International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Construct Validity Matters: Are CAT and 5STS Surrogates of Exercise Capacity in COPD? [Letter].","authors":"Roberto Vera-Uribe, Rodrigo Torres-Castro, Matías Otto-Yáñez","doi":"10.2147/COPD.S619084","DOIUrl":"https://doi.org/10.2147/COPD.S619084","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"619084"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844870","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 <i>CD14</i> as a Potential Biomarker Relating to PANoptosis in Chronic Obstructive Pulmonary Disease.","authors":"Xue Fu, Jiawei Dong, Jian Yang, Xiaotian Zhang, Shangkun Cai, Yiwei Zhang, Shenglong Lv, Meng Zhang","doi":"10.2147/COPD.S577042","DOIUrl":"https://doi.org/10.2147/COPD.S577042","url":null,"abstract":"<p><strong>Background: </strong>The processes of pyroptosis, apoptosis, and necroptosis (PANoptosis) play a crucial role in the development of chronic obstructive pulmonary disease (COPD). Our objective is to explore potential PANoptosis-related genes in COPD.</p><p><strong>Methods: </strong>Human COPD-related transcriptomic datasets (GSE8545, GSE20257, GSE11784 and GSE1650) were retrieved from the Gene Expression Omnibus (GEO). First, based on GSE8545 dataset, candidate genes were identified using differentially expressed gene (DEG) analysis, Weighted Gene Co-expression Network Analysis (WGCNA), Least Absolute Shrinkage and Selection Operator (LASSO) regression, and Support Vector Machine-Recursive Feature Elimination (SVM-RFE). Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted for the relevant genes. <i>CD14</i> was identified as a diagnostic biomarker through validation across independent human cohorts (GSE20257 and GSE11784). CIBERSORT was employed to evaluate immune infiltration differences between <i>CD14</i> expression groups. Finally, potential therapeutic drugs for <i>CD14</i> were predicted using the Drug-Gene Interaction Database (DGIdb).</p><p><strong>Results: </strong>Three PANoptosis-related hub genes (<i>CD14, IRF2</i>, and <i>BOK</i>) were defined in this study. KEGG enrichment analysis revealed that these genes were significantly enriched in the \"Apoptosis - multiple species\" signaling pathway. Validation across multiple independent human datasets identified <i>CD14</i> as the key gene. <i>CD14</i> exhibited significantly elevated expression in the lung tissues of COPD patients (P < 0.001). Immune infiltration analysis indicated that <i>CD14</i> expression levels were significantly negatively correlated with resting mast cells and positively correlated with monocytes. Receiver Operating Characteristic curve analysis confirmed the robust diagnostic performance and stability of <i>CD14</i>, with Area Under the Curve values of 0.756, 0.702, 0.703, and 0.732 in the GSE8545, GSE20257, GSE11784, and GSE1650 datasets, respectively. Furthermore, three potential therapeutic agents targeting <i>CD14</i>-VB-201, LOVASTATIN, and IC143-were predicted.</p><p><strong>Conclusion: </strong>We identified <i>CD14</i> as a marker gene associating with PANoptosis in COPD, providing new ideas for clinical diagnosis and drug design of COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"577042"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844933","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 Feasibility and Acceptability of Culturally Appropriate Pulmonary Rehabilitation for Adults with Chronic Obstructive Pulmonary Disease in Sri Lanka: Randomized Controlled Trial.","authors":"Akila R Jayamaha, Chamilya H Perera, Mark W Orme, Ravini De S Karunatillake, Amitha Fernando, Andy Barton, Michael C Steiner, Jesse Matheson, James Manifield, Amy C Barradell, Suresh Chathurantha, Ruwin R Dias, Thamara D Amarasekara, Savithri W Wimalasekera, Sally J Singh","doi":"10.2147/COPD.S527013","DOIUrl":"https://doi.org/10.2147/COPD.S527013","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary rehabilitation (PR) is recommended internationally for individuals with chronic obstructive pulmonary disease (COPD), but there is limited evidence and practice of PR in Sri Lanka. Key challenges for PR such as poor accessibility, uptake and completion need to be addressed when designing and delivering new PR programmes. Accordingly, this study determined the feasibility and acceptability of culturally adapted PR for adults with COPD in Sri Lanka.</p><p><strong>Patients and methods: </strong>A randomized controlled feasibility trial was conducted with 50 adults living with COPD in Colombo, Sri Lanka. A culturally adapted PR comprised a 6-week rolling programme with sessions conducted twice every week. Sessions involved endurance and resistance exercise training, education and cultural adaptations of nutritional support and group singing. The control group received usual care, which did not include any form of PR or exercise training. Feasibility was determined by uptake (≥60% of eligible participants consented) and completion (≥70% of recruited participants). Acceptability was explored by focus group discussions (FGDs) analysed thematically.</p><p><strong>Results: </strong>Seventy-nine eligible individuals (94% of screened) were referred in order to recruit 50 participants (63% uptake). The majority of participants in both intervention (72%, n=18) and control (64%, n=16) groups completed the study. Based on qualitative focus group discussions four themes emerged: (1) Increased knowledge following PR, including dispelling misbeliefs about COPD and improving medication adherence; (2) Perceived improvements in health following PR, including improved walking ability and reduced breathlessness (3) Enjoyment and benefits of cultural adaptations to PR, and (4) Challenges during PR, including adherence to exercise and travel requirements.</p><p><strong>Conclusion: </strong>Culturally adapted PR was feasible and acceptable to adults with COPD in Sri Lanka. A fully powered trial is warranted for evaluating clinical and cost-effectiveness of culturally adapted PR.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"527013"},"PeriodicalIF":3.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844892","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 an Integrated Medical-Nursing Clinical Pathway on 30-Day Readmission and Long-Term Prognosis in Patients with Acute Exacerbation of COPD: A Retrospective Cohort Study Using Real-World Data.","authors":"Yaping Dou, Li Wang, Yajie Wang, Jing Wang, Hongqian Qin, Lihong Wang, Kun Li, Na Li","doi":"10.2147/COPD.S589413","DOIUrl":"https://doi.org/10.2147/COPD.S589413","url":null,"abstract":"<p><strong>Background: </strong>Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is associated with high rates of hospital readmission and mortality. Traditional fragmented care often fails to address the complex needs of these patients. This study aimed to evaluate the impact of an Integrated Medical-Nursing Management (IMNM) model on readmission rates, mortality, and patient-centered outcomes in AECOPD patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at the First Hospital of Hebei Medical University involving AECOPD patients admitted between January 2022 and January 2025. Patients were divided into a Control Group (standard care, Jan 2022-Jun 2023) and an Intervention Group (IMNM model, Aug 2023-Jan 2025). The IMNM model featured interdisciplinary rounds, joint discharge planning, and structured follow-up. Propensity Score Matching (PSM) was used to balance baseline covariates (1:1 matching). The primary outcome was hospital readmission rates at 30, 90, 180, and 365 days. Secondary outcomes included all-cause mortality, CAT scores, and treatment adherence.</p><p><strong>Results: </strong>A total of 120 patients (60 per group) were included after PSM. The Intervention Group showed significantly lower readmission rates at 30 days (15.0% vs. 28.3%, P=0.046) and 365 days (26.7% vs. 51.7%, P<0.001). The hazard ratio for readmission-free survival favored the intervention (HR 0.38, 95% CI 0.21-0.70). All-cause mortality at 1 year was significantly lower in the Intervention Group (5.0% vs. 13.3%, P=0.041). Patients in the IMNM group also demonstrated improved CAT scores (MD -5.4, P<0.001) and higher medication adherence (80.0% vs. 53.3%, P=0.004).</p><p><strong>Conclusion: </strong>In conclusion, the Integrated Medical-Nursing Management model is associated with reduced hospital readmissions and mortality, as well as improved patient quality of life and treatment adherence in AECOPD patients. These findings provide actionable evidence for healthcare systems to adopt collaborative clinical pathways, thereby standardizing routine clinical practice to mitigate the burden of AECOPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"589413"},"PeriodicalIF":3.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822528","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":"A Predicted FEV1/FVC Model Based on a Simple Respiratory Questionnaire for Early Diagnosis of COPD in Shimane Cohort, Japan.","authors":"Mika Nakao, Tamio Okimoto, Akari Tanino, Yoshihiro Amano, Takamasa Hotta, Megumi Hamaguchi, Shunichi Hamaguchi, Yukari Tsubata, Toshihiko Kawamura, Takeshi Isobe","doi":"10.2147/COPD.S575341","DOIUrl":"https://doi.org/10.2147/COPD.S575341","url":null,"abstract":"<p><strong>Purpose: </strong>Early detection of chronic obstructive pulmonary disease (COPD) remains challenging in primary care settings where spirometry is not always available. We aimed to develop a simple questionnaire-based approach to estimate the forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) ratio for COPD screening.</p><p><strong>Patients and methods: </strong>This was a single-center retrospective observational study based on the Shimane cohort. From 2008 to 2014, respiratory questionnaires and spirometry were performed during health check-ups of individuals aged ≥40 years. Among 2230 participants who underwent spirometry, 727 current or former smokers without a history of bronchial asthma were included for model development. Multiple regression analysis was used to identify questionnaire items associated with FEV₁/FVC and to construct a simplified estimation model.</p><p><strong>Results: </strong>Four variables-age, smoking intensity, exertional dyspnea, and paroxysmal dyspnea-were independently associated with FEV₁/FVC and were incorporated into the model. The model demonstrated modest explanatory power <i>(R²</i> = 0.136), with no significant lack-of-fit (F = 1.152). Based on these variables, a simple four-item model enabled estimation of FEV₁/FVC and identification of individuals at risk for airflow limitation.</p><p><strong>Conclusion: </strong>We developed a simple questionnaire-based model to estimate FEV₁/FVC using four easily obtainable variables. Although the model is exploratory and requires external validation, it may serve as a practical screening tool to identify individuals at risk for COPD in settings where spirometry is not readily available.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"575341"},"PeriodicalIF":3.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822565","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 in Africa in the Post-COVID Era: A GBD 2023 Analysis of Trends, Demographic Drivers and Health-System Performance.","authors":"BoWen Shi, Jing Liu, FuCheng Zhou, BangLing Han, YanBo Wang","doi":"10.2147/COPD.S588302","DOIUrl":"https://doi.org/10.2147/COPD.S588302","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is an emerging non-communicable priority in Africa, yet how the COVID-19 era has shaped COPD burden and its drivers across the continent remains unclear.</p><p><strong>Methods: </strong>Using Global Burden of Disease (GBD) 2023 estimates, we quantified COPD incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for 52 African countries from 2019 to 2023. Age-standardised rates (ASRs) per 100,000 population were calculated using the GBD standard population. Trends were summarised using estimated annual percentage change (EAPC). Das Gupta decomposition partitioned changes in total DALYs into contributions from population growth, population ageing, and epidemiologic change (changes in age-specific DALY rates). Frontier analysis benchmarked 2023 age-standardised DALY rates against Socio-demographic Index (SDI)-expected values to identify over- and under-performing countries. Socioeconomic gradients were assessed using the Slope Index of Inequality (SII).</p><p><strong>Results: </strong>From 2019 to 2023, incident COPD cases increased from 751,091 to 871,054 (+16.0%), prevalent cases from 10.99 to 12.70 million (+15.6%), DALYs from 3.56 to 3.86 million (+8.5%), and deaths from 119,371 to 125,680 (+5.3%). Median age-standardised DALY and mortality rates declined from 579.6 to 540.6 and from 23.2 to 21.2 per 100,000, respectively, whereas incidence and prevalence ASRs rose modestly in most countries. Men had higher age-specific incidence and prevalence than women, with substantially larger excesses in DALYs (~50-60%) and mortality (~70-80%) across adult age groups. Decomposition showed that the net increase of ~303,100 DALYs was driven mainly by population growth and ageing, while epidemiologic improvements offset ~60% of demographic pressure. Frontier analysis showed marked heterogeneity: about one-third of countries had DALY rates ≥20% above SDI-expected values, whereas another third achieved burdens at or below the frontier.</p><p><strong>Conclusion: </strong>In the immediate post-pandemic period, Africa has rising absolute COPD burden but improving age-standardised disability and mortality in most countries. Large sex disparities and wide performance gaps at similar SDI levels highlight opportunities for targeted tobacco control, clean-energy transitions, and strengthened chronic respiratory care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"588302"},"PeriodicalIF":3.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786630","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":"Community-Based Case-Finding for Chronic Obstructive Pulmonary Disease and Self-Management Education in Partnership with Faith-Based Organizations.","authors":"Lorriane A Odhiambo, Katherine M Joseph, Adell Moore, Bernice Crafton, Lorraine W Jackson, Anneka Ruffin, Brianica Collier, K M Monirul Islam, Varsha Taskar, Caralee Forseen, Stephanie Wright","doi":"10.2147/COPD.S572998","DOIUrl":"https://doi.org/10.2147/COPD.S572998","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is poorly diagnosed with millions unaware they have the condition, preventing or delaying treatment and behavioral changes. We partnered with faith-based organizations (FBOs) to raise awareness of COPD among Black Americans by facilitating diagnosis and offering self-management education in the community.</p><p><strong>Methods: </strong>Cross-sectional and pre-post study designs were applied. Three churches identified representatives to serve as COPD liaisons (CLs). CLs received training on screening procedures and an overview of COPD. Case-finding was conducted at health fairs where CLs helped administer a screening tool (COPD-population screener (PS)) to identify high-risk individuals and refer those who scored ≥5 for spirometry performed by respiratory therapists (RTs). RTs referred those with high risk of having COPD (scores ≥5 and FEV1/FVC ~ 0.70) to discuss results with their provider, and those eligible (COPD high-risk, COPD diagnosed, caregivers, and current or former smokers), to attend bi-monthly educational sessions. Bristol COPD Knowledge Questionnaire was used to assess participants' knowledge pre-post intervention and CL training. CLs also completed a self-efficacy questionnaire. Independent <i>t</i>-test, paired <i>t</i>-test, and Chi-squared test or Fisher's Exact test were applied.</p><p><strong>Results: </strong>We attended seven health fairs and engaged four CLs. CL self-efficacy was higher, while knowledge increased by 6.2% post-training then declined by 5%. Of the 170 people who completed the screening tool, 40 received spirometry, 3 (8.1%) and 9 (24.3%) had FEV1/FVC ratios of 0.70, and >0.70 to <0.80, respectively. Prevalence of COPD was approximately 12.6%, smoking history (former: 27.3%, current: 3.6%), and sleep apnea, 23.8%. About 11/38 people attended at least one educational session and knowledge scores increased significantly from baseline to post-session, 42% to 55% (t=-4.82, df=12, p=0.00).</p><p><strong>Conclusion: </strong>COPD case-finding implemented in partnership with FBOs can supplement efforts in primary care. Routine educational sessions in the community improved access to self-management education for people with COPD and their caregivers. Engaging CLs in addressing respiratory health inequities can lead to greater impact in minority populations.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"572998"},"PeriodicalIF":3.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786562","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":"A Quarter-Century of Chronic Obstructive Pulmonary Disease in the Intensive Care Unit (2000-2025): A Bibliometric Roadmap of Thematic Evolution and Future Frontiers.","authors":"Yanyan Chen, Wen Wang","doi":"10.2147/COPD.S598017","DOIUrl":"https://doi.org/10.2147/COPD.S598017","url":null,"abstract":"<p><strong>Background: </strong>Research on Chronic Obstructive Pulmonary Disease (COPD) in the Intensive Care Unit (ICU) has expanded rapidly, yet a comprehensive, longitudinal bibliometric analysis mapping its is scientific evolution lacking.</p><p><strong>Methods: </strong>We conducted a bibliometric analysis of 2,512 publications from the Web of Science Core Collection (2000-2025). A preliminary literature search confirmed no prior bibliometric study has specifically and systematically mapped this entire domain. Using VOSviewer and CiteSpace, we analyzed publication trends, collaborations, co-citation networks, and keyword bursts.</p><p><strong>Results: </strong>Annual publications show a consistent upward trajectory, with accelerated growth post-2019. The United States, China, and France are leading contributors, with robust international collaboration. The intellectual structure has evolved from foundational mechanical ventilation research to integrated management and prognostic modeling. Current research frontiers emphasize non-invasive ventilation, acute exacerbation management, and outcomes in multi-organ failure.</p><p><strong>Conclusion: </strong>This study provides the first quarter-century roadmap of ICU-focused COPD research, demonstrating its maturation toward data-driven and personalized care. By delineating the thematic evolution and identifying emergent interdisciplinary frontiers, such as data science integration and post-ICU recovery, this analysis offers a strategic guide for prioritizing research and optimizing care for this vulnerable population.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"598017"},"PeriodicalIF":3.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786639","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":"Perceived Acceptability of SPACE for COPD© as a Maintenance Option Following Pulmonary Rehabilitation Discharge: A Qualitative Interview Study with Patients and Facilitators Using Framework Analysis.","authors":"Amy C Barradell, Khaled Alqahtani, Annabel Hong, Jessica Lapworth, Kathryn Greenall, Israa Al-Naabi, Ala Szczepura, William D C Man, Claire M Nolan, Gillian Doe, Nikki Gardiner, Charlotte Gerlis, Claire Bourne, Sally J Singh, Linzy Houchen-Wolloff","doi":"10.2147/COPD.S538733","DOIUrl":"https://doi.org/10.2147/COPD.S538733","url":null,"abstract":"<p><strong>Introduction: </strong>Following completion of Pulmonary Rehabilitation (PR), the biopsychosocial benefits often decline. PR maintenance is recommended to extend the benefits; however, detail lacks on what this should entail. SPACE for COPD© is a light touch, evidenced-based self-management intervention which we tested as a maintenance strategy during the COVID-19 pandemic. We explored the acceptability of SPACE for COPD© as a maintenance option following PR for both patients and facilitators using qualitative research methods.</p><p><strong>Methods: </strong>We conducted semi-structured interviews and focus groups with patients and intervention facilitators involved in the SPACE for COPD© maintenance study. These were audio recorded, transcribed verbatim and analysed using Framework Analysis.</p><p><strong>Results: </strong>Seventeen patients were interviewed; 13 (76.5%) of which were programme completers: five (29.4%) received a group-based intervention, four (23.5%) received one-to-one, and eight (47.1%) received hybrid. Two focus groups were conducted with eight facilitators; six (75%) were physiotherapists, one (12.5%) was a nurse, and one (12.5%) was a health psychologist. Analysis generated six themes: (1) the changing structure of maintenance SPACE for COPD©; (2) the integral role of the facilitator; (3) engagement with the manual required time and commitment from patients; (4) staying active on maintenance SPACE for COPD© was facilitated by goal setting and exercise; (5) biopsychosocial outcomes of maintenance SPACE for COPD©; and (6) the future of maintenance SPACE for COPD©.</p><p><strong>Conclusion: </strong>Maintenance SPACE for COPD© was acceptable and could be implemented into the PR healthcare pathway during the COVID-19 pandemic. It helped patients to adopt and integrate new exercise habits if they could adapt and personalise these to their home lives. Adaptions made during the COVID-19 pandemic created a menu of options. Building upon this personalisation is required to ensure the intervention is accessible and patient-centred.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"538733"},"PeriodicalIF":3.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786115","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":"Nicotine Metabolism and Chronic Obstructive Pulmonary Disease: Mendelian Randomization and Phenotypic Characterization Analysis.","authors":"Ting-Fen Ji, Shi-Wen Song, Ying Xie, Zhao Liu, Ying-Man Gao, An-Qi Cheng, Xin-Mei Zhou, Min Wang, Hua-Ping Dai, Liang Zhao, Dan Xiao, Chen Wang","doi":"10.2147/COPD.S594021","DOIUrl":"https://doi.org/10.2147/COPD.S594021","url":null,"abstract":"<p><strong>Background: </strong>Smokers with similar smoking exposure show markedly different risks of chronic obstructive pulmonary disease (COPD), and it remains unclear whether genetically determined nicotine metabolism, measured by the nicotine metabolite ratio (NMR), is independently associated with COPD beyond smoking exposure.</p><p><strong>Methods: </strong>This study integrated genetic evidence and population-based phenotypic analyses. First, two-sample Mendelian randomization (MR) analyses were conducted using genome-wide association study summary statistics to evaluate the causal effect of the NMR on COPD, with colocalization analyses to assess shared causal genetic variants. Second, phenotypic analyses in the China National Tobacco Cessation Cohort Study were conducted in a cross-sectional setting to compare COPD prevalence across metabolic phenotypes under comparable smoking exposure, with mediation analyses evaluating the contribution of smoking behavior.</p><p><strong>Results: </strong>MR analysis showed a causal association between a higher NMR and increased risk of COPD (OR = 1.06, 95% CI: 1.05-1.08). Colocalization analyses identified shared causal variants. Population-based phenotypic analyses showed that COPD prevalence was consistently higher in normal metabolizers (NMR ≥ 0.31) than slow metabolizers (NMR < 0.31), regardless of smoking exposure strata, and more importantly, remained higher within comparable levels of cumulative smoking. Mediation analysis showed that smoking behavior partially mediated this association (indirect effect β = 0.0049, P < 0.001), accounting for 14.5% of the total effect.</p><p><strong>Conclusion: </strong>Nicotine metabolism, as captured by NMR, is causally associated with COPD susceptibility. These findings suggest that incorporating nicotine metabolism into smoking exposure assessment may have potential value in improving COPD risk stratification.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"594021"},"PeriodicalIF":3.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786023","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}