Small airway morphology and lung function in the transition from normality to chronic airway obstruction

2003 ◽  
Vol 95 (1) ◽  
pp. 441-447 ◽  
Author(s):  
Angelo Corsico ◽  
Manlio Milanese ◽  
Simonetta Baraldo ◽  
Gian Luca Casoni ◽  
Alberto Papi ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Pulmonary Function Tests ◽  
Lung Resection ◽  
Muscle Thickness ◽  
Forced Expiratory Volume ◽  
Normal Lung ◽  
Small Airways ◽  
Airway Wall ◽  
Normal Lung Function

This study investigated the relationships between pathological changes in small airways (<6 mm perimeter) and lung function in 22 nonasthmatic subjects (20 smokers) undergoing lung resection for peripheral lesions. Preoperative pulmonary function tests revealed airway obstruction [ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) < 70%] in 12 subjects and normal lung function in 10. When all subjects were considered together, total airway wall thickness was significantly correlated with FEV1/FVC ( r2 = 0.25), reactivity to methacholine ( r2 = 0.26), and slope of linear regression of FVC against FEV1 values recorded during the methacholine challenge ( r2 = 0.56). Loss of peribronchiolar alveolar attachments was significantly associated ( r2 = 0.25) with a bronchoconstrictor effect of deep inhalation, as assessed from a maximal-to-partial expiratory flow ratio <1, but not with airway responses to methacholine. No significant correlation was found between airway smooth muscle thickness and lung function measurements. In conclusion, this study suggests that thickening of the airway wall is a major mechanism for airway closure, whereas loss of airway-to-lung interdependence may contribute to the bronchoconstrictor effect of deep inhalation in the transition from normal lung function to airway obstruction in nonasthmatic smokers.

scholarly journals Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults

2021 ◽  
Vol 18 (5) ◽  
pp. 2344
Author(s):  
Sun-Wung Hsieh ◽  
Da-Wei Wu ◽  
Chih-Wen Wang ◽  
Szu-Chia Chen ◽  
Chih-Hsing Hung ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Lung Function ◽  
Lung Diseases ◽  
Mmse Score ◽  
Multivariable Analysis ◽  
Forced Expiratory Volume ◽  
Normal Lung ◽  
Obstructive Lung Diseases ◽  
Normal Lung Function ◽  
Function Group

Previous studies have reported an association between the impairment of cognitive performance and lung diseases. However, whether obstructive or restrictive lung diseases have an impact on cognitive function is still inconclusive. We aimed to investigate the association between cognitive function and obstructive or restrictive lung diseases in Taiwanese adults using the Mini-Mental State Examination (MMSE). In this study, we used data from the Taiwan Biobank. Cognitive function was evaluated using the MMSE. Spirometry measurements of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were obtained to assess lung function. Participants were classified into three groups according to lung function, namely, normal, restrictive, and obstructive lung function. In total, 683 patients enrolled, of whom 357 participants had normal lung function (52.3%), 95 had restrictive lung function (13.9%), and 231 had obstructive lung function (33.8%). Compared to the normal lung function group, the obstructive lung function group was associated with a higher percentage of cognitive impairment (MMSE < 24). In multivariable analysis, a low MMSE score was significantly associated with low FVC, low FEV1, and low FEV1/FVC. Furthermore, a low MMSE score was significantly associated with low FEV1 in the participants with FEV1/FVC < 70%, whereas MMSE was not significantly associated with FVC in the participants with FEV1/FVC ≥ 70%. Our results showed that a low MMSE score was associated with low FEV1, low FVC and low FEV1/FVC. Furthermore, a low MMSE score was associated with obstructive lung diseases but not with restrictive lung diseases.

scholarly journals Increased myofibroblasts in the small airways and relation to remodelling and functional changes in smokers and COPD patients: potential role of epithelial-mesenchymal transition (EMT)

2021 ◽  
pp. 00876-2020
Author(s):  
Mathew Suji Eapen ◽  
Wenying Lu ◽  
Tillie L. Hackett ◽  
Gurpreet Kaur Singhera ◽  
Malik Q. Mahmood ◽  
...  
Keyword(s):  
Lung Function ◽  
Epithelial Mesenchymal Transition ◽  
Small Airway ◽  
Normal Lung ◽  
Small Airways ◽  
Mesenchymal Transition ◽  
Functional Changes ◽  
Highly Active ◽  
Copd Patients ◽  
Normal Lung Function

IntroductionPrevious reports showed epithelial mesenchymal transition (EMT) as an active process that contributes to small airway (SA) fibrotic pathology. Myofibroblasts are highly active pro-fibrotic cells that secrete excessive and altered extracellular matrix (ECM). Here we relate SA myofibroblast presence with airway remodelling, physiology and EMT activity in smokers and COPD patients.MethodsLung resections from non-smoker controls (NC), normal lung function smokers (NLFS), COPD current (CS) and ex-smokers (ES) were stained with anti-human αSMA, collagen 1, and fibronectin. αSMA+ive cells were computed in reticular basement membrane (Rbm), lamina propria (LP), and adventitia and presented per mm of Rbm and mm2 of LP. Collagen-1 and fibronectin are presented as a percentage change from normal. All analysis including airway thickness were measured using Image-pro-plus 7.0.ResultsWe found an increase in sub-epithelial LP (especially) and adventitia thickness in all pathological groups compared to NC. Increases in αSMA+ive myofibroblasts were observed in sub-epithelial Rbm, LP, and adventitia in both the smoker and COPD groups compared to NCs. Further, the increase in the myofibroblast population in the LP was strongly associated with decrease in lung function, LP thickening, increase in ECM protein deposition, and finally EMT activity in epithelial cells.ConclusionsThis is the first systematic characterisation of small airway myofibroblasts in COPD based on their localisation, with statistically significant correlations between them and other pan-airway structural, lung function, and ECM protein changes. Finally, we suggest that EMT may be involved in such changes.

scholarly journals Endothelial dysfunction in pulmonary arteries of patients with mild COPD

1998 ◽  
Vol 274 (6) ◽  
pp. L908-L913 ◽  
Author(s):  
Víctor I. Peinado ◽  
Joan A. Barberà ◽  
Josep Ramírez ◽  
Federico P. Gómez ◽  
Josep Roca ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Lung Function ◽  
Lung Resection ◽  
Critical Role ◽  
Airflow Obstruction ◽  
Pulmonary Arteries ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Small Arteries ◽  
Normal Lung Function

To investigate whether endothelial dysfunction of pulmonary arteries (PA) is present in patients with mild chronic obstructive pulmonary disease (COPD) and to what extent it is related to the morphological abnormalities of PA, we studied 41 patients who underwent lung resection. Patients were divided into the following groups: nonsmokers ( n = 7), smokers with normal lung function ( n = 13), and COPD ( n = 21). Endothelium-dependent relaxation mediated by nitric oxide was evaluated in vitro in PA rings exposed to cumulative concentrations of acetylcholine (ACh) and ADP. Structural abnormalities of PA were assessed morphometrically. PA of COPD patients developed lower maximal relaxation in response to ADP than both nonsmokers and smokers ( P < 0.05 each) and a trend to reduced relaxation in response to ACh ( P = 0.08). Maximal relaxation to ADP correlated with the degree of airflow obstruction ( r = 0.48, P < 0.01). Morphometrical analysis of PA revealed thicker intimas, especially in small arteries, in both smokers and COPD compared with nonsmokers ( P < 0.05 each). We conclude that endothelial dysfunction of PA is already present in patients with mild COPD. In these patients, as well as in smokers with normal lung function, small arteries show thickened intimas, suggesting that tobacco consumption may play a critical role in the pathogenesis of pulmonary vascular abnormalities in COPD.

scholarly journals Asthma Symptoms Do not Predict Spirometry

2007 ◽  
Vol 14 (6) ◽  
pp. 339-342 ◽  
Author(s):  
Robert L Cowie ◽  
Margot F Underwood ◽  
Stephen K Field
Keyword(s):  
Lung Function ◽  
Vital Capacity ◽  
Airflow Obstruction ◽  
Asthma Severity ◽  
Forced Expiratory Volume ◽  
Normal Lung ◽  
Asthma Symptoms ◽  
Normal Lung Function ◽  
And Control ◽  
Routine Assessment

BACKGROUND: Asthma is a disease characterized by variable airflow obstruction, but the measurement of airflow is often omitted in the process of diagnosis and management of the disease.OBJECTIVES: Features of asthma severity and control were examined to determine the extent to which objective measurements, including forced expiratory volume in 1 s and forced expiratory volume in 1 s/forced vital capacity, correlated with other manifestations of the disease.METHODS: Subjects were a consecutive sample of patients with asthma attending a university-based asthma clinic. All subjects underwent routine assessment using a standard questionnaire and spirometry.RESULTS: A total of 500 subjects were included in the present study, and their assessment showed that neither symptoms nor history could predict or be predicted by their measurements of lung function.CONCLUSION: Routine measurement of lung function should be performed on subjects with asthma if normal or near-normal lung function is a desired component of asthma control.

scholarly journals Quantitative CT parameters correlate with lung function in chronic obstructive pulmonary disease: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Yan Wang ◽  
Shan Lin ◽  
Jian-Ting Li ◽  
Jing Wu ◽  
Dong Han ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Airway Wall ◽  
Quantitative Ct ◽  
Ct Measurements

Abstract Abstract purpose : The aim of the study was to analyze the correlation between quantitative computed tomography (CT) parameters and airflow obstruction in patients with chronic obstruction pulmonary disease (COPD). Methods: PubMed, Embase, Cochrane and Web of Knowledge were searched by two investigators from inception to 2018, using a combination of pertinent items to discover articles that investigated the relationship between CT measurements and lung function parameters in patients with COPD. Five reviewers independently evaluated the quality, extracted data and evaluated bias. The correlation coefficient was calculated and heterogeneity was explored. The following CT measurements were extracted: percentage of lung attenuation area < -950 Hounsfield Units (HU), mean lung density, percentage of airway wall area, air trapping index, airway wall thickness. Two airflow obstruction parameters were extracted: forced expiratory volume in the first second as a percentage of prediction (FEV 1 % pred) and FEV 1 divided by forced expiratory volume lung capacity. Results: A total of 117 studies (19,942 participants) were identified, 36 of which (4,762 participants) were suitable for meta-analysis. Results from our analysis demonstrated that there was a significant correlation between quantitative CT parameters and lung function. The absolute pooled correlation coefficients ranged from 0.44 (95% CI, 0.36 to 0.53) to 0.71(95% CI,0.65 to 0.77) for inspiratory CT and 0.59 (95% CI, 0.53 to 0.65) to 0.66 (95% CI,0.61 to 0.72) for expiratory CT. Conclusions: Results from this analysis demonstrated that quantitative CT parameters are significantly correlated with lung function in patients with COPD. With recent advances in chest CT, we can evaluate morphological features in the lungs that cannot be obtained by other clinical indices, such as pulmonary function tests. Therefore, CT can provide a quantitative method to advance the development and testing of new interventions and therapies for patients with COPD. Keywords: Airway obstruction, Systematic review, Meta-analysis.

scholarly journals Quantitative CT parameters correlate with lung function in chronic obstructive pulmonary disease: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Yan Wang ◽  
Shan Lin ◽  
Jian-Ting Li ◽  
Jing Wu ◽  
Dong Han ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Quantitative Computed Tomography ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Airway Wall ◽  
Quantitative Ct ◽  
Ct Measurements

Abstract Background The aim of the study was to analyze the correlation between quantitative computed tomography (CT) parameters and airflow obstruction in patients with chronic obstruction pulmonary disease (COPD). Methods PubMed, Embase, Cochrane and Web of Knowledge were searched by two investigators from inception to 2018, using a combination of pertinent items to discover articles that investigated the relationship between CT measurements and lung function parameters in patients with COPD. Five reviewers independently evaluated the quality, extracted data and evaluated bias. The correlation coefficient was calculated and heterogeneity was explored. The following CT measurements were extracted: percentage of lung attenuation area < -950 Hounsfield Units (HU), mean lung density, percentage of airway wall area, air trapping index, airway wall thickness. Two airflow obstruction parameters were extracted: forced expiratory volume in the first second as a percentage of prediction (FEV1% pred) and FEV1 divided by forced expiratory volume lung capacity. Results A total of 117 studies (19,942 participants) were identified, 36 of which (4,762 participants) were suitable for meta-analysis. Results from our analysis demonstrated that there was a significant correlation between quantitative CT parameters and lung function. The absolute pooled correlation coefficients ranged from 0.44 (95% CI, 0.36 to 0.53) to 0.71(95% CI,0.65 to 0.77) for inspiratory CT and 0.59 (95% CI, 0.53 to 0.65) to 0.66 (95% CI,0.61 to 0.72) for expiratory CT. Conclusions Results from this analysis demonstrated that quantitative CT parameters are significantly correlated with lung function in patients with COPD. With recent advances in chest CT, we can evaluate morphological features in the lungs that cannot be obtained by other clinical indices, such as pulmonary function tests. Therefore, CT can provide a quantitative method to advance the development and testing of new interventions and therapies for patients with COPD .

Asthma with Irreversible Airway Obstruction in Smokers and Nonsmokers: Links between Airway Inflammation and Structural Changes

Respiration ◽  
2020 ◽  
pp. 1-11
Author(s):  
Louis-Philippe Boulet ◽  
Marie-Eve Boulay ◽  
Harvey O. Coxson ◽  
Cameron J. Hague ◽  
Joanne Milot ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Obstruction ◽  
Airway Inflammation ◽  
Wall Thickness ◽  
Structural Changes ◽  
Smoking History ◽  
Airway Wall ◽  
Tobacco Exposure ◽  
Airway Wall Thickness ◽  
Irreversible Airway Obstruction

<b><i>Background:</i></b> The development of irreversible airway obstruction (IRAO) in asthma is related to lung/airway inflammatory and structural changes whose characteristics are likely influenced by exposure to tobacco smoke. <b><i>Objective:</i></b> To investigate the interplay between airway and lung structural changes, airway inflammation, and smoking exposure in asthmatics with IRAO. <b><i>Methods:</i></b> We studied asthmatics with IRAO who were further classified according to their smoking history, those with ≥20 pack-years of tobacco exposure (asthmatics with smoking-related IRAO [AwS-IRAO]) and those with &#x3c;5 pack-years of tobacco exposure (asthmatics with nonsmoking-related IRAO [AwNS-IRAO]). In addition to recording baseline clinical and lung function features, all patients had a chest computed tomography (CT) from which airway wall thickness was measured and quantitative and qualitative assessment of emphysema was performed. The airway inflammatory profile was documented from differential inflammatory cell counts on induced sputum. <b><i>Results:</i></b> Ninety patients were recruited (57 AwS-IRAO and 33 AwNS-IRAO). There were no statistically significant differences in the extent of emphysema and gas trapping between groups on quantitative chest CT analysis, although Pi10, a marker of airway wall thickness, was significantly higher in AwS-IRAO (<i>p</i> = 0.0242). Visual analysis showed a higher prevalence of emphysema (<i>p</i> = 0.0001) and higher emphysema score (<i>p</i> &#x3c; 0.0001) in AwS-IRAO compared to AwNS-IRAO and distribution of emphysema was different between groups. Correlations between radiological features and lung function were stronger in AwS-IRAO. In a subgroup analysis, we found a correlation between airway neutrophilia and emphysematous features in AwS-IRAO and between eosinophilia and both airway wall thickness and emphysematous changes in AwNS-IRAO. <b><i>Conclusions:</i></b> Although bronchial structural changes were relatively similar in smoking and nonsmoking patients with asthma and IRAO, emphysematous changes were more predominant in smokers. However, neutrophils in AwS-IRAO and eosinophils in AwNS-IRAO were associated with lung and airway structural changes.

scholarly journals Correlation between Level of Autophagy and Amount of CD8+T Cells in Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Songming Zhuo ◽  
Hong Zhuang ◽  
Na Li ◽  
Sida Chen ◽  
Wugen Zhan ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Lung Function ◽  
Normal Lung ◽  
Stable Phase ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Normal Lung Function ◽  
Healthy Control ◽  
Function Group

Abstract Background: This study aimed to shed light on the correlation between the amounts of CD8+ T cells and autophagy level in COPD. Results: The objects (n = 90) were divided into three groups: COPD group (patients in the stable phase; n = 30), SN group (healthy control of smoking with normal lung function group; n = 30), and NSN groups (healthy control of non-smoking with normal lung function group; n = 30). The amounts of CD8+ (32.33 ± 4.23%), CD8+ effector (25.63 ± 8.57%) and CD8+memory (11.94 ± 5.77%) T cell in the COPD group were significantly higher those in the other two groups, while the apoptotic rate was lower in the COPD group (P < 0.05). Significant linear correlations were found of P62/GAPDH (‰) with CD8+, CD8+effector, and CD8+ memory- T cell amounts (P<0.001). Conclusions: Autophagy level is positively and linearly associated with the amounts of CD8+ T cells, suggesting that cell autophagy might be involved in COPD pathogenesis.

scholarly journals Asthma‐chronic obstructive pulmonary disease overlap: A clinical entity?

2020 ◽  
Vol 3 (1) ◽  
pp. 2-8
Author(s):  
Robert A. Wise
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Middle Age ◽  
Clinical Manifestations ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophilic Inflammation ◽  
Normal Lung Function

Asthma and COPD are easily recognizable clinical entities in their characteristic presentations. Asthma is an early-onset disorder characterized by Type 2, eosinophil-predominant, inflammation of the airways and is associated with atopy. COPD presents in middle age and is characterized by neutrophilic inflammation of the airways and is associated with cigarette smoking or biomass fuel exposure. Between exacerbations, asthma typically has normal lung function whereas COPD has incompletely reversible lung function. Approximately one in five patients with either of these disorders will show some features of both COPD and Asthma. This overlap is far more common than can be accounted for by chance concurrence of two common diseases. There are likely genetic and environmental susceptibilities to both disorders, but there is no single pathobiological mechanism that identifies all such overlap patients. Most likely there are numerous predispositions that lead to Asthma-COPD overlap that may be grounded in early childhood or even pre-natal events. Thus, Asthma-COPD overlap is best considered a family of diseases with overlapping clinical manifestations. The future elucidation of these different pathways to Asthma-COPD overlap, in conjunction with highly targeted therapies will aid clinicians in treating these patients.

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