International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"The Impact of Age and Disease Entity on Small Airway Dysfunction in Obstructive Airway Diseases.","authors":"Yang Li, Kang-Cheng Su, Yi-Han Hsiao, Kun-Ta Chou, Yen-Jung Li, Tien-Hsin Jeng, Hsin-Kuo Ko, Diahn-Warng Perng","doi":"10.2147/COPD.S505855","DOIUrl":"https://doi.org/10.2147/COPD.S505855","url":null,"abstract":"<p><strong>Purpose: </strong>Small airway dysfunction (SAD) is prevalent in asthma and chronic obstructive pulmonary disease (COPD). Aging is acknowledged to be associated with the loss of small airway structures. However, the impact of aging and pathophysiological changes on SAD in asthma and COPD remains unclear. We aimed to investigate the impact of aging and disease entity on pathophysiological change-related SAD in asthma and COPD assessed by spirometry and impulse oscillometry (IOS).</p><p><strong>Patients and methods: </strong>We retrospectively reviewed adult patients diagnosed with asthma or COPD between May 2017 and August 2021 in Taipei Veterans General Hospital. Treatment-naïve COPD patients aged ≥60 years were enrolled, along with age- and gender-matched elderly asthmatics (EA), and younger asthmatics aged <60 years (YA) for comparison. All participants underwent spirometry and IOS with a bronchodilator test. Blood eosinophil counts (BECs) and immunoglobulin E(IgE) levels were documented if blood tests were conducted at the time of diagnosis.</p><p><strong>Results: </strong>The mean age of YA, EA, and COPD were 44, 73, and 73 years, respectively. The FEV₁, FEV₁/FVC and FEF_25-75% were higher in the YA followed by EA and COPD groups. The spirometric values were significantly correlated with IOS parameters in both asthmatic and COPD groups. No significant differences were observed in baseline IOS parameters among the three groups for participants with FEV₁ ≥80% predicted. However, in patients with FEV₁< 80% predicted, COPD patients exhibited significantly worse spirometric values and most IOS parameters (except R₅-R₂₀) compared to asthmatics. Additionally, asthmatics with AX reduction ≥35% exhibited significantly higher levels of blood eosinophil counts and IgE.</p><p><strong>Conclusion: </strong>Aging process contributes to more impact on small airway reactance in asthma, while disease entity in COPD exhibits worse spirometric and IOS parameters compared to the age- and gender-matched EA.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"821-830"},"PeriodicalIF":2.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Oxidative Stress-Associated Biomarkers in Chronic Obstructive Pulmonary Disease: An Integrated Bioinformatics Analysis.","authors":"Xianwei Jiang, Minghang Wang, Huiru Li, Yuanyuan Liu, Xiaosheng Dong","doi":"10.2147/COPD.S485505","DOIUrl":"https://doi.org/10.2147/COPD.S485505","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is among the three leading causes of death worldwide, with its prevalence, morbidity, and mortality rates increasing annually. Oxidative stress (OS) is a key mechanism in COPD development, making the identification of OS-related biomarkers beneficial for improving its diagnosis and treatment.</p><p><strong>Methods: </strong>The genetic data from patients with COPD and controls were obtained from the Gene Expression Omnibus database to identify OS-related genes (OSRGs). Functional enrichment analysis was conducted using the Kyoto encyclopedia of genes and genomes signaling pathway and gene ontology (GO). Protein-protein interaction networks were constructed to identify the core genes, which were further evaluated using receiver operating characteristic (ROC) curves. Diagnostic models were developed based on the core genes. Besides, the correlation between the expression of the core genes and the immune cells was analyzed using single-sample gene set enrichment analysis. Drug-gene interactions were explored to predict target drugs, and related microribonucleic acid (miRNA) and transcription factors (TFs) were identified using miRNet.</p><p><strong>Results: </strong>In this study, we identified 299 differential genes, including 16 OSRGs. Among these, five core genes-heat shock protein family A (Hsp70) member 1A (HSPA1A), glutamate-cysteine ligase modifier subunit, interleukin-1 beta (IL-1β), intercellular adhesion molecule 1 (ICAM1), and glutamate-cysteine ligase catalytic subunit (GCLC)-were screened and validated using ROC curve analysis. The results of GO enrichment analysis were mainly focused on the OS response, the negative regulation of the exogenous apoptosis signaling pathway, and the regulation of the apoptosis signaling pathway. Additionally, 33 target drugs were predicted, including ofloxacin, cisplatin, and pegolimumab, among others. Meanwhile, the regulatory networks comprising 33 miRNAs related to the core genes and 38 TFs associated with HSPA1A, IL-1β, ICAM1, and GCLC were constructed. A diagnostic model based on the five genes was constructed and validated with an area under the curve of 0.981 (95% confidence interval: 0.941-1.000).</p><p><strong>Conclusion: </strong>This study identifies potential biomarkers for diagnosing COPD, new potential targets, and new directions for drug development and treatment.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"841-855"},"PeriodicalIF":2.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Airway-Occluding Mucus Plugs on Mortality in Patients with COPD According to Disease Severity: A Subset Analysis of Data From COPDGene.","authors":"Paola Rogliani, Luigino Calzetta","doi":"10.2147/COPD.S504065","DOIUrl":"https://doi.org/10.2147/COPD.S504065","url":null,"abstract":"<p><strong>Background: </strong>Chronic mucus hypersecretion (CMH) in chronic obstructive pulmonary disease (COPD) is associated with severe outcomes, but its impact on mortality across COPD stages is not well understood. This study evaluated the risk of mortality according to mucus plugs and COPD severity.</p><p><strong>Methods: </strong>A subset analysis was performed using secondary unadjusted data from published figures of a study on the COPDGene cohort. Data on mortality rates and mucus plug scores were extracted and classified by the GOLD stages. The mortality risk was calculated based on the number of mucus plugs occluding lung segments and GOLD stage, using calibration curves and best-fitting non-linear regression curve analysis.</p><p><strong>Results: </strong>The risk of all-cause mortality was significantly increased for GOLD stage 1 patients with ≥1 occluded lung segments (1.48, 95% CI 1.10-1.86; P<0.01) compared to those with no occlusions. Patients with GOLD stage 1 and ≥3 occluded lung segments had a significantly higher mortality risk (1.89, 95% CI 1.43-2.36; P<0.001). No increased mortality risk resulted for patients with 1-2 occluded lung segments and those at GOLD stage 2-4. The number needed to harm analysis indicated that 6 patients with ≥3 occluded segments at GOLD stage 1 were required to observe one death, compared to 26 patients at GOLD stage 4.</p><p><strong>Conclusion: </strong>The significant mortality risk associated with multiple mucus-plugged segments at GOLD stage 1 supports the potential benefit of thiol-based mucolytic therapy. Targeted interventions to reduce mucus plugs could be crucial in improving survival outcomes for early-stage COPD patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"831-840"},"PeriodicalIF":2.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an AI-Powered Smart Dry Powder Inhaler (RS01X) for Asthma and COPD in a Clinical Setting.","authors":"Dumiana Chamaon, Esther Sportel, Emma C M Elferink, Job van der Palen","doi":"10.2147/COPD.S490684","DOIUrl":"https://doi.org/10.2147/COPD.S490684","url":null,"abstract":"<p><strong>Introduction: </strong>The main treatment for patients with chronic obstructive pulmonary disease (COPD) or asthma is inhalation medication. Treatment efficacy is often suboptimal due to poor therapy adherence and errors in inhalation technique. The RS01X^TM (RS01X) is a smart, single dose dry powder inhaler (smart DPI) that monitors therapy adherence and inhalation technique via inhalation profiles, consisting of duration, volume and peak inspiratory flow (PIF). The objective was to validate the smart DPI compared to an external inhalation profile recorder (IPR).</p><p><strong>Methods: </strong>This monocenter cross-sectional study with 97 participants comprises patients with COPD, asthma and healthy participants. Participants performed three inhalations with the smart DPI. The inhalations differed in duration, volume and PIF, and orientation of the inhaler (horizontal (correct) and at a 45-degree angle (incorrect)). A paired sample <i>t</i>-test was performed to test for differences in the mean values between the smart DPI and the IPR. Also, the intraclass correlation coefficient (ICC) was calculated.</p><p><strong>Results: </strong>The correlation between the smart DPI and the IPR shows for all the inhalation parameters an ICC > 0.95 (all p < 0.001). Analyses for healthy subjects, and patients with COPD and asthma show no relevant differences between the groups (all ICC > 0.93, all P < 0.001). Inhalations with the inhaler in an incorrect 45-degree angle show negligible but statistically significant differences on the parameters volume (0.44 milliliters) and PIF (1.5L/min) between IPR and smart DPI (P < 0.05).</p><p><strong>Discussion: </strong>The smart DPI is a valid instrument for measuring inhalation parameters to improve therapy adherence and inhalation techniques in patients with asthma and COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"811-819"},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year Results of Bronchoscopic Lung Volume Reduction Using One-Way Endobronchial Valves: Real-World Single Center Data.","authors":"Dorian Bivort, Astrid Blondeel, Hannelore Geysen, Christelle M Vandervelde, Johan Coolen, Laurens J Ceulemans, Christophe Dooms, Wim Janssens, Stephanie Everaerts","doi":"10.2147/COPD.S509468","DOIUrl":"https://doi.org/10.2147/COPD.S509468","url":null,"abstract":"<p><strong>Background: </strong>Bronchoscopic lung volume reduction (BLVR) using one-way endobronchial valves (EBV) is a minimally invasive treatment for patients with advanced emphysema and severe hyperinflation. While several randomized controlled trials have demonstrated improvements in lung function, exercise performance, and quality of life, information on long-term outcomes of BLVR outside clinical trial settings are limited.</p><p><strong>Objective: </strong>This study provides real-world data with a follow-up of up to two years, incorporating the BODE index (Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index), as part of the follow-up assessments.</p><p><strong>Methods: </strong>Data were collected for all patients treated with BLVR at the University Hospitals of Leuven, Belgium, including lung function parameters, 6-minute walking distance, respiratory questionnaires, and the BODE index at intervals of 3, 6, 12, and 24 months. A composite outcome combining FEV1 (forced expiratory volume in 1 second), 6MWD (6-minute walk distance), and SGRQ (St. George's Respiratory Questionnaire) was used to evaluate the overall impact of BLVR. Mixed model analyses were performed.</p><p><strong>Results: </strong>All outcome parameters, including FEV1, residual volume (RV), 6MWD, modified Medical Research Council (mMRC) and SGRQ exhibited significant improvement up to 1 year of treatment. RV and mMRC maintained statistical significance compared to baseline at the 2-year follow-up. The BODE index as well, revealed a significant improvement persisting up to 2 years of treatment. Response rate for the composite outcome was 86% (44/51) at one year and 71% (17/24) at 2 years follow-up.</p><p><strong>Conclusion: </strong>Follow-up data of a real-world setting show maintained benefits of bronchoscopic lung volume reduction with endobronchial valves up to 2 years after treatment, for patients of whom the valves are still in situ. A potential survival benefit of BLVR, based on BODE, and high response rate on the composite outcome was present, in patients who remained in follow-up.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"799-810"},"PeriodicalIF":2.7,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associated Factors and Pulmonary Function Outcomes of Preserved Ratio Impaired Spirometry: A Scoping Review.","authors":"Haibo Xu, Xiaoke Jiang, Qiuxuan Zeng, Ronghua Li","doi":"10.2147/COPD.S506115","DOIUrl":"https://doi.org/10.2147/COPD.S506115","url":null,"abstract":"<p><strong>Background: </strong>Preserved ratio impaired spirometry (PRISm) is a common but understudied abnormal pulmonary function state and is strongly associated with poor health outcomes. However, there is a lack of uniformity in defining the factors and pulmonary function outcomes associated with PRISm.</p><p><strong>Objective: </strong>This scoping review aims to elucidate the associated factors and pulmonary function outcomes of PRISm, thereby enhancing healthcare professionals' understanding of PRISm and laying the groundwork for its prevention and treatment.</p><p><strong>Methods: </strong>This scoping review follows the 5-step framework developed by Arksey and O'Malley. Literature on PRISm was systematically searched from databases including PubMed, Embase, CINAHL, the Cochrane Library, Web of Science, CNKI, and Wan Fang, spanning from inception to July 2024. Inclusion and exclusion criteria were applied to enroll relevant studies. Data were extracted, collected, summarized, and reported.</p><p><strong>Results: </strong>A total of 38 studies were included. The analysis revealed that associated factors for PRISm encompass possible pathogenic factors (older age, female, lower education level, smoking, obesity, etc), comorbidity associations (asthma, diabetes, cardiovascular diseases, etc), and disease characteristic factors (disease burden, physical performance, radiological characteristics, etc). The pulmonary function status of the PRISm population is unstable, making progression to airflow obstruction (AFO) more likely than in the normal population. PRISm exhibits multiple subgroups (incident or stable PRISm, definite PRISm or PRISm with AFO, non-restrictive or restrictive PRISm, etc) and significant differences exist in pulmonary function outcomes among different subgroups.</p><p><strong>Conclusion: </strong>This scoping review offers a more comprehensive understanding of PRISm. It is recommended that future research focus on a deeper investigation of the pulmonary function of PRISm, elucidating its pathophysiological characteristics, and proposing new strategies for its prevention and treatment. Furthermore, more research is needed in low-income and middle-income economies to understand PRISm comprehensively.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"767-784"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Mechanical Power and 28-Day All-Cause Mortality in Chronic Obstructive Pulmonary Disease Patients Undergoing Invasive Ventilation: Analysis of the MIMIC-IV Database.","authors":"Shaoxing Wu, Haipeng Li, Junhao Xu, Junxiang Cai, Lei Wu, Yinji Xu","doi":"10.2147/COPD.S499985","DOIUrl":"https://doi.org/10.2147/COPD.S499985","url":null,"abstract":"<p><strong>Purpose: </strong>Increasing evidence suggests that mechanical power (MP) is associated with mortality among patients undergoing invasive mechanical ventilation. However, the relationship between MP and mortality in chronic obstructive pulmonary disease (COPD) patients undergoing invasive ventilation remains uncertain. The aim of this study was to investigate the association between MP and 28-day all-cause mortality among COPD patients undergoing invasive ventilation.</p><p><strong>Patients and methods: </strong>Data were obtained from the Medical Information Mart for Intensive Care (MIMIC-IV) database. COPD patients undergoing invasive ventilation were categorized into three categories based on MP tertiles to further assess the robustness of our results. The primary outcome was 28-day all-cause mortality. The relationship between MP and 28-day all-cause mortality in COPD patients undergoing invasive ventilation was performed to evaluate restricted cubic splines and Cox proportional hazards regression analysis. Receiver operating characteristic (ROC) curves and Kaplan-Meier survival analysis were employed to evaluate and visualize the predictive value of MP for 28-day all-cause mortality. Additionally, the optimal cut-off value of MP was determined. Finally, subgroup analysis was conducted to assess the robustness of the findings.</p><p><strong>Results: </strong>1704 COPD patients undergoing invasive ventilation (56.92% male) were included in the study. Based on the Cox regression analysis, MP was significantly associated with 28-day all-cause mortality risk in the unadjusted model (Model 1) [HR (95% CI) 1.04 (1.03-1.05), p<0.001]. However, as this is an observational study, causality cannot be inferred. Restricted cubic spline regression models revealed a linear rise in the risk of 28-day mortality as MP increased (P for non-linearity = 0.967). The area under the curve (AUC) for MP was 0.602. This study also identified an optimal cut-off value of 17.38 J/min for MP. Kaplan-Meier survival analysis demonstrated statistically significant differences in survival among invasive ventilation patients stratified by MP tertiles. Subgroup analysis of potential confounding factors indicated no significant interaction between MP and any subgroup (P for interaction: 0.114-0.967).</p><p><strong>Conclusion: </strong>MP is associated with 28-day all-cause mortality in COPD patients undergoing invasive ventilation. The cut-off value of 17.38 J/min may serve as a reference point for clinicians in assessing disease severity. However, further research is needed to investigate the causal relationship between MP and mortality.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"785-797"},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Risk Status of OSA and Its Association with COPD Incidence and Progression to Oxygen Therapy: Insights from a US National Cohort.","authors":"Yuxin Wang, Jinmei Luo, Rong Huang, Yi Xiao","doi":"10.2147/COPD.S496086","DOIUrl":"10.2147/COPD.S496086","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are prevalent respiratory disorders with significant health implications. This study investigates the relationship between OSA risk and the incidence and progression of COPD.</p><p><strong>Patients and methods: </strong>We analyzed data from the Health and Retirement Study (HRS) cohort. Participants' OSA risk was assessed using the STOP-Bang questionnaire. Changes in OSA risk were evaluated by comparing baseline and follow-up assessments. COPD incidence and progression were determined through self-reported physician diagnoses and the use of oxygen therapy. After adjusting for covariates, hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated using Cox proportional hazards models.</p><p><strong>Results: </strong>The analysis included 14398 participants for baseline OSA risk and 11177 for OSA risk changes. Participants with high baseline OSA risk had a significantly higher risk of developing COPD (adjusted HR: 1.255, 95% CI: 1.054-1.496) compared to those with low risk, although no significant relationship was found with progression to oxygen therapy. Participants whose OSA risk decreased showed a lower risk of developing COPD (Baseline low-risk group: adjusted HR: 0.603, 95% CI: 0.418-0.871; Baseline high-risk group: adjusted HR: 0.586, 95% CI: 0.396-0.869). This relationship was significant in women but not in men. Changes in OSA risk were not significantly related to COPD progression to oxygen therapy.</p><p><strong>Conclusion: </strong>OSA risk and its changes are associated with varying risks of COPD. Progression in OSA risk increases the risk of COPD, while improvement in OSA risk reduces it.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"753-766"},"PeriodicalIF":2.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COPD Exacerbations, Air Pollutant Fluctuations, and Individual-Level Factors in the Pandemic Era.","authors":"Sahar Mikaeeli, Dany Doiron, Jean Bourbeau, Pei Zhi Li, Shawn D Aaron, Kenneth R Chapman, Paul Hernandez, François Maltais, Darcy D Marciniuk, Denis E O'Donnell, Don D Sin, Brandie L Walker, Wan C Tan, Simon Rousseau, Bryan A Ross","doi":"10.2147/COPD.S498088","DOIUrl":"10.2147/COPD.S498088","url":null,"abstract":"<p><strong>Purpose: </strong>Pandemic-era associations between air pollutant exposures and exacerbations of chronic obstructive pulmonary disease (COPD) are under-explored. Given the considerable observed pandemic-era pollutant fluctuations, these associations were investigated along with possible individual-level risk factors.</p><p><strong>Patients and methods: </strong>Participants with spirometry-confirmed COPD from Canadian Cohort Obstructive Lung Disease (CanCOLD) were included, with data collected before (\"pre-pandemic\") and during (\"pandemic\") the COVID-19 pandemic. Nitrogen dioxide (NO₂), fine particulate matter (PM_2.5), ground-level ozone (O₃), total oxidant (O_x) and weather data were obtained from national databases. Associations between each air pollutant and \"symptom-based\" exacerbations (increased dyspnea or sputum volume/purulence ≥48hrs) and \"event-based\" exacerbations (\"symptom-based\" plus requiring antibiotics, corticosteroids, or unscheduled healthcare use) were estimated in separate models. Generalized estimating equations (GEE) models were reported as rate ratios (RRs) per interquartile range (IQR) increment in pollutant concentration with 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>NO₂, PM_2.5, and O_x (NO₂+O₃) concentrations (but not O₃) fell significantly during the pandemic. In the 673 participants with COPD included, both symptom-based and event-based exacerbation rates were likewise significantly higher during the pre-pandemic period. During the pre-pandemic period, O_x was positively associated with symptom-based exacerbations (RR: 1.21 [1.08,1.36]). During the pandemic period, O_x was positively associated with symptom-based (1.46 [1.13,1.89]) and event-based (1.43 [1.00,2.05]) exacerbations. Fewer self-reported pandemic protective behaviors, and higher viral infectious symptoms, were also associated with exacerbations. In stepwise multivariable risk-factor analyses, female gender (1.23 [1.04,1.45] and 1.41 [1.13,1.76]) and co-morbid asthma (1.65 [1.34,2.03] and 1.54 [1.19,2.00]) were associated with symptom-based and event-based exacerbations, respectively, blood eosinophils (1.42 [1.10,1.84]) were associated with event-based exacerbations, and each IQR increment in O_x was associated with symptom-based exacerbations (1.31 [1.06,1.61]).</p><p><strong>Conclusion: </strong>O_x exposure was consistently associated with symptom-based COPD exacerbations, and female gender, co-morbid asthma, and blood eosinophilia were found to be relevant risk factors.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"735-751"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Causal Relationship Between Gut and Skin Microbiota and Chronic Obstructive Pulmonary Disease:A Bidirectional Two-Sample Mendelian Randomization Analysis.","authors":"Zhiyan Luo, Gang Liao, Miaodi Meng, Xiufang Huang, Xiaohong Liu, Wujin Wen, Tiegang Yue, Weifeng Yu, Changjun Wang, Yong Jiang","doi":"10.2147/COPD.S494289","DOIUrl":"10.2147/COPD.S494289","url":null,"abstract":"<p><strong>Background: </strong>Recently, numerous studies have explored the potential impact of gut microbiota on Chronic Obstructive Pulmonary Disease (COPD). However, the causal relationship between skin microbiota and COPD, as well as the differences and similarities between the relationships of gut microbiota and COPD, has not been thoroughly studied.</p><p><strong>Methods: </strong>We conducted a comprehensive two-sample Mendelian randomization (MR) analysis to investigate the relationships between gut and skin microbiota and COPD. The inverse variance weighted (IVW) method was used as the primary approach. MR-Egger, weighted median, and MR-PRESSO methods were used as supplementary approaches. Various sensitivity and stability analyses were conducted to validate the results. Genetic variations of gut microbiota were obtained from the FR02 cohort study. Genetic variations of skin microbiota were derived from the KORA FF4 and PopGen cohorts, with a total of 1,656 skin samples. GWAS data for COPD were obtained from the FinnGen consortium, including 18,266 COPD cases and 311,286 controls from European cohorts.</p><p><strong>Results: </strong>The results of IVW method of MR analysis showed that 10 gut microbiotas and 4 skin microbiotas were negatively associated with COPD [<i>p</i> < 0.05, odds ratio (OR) < 1]; 3 gut microbiotas and 6 skin microbiotas were positively associated with COPD (<i>p</i> < 0.05, OR > 1). None of them were heterogeneous or horizontally pleiotropic (<i>p</i> > 0.05) or reverse causality.</p><p><strong>Conclusion: </strong>This study revealed the causal relationships between gut and skin microbiota and COPD, offering fresh perspectives for the prevention, diagnosis, and management of COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"709-722"},"PeriodicalIF":2.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}