scholarly journals TIMP-1 and MMP-9 expressions in COPD patients complicated with spontaneous pneumothorax and their correlations with treatment outcomes

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Hang Li ◽  
Kaihu Shi ◽  
Yang Zhao ◽  
Jin Du ◽  
Dinghui Hu ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Spontaneous Pneumothorax ◽  
Term Treatment ◽  
Control Group ◽  
Chronic Obstructive ◽  
Short Term Treatment ◽  
Improvement Rate ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Copd Patients

Objective: To study the expressions of TIMP-1 and MMP-9 in patients with chronic obstructive pulmonary disease (COPD) complicated with spontaneous pneumothorax, and their correlations with treatment outcomes. Methods: A total of 80 COPD patients complicated with spontaneous pneumothorax treated in our hospital from December 2015 to December 2017. The serum expressions of TIMP-1 and MMP-9 in 80 COPD patients complicated with spontaneous pneumothorax (COPD group) and 52 healthy volunteers (control group) were detected by ELISA. The correlations of TIMP-1 and MMP-9 expressions with arterial blood gas parameters as well as scores of MRC breathlessness scale and St. George’s Respiratory Questionnaire (SGRQ) were analyzed. Results: The serum expressions of TIMP-1 and MMP-9 of COPD group were significantly higher than those of control group (P<0.05), but the two groups had similar MMP-9/TIMP-1 ratios (P>0.05). For COPD group, TIMP-1 expression, MMP-9 expression, MMP-9/TIMP-1, Sa(O2) and p(O2) were not correlated (P>0.05). TIMP-1 expression was significantly positively correlated with MRC scale and SGRQ scores (P<0.05). Sa(O2), p(O2) and MRC scale score of low MMP-9 expression, low TIMP-1 expression and low MMP-9/TIMP-1 group were significantly improved compared with those of high MMP-9 expression, high TIMP-1 expression and high MMP-9/TIMP-1 group (P<0.05). MMP-9 expression, TIMP-1 expression or MMP-9/TIMP-1 was not correlated with improvement of SGRQ score. Pulmonary function improvement (Sa(O2) improvement rate ≥5% and/or p(O2) improvement rate ≥10%) was correlated with serum MMP-9 expression, baseline Sa(O2) and p(O2). Conclusion: Increase of serum TIMP-1 and MMP-9 expressions in COPD patients was correlated with symptoms and scores of quality of life, and the expressions were also correlated with short-term treatment reactivity. doi: https://doi.org/10.12669/pjms.36.2.1244 How to cite this:Li H, Shi K, Zhao Y, Du J, Hu D, Liu Z. TIMP-1 and MMP-9 expressions in COPD patients complicated with spontaneous pneumothorax and their correlations with treatment outcomes. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1244 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Long-Term Oxygen Therapy in COPD: evidences and open questions of current indications

2016 ◽  
Vol 73 (1) ◽  
Author(s):  
A. Corrado ◽  
T. Renda ◽  
S. Bertini
Keyword(s):  
Oxygen Therapy ◽  
Supplemental Oxygen ◽  
Future Research ◽  
Chronic Obstructive ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Copd Patients ◽  
Number Of Patients ◽  
Long Term Oxygen Therapy

Long term oxygen therapy (LTOT) has been shown to improve the survival rate in Chronic Obstructive Pulmonary Disease (COPD) patients with severe resting hypoxemia by NOTT and MRC studies, published more than 25 years ago. The improved survival was found in patients who received oxygen for more than 15 hours/day. The effectiveness of LTOT has been documented only in stable COPD patients with severe chronic hypoxemia at rest (PaO255%. In fact no evidence supports the use of LTOT in COPD patients with moderate hypoxemia (55&lt;PaO2&lt;65 mmHg), and in those with decreased oxygen saturation (SO2&lt;90%) during exercise or sleep. Furthermore, it is generally accepted without evidence that LTOT in clinical practice is warranted in other forms of chronic respiratory failure not due to COPD when arterial blood gas criteria match those established for COPD patients. The prescription of oxygen in these circumstances, as for unstable patients, increases the number of patients receiving supplemental oxygen and the related costs. Comorbidities are likely to affect both prognosis and health outcomes in COPD patients, but at the moment we do not know if LTOT in these patients with complex chronic diseases and mild-moderate hypoxemia could be of any use. For these reasons a critical revision of the actual guide lines indications for LTOT in order to optimise effectiveness and costs, and future research in the areas that have not previously been addressed by NOTT and MRC studies, are mandatory.

scholarly journals The Effect of Arterial PaCO2 in COPD Exacerbations with and without Peripheral Edema

2015 ◽  
Vol 53 (4) ◽  
pp. 343-347
Author(s):  
Fariba Rezaeetalab ◽  
Abbas Ali Zeraatti ◽  
Farzaneh Sharifipour ◽  
Rozita Davoodi ◽  
Hoorak Pourzand
Keyword(s):  
Endocrine Function ◽  
Renal Diseases ◽  
Chronic Obstructive ◽  
Sodium Retention ◽  
Left Heart Failure ◽  
Arterial Blood Gas ◽  
Hepatic Diseases ◽  
Arterial Blood ◽  
Copd Patients ◽  
Significant Difference

AbstractIntroduction. Studies often suggest hypoxemia is an important factor for sodium retention in chronic obstructive pulmonary disease (COPD), although hypercapnia is also associated with sodium retention in these patients. Hence, we have presented the major role of PaCO2 in edema due to COPD.Method. COPD patients who were hospitalized due to exacerbation were enrolled in the study and divided into two groups: with and without edema. Exclusion criteria included primary hepatic diseases, nephrotic syndrome and other renal diseases, left heart failure, or using drugs that would interfere with these organs or endocrine function. Data were coded and analyzed by SPSS software. Arterial blood gas variables including bicarbonate, pH, and PaO2, PaCO2 and O2 saturation, and FEV1, FVC, FEV1/FVC were measured and compared between the groups.Results. No significant difference was found between the averages of bicarbonate, pH, PaO2, O2 saturation, FEV1, FVC and FEV1/FVC in COPD in the two groups. PaCO2 levels were significantly higher in patients with edema, compared to those without edema (p = 0.05). A reverse and significant correlation between PaCo2 and FEV1 levels (p = 0.03) (r = −0.501) was observed in patients with edema.Conclusion. This study suggests that hypercapnia is a major factor in causing edema in COPD patients compared to hypoxemia.

scholarly journals Interleukin-6 serum level and -597 A/G gene polymorphism in moderate and severe chronic obstructive pulmonary disease

2020 ◽  
Vol 18 ◽  
pp. 205873922096646
Author(s):  
Ana Florica Chiș ◽  
Andreea Cătană ◽  
Olga Sorițău ◽  
Bogdan Augustin Chiș ◽  
Ancuța Cutaș ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Interleukin 6 ◽  
Healthy Subjects ◽  
Serum Levels ◽  
Smoking History ◽  
Control Group ◽  
Chronic Obstructive ◽  
Allele Distribution ◽  
Arterial Blood ◽  
Copd Patients

Inflammation is a major pathogenic pathway in pulmonary chronic obstructive disease (COPD). Interleukin-6 (IL-6) mediates the local and systemic immune response. The aim consisted in investigating the relationship between IL-6 serum levels and IL-6 -597A/G gene polymorphism (rs1800797) with COPD. Serum levels of IL-6 were determined using an enzyme-linked immune-sorbent assay, in 120 participants (60 COPD patients and 60 healthy subjects), from Transylvanian region. The IL-6 -597A/G gene polymorphism was investigated by high molecular weight genomic DNA extracted from the peripheral blood leukocytes, and subsequently analyzed by the Polymerase Chain Reaction Restriction Fragment Length Polymorphism (PCR-RFLP) technique. Smoking history, the severity of the disease, expressed by the GOLD stages, and arterial blood partial pressure of oxygen (PaO2) levels were also investigated. COPD patients had significantly elevated blood levels of IL-6 when compared to the control group ( p < 0.05). The frequencies of AA, AG, and GG genotypes were 61.6%, 26.6%, and 11.6% in the COPD cases and 70%, 23.3%, and 6.7% in healthy subjects, respectively. There were no statistically significant differences in IL-6 rs1800797 genotypes and allele frequencies between cases and controls ( χ2 = 0.54, OR = 1.29 and χ2 = 0.21, OR = 1.48, respectively). Higher serum levels of IL-6 were found in the GG genotype subgroup in COPD patients. IL 6 levels are higher in COPD patients, where positively correlate with pack-year index, but not with clinical features. Although COPD patients did not have statistically different rs1800797 allele distribution compared to healthy subjects, the GG genotype is associated with higher IL6 serum levels.

scholarly journals Neurophysiological biomarkers of peripheral nervous system affection in patients with stable chronic obstructive pulmonary disease (COPD)

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Hossam Abd El Monem Ali ◽  
Ahmed Salama Al-Adl
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Nervous System ◽  
Pulmonary Disease ◽  
Peripheral Nervous System ◽  
Early Recognition ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood ◽  
Copd Patients

Abstract Background Chronic obstructive pulmonary disease (COPD) is accompanied by substantial systemic dysregulations that comprise systemic inflammation and neurohormonal activation in addition to many neurological involvements, such as cerebrovascular diseases, polyneuropathies, motor neuron diseases, and cognitive impairment has been described in COPD patients. The aim of the current work was to detect the subclinical affection of the peripheral nervous system in patients with stable COPD. Results Forty COPD patients and 30 subjects as healthy control were enrolled. All included subjects were submitted to complete medical history, clinical evaluations, investigations in the form of; arterial blood gases, spirometry, in addition to nerve conduction study. The patients with COPD were classified according to GOLD criteria for severity in grade I in 7.5% grade II in 62.5%, grade III in 20%, and grade IV in 10%. The results show a statistically significant increase in distal latency and a statistically significant decrease of amplitude and conduction velocity in patients with COPD when compared to the examined nerves of control group. The demyelinating nerve affection was the most common. Conclusion In COPD patients the peripheral nervous system could be affected subclinically once the severity of COPD increased and the patient should be neurophysiologically observed for early recognition of peripheral nervous system affection.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

RELATION OF THE MARKERS OF MYOCARDIAL DYSFUNCTION AND SYSTEMIC INFLAMMATION WITH STRUCTURAL AND FUNCTIONAL PARAMETERS OF THE LUNGS IN MYOCARDIAL INFARCTION PATIENTS

2018 ◽  
Vol 17 (2) ◽  
pp. 24-28
Author(s):  
O. M. Polikutina ◽  
Y. S. Slepynina ◽  
E. D. Bazdyrev ◽  
V. N. Karetnikova ◽  
O. L. Barbarach
Keyword(s):  
Myocardial Infarction ◽  
Systemic Inflammation ◽  
Myocardial Dysfunction ◽  
Control Group ◽  
Chronic Obstructive ◽  
Lung Pathology ◽  
Functional Changes ◽  
Functional Parameters ◽  
Lung Capacity ◽  
Copd Patients

Aim. To evaluate the structural and functional changes in the lungs of ST elevation myocardial infarction (STEMI) patients with absence or presence of chronic obstructive lung disease (COPD), and the relation with myocardial dysfunction and systemic inflammation.Material and methods. Totally, 189 STEMI patients included: group 1 — STEMI with COPD of moderate and mild grade, 2 — STEMI with no lung pathology. Groups were comparable by clinical and anamnestic parameters. Assessment of lung function and blood collection were done at 10­12 day of STEMI. For comparison of the parameters representing structural and functional changes in the lungs and comparison of C­reactive protein (CRP), N­terminal pro­brain natriuretic peptide (NT­proBNP) concentration, a control group was formed with no pulmonary pathology, comparable by age and sex with the STEMI patients.Results. In COPD patients, higher values revealed of the parameters representing the part of residual volumes in pulmonary structure. Higher residual volume (RV) was found also in STEMI and no COPD comparing to controls, however the relation RV/TLC (total lung capacity) was not higher than normal range. In both groups there were lower values of diffusion lung capacity (DLCO) comparing to controls. The lowest DLCO found in COPD patients. Concentration of NT­proBNP (H=41,6; p<0,001) and CRP (H=38,6; p<0,001) in COPD was significantly higher in STEMI with no COPD patients than in controls. The negative correlations found for NT­proBNP and CRP with forced expiratory volume 1 sec, FEV/FVC1, DLCO, and positive — with the values of thoracic volume, RV/TLC.Conclusion. In STEMI patients the increase revealed of residual lung volumes. Mostly the level of residual volumes is high in STEMI and COPD patients. There are associations of NT­proBNP and CRP with structural and functional parameters of the lungs regardless of COPD.

scholarly journals Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

2021 ◽  
Vol 18 (8) ◽  
pp. 4207
Author(s):  
Jose L. Gonzalez-Montesinos ◽  
Jorge R. Fernandez-Santos ◽  
Carmen Vaz-Pardal ◽  
Jesus G. Ponce-Gonzalez ◽  
Alberto Marin-Galindo ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Rehabilitation Programme ◽  
Group Differences ◽  
Control Group ◽  
Chronic Obstructive ◽  
Maximum Value ◽  
Copd Patients ◽  
Significant Difference ◽  
Pulmonary Rehabilitation Programme ◽  
Positive Increment

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (PostPRE), FBG obtained lower values in oxygen consumption (VO2, mean = −435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, −8.5 L/min, BF10 = 25), respiratory rate (RR, −3.3 breaths/min, BF10 = 2), heart rate (HR, −13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, −183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (PostFINAL), FBG showed higher values in the total time of the test (Tt, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at PrePOST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO2, −3.8 L/min, BF10 = 1.1) and compared to CG in VE (−8.3 L/min, BF10 = 3.6), VCO2 (−215.9 L/min, BF10 = 3.0), EqCO2 (−3.7 L/min, BF10 = 1.1) and HR (−12.9 beats/min, BF10 = 3.4). FBG also showed a greater PrePOST positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At PreFINAL, FBG presented a greater positive increment compared to CG in Tt (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (−4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO2. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.

Neutrophil gelatinase-associated lipocalin as a potential biomarker for pulmonary thromboembolism

2019 ◽  
Vol 45 (1) ◽  
pp. 51-56
Author(s):  
Songul Ozyurt ◽  
Mevlut Karatas ◽  
Medeni Arpa ◽  
Bilge Yilmaz Kara ◽  
Hakan Duman ◽  
...  
Keyword(s):  
Predictive Value ◽  
Pulmonary Thromboembolism ◽  
High Sensitivity ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Arterial Blood ◽  
Potential Biomarker ◽  
Healthy Control ◽  
Neutrophil Gelatinase

Abstract Objective Pulmonary thromboembolism (PTE) is a clinical condition that can be lethal unless promptly diagnosed and treated. The objective was to evaluate the significance of serum neutrophil gelatinase-associated lipocalin (NGAL) in the diagnosis of PTE. Materials and methods In this study, 60 patients hospitalized for acute PTE between May 2015 and December 2016 were enrolled. PTE was diagnosed using spiral computed tomography angiography of the thorax. Cardiac enzyme levels, arterial blood gas, and echocardiography measurements were performed. Whole blood samples were drawn to measure serum NGAL before treatment. Results The PTE group comprised 34 women and 26 men, and the healthy control group included 22 women and 18 men. The mean ages of the patient and control groups were 70.3 ± 14.4 years and 69.0 ± 10.2 years, respectively. Serum NGAL was significantly higher in the patients than in the controls (88.6 ± 33.6 vs. 31.7 ± 10.0 ng/mL, p < 0.001, respectively). The optimal NGAL cut-off value was >50 ng/mL, the sensitivity was 100%, specificity was 98.3%, the negative predictive value was 100%, and the positive predictive value was 68%. Conclusion Serum NGAL is a new biomarker with high sensitivity and specificity to detect, diagnose, and exclude PTE.

RISK PREDICTION FOR ARRHYTHMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 74 (10) ◽  
pp. 2605-2609
Author(s):  
Tetyana M. Ternushchak ◽  
Marianna I. Tovt-Korshynska
Keyword(s):  
P Wave ◽  
Doppler Imaging ◽  
Control Group ◽  
Chronic Obstructive ◽  
Conduction Time ◽  
Electromechanical Delay ◽  
P Wave Dispersion ◽  
Atrial Electromechanical Delay ◽  
Copd Patients ◽  
Significant Difference

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.

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