Effectiveness of pneumococcal vaccine in patients with chronic obstructive pulmonary disease (COPD)

Background: Pneumococcal infections are frequent cause chronic obstructive pulmonary disease (COPD) exacerbations and though various guidelines recommend the use of pneumococcal vaccines routinely to COPD patients to prevent exacerbations, the data regarding the effectiveness of this vaccine is limited and contradictory. Aims and objectives was to compare the frequency of exacerbations in patients of COPD before and after administration of pneumococcal vaccine and to find out the frequency of exacerbations in patients of COPD who are vaccinated against those who are not vaccinated as well as to study the effectiveness of pneumococcal vaccine will be analysed in respect to age, sex, Body mass index (BMI), severity of disease and other co-morbidity.Methods: This was a randomized non-placebo controlled trial, conducted from September 2013 to August 2015 including total of 150 patients divided into two groups: cases and controls. The cases were administered PPV23 along with specific medication and were followed up at intervals of 3months. Exacerbations were identified based on ANTHONISEN’S criteria. Number of exacerbations in each follow-up was recorded. The data from both the groups were analysed statistically.Results: After 1 year of follow up, there was significant reduction in mean number of exacerbations (p value <0.0001) in patients with COPD in vaccinated group. PPV23 was more effective in patients with COPD of less than 65 years of age and with severe and/or very severe airflow obstruction and also in patients with lower BMI (≤21kg/m2), females and with co-morbidities.Conclusions: This is an important strategy to prevent the repeated exacerbations in COPD patients particularly in severe and very severe disease groups and we support the recommendation that pneumococcal vaccine should be administered to these patients.

Download Full-text

GPNMB contributes to a vicious circle for chronic obstructive pulmonary disease

Bioscience Reports ◽

10.1042/bsr20194459 ◽

2020 ◽

Vol 40 (6) ◽

Author(s):

Xi-Juan Zhang ◽

Zhong-Hua Cui ◽

Yan Dong ◽

Xiu-Wen Liang ◽

Yan-Xin Zhao ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Large Scale ◽

Enrichment Analysis ◽

Gene Set Enrichment Analysis ◽

Chronic Obstructive ◽

P Value ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Size Population

Abstract Osteoporosis (OP) is significant and debilitating comorbidity of chronic obstructive pulmonary disease (COPD). We hypothesize that genetic variance identified with OP may also play roles in COPD. We have conducted a large-scale relation data analysis to explore the genes implicated with either OP or COPD, or both. Each gene linked to OP but not to COPD was further explored in a mega-analysis and partial mega-analysis of 15 independently collected COPD RNA expression datasets, followed by gene set enrichment analysis (GSEA) and literature-based pathway analysis to explore their functional linked to COPD. A multiple linear regression (MLR) model was built to study the possible influence of sample size, population region, and study date on the gene expression data in COPD. At the first step of the analysis, we have identified 918 genes associated with COPD, 581 with OP, and a significant overlap (P<2.30e-140; 210 overlapped genes). Partial mega-analysis showed that, one OP gene, GPNMB presented significantly increased expression in COPD patients (P-value = 0.0018; log fold change = 0.83). GPNMB was enriched in multiple COPD pathways and plays roles as a gene hub formulating multiple vicious COPD pathways included gene MMP9 and MYC. GPNMB could be a novel gene that plays roles in both COPD and OP. Partial mega-analysis is valuable in identify case-specific genes for COPD.

Download Full-text

Chronic obstructive pulmonary disease patients electronic register analysis: the effectiveness of patient’s dynamic follow up and evaluation of treatment program

Terapevticheskii arkhiv ◽

10.26442/00403660.2019.01.000034 ◽

2019 ◽

Vol 91 (1) ◽

pp. 78-83

Author(s):

V Ju Mishlanov ◽

I V Shubin ◽

K N Bekker ◽

A V Katkova ◽

E P Koshurnikova

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Pneumococcal Infection ◽

Chronic Obstructive ◽

Inhaled Corticosteroid ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

Long Acting

In the last few years new informatics methods were implemented in medicine and allowed to create big data including individual clinical markers of every patient. It is suggested that clinical electronic patient’s register analysis will present accurate information about different treatment programs effectiveness, including those whose effectiveness is not still proved today. The aim of the study. To estimate the effectiveness of clinical patients register implementation as well as to analyze different treatment and prophylactic programs on chronic obstructive pulmonary disease (COPD) patients’ structure. Materials and methods. The COPD patient’s register consists of 4257 cases. Spirometrical data were evaluated. Dynamic follow was performed on 567 COPD patients. Bronchodilator’s therapy was estimated as well as combined inhaled corticosteroid/ long acting β2-agonist medications and vaccination against pneumococcal infection. Results. Computer program “Electronic polyclinic” proposed by the authors of this article is effective in precision of diagnostic decision making in cohort study, dynamic follow up after clinical symptoms, evaluation of instrumental and laboratory results, prophylactics and treatment effectiveness, “clinical patients registers” automatic formation using syndrome or nosological principle, checking the COPD patients in the group of those with bronchial obstruction. Conclusion. Positive effects of long-acting bronchodilator treatment on COPD exacerbation decreasing and more expressed effect of inhaled corticosteroid/ long acting β2-agonists were confirmed. More interesting result was influence of vaccination against pneumococcal infection PCV13 (polyvalent conjugated vaccine) on exacerbation frequency and dyspnea severity.

Download Full-text

Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease

Respiration ◽

10.1159/000511022 ◽

2020 ◽

pp. 1-11

Author(s):

Eun Kyung Kim ◽

Dave Singh ◽

Joo Hun Park ◽

Yong Bum Park ◽

Seung-Il Kim ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Body Mass Index ◽

Pulmonary Disease ◽

Body Mass ◽

Longitudinal Change ◽

Chronic Obstructive ◽

Outpatient Basis ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Background: Low body mass index (BMI) is an important prognostic factor in chronic obstructive pulmonary disease (COPD). However, the prognostic value of longitudinal BMI change in COPD has not been well studied. Objective: We aimed to evaluate the association between longitudinal change of BMI and prognosis of COPD in Korean COPD cohort. Methods: This study was conducted in a prospective Korean Obstructive Lung Disease (KOLD) cohort where COPD patients were recruited on an outpatient basis at 17 hospitals in South Korea. Annual BMI was measured over a period of 3 years or more. All patients were categorized into underweight (UW), normal weight (NW), and overweight (OW) groups by BMI. Clinical characteristics and outcomes including exacerbation and mortality were compared based on initial BMI grade and longitudinal change of BMI. Results: This analysis included 537 COPD patients (mean age = 67.4 ± 7.9 years, male = 97.0%, mean BMI = 23.0 ± 3.1) of KOLD cohort. The proportions of UW, NW, and OW groups were 6.9% (n = 37), 68.9% (n = 370), and 24.2% (n = 130) respectively. The UW group showed lower forced expiratory volume in 1 s (FEV1) (p < 0.001), shorter 6-minute walk distance (p < 0.001), higher modified Medical Research Council score (p = 0.002), higher St. George Respiratory Questionnaire score (p < 0.001), higher emphysema index (p < 0.001) and air-trapping index (p < 0.001), and more frequent (p < 0.001) and severe exacerbations (p = 0.003). Multivariable analyses demonstrated that decrease of BMI (hazard ratio [HR] = 0.786, p = 0.038) and the descent of BMI group (HR = 3.167, p = 0.016) at 3-year follow-up along with age, initial BMI, post-bronchodilator FEV1, and severe exacerbations were significantly associated with mortality. Conclusions: This study demonstrated that BMI decrease during follow-up was independently associated with exacerbation and higher mortality of COPD, suggesting BMI reduction in COPD should be carefully managed.

Download Full-text

ADAPT (After DischArge Pulmonary Telehealth): home telemonitoring follow-up for chronic obstructive pulmonary disease (COPD) patients post hospital discharge

http://isrctn.org/> ◽

10.1186/isrctn34235668 ◽

2013 ◽

Author(s):

Keir Lewis

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Hospital Discharge ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Home Telemonitoring ◽

Copd Patients

Download Full-text

Effects of the Chinese herbal formula San-Huang Gu-Ben Zhi-Ke treatment on stable chronic obstructive pulmonary disease: study protocol of a randomized, double-blind, placebo-controlled trial

Trials ◽

10.1186/s13063-019-3729-1 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Yaqi Zu ◽

Demin Li ◽

Xiang Lei ◽

Hongchun Zhang

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Controlled Trial ◽

Chronic Obstructive ◽

Double Blind ◽

Obstructive Pulmonary Disease ◽

Double Blind Placebo ◽

Chinese Herbal Formula ◽

Chinese Herbal ◽

Copd Patients

Abstract Background Due to the large number of patients, high mortality rate as well as high social costs and economic burden, chronic obstructive pulmonary disease (COPD) has become one of the most important health problems around the world, which has attracted people’s attention. Currently, Chinese herbs have been widely used as alternative medicine (CAM) for COPD patients. The Chinese herbal formula San-Huang Gu-Ben Zhi-Ke (SHGBZK) has shown good clinical efficacy in COPD in preclinical studies. Animal experiments have shown that it has mucosal immune barrier function and can maintain airway wall integrity, reduce inflammatory cell infiltration, promote inflammatory damage repair, and relieve narrow airway conditions. Methods/design This study is a randomized, double-blind, placebo-controlled trial. A total of 100 patients with stable COPD diagnosed with deficiency of lung qi and spleen qi will be recruited and randomly assigned to one of two treatment groups: SHGBZK treatment, N = 50; placebo treatment, N = 50. The two groups will receive basic treatment for COPD according to the 2017 GOLD Guidelines for Chronic Obstructive Pulmonary Disease. Patients will stick to the treatment they used to take as much as possible, and will be given present general treatment when acute exacerbation of COPD occurs during the study. Both groups will receive a 24-week intervention and patient status will be assessed at 24 weeks and then 28 weeks after treatment. After the 24-week treatment, patients will be followed up for another 28 weeks. Outcome measures, including the frequency and duration of acute exacerbation, lung function, traditional Chinese medicine symptom score, exercise capacity, and quality of life will be assessed. Discussion It is hypothesized that SHGBZK will have beneficial effects in reducing the frequency and duration of acute exacerbations, improving the exercise capacity function of patients with stable COPD diagnosed with a deficiencies in lung qi and spleen qi. This study may establish a new treatment method for COPD patients, differentiating it from other drugs in clinical use used for similar clinical indications. Trial registration Chinese Clinical Trial Registry, ChiCTR1800016349. Registered on 26 May 2018.

Download Full-text

Impact of tobacco-related chronic obstructive pulmonary disease on developmental trajectories of comorbidities in the Taiwan population

Scientific Reports ◽

10.1038/s41598-020-78325-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Te-Wei Ho ◽

Yi-Ju Tsai ◽

Chun-Ta Huang ◽

Angela Shin-Yu Lien ◽

Feipei Lai

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Developmental Trajectories ◽

Chronic Obstructive ◽

Control Groups ◽

Obstructive Pulmonary Disease ◽

Copd Patients ◽

And Control ◽

The Impact

AbstractComorbidities adversely affect the quality of life and survival of patients with chronic obstructive pulmonary disease (COPD), and timely identification and management of comorbidities are important in caring for COPD patients. This study aimed to investigate the impact of COPD on long-term developmental trajectories of its comorbidities. From 2010 to 2013, all spirometry-confirmed COPD patients with a 5-year follow-up period were identified as the cases. The prevalence of comorbidities and their trajectories in COPD cases were obtained and compared with those in non-COPD controls matched for age, sex, smoking status and Charlson comorbidity index (CCI). Over the study period, a total of 682 patients, 341 each in COPD and control groups were included, with a mean age of 69.1 years and 89% male. The baseline mean CCI was 1.9 for both groups of patients and significantly increased to 3.4 and 2.7 in COPD and control groups after 5 years, respectively (both P < 0.001). Through the 5-year follow-up, a significant increase in the prevalence of all comorbidities of interest was observed in the COPD cohort and the incidence was remarkably higher for hypertension [incidence rate ratio (IRR) 1.495; 95% confidence interval (CI) 1.017–2.198], malignancy (IRR 2.397; 95% CI 1.408–4.081), diabetes mellitus (IRR 2.927; 95% CI 1.612–5.318), heart failure (IRR 2.531; 95% CI 1.502–4.265) and peptic ulcer disease (IRR 2.073; 95% CI 1.176–3.654) as compared to the non-COPD matched controls. In conclusion, our findings suggest that the presence of COPD may be considered a pathogenic factor involved in the development of certain comorbidities.

Download Full-text

Urinary incontinence in female patients with chronic obstructive pulmonary disease

South African Journal of Physiotherapy ◽

10.4102/sajp.v57i4.521 ◽

2001 ◽

Vol 57 (4) ◽

pp. 29

Author(s):

M. Papadopoulos ◽

I. Muller ◽

S. Cullen

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pulmonary Disease ◽

Smoking History ◽

Chronic Obstructive ◽

P Value ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Copd Patients

Background: Urinary incontinence has been experienced as a problem since 1500 BC. In the twentieth century it is still a major problem that remains a source of distress for many sufferers. A lack of literature regarding the prevalence of stress urinary incontinence (SUI) amongst chronic obstructive pulmonary disease (COPD) patients lead to this studyObjective: To determine the prevalence of stress urinary incontinence in female COPD patients between the ages of 30 and 70 years.Methods: This cross-sectional study included 67 female COPD patients (aged 30-70 years) who were interviewed during a three month period. A structured COPD / incontinence questionnaire was used to obtain data. Statistical analysis of results included Fisher’s exact test and two-tailed t-tests. A p-value of < 0,05 was considered to be statistical significant.Results: The prevalence of SUI in female COPD patients was estimated as 82,1%. Smoking history was the only variable with a significant positive correlation regarding the patients presenting with SUI (p < 0,05). The proportion of smokers in the subjects presenting with SUI (SUI group - 29/55) is significantly higher than the subjects with no symptoms of SUI (normal group - 2/12).Discussion and Conclusion: The outcome of this study revealed a high prevalence of SUI in female COPD patients. Cigarette smoking, as the major contributing factor, revealed a strong statistical correlation between COPD and SUI.

Download Full-text

Effects of the Chinese herbal formula San-Huang Gu-Ben Zhi-Ke treatment on Stable Chronic Obstructive Pulmonary disease:study protocol of a randomized, double-blind, placebo-controlled trial

10.21203/rs.2.224/v1 ◽

2019 ◽

Author(s):

Yaqi Zu ◽

Demin Li ◽

Xiang Lei ◽

Hongchun Zhang

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Controlled Trial ◽

Chronic Obstructive ◽

Herbal Formula ◽

Double Blind ◽

Obstructive Pulmonary Disease ◽

Chinese Herbal Formula ◽

Chinese Herbal ◽

Copd Patients

Abstract Background: Due to the large number of patients, high mortality rate as well as high social costs and economic burden, Chronic obstructive pulmonary disease（COPD）has become one of the most important health problem around the world, which has attracted people's attention. Currently, Chinese herbs have been widely used as alternative medicine（CAM）for COPD patients. Chinese herbal formula San-Huang Gu-Ben Zhi-Ke（SHGBZK）have shown good clinical efficacy in COPD in preclinical studies. Animal experiments have enhanced that it has mucosal immune barrier function, it can maintain airway wall integrity, reduce inflammatory cell infiltration, promote inflammatory damage repair, and relieve airway narrow conditions. Methods/design: The study is a randomized, double-blind, placebo-controlled trial. A total of 100 COPD patients at stable stage that diagnosed with syndrome of deficiency of lung qi and spleen qi will be recruited and randomly assigned to one of the two treatments group, with 50 in each group. One hundred COPD patients were randomly assigned to two treatment groups（SHGBZK treatment, N=50; placebo treatment, N=50).The two groups will receive basic treatment for COPD according to the 2017 GOLD Guidelines for Chronic Obstructive Pulmonary Disease. Patients will stick to the treatment they used to take as much as possible, and will be given present general treatment when AECOPD occurs during the study. Both groups will receive an 24-weeks intervention, and patient status was assessed at 24 weeks later and 28 weeks after treatment. After the 24-weeks treatment, another 28 weeks will be followed up. The outcome measures including the frequency and duration of acute exacerbation, lung function, TCM symptom score, exercise capacity, and quality of life will be assessed. Discussion: It is hypothesized that SHGBZK will have beneficial effects in reducing the frequency and duration of acute exacerbation, improving exercise capacity function of COPD patients at stable stage that diagnosed with syndrome of deficiency of lung qi and spleen qi. This study may establish a new method for COPD patients, and thus differentiation from other drugs used for similar clinical indications in clinical use. Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR1800016349. Registered on 26 May 2018. Keywords: Chronic obstructive pulmonary disease; traditional Chinese medicine; Chinese herbal formula San-Huang Gu-Ben Zhi-Ke; clinical trials; clinical protocols.

Download Full-text

Quantitative Assessment the Longitudinal Changes of Pulmonary Vascular Counts in Chronic Obstructive Pulmonary Disease

10.21203/rs.3.rs-861379/v1 ◽

2021 ◽

Author(s):

Sang Won Park ◽

Myoung-Nam Lim ◽

Woo Jin Kim ◽

So Hyeon Bak

Keyword(s):

Computed Tomography ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Function ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Longitudinal Changes ◽

Severe Emphysema ◽

Copd Patients

Abstract BackgroundChest computed tomography(CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. However, there are few studies of changes in vascular during longitudinal follow-up in COPD patients. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.Materials and MethodsA total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856exp). Total number of vessels (Ntotal) and total number of vessels with area less than 5 mm2 (N<5mm) per 1 cm2 of lung surface area (LSA) were measured at 6 mm from the pleural surface.ResultsNtotal/LSA and N<5mm/LSA changed from 1.16±0.27 to 0.87±0.2 and from 1.02±0.22 to 0.78±0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39±0.21 to 0.74±0.17 and from 1.18±0.19 to 0.67±0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with Ntotal/LSA (r=-0.738, -0.529) and N<5mm /LSA (r=-0.729, -0.497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with Ntotal/LSA and N<5mm/LSA (r=0.205, 0.210). The depth in CT subtypes for longitudinal change both Ntotal/LSA and N<5mm/LSA was (-0.032, -0.023) and (-0.027) in normal and SAD, respectively.ConclusionsQuantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.Trial registrationWe obtained the written informed consent from all participants in this study and the approval for all processes by our institution Institutional Review Board.

Download Full-text

The effect of uphill and downhill aerobic exercises on serum Apolipoprotein A1 and Apolipoprotein B levels and their ratio in patients with chronic obstructive pulmonary disease

Current Respiratory Medicine Reviews ◽

10.2174/1573398x17666210831160728 ◽

2021 ◽

Vol 17 ◽

Author(s):

Rostam Yazdani ◽

Hamid Marefati ◽

Armita Shahesmaeili ◽

Alireza Bagheri ◽

Ahmad Alinaghi Langari ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Serum Levels ◽

Apolipoprotein A1 ◽

Chronic Obstructive ◽

P Value ◽

Obstructive Pulmonary Disease ◽

Apo B ◽

Copd Patients ◽

Before And After

Background: Chronic obstructive pulmonary disease (COPD) is a major health issue worldwide. Introduction: This study aimed to evaluate the effect of aerobic exercises at steep surfaces on Apo A1 and Apo B serum levels and their ratio in COPD patients. Methods: This interventional study was undertaken on 16 COPD patients. The sample was selected by using the random sampling method. Patients were randomly divided into 2 groups of 8 members: uphill and downhill. Spirometry was conducted prior to the exercises and pulmonary volumes were measured. Aerobic exercises (stationary bicycle and treadmill) were started 3 times a week for 8 weeks. The duration of exercises in each session was determined based on the patients’ ability (30-40 min). In the first and second group, exercises were performed on sloped surfaces that were downwards and upwards at a 10-degree angle, respectively. Blood samples were taken from the patients before and after the 8 weeks. Apo A1 and Apo B serum levels and Apo A1 to Apo B ratio were measured. Data were analyzed by SPSS software. P<0.05 was considered statistically significant. Results: ApoA1/Apo B ratio in the uphill group before and after the intervention was 1.43±0.21 and 1.53±0.24 mg/dL, respectively, with P-value=0.36. In the downhill group, this value was 1.27±0.17 and 1.30±0.18, respectively, with a P-value=0.032. Conclusion: In light of the results of the present study, incorporating downhill exercises in COPD patients' rehabilitation program can help improve pulmonary function and prevent atherosclerotic events.

Download Full-text