Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation最新文献

{"title":"Psychobiologic Correlates of Stress in Individuals With COPD.","authors":"Trish M Parekh, Rekha Ramachandran, Young-Il Kim, Zahra Haider, Darlene Bhavnani, J Michael Wells, Elizabeth Matsui, Mark T Dransfield","doi":"10.15326/jcopdf.2024.0578","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0578","url":null,"abstract":"<p><strong>Rationale: </strong>Psychological stress is elevated in individuals with chronic medical conditions, including those with chronic obstructive pulmonary disease (COPD). Nail cortisol may have utility as a marker for testing the biologic effects of stress reduction interventions. The aim of this pilot study is to explore the use of nail cortisol as a marker of chronic psychological stress in individuals with COPD.</p><p><strong>Methods: </strong>Pearson's correlation was used to test if nail cortisol was correlated with perceived stress, serum cortisol, or inflammatory biomarkers. Multivariable linear regression model was used to evaluate the association between perceived stress and nail cortisol. Stepwise logistic regression modeling was used to determine associations of psychobiologic measures of stress with demographic, clinical, and psychological variables.</p><p><strong>Results: </strong>Fifty participants were included in the study. The mean (SD) perceived stress score was 12 (+/-6) and mean (SD) nail cortisol level was 0.05 (+/-0.09) nmol/g. Nail cortisol was not correlated with perceived stress, serum cortisol, or inflammatory markers. There was no association between nail cortisol and perceived stress after controlling for confounders. Suboptimal health status and grit score were associated with perceived stress. Higher levels of serum fibrinogen were associated with higher levels of serum cortisol. Experiencing three or more negative lifetime events was associated with a decrease in nail cortisol.</p><p><strong>Conclusions: </strong>We found no correlation between nail cortisol and levels of perceived stress, serum cortisol, or inflammatory biomarkers and there were no similar associations of variables across psychobiologic measures of stress.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of <i>MicroRNA-144</i> in Regulating Airway Immune Dysfunction in COPD Through the Transforming Growth Factor-Beta/Polymeric Immunoglobulin Receptor Pathway: An In Vitro Study.","authors":"Hu Liu, Yun Zhao, Jing Cao, Lei Liang, Jinmeng Zhou","doi":"10.15326/jcopdf.2024.0592","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0592","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is characterized by progressive airway inflammation and compromised immune defense, often worsened by reduced secretory immunoglobulin A (sIgA) levels. This decline in sIgA is linked to diminished polymeric immunoglobulin receptor (pIgR) activity, which impairs mucosal immunity. microRNA-144 (miR-144), a microRNA implicated in inflammation, may contribute to pIgR suppression, though this pathway in COPD remains poorly understood.</p><p><strong>Methods: </strong>Human bronchial epithelial cells (16HBECs) were exposed to cigarette smoke extract (CSE) to mimic COPD conditions, and were subsequently divided into control and CSE-treated groups. miR-144 was either inhibited or overexpressed in these cells via transient transfection. Expression levels of miR-144, TGIF-1, TGF-β, and pIgR were analyzed using qRT-PCR and Western blot. Additionally, a TGF-β inhibitor was applied to assess TGF-β's role in miR-144-mediated regulation of pIgR.</p><p><strong>Results: </strong>CSE treatment significantly upregulated miR-144 and TGIF-1 while reducing TGF-β and pIgR expression. miR-144 inhibition restored TGF-β and pIgR levels, while miR-144 overexpression reduced them further, indicating miR-144's direct influence on this regulatory pathway. TGF-β inhibition enhanced the reduction of pIgR under miR-144 overexpression, underscoring TGF-β's key role in pIgR regulation.</p><p><strong>Conclusion: </strong>miR-144 mediates immune suppression in COPD by downregulating pIgR through the TGF-β pathway, suggesting that miR-144 could serve as a therapeutic target to restore airway immune function and mitigate disease progression in COPD.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications of <i>Pseudomonas Aeruginosa</i> Colonization in Chronic Obstructive Pulmonary Disease Patients.","authors":"","doi":"10.15326/jcopdf.2024.0582E","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0582E","url":null,"abstract":"<p><p>This corrects the article, \"Clinical Implications of Pseudomonas Aeruginosa Colonization in Chronic Obstructive Pulmonary Disease Patients,\" published in Volume 12, Issue 2, pp. 137-145.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pragmatic Evaluation of an Improvement Program for People Living With Modifiable High-Risk COPD Versus Usual Care: Protocols for the Cluster Randomized PREVAIL Trial.","authors":"Katherine Hickman, Yasir Tarabichi, Andrew P Dickens, Rachel Pullen, Margee Kerr, Amy Couper, Alexander Evans, James Gatenby, Luis Alves, Cono Ariti, Mona Bafadhel, Victoria Carter, James Chalmers, Rongchang Chen, Graham Devereux, M Bradley Drummond, J Martin Gibson, David M G Halpin, MeiLan Han, Nicola A Hanania, John R Hurst, Alan Kaplan, Konstantinos Kostikas, Barry Make, Douglas Mapel, Jonathan Marshall, Fernando Martinez, Catherine Meldrum, Marije van Melle, Marc Miravitlles, Tamsin Morris, Hana Mullerova, Ruth Murray, Shigeo Muro, Clementine Nordon, Jill Ohar, Wilson Pace, Michael Pollack, Jennnifer K Quint, Anita Sharma, Dave Singh, Mukesh Singh, Frank Trudo, Dennis Williams, Tom Wilkinson, Tonya Winders, David Price","doi":"10.15326/jcopdf.2024.0564","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0564","url":null,"abstract":"<p><strong>Background: </strong>The burden of COPD is well established, but opportunities for earlier diagnosis and improved management are still missed. Compared to the general COPD population, patients with a history of exacerbations and sub-optimal treatment ('modifiable high-risk') are at greater risk of future exacerbations and adverse health outcomes. To date there is no systematic approach for identifying and treating this patient group.</p><p><strong>Method: </strong>Two cluster randomized controlled trials (CRTs) in the UK and US will assess the impact of a primary care-based quality improvement program (CONQUEST), compared to routine care. In each trial, 126 primary care clusters will be randomized 1:1 to intervention or control arms. Three groups of modifiable high-risk patients will be identified using electronic medical records: undiagnosed with potential COPD, newly diagnosed COPD and already diagnosed COPD. Eligible patients will be aged ≥40 years, have experienced ≥2 moderate/≥1 severe exacerbations in the prior 24 months, including ≥1 in the last 12 months, and not be prescribed inhaled triple therapy. Patients in the undiagnosed group will also be required to have a positive smoking history. Primary trial outcomes will be the annual rate of exacerbations and the annual rate of major adverse cardiac and respiratory events, comparing the quality improvement program against routine care.</p><p><strong>Discussion: </strong>These will be the first CRTs assessing such a comprehensive primary care-based COPD quality improvement program. Intention to treat analysis of trial outcomes after 24 months will inform its effectiveness in targeting the identification, assessment, treatment and follow-up of patients with modifiable high-risk COPD.</p><p><strong>Trial registration: </strong>UK trial: ISRCTN15819828; US trial: NCT05306743.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationale and Design of the Alpha-1 Biomarkers Consortium Study.","authors":"Monica P Goldklang, Cheryl Pirozzi, Igor Barjaktarevic, Surya Bhatt, Sandeep Bodduluri, M Bradley Drummond, D Kyle Hogarth, Alison Keaveny, Zhonghua Liu, Noel G McElvaney, Oliver J McElvaney, Nadine Nuchovich, Sabrina Palumbo, Randel Plant, Robert Sandhaus, J Michael Wells, Andrew Wilson, Charlie Strange, Jeanine M D'Armiento","doi":"10.15326/jcopdf.2025.0603","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0603","url":null,"abstract":"<p><strong>Rationale: </strong>Alpha-1 antitrypsin deficiency (AATD) is the most common genetic cause of chronic obstructive pulmonary disease (COPD), but considerable phenotypic variability exists among affected individuals who share disease-causing variants. Therefore, a multi-center longitudinal cohort study of 270 adult participants with PiZZ AATD will be established with goal of examining how computed tomography (CT) imaging and serum and airway biomarkers can be used to explain differences in phenotypic manifestations and outcomes.</p><p><strong>Methods: </strong>Study visits at enrollment, 18 months and 36 months will obtain spirometry, patient-reported outcomes and biosampling from blood, nasal mucosa and sputum. Chest CT image acquisition will be utilized for whole lung and lobar estimations of emphysema based on lung density and to test novel measurements of airway remodeling and lung tissue mechanics. Dried blood spot cards will be collected if the participant experiences an acute exacerbation of COPD (AECOPD) during the study. Genetic analysis will be performed with complete SERPINA1 sequencing, and peripheral blood mononuclear cells (PBMCs) will be isolated to generate a repository of inducible pluripotent stem cells (iPSCs).</p><p><strong>Results: </strong>The cohort will be deeply characterized including imaging, physiology, and symptomatology cross-sectionally and longitudinally over a 3-year follow-up period. A validation cohort from Ireland will independently enroll patients with identical procedures.</p><p><strong>Conclusion: </strong>This is the first cohort of AATD to incorporate such detailed metrics of disease including quantitative emphysema measures with the overarching goal of improving the understanding of disease heterogeneity in AATD and identifying factors associated with disease severity and progression.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhalation Innovation: Optimizing COPD Care Through Clinical Pharmacist Integration in a Rehabilitation Hospital's Multidisciplinary Team - A Quality Improvement Study.","authors":"Annelies Walravens, Emma Walravens, Stephanie Wuyts, Sander Boudewyn, Kayleigh Spriet, Kristel De Paepe, Eline Tommelein","doi":"10.15326/jcopdf.2024.0569","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0569","url":null,"abstract":"<p><strong>Inhalation innovation: </strong>Inhalation Innovation: Optimizing COPD Care through Clinical Pharmacist Integration in a Rehabilitation Hospital's Multidisciplinary Team - a quality improvement study.</p><p><strong>Background: </strong>Inhalation therapy is the cornerstone of COPD management. However, errors frequently occur since every type of inhalation device has different characteristics, complicating their use. The clinical pharmacist is an expert on these devices and can be involved in the care and education of inhaler use in patients with COPD.</p><p><strong>Aim: </strong>The feasibility of a pharmaceutical care protocol specifically for patients with COPD in a rehabilitation hospital was assessed in a quality improvement study (mixed-methods).</p><p><strong>Method: </strong>First, the clinical pharmacist had six contact moments with hospitalized patients between January and April 2022, which contained appropriateness evaluations and educational moments that were focused on inhalation techniques. Subsequently, a focus group discussion with all involved healthcare professionals (HCPs) took place to evaluate the preliminary results of the protocol's implementation.</p><p><strong>Results: </strong>Nineteen patients entered the study, the protocol results in a decrease of critical device errors (38.5% at baseline, to 7.7% at discharge). The HCPs concluded that it was feasible to implement the protocol given certain adjustments. A multidisciplinary collaboration between pharmacists and nurses is necessary to permit the practical implementation, as well as an individualization of the protocol based on the patient's needs. In patient follow-up, transmural care is essential including the HCPs in primary care, and the outpatient clinic.</p><p><strong>Conclusion: </strong>The evaluation of the protocol by the involved HCPs emphasizes the importance of a clinical pharmacist in the care for patients with COPD as part of the multidisciplinary team, not only in the community or in acute hospital setting, but also in a rehabilitation hospital.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Virtual Pulmonary Rehabilitation in Oxygen-Dependent COPD Patients.","authors":"Hector Filizola, Anirudh Kumar, Russell G Buhr, Kristin Schwab Jensen","doi":"10.15326/jcopdf.2024.0572","DOIUrl":"10.15326/jcopdf.2024.0572","url":null,"abstract":"<p><p>Virtual pulmonary rehabilitation (PR) is a proven yet underutilized intervention in chronic obstructive pulmonary disease (COPD) patients. However, neither the safety nor the effectiveness of virtual PR is established for patients with advanced disease and higher disease severity, particularly those requiring supplemental oxygen. We performed a retrospective review of 167 patients to evaluate the feasibility, safety, and effectiveness of virtual PR in oxygen-dependent versus nonoxygen-dependent COPD patients. Our primary outcome, attendance, was high (88% of sessions were attended by both groups). Adverse events occurred in only 2 (1%) participants, one in each group. Both groups showed significant postintervention improvements in dyspnea and depression scores (COPD Assessment Test [CAT], modified Medical Research Council [mMRC], Patient Health Questionnaire-9 [PHQ-9]) and functional exercise capacity (1-minute sit-to-stand [1MSTS]), with the improvements approaching or exceeding the established minimal clinically important difference values. When comparing the oxygen-dependent and nonoxygen groups, there were no significant differences in the degree of improvement for CAT, PHQ-9, and 1MSTS. For mMRC, those on oxygen did improve by 0.3 less than those not on oxygen (<i>P</i>=0.052). These findings suggest virtual PR is safe and effective for COPD patients requiring oxygen. To our knowledge, this is the first study to compare outcomes of virtual PR in patients on and off oxygen. Future research should explore patient-specific factors that can further individualize care.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"184-189"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Recording in Electronic Health Records: A Systematic Review.","authors":"Elizabeth Moore, Philip Stone, Ayda Alizadeh, Jaspreet Sangha, Saranya Das, Shraddha Arshanapalli, Jennifer K Quint","doi":"10.15326/jcopdf.2024.0577","DOIUrl":"10.15326/jcopdf.2024.0577","url":null,"abstract":"<p><strong>Objective: </strong>Acute exacerbations of COPD(AECOPD) can have severe impacts on patients with the disease and a heavy burden on health care resources. Electronic health records (EHRs) are a valuable resource for identifying cases of AECOPD and research. Studies have attempted to validate case definitions of AECOPD and this review aims to summarize validated AECOPD definitions in EHRs and to provide guidance on the best algorithms to use to ensure accurate cohorts of AECOPD cases are available for researchers using EHRs.</p><p><strong>Methods: </strong>MEDLINE and Embase were searched and studies that met the inclusion criteria were reviewed by ≥2 reviewers. Data extracted included the algorithms used to identify AECOPD, the reference standards used to compare against the algorithm, and measures of validity. The risk of bias was assessed using QUADAS-2 adapted for this review.</p><p><strong>Results: </strong>Out of 2784 studies found by the search strategy, 12 met the inclusion criteria. The clinical terminology used to build algorithms to detect AECOPD included codes from the International Classification of Diseases (ICD) Ninth Revision, Clinical Modification and Tenth Revision (ICD-9-CM and ICD-10), along with the Read codes from United Kingdom general practices. AECOPD can be identified within EHRs using validated definitions, however, the validity of AECOPD definitions varies considerably depending on the algorithm used and the settings to which they are applied.</p><p><strong>Conclusion: </strong>Although there are validated definitions that can be used to identify AECOPD, there is no clear consensus on which provides the highest validity or the most sensitive and specific definition to use.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"190-202"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Chart Review and Administrative Data in Developing Predictive Models for Readmissions in Chronic Obstructive Pulmonary Disease.","authors":"Sukarn Chokkara, Michael G Hermsen, Matthew Bonomo, Samuel Kaskovich, Maximilian J Hemmrich, Kyle A Carey, Laura Ruth Venable, Juan C Rojas, Matthew M Churpek, Valerie G Press","doi":"10.15326/jcopdf.2024.0542","DOIUrl":"10.15326/jcopdf.2024.0542","url":null,"abstract":"<p><p>This study aimed to evaluate the performance of machine learning models for predicting readmission of patients with chronic obstructive pulmonary disease (COPD) based on administrative data and chart review data. The study analyzed 4327 patient encounters from the University of Chicago Medicine to assess the risk of readmission within 90 days after an acute exacerbation of COPD. Two random forest prediction models were compared. One was derived from chart review data, while the other was derived using administrative data. The data were randomly partitioned into training and internal validation sets using a 70% to 30% split. The 2 models had comparable accuracy (administrative data area under the curve [AUC]=0.67, chart review AUC=0.64). These results suggest that despite its limitations in precisely identifying COPD admissions, administrative data may be useful for developing effective predictive tools and offer a less labor-intensive alternative to chart reviews.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"175-183"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Stress is Associated with Health Outcomes, Platelet Activation, and Oxidative Stress in COPD.","authors":"Obiageli Offor, Michelle N Eakin, Han Woo, Daniel Belz, Marlene Williams, Sarath Raju, Meredith McCormack, Nadia N Hansel, Nirupama Putcha, Ashraf Fawzy","doi":"10.15326/jcopdf.2024.0561","DOIUrl":"10.15326/jcopdf.2024.0561","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic obstructive pulmonary disease (COPD) are disproportionately affected by social determinants of health that have been associated with worse respiratory outcomes. This study evaluates the association of perceived stress with respiratory outcomes and distinct biological mechanisms among former smokers with COPD.</p><p><strong>Methods: </strong>Participants were assessed in an observational study at baseline, 3-months, and 6-months. Questionnaires assessed perceived stress (Perceived Stress Scale, [PSS]), respiratory symptoms, and incidence of COPD exacerbations. Generalized linear mixed models evaluated the association of PSS score with COPD outcomes and biomarkers of platelet activation (urine 11-dehydro-thromboxane B2 [11dTxB2]), oxidative stress (urine thiobarbituric acid reactive substances [TBARS], 8- hydroxydeoxyguanosine, and 8-isoprostane), and inflammation.</p><p><strong>Results: </strong>Among 99 participants, the median PSS score was 13 (interquartile range 8-18) across all visits. Compared with low perceived stress (PSS 0-13), moderate (PSS 14-26) and high perceived stress (PSS 27-40) were associated with worse respiratory health status and respiratory-related quality of life, with point estimates for high perceived stress exceeding clinically important differences. Only high PSS was associated with increased moderate/severe exacerbations (odds ratio 4.15, 95% confidence interval [CI]: 1.28-13.47). Compared to low stress, high stress was associated with lower TBARS (β=-25.5%, 95%CI: -43.8- -1.2%) and higher 8-isoprostane (β=40.1%, 95%CI: 11.5-76.0%). Among individuals with mild-moderate COPD, compared to low stress, moderate (β=20.1%, 95%CI: 3.1-40.0%) and high (β=52.9%, 95%CI: 22.1-91.6%) stress were associated with higher 11dTxB2.</p><p><strong>Conclusion: </strong>Among former smokers with COPD, higher perceived stress is associated with worse respiratory outcomes. Platelet activation and oxidative stress may be biological pathways through which perceived stress plays a role in COPD.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"98-108"},"PeriodicalIF":2.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}