International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Effect of Telemonitoring on Moderate and Severe Exacerbations in Patients with COPD: Pooled Analysis of Two Randomized Controlled Trials in Denmark.","authors":"Charlotte Hyldgaard, Thomas Ringbæk, Frank Dyekjær Andersen, Ejvind Frausing Hansen, Michael Skov Jensen, Morten Fenger-Grøn, Christian Trolle, Charlotte Suppli Ulrik","doi":"10.2147/COPD.S528852","DOIUrl":"10.2147/COPD.S528852","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are serious events with high morbidity and mortality. Previous studies investigated telemonitoring as a tool for prevention of hospitalizations with ambiguous results. The aim of the present study was to combine data from two randomized controlled trials conducted in Denmark in similar healthcare settings to explore number of hospitalizations for COPD, days of admission, and exacerbations treated outside hospitals.</p><p><strong>Methods: </strong>Recruitment took place during hospitalization for AECOPD and from outpatient COPD clinics. Patients were equally randomized to telemonitoring (N=251) in addition to usual care for six months or usual care alone (N=252). We used a negative binomial regression model with between-group comparisons expressed as incidence rate ratios (IRRs) for assessment of hospitalizations, admission days and moderate exacerbations and Kaplan-Meier time-to-event analysis for assessment of time to first COPD hospitalization.</p><p><strong>Results: </strong>No significant differences between the two studies were identified. In combined analyses, numerically fewer hospitalizations (IRR 0.85, 95% CI 0.62-1.17) and hospitalization days (IRR 0.72, 95% CI 0.42-1.23) were seen in the telemonitoring group, but the findings did not reach statistical significance whereas treatment for moderate exacerbations was significantly more frequent in the telemonitoring group (IRR 1.91, 95% CI 1.49-2.45).</p><p><strong>Conclusion: </strong>No effect of telemonitoring on hospitalizations for AECOPD was documented in this large cohort of patients with severe COPD. However, the telemonitoring group received significantly more treatment for moderate exacerbations. This risk of overtreatment should be considered when telemonitoring is used in the care of patients with COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2361-2369"},"PeriodicalIF":2.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643929","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":"Factors Associated with Initial Treatment Failure in Inpatients with Exacerbation of Chronic Obstructive Pulmonary Disease: A Cohort Study.","authors":"Noriko Kohyama, Kuniaki Hirai, Hironori Sagara, Miki Takenaka Sato, Masayuki Ohbayashi, Mari Kogo","doi":"10.2147/COPD.S516855","DOIUrl":"10.2147/COPD.S516855","url":null,"abstract":"<p><strong>Purpose: </strong>Some patients do not respond to initial therapy for exacerbation of chronic obstructive pulmonary disease (ECOPD), resulting in treatment failure that requires antimicrobial changes or advanced therapies. Appropriate treatment is possible if patients at a high risk of treatment failure at the start of treatment are properly identified. Therefore, this study examined the factors associated with initial treatment failure in patients with ECOPD.</p><p><strong>Patients and methods: </strong>We conducted a cohort study involving patients with ECOPD admitted to our hospital. The primary outcome was initial treatment failure, defined as a composite of treatment intensification for ECOPD and in-hospital mortality. Uni- and multivariate analyses were performed to identify the factors associated with initial treatment failure.</p><p><strong>Results: </strong>The analysis included data of 152 patients with a mean age of 76±8 years (mean±standard deviation); 81% of them were male patients. Treatment failure occurred in 26 (17%) patients. These included nine, two, one, and 14 patients who changed antimicrobial agents, received additional non-invasive positive pressure ventilation therapy due to non-improvement or symptom exacerbation, received additional invasive positive pressure ventilation therapy, and died in the hospital, respectively. Using multivariable analysis, home oxygen therapy (odds ratio, 5.335; 95% confidence interval, [1.542-18.457]), neutrophil count ≥7000 cells/µL (3.550; [1.007-12.519]), and acidemia (3.129; [1.009-9.698]) were significant factors associated with treatment failure. In patients treated with narrow-spectrum antibiotics as the initial antibacterial therapy, the treatment failure rate in patients receiving home oxygen therapy was significantly higher than in those receiving none.</p><p><strong>Conclusion: </strong>Home oxygen therapy, high neutrophil count, and acidemia on admission were risk factors for treatment failure. Particularly, patients receiving home oxygen therapy were at a higher risk of treatment failure with the use of narrow-spectrum antibiotics.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2349-2360"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638513","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 Association Between Daily Step Count, Step Frequency and the Risk of Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study Using NHANES Data.","authors":"Lindong Yuan, Zhen Tian, Xiaodong Jia, Zhe Chen","doi":"10.2147/COPD.S523574","DOIUrl":"10.2147/COPD.S523574","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a major public health concern globally, and physical activity is considered a modifiable factor in its prevention.</p><p><strong>Purpose: </strong>This study examined the association between daily step count, step frequency, and the prevalence of chronic obstructive pulmonary disease (COPD) using nationally representative data.</p><p><strong>Patients and methods: </strong>A cross-sectional analysis was conducted using data from adults aged ≥40 years in the 2003-2006 National Health and Nutrition Examination Survey (NHANES). Participants wore accelerometers for 7 days to measure daily step count and three step frequency indicators: bout cadence, peak 30-minute cadence, and peak 1-minute cadence (steps/minute). Weighted logistic regression was used to assess associations with COPD, adjusting for demographic, behavioral, and health-related covariates. Sensitivity analyses and subgroup analyses were conducted to confirm robustness.</p><p><strong>Results: </strong>Among 3690 participants (representing ~26.8 million US adults), higher daily step count and step frequency were inversely associated with COPD prevalence. Compared to those taking <4000 steps/day, those taking ≥8000 steps/day had a 63% lower odds of COPD (OR 0.37, 95% CI 0.15-0.91; P for trend <0.001). Higher bout cadence (92.3-153.4 steps/minute) and peak 30-minute cadence (69.8-128.2 steps/minute) were also associated with significantly reduced COPD odds (ORs 0.30 and 0.33, respectively). Combined higher step count and frequency yielded a greater risk reduction. Restricted cubic splines indicated a nonlinear association, and ROC analysis showed moderate discriminatory power (AUC 0.71-0.75). Results remained robust in sensitivity analyses and across subgroups.</p><p><strong>Conclusion: </strong>In this cross-sectional study of US adults, higher daily step counts and greater walking cadence were associated with a lower prevalence of COPD. These findings support the relevance of step-based metrics in assessing COPD risk, although longitudinal studies are needed to establish causality.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2325-2335"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627421","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":"Long COVID in Elderly COPD Patients: Clinical Features, Pulmonary Function Decline, and Proteomic Insights.","authors":"Shuangyan Li, Hui Zhao, Min Zhang, Tingting Yuan, Di Chai, Zhengyin Shen, Chengfeng Qin, Yanming Li, Mingming Pan","doi":"10.2147/COPD.S520300","DOIUrl":"10.2147/COPD.S520300","url":null,"abstract":"<p><strong>Background: </strong>Elderly patients with chronic obstructive pulmonary disease (COPD) face a heightened risk of developing long coronavirus disease (COVID); however the exact clinical characteristics and underlying mechanisms remain unclear.</p><p><strong>Methods: </strong>We enrolled 85 elderly COPD patients, of whom 43 reported newly onset persistent fatigue (the most dominant complaint of long COVID) within 1 year after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and they were allocated to the Long-COVID group. The remaining 42 patients were assigned to the Control group. Patients completed questionnaires, pulmonary function tests, chest CT, routine laboratory tests, and blood proteomic analysis.</p><p><strong>Results: </strong>Long-COVID patients had a longer course of COPD (> 5 years, 76.8% vs 52.4%) and duration of SARS-CoV-2 infection (10.0 days vs 7.0 days) (All <i>P</i> < 0.05), higher symptom burden, worse pulmonary ventilation function and a more rapid decrease in DL_CO (All <i>P</i> < 0.05). Proteomic analysis indicated disruptions in inflammation and energy metabolism, potentially underlying long COVID in these patients. The machine learning model identified wheezing, the duration of SARS-CoV-2 infection, EIF2S3 (eukaryotic translation initiation factor 2 subunit gamma), current FEV1/FVC (%), and the course of COPD as key features distinguishing Long-COVID patients, and exhibited excellent performance.</p><p><strong>Conclusion: </strong>Elderly COPD patients with a longer COPD course and duration of COVID-19 are more prone to develop long COVID, with decreased pulmonary ventilation and diffusion ability. Disordered inflammation regulation and energy metabolism may be the potential mechanisms, highlighting the importance of monitoring inflammation and metabolic dysregulation in elderly COPD patients after recovery from COVID-19.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2337-2347"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627504","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":"Predictors of Clinical Stability and Mortality in COPD: A Longitudinal Study.","authors":"Wesley Teck Wee Loo, Si Yuan Chew, Jessica Han Ying Tan, Rui Ya Soh, Mariko Siyue Koh, Therese S Lapperre, Pei Yee Tiew","doi":"10.2147/COPD.S531435","DOIUrl":"10.2147/COPD.S531435","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on the definition of clinical stability in chronic obstructive pulmonary disease (COPD), and it is less frequently used as a treatment target compared to severe asthma. The factors that determine clinical stability and their effects on mortality are less well-studied in patients with COPD.</p><p><strong>Methods: </strong>To address this gap, we conducted a prospective longitudinal cohort study to identify predictors of two-year clinical stability, defined as no exacerbations and stable symptoms (<2 point change in CAT score from baseline), and the impact of comorbid cardiovascular disease (CVD) on clinical stability and mortality in COPD patients.</p><p><strong>Results: </strong>A total of 463 patients (mean age 71 ± 9 years) were enrolled in this study. The cohort was predominantly Chinese (81.7%) and 45.6% of participants were current smokers. The majority (55.7%) had a history of CVD. Approximately 36% of the cohort achieved clinical stability at one year, and one-third achieved stability at two years. Predictors of 2-year clinical stability included higher body mass index (BMI) (p<0.001), higher post-bronchodilator FEV1/FVC ratio (p=0.0132), fewer baseline exacerbations (p=0.007), absence of bronchiectasis (p=0.045), preserved hemoglobin levels (p=0.019), and successful smoking cessation (p=0.039). Notably, while 2-year clinical stability did not predict subsequent mortality, the presence of CVD was a significant predictor of 5-years mortality (HR 1.48, 95% CI 0.99-2.22; p=0.05).</p><p><strong>Conclusion: </strong>Our study identified several predictors of 2-year clinical stability in patients with COPD. However, clinical stability at 2 years did not predict subsequent mortality. These findings suggest that clinical stability and mortality are distinct outcomes that are driven by different sets of predictive variables. This underscores the need for a comprehensive approach to COPD management that not only addresses exacerbations and symptoms, but also considers a broader range of factors influencing survival, particularly the management of comorbidities such as cardiovascular disease.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2311-2324"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627420","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 Crucial Role of the PPAR Signaling Pathway in the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease: An Analysis of Gene Expression and Macrophage Polarization.","authors":"Ling Zhang, Rong Guo, Haixia Wu, Abula Abudusalamu, Wei Ding, Dewei Li, Xuemei Wei, Lin Niu","doi":"10.2147/COPD.S518592","DOIUrl":"10.2147/COPD.S518592","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the role of the peroxisome proliferator-activated receptor (PPAR) signaling pathway in chronic obstructive pulmonary disease (COPD) and identify potential biomarkers and therapeutic targets, given that COPD is a major global health burden and the specific molecular mechanisms of the PPAR pathway in COPD are not fully understood.</p><p><strong>Patients and methods: </strong>Gene expression data from the GEO database were analyzed to identify key genes and immune cells related to COPD. Peripheral blood samples were collected from COPD patients and healthy controls. Key genes were confirmed by PCR, and immune cells were characterized using flow cytometry.</p><p><strong>Results: </strong>Eight core genes associated with the PPAR signaling pathway were identified. NCOA1 and PPARGC1A were downregulated in COPD patients, while NCOR1, NRIP1, and SLC27A5 were upregulated. Receiver operating characteristic (ROC) curve analysis showed that NCOA1, NCOR1, and SLC27A5 have potential for COPD diagnosis. There was a significant increase in the proportion of M2 macrophages in COPD patients, indicating a shift in macrophage polarization towards the M2 phenotype. Genes within the PPAR signaling pathway were closely associated with macrophage polarization state.</p><p><strong>Conclusion: </strong>The research findings provide new biomarkers and potential therapeutic targets for the early diagnosis and personalized treatment of COPD, emphasizing the significant role of the PPAR signaling pathway in the pathogenesis of COPD.</p><p><strong>Clinical trial registry: </strong>The population study involved in this research has been registered under the (chictr.org.cn). Registry identifier: ChiCTR2400086268.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2287-2304"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627422","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 Low Hand Grip Strength on Quality of Life, Utilization of Healthcare, and Mental Health in Individuals with Airflow Limitation.","authors":"Sang Hyuk Kim, Sungmin Zo, Sung A Kong, Ju Hee Cho, Jong Geol Do, Sun Hye Shin, Hye Yun Park","doi":"10.2147/COPD.S510974","DOIUrl":"10.2147/COPD.S510974","url":null,"abstract":"<p><strong>Purpose: </strong>A higher prevalence of sarcopenia has been demonstrated in individuals with airflow limitation (AFL). However, data on the impact of sarcopenia on quality of life, utilization of healthcare, and mental health in individuals with AFL are limited.</p><p><strong>Patients and methods: </strong>We used data from the 2014-2019 Korea National Health and Nutrition Examination Survey (KNHANES), and participants with AFL were included. Sarcopenia was assessed using hand grip strength (HGS). The outcomes were health-related quality of life (HRQoL), utilization of healthcare, and mental health. The impact of low HGS and outcomes was assessed using multivariable logistic regression analysis.</p><p><strong>Results: </strong>Among participants with AFL, 12.6% had low HGS and the median (interquartile range) of HGS was 22.5 (18.9-26.1) kg for women and 37.7 (32.9-42.6) kg for men. After adjusting for confounders, low HGS was associated with a decrease in HRQoL (usual activities: adjusted odds ratio [aOR], 1.70; 95% confidence interval [CI], 1.14-2.54; pain/discomfort: aOR, 1.44; 95% CI, 1.02-2.02, anxiety/depression: aOR, 1.59; 95% CI, 1.05-2.41), and increased perceived stress (aOR, 1.77; 95% CI, 1.24-2.53). In the subgroup analysis, the impact of low HGS on HRQoL, utilization of healthcare, and mental health was more evident in the reduced lung function and inactive physical activity groups.</p><p><strong>Conclusion: </strong>Overall, low HGS was associated with decreased quality of life and worsening mental health in participants with AFL. Our findings underscore the importance of muscle strength for HRQoL, particularly in those with impaired lung function and sedentary lifestyles, suggesting that regular physical activity including muscle-strengthening exercises may improve HRQoL.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2199-2210"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601982","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":"Potential Causal Relationship Between Chronic Obstructive Pulmonary Disease and Diabetes: A Bidirectional Two-Sample Mendelian Randomization Study.","authors":"Xinyan Wang, Xin Chen, Ruizhi Feng, Hongli Jiang, Wei Liu","doi":"10.2147/COPD.S516346","DOIUrl":"10.2147/COPD.S516346","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes, particularly type 2 diabetes (T2D), is a common comorbidity that occurs at a higher frequency in chronic obstructive pulmonary disease (COPD) patients compared to the general population. The COPD-diabetes association is documented epidemiologically and experimentally. Potential mechanisms, including systemic inflammation and metabolic dysregulation, are discussed as plausible pathways. However, their causal relationship still needs to be confirmed.</p><p><strong>Methods: </strong>We conducted a comprehensive bidirectional two-sample Mendelian randomization (MR) analysis to evaluate the causal links between COPD and both type 1 diabetes (T1D) and T2D by using genome-wide association study (GWAS) summary statistics in European and Asian populations. By employing MR methods, the causal effect of diabetes on the risk of COPD as well as specific COPD-related clinical outcomes, including COPD with infections (COPD-I), pneumonia or pneumonia-derived septicaemia, chronic opportunistic infections, respiratory insufficiency, hospital admissions, and onset age (early or late) were explored.</p><p><strong>Results: </strong>Forward MR analysis provided evidence consistent with a causal relationship between T2D and an increased risk of COPD in the European population (IVW odds ratio (OR): 1.002, 95% confidence interval (CI): 1.001-1.003, <i>P</i> = 0.001). This association appeared consistent with MR Egger analysis, yielding a similar result for European COPD patients (MR Egger OR: 1.108, 95% CI: 1.016 -1.208, <i>P</i> = 0.021). No statistically conclusive evidence of a causal relationship between diabetes and COPD was found in the Asian population. Besides, genetically determined T1D was identified as a risk factor for the incidence of COPD-I in the European-specific population (IVW OR: 1.017, 95% CI: 1.009-1.025, <i>P</i> < 0.001). The reverse MR analysis, exploring the effect of COPD on the risk of diabetes, did not achieve consistent results in either the European or Asian populations.</p><p><strong>Conclusion: </strong>This study suggested a modest but statistically significant causal association between T2D and COPD in individuals of European ancestry. Further explorations are required to better understand the underlying mechanisms linking diabetes to COPD development.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2259-2272"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592757","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-Component Compatibility of Bufei Yishen Formula III Protects Lung Air-Blood Barrier by Regulating the Oxidative Stress: via the Nuclear Factor-E₂-Related Factor 2 Pathway.","authors":"Kexin Xu, Xuejie Shao, Ruilong Lu, Yixi Liao, Yakun Zhao, Bo Wang, Zhiguang Qiu, Yange Tian","doi":"10.2147/COPD.S513071","DOIUrl":"10.2147/COPD.S513071","url":null,"abstract":"<p><strong>Purpose: </strong>Bufei Yishen formula (BYF) is an effective treatment strategy for chronic obstructive pulmonary disease (COPD). Effective-component compatibility of BYF III (ECC-BYF III), composed of 5 active ingredients (ginsenoside Rh1, paeonol, astragaloside, icariin and nobiletin) from BYF, has similar effects to BYF in intervening COPD. The abnormal structure and hypofunction of lung air-blood barrier induces inefficiency gas exchange and promotes development of COPD. However, the role of ECC-BYF III in the air-blood barrier remains unknown. This study dedicated to exploring the effect and mechanism of ECC-BYF III improve structure and function of lung air-blood barrier in COPD.</p><p><strong>Methods: </strong>A COPD rat model was established to study the treatment of ECC-BYF III against COPD. The protective effect of ECC-BYF III on COPD was evaluated through pulmonary function and lung tissue pathology. The structure damage of the lung air-blood barrier was assessed using electron microscopy and immunofluorescence. Finally, we proved the regulating effect of ECC-BYF III in oxidative via the Nrf2 pathway.</p><p><strong>Results: </strong>The ECC-BYF III could significantly alleviate reduced pulmonary function, decrease damage of lung tissue and regulate oxidative stress in COPD rats. And ECC-BYF III reduced thickness of respiratory membrane, ameliorated damage of pulmonary capillary endothelial cells (PCECs) and alveolar epithelial cells (AECs) in COPD rats. Also, ECC-BYF III protected the function and normal cell morphology of type I alveolar epithelial cell (AT I) and type II alveolar epithelial cell (AT II) in COPD rats. Lastly, ECC-BYF III was indicated to adjust the Nrf2 pathway to improve oxidative stress and protect lung air-blood barrier in COPD rats.</p><p><strong>Conclusion: </strong>ECC-BYF III protects lung air-blood barrier in COPD by regulating oxidative stress via Nrf2 pathway.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2211-2226"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601981","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":"Efficacy and Safety of Biologics Targeting Type 2 Inflammation in COPD: A Systematic Review and Network Meta-Analysis.","authors":"Shujie Li, Baiyi Yi, Huan Wang, Xianghuai Xu, Li Yu","doi":"10.2147/COPD.S504774","DOIUrl":"10.2147/COPD.S504774","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to comparatively evaluate the efficacy and safety profiles of biologic agents targeting type 2 inflammation in COPD.</p><p><strong>Methods: </strong>As of September 1, 2024, we identified and screened eight clinical studies evaluating biologic agents targeting type 2 inflammation for COPD treatment from multiple databases. Following data extraction, we conducted a network meta-analysis using R software to indirectly compare the efficacy and safety profiles of the five included biologic agents, incorporating visualization of the analytical results.</p><p><strong>Results: </strong>In COPD patients with elevated eosinophil levels (peripheral blood eosinophil count ≥200 cells/μL), dupilumab demonstrated significant therapeutic efficacy by: (1) reducing the annualized rate of acute exacerbations (versus placebo: -0.44; 95% CI -0.77 to -0.10), (2) decreasing SGRQ total scores (versus placebo: -3.41; 95% CI -6.00 to -0.82), and (3) increasing pre-bronchodilator FEV1 (versus placebo: 0.06 L; 95% CI 0.00 to 0.12). Benralizumab also showed clinical benefits in reducing acute exacerbation rates (10 mg versus placebo: -0.21; 95% CI -0.39 to -0.04) and improving SGRQ scores (100 mg versus placebo: -1.70; 95% CI -3.35 to -0.04). Furthermore, all five biologic agents evaluated in this network meta-analysis exhibited favorable safety profiles.</p><p><strong>Conclusion: </strong>This NMA demonstrates that both dupilumab and benralizumab show statistically significant efficacy in COPD management, particularly among patients with eosinophilic inflammation. And these biological agents maintain favorable safety profiles. Future research should focus on large-scale multicenter clinical trials, biomarker-based patient stratification, optimization of drug delivery regimens, and development of multi-target combination therapies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"2143-2159"},"PeriodicalIF":3.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585417","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}