consideration of GOLD recommendations for prescription choice, as well as patients' CAT score were significant predictors of adherence to GOLD.</p><p><strong>Conclusion: </strong>The STEPINCOPD study highlights the reasons for inhaled treatment change in Greek physicians with high adherence to GOLD recommendations and provides insights for future research that may inform the development of decision support tools.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2427755"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667195","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}
Paul Jones, Ashraf Alzaabi, Alejandro Casas Herrera, Mehmet Polatli, Marcelo Fouad Rabahi, Arturo Cortes Telles, Bhumika Aggarwal, Sudeep Acharya, Abdelkader El Hasnaoui, Chris Compton
{"title":"Understanding the Gaps in the Reporting of COPD Exacerbations by Patients: A Review.","authors":"Paul Jones, Ashraf Alzaabi, Alejandro Casas Herrera, Mehmet Polatli, Marcelo Fouad Rabahi, Arturo Cortes Telles, Bhumika Aggarwal, Sudeep Acharya, Abdelkader El Hasnaoui, Chris Compton","doi":"10.1080/15412555.2024.2316594","DOIUrl":"10.1080/15412555.2024.2316594","url":null,"abstract":"<p><p>Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function, poor quality of life, loss of exercise capacity, risk of serious cardiovascular events, hospitalization, and death. However, patients underreport exacerbations, and evidence suggests that unreported exacerbations have similar negative health implications for patients as those that are reported. Whilst there is guidance for physicians to identify patients who are at risk of exacerbations, they do not help patients recognise and report them. Newly developed tools, such as the COPD Exacerbation Recognition Tool (CERT) have been designed to achieve this objective. This review focuses on the underreporting of COPD exacerbations by patients, the factors associated with this, the consequences of underreporting, and potential solutions.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2316594"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989561","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":"Real-World Effectiveness of Single-Inhaler Triple Therapy for COPD: Impact of Diabetes Comorbidity.","authors":"Sophia Eilat-Tsanani, Pierre Ernst, Samy Suissa","doi":"10.1080/15412555.2024.2327345","DOIUrl":"10.1080/15412555.2024.2327345","url":null,"abstract":"<p><p>Type 2 diabetes is a frequent comorbidity in chronic obstructive pulmonary disease (COPD) patients, with the GOLD treatment recommendations asserting that the presence of diabetes be disregarded in the choice of treatment.</p><p><p>In a cohort of COPD patients with frequent exacerbations, initiators of single-inhaler triple therapy or dual bronchodilators were compared on the incidence of COPD exacerbation and pneumonia over one year, adjusted by propensity score weighting and stratified by type 2 diabetes.</p><p><p>The COPD cohort included 1,114 initiators of triple inhalers and 4,233 of dual bronchodilators (28% with type 2 diabetes). The adjusted hazard ratio (HR) of exacerbation with triple therapy was 1.04 (95% CI: 0.86-1.25) among COPD patients with type 2 diabetes and 0.74 (0.65-0.85) in those without. The incidence of severe pneumonia was elevated with triple therapy among patients with type 2 diabetes (HR 1.77; 1.14-2.75).</p><p><p>Triple therapy in COPD is effective among those without, but not those with, type 2 diabetes. Future therapeutic trials in COPD should consider diabetes comorbidity.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2327345"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174053","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}
Harkiran K Kooner, Paulina V Wyszkiewicz, Alexander M Matheson, Marrissa J McIntosh, Mohamed Abdelrazek, Inderdeep Dhaliwal, J Michael Nicholson, Miranda Kirby, Sarah Svenningsen, Grace Parraga
{"title":"Chest CT Airway and Vascular Measurements in Females with COPD or Long-COVID.","authors":"Harkiran K Kooner, Paulina V Wyszkiewicz, Alexander M Matheson, Marrissa J McIntosh, Mohamed Abdelrazek, Inderdeep Dhaliwal, J Michael Nicholson, Miranda Kirby, Sarah Svenningsen, Grace Parraga","doi":"10.1080/15412555.2024.2394129","DOIUrl":"10.1080/15412555.2024.2394129","url":null,"abstract":"<p><p>Chest CT provides a way to quantify pulmonary airway and vascular tree measurements. In patients with COPD, CT airway measurement differences in females are concomitant with worse quality-of-life and other outcomes. CT total airway count (TAC), airway lumen area (LA), and wall thickness (WT) also differ in females with long-COVID. Our objective was to evaluate CT airway and pulmonary vascular and quality-of-life measurements in females with COPD as compared to ex-smokers and patients with long-COVID. Chest CT was acquired 3-months post-COVID-19 infection in females with long-COVID for comparison with the same inspiratory CT in female ex-smokers and COPD patients. TAC, LA, WT, and pulmonary vascular measurements were quantified. Linear regression models were adjusted for confounders including age, height, body-mass-index, lung volume, pack-years and asthma diagnosis. Twenty-one females (53 ± 14 years) with long-COVID, 17 female ex-smokers (69 ± 9 years) and 13 female COPD (67 ± 6 years) patients were evaluated. In the absence of differences in quality-of-life scores, females with long-COVID reported significantly different LA (<i>p</i> = 0.006) compared to ex-smokers but not COPD (<i>p</i> = 0.7); WT% was also different compared to COPD (<i>p</i> = 0.009) but not ex-smokers (<i>p</i> = 0.5). In addition, there was significantly greater pulmonary small vessel volume (BV<sub>5</sub>) in long-COVID as compared to female ex-smokers (<i>p</i> = 0.045) and COPD (<i>p</i> = 0.003) patients and different large (BV<sub>10</sub>) vessel volume as compared to COPD (<i>p</i> = 0.03). In females with long-COVID and highly abnormal quality-of-life scores, there was CT evidence of airway remodelling, similar to ex-smokers and patients with COPD, but there was no evidence of pulmonary vascular remodelling.<b>Clinical Trial Registration:</b> www.clinicaltrials.gov NCT05014516 and NCT02279329.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2394129"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105142","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":"In a Strained Healthcare System, Patients with Advanced COPD Struggle to Access the Needed Support from the Healthcare Professionals - A Qualitative Study.","authors":"M Lavesen, M Paine, D G Bove","doi":"10.1080/15412555.2024.2361669","DOIUrl":"https://doi.org/10.1080/15412555.2024.2361669","url":null,"abstract":"<p><p>This study aimed to explore the self-management strategies of Danish patients living with advanced Chronic Obstructive Pulmonary Disease (COPD), with a particular focus on their daily life and their interactions with the respiratory outpatient clinic. Data were collected through semi-structured interviews with 11 patients with COPD affiliated with a Danish respiratory outpatient clinic. The data were thematically analyzed as suggested by Braun & Clarke. The analysis revealed one overarching theme, three main themes, and six subthemes. The overarching theme 'In a strained healthcare system patients with COPD struggle to access needed support to be able to self-manage their disease' revolved around the challenges that patients face in an overburdened healthcare system as they seek support to effectively self-manage their condition. The three main themes were: (1) Only physical symptoms provide legal access to the respiratory outpatient clinic, (2) For patients, the measurements serve as indicators of their health status and overall well-being, (3) Healthcare professionals' skills and not the mode of contact matters to the patients. Healthcare professionals should be aware that the rhetoric surrounding a busy healthcare system with a stressed-out staff also affects patients. Patients with COPD may be particularly sensitive to this message and try to avoid burdening the healthcare system further by setting aside their own needs. However, this approach can lead to neglecting symptoms of deterioration and mental symptoms, which increase the risk of disease progression and subsequent risk of hospital admission.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2361669"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305609","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}
Nicholas A Barrett, Francesco Murgolo, Salvatore Grasso, Eirini Kostakou, Nicholas Hart, Patrick Murphy, Abdel Douiri, Luigi Camporota
{"title":"Physiological Assessment of ECCO<sub>2</sub>R on the Work of Breathing in Exacerbations of COPD.","authors":"Nicholas A Barrett, Francesco Murgolo, Salvatore Grasso, Eirini Kostakou, Nicholas Hart, Patrick Murphy, Abdel Douiri, Luigi Camporota","doi":"10.1080/15412555.2024.2436169","DOIUrl":"10.1080/15412555.2024.2436169","url":null,"abstract":"<p><strong>Rationale: </strong>The impact of extracorporeal carbon dioxide removal (ECCO<sub>2</sub>R) on work of breathing and aeration in exacerbations of chronic obstructive pulmonary disease (AECOPD) is poorly understood.</p><p><strong>Objectives: </strong>The study explores the impact of non-invasive ventilation (NIV) and ECCO<sub>2</sub>R on respiratory drive, effort and distribution of ventilation in AECOPD.</p><p><strong>Methods: </strong>Patients enrolled in a randomised controlled study of the addition of ECCO<sub>2</sub>R to NIV compared with NIV underwent oesophageal pressure measurement, electrical impedance tomography and parasternal electromyography.</p><p><strong>Measurements and main results: </strong>18 patients were enrolled, nine in each arm. Of these, eight in the NIV arm and seven in the ECCO<sub>2</sub>R arm underwent physiological assessment. Patients randomised to ECCO<sub>2</sub>R, had a period of NIV combined with ECCO<sub>2</sub>R and, after removal of NIV, a period of ECCO<sub>2</sub>R alone. The removal of NIV whilst remaining on ECCO<sub>2</sub>R resulted in a respiratory acidosis (pH 7.34 (7.31-7.34) vs. 7.31 (7.31-7.34), <i>p</i> < 0.0001), increased work of breathing (7.43 (6.08-10.19) vs. 11.1 (8.11-15.15) J/min, <i>p</i> < 0.0001) and increased neural drive (884.4 (684.7-967.3) vs. 1321.1 (903.3-1575.3) AU, <i>p</i> = 0.0005). On day 1, the work of breathing was lower in the NIV than the ECCO<sub>2</sub>R group (4.38 (2.76-7.27) vs. 8.03 (4.8-15.94) J/min, <i>p</i> < 0.0001), minute ventilation was higher (15.54 (13.14-18.48) vs. 12.24 (8.51-13.9) L/min, <i>p</i> < 0.0001) and neural drive was the same (1,163.8 (1,085.5-1,325.5) vs. 1,093.8 (885.7-1,258.7) AU, <i>p</i> = 0.5556).</p><p><strong>Conclusions: </strong>The combination of NIV and ECCO<sub>2</sub>R results in lower work of breathing and improved neuro-ventilatory coupling. NIV fully supports ventilation early whilst ECCO<sub>2</sub>R improves neuro-ventilatory coupling and work of breathing over time.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov; NCT02086084; registered 1 December 2015; https://clinicaltrials.gov/study/NCT02086084?cond=copd&term=ecco2r&rank=4.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2436169"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784354","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":"Beclometasone Dipropionate/Formoterol Fumarate is Similarly Effective to Budesonide/Formoterol Fumarate in Chinese Patients with COPD: The FORSYYN Double-Blind, Randomised Study.","authors":"Fuqiang Wen, Yanmin Wu, Chunyan Xing, Yingqun Zhu, Yongxing Chen, Xiaodong Mei, Massimo Corradi, Glauco Cappellini, Emanuele Calabro, Sergio Amodio, Cissy Zhu, Dmitry Galkin","doi":"10.1080/15412555.2024.2425157","DOIUrl":"https://doi.org/10.1080/15412555.2024.2425157","url":null,"abstract":"<p><p>The fixed-dose combination of beclometasone dipropionate/formoterol fumarate (BDP/FF) delivered <i>via</i> pressurised metered-dose inhaler (pMDI) has demonstrated efficacy in chronic obstructive pulmonary disease (COPD), in studies predominantly conducted in Caucasian adults. The current study evaluated the efficacy and safety of BDP/FF pMDI in Chinese patients with COPD, as part of registration for COPD in China. This double-blind, double-dummy, randomised, parallel-group study was conducted in patients with COPD of Chinese ethnicity aged ≥40 years. After a 4-week open-label budesonide/formoterol fumarate (BUD/FF) run-in period, patients were randomised to BUD/FF or BDP/FF for 24 weeks. The primary objective was to demonstrate non-inferiority of BDP/FF to BUD/FF in terms of change from baseline in pre-dose morning forced expiratory volume in 1 sec (FEV<sub>1</sub>) at Week 24 (i.e. the lower 95% CI limit of the difference was above the pre-defined non-inferiority margin of -0.07 L). Of 750 patients randomised (377 BDP/FF; 373 BUD/FF), 87.6% completed the study. The primary endpoint was met in both the per-protocol (adjusted mean difference -0.001 L [95% CI: -0.025, 0.022], non-inferiority <i>p</i> < 0.001) and intention-to-treat populations (-0.001 L [-0.024, 0.022]; non-inferiority <i>p</i> < 0.001). There were no statistically significant BDP/FF-BUD/FF differences for the secondary endpoints, and a similar proportion of patients had adverse events (BDP/FF, 51.7%; BUD/FF, 51.2%), with most mild/moderate in severity. In conclusion, BDP/FF pMDI was non-inferior to BUD/FF in terms of pre-dose morning FEV<sub>1</sub>, supported by a range of secondary endpoints. Both treatments were similarly tolerated. The study supports the use of BDP/FF pMDI in Chinese patients with COPD.</p><p><strong>Study registration: </strong>China Centre for Drug Evaluation (CTR20180475).</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"2425157"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616390","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":"Granzyme B May Act as an Effector Molecule to Control the Inflammatory Process in COPD.","authors":"Won-Dong Kim, Don D Sin","doi":"10.1080/15412555.2023.2299104","DOIUrl":"10.1080/15412555.2023.2299104","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is caused by smoking, but only a small proportion of smokers have disease severe enough to develop COPD. COPD is not always progressive. The question then arises as to what explains the different trajectories of COPD. The role of autoimmunity and regulatory T (Treg) cells in the pathogenesis of COPD is increasingly being recognized. Nine published studies on Treg cells in the lung tissue or bronchoalveolar lavage fluid have shown that smokers with COPD have fewer Treg cells than smokers without COPD or nonsmokers. Three studies showed a positive correlation between Treg cell count and FEV<sub>1</sub>%, suggesting an important role for Treg cells in COPD progression. Treg cells can regulate immunological responses <i>via</i> the granzyme B (GzmB) pathway. Immunohistochemical staining for GzmB in surgically resected lungs with centrilobular emphysema showed that the relationship between the amount of GzmB+ cells and FEV<sub>1</sub>% was comparable to that between Treg cell count and FEV<sub>1</sub>% in the COPD lung, suggesting that GzmB could be a functional marker for Treg cells. The volume fraction of GzmB+ cells in the small airways, the number of alveolar GzmB+ cells, and GzmB expression measured by enzyme-linked immunosorbent assay in the lung tissue of smokers were significantly correlated with FEV<sub>1</sub>%. These results suggest that the GzmB content in lung tissue may determine the progression of COPD by acting as an effector molecule to control inflammatory process. Interventions to augment GzmB-producing immunosuppressive cells in the early stages of COPD could help prevent or delay COPD progression.</p>","PeriodicalId":10704,"journal":{"name":"COPD: Journal of Chronic Obstructive Pulmonary Disease","volume":"21 1","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680814","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}