scholarly journals Eosinophilic Chronic Obstructive Pulmonary Disease

Lung ◽  
2021 ◽  
Author(s):  
Jonathan C. Weissler ◽  
Traci N. Adams
Keyword(s):  
Current Data ◽  
Chronic Obstructive ◽  
Peripheral Eosinophilia ◽  
Distinct Entity ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophilia ◽  
Copd Patients ◽  
Review Current ◽  
Peripheral Blood Eosinophilia

AbstractRecent therapeutic advances in the management of asthma have underscored the importance of eosinophilia and the role of pro-eosinophilic mediators such as IL-5 in asthma. Given that a subset of patients with COPD may display peripheral eosinophilia similar to what is observed in asthma, a number of recent studies have implied that eosinophilic COPD is a distinct entity. This review will seek to contrast the mechanisms of eosinophilia in asthma and COPD, the implications of eosinophilia for disease outcome, and review current data regarding the utility of peripheral blood eosinophilia in the management of COPD patients.

scholarly journals Nutrition in chronic obstructive pulmonary disease: A review

2015 ◽  
Vol 3 (4) ◽  
pp. 151-154 ◽  
Author(s):  
Gautam Rawal ◽  
Sankalp Yadav
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Exercise Tolerance ◽  
Muscle Wasting ◽  
Nutritional Supplement ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Supplement Therapy

AbstractCachexia and muscle wasting is a frequent but partly reversible complication in patients with chronic obstructive pulmonary disease (COPD), and affects the disease progression and prognosis. Weight loss in COPD is a consequence of increased energy requirements unbalanced by dietary intake. Nutritional supplement therapy has been shown to be effective for maintaining and improving the muscle strength and exercise tolerance in poorly nourished COPD patients, thereby decreasing morbidity and mortality. This mini review discusses the role of nutritional supplement therapy in the treatment of COPD.

scholarly journals Reassessing the Role of Eosinophils as a Biomarker in Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 8 (7) ◽  
pp. 962 ◽  
Author(s):  
Tinè ◽  
Biondini ◽  
Semenzato ◽  
Bazzan ◽  
Cosio ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Real Life ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Exacerbation Risk ◽  
Blood Eosinophils

Blood eosinophils measurement, as proxy for tissue eosinophils, has become an important biomarker for exacerbation risk and response to inhaled corticosteroids (ICS) in Chronic Obstructive Pulmonary Disease (COPD). Its use to determine the pharmacological approach is recommended in the latest COPD guidelines. The potential role of blood eosinophils is mainly based on data derived from post-hoc and retrospective analyses that showed an association between increased blood eosinophils and risk of exacerbations, as well as mitigation of this risk with ICS. Yet other publications, including studies in real life COPD, do not confirm these assumptions. Moreover, anti-eosinophil therapy targeting interleukin (IL)-5 failed to reduce exacerbations in COPD patients with high blood eosinophils, which casts significant doubts on the role of eosinophils in COPD. Furthermore, a reduction of eosinophils might be harmful since COPD patients with relatively high eosinophils have better pulmonary function, better life quality, less infections and longer survival. These effects are probably linked to the role of eosinophils in the immune response against pathogens. In conclusion, in COPD, high blood eosinophils are widely used as a biomarker for exacerbation risk and response to ICS. However, much is yet to be learned about the reasons for the high eosinophil counts, their variations and their controversial effects on the fate of COPD patients.

Role of the Management Pathway in the Care of Advanced COPD Patients in Their Own Homes

2010 ◽  
Vol 11 (4) ◽  
pp. 249-253 ◽  
Author(s):  
Ashok A. Ramani ◽  
Anthony A. Pickston ◽  
James L. Clark ◽  
Courtney A. Clark ◽  
Michael Brown
Keyword(s):  
Home Visits ◽  
Cost Benefit ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Therapists ◽  
The Third ◽  
Home Based ◽  
Copd Patients ◽  
Home Based Intervention

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, and the incidence and prevalence are rising every decade. The cost of hospital admission is substantial and is the single largest source of expenditure in care of COPD patients. Home-based intervention has been shown to provide long-term cost benefit in a range of chronic illnesses; however, the role of home visits by respiratory therapists (RT) in COPD management has not been evaluated. The aim of this study was to assess the effectiveness of a management pathway in the care of oxygen dependent COPD patients in their homes. Oxygen-dependent COPD patients were enrolled in the management pathway after discharge from the hospital or referred from a provider’s office. At least three home visits were made: the first within 3 days of enrollment, the second in 1 month, and the third 10 months later. Three hundred and twenty-four patients were enrolled in the study. During the study period, the overall hospitalization rate dropped (11% per month at the second visit vs. 2.1% per month at the third visit). The patients’ understanding of the disease improved substantially (21.6% vs. 83.9%), knowledge of medications the patients were taking improved (56.0% vs. 87.0%), and appropriate use of medications increased (52.0% vs. 86.0%). In our community, this RT-led program helped patients’ self-management of COPD in their own homes by increasing understanding of the disease, assisted physicians in monitoring their patients, and reduced hospitalization.

scholarly journals The Mechanisms of Benefit of High-Flow Nasal Therapy in Stable COPD

2020 ◽  
Vol 9 (12) ◽  
pp. 3832
Author(s):  
Massa Zantah ◽  
Aloknath Pandya ◽  
Michael R. Jacobs ◽  
Gerard J. Criner
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mucociliary Clearance ◽  
High Flow ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Flow Rates ◽  
Copd Patients ◽  
Unique System ◽  
Co2 Washout

High-flow nasal therapy (HFNT) is a unique system that delivers humidified, heated oxygen-enriched air via nasal cannula at high flow rates. It is a promising therapy for chronic obstructive pulmonary disease (COPD) patients. Several studies have examined the physiologic effects of this therapy in the patient population and have revealed that it improves mucociliary clearance, reduces nasopharyngeal dead space, and subsequently increases CO2 washout. It also improves alveolar recruitment and gas exchange. These mechanisms may explain the promising results observed in recently published studies that examined the role of HFNT in stable COPD patients.

Erythropoietin response after correction of severe hypoxaemia due to acute respiratory failure in chronic obstructive pulmonary disease patients

2004 ◽  
Vol 106 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Gordana PAVLISA ◽  
Veljko VRBANIC ◽  
Vesna KUSEC ◽  
Branimir JAKSIC
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Early Stage ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Complex Process ◽  
Severe Hypoxaemia ◽  
Physiological Research

In order to determine the initial values and dynamic changes of EPO (erythropoietin) after therapy, 57 consecutively presenting, typical COPD (chronic obstructive pulmonary disease) patients with chronic hypoxia and acute exacerbated serum EPO levels were serially measured. Initial mean EPO levels were slightly above the normal range (41.4±83.5 units/l), but in the majority of patients the initial EPO levels were significantly reduced. Following the correction of hypoxaemia, mean EPO levels decreased to 14.1±16.9 units/l (P=0.0093). However, not all COPD patients showed this pattern; in an important subset of patients (36.8%), who had initially lower EPO levels and lower erythrocyte count, EPO levels were significantly increased (by more than 60%; P=0.0028) on the second day of treatment, despite correction of the hypoxaemia. This finding was unexpected and paradoxical when compared with physiological studies addressing the same issue. The data presented support previous reports of variable EPO levels in severely hypoxic COPD patients and suggest that the haematological response is already hampered at an early stage, at the level of EPO production, and much less likely at later steps in the haemopoietic response by failure to respond to elevated EPO levels. Our data are consistent with recent discoveries that the O2 sensing and regulation of EPO production is a complex process in which multiple factors, including cytokines and therapeutic agents, play a role by enhancing or inhibiting the response. We believe that further studies on this clinical condition are complementary to basic physiological research and may help to elucidate the role of cytokines and other individual factors in complex clinical hypoxic situations.

scholarly journals Association of polymorphic variants of matrix metalloproteinase and antiprotease genes with development and severity of chronic obstructive pulmonary disease

2008 ◽  
pp. 33-38
Author(s):  
G. F. Korytina ◽  
L. Z. Akhmadishina ◽  
D. G. Yanbaeva ◽  
Sh. Z. Zagidullin ◽  
T. V. Viktorova
Keyword(s):  
Stage Iv ◽  
Chronic Obstructive ◽  
Disease Manifestation ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Polymorphic Variants ◽  
Hereditary Susceptibility ◽  
Mmp9 Gene ◽  
T Locus

To evaluate a role of polymorphic variants of metalloproteinase and protease genes for hereditary susceptibility to COPD and its severity, we analyzed polymorphic loci of MMP1, MMP9, MMP12, PI, and AACT genes in COPD patients (n = 318) and healthy persons (n = 319) living at the Bashkortostan Republic. Results showed that frequency of genotypes and alleles of G(-1607)GG gene MMP1, С(-1562)T gene MMP9, A(-82)G gene MMP12, and Ala 15 Thr gene ААСТ did not differ in COPD patients and healthy subjects. The Zand S-mutations of the PI gene were also similar in both the groups. The heterozygous GA genotype of G1237A locus in the 3'-non-translated region of PI gene was associated with COPD occurrence (OR = 2.09; 95 % CI: 1.15–3.81). To determine polymorphic variants associated with severity of clinical course and age of the disease manifestation, a comparative analysis of rates of genotypes and alleles was performed in patients with different COPD stages and of different age. The stage IV COPD patients significantly more often carried rare T allele in С(-1562)T locus of the MMP9 gene (15.89 % vs 8.38 %; χ2 = 7.804; df = 1; p = 0.005; OR = 2.06; 95 % CI: 1.22–3.49). Individuals with rare TT genotype of MMP9 gene were found only among the stage IV COPD patients (3.97 % vs 0 %; χ2 = 4.78; p = 0.029; pcor = 0.058). Moreover, analysis of this locus in patients with early manifestation of COPD (younger the 55 yrs) revealed significantly more frequent rate of T allele in patients with stage IV COPD compared to patients of the same age but less severe COPD (χ2 = 5.26; df = 1; p = 0.022).

scholarly journals Chronic Obstructive Pulmonary Disease (COPD) and Its Association with Lung Cancer: Molecular Mechanism and Therapeutic Targets

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Shanmugam G ◽  
◽  
Rakshit S ◽  
Sarkar K ◽  
◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Therapeutic Targets ◽  
Epidemiological Studies ◽  
Chronic Obstructive ◽  
Lung Carcinogenesis ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Chronic Obstructive Pulmonary Disease (COPD) and Lung cancer are the major reasons for lung disease-related mortality worldwide. Chronic inflammation is a key attribute of COPD and a potential driver of lung carcinogenesis. Among various environmental risk factors, cigarette smoke plays a crucial role in the development and progression of COPD and lung cancer. Several epidemiological studies show that COPD patients are at a greater risk of developing lung cancer independently of cigarette smoking which suggests the role of genetic predisposition in the disease development. Uncovering the mechanistic link between these two diseases is hampered due to their heterogeneous nature: each is characterized by several sub-phenotypes of diseases. This review focuses on the nature of the link between the two diseases and specific mechanisms that occur in both COPD and lung cancer, some of the therapeutic targets which are currently employed, and the role of gene-editing technology to combat these debilitating lung-inflammatory disorders.

scholarly journals Diaphragm Ultrasound Distinguishes Exacerbation From Stable Status in Chronic Obstructive Pulmonary Disease

2021 ◽  
Author(s):  
Tai Joon An ◽  
Yeun Jie Yoo ◽  
Jeong Uk Lim ◽  
Wan Seo ◽  
Chan Kwon Park ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Operating Characteristic ◽  
Forced Expiratory Volume ◽  
Diaphragm Muscle ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Status

Abstract Background: The importance of evaluating the diaphragm muscle in chronic obstructive pulmonary disease (COPD) is widely accepted. However, the role of diaphragm ultrasound (DUS) in COPD is not fully understood. We set this study to evaluate the role of DUS for distinguishing the status of COPD. Methods: COPD patients who underwent DUS were enrolled between March 2020 and November 2020. The diaphragm thickening fraction (TFmax) and diaphragm excursion (DEmax) during maximal deep breathing were measured. Patients were divided into exacerbation and stable groups. Demographics, lung function, and DUS findings were compared between the two groups. Receiver operating characteristic (ROC) curve and univariate/multivariate logistic regression analyses were performed.Results: Fifty-five patients were enrolled. The exacerbation group had a lower body mass index (BMI) (20.9 vs. 24.2, p = 0.003), lower TFmax (94.8 ± 8.2% vs. 158.4 ± 83.5%, p = 0.010), and lower DEmax (30.8 ± 11.1 mm vs. 40.5 ± 12.5 mm, p = 0.007) compared to stable group. The areas under the TFmax (0.745) and DEmax (0.721) curves indicated fair results for distinguishing exacerbation. The patients were divided into low and high TFmax and DEmax groups based on calculated cut-off values. Low TFmax (odds ratio [OR] 8.40; 95% confidence interval [CI] 1.55–45.56) and low DEmax (OR 11.51; 95% CI 1.15–115.56) were associated with exacerbation after adjusting for age, sex, BMI, forced vital capacity and forced expiratory volume in 1 sec.Conclusion: TFmax and DEmax distinguished exacerbation from stable status. We describe the DUS cut-off values for determining an exacerbation status in this study.

scholarly journals Role of Type2 Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 9 (8) ◽  
pp. 2670
Author(s):  
Keiji Oishi ◽  
Kazuto Matsunaga ◽  
Toshihiro Shirai ◽  
Keita Hirai ◽  
Yasuhiro Gon
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Stable State ◽  
Epidemiologic Studies ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Blood Eosinophils ◽  
The Relationship

Airway inflammation in chronic obstructive pulmonary disease (COPD) is typically thought to be driven by Type1 immune responses, while Type2 inflammation appears to be present in definite proportions in the stable state and during exacerbations. In fact, some COPD patients showed gene expression of Type2 inflammation in the airway, and this subset was associated with the inhaled corticosteroid (ICS) response. Interestingly enough, the relationship between COPD and diseases associated with Type2 inflammation from the perspective of impaired lung development is increasingly highlighted by recent epidemiologic studies on the origin of COPD. Therefore, many researchers have shown an interest in the prevalence and the role of existent Type2 biomarkers such as sputum and blood eosinophils, exhaled nitric oxide fraction, and atopy, not only in asthma but also in COPD. Although the evidence about Type2 biomarkers in COPD is inconsistent and less robust, Type2 biomarkers have shown some potential when analyzing various clinical outcomes or therapeutic response to ICS. In this article, we review the existent and emerging Type2 biomarkers with clinically higher applicability in the management of COPD.

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