International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Pharmacist-Driven Outcomes in Asthma and COPD: A Meta-Analysis of Clinical Outcomes and Medication Adherence.","authors":"Wenting Xie, Xuwen Zhang, Wenjun Wei, Na Li, Xingyu He, Zheng Shi, Yao Wang","doi":"10.2147/COPD.S547614","DOIUrl":"https://doi.org/10.2147/COPD.S547614","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to evaluate the effectiveness of pharmaceutical care in managing asthma and chronic obstructive pulmonary disease (COPD), focusing on clinical outcomes, medication adherence, and quality of life.</p><p><strong>Patients and methods: </strong>Randomized controlled trials comparing asthma or COPD patients who received pharmaceutical care intervention on the basis of the original treatment and the control group who only received the original treatment were included. The main results include Asthma Control Test (ACT); COPD Assessment Test (CAT); modified Medical Research Council (mMRC) dyspnea scale. Secondary outcomes were medication adherence; correct rate of inhaler technique; emergency room visit; hospitalization; Asthma Quality of Life Questionnaire (AQLQ); Peak Expiratory Flow Rate (PEFR, L/min). All analyses used a random - effects model.</p><p><strong>Results: </strong>A total of 18 randomized controlled trials involving 4173 patients were included. The results showed that in the pharmaceutical care group, the mean correct inhalation technique rate (OR = 6.53, 95% CI: [3.19, 13.37], P < 0.001), medication adherence (OR = 1.45, 95% CI: [1.03, 2.03], P = 0.031), and the number of patients with better asthma control as indicated by ACT results (OR = 2.51, 95% CI: [2.51, 4.35], P < 0.01) were significantly better than those in the control group. The emergency room visit rate (OR = 0.44, 95% CI: [0.29, 0.67], P < 0.001) and hospital admissions rate (OR = 0.27, 95% CI: [0.19, 0.39], P < 0.001) were significantly lower. The PEFR of patients was better (SMD = 0.37, 95% CI: [0.09, 0.6], P < 0.01). However, no significant changes were observed in CAT, AQLQ, or mMRC.</p><p><strong>Conclusion: </strong>Pharmacists' interventions exert a positive effect on asthma and COPD management outcomes, though improved research design and quality are still needed.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"547614"},"PeriodicalIF":3.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786086","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":"Differences in Clinical Characteristics of AECOPD Patients with or without <i>Candida</i> Isolation from the Lower Respiratory Tract.","authors":"Xuan Wei, Xiaofeng Li, Jiehua Deng, Xin Wu, Yubin Zhang, Ruobin Liu, Qing Liang, Caiyan Wu, Hui Zhang, Jianquan Zhang","doi":"10.2147/COPD.S594531","DOIUrl":"https://doi.org/10.2147/COPD.S594531","url":null,"abstract":"<p><strong>Background: </strong><i>Candida</i> species are frequently found in the lower respiratory tract (LRT) of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), but the clinical significance is uncertain. This study compared the clinical differences between AECOPD patients with and without <i>Candida</i> in their LRT and assessed the impact on disease outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study on AECOPD patients hospitalized at the First Affiliated Hospital of Guangxi Medical University. Demographic characteristics, clinical data, and follow-up data were compared between AECOPD patients with and without <i>Candida</i> isolated from their LRT. Univariate and multivariate logistic regression analyses were performed to identify risk factors for AECOPD. Survival curves for the patients with and without <i>Candida</i>-positive LRT samples were calculated using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 225 hospitalized AECOPD patients were included in the study, 88 of whom had <i>Candida</i> isolated from their LRT, while 137 did not. The <i>Candida</i>-positive group had a greater pack-year history and higher COPD Assessment Test (CAT) scores compared to the <i>Candida</i>-negative group. The proportion of patients with Modified Medical Research Council (mMRC) grade 4, Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) grade 4 and hospitalizations for AECOPD in the past year were higher in the <i>Candida</i>-positive group. Peripheral blood lymphocytes, CD8⁺ T-lymphocytes and percent predicted forced expiratory volume in 1 s (FEV₁) were significantly lower in the <i>Candida</i>-positive group (<i>P</i> < 0.05). Patients without <i>Candida</i> survived significantly longer than those with <i>Candida</i> (<i>P</i> < 0.001). The presence of <i>Candida</i> and mMRC grade 4 were independent risk factors for both acute exacerbation and hospitalization in the past year.</p><p><strong>Conclusion: </strong>Positive C<i>andida</i> isolation and mMRC grade 4 are independent risk factors for AECOPD. <i>Candida</i> in the LRT of COPD patients may predict more severe clinical symptoms, greater airflow limitation, and poorer survival outcomes.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"594531"},"PeriodicalIF":3.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786593","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":"Re-Evaluating the Relationship Between Insulin Resistance and Chronic Obstructive Pulmonary Disease: Evidence from NHANES and Mendelian Randomization.","authors":"Na Jiang, Qian Jin, Weihua Xu, Feihua Huang","doi":"10.2147/COPD.S587160","DOIUrl":"https://doi.org/10.2147/COPD.S587160","url":null,"abstract":"<p><strong>Background and purpose: </strong>Observational studies suggest an association between insulin resistance (IR) and chronic obstructive pulmonary disease (COPD), but this link is susceptible to confounding and reverse causality. This study integrated cross-sectional analysis with Mendelian Randomization (MR) to systematically evaluate their potential causal relationship.</p><p><strong>Methods: </strong>Using NHANES data, we employed complex sampling weighting and multivariable logistic regression to assess the observational association between IR (measured by HOMA-IR) and COPD. For genetic analysis, genetic variants strongly associated with IR were selected as instrumental variables from GWAS summary data. Two-sample MR analyses were conducted using inverse-variance weighted (IVW), weighted median, and MR-Egger regression, with rigorous testing for pleiotropy and heterogeneity.</p><p><strong>Results: </strong>Observational analysis showed no significant association before confounder adjustment (P=0.166). After adjustment, moderate IR levels (third quintile) were associated with increased COPD risk (OR=2.24, 95% CI: 1.15-4.37, P=0.018). MR analysis revealed inconsistent estimates: IVW suggested a weak risk effect (OR=1.009, P<0.001), while MR-Egger indicated a protective effect (OR=0.998, P=1.54e-05). The MR-Egger intercept test detected significant horizontal pleiotropy (P<2e-16), indicating that genetic instruments influence COPD through pathways independent of IR, violating a key MR assumption. The genetic effect sizes were extremely small and not clinically meaningful.</p><p><strong>Conclusion: </strong>This integrated analysis does not support an independent causal role of IR in COPD. The observational association is confounded and non-linear, while genetic evidence is undermined by substantial pleiotropy. Therefore, IR should be regarded as a comorbid risk marker reflecting a systemic metabolic-inflammatory state rather than a direct causal target. For COPD patients with comorbid IR, clinical management should shift from targeting a single metabolic parameter toward a comprehensive strategy grounded in smoking cessation and pulmonary rehabilitation, alongside active management of obesity and dyslipidemia. Future research should prioritize elucidating the common upstream mechanisms linking metabolic dysregulation and lung function decline.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"587160"},"PeriodicalIF":3.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786433","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":"Beyond the Lungs: A Narrative Review of Cardiopulmonary Risk Reduction and Management Perspectives in Thai COPD Patients.","authors":"Kittipong Maneechotesuwan, Siwasak Juthong, Piamlarp Sangsayunh, Pailin Ratanawatkul, Prin Vathesatogkit, Teerapat Yingchoncharoen, Srisakul Chirakarnjanakorn, Chee Kuan Wong, Thitiwat Sriprasart","doi":"10.2147/COPD.S591999","DOIUrl":"https://doi.org/10.2147/COPD.S591999","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and results in chronic lung damage and airway obstruction, significantly impacting individual health. Apart from increased all-cause mortality, COPD exacerbations are associated with higher rates of cardiovascular (CV) events-driven by shared risk factors and pathophysiological mechanisms-with peaks in the first 30 days of post-exacerbation. Therefore, cardiopulmonary risk management is essential during this vulnerable period. This narrative review was developed through an evaluation of clinical studies, guideline recommendations and Thailand-specific data to outline cardiopulmonary linkage in COPD and propose post-COPD exacerbation management. Patient management strategies include optimized pharmacological and non-pharmacological therapies, integrated cardiopulmonary care and CV risk assessment to reduce exacerbations, mortality and CV-related events, particularly in COPD patients with established or suspected CV diseases. Furthermore, implementation of these concepts should emphasize strengthening multidisciplinary awareness among pulmonary and cardiology through professional education, continuing-development activities and integration of collaborative care into national guidelines.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"591999"},"PeriodicalIF":3.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786634","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":"Comparison of Tools for Nutrition Assessment in Stable Subjects with Chronic Obstructive Pulmonary Disease: Which is the Best Mortality Predictor in Real Clinical Practice?","authors":"Koichi Nishimura, Masaaki Kusunose, Ayumi Shibayama, Kazuhito Nakayasu","doi":"10.2147/COPD.S593903","DOIUrl":"https://doi.org/10.2147/COPD.S593903","url":null,"abstract":"<p><strong>Purpose: </strong>Malnutrition is associated with poor outcomes in chronic obstructive pulmonary disease (COPD), but the prognostic value of different nutritional assessment tools in outpatient settings remains unclear. We aimed to identify which of five commonly used nutritional indicators best predicts all-cause mortality in stable COPD in real-world clinical practice.</p><p><strong>Patients and methods: </strong>This secondary analysis of a prospective, hospital-based observational cohort included 141 outpatients with stable COPD. Nutritional status was assessed using body mass index (BMI), percent ideal body weight (%IBW), geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score. Patients were categorized as malnourished or well-nourished according to established cut-off values, including PNI <45 as a widely used threshold for malnutrition. Associations with all-cause mortality over a median follow-up of 54 months were examined using Cox proportional hazards models. Multivariate analyses adjusted for age, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, and COPD Assessment Test (CAT) score, and model fit was compared using Akaike's Information Criterion (AIC).</p><p><strong>Results: </strong>During follow-up, 29 deaths (20.6%) occurred. The proportion classified as malnourished ranged from 7.8% (PNI <45) to 25.5% (CONUT ≥2). In multivariate analyses, only PNI <45 remained significantly associated with mortality (adjusted hazard ratio 3.85; 95% confidence interval 1.33-11.13; p = 0.013) and provided the best AIC among the five tools. Kaplan-Meier curves demonstrated significantly poorer survival in the low PNI group (log-rank p < 0.001).</p><p><strong>Conclusion: </strong>Among five simple nutritional assessment tools, only PNI independently predicted long-term mortality in stable COPD. Given its simplicity, objectivity, and reliance on routinely available laboratory parameters, PNI appears to be a practical marker to support risk stratification and guide proactive management in outpatient COPD care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"593903"},"PeriodicalIF":3.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786618","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":"Accurate Asthma-COPD Overlap Classification via Deep Transfer Learning in Medical Image Segmentation.","authors":"Weijie Ye, Dieyi Mo, Yubin Yang","doi":"10.2147/COPD.S578685","DOIUrl":"https://doi.org/10.2147/COPD.S578685","url":null,"abstract":"<p><p>Differentiating asthma from chronic obstructive pulmonary disease (COPD) remains challenging in clinical practice, and asthma-COPD overlap (ACO) lacks universally accepted diagnostic criteria. In this study, we propose a chest computed tomography (CT) image segmentation framework based on deep transfer learning to support imaging-assisted ACO-related classification as a proof-of-concept approach. Experiments were performed in a single-center cohort of patients with asthma, COPD, and ACO. Model performance was evaluated using classification accuracy and segmentation Dice similarity coefficient against expert-annotated reference masks. In addition, lung function parameters, inflammatory biomarkers, and ACT/CAT scores were summarized to characterize cohort profiles and assist clinical interpretation; these variables were not predicted by the AI model. The proposed approach achieved the highest ACO classification accuracy (93.21%), outperforming NUS-PSL (85.43%) and PRE-1000C (86.92%). These findings suggest potential utility for imaging-assisted ACO-related classification within this internal single-center evaluation. Further multi-center external validation and robustness analyses are warranted before conclusions regarding stability and generalizability can be made.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"578685"},"PeriodicalIF":3.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786571","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":"Pharmacist-Led Integrated Management for Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis.","authors":"Xinyi Li, Xuedi Ma, Wangjun Qin, Changcheng Shi, Lihong Liu, Chen Wang","doi":"10.2147/COPD.S589904","DOIUrl":"https://doi.org/10.2147/COPD.S589904","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide, and suboptimal medication management contributes to exacerbations and preventable healthcare utilization. Pharmacist-led integrated care has the potential to improve medication use and clinical outcomes. We conducted a systematic review and meta-analysis to evaluate the effects of pharmacist-led interventions in COPD.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted and reported in accordance with PRISMA 2020. We searched PubMed, Embase, and Web of Science from inception until June 23, 2025. Randomized controlled trials (RCTs) assessing the effects of pharmaceutical care on clinical outcomes in COPD patients were included. A random-effects model was used to estimate pooled relative risks (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane Risk of Bias tool.</p><p><strong>Results: </strong>A total of 11 randomized controlled trials involving 2313 participants were included. Pharmacist-led interventions were associated with a lower risk of exacerbation-related hospital admissions (RR = 0.43, 95% CI: 0.33-0.55). Improvements in medication adherence and higher smoking cessation rates were also observed. Improvements in health-related quality of life were reported; however, substantial heterogeneity was present. In contrast, effects on COPD Assessment Test scores and objective disease measures, including lung function, were non-significant. Overall study quality was variable, with many trials being small and at high risk of bias.</p><p><strong>Conclusion: </strong>Pharmacist-led interventions in COPD may improve selected medication-related and patient-centered outcomes; however, the available evidence is heterogeneous and limited by study quality and inconsistent effects across outcomes. These findings should be interpreted cautiously, and well-designed, adequately powered trials with standardized outcomes are needed before robust conclusions regarding clinical effectiveness can be drawn.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"589904"},"PeriodicalIF":3.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786269","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":"Mendelian Randomization Study in East Asian Populations Supports the Causal Relationship Between Blood Metabolites and COPD: Insights from Amino Acids, Phospholipids, Vitamin D, and Trace Elements.","authors":"Shixiang Guo, Zheng Li, Mingfeng Wei, Lefei Hu, Shuai Jiang, Fuzhi Yang, Zhengyao Yang, Xunxia Zhu, Xiaoyong Shen","doi":"10.2147/COPD.S588120","DOIUrl":"https://doi.org/10.2147/COPD.S588120","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic obstructive pulmonary disease (COPD) is the most common respiratory disease among middle-aged and older adults worldwide, and its etiology remains incompletely understood. As intermediate products of biochemical reactions, blood metabolites have a debated role in the pathogenesis of COPD, with observational studies yielding conflicting results. Most existing genetic studies are based on European cohorts, whereas East Asian populations differ substantially in genetic architecture and environmental exposures, limiting the generalizability of current findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed two-sample Mendelian randomization (MR) leveraging the most recently released summary statistics from large-scale genome-wide association studies (GWAS) in East Asian populations. Independent SNPs significantly associated with circulating metabolite levels were selected from multiple East Asian datasets as instrumental variables (3432 Chinese participants, 2022). Outcome data were obtained from two independent East Asian COPD GWAS cohorts: ebi-a-GCST90018587 (4017 cases, 162,653 controls, BioBank Japan, 2021) and bbj-a-103 (3315 cases, 201,592 controls, BioBank Japan, 2019). Inverse-variance weighting (IVW) served as the primary estimator, with sensitivity analyses conducted using MR-Egger regression, the weighted median, and additional complementary approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven blood metabolites showed suggestive causal links with COPD. In the ebi-a-GCST90018587 cohort, genetically predicted platelet count was positively associated with COPD risk (OR = 1.51, 95% CI 1.01-2.27, &lt;i&gt;P&lt;/i&gt; = 0.0467), and in the bbj-a-103 cohort higher genetically predicted manganese levels likewise indicated increased risk (OR = 1.27, 95% CI 1.00-1.62, &lt;i&gt;P&lt;/i&gt; = 0.0460). Conversely, higher genetically predicted levels of leucine (OR = 0.56, 95% CI 0.34-0.91, &lt;i&gt;P&lt;/i&gt; = 0.0197), alpha-aminoadipic acid (OR = 0.75, 95% CI 0.59-0.96, &lt;i&gt;P&lt;/i&gt; = 0.0208), serum-alanine-transaminase (ALT)(OR = 0.87, 95% CI 0.76-0.99, &lt;i&gt;P&lt;/i&gt; = 0.0345), phosphoethanolamine (OR=0.75, 95% CI 0.56-1.00, &lt;i&gt;P&lt;/i&gt; = 0.0500), and 25-hydroxyvitamin-D2 (OR = 0.81, 95% CI 0.70-0.94, &lt;i&gt;P&lt;/i&gt; = 0.0045) were associated with lower COPD risk, with phosphoethanolamine and 25-hydroxyvitamin-D2 showing concordant directions and comparable effect sizes across the two independent COPD GWAS cohorts. For all exposures, Cochran's Q tests and MR-Egger intercepts indicated no significant heterogeneity (&lt;i&gt;P &gt; 0.05&lt;/i&gt;), and Steiger directionality tests (&lt;i&gt;P&lt;0.05&lt;/i&gt;) did not suggest reverse causation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Leveraging large East Asian cohorts, this study provides MR evidence implicating amino-acid metabolism, phospholipid metabolism, vitamin D status, and selected trace elements in COPD pathophysiology. The replicated protective signals for phosphoethanolamine and 25(OH)D&lt;sub&gt;2&lt;/sub&gt;, and the risk signals for platelet count a","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"588120"},"PeriodicalIF":3.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785739","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":"Predictive Value of the COPD Assessment Test Combined with Five-Repetition Sit-to-Stand Test for Impaired Exercise Tolerance in Primary Care COPD Patients: A Comparative Study with Cardiopulmonary Exercise Testing.","authors":"Tianyi Yang, Shiwei Qumu, Xiaoxia Ren, Chunyan Yu, Ruirui Duan, Siyuan Wang, Xin Wang, Ting Yang, Shan Jiang","doi":"10.2147/COPD.S585819","DOIUrl":"https://doi.org/10.2147/COPD.S585819","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the longitudinal trends of impaired exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) and to evaluate the predictive value, agreement, and longitudinal stability of the COPD Assessment Test (CAT) combined with the the Five-Repetition Sit-to-Stand Test (5STS) in relation to cardiopulmonary exercise testing.</p><p><strong>Patients and methods: </strong>This exploratory, prospective, 12-month cohort study consecutively enrolled 100 patients with stable COPD who attended the outpatient clinic of the Department of Respiratory and Critical Care Medicine at China-Japan Friendship Hospital from January 2021 to October 2025. Impaired exercise tolerance group was defined as a predicted percentage of peak oxygen uptake (peak VO_2pred) < 85%, as measured by CPET. Patients were evaluated for Physical Fitness at baseline and 12 months using the following tools: modified Medical Research Council (mMRC) questionnaire, CAT score, 5STS, Hand Grip Strength (HGS), Timed Up and Go (TUG) test, and Quadriceps maximal voluntary contraction (QMVC).</p><p><strong>Results: </strong>At baseline, 58% of COPD patients exhibited impaired exercise tolerance. A statistically significant difference (P < 0.05) was observed in CAT score and 5STS results between the impaired exercise tolerance group and the normal exercise tolerance group. The combined CAT score and 5STS demonstrated a sensitivity of 52.5%, a specificity of 92.7%, and an area under the receiver operating characteristic curve (AUC) of 0.759 (95% CI: 0.666-0.852, P < 0.001) for identifying impaired exercise tolerance, indicating that this combination is most effective for ruling in the impairment. Agreement analysis with peak VO_2pred demonstrated that the CAT score and 5STS showed fair agreement, with consistently moderate predictive value across all time points.</p><p><strong>Conclusion: </strong>The combined application of the CAT score and the 5STS provides both screening and longitudinal monitoring capabilities, indicating potential for identifying patients with COPD at high risk of impaired exercise tolerance in primary care.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"585819"},"PeriodicalIF":3.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786406","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":"Mechanical Forces and Mechanotransduction in COPD: Pathogenesis, Clinical Phenotypes, and Therapeutic Implications.","authors":"Jingli Li, E Qin, Chunyi Zhang, Yuefang Yu, Lingjing Liu, Jian Sun, Guimei Pu, Jixian Tang","doi":"10.2147/COPD.S595107","DOIUrl":"https://doi.org/10.2147/COPD.S595107","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) remains a leading cause of global morbidity and mortality. Despite advances in therapy, its complex pathogenesis involves mechanisms beyond the traditional paradigms of inflammation and protease-antiprotease imbalance. Emerging evidence indicates that COPD is also shaped by important mechanobiological processes, in which altered airway mechanics, parenchymal destruction, and respiratory muscle dysfunction create a pathological physical environment. In this narrative review, we synthesize current knowledge on how abnormal mechanical forces are sensed by key mechanosensors-including integrins, Piezo channels, and YAP/TAZ-and transduced into biochemical signals that drive chronic inflammation, fibrosis, and defective repair. We further discuss how these mechanotransduction feedback loops perpetuate structural injury and may help explain the clinical heterogeneity observed across airflow obstruction, emphysema, and exacerbation-prone phenotypes. Furthermore, we discuss therapeutic strategies, positioning pulmonary rehabilitation, lung volume reduction, and ventilation as interventions that restore mechanical homeostasis. Finally, we highlight the emerging possibility of targeting mechanosensitive pathways (e.g. ROCK and YAP/TAZ inhibitors) and utilizing mechanobiology-informed regenerative medicine. By integrating biomechanics with clinical management, this review provides a conceptual framework that may inform future efforts to move beyond symptomatic palliation toward more mechanism-based and potentially disease-modifying strategies in COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"595107"},"PeriodicalIF":3.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724402","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}