scholarly journals Defective monocyte-derived macrophage phagocytosis is associated with exacerbation frequency in COPD

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
R. Singh ◽  
◽  
K. B. R. Belchamber ◽  
P. S. Fenwick ◽  
K. Chana ◽  
...  
Keyword(s):  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Stable State ◽  
Smoking History ◽  
Lower Airway ◽  
Lung Function Decline ◽  
Bacterial Colonisation ◽  
Exacerbation Frequency ◽  
Macrophage Phagocytosis ◽  
Copd Patients

Abstract Background Lower airway bacterial colonisation (LABC) in COPD patients is associated with increased exacerbation frequency and faster lung function decline. Defective macrophage phagocytosis in COPD drives inflammation, but how defective macrophage function contributes to exacerbations is not clear. This study investigated the association between macrophage phagocytosis and exacerbation frequency, LABC and clinical parameters. Methods Monocyte-derived macrophages (MDM) were generated from 92 stable COPD patients, and at the onset of exacerbation in 39 patients. Macrophages were exposed to fluorescently labelled Haemophilus influenzae or Streptococcus pneumoniae for 4 h, then phagocytosis measured by fluorimetry and cytokine release by ELISA. Sputum bacterial colonisation was measured by PCR. Results Phagocytosis of H. influenzae was negatively correlated with exacerbation frequency (r = 0.440, p < 0.01), and was significantly reduced in frequent vs. infrequent exacerbators (1.9 × 103 RFU vs. 2.5 × 103 RFU, p < 0.01). There was no correlation for S. pneumoniae. There was no association between phagocytosis of either bacteria with age, lung function, smoking history or treatment with inhaled corticosteroids, or long-acting bronchodilators. Phagocytosis was not altered during an exacerbation, or in the 2 weeks post-exacerbation. In response to phagocytosis, MDM from exacerbating patients showed increased release of CXCL-8 (p < 0.001) and TNFα (p < 0.01) compared to stable state. Conclusion Impaired COPD macrophage phagocytosis of H. influenzae, but not S. pneumoniae is associated with exacerbation frequency, resulting in pro-inflammatory macrophages that may contribute to disease progression. Targeting these frequent exacerbators with drugs that improve macrophage phagocytosis may prove beneficial.

scholarly journals The association of elevated circulating endocan levels with lung function decline in COPD patients

2018 ◽  
Vol Volume 13 ◽  
pp. 3699-3706 ◽  
Author(s):  
Luqi Dai ◽  
Junyun He ◽  
Jun Chen ◽  
Tao Wang ◽  
Lian Liu ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Function Decline ◽  
Copd Patients

LUNG FUNCTION DECLINE IN COPD PATIENTS AT 5 YEARS OF A TOBACCO INTERVENTION

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 526B
Author(s):  
Jaime Signes-Costa ◽  
Monica Llombart ◽  
Eusebi Chiner ◽  
Cristina Senent ◽  
Ada Luz Andreu ◽  
...  
Keyword(s):  
Lung Function ◽  
Lung Function Decline ◽  
Copd Patients ◽  
Tobacco Intervention

scholarly journals Comparison of Bronchodilator Effect of Salbutamol Delivered via MDI and DPI in COPD Patients

1970 ◽  
Vol 6 (2) ◽  
pp. 22-30 ◽  
Author(s):  
R Shrestha ◽  
R Shakya
Keyword(s):  
Lung Function ◽  
Smoking Habit ◽  
Dry Powder Inhaler ◽  
Smoking History ◽  
Dose Inhaler ◽  
Chronic Obstructive ◽  
P Value ◽  
Total N ◽  
Copd Patients ◽  
Significant Difference

Introduction : Chronic Obstructive Pulmonary Disease (COPD) is one of the leading problems affecting majority of population all over the world which diminishes the quality of life of the individual and create extra burden to the society as well as country. Inhaled bronchodilator therapy is the mainstay of treatment in the management of COPD. Various inhaled [e.g. metered dose inhaler (MDI) /dry powder inhaler (DPI)] formulations are available and are widely used among the COPD patients in Nepal. Methodology : This is cross sectional prospective study, designed to compare the bronchodilating effect produced when salbutamol is delivered via two devices: MDI (Asthalin® from Cipla) and DPI (Asthalin® rotacap delivered via Rotahaler® from Cipla), in patients with stable COPD. It is proven by previous studies that intervention is necessary to improve the compliance of the patients; all subjects (total n=60; 30 in each group) are counseled and trained to follow correct inhaling technique through particular device. Then their improvements in lung function were measured with reference to the pulmonary function test based on spirometry. Results : Patients enrolled in each group were not statistically different regarding to age (P=0.318), weight (P=0.324) & BMI (P=0.836). Among the total subjects 87% had smoking history and 2% were still smoking and there was no signifi cant difference in smoking habit between the two groups (p-value 0.544 > 0.05). Similarly 91.6 % of the total had exposure to indoor air pollution which had been the major risk factor for COPD. Most of the patients were on stage II COPD (62%). Salbutamol was found to have no effect on vital statistics of patients. Study showed there was no significant difference in the improvement of forced expiratory volume in one second (FEV1) (p=0.802), FVC (p= 0.693), FEV1 % (p=1) and PEF (p=0.448) between MDI and Rotahaler groups. Major side effect associated with the MDI users is headache (79%) while those among Rotahaler users were muscle cramps (79%). Even though intervention improved the inhaler using technique among the patients in both the groups, it was found even after counseling, DPI seemed to be better understood by the patients in comparison to MDI (p=0.003 & 0.00). In addition DPI was preferred by most of the patients who were familiar with both delivery systems. It was also found to be cheaper than the MDI. Conclusion : Overall evidence suggests that although both MDI & DPI improve the lung function of COPD patients to similar extent, DPI is cheaper and more preferred and can be easily handled by the patients which can result in reduction of non-compliance. Keyword : COPD; Salbutamol; DPI; MDI; Spirometry DOI: 10.3126/saarctb.v6i2.3054 SAARC J. Tuber. Lung Dis. HIV/AIDS 2009 VI (2) 22-30

scholarly journals Asthma progression and mortality: the role of inhaled corticosteroids

2019 ◽  
Vol 54 (1) ◽  
pp. 1900491 ◽  
Author(s):  
Paul O'Byrne ◽  
Leonardo M. Fabbri ◽  
Ian D. Pavord ◽  
Alberto Papi ◽  
Stefano Petruzzelli ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Inhaled Corticosteroids ◽  
Administrative Databases ◽  
Rapid Decline ◽  
Lung Function Decline ◽  
The Impact ◽  
Asthma Mortality

Overall, asthma mortality rates have declined dramatically in the last 30 years, due to improved diagnosis and to better treatment, particularly in the 1990s following the more widespread use of inhaled corticosteroids (ICSs). The impact of ICS on other long-term outcomes, such as lung function decline, is less certain, in part because the factors associated with these outcomes are incompletely understood. The purpose of this review is to evaluate the effect of pharmacological interventions, particularly ICS, on asthma progression and mortality. Furthermore, we review the potential mechanisms of action of pharmacotherapy on asthma progression and mortality, the effects of ICS on long-term changes in lung function, and the role of ICS in various asthma phenotypes.Overall, there is compelling evidence of the value of ICS in improving asthma control, as measured by improved symptoms, pulmonary function and reduced exacerbations. There is, however, less convincing evidence that ICS prevents the decline in pulmonary function that occurs in some, although not all, patients with asthma. Severe exacerbations are associated with a more rapid decline in pulmonary function, and by reducing the risk of severe exacerbations, it is likely that ICS will, at least partially, prevent this decline. Studies using administrative databases also support an important role for ICS in reducing asthma mortality, but the fact that asthma mortality is, fortunately, an uncommon event makes it highly improbable that this will be demonstrated in prospective trials.

scholarly journals P184 Macrophage phagocytosis in COPD patients at exacerbation compared to stable state

Thorax ◽  
2013 ◽  
Vol 68 (Suppl 3) ◽  
pp. A159.1-A159
Author(s):  
R Singh ◽  
K Such ◽  
BS Kowlessar ◽  
ARC Patel ◽  
AJ Mackay ◽  
...  
Keyword(s):  
Stable State ◽  
Macrophage Phagocytosis ◽  
Copd Patients

scholarly journals Clinical characteristics of people with cystic fibrosis and frequent fungal infection

2021 ◽  
Author(s):  
Thomas Poore ◽  
Maxene Meier ◽  
Elin Towler ◽  
John Brinton ◽  
Stacey Martiniano ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Fungal Infection ◽  
Clinical Characteristics ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Baseline Period ◽  
Lower Airway ◽  
Potential Contribution ◽  
Lung Function Decline

Background: Individuals with cystic fibrosis (CF) and fungal airway infection may present with fungal bronchitis, allergic bronchopulmonary aspergillosis (ABPA) or may appear unaffected despite fungal detection. We sought to characterize people with CF with frequent detection of fungi from airway samples and determine clinical outcomes. Methods: This retrospective study included individuals with CF with ≥ 4 lower airway cultures over a 2-year baseline period and ≥ 2 years of follow-up. We defined two groups: ≤ 1 positive fungus culture (rare) or ≥ 2 positive cultures during baseline (frequent). Clinical characteristics and outcomes were determined. Results: Between 2004-2016, 294 individuals met inclusion with 62% classified as rare and 38% as frequent fungi during baseline. Median follow-up was 6 years (range 2-9 years). Aspergillus fumigatus was the most common fungal species detected. Individuals with frequent fungi were older (13.7 vs. 11.7 yrs, p = 0.02) and more likely to have Stenotrophomonas maltophilia (35% vs 17%, p < 0.001) at baseline, but did not differ in lung function or ABPA diagnosis. During follow-up, those with frequent fungi were more likely to have chronic P. aeruginosa and S. maltophilia. Individuals with ABPA and frequent fungi had the highest rates of co-infection and co-morbidities, and a trend towards more rapid lung function decline. Discussion: Fungal infection in CF was associated with frequent P. aeruginosa and S. maltophilia co-infection even in those without ABPA. Individuals with frequent fungi and ABPA had worse outcomes, highlighting the potential contribution of fungi to CF pulmonary disease.

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