scholarly journals Asthma and smoking-induced airway disease without spirometric COPD

2017 ◽  
Vol 49 (5) ◽  
pp. 1602061 ◽  
Author(s):  
Neil C. Thomson
Keyword(s):  
Cigarette Smoking ◽  
Clinical Outcomes ◽  
Structural Changes ◽  
Asthma Management ◽  
Airway Disease ◽  
Future Research ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Airway Disease ◽  
Never Smokers

Due to the high prevalence rates of cigarette smoking and asthma, current and ex-smokers frequently develop chronic airway disease without spirometric evidence of chronic obstructive pulmonary disease (COPD), either alone or associated with asthma. This review considers the classification, clinical outcomes, inflammatory and imaging variables, phenotypes, and management of current and ex-smokers with airway disease without COPD, focusing on overlaps in those with and without asthma. These individuals have more respiratory symptoms, worse quality of life, increased exacerbation rates, reduced lung function and more comorbidities than never-smokers with asthma or healthy never-smokers. As well as clinical features, airway inflammatory and structural changes in smoking-induced airway disease without COPD overlap with those found in smokers with asthma. Cigarette smoking is associated with worse clinical outcomes in some phenotypes of asthma. Management involves public health measures to control exposure to tobacco smoke, personal advice on smoking cessation and the use of appropriate targeted therapies, although evidence is limited on their effectiveness. Understanding the mechanisms, natural history and management of current and ex-smokers with asthma and smoking-induced airway disease without COPD is a priority for future research.

scholarly journals Prevalence of asthma chronic obstructive pulmonary disease overlap in patients attending a tertiary health care centre

2021 ◽  
Vol 8 (8) ◽  
pp. 1154
Author(s):  
Suresh Chandravanshi ◽  
Mahesh Kumar Sharma ◽  
D. P. Lakra ◽  
Manisha Khande ◽  
R. K. Panda
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Asthma Management ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Health Care Centre ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Chronic Airway Disease ◽  
Chronic Airway

Background: The study aimed to assess the magnitude of asthma chronic obstructive pulmonary disease asthma chronic obstructive (ACO) in patients with chronic airway disease.Methods: The study was conducted as cross-sectional study on patients with chronic airway disease presenting at our institute during the study period of 1 year. Global initiative for asthma management and prevention (GINA) syndromic approach table was used to diagnose patients with chronic airways disease. Syndromic and confirmatory diagnosis of ACO was made based upon clinical features and spirometry respectively.Results: About 73.6% were diagnosed as chronic obstructive pulmonary disease (COPD) and 26.4% cases were diagnosed as asthma. Overall ACO was present in 20% cases. ACO was significantly associated with advancing age, male gender, and longer duration of smoking (p<0.05) in asthma patients whereas in COPD patients ACO was associated with advancing age (p<0.05).Conclusions: Overall one fifth of the patients with chronic airway disease have asthma COPD overlap. The ACO is observed in almost equal proportions in asthma and COPD. ACO prevalence was found to increase with age in patients with asthma and COPD.

scholarly journals Differences in regional air trapping in current smokers with normal spirometry

2017 ◽  
Vol 49 (1) ◽  
pp. 1600345 ◽  
Author(s):  
Reza Karimi ◽  
Göran Tornling ◽  
Helena Forsslund ◽  
Mikael Mikko ◽  
Åsa M. Wheelock ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Structural Changes ◽  
Forced Expiratory Volume ◽  
Wall Thickening ◽  
Chronic Obstructive ◽  
Air Trapping ◽  
Obstructive Pulmonary Disease ◽  
Never Smokers ◽  
Detection Of Smoking ◽  
Specific Manifestation

We investigated regional air trapping on computed tomography in current smokers with normal spirometry. It was hypothesised that presence of regional air trapping may indicate a specific manifestation of smoking-related changes.40 current smokers, 40 patients with chronic obstructive pulmonary disease (COPD), and 40 healthy never- smokers underwent computed tomography scans. Regional air trapping was assessed on end-expiratory scans and emphysema, micronodules and bronchial wall thickening on inspiratory scans. The ratio of expiratory and inspiratory mean lung attenuation (E/I) was calculated as a measure of static (fixed) air trapping.Regional air trapping was present in 63% of current smokers, in 45% of never smokers and in 8% of COPD patients (p<0.001). Current smokers with and without regional air trapping had E/I ratio of 0.81 and 0.91, respectively (p<0.001). Forced expiratory volume in 1 s (FEV1) was significantly higher and emphysema less frequent in current smokers with regional air trapping.Current smokers with regional air trapping had higher FEV1 and less emphysema on computed tomography. In contrast, current smokers without regional air trapping resembled COPD. Our results highlight heterogeneity among smokers with normal spirometry and may contribute to early detection of smoking related structural changes in the lungs.

scholarly journals NK Cells in the Pathogenesis of Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Yafei Rao ◽  
Yanqing Le ◽  
Jing Xiong ◽  
Yuqiang Pei ◽  
Yongchang Sun
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Nk Cells ◽  
Pulmonary Disease ◽  
Airway Disease ◽  
Current Evidence ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Current State ◽  
Chronic Airway Disease ◽  
Underlying Mechanisms

Chronic obstructive pulmonary disease (COPD) is a prevalent chronic airway disease with varied frequencies of acute exacerbations, which are the main cause of morbidity and mortality of the disease. It is, therefore, urgent to develop novel therapies for COPD and its exacerbations, which rely heavily on understanding of the pathogenesis and investigation for potential targets. Current evidence indicates that natural killer (NK) cells play important roles in the pathological processes of COPD. Although novel data are revealing the significance of NK cells in maintaining immune system homeostasis and their involvement in pathogenesis of COPD, the specific mechanisms are largely unknown. Specific and in-depth studies elucidating the underlying mechanisms are therefore needed. In this review, we provided a brief overview of the biology of NK cells, from its development to receptors and functions, and outlined their subsets in peripheral blood and lungs. Then we reviewed published findings highlighting the important roles played by NK cells in COPD and its exacerbations, with a view of providing the current state of knowledge in this area to facilitate related in-depth research.

scholarly journals Clinical features related to hospital expenses for non-cystic fibrosis bronchiectasis in China

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093161
Author(s):  
Yanliang Ma ◽  
Daishun Liu ◽  
Yingqun Ji ◽  
Xuemei Wei ◽  
Dianzhu Pan ◽  
...  
Keyword(s):  
Smoking Status ◽  
Airway Disease ◽  
Cor Pulmonale ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Hospitalization Costs ◽  
Chronic Airway Disease ◽  
Tertiary Hospitals ◽  
Discharged Patients ◽  
Hospital Expenses

Objective Bronchiectasis is a common chronic airway disease. We investigated the economic burden and associated factors of bronchiectasis in China. Methods In this multicenter retrospective cohort study, we reviewed medical records of patients admitted to 18 tertiary hospitals during 2010 to 2014 with a bronchiectasis-related diagnosis. Results A total 5469 patients with bronchiectasis were admitted, accounting for 3.13% ± 1.80% of all discharged patients with any diagnosis during the same period; 13 patients died upon discharge. The median hospitalization cost was RMB 8421.52 (RMB 5849.88–12,294.47). Risk factors associated with hospitalization costs included age at admission (>70 vs. <40 years, odds ratio (OR) = 1.221, 95% confidence interval (CI) = 1.082–1.379; >80 vs. <40 years, OR = 1.251, 95% CI = 1.089–1.438), smoking (≤15 packs/year vs. non-smokers, OR = 1.125, 95% CI = 1.006–1.271; >15 packs/year vs. non-smokers, OR = 1.127, 95% CI = 1.062–1.228), length of hospitalization (OR = 1.05, 95% CI = 1.046–1.054), combination antibiotic treatment (OR = 1.089, 95% CI = 1.033–1.148), cough (OR = 0.851, 95% CI = 0.751–0.965), dyspnea (OR = 0.93, 95% CI = 0.878–0.984), chronic obstructive pulmonary disease (OR = 0.935, 95% CI = 0.878–0.996), respiratory failure (OR = 0.923, 95% CI = 0.862–0.989), cor pulmonale (OR = 0.919, 95% CI = 0.859–0.982), and death (OR = 1.816, 95% CI = 1.113–2.838). Conclusions Age, smoking status, symptoms, and respiratory comorbidities were associated with hospitalization costs of bronchiectasis.

scholarly journals Human rhinovirus-induced inflammatory responses are inhibited by phosphatidylserine containing liposomes

2016 ◽  
Vol 9 (5) ◽  
pp. 1303-1316 ◽  
Author(s):  
C A Stokes ◽  
R Kaur ◽  
M R Edwards ◽  
M Mondhe ◽  
D Robinson ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Inflammatory Responses ◽  
Airway Disease ◽  
Human Rhinovirus ◽  
Membrane Microdomains ◽  
Chronic Obstructive ◽  
Receptor Signaling ◽  
Obstructive Pulmonary Disease ◽  
Chronic Airway Disease ◽  
Target Membrane

Abstract Human rhinovirus (HRV) infections are major contributors to the healthcare burden associated with acute exacerbations of chronic airway disease, such as chronic obstructive pulmonary disease and asthma. Cellular responses to HRV are mediated through pattern recognition receptors that may in part signal from membrane microdomains. We previously found Toll-like receptor signaling is reduced, by targeting membrane microdomains with a specific liposomal phosphatidylserine species, 1-stearoyl-2-arachidonoyl-sn-glycero-3-phospho-L-serine (SAPS). Here we explored the ability of this approach to target a clinically important pathogen. We determined the biochemical and biophysical properties and stability of SAPS liposomes and studied their ability to modulate rhinovirus-induced inflammation, measured by cytokine production, and rhinovirus replication in both immortalized and normal primary bronchial epithelial cells. SAPS liposomes rapidly partitioned throughout the plasma membrane and internal cellular membranes of epithelial cells. Uptake of liposomes did not cause cell death, but was associated with markedly reduced inflammatory responses to rhinovirus, at the expense of only modest non-significant increases in viral replication, and without impairment of interferon receptor signaling. Thus using liposomes of phosphatidylserine to target membrane microdomains is a feasible mechanism for modulating rhinovirus-induced signaling, and potentially a prototypic new therapy for viral-mediated inflammation.

scholarly journals A 3D-CNN model with CT-based parametric response mapping for classifying COPD subjects

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thao Thi Ho ◽  
Taewoo Kim ◽  
Woo Jin Kim ◽  
Chang Hyun Lee ◽  
Kum Ju Chae ◽  
...  
Keyword(s):  
Neural Network ◽  
Pulmonary Function Tests ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Respiratory Disorder ◽  
Obstructive Pulmonary Disease ◽  
Response Mapping ◽  
Small Airway Disease ◽  
3D Cnn ◽  
Parametric Response

AbstractChronic obstructive pulmonary disease (COPD) is a respiratory disorder involving abnormalities of lung parenchymal morphology with different severities. COPD is assessed by pulmonary-function tests and computed tomography-based approaches. We introduce a new classification method for COPD grouping based on deep learning and a parametric-response mapping (PRM) method. We extracted parenchymal functional variables of functional small airway disease percentage (fSAD%) and emphysema percentage (Emph%) with an image registration technique, being provided as input parameters of 3D convolutional neural network (CNN). The integrated 3D-CNN and PRM (3D-cPRM) achieved a classification accuracy of 89.3% and a sensitivity of 88.3% in five-fold cross-validation. The prediction accuracy of the proposed 3D-cPRM exceeded those of the 2D model and traditional 3D CNNs with the same neural network, and was comparable to that of 2D pretrained PRM models. We then applied a gradient-weighted class activation mapping (Grad-CAM) that highlights the key features in the CNN learning process. Most of the class-discriminative regions appeared in the upper and middle lobes of the lung, consistent with the regions of elevated fSAD% and Emph% in COPD subjects. The 3D-cPRM successfully represented the parenchymal abnormalities in COPD and matched the CT-based diagnosis of COPD.

The role of beta-agonist therapy for chronic obstructive airway disease in patients with coexistent atrial fibrillation: Literature review

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Rodríguez Miguel ◽  
◽  
Chinta Siddharth ◽  
Vittorio Timothy ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airway Disease ◽  
The Other ◽  
Beta Agonist ◽  
Beta Blockade ◽  
Chronic Obstructive ◽  
Agonist Therapy ◽  
Obstructive Pulmonary Disease

Background: New advances have been made in medicine, but the incidence and prevalence of Chronic Obstructive Pulmonary Disease (COPD) are evident, and it is established as the fourth cause of death in the United States representing a high cost for the healthcare system. This condition has been related to atrial fibrillation due to the changes in the lungs and vasculature. Based on this history, we seek to evaluate the outcome of AF in the patients with COPD and its relationship with medical therapy utilized to treat this pulmonary condition with the objective of establishing the relationship between the use of beta-agonist therapy for obstructive airway disease in patients with AF. Discussion: Cell receptors participate in multiple reactions and the sympathetic response is received via the alpha- and beta-receptors are related to the hemodynamic of the vasculature of the lungs and cardiovascular system. The beta-blockade agents are one of the most common medication classes used for rate control in cardiac arrhythmias, but the side effect could be COPD exacerbation; on the other hand, beta-adrenergic or beta-agonist as a therapy for this pulmonary condition could increase the heart rate leading to AF decompensation. There is a clear dilemma in our patients who have airway disease and AF since the treatment for one might worsen the other. The clear benefit in morbidity and mortality of beta-blocker therapy, especially beta1-selective, outweighs the potential for any pulmonary side-effects related to ex-acerbation of COPD or airway disease. Conclusion: There is clear data showing the evidence of the potential paradoxical side-effect between COPD and AF therapies, given the exacerbation of one due to treatment of the other, benefits versus risks should be discussed and the medical decision should be made based on them. The deteriorated cardiac condition can rapidly predispose to critical complications leading to death, which is why the use of beta-blockade agents will be chosen over possible complications with pulmonary disease. In other words, the benefit should outweigh the risk based on the best outcome for the patient. Keywords: atrial fibrillation; pulmonary disease; obstructive pulmonary disease; chronic obstructive pulmonary disease (COPD); B-Agonist; B-Block (selective; non-selective); digitalis; other antiarrhythmic.

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