International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Long-Term Inhaled Corticosteroid Use and the Risk of Open-Angle Glaucoma in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Inès Ben Ghezala, Sophie Dell'Aniello, Pierre Ernst, Samy Suissa","doi":"10.2147/COPD.S634969","DOIUrl":"https://doi.org/10.2147/COPD.S634969","url":null,"abstract":"<p><strong>Purpose: </strong>The question of whether inhaled corticosteroids (ICS) increase the risk of open-angle glaucoma (OAG) has produced conflicting data on short-term effects, but no study has evaluated their long-term effects. We assessed whether long-term cumulative ICS use is associated with an increased risk of incident OAG among patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Patients and methods: </strong>The United Kingdom Clinical Practice Research Datalink was used to form a cohort of patients with COPD, aged 40 years or more, who initiated an inhaled maintenance treatment, between September 2013 and March 2021. Subjects were followed until the occurrence of the first OAG diagnosis. Using a nested case-control design, each OAG case was matched with up to 100 concurrently glaucoma-free controls using risk-set sampling. Conditional logistic regression was used to compute the adjusted odds ratio of incident OAG associated with cumulative ICS exposure, as an estimate of the hazard ratio (HR) and its 95% confidence interval (CI).</p><p><strong>Results: </strong>The COPD cohort included 84,564 subjects, with 732 developing OAG (incidence rate 2.64 per 1000 person-years) and 56% having used an ICS since cohort entry. The adjusted HR of OAG associated with any ICS use since cohort entry, compared with non-use, was 1.14 (95% CI, 0.94-1.38). The HR was 1.11 (95% CI, 0.83-1.48) for total cumulative dose ≥365 mg and 1.23 (95% CI, 0.90-1.68) for over 3 years since ICS initiation.</p><p><strong>Conclusion: </strong>This large cohort study did not observe a statistically significant increase in the risk of OAG with ICS use, including long-term use and higher cumulative doses, among patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"634969"},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229054","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 of Peak Expiratory Flow with Pulmonary Fungal Infection in Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Single-Center Retrospective Study.","authors":"Awei Deng, Chengfeng Fu, Shengli Yi, Depeng Jiang","doi":"10.2147/COPD.S628459","DOIUrl":"https://doi.org/10.2147/COPD.S628459","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary fungal infections are increasingly recognized as important complications of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but early identification remains challenging. This study investigated the independent association between peak expiratory flow (PEF) and pulmonary fungal infection in hospitalized patients with AECOPD.</p><p><strong>Methods: </strong>This retrospective study enrolled 729 adult inpatients with AECOPD admitted to a tertiary hospital in Chongqing from January to December 2023. PEF was measured after admission and before treatment initiation. Pulmonary fungal infection was diagnosed based on host risk factors, microbiological evidence, clinical findings, and histopathology. Multivariable logistic regression assessed the association between PEF and pulmonary fungal infection. Subgroup and mediation analyses were also performed.</p><p><strong>Results: </strong>The mean age was 71.7 years, and 68.4% were male. Patients with pulmonary fungal infection were older and had lower PEF values than those without infection (2.1 ± 0.9 vs 2.4 ± 1.3, respectively), and showed higher ESR, CRP, and IL-6 levels. After covariate adjustment, higher PEF was independently associated with a lower risk of pulmonary fungal infection (OR = 0.81, 95% CI: 0.66-0.98, P = 0.034). This association remained consistent across age, sex, and smoking subgroups, without significant interactions. Age partially mediated this association, accounting for 15.68% of the total effect.</p><p><strong>Conclusion: </strong>Lower PEF was independently associated with increased pulmonary fungal infection risk in hospitalized patients with AECOPD. PEF may serve as a simple bedside indicator for early risk stratification and targeted clinical evaluation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"628459"},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228924","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":"Cytokine- and Airflow-Based Clustering Identifies COPD Phenotypes with Differing Quantitative CT Features.","authors":"Qing Wang, Yinan Yao, Mengling Xia, Jingyang Huang, Xinhong Huang, Yuan Ye, Jianya Zhou","doi":"10.2147/COPD.S634701","DOIUrl":"https://doi.org/10.2147/COPD.S634701","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with distinct inflammatory profiles that may be associated with key pathological features, including emphysema and airway wall remodeling. This study aimed to identify COPD subgroups based on circulating pro- and anti-inflammatory cytokine activity and airflow limitation and to examine their clinical, physiological, and quantitative CT characteristics.</p><p><strong>Methods: </strong>Demographic characteristics, symptom scores, pulmonary function parameters, and quantitative CT indices were collected from patients with stable COPD. Serum levels of pro- and anti-inflammatory cytokines were measured using enzyme-linked immunosorbent assay (ELISA). Cluster analysis was performed using a Gaussian mixture model (GMM).</p><p><strong>Results: </strong>A total of 319 stable COPD patients were included. Four distinct clusters were identified. Cluster 1 (Severe-low inflammation) was characterized by the lowest circulating inflammatory cytokine levels, the greatest symptom burden, the most severe airflow limitation, an increased exacerbation frequency, and the most extensive emphysema. Cluster 2 (Mild-low inflammation) exhibited low levels of pro- and anti-inflammatory cytokines, mild symptoms, relatively preserved lung function, and a low frequency of annual exacerbations. Cluster 3 (Moderate-elevated inflammation) had moderately elevated levels of pro- and anti-inflammatory cytokines, with intermediate mMRC and CAT scores, pulmonary function impairment and exacerbation frequency. Cluster 4 (Extremely high inflammation) was characterized by markedly elevated levels of pro- and anti-inflammatory cytokines, intermediate symptom burden, relatively preserved pulmonary function, pronounced airway wall thickening and a high frequency of moderate-to-severe exacerbations. Further cytokine ratio analysis revealed an IL-6-related shift in Clusters 3 and 4 and an IL-17-related shift predominantly in Cluster 3.</p><p><strong>Conclusion: </strong>Integrating cytokine profiles with airflow limitation identified four exploratory COPD phenotypes, highlighting a potential dissociation between systemic inflammation and disease severity. External and longitudinal validation is needed to confirm their reproducibility and clinical relevance.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"634701"},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229038","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":"Effective Connectivity and Clinical Correlates in Chronic Obstructive Pulmonary Disease.","authors":"Kyung-Il Han, Jin Ho Bae, Hang Joon Jo, Jae Min Park, Yoomi Yeo, Tai Sun Park, Dong Woo Park, Tae-Hyung Kim","doi":"10.2147/COPD.S634467","DOIUrl":"https://doi.org/10.2147/COPD.S634467","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is a substantial comorbidity in chronic obstructive pulmonary disease (COPD); however, the neural mechanisms underlying this association remain poorly understood. This study aimed to assess alterations in effective connectivity (EC) in patients with COPD and investigate their relationships with clinical measures.</p><p><strong>Methods: </strong>Resting-state functional magnetic resonance imaging (RS-fMRI) was performed in 38 patients with COPD and 30 healthy controls. EC was estimated using vector autoregressive (VAR) modelling combined with Granger causality analysis across 26 prespecified brain regions of interest derived from our previous functional connectivity study of the same cohort. Between-group differences in directed connectivity were assessed using Welch's <i>t</i>-tests. Associations between EC measures showing between-group differences and clinical measures were evaluated using age-adjusted partial Pearson correlations.</p><p><strong>Results: </strong>At the nominal two-sided <i>p</i> < 0.05 level, 37 directed connections showed between-group differences in effective connectivity, and the mean vector autoregressive coefficients for 35 of these connections lay on opposite sides of zero between the COPD and control groups. Among the connections showing between-group differences, age-adjusted associations in patients with COPD involved pulmonary function, systemic oxygenation, cognition, affect, and health status. These associations involved distributed cortical, subcortical, and cerebellar regions, with several directed connections showing convergence across multiple clinical domains.</p><p><strong>Conclusion: </strong>Resting-state VAR-based EC revealed distributed between-group differences in direction-sensitive BOLD temporal organization in COPD. Several of these EC measures were associated with pulmonary function, SpO₂, respiratory and COPD symptom burden, cognition, affect, and health status after age adjustment. These findings extend the functional connectivity profile of COPD by linking directed temporal relationships to its multidimensional clinical burden.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"634467"},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229012","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":"Baseline Neutrophil-to-Lymphocyte Ratio and Longitudinal Lung Function Decline in Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study.","authors":"Hanyu Xue, Zexiu Wang, Lihua Luo, Di Zhang, Xiaoying Yang, Mingyue Su, Tianwu Zhang","doi":"10.2147/COPD.S640635","DOIUrl":"10.2147/COPD.S640635","url":null,"abstract":"<p><strong>Background: </strong>Systemic inflammation may contribute to heterogeneous lung function trajectories in chronic obstructive pulmonary disease (COPD), but evidence linking the neutrophil-to-lymphocyte ratio (NLR) to longitudinal forced expiratory volume in one second (FEV1) change is limited.</p><p><strong>Methods: </strong>We analyzed repeated spirometry from a single-center retrospective cohort. Eligibility required clinically stable chronic obstructive pulmonary disease, baseline blood counts, at least two qualified spirometry assessments, and at least 12 months of recorded follow-up. Linear mixed-effects models estimated the association between baseline log2-transformed neutrophil-to-lymphocyte ratio and annual forced expiratory volume in one second (FEV1) change. Sequential models added demographic and exposure variables, then baseline disease severity. Post hoc analyses examined common visit windows and sensitivity to covariate selection.</p><p><strong>Results: </strong>Of 819 patients, 667 met longitudinal cohort criteria; 640 patients with 2525 qualified observations entered the complete-case model. Median recorded follow-up was 22 months, with a median of four qualified assessments per patient. Additional FEV1 decline per ratio doubling increased from 4.05 mL/year unadjusted (95% confidence interval -1.95 to 10.04) to 8.26 mL/year after severity adjustment (2.29 to 14.23; P=0.0068). Comparisons within the same 640 patients also showed model dependence. Restriction to baseline, 6-month and 12-month visit windows yielded 12.78 mL/year (2.72 to 22.84; 269 patients). The corresponding baseline, 12-month and 24-month estimate was imprecise (13.57 mL/year; -0.04 to 27.17; 116 patients).</p><p><strong>Conclusion: </strong>Higher baseline neutrophil-to-lymphocyte ratio was associated with modestly faster lung function decline after adjustment for disease severity. The association depended on the adjustment model and does not establish causality or individual predictive value. Prospective studies with standardized follow-up are needed.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"640635"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221068","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":"Development and Internal Validation of a Retrospective Prediction Model for Fungal Infections in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Xiaolan Chen, Mingyan Wu, Jingjing Wang, Hongbin Jiang, Shanmei Wang","doi":"10.2147/COPD.S562056","DOIUrl":"https://doi.org/10.2147/COPD.S562056","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic obstructive pulmonary disease (COPD) are at an elevated risk of fungal infections, yet reliable tools for early risk stratification are lacking. This study aimed to analyze the risk factors associated with fungal infections in patients with COPD and to develop a predictive model.</p><p><strong>Methods: </strong>This study retrospectively analyzed patients with COPD who were admitted to Shanghai Pulmonary Hospital, between June 2021 and June 2023. Demographic and clinical data were extracted from electronic medical records. The risk factors were explored by univariate logistic regression and stepwise multivariate logistic regressions. Model performance was assessed using the receiver operating characteristic curve and area under the curve (AUC), along with calibration and decision curve analyses. The internal validation was performed using Bootstrap (n=1000) method.</p><p><strong>Results: </strong>A total of 498 patients with COPD were enrolled, with 78 patients in the fungal infection group. Multivariable logistic regression analysis revealed that PaO2 within the normal range (OR=2.04, 95% CI: 1.12-3.71, <i>P</i>=0.02) and mold mix specific IgE above the normal threshold (OR=2.37, 95% CI: 1.04-5.36, <i>P</i>=0.04) were independently associated with an increased risk of fungal infections, whereas lymphocyte counts within the normal range (OR=0.37, 95% CI: 0.21-0.63, <i>P</i><0.01) were associated with a reduced risk. Procalcitonin, albumin, and medical history of COPD duration were also included in predictive model based on the regression analysis. The AUC was 0.74 (95% CI: 0.68-0.79), and the Hosmer-Lemeshow goodness-of-fit test and decision curves indicated good differentiation and calibration.</p><p><strong>Conclusion: </strong>This study identifies elevated PaO2, mold mix specific IgE and lymphocyte counts as risk factors for fungal infections. The predictive model incorporating PaO2, mold mix specific IgE, lymphocyte counts, procalcitonin, albumin, and medical history of COPD duration demonstrated good predictive performance, offering a potential tool for early identification of high-risk patients in clinical practice.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"562056"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225217","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 Recognition-to-Practice Gap: Physicians' Approaches to Osteoporosis Assessment and Management in COPD.","authors":"Rayan A Siraj, Aminah Mengash, Maryam M Almulhem, Mushabbab A Alahmari, Abdulelah M Aldhahir, Abdullah A Alqarni, Jaber S Alqahtani, Nowaf Y Alobaidi, Saleh S Algarni, Abdulrhman S Alghamdi, Malak A Alowaisi, Hussam S Alghamdi, Ghadeer S Alshammari, Abdulelah Alsulami, Mohammed M Alyami","doi":"10.2147/COPD.S634509","DOIUrl":"10.2147/COPD.S634509","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a common yet frequently under-recognised comorbidity in patients with chronic obstructive pulmonary disease (COPD), yet its integration into routine COPD care remains poorly understood. This study evaluated physicians' perceptions, confidence, clinical practices, perceived barriers, and factors associated with routine osteoporosis risk assessment.</p><p><strong>Methods: </strong>A national cross-sectional survey of general practitioners, pulmonologists, and critical care physicians practising in Saudi Arabia between October 2025 and March 2026 was conducted. The questionnaire assessed physicians' perceptions, confidence, osteoporosis-related clinical practices, and perceived barriers. Univariate and multivariate logistic regression analyses identified factors associated with routine osteoporosis risk assessment.</p><p><strong>Results: </strong>A total of 977 physicians participated. Most physicians recognised osteoporosis as an important comorbidity in COPD and agreed that it increases the risk of fractures, falls, and impaired lung function. Although 61.0% reported routinely assessing osteoporosis risk, several practices were inconsistently implemented, including fracture risk assessment and referral for bone health evaluation. Physicians generally reported moderate-to-high confidence in recognising and managing osteoporosis; however, gaps remained in identifying at-risk patients. The most frequently reported barriers were prioritisation of respiratory symptoms (58.9%), lack of clinical protocols (55.1%), limited consultation time (51.1%), and restricted access to diagnostic resources (51.1%). In multivariate analysis, pulmonologists (AOR=1.53, 95% CI: 1.07-2.18), physicians managing 10-30 COPD patients monthly (AOR=1.70, 95% CI: 1.20-2.40), formal training (AOR=1.45, 95% CI: 1.04-2.03), and self-reported knowledge (AOR=1.71, 95% CI: 1.22-2.39) were independently associated with routine osteoporosis assessment.</p><p><strong>Conclusion: </strong>Despite favourable perceptions and moderate-to-high confidence, osteoporosis risk assessment remains inconsistently integrated into COPD care. Educational initiatives and standardised clinical pathways may help improve the recognition and management of osteoporosis in patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"634509"},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221020","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 Burden Across 48 Asian Locations, 2009-2023: Demographic Drivers and Socioeconomic Inequality.","authors":"Qin Luo, Yao Chen, Wu Yang, Yuzhu Wang, Zhenling Gao, Huilei Zeng","doi":"10.2147/COPD.S626397","DOIUrl":"10.2147/COPD.S626397","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) can show declining age-standardized rates while the number of affected people grows. We quantified this divergence and its demographic and socioeconomic pattern across Asia.</p><p><strong>Methods: </strong>Using Global Burden of Disease 2023 estimates for 48 Asian locations (2009-2023), primary analyses examined incidence, prevalence, deaths, disability-adjusted life-years (DALYs), age-sex patterns, estimated annual percentage changes, demographic decomposition, and Socio-demographic Index (SDI)-related inequality. Exploratory analyses assessed pre-2020 trend deviations and subregional ARIMA forecasts to 2030.</p><p><strong>Results: </strong>From 2009 to 2023, incident cases increased from 7.74 million to 10.75 million (38.9%), prevalent cases from 91.88 million to 129.76 million (41.2%), deaths from 2.11 million to 2.63 million (24.8%), and DALYs from 46.43 million to 55.97 million (20.5%). Age-standardized incidence and prevalence rates declined in 34 of 48 locations, death rates in 37, and DALY rates in 43. Of 522,061 additional deaths, population growth contributed 345,084 and population aging 933,776, partly offset by epidemiological change (-756,799). The death-rate SII changed from -69.90 in 2009 to -87.22 in 2023, and the concentration index from -0.140 to -0.220, indicating increasing concentration in lower-SDI populations. Summed subregional point deviations for 2020-2023 were small relative to expected burden: deaths were 0.57% and DALYs 0.26% above expected, whereas incidence was 0.35% and prevalence 0.51% below expected. Conditional 2030 point forecasts were 13.28 million incident cases, 156.74 million prevalent cases, 2.81 million deaths, and 62.63 million DALYs.</p><p><strong>Conclusion: </strong>Declining age-standardized rates have not reduced COPD service need across Asia. Population aging and lower-SDI disadvantage support prevention and care strategies tailored to demographic and socioeconomic context.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"626397"},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217104","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 of Low Weight-Adjusted Muscle Mass with the Frequent Exacerbation Phenotype in COPD: A Retrospective Cross-Sectional Study.","authors":"Yunfeng Zhang, Cheng Xu, Xinhao Jiang, Ling Qu, Zhouwei Chen, Qing Cheng, Xianghuai Xu","doi":"10.2147/COPD.S633358","DOIUrl":"10.2147/COPD.S633358","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional height-adjusted muscle mass index (ASMI) may be influenced by weight loss in advanced COPD. This study compared the associations of ASMI and appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI) with the frequent exacerbation phenotype, assessed whether the ASM/BMI association differed by BMI category, and evaluated the discriminative performance of ASM/BMI.</p><p><strong>Patients and methods: </strong>This retrospective cross-sectional study included 419 patients with COPD. Body composition was measured using multifrequency bioelectrical impedance analysis. Multivariable logistic regression and subgroup interaction analyses were used to evaluate the independent associations of ASMI and ASM/BMI with the frequent exacerbation phenotype (≥2 moderate or ≥1 severe exacerbations in the preceding year).</p><p><strong>Results: </strong>Low ASMI was not significantly associated with the frequent exacerbation phenotype (adjusted OR [aOR], 1.52; 95% CI, 0.96-2.41). Low ASM/BMI was significantly associated with this phenotype (aOR, 1.74; 95% CI, 1.07-2.87). This association was modified by BMI (P_interaction = 0.005). Among patients with a BMI < 24 kg/m², the association between low ASM/BMI and the frequent exacerbation phenotype was strongest (aOR, 5.66; 95% CI, 2.22-17.66). This association was not observed in patients with a BMI ≥ 24 kg/m² (aOR, 1.00; 95% CI, 0.51-1.97).</p><p><strong>Conclusion: </strong>In COPD, muscle mass should be interpreted in the context of body weight. Low ASM/BMI was strongly associated with the frequent exacerbation phenotype specifically among patients with a BMI < 24 kg/m². These findings support further evaluation of ASM/BMI as a complementary body-composition marker in this subgroup rather than as a standalone discriminative tool.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"633358"},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217112","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":"Revealing Biomarkers and Candidate Drugs for Chronic Obstructive Pulmonary Disease Using Bioinformatics and Deep Learning.","authors":"Tianbiao Wu, Aiping Wang, Jinggang Xu","doi":"10.2147/COPD.S636946","DOIUrl":"10.2147/COPD.S636946","url":null,"abstract":"<p><strong>Background: </strong>There is a dearth of precise treatments capable of effectively decelerating the progression of chronic obstructive pulmonary disease (COPD). Consequently, there is an urgent necessity to discover novel potential biomarkers and rapidly translatable therapeutic drugs.</p><p><strong>Methods: </strong>The GSE57148, GSE38974, and GSE173896 datasets were included in this study. Cell clustering and annotation were conducted via Seurat, and disease-related genes were screened through an integrated approach combining Scissor-based prioritization, differential expression profiling, and weighted gene co-expression network analysis. Subsequently, 12 machine learning algorithms were used to construct models and identify biomarkers. The mechanisms of immune microenvironment remodeling were analyzed through cell communication and pseudo-time series analysis. Furthermore, an in vitro COPD model was constructed based on BEAS-2B cells and validated by RT-qPCR. Finally, a deep learning model and molecular docking were utilized to conduct AI-driven drug repurposing screening targeting biomarkers.</p><p><strong>Results: </strong>A total of 67 intersection genes were obtained. APRT, COX8A, EDF1 and RPL37 were identified as biomarkers for COPD. Further cell communication analysis revealed that CD4 naive T cells mediate immune microenvironment remodeling via the HLA-E-CD94/NKG2A inhibitory axis. Additionally, in vitro experiments confirmed that APRT, COX8A, and EDF1 were significantly underexpressed in the model group. Among these, EDF1 represented a previously unreported candidate biomarker in COPD and was therefore selected as a putative target for AI-driven drug repurposing. Deep learning and molecular docking targeting the novel target EDF1 identified several FDA - approved drugs with binding energies ≤ -5.0 kcal/mol. Among these drugs, doxycycline exhibited a stable binding conformation and strong binding activity with EDF1, indicating high potential for drug repurposing.</p><p><strong>Conclusion: </strong>This study identified four potential biomarkers for COPD and screened several candidate drugs targeting EDF1, providing new targets and translational strategies for the early diagnosis and precision treatment of COPD. EDF1 is a novel candidate target not previously reported in COPD; however, functional validation is required before it can be considered a therapeutic target.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"636946"},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217155","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}