International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"A Web-Based Pedometer-Mediated Intervention Maintains Benefits After Pulmonary Rehabilitation: A Pilot Study.","authors":"Julia T Desiato, Patricia M Bamonti, Avani Agrawal, Reema Kadri, David R Gagnon, Marilyn L Moy","doi":"10.2147/COPD.S611518","DOIUrl":"https://doi.org/10.2147/COPD.S611518","url":null,"abstract":"<p><strong>Rationale: </strong>The optimal content and delivery method of pulmonary rehabilitation (PR) maintenance programs are unknown. We developed a web-based, pedometer-mediated intervention, based on the Behavioral Theory of Self-Regulation, to promote physical activity in persons with COPD. In this pilot single-arm cohort study, we examined whether it can maintain benefits after PR completion.</p><p><strong>Methods: </strong>US Veterans with COPD who completed PR were enrolled for 12 months. At baseline and follow-up every 3 months, the Fitbit Inspire-2 pedometer objectively measured daily step count. The 6-minute walk test (6MWT) assessed exercise capacity, modified Medical Research Council (mMRC) score assessed dyspnea, and St. George's Respiratory Questionnaire Total Score (SGRQ-TS) examined health-related quality of life. Linear mixed-effects models (PROC MIXED, SAS v9.4) for repeated measures examined change from baseline over 12 months. Models adjusted for age, FEV₁%predicted, supplemental oxygen use, and PR delivery mode. Adjusted least square (LS) means ± standard errors or <i>p</i> values for change are presented.</p><p><strong>Results: </strong>Twenty participants who completed PR had mean±sd age 72±6 years and FEV₁%predicted 57±23%. There was no significant decline in daily step count over 12 months of using the intervention (n=20, <i>p</i>=0.80). For the 7 participants who performed 6MWTs, there was an improvement of 66±14 m post-PR compared to pre-PR, <i>p</i><0.001. There was a clinically relevant, but not statistically significant, decrease in 6MWT distance of 26±24 m (n=8, <i>p</i>=0.27) over 12 months. The adjusted LS mean for 6MWT distance at 12 months (361±20 m) trended lower than the value post-PR (403±19 m), <i>p</i>=0.10, but not significantly different than the value pre-PR (337±19 m), <i>p</i>=0.37. There were no significant changes in mMRC dyspnea score (n=8, 0.02±0.39, <i>p</i>=0.96) or SGRQ-TS (n=20, 0.42±2.82, <i>p</i>=0.88).</p><p><strong>Conclusion: </strong>These results suggest that a web-based, pedometer-mediated intervention may be an effective part of a long-term maintenance program after completion of PR.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"611518"},"PeriodicalIF":4.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800320","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":"Real-World Identification of Eosinophilic COPD Patients Potentially Eligible for Dupilumab: A Retrospective Observational Study.","authors":"Nicoletta Di Giorgi, Ilaria Barisone, Jasmine Nour, Devis Moretti, Andrea Pagliai, Alfredo Cesario, Angela Nervoso, Angelo Coppola, Edoardo Pompei, Chiara Iacomini, Carlotta Masciocchi, Stefano Patarnello, Francesco Macagno","doi":"10.2147/COPD.S598641","DOIUrl":"10.2147/COPD.S598641","url":null,"abstract":"<p><strong>Purpose: </strong>Despite optimized inhaled therapy, many patients with Chronic Obstructive Pulmonary Disease (COPD) continue to experience frequent exacerbations, lung function decline, and impaired quality of life, with severe exacerbations driving disease progression and increasing healthcare costs. Recently, BOREAS & NOTUS studies suggested that a subset of COPD patients with type 2 (T2) inflammation may benefit from biologic therapies. This study aimed to identify COPD patients exhibiting eosinophil-defined T2 inflammatory features potentially responsive to dupilumab among those treated at a tertiary-level hospital in Italy, characterizing them according to disease severity and biomarker profiles.</p><p><strong>Patients and methods: </strong>Real-world data were extracted from Fondazione Policlinico Universitario Agostino Gemelli IRCCS (FPG) Hospital Information Systems through the implementation of the COPD DataMart. A multilevel RWE-based approach identified patients (2020-2023) aged ≥40 years on triple inhaled therapy with ≥2 moderate or ≥1 severe exacerbations. Patients were stratified according to their blood eosinophil levels (EOS), and healthcare pathways, comorbidities, symptoms, smoking status, and all-cause mortality were descriptively analyzed.</p><p><strong>Results: </strong>Among 3,279 COPD patients, 224 met inclusion criteria. Eosinophil data were available for 179 patients, of whom, 87 (48.6%) had at least one EOS ≥300 cells/μL, corresponding to 38.8% (87/224) of the total cohort. Patients with EOS ≥300 had a median of 4 EOS measurements/year, with a median value of 210 [interquartile ranges 130-335] cells/μL. Compared with EOS <300, they showed a higher inpatient origin (23.0% vs 12.2%, p=0.005), greater comorbidity burden (71.3% cardiovascular, 59.8% metabolic, and 50.6% of other comorbidities), numerically higher all-cause mortality although not statistically significant (19.5% vs 13.0%, p=0.437), and higher annual hospital contacts (4.5 vs 3.0, p<0.001).</p><p><strong>Conclusion: </strong>This real-world exploratory study identified a subgroup of patients with severe COPD within a tertiary-care setting and suggested that eosinophil monitoring may contribute to guide targeted therapeutic strategies, including emerging biological therapies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"598641"},"PeriodicalIF":4.1,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800244","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":"Development and Internal Validation of a Multivariable Prognostic Model for in-Hospital Mortality in Critically Ill Patients with Acute Exacerbation of COPD.","authors":"Ahmet Fırat, Mert Akbulut, Başak Toptaş Fırat, Ayşegül Aykaç İbişoğlu","doi":"10.2147/COPD.S632533","DOIUrl":"10.2147/COPD.S632533","url":null,"abstract":"<p><strong>Purpose: </strong>Acute exacerbations of chronic obstructive pulmonary disease (COPD) requiring intensive care unit (ICU) admission are associated with substantial mortality. Although the Acute Physiology and Chronic Health Evaluation II (APACHE II) score is widely used for prognostic assessment, its complexity and limited disease-specific applicability have prompted the development of simpler prognostic models. Therefore, this study aimed to develop and internally validate a multivariable prognostic model for predicting in-hospital mortality in critically ill patients with acute exacerbation of COPD and to compare its performance with APACHE II.</p><p><strong>Patients and methods: </strong>This retrospective observational study included 392 adult patients admitted to the ICU with acute exacerbation of COPD between January 2022 and December 2025. Demographic characteristics, laboratory findings, arterial blood gas parameters, Charlson Comorbidity Index, and APACHE II scores were recorded. Independent predictors of mortality were identified using multivariable logistic regression. Model discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis, while calibration was evaluated using the Hosmer-Lemeshow test and calibration plots. Internal validation was performed using 1000 bootstrap resamples.</p><p><strong>Results: </strong>A total of 392 patients were included, of whom 94 (23.9%) died during hospitalization. Multivariable logistic regression identified age, male sex, urea, albumin, C-reactive protein (CRP), and Charlson Comorbidity Index as independent predictors of in-hospital mortality. The final prediction model demonstrated excellent discriminatory performance (AUC 0.899, 95% CI 0.865-0.927) and significantly outperformed APACHE II (AUC 0.813, 95% CI 0.771-0.851; DeLong p = 0.0014). Calibration was good according to the Hosmer-Lemeshow test (p = 0.066), and internal validation using 1,000 bootstrap resamples confirmed model stability.</p><p><strong>Conclusion: </strong>A multivariable prognostic model based on six routinely available admission variables demonstrated excellent discriminatory performance and good calibration for predicting in-hospital mortality in critically ill patients with acute exacerbation of COPD. The model showed higher discriminatory performance than APACHE II in our cohort. Nevertheless, external validation and direct comparison with established COPD-specific prognostic models are required before routine clinical implementation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"632533"},"PeriodicalIF":4.1,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765544","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 Mannose Metabolism-Related Biomarkers in COPD Through Integrated Bioinformatics and Machine Learning Analysis: A Pilot Study.","authors":"Xiaodan Li, Jin Wang, Zhong Hu, Shanting Chen, Chang Liu","doi":"10.2147/COPD.S604522","DOIUrl":"https://doi.org/10.2147/COPD.S604522","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) represents a progressive respiratory disorder marked by sustained airflow restriction and ongoing inflammatory processes. Recently, mannose metabolism has emerged as a significant factor in chronic disease development. This investigation explored how mannose metabolism-related genes (MMRGs) contribute to COPD pathogenesis and evaluated their utility as candidate diagnostic and therapeutic targets.</p><p><strong>Methods: </strong>We obtained blood sample gene expression data from COPD patients and healthy controls via the GEO database. Differentially expressed genes (DEGs) were identified and intersected with MMRGs to obtain candidate genes. Three machine learning algorithms combined with expression validation across independent datasets were applied to identify biomarkers. A nomogram prediction model was constructed and its diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Subsequently, gene set enrichment analysis (GSEA), immune infiltration analysis, drug prediction, and molecular docking were performed.</p><p><strong>Results: </strong>Nineteen candidate genes were identified from 1685 DEGs and subsequently screened for two biomarkers: MAN1C1 and MAN2B2. A nomogram model constructed on the basis of the two showed moderate discriminatory efficacy (area under the curve (AUC) = 0.701). In addition, GSEA analysis showed that both were co-enriched in pathways such as TNF's target up-regulated gene sets. The immune infiltration results revealed significant differences (p < 0.05) between COPD and controls in a total of 12 categories of immune cells, such as activated B cells. Finally, drug prediction revealed 12 and 3 potential drugs for MAN1C1 and MAN2B2, respectively, with trichostatin A showing a potential binding conformation.</p><p><strong>Conclusion: </strong>This study revealed the potential roles of MMRGs in COPD and identified novel biomarkers. These findings provided new insights and research foundations for the early diagnosis, personalized treatment, and drug development of COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"604522"},"PeriodicalIF":4.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762755","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":"Mitochondrial Mechanisms of Resistance Exercise in COPD-Related Skeletal Muscle Dysfunction: A Narrative Review.","authors":"Yifan Lv, Qian Gao, Xiaoyu Han, Weibing Wu","doi":"10.2147/COPD.S610640","DOIUrl":"https://doi.org/10.2147/COPD.S610640","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a heterogeneous pulmonary disorder characterized by airway or alveolar abnormalities. Beyond pulmonary impairment, COPD frequently leads to skeletal muscle dysfunction, manifesting as muscle atrophy, myofibrillar type switching, and reduced muscle strength and endurance, which severely impair exercise capacity and quality of life. Mitochondrial dysfunction, including reduced mitochondrial density, altered respiratory function, and increased oxidative stress, is recognized as a key contributor to skeletal muscle impairment in COPD. Resistance exercise (RE), an effective exercise therapy, has been shown to improve lower-limb muscle function and quality in COPD patients, and it appears feasible even for those with severe airflow obstruction and significant dyspnea. Mechanistically, RE may enhance mitochondrial respiratory capacity and promote mitochondrial biogenesis, and might also counteract mitochondrial dysfunction induced by secondhand smoke. In this narrative review, we analyze the effects of RE on skeletal muscle dysfunction in COPD and summarize the underlying mitochondrial mechanisms.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"610640"},"PeriodicalIF":4.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762889","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":"Development and Internal Validation of a Nutrition-Related Indicator-Based Prediction Model for in-Hospital Mortality in Hospitalized Patients with AECOPD.","authors":"Qing Tu, Yi Ding, Fangfang Bai, Qian Li, Yun Zhou, Wenjie Sun, Bangzhu Liu, Zhaoyan Wu, Yeshan Li","doi":"10.2147/COPD.S618346","DOIUrl":"10.2147/COPD.S618346","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the predictive value of routinely available nutrition-related laboratory indicators for in-hospital mortality in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and to develop and internally validate a clinically applicable prediction model.</p><p><strong>Patients and methods: </strong>A retrospective cohort study included 2167 patients hospitalized for AECOPD at the Second People's Hospital of Wuhu between January 1, 2016 and October 21, 2025. Candidate predictors were prespecified based on clinical relevance and previous evidence. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of in-hospital mortality. A prediction model was developed and internally validated using receiver operating characteristic (ROC) analysis, calibration curves with bootstrap resampling, the Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among the 2167 patients, 109 (5.0%) died during hospitalization. Multivariable analysis identified five independent predictors of in-hospital mortality: older age (OR = 1.234, 95% CI: 1.077-1.422), lower hemoglobin (OR = 1.095, 95% CI: 1.036-1.152), lower albumin (OR = 1.135, 95% CI: 1.083-1.192), respiratory failure at admission (OR = 6.002, 95% CI: 3.936-9.234), and a history of lung cancer (OR = 4.430, 95% CI: 1.815-9.855). The prediction model achieved good discrimination, with an area under the receiver operating characteristic curve (AUC) of 0.811. The calibration curve demonstrated good agreement between predicted and observed outcomes, and the Hosmer-Lemeshow test indicated good model fit (P = 0.196). Decision curve analysis showed that the model provided greater net benefit than both the treat-all and treat-none strategies across a threshold probability range of approximately 5%-50%.</p><p><strong>Conclusion: </strong>We developed and internally validated a simple prediction model incorporating routinely available nutrition-related laboratory indicators and key clinical characteristics for predicting in-hospital mortality in hospitalized patients with AECOPD. The model demonstrated good discrimination and calibration and may serve as a practical bedside tool for early risk stratification and individualized clinical decision-making. External validation in independent multicenter cohorts is warranted before widespread clinical implementation.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"618346"},"PeriodicalIF":4.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714221","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":"Exploring Relevance of Graded Sputum Production in Stable COPD in Clinical Practice.","authors":"Laurent Morin, Jean-Christian Borel, Nathalie Arnol, Bernard Aguilaniu","doi":"10.2147/COPD.S626094","DOIUrl":"10.2147/COPD.S626094","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"626094"},"PeriodicalIF":4.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714219","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":"Methodological Concerns Regarding the Causal Relationship Between Methotrexate and COPD: The Missing Confounding by Indication [Letter].","authors":"Qingqing Shan","doi":"10.2147/COPD.S640052","DOIUrl":"10.2147/COPD.S640052","url":null,"abstract":"","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"640052"},"PeriodicalIF":4.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707949","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":"Baseline Blood Eosinophil Count and 28-Day in-Hospital Mortality in ICU-Admitted Patients with AECOPD: A Cohort Study with External Validation.","authors":"Zeqiang Wang, Jianlong Tan, Hanying Liu, Jiangchuan Chen, Lingjia Chen, Weidong Zhang, Wei Liu","doi":"10.2147/COPD.S621415","DOIUrl":"10.2147/COPD.S621415","url":null,"abstract":"<p><strong>Background: </strong>Blood eosinophil count is widely used to guide corticosteroid decisions in stable chronic obstructive pulmonary disease (COPD) and non-ICU acute exacerbations of COPD (AECOPD), but its prognostic value and interpretation in ICU-admitted AECOPD remain uncertain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using MIMIC-IV as the primary cohort and eICU-CRD for external validation. Adults with AECOPD were included if ICU admission occurred within 24 h of hospital admission and baseline eosinophil count was available within a predefined peri-ICU window. The primary outcome was 28-day in-hospital mortality after ICU admission. Baseline eosinophil count was analyzed per 100 cells/µL increase in prespecified multivariable Cox models.</p><p><strong>Results: </strong>The analytic cohorts included 645 patients from MIMIC-IV and 2503 from eICU-CRD. Twenty-eight-day in-hospital mortality was 14.3% and 6.7%, respectively. In MIMIC-IV, higher baseline eosinophil count was associated with a lower hazard of death (adjusted hazard ratio [HR] per 100 cells/µL: 0.58, 95% confidence interval [CI]: 0.39-0.85; <i>P</i> = 0.005). A similar association was observed in eICU-CRD (adjusted HR: 0.82, 95% CI: 0.72-0.93; <i>P</i> = 0.002). Categorical, competing-risk, and age-restricted analyses were broadly consistent with the primary findings, and restricted cubic splines did not identify a clear threshold.</p><p><strong>Conclusion: </strong>Among ICU-admitted patients with AECOPD who had clinically available baseline eosinophil measurements, higher baseline eosinophil count was associated with lower 28-day in-hospital mortality.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"621415"},"PeriodicalIF":4.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714268","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":"Low sRAGE Level is Associated with Increased Future Exacerbation Risk in Mild-to-Moderate COPD and Patients with Chronic Bronchitis Symptoms.","authors":"Yutian Zhang, Bi Ran, Hao Wang, Dianmei Zhou, Kai Zi, Zijian Zeng, Xi Yan, Tao Wang, Lei Chen, Tao Ye, Paul Jones, Jun Chen, Fuqiang Wen","doi":"10.2147/COPD.S615390","DOIUrl":"10.2147/COPD.S615390","url":null,"abstract":"<p><strong>Background: </strong>Early identification of patients at high-risk for exacerbation in mild-to-moderate chronic obstructive pulmonary disease (COPD), particularly those with chronic bronchitis (CB) phenotype exhibiting worse outcomes, is critical for slowing lung function decline and reducing the subsequent healthcare burden. While the soluble receptor for advanced glycation end products (sRAGE) correlates with emphysema severity in COPD, in mild-to-moderate COPD or patients with CB symptoms, no prospective investigation has evaluated the association between sRAGE and exacerbation risk.</p><p><strong>Methods: </strong>Sub-cohort data from the COMPASS study, a prospective study in China, were analyzed. Associations between sRAGE levels and exacerbations were assessed treating sRAGE as a continuous variable and categorized into tertile. Negative binomial regression and cox regression were used to assess exacerbation rate and onset time. Subsequent analyses of lung function, COPD Assessment Tool (CAT) score and high-resolution computed tomography (HRCT) parameters were evaluated using linear mixed-effects models based on a cutoff determined by Akaike information criteria (AIC).</p><p><strong>Results: </strong>In the COMPASS sub-cohort, 201 patients had mild-to-moderate COPD and 230 individuals reported CB symptoms. Continuous sRAGE level was not associated with exacerbation risks, but with earlier onset time. In addition, participants in the lowest sRAGE tertile exhibited significant shorter time to first exacerbation in both populations. The lowest tertile was also associated with increased exacerbation risks in patients with CB and showed a borderline significant association in patients with mild-to-moderate COPD. No significant differences in lung function decline, HRCT changes, or CAT score progression were observed between the low- and high-sRAGE groups.</p><p><strong>Conclusion: </strong>Lower sRAGE level may be associated with an increased exacerbation risk in mild-to-moderate COPD and in patients with CB symptoms. Blood sRAGE is a candidate biomarker for identifying subgroups at higher exacerbation risk in populations at high risk of disease progression.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov identifier NCT04853225; GSK study code 208630.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"21 ","pages":"615390"},"PeriodicalIF":4.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698089","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}