International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Efficacy of Biologics in Patients with Moderate to Very Severe COPD: A Systematic Review.","authors":"Christopher E Brightling, Klaus F Rabe, Dave Singh, MeiLan K Han, Mohit Bhutani, Jean Bourbeau, Parameswaran Nair, M Bradley Drummond, Elizabeth A Gandhi, Navreet S Sindhwani, Nestor A Molfino, Amit D Parulekar, Sandhia S Ponnarambil","doi":"10.2147/COPD.S603471","DOIUrl":"10.2147/COPD.S603471","url":null,"abstract":"<p><p>A growing number of biologics are approved or in development for the treatment of chronic obstructive pulmonary disease (COPD). Many reduce acute exacerbations of COPD (AECOPD), particularly among patients with an elevated blood eosinophil count (BEC). In this systematic review, PubMed and Ovid (MEDLINE and Embase) were searched for phase 2 and 3 randomized controlled trials of biologics in patients with moderate to very severe COPD published between database inception and July 9, 2025. AECOPD rates and changes from baseline in pre-bronchodilator (BD) forced expiratory volume in 1 second (FEV₁) and St George's Respiratory Questionnaire (SGRQ)/SGRQ for COPD (SGRQ-C) total scores were evaluated for each biologic, overall and by baseline BEC. Sixteen publications were included, covering 12 studies of seven biologics (astegolimab, benralizumab, dupilumab, itepekimab, mepolizumab, tezepelumab and tozorakimab). In overall study populations with no baseline BEC limits, no biologics tested (astegolimab, benralizumab, itepekimab and tezepelumab) reduced AECOPD versus placebo. AECOPD reductions were seen in patients with a baseline BEC ≥300 cells/µL (benralizumab, dupilumab and mepolizumab), BEC <300 cells/µL (astegolimab), and BEC ≥150 cells/µL (mepolizumab and tezepelumab). Only benralizumab and tezepelumab were assessed in patients with a baseline BEC <150 cells/µL; neither reduced AECOPD in this subgroup. Patients with a baseline BEC ≥300 cells/µL (dupilumab and tezepelumab), BEC ≥250 cells/µL (itepekimab) and BEC ≥150 cells/µL (tozorakimab) had improvements in pre-BD FEV₁ versus placebo. Improvements in SGRQ total score were observed in patients with BEC ≥300 cells/µL (dupilumab and tezepelumab) and astegolimab improved SGRQ-C total score in patients with BEC >170 cells/µL. Overall, AECOPD reductions and improvements in lung function and health-related quality of life in patients with moderate to very severe COPD varied by biologic and baseline BEC subgroup; within studies, efficacy was generally greater in patients with an elevated baseline BEC, suggesting these patients may benefit most from biologic treatment.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"603471"},"PeriodicalIF":4.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971816","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":"Alpha-1 Antitrypsin Levels and Phenotypes in Patients with Asthma and COPD in Appalachian East Tennessee.","authors":"Rajiv Dhand, Ghassan Wadi, Jennifer Ferris, Gulsah Sofia Onar, Paul Terry, Robert Eric Heidel, Yuliya Nemykina","doi":"10.2147/COPD.S619871","DOIUrl":"10.2147/COPD.S619871","url":null,"abstract":"<p><strong>Purpose: </strong>Alpha-1 Antitrypsin Deficiency (A1ATD) is associated with an increased risk of emphysema and chronic obstructive pulmonary disease (COPD). In view of the high prevalence of chronic respiratory diseases in East Tennessee and limited data on A1AT phenotypes in this area, we determined A1AT allele frequency among patients with COPD, asthma, or asthma-COPD overlap (ACO) in our clinic population.</p><p><strong>Patients and methods: </strong>We conducted an IRB-approved retrospective analysis of patient demographics, medical history, comprehensive pulmonary function tests (PFTs), and serum A1AT levels and phenotypes in a cohort of general pulmonary clinic patients with COPD, asthma, or ACO at the University of Tennessee Medical Center in Knoxville, TN. We employed descriptive and nonparametric statistical methods for data analysis, and an alpha value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>In this cohort of 177 patients (mean age 63.2 ± 11.9 years), most were white (94.4%), female (59.3%), former or current smokers (79.1%), and homozygous for the normal PiMM A1AT phenotype (78.5%). Heterozygous A1AT phenotypes PiMS, PiMZ, PiSZ, and PiXZ were found in 23.9%, 20%, and 8.3% of patients with COPD, ACO, and asthma, respectively. Compared with PiMM, serum A1AT levels were significantly lower with PiMZ, PiSZ, and PiXZ phenotypes (p < 0.001). PFTs did not differ among A1AT phenotypes. In fact, there was a weak negative correlation between serum A1AT levels and forced vital capacity (r = -0.29; p = 0.01) and diffusion capacity for carbon monoxide (r = -0.27; p = 0.03).</p><p><strong>Conclusion: </strong>Among our East Tennessee cohort with COPD, asthma, or ACO, we found a 2- to 6-fold higher prevalence of heterozygous A1AT phenotypes than a national survey of US veterans. Further investigation through larger, prospective, population-based studies is needed to determine the clinical relevance of the higher prevalence of A1AT heterozygotes in this region.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"619871"},"PeriodicalIF":4.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971863","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 and Validation of a Two-Gene NK Cell-Related Risk Model for COPD: Integration of Single-Cell and Bulk RNA-Seq Analysis.","authors":"Xue Fu, Jiawei Dong, Jian Yang, Xiaotian Zhang, Shangkun Cai, Yiwei Zhang, Shenglong Lv, Meng Zhang","doi":"10.2147/COPD.S618802","DOIUrl":"10.2147/COPD.S618802","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) involves chronic inflammation with potential involvement of natural killer (NK) cells, but NK cell-related diagnostic markers remain limited. This study aimed to identify NK cell-related hub genes and construct a risk model for COPD.</p><p><strong>Methods: </strong>This work was mainly based on multiple transcriptomic datasets, including single-cell RNA-seq data (GSE173896, 5 COPD vs 2 control) and bulk data (GSE38974 (23 COPD vs 9 control), GSE8545 (18 COPD vs 18 control), GSE11784 (22 COPD vs 72 control)). NK cell-related differentially expressed genes (DEGs) were identified. GO, KEGG, and LASSO logistic regression were applied to screen hub genes and build a risk score model. ROC analysis evaluated model performance. Immune cell infiltration was assessed via CIBERSORT.</p><p><strong>Results: </strong>A total of 135 NK cell-related DEGs were identified. After cross-analysis, two hub genes, JUNB and TNFAIP3, were selected to construct the risk model, both significantly upregulated in COPD comparing with controls (p <0.05). The risk model showed relatively good performance, achieving AUCs of 0.928 (95% CI: 0.891-0.962) in training set and 0.754 (95% CI: 0.674-0.835) in validation set. High-risk patients showed increased infiltration of monocytes and macrophages M0, and all differential immune cells exhibited significant positive/negative correlation with the risk score.</p><p><strong>Conclusion: </strong>Our two-gene NK cell-related diagnostic risk model shows good discriminatory ability for distinguishing COPD patients, providing insights into inflammatory and immune associations. The model holds promise as a potential non-invasive diagnostic tool and may inform personalized therapeutic strategies for COPD patients.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"618802"},"PeriodicalIF":4.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971845","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":"Effect of High-Intensity Exercise Training on Dietary Intake in Patients with Chronic Obstructive Pulmonary Disease: A Prospective Observational Study.","authors":"Tomoyuki Ikeuchi, Kazuaki Suyama, Miyako Yagita, Shunichiro Mori, Daichi Mori, Tetsuya Kawano, Hideaki Takahata, Terumitsu Sawai, Toru Tsuda, Ryo Kozu","doi":"10.2147/COPD.S602683","DOIUrl":"10.2147/COPD.S602683","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is frequently complicated by nutritional disorders, and low body weight is an independent prognostic factor. High-intensity exercise training may affect leptin, an appetite-regulating hormone, and dietary intake. However, longitudinal evidence regarding these associations in COPD is limited. This study aimed to examine changes in dietary intake and leptin levels during pulmonary rehabilitation in patients with COPD, with exploratory analyses according to attainment of high-intensity exercise training.</p><p><strong>Patients and methods: </strong>In this prospective observational study, patients with COPD participated in a 6-week pulmonary rehabilitation program. High-intensity exercise training (≥ 80% prescribed intensity) was performed whenever feasible. Dietary intake (primary outcome) and leptin were assessed before and after the program. In exploratory subgroup analyses, participants were classified as high-intensity \"attainers\" (Attainment group) or \"nonattainers\" (Nonattainment group), and within-group before and after changes as well as between-group differences in change scores were compared. Furthermore, multivariate linear regression analysis was performed to examine whether exercise intensity was independently associated with changes in dietary intake and leptin.</p><p><strong>Results: </strong>Of the 69 participants, 55 completed the study and were included in the analysis. Dietary intake increased significantly from 1367 to 1484 kcal/day (p = 0.01), whereas leptin did not change significantly in the overall cohort. Between-group comparisons of change scores revealed a significant difference in leptin (p < 0.01) but not in dietary intake (p = 0.16). Multivariable regression analysis showed that exercise intensity attainment was associated with changes in leptin (B = -4.47, p < 0.01) but not dietary intake (p = 0.12).</p><p><strong>Conclusion: </strong>Dietary intake increased following pulmonary rehabilitation in patients with COPD. Although exploratory analyses suggested an association between attainment of high-intensity exercise training and changes in leptin levels, the relationship with dietary intake remains unclear.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"602683"},"PeriodicalIF":4.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963774","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":"Genetic Liability to COPD and Periodontitis Risk: Integrative Genetic and Single-Cell Evidence Implicating Macrophage Reprogramming.","authors":"Zelong Hu, Rui Mu, Shijia Huang, Yuchong Xie, Lei Jin","doi":"10.2147/COPD.S622582","DOIUrl":"10.2147/COPD.S622582","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) and periodontitis frequently coexist, but directionality and shared cellular mechanisms remain uncertain. We evaluated whether genetically proxied COPD liability is associated with periodontitis risk and explored candidate immune mechanisms.</p><p><strong>Methods: </strong>We performed two-sample Mendelian randomization (MR) and smoking-adjusted multivariable MR (MVMR), followed by pathway enrichment and summary-data-based MR. Single-cell RNA sequencing (scRNA-seq) datasets from COPD peripheral blood and periodontitis gingiva were reanalyzed to localize implicated cell states. RAW264.7 macrophages were exposed to <i>Porphyromonas gingivalis</i> lipopolysaccharide (LPS, 1 μg/mL, 24 h) to assess candidate-gene responsiveness.</p><p><strong>Results: </strong>In univariable inverse-variance weighted MR, COPD liability was positively associated with chronic periodontitis (odds ratio [OR] 1.282, 95% confidence interval [CI] 1.097-1.499). The association persisted after adjustment for smoking initiation (OR 1.183, 95% CI 1.054-1.328) and past tobacco smoking (OR 1.235, 95% CI 1.101-1.387). The conditional F-statistic for COPD was 5.02 in the smoking-initiation model, requiring cautious interpretation. Enrichment implicated major histocompatibility complex class II antigen presentation and arachidonic-acid metabolism. HSP90AA1 and ALOX15B were prioritized as candidate protective mediators. Across separate cohorts, scRNA-seq signals converged on the monocyte-macrophage lineage. LPS reduced HSP90AA1 and ALOX15B transcript abundance in RAW264.7 cells.</p><p><strong>Conclusion: </strong>The findings support a smoking-adjusted genetic association, not definitive smoking-independent causality. Macrophages and the two prioritized genes represent hypothesis-generating mediators that require validation in matched human cohorts and targeted perturbation models.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"622582"},"PeriodicalIF":4.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963804","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":"User-Centered Design of an Electronic COPD Patient Questionnaire for Clinical Decision Support.","authors":"Andrew Kouri, Zoe Garzouzi, Anna M Chudyk, Alexander Singer, Stacey J Butler, Bryan A Ross, Samir Gupta","doi":"10.2147/COPD.S629800","DOIUrl":"10.2147/COPD.S629800","url":null,"abstract":"<p><strong>Purpose: </strong>Effective COPD management depends on structured symptom and risk assessment, individualized therapy, and action plan provision, yet these are inconsistently delivered in routine care. Electronic health record (EHR)-integrated clinical decision support systems (CDSSs) can help close these gaps but require accurate, structured patient data to drive their recommendations. Digital pre-visit questionnaires are increasingly used to collect such data, but patient preferences for their content and design remain poorly understood, particularly in COPD.</p><p><strong>Patients and methods: </strong>We used a user-centered design process to develop an electronic COPD questionnaire to inform an EHR-integrated CDSS. Content was mapped to planned CDSS actions and built into a mobile-optimized prototype using eHealth design principles. We face validated the prototype with 10 people living with COPD, then refined it through successive focus groups until saturation. Usability was assessed with the System Usability Scale (SUS) and Likert ratings and transcripts were analyzed thematically.</p><p><strong>Results: </strong>Face validation (n=10) and three focus groups (n=13) were conducted to saturation. Four critical issues were identified and addressed. Usability was high throughout (mean SUS 88.07, \"excellent\"), with strong Likert ratings for functionality, navigation, and appearance. Thematic analysis yielded four themes: standardized measures versus real-life experience; usability and format as enablers; support for communication, memory, and efficient care; and desire for transparency and education.</p><p><strong>Conclusion: </strong>Through iterative co-design with older adults, we developed an EHR-integrated electronic COPD questionnaire with excellent usability and relevance to patients' lived experience. Patients anticipated benefits beyond data capture: improved symptom recall, visit preparation, and provider efficiency. This is one of the first electronic COPD questionnaires developed through structured patient co-design and qualitative evaluation, providing a transferable model for tools that inform clinical decision support.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"629800"},"PeriodicalIF":4.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963775","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":"Global Research Landscape and Clinical Hotspots in COPD-OSA Overlap Syndrome: A Bibliometric and Visualization Analysis.","authors":"Shanshan Li, Yanwen Liu, Chenggang Liu","doi":"10.2147/COPD.S636134","DOIUrl":"10.2147/COPD.S636134","url":null,"abstract":"<p><strong>Background: </strong>This study systematically depicts the global research landscape, knowledge base, and thematic evolution of chronic obstructive pulmonary disease combined with obstructive sleep apnea overlap syndrome (COPD-OSA overlap syndrome), providing a reference for subsequent research and clinical translation.</p><p><strong>Methods: </strong>Relevant literature published between 2000 and 2025 was retrieved from the Web of Science Core Collection, Scopus, and PubMed databases. Records from Web of Science and Scopus were merged and deduplicated to construct the primary bibliometric dataset, while PubMed was analyzed separately as a supplementary source for cross-database comparison using keywords and MeSH terms. Bibliometrix, VOSviewer, and CiteSpace were used to analyze research output, collaboration networks, core sources, co-citation structure, and research hotspots. A latent Dirichlet allocation (LDA) model was applied to identify latent topics and their temporal trends.</p><p><strong>Results: </strong>The primary dataset included 1239 publications, with an average annual growth rate of 20.62%; publication volume increased markedly after 2017. The United States, China, and Italy ranked highest in publication count, yet the overall international co-authorship rate was only 6.3%. The field's knowledge base centers on nocturnal hypoxemia, cardiovascular outcomes, acute exacerbations, and positive airway pressure therapy. The LDA model identified 10 latent topics, with two showing significant upward trends (COVID-19 with OSA; acute cardiovascular events and adipose tissue) and one showing a downward trend (anthropometry and lung function parameters). The 274 PubMed-included articles complemented cross-database comparisons and indicated growing attention to cognitive function, oxygen saturation, and digital screening.</p><p><strong>Conclusion: </strong>Research on COPD-OSA overlap syndrome is shifting from describing disease coexistence toward complex multimorbidity, risk stratification, and individualized management. However, international collaboration and high-level clinical evidence remain insufficient. Future work should standardize case definitions, establish multicenter longitudinal cohorts, and conduct phenotype-based treatment studies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"636134"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901392","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":"Right Ventricular Isovolumetric Relaxation Time is Associated with Pulmonary Vascular Load and Functional Limitation in Chronic Obstructive Pulmonary Disease.","authors":"Fushi Dong, Yosuke Tanaka, Ken Okamura, Katsuyuki Higa, Shota Kaburaki, Yozo Sato, Toru Tanaka, Ayumi Shimizu, Susumu Takeuchi, Yoshiaki Kubota, Namiko Taniuchi, Koichiro Kamio, Kazuo Kasahara, Lina Wu, Masahiro Seike, Mitsunori Hino, Hiroshi Kimura","doi":"10.2147/COPD.S628505","DOIUrl":"10.2147/COPD.S628505","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hypertension is a frequent complication of chronic obstructive pulmonary disease (COPD) and an independent determinant of prognosis. Increases in pulmonary vascular resistance often precede overt elevation of pulmonary arterial pressure, but early pulmonary vascular involvement remains difficult to detect noninvasively. Conventional echocardiographic assessment in COPD focuses mainly on right ventricular systolic indices, which may remain preserved despite increased pulmonary vascular load.</p><p><strong>Methods: </strong>We conducted a single-center retrospective observational study of 58 patients with stable COPD who underwent right heart catheterization and comprehensive transthoracic echocardiography during the same hospitalization. Right ventricular isovolumetric relaxation time (IRT), a Doppler-derived index of diastolic timing, was evaluated in relation to invasively measured pulmonary vascular resistance, dyspnea severity, exercise capacity, and pulmonary function.</p><p><strong>Results: </strong>A total of 58 patients were included. Patients meeting hemodynamic criteria for pulmonary hypertension exhibited lower diffusing capacity, more severe dyspnea, and reduced exercise capacity despite similar airflow limitation. Pulmonary vascular resistance was significantly higher, while cardiac index remained preserved. IRT was significantly prolonged in patients with pulmonary hypertension and showed a moderate correlation with pulmonary vascular resistance (<i>ρ</i> = 0.56, p < 0.001), six-minute walk distance (<i>ρ</i> = -0.46, p < 0.001), and dyspnea severity (<i>ρ</i> = 0.36, p = 0.006). In contrast, conventional right ventricular systolic indices showed no significant associations with pulmonary vascular resistance.</p><p><strong>Conclusion: </strong>Echocardiographic assessment of IRT may provide a physiologically grounded, noninvasive parameter associated with early right ventricular diastolic response to pulmonary vascular load.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"628505"},"PeriodicalIF":4.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901322","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 Web-Based, Pedometer-Mediated Intervention Increases Amount and Intensity of Physical Activity in COPD: A Randomized Controlled Trial.","authors":"Patricia M Bamonti, Julia T Desiato, Reema Kadri, David R Gagnon, Marilyn L Moy","doi":"10.2147/COPD.S611540","DOIUrl":"10.2147/COPD.S611540","url":null,"abstract":"<p><strong>Introduction: </strong>Ground-based walking training is an aerobic exercise used in supervised pulmonary rehabilitation (PR). Physical activity (PA) interventions typically promote step counts, but it is unclear whether community-based walking intensity can be targeted as aerobic exercise. This randomized controlled trial evaluated a web-based, pedometer-mediated PA intervention designed to increase walking amount and intensity.</p><p><strong>Material and methods: </strong>Participants with COPD who had never enrolled in PR were randomized 1:1 to control or intervention. The intervention included individualized step-count goals, iterative feedback, educational content, and an online community forum. The Fitbit Inspire Heart Rate objectively monitored daily step counts. Participants were instructed to achieve step-count goals with as many steps of moderate-intensity as possible guided by a modified Borg rating of 4-5 for dyspnea. The primary outcome was change in PA measured as average daily step count at 12 weeks. Aerobic intensity was assessed by the Rapid Assessment of PA Questionnaire which uses self-reported moderate or vigorous PA to categorize responders as underactive or active. Linear mixed-effects models (PROC MIXED, SAS v9.4), adjusting for group, time, group*time, FEV_1%predicted, enrollment season, and study modality (eg, in-person, virtual, hybrid), assessed between-group change.</p><p><strong>Results: </strong>Participants (57 intervention, 52 control) were 97% male, mean age 73±7 years, and baseline FEV₁ 73±23% predicted. Baseline daily steps were 4,222±1,929 (intervention) and 4,851±2,637 (control). Intervention participants increased average daily steps by 1,410 steps/day more than controls (p=0.005). The intervention group showed greater transitions from underactive to active intensity (between-group: p=0.025), with 20 (41%) moving to active status (within-group: p=0.001).</p><p><strong>Conclusion: </strong>Technology-mediated community-based walking increased PA amount and intensity. These findings support further evaluation of this intervention as a potential option for ground-based walking training with objective measurement of exercise intensity.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"611540"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898185","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":"Bioinformatics Screening and Preliminary Experimental Verification of Integrated Stress Response-Associated MYC and BAG3 in Chronic Obstructive Pulmonary Disease.","authors":"Xueping Liu, Lu Wang, Ting Tang, Hang Qian, Binfeng He, Zhi Xu, Guansong Wang, Mingzhou Zhang","doi":"10.2147/COPD.S615813","DOIUrl":"10.2147/COPD.S615813","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) has high morbidity and mortality, and integrated stress response (ISR) participates in its progression. Traditional COPD diagnosis relies mainly on GOLD criteria, while ISR-based auxiliary molecular markers are still lacking. This study aimed to comprehensively analyze and identify ISR-related biomarkers in COPD, and to uncover their underlying molecular mechanisms.</p><p><strong>Methods: </strong>COPD data were obtained from the GEO database. Biomarkers were identified and validated through a comprehensive approach, including differential expression analysis, machine learning algorithms, expression level verification, and receiver operating characteristic (ROC) curve analysis. Moreover, a nomogram was applied to construct an ISR-related predictive model for COPD. Enrichment analysis, immune infiltration analysis, molecular regulatory network, and drug prediction were performed to further confirm the regulatory roles of biomarkers. Furthermore, the expression patterns of biomarkers in core cells were investigated using dataset GSE173896. Furthermore, Western blotting was employed to detect the protein expression levels of biomarkers in clinical samples.</p><p><strong>Results: </strong>Overall, 2 biomarkers (MYC and BAG3) were identified as significantly associated with ISR in COPD. A predictive nomogram constructed based on MYC and BAG3 demonstrated excellent diagnostic performance, with an area under the curve (AUC) value of 0.799. The biomarkers were significantly enriched in the MAPK signaling pathway and cell cycle. Notably, biomarkers were positively correlated with effector memory CD4 T cells and eosinophils. Subsequently, 36 microRNAs (miRNAs) (like hsa-miR-4699-3p), 260 transcription factors (TFs) (like SNAI2, ZBTB43, and ZNF395) and 9 drugs (like staurosporine and N-acetyl-L-cysteine) were associated with the biomarkers. Moreover, significant changes in MYC and BAG3 expression were observed during T cell differentiation. Clinically, MYC and BAG3 were significantly upregulated in COPD tissues, with protein levels increased by 58.4% and 252.2% respectively.</p><p><strong>Conclusion: </strong>This study identified and preliminarily verified ISR-associated MYC and BAG3, offering novel molecular references to complement conventional COPD clinical assessment.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"615813"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898157","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}