International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Real-World Evaluation of an EHR-Enabled Chronic Obstructive Pulmonary Disease Assessment Test.","authors":"Nathaniel Gaeckle, Edward Corazalla, Judy S Kelloway, Joshua N Liberman, Jonathan David Darer, Kristin Kahle-Wrobleski, Rosirene Paczkowski, Purva Parab, Charles Ruetsch","doi":"10.2147/COPD.S479853","DOIUrl":"10.2147/COPD.S479853","url":null,"abstract":"<p><strong>Purpose: </strong>The Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) measures COPD's impact on well-being and daily activities and is a recommended assessment by the Global Initiative for Obstructive Lung Disease (GOLD). Our research objective was to describe a real-world CAT implementation, including the association of CAT scores with subsequent treatment and clinical outcomes.</p><p><strong>Patients and methods: </strong>A retrospective, observational, comparative cohort study was conducted among adults with COPD who received care from M Health Fairview, a US healthcare delivery system. Eligible patients had an initial electronic health record (EHR) enabled CAT administration (index) between 8/2017 and 12/2021. Patients were grouped by score (<10 [low impact]; 11-20 [moderate]; and 21-40 [high]). Demographics, comorbidities, provider specialty, and exacerbation history were derived from EHR data in the 12 months preceding index.</p><p><strong>Results: </strong>Of 11,194 eligible individuals, 821 (7.3%) were administered CAT (cases). Compared to individuals with no documented CAT scores (comparators), cases were older (66.7 vs 63.9 years; <i>p</i> < 0.05) and had higher rates of comorbidities (93.9% vs 79.2%, <i>p</i> < 0.05) and exacerbations (0.31 vs 0.14 PPPY). A total of 61.5% of pulmonologists and 11.5% of primary care providers (PCPs) administered the CAT at least once. Repeated use was more common among pulmonologists (55.7%) than PCPs (7.0%). Medication intensification was most common (28.1%) among individuals with high CAT scores, followed by moderate (21.6%), and low (10.0%). Post-index exacerbations were experienced by 24.2%, 17.4%, and 7.7% of patients with high, moderate, and low CAT scores.</p><p><strong>Conclusion: </strong>In a real-world practice setting, few patients with COPD received a CAT, although pulmonologists demonstrated repeated use. Higher CAT scores were associated with COPD medication regimen intensification and exacerbations. Further investigation on how to incorporate the CAT into routine care and optimize its impact on medical decision making and evaluation is warranted.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"325-334"},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460377","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":"Clinical and Economic Evaluation of Fluticasone Furoate/Umeclidinium/Vilanterol Versus Tiotropium/Olodaterol Therapy in Maintenance Treatment-Naive Patients with COPD in the US.","authors":"Asif Shaikh, John Ritz, Julian Casciano, Swetha R Palli, Brendan Clark, Zenobia Dotiwala, Jennifer K Quint","doi":"10.2147/COPD.S479504","DOIUrl":"10.2147/COPD.S479504","url":null,"abstract":"<p><strong>Purpose: </strong>Long-acting bronchodilator (LABD) therapy is recommended for maintenance treatment in most patients with chronic obstructive pulmonary disease (COPD). However, triple therapy (TT; dual LABDs + inhaled corticosteroid [ICS]) is often used as first-line maintenance treatment. The benefits of TT versus dual LABDs as first-line treatments are unknown, necessitating an evaluation of its effectiveness and costs versus non-ICS alternatives.</p><p><strong>Patients and methods: </strong>This retrospective study assessed administrative claims of maintenance treatment-naive patients in the United States with COPD aged ≥40 years initiating single-inhaler fluticasone furoate+umeclidinium+vilanterol (FF+UMEC+VI) or tiotropium+olodaterol (TIO+OLO). Patients were propensity score-matched (1:1) and followed for up to 12 months. The primary outcome was time to first COPD exacerbation. Secondary outcomes included time to first pneumonia diagnosis, pneumonia-related hospitalization, healthcare resource utilization (HCRU), and costs. COPD exacerbation and pneumonia risk were assessed using Cox proportional hazards regression.</p><p><strong>Results: </strong>A total of 5,121 and 3,996 patients met the eligibility criteria for the FF+UMEC+VI and TIO+OLO groups, respectively. Outcomes were assessed among 2,951 matched pairs. The risk of moderate or severe COPD exacerbation was not significantly different between FF+UMEC+VI and TIO+OLO groups (hazard ratio [HR] [95% confidence interval {CI}]: 1.13 [0.99-1.29]; <i>P</i>=0.064). The risks of pneumonia (HR [95% CI]: 1.04 [0.85-1.27]; <i>P</i>=0.723) and pneumonia-related hospitalization (HR [95% CI]: 1.18 [0.78-1.79]; <i>P</i>=0.429) were also not significantly different between the groups. There were no significant differences in HCRU events or all-cause costs; however, FF+UMEC+VI initiators incurred greater COPD- and/or pneumonia-related pharmacy costs than TIO+OLO initiators (FF+UMEC+VI: $2,934 [$2,827-$3,041], TIO+OLO: $1,994 [$1,915-$2,073]; <i>P</i><0.001).</p><p><strong>Conclusion: </strong>In maintenance treatment-naive patients, FF+UMEC+VI offered no reduction in COPD exacerbation risk over TIO+OLO and resulted in higher pharmacy costs related to COPD and/or pneumonia treatment. These results support treatment recommendations for LAMA+LABA as initial maintenance therapy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier - NCT05169424.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"335-348"},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449835","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":"Diagnostic Inaccuracies in COPD: Misdiagnosis, Race and Gender Disparities.","authors":"Sarah E Maus, Dustin L Norton, Amit K Saha, Brian J Wells, Jill A Ohar","doi":"10.2147/COPD.S490781","DOIUrl":"10.2147/COPD.S490781","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"319-323"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442477","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":"Prevalence of Myocardial Infarction With Obstructive and Non-Obstructive Coronary Arteries in a Middle-Aged Population With Chronic Airflow Limitation: A Cross-Sectional Study.","authors":"Josefin Sundh, Magnus Ekström, Anders Blomberg, Eva Lindberg, Andrei Malinovschi, Anna-Carin Olin, C Magnus Sköld, Kjell Torén, Per Wollmer, Carl Johan Östgren, Tomas Jernberg","doi":"10.2147/COPD.S477986","DOIUrl":"10.2147/COPD.S477986","url":null,"abstract":"<p><strong>Purpose: </strong>Myocardial infarctions (MIs) can occur in underlying obstructive coronary artery disease (MI-CAD) or in non-obstructive coronary arteries (MINOCA). The primary objectives of the study were to investigate the prevalence of MI-CAD and MINOCA in people with CAL, and to explore if CAL is an independent risk factor for MI-CAD and MINOCA. Secondary objectives were to explore these research questions stratified by sex and by smoking history.</p><p><strong>Patients and methods: </strong>Cross-sectional analysis of the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of people aged 50-64 years. CAL was defined as a post-bronchodilator ratio of forced expiratory volume in one second and forced vital capacity below 0.70. MI-CAD was defined as a self-reported MI with coronary computed tomography angiography findings of previous revascularization or at least one significant coronary stenosis (>50%), and MINOCA as self-reported MI with no previous revascularization and no significant coronary stenosis.</p><p><strong>Results: </strong>In total, 1735 (8.3%) of 20,882 included participants had CAL. MI-CAD was more common than MINOCA both in people with (2.8 vs 0.6%) and without CAL (1.2 vs 0.3%). Compared with those without CAL, people with CAL had an almost doubled independent risk of both MI-CAD ([adjusted OR] 1.72; [95% CI] 1.22-2.42) and MINOCA (1.99; 1.02-3.86). In men, CAL was associated with increased risk of MINOCA (2.63; 1.23-5.64), and in women with increased risk for MI-CAD (3.43; 1.68-1.26).</p><p><strong>Conclusion: </strong>Middle-aged people with CAL have an almost doubled risk of both MI-CAD and MINOCA, compared with people without CAL. In contrast to people without CAL, the risk of MINOCA is increased in men and the risk of MI-CAD is increased in women. In a clinical context, both MI types should be considered in CAL.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"303-312"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442483","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":"Single-Use Flexible Bronchoscope in Facilitating Endobronchial Valve Treatment in Severe Emphysema.","authors":"Tadashi Sakaguchi, Dirk-Jan Slebos","doi":"10.2147/COPD.S506291","DOIUrl":"10.2147/COPD.S506291","url":null,"abstract":"<p><p>Ensuring proper placement of one-way endobronchial valves is a vital step in achieving successful bronchoscopic lung volume reduction. The ability to navigate into sharply angled airways may be limited by the maximal flexion capability of bronchoscopes. We sometimes encounter difficult anatomical situations, causing a challenging, or sometimes even impossible placement of the EBV in the appropriate position due to steep bronchial bifurcation angles, particularly in the apical segments. A 56-year-old woman with severe emphysema was referred to our hospital after an incomplete EBV treatment due to a very sharp bronchial bifurcation angle in the right upper lobe apical segment (RB1). We were able to easily solve the problem by placing the final RB1 valve using a single-use therapeutic bronchoscope with a greater angulation range than conventional reusable bronchoscopes. The use of single-use therapeutic bronchoscopes with greater flexibility than conventional reusable therapeutic bronchoscopes may be a valuable approach for achieving successful EBV placement in anatomically challenging cases with sharp bronchial branching angles.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"313-317"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442486","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":"Risk of All-Cause Mortality in US Adults With Preserved Ratio Impaired Spirometry: An Observational Study.","authors":"Shan Xiao, Jie Ou, Wangli Qiu, Chunxin Ye, Na Li, Sida Chen, Yuting Lai, Zhishan Deng, Fan Wu, Yan Shen","doi":"10.2147/COPD.S497674","DOIUrl":"10.2147/COPD.S497674","url":null,"abstract":"<p><strong>Background: </strong>Preserved ratio impaired spirometry (PRISm) is defined as forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC)≥0.70 and FEV₁<80% predicted. Previous studies have shown that individuals with PRISm may develop airflow obstruction and have an increased mortality risk. However, studies with long-term follow-up are lacking, and this topic has not been evaluated in the general population. We explored the all-cause mortality risk of individuals with PRISm in a large sample of the general population.</p><p><strong>Methods: </strong>We used data from the National Health and Nutrition Examination Survey III and 2007-2012. Participants aged 20-79 years at baseline and who underwent spirometry were included. Normal spirometry was defined as a prebronchodilator FEV₁/FVC≥0.70 and FEV₁≥80% predicted. We used Cox proportional hazards regression models to compare all-cause mortality between the groups. We performed sensitivity analyses stratified by the lower limit of normal definition of spirometry criteria. Subgroup analyses by sex, age, smoking status, race, body mass index, level of education, poverty-to-income ratio, respiratory symptoms, and comorbidities were performed in participants with the different spirometry classifications.</p><p><strong>Results: </strong>Overall, 24,691 participants were included, with a median follow-up time of 25.7 years. Of these, 19,969 had normal spirometry and 1,452 had PRISm. PRISm was associated with a high all-cause mortality risk (unadjusted hazard ratio [HR]=2.47, 95% confidence interval [CI]: 2.25-2.71, P<0.001; adjusted HR=1.69, 95% CI: 1.54-1.86, P<0.001) compared with normal spirometry. Sensitivity analyses and subgroup analyses showed a similar increased all-cause mortality risk in PRISm.</p><p><strong>Conclusion: </strong>Our finding revealed that PRISm was significantly associated with increased risk of all-cause mortality in the general population compared with normal spirometry. Further research is needed to explore the intervention effect of PRISm.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"287-302"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434169","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":"Chronic Airflow Limitation, Lower Respiratory Symptoms, COPD and Chronic Rhinosinusitis in a Middle-Aged Population: The Swedish CArdioPulmonary bioImage Study (SCAPIS). A Link Between the Lower and Upper Airways.","authors":"Anders Andersson, Joel Bergqvist, Linus Schiöler, Apostolos Bossios, Lovisa Farnebo, Thorbjörn Holmlund, Christer Janson, Sumru Keceli, Mirjam Ljunggren, Andrei Malinovschi, Ensieh Memarian, Ulf Nihlén, Peter M Nilsson, Ida Pesonen, Marcus Sjöström, Nikolai Stenfors, Fredrik Sundbom, Mimmi Werner, Kjell Torén, Magnus Sköld, Johan Hellgren","doi":"10.2147/COPD.S493219","DOIUrl":"10.2147/COPD.S493219","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic rhinosinusitis (CRS) is related to asthma and chronic obstructive pulmonary disease (COPD). However, combined data on CRS, pulmonary function, lower airway symptoms, and cigarette smoking from the general population are lacking. The current study investigates the relationships between CRS and chronic airflow limitation (CAL), lower airway symptoms and COPD in a middle-aged population of ever-smokers and never-smokers.</p><p><strong>Patients and methods: </strong>All subjects from the Swedish CArdioPulmonary bioImage Study (SCAPIS) were included. Subjects underwent spirometry after bronchodilation. Chronic airflow limitation was defined as FEV₁/FVC ratio <0.7. Computed tomography imaging of the thorax was performed to detect the presence of emphysema, and the subjects answered a comprehensive questionnaire on CRS, lower airway symptoms, asthma, chronic bronchitis, and cigarette smoking habits.</p><p><strong>Results: </strong>In total, 30,154 adult subjects in the age range of 50-64 years were included. The prevalence of CRS was 5.6%. CRS was more-prevalent among subjects in the following categories: CAL (7.6%), lower airway symptoms (15.7%), current smokers (8.2%), asthma (13.6%), never-smokers and ever-smokers with COPD (17.6% and 15.3%, respectively), emphysema (6.7%), and chronic bronchitis (24.5%). In the adjusted regression model, CRS was significantly associated with CAL (OR 1.40), lower airway symptoms (OR 4.59), chronic bronchitis (OR 6.48), asthma (OR 3.08), and COPD (OR 3.10).</p><p><strong>Conclusion: </strong>In this national, randomly chosen population sample of more than 30,000 middle-aged men and women, CRS is associated with CAL, lower airway symptoms, chronic bronchitis, asthma, and COPD. In patients with CRS and in patients with lower airway inflammation, it is important to consider the inflammatory status of the entire airway system.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"273-286"},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434165","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 Bidirectional Mendelian Randomization Study Investigating the Causal Relationship Between Ankylosing Spondylitis and Chronic Obstructive Pulmonary Disease.","authors":"Di Pan, Xiaoling Dai, Pan Li, Luan Xue","doi":"10.2147/COPD.S491579","DOIUrl":"10.2147/COPD.S491579","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have found an association between ankylosing spondylitis (AS) and chronic obstructive pulmonary disease (COPD); however, no research has investigated this relationship using Mendelian randomization (MR).</p><p><strong>Methods: </strong>This study employed a bidirectional two-sample MR approach to assess the causal connection between AS and COPD. The analysis utilized publicly available statistics on AS and COPD from the Genome-wide Association Study (GWAS). The primary MR method employed was Inverse-Variance Weighting (IVW), supplemented by additional MR methods such as weighted median, MR-Egger, simple mode, and weighted mode. Sensitivity analyses were also performed to evaluate the impact of heterogeneity and pleiotropy on the MR results.</p><p><strong>Results: </strong>The study included two datasets related to AS (ebi-a-GCST005529 and ukb-a-88) and two datasets related to COPD (ebi-a-GCST90018807 and finn-b-J10_COPD). In our forward MR, the analysis of ebi-a-GCST005529 dataset against ebi-a-GCST90018807 dataset showed that AS was associated with an increased risk of COPD (<i>OR</i> = 1.1326, <i>95% CI</i> = 1.0181-1.2600, <i>P</i> = 0.0221). However, there was no causal relationship between AS and COPD in the rest of the dataset analyses. In reverse MR analysis, no causal effect between COPD and AS was found among the datasets.</p><p><strong>Conclusion: </strong>Our research provided partial evidence to support the viewpoint that AS may increase the prevalence of COPD. AS may be a risk factor for COPD, however, further studies are needed to validate these results and elucidate the underlying mechanisms.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"259-271"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411314","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 Mediation of Circulating Inflammatory Proteins in the Causal Pathway from Immune Cells to COPD.","authors":"Kunrong Yan, Yingjian Wang, Peng Xin","doi":"10.2147/COPD.S495073","DOIUrl":"10.2147/COPD.S495073","url":null,"abstract":"<p><strong>Objective: </strong>Observational studies have indicated that immune cells and circulating inflammatory proteins may play a dual role in the progression of COPD; however, the precise mechanisms remain uncertain. The objective of this study was to ascertain the causal relationship between immune cells and COPD and to quantify the potential role of circulating inflammatory proteins as mediators.</p><p><strong>Methods: </strong>A two-sample Mendelian randomisation analysis was conducted involving 731 immune cells, 91 inflammatory proteins and COPD, utilising summary-level data from genome-wide association studies. The causal relationships between immune cells, inflammatory proteins and COPD were sequentially analysed by multivariate Mendelian randomisation and validated using Bayesian weighted Mendelian randomisation. Subsequently, sensitivity analyses were conducted, employing Cochran's Q test to assess heterogeneity, MR-PRESSO and MR-Egger tests to assess pleiotropy, and reverse MR and Steiger directionality tests to rule out reverse causality. Lastly, a two-step approach was employed to ascertain the proportion of inflammatory proteins that mediate immune cell-mediated effects in COPD.</p><p><strong>Results: </strong>The combination of the inverse variance weighting method and the Bayesian weighting algorithm identified 30 immune cells that were found to be causally associated with COPD, as well as eight inflammatory proteins that were associated with COPD. By two-step analysis, six inflammatory proteins were found to mediate the effects of eight immune cell phenotypes on COPD, with CXCL10 having the highest percentage of mediation at 14.49%, followed by IL20RA at 11.47%.</p><p><strong>Conclusion: </strong>This study provides a comprehensive investigation of the causal relationship between immune cells and COPD, as well as an estimation of the proportion of the effect of inflammatory proteins as mediators. These findings facilitate the identification of individuals at high risk of COPD and offer novel insights for early prevention and clinical intervention.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"245-257"},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400535","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 \"Inhaled Corticosteroid Particle Size and Risk of Hospitalization Rue to Exacerbations and All-Cause Mortality in Patients With Chronic Obstructive Respiratory Disease. A Nationwide Cohort Study\". Heerfordt et al [Letter].","authors":"Richard Hubbard, Victoria Carter, William Henley, David Price","doi":"10.2147/COPD.S514150","DOIUrl":"10.2147/COPD.S514150","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"243-244"},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392304","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}