United Airway Diseases. Should We Add Upper Airway Inflammatory Disorders to the List of Chronic Obstructive Pulmonary Disease Comorbidities?

2015 ◽  
Vol 12 (7) ◽  
pp. 968-970 ◽  
Author(s):  
Pierre-Régis Burgel
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Upper Airway ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Inflammatory Disorders ◽  
Airway Diseases

scholarly journals Update on Clinical Inflammometry for the Management of Airway Diseases

2013 ◽  
Vol 20 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Parameswaran Nair
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Airway Inflammation ◽  
Pulmonary Disease ◽  
Treatment Strategies ◽  
Chronic Obstructive ◽  
Central Feature ◽  
Obstructive Pulmonary Disease ◽  
Cell Counts ◽  
Airway Diseases ◽  
Anti Inflammatory

Airway inflammation is a central feature of many airway diseases such as asthma, chronic bronchitis, bronchiectasis and chronic cough; therefore, it is only logical that it is measured to optimize its treatment. However, most treatment recommendations, including the use of anti-inflammatory therapies such as corticosteroids, are based on assessments of only airflow and symptoms. Over the past 10 years, methods have been developed to assess airway inflammation relatively noninvasively. Quantitative cell counts in sputum and the fraction of exhaled nitric oxide are the most validated tests. Judicious use of currently available drugs, such as corticosteroids, bronchodilators and antibiotics, and other anti-inflammatory therapies guided by sputum eosinophil and neutrophil counts, have been demonstrated to decrease exacerbations of asthma and chronic obstructive pulmonary disease, ameliorate cough, improve quality of life in patients with these diseases and is cost effective compared with treatment strategies based on guidelines that do not incorporate these measurements. Thus, it is unfortunate that this is not used more widely in the management of airway diseases, particularly in patients with severe asthma and chronic obstructive pulmonary disease who experience frequent exacerbations.

scholarly journals A study on asthma and chronic obstructive pulmonary disease overlaps among patients with obstructive airway diseases

2021 ◽  
Vol 6 (2) ◽  
pp. 71-74
Author(s):  
Venkatesh B.C ◽  
Raju C.H
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
History Of ◽  
Sputum Eosinophils ◽  
Obstructive Airway Diseases ◽  
Asthma Group

There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition may evolve into the other. This is prospective, observational and descriptive study conducted at MNR Medical College and Hospital, Sangareddy, India from June 2020 to December 2020 among chronic airway diseases who were classified into three groups (COPD, Asthma, and Asthma and COPD overlap (ACO)). Patients with COPD and ACO were diagnosed according to GOLD guidelines 2020 and patients with asthma were diagnosed according to Global Initiative for Asthma (GINA) guidelines 2020. : Regarding the age difference between groups, it was found that patients who were diagnosed as having COPD and ACO were with mean age of 57.23±8.54 and 56.26±7.73 years, respectively. The men age of patients of Asthma was 57.51±8.43. In our study, 28 (30%) patients as having COPD, 39 (45.5%) patients were diagnosed as having ACO, 23 (24.4%) patients were diagnosed as having asthma. In our study comparison of groups regarding history of atopy. We found that 71.7% of ACO group, 78.2% of asthma group and 25% of COPD group had a positive history of atopy. Comparison of study groups regarding sputum eosinophils revealed that 30.7 % of ACO group, 73.9% of asthma group and 32.1% of COPD group had positive sputum eosinophils.  ACO represents a large percentage among patients with obstructive airway diseases. It shares some features of asthma such as atopy and positive sputum eosinophilia, and some features of COPD like old age of presentation and positive smoking history.

scholarly journals Predictive Factors for the Effect of Treatment by Noninvasive Ventilation in Patients with Respiratory Failure as a Result of Acute Exacerbation of the Chronic Obstructive Pulmonary Disease

2015 ◽  
Vol 3 (4) ◽  
pp. 655-660 ◽  
Author(s):  
Sava Pejkovska ◽  
Biserka Jovkovska Kaeva ◽  
Zlatica Goseva ◽  
Zoran Arsovski ◽  
Jelena Jovanovska Janeva ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Upper Airway ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Failure Group ◽  
Copd Patients ◽  
Arterial Ph ◽  
Increased Risk ◽  
Group 2

BACKGROUND: Noninvasive mechanical ventilation (NIV) applies ventilator support through the patient’s upper airway using a mask.AIM: The aim of the study is to define factors that will point out an increased risk of NIV failure in patients with exacerbation of Chronic Obstructive Pulmonary Disease (COPD).PATIENTS AND METHODS: Patients over the age of 40, treated with NIV, were prospectively recruited. After data processing, the patients were divided into two groups: 1) successful NIV treatment group; 2) failed NIV treatment group.RESULTS: On admission arterial pH and Glasgow coma scale (GCS) levels were lower (pH: p < 0.05, GCS: p < 0.05), and Acute Physiology and Chronic Health Evaluation II (APACHE) score and PaCO2 were higher (p < 0.05) in the NIV failure group. Arterial pH was lower (p < 0.05) and PaCO2 and respiratory rate were higher (p < 0.05) after 1h, and arterial pH was lower (p < 0.05) and PaCO2 (p < 0.05), respiratory and heart rate were higher (p < 0.05) after 4h in the NIV failure group.CONCLUSION: Measurement and monitoring of certain parameters may be of value in terms of predicting the effectiveness of NIV treatment.

scholarly journals Inhaled corticosteroid suppression of cathelicidin drives dysbiosis and bacterial infection in chronic obstructive pulmonary disease

2019 ◽  
Vol 11 (507) ◽  
pp. eaav3879 ◽  
Author(s):  
Aran Singanayagam ◽  
Nicholas Glanville ◽  
Leah Cuthbertson ◽  
Nathan W. Bartlett ◽  
Lydia J. Finney ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Bacterial Infection ◽  
Pulmonary Disease ◽  
Cathepsin D ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Airway Diseases ◽  
Infection Susceptibility ◽  
Pulmonary Immunity

Bacterial infection commonly complicates inflammatory airway diseases such as chronic obstructive pulmonary disease (COPD). The mechanisms of increased infection susceptibility and how use of the commonly prescribed therapy inhaled corticosteroids (ICS) accentuates pneumonia risk in COPD are poorly understood. Here, using analysis of samples from patients with COPD, we show that ICS use is associated with lung microbiota disruption leading to proliferation of streptococcal genera, an effect that could be recapitulated in ICS-treated mice. To study mechanisms underlying this effect, we used cellular and mouse models of streptococcal expansion withStreptococcus pneumoniae, an important pathogen in COPD, to demonstrate that ICS impairs pulmonary clearance of bacteria through suppression of the antimicrobial peptide cathelicidin. ICS impairment of pulmonary immunity was dependent on suppression of cathelicidin because ICS had no effect on bacterial loads in mice lacking cathelicidin (Camp−/−) and exogenous cathelicidin prevented ICS-mediated expansion of streptococci within the microbiota and improved bacterial clearance. Suppression of pulmonary immunity by ICS was mediated by augmentation of the protease cathepsin D. Collectively, these data suggest a central role for cathepsin D/cathelicidin in the suppression of antibacterial host defense by ICS in COPD. Therapeutic restoration of cathelicidin to boost antibacterial immunity and beneficially modulate the lung microbiota might be an effective strategy in COPD.

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