Serum Immunoglobulins and Alpha1-Antitrypsin: Variation with Clinical Type of Chronic Obstructive Pulmonary Disease1

As a known genetic cause of chronic obstructive pulmonary disease (COPD), alpha1-antitrypsin deficiency (AATD) can cause severe respiratory problems at a relatively young age. These problems are caused by decreased or absent levels of alpha1-antitrypsin (AAT), an antiprotease which is primarily functional in the respiratory system. If the levels of AAT fall below the protective threshold of 11 µM, the neutrophil-derived serine proteases neutrophil elastase (NE) and proteinase 3 (PR3), which are targets of AAT, are not sufficiently inhibited, resulting in excessive degradation of the lung parenchyma, increased inflammation, and increased susceptibility to infections. Because other therapies are still in the early phases of development, the only therapy currently available for AATD is AAT augmentation therapy. The controversy surrounding AAT augmentation therapy concerns its efficiency, as protection of lung function decline is not demonstrated, despite the treatment’s proven significant effect on lung density change in the long term. In this review article, novel biomarkers of NE and PR3 activity and their use to assess the efficacy of AAT augmentation therapy are discussed. Furthermore, a series of seven synthetic NE and PR3 inhibitors that can be used to evaluate the specificity of the novel biomarkers, and with potential as new drugs, are discussed.

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Study of Serum Alpha1 Antitrypsin Levels and Protease Inhibitor System in Korean Patients with Chronic Obstructive Pulmonary diseases

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.1988.35.2.110 ◽

1988 ◽

Vol 35 (2) ◽

pp. 110-119

Author(s):

Youn Suck Koh ◽

Ho Ju Yun ◽

Woo Jin Lew ◽

Sung Soo Park ◽

Jung Hee Lee ◽

...

Keyword(s):

Protease Inhibitor ◽

Pulmonary Diseases ◽

Chronic Obstructive ◽

Korean Patients ◽

Chronic Obstructive Pulmonary Diseases ◽

Inhibitor System ◽

Alpha1 Antitrypsin

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Not Only High Number and Specific Comorbidities but Also Age Are Closely Related to Progression and Poor Prognosis in Patients With COVID-19

Frontiers in Medicine ◽

10.3389/fmed.2021.736109 ◽

2022 ◽

Vol 8 ◽

Author(s):

Dafeng Liu ◽

Yongli Zheng ◽

Jun Kang ◽

Dongmei Wang ◽

Lang Bai ◽

...

Keyword(s):

Clinical Trial ◽

Disease Progression ◽

Disease Severity ◽

Poor Prognosis ◽

Chronic Obstructive ◽

Clinical Trial Registry ◽

Alcoholic Fatty Liver ◽

Clinical Type ◽

Conversion Time ◽

Negative Conversion

Background: Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim: We aimed to investigate the characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods: A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results: Approximately 91.23% (655/718) of COVID-19 patients were younger than 60 years old. Approximately 64.76% (465/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia, and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients. According to spearman correlation analysis the number of comorbidities was correlated positively with disease severity, the number of comorbidities and NAFLD were correlated positively with virus negative conversion time, hypertension, CKD and CVD were primarily associated with those who died, and the above-mentioned correlation existed independently of age. Risk factors included age, the number of comorbidities and hyperlipidaemia for disease severity, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities and age played a predictive role in disease progression and outcomes.Conclusion: Not only high number and specific comorbidities but also age are closely related to progression and poor prognosis in patients with COVID-19. These findings provide a reference for clinicians to focus on not only the number and specific comorbidities but also age in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563.

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Immunological parameters in the treatment of patients with chronic obstructive bronchitis with pentoxil

Kazan medical journal ◽

10.17816/kazmj61928 ◽

1985 ◽

Vol 66 (4) ◽

pp. 319-319

Author(s):

F. V. Arsentiev ◽

S. B. Marasanov

Keyword(s):

Chronic Obstructive ◽

Immunological Parameters ◽

Serum Immunoglobulins ◽

Chronic Obstructive Bronchitis

In 81 patients with exacerbation of chronic obstructive bronchitis, a decrease in the content of serum immunoglobulins M, G, A, an increase in the eosinophilic reaction and degranulation of basophils were revealed, indicating immunodeficiency and a tendency to allergies.

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Analysis of Epidemiological and Clinical Features in Older Patients With Coronavirus Disease 2019 (COVID-19) Outside Wuhan

Clinical Infectious Diseases ◽

10.1093/cid/ciaa242 ◽

2020 ◽

Vol 71 (15) ◽

pp. 740-747 ◽

Cited By ~ 95

Author(s):

Jiangshan Lian ◽

Xi Jin ◽

Shaorui Hao ◽

Huan Cai ◽

Shanyan Zhang ◽

...

Keyword(s):

Clinical Features ◽

Medical Records ◽

Older Patients ◽

Chronic Obstructive ◽

Older Patient ◽

Obstructive Pulmonary Disease ◽

Younger Patients ◽

Clinical Type ◽

Treatment Data ◽

Critical Type

Abstract Background The outbreak of coronavirus disease 2019 (COVID-19) has become a large threat to public health in China, with high contagious capacity and varied mortality. This study aimed to investigate the epidemiological and clinical characteristics of older patients with COVID-19 outside Wuhan. Methods A retrospective study was performed, with collecting data from medical records of confirmed COVID-19 patients in Zhejiang province from 17 January to 12 February 2020. Epidemiological, clinical, and treatment data were analyzed between older (≥ 60 years) and younger (< 60 years) patients. Results A total of 788 patients with confirmed COVID-19 were selected; 136 were older patients with corresponding mean age of 68.28 ± 7.31 years. There was a significantly higher frequency of women in older patient group compared with younger patients (57.35% vs 46.47%, P = .021). The presence of coexisting medical conditions was significantly higher in older patients compared with younger patients (55.15% vs 21.93%, P < .001), including the rate of hypertension, diabetes, heart disease, and chronic obstructive pulmonary disease. Significantly higher rates of severe clinical type (older vs younger groups: 16.18% vs 5.98%, P < .001), critical clinical type (8.82% vs 0.77%, P < .001), shortness of breath (12.50% vs 3.07%, P < .001), and temperature of > 39.0°C (13.97% vs 7.21%, P = .010) were observed in older patients compared with younger patients. Finally, higher rates of intensive care unit admission (9.56% vs 1.38%, P < .001) and methylprednisolone application (28.68% vs 9.36%, P < .001) were also identified in older patients compared with younger ones. Conclusions The specific epidemiological and clinical features of older COVID-19 patients included significantly higher female sex, body temperature, comorbidities, and rate of severe and critical type disease.

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