Plasma Fibrinogen as a Biomarker of Stable and Exacerbated Chronic Obstructive Pulmonary Disease

Study Design: An experimental, comparative, cross-sectional study Place and Duration of Study: Department of Physiology, Federal Post Graduate Medical Institute (FPGMI), Sheikh Zayed Medical Complex Lahore, Pakistan from August 2013 to 2014 Background: Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease, but is a partially reversible chronic inflammatory condition characterized by airway obstruction. COPD remains under-diagnosed and under-treated because the only available diagnostic method at present is testing lung functions by spirometry which is not helpful to determine the severity and clinical outcomes of the disease. Circulating biomarkers are under consideration for various diseases worldwide. Plasma fibrinogen is emerging as one of the most promising biomarkers of COPD in smokers. Objective: The objective of this study is to investigate if plasma fibrinogen can serve as a diagnostic biomarker of COPD in smokers, and if its further higher levels are seen in the exacerbated state of the disease in comparison to the stable disease. Materials and Methods: 75 middle-aged to old-age smokers of either gender were selected. Lung functions of every participant were measured to determine Forced Expiratory Volume in the first second (FEV1), Forced Vital Capacity (FVC), and the ratio of FEV1/FVC by spirometry. On the basis of the results of the tests, subjects were divided into three groups; firstly, the control group of chronic smokers without COPD, secondly, smokers with COPD in a stable state, and thirdly, patients in an exacerbated state of COPD. Plasma fibrinogen was quantitatively estimated in every individual of all three groups by the Clauss method using the Hemostat Fibrinogen kit. Results: The average Plasma fibrinogen level was found to be 235.008 mg/dl in healthy smokers (control group), while an average of 440.12mg/dl was measured in patients with stable COPD. The difference in plasma fibrinogen levels was found to be significant, having a p-value of (0.000). In the third group with declined lung function predicting acute exacerbated COPD, fibrinogen was found to be > 453.2 mg/dl, which was significantly higher than in the stable disease group (p-value > 0.0017) Conclusion: Plasma fibrinogen level measurement is a reliable and accessible test in terms of a diagnostic marker of COPD, as compared to conventional lung function testing done in the past.

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Plasma Fibrinogen Level in Chronic Obstructive Pulmonary Disease and Its Correlation with GOLD Severity Staging

Journal of Institute of Medicine ◽

10.3126/jiom.v43i1.37460 ◽

2021 ◽

Vol 43 (1) ◽

pp. 1-4

Author(s):

Achyut Gyawali ◽

Niraj Bam ◽

Pankaj Pant ◽

Santa K Das

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Fibrinogen Level ◽

Airflow Obstruction ◽

Plasma Fibrinogen ◽

Chronic Obstructive ◽

Plasma Fibrinogen Level ◽

Obstructive Pulmonary Disease ◽

Significant Difference ◽

Severe Copd

Introduction Chronic obstructive pulmonary disease (COPD) has great implications on global health accounting for significant morbidity and mortality. It is a state of chronic inflammation of airways. The aim of this study was to measure the plasma fibrinogen level in patient with COPD and find the relationship between plasma fibrinogen levels and severity of airflow obstruction. MethodsThis observational study was conducted from September 2017 to October 2018, where 80 eligible patients with the diagnosis of acute exacerbation of COPD (AECOPD) were included in the study and their plasma fibrinogen level was measured at the time of discharge. Clinical information was obtained and pulmonary function test (PFT) was done. ResultA total of 80 patients were enrolled. The mean age of the patient was 67.87±11.60 years. Plasma fibrinogen level was 159±12.72 mg/dl in mild COPD, 273.52±62.34 mg/dl in moderate COPD, 312.30±103.67 mg/dl in severe COPD, and 487±102.76 mg/dl in very severe COPD. The comparison between groups showed significant difference in plasma fibrinogen level (p<0.001). There was significant negative correlation between plasma fibrinogen level and forced expiratory volume in one second (FEV1%) predicted (r=-0.71, p=0.01). ConclusionHigh plasma fibrinogen level on discharge was found in COPD patients with severe airflow obstruction, frequent exacerbations and severe level of dyspnoea during AECOPD.

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Measurement of plasma fibrinogen and D-dimer in a sample of Iraqi patients with solid malignant tumors

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v16i2.261 ◽

2020 ◽

Vol 16 (2) ◽

pp. 21-24

Author(s):

Maysaa Awadh Bahaaldeen ◽

Haithem Ahmed Al-Rubaie ◽

Ali Almothaffar

Keyword(s):

Laboratory Tests ◽

Fibrinogen Level ◽

Malignant Tumors ◽

Plasma Fibrinogen ◽

Control Group ◽

P Value ◽

Plasma Fibrinogen Level ◽

Medical City ◽

D Dimer ◽

Solid Malignant Tumors

Background: Multifactor affect the pathogenesis of thrombosis in solid malignancy; however, a significant role is attributed to the cancer cells ability to interact with and activate the host hemostatic system. [1] Hemostasis is highly correlated to tumor growth, angiogenesis and metastasis, modulation of these pathways reflects interesting and promising treatment options in the future. [1] Most patients with cancer frequently suffer from chronic compensated DIC and have abnormal laboratory coagulation tests without clinical manifestations of thrombosis, which is a subclinical hypercoagulable state that can be detected by varying degrees of activation of blood clotting. The results of laboratory tests in these patients reflect continuous fibrin formation and lysis during the course of malignancy. [1] Aim of study: To study the effect of solid malignant tumors on blood coagulation via measurements of plasma fibrinogen and D-dimer. Subjects and methods: Thirty patients (9 males and 21 females) attending the oncology consultatory out-patient clinic at Baghdad Teaching Hospital/ Medical City were randomly selected and included in this study. These patients were newly diagnosed as having malignant solid tumors depending on histopathological reports from private and governmental sectors. All the laboratory tests were done at the hematology and biochemistry departments of Teaching Laboratories/ Medical City. Results: Plasma fibrinogen level was significantly higher in patients group rather than control group (3.863 ±0.706) Vs (2.497±0.457 g/L} respectively, (P-value 0.001).The mean value of factor VIII activity was {181% ±58.4)and (99.3% ±11.1)for patient and control groups respectively, the P-Value was significant ( > 0.001 ).D-dimer was negative for all members of control group, for patients group ( 66.7 %) of them showed positive D-dimer and (33.3)were negative for D-dimer ,P-value was significant ( >0.001 ). Conclusions: There was increase in plasma fibrinogen level and positive D-dimer in cancer patients compared to the control group reflecting subclinical thrombophilia and higher risk of VTE in patients with solid tumors due to activation of prothrombotic and fibrinolytic pathways by malignant cells which is vital for the use of primary prophylaxis by anticoagulants.

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WeChat as a Platform for Baduanjin Intervention in Patients With Stable Chronic Obstructive Pulmonary Disease in China: Retrospective Randomized Controlled Trial (Preprint)

10.2196/preprints.23548 ◽

2020 ◽

Author(s):

Junjie Bi ◽

Wei Yang ◽

Ping Hao ◽

Yongmei Zhao ◽

Dan Wei ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Lung Function ◽

Pulmonary Rehabilitation ◽

Life Quality ◽

Satisfaction Survey ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Significant Difference ◽

Before And After

BACKGROUND Pulmonary rehabilitation is a crucial part of the nonpharmacological treatment of stable chronic obstructive pulmonary disease (COPD), but management remains problematic. WeChat could serve as a useful tool in patient management. Baduanjin is a popular exercise in China that is usually applied in pulmonary rehabilitation, which has been confirmed to be effective in improving lung function and life quality. OBJECTIVE This study aimed to explore the efficiency of WeChat in the management of Baduanjin exercise in COPD patients. METHODS A total of 200 patients from the respiratory department of Putuo Hospital participated in the Baduanjin rehabilitation project from September 2018 to October 2019, and were randomly assigned to the WeChat and control groups and followed up using the WeChat platform or telephone for 12 weeks. The frequency of Baduanjin exercise, lung function (percentage of forced expiratory volume in 1 second predicted, FEV1% predicted), and COPD assessment test (CAT) scores were collected and compared between the two groups. The number of message exchanges and a satisfaction survey on the WeChat platform were used to assess the feasibility of WeChat management outside the hospital. RESULTS The Baduanjin exercise frequency significantly differed between the control group and WeChat group (F=33.82, P<.001) and across various time points (F=214.87, P<.001). After the follow-up on WeChat, there were fewer patients not performing Baduanjin exercise. The FEV1% predicted value significantly differed before and after Baduanjin exercise in the control group (Z=−3.686, P<.001) and the WeChat group (Z=−6.985, P<.001). A significant difference in the FEV1% predicted value was observed after Baduanjin exercise between the two groups (Z=−3.679, P<.001). The CAT score significantly differed before and after Baduanjin exercise in the control group (Z=−4.937, P<.001) and the WeChat group (Z=−5.246, P<.001). A significant difference in the CAT score was observed after Baduanjin exercise between the two groups (Z=−5.246, P<.001). The number of completed Baduanjin exercises, lung function, and CAT scores in active patients were higher than those in nonactive patients. All satisfaction survey items were scored with more than 4 points. Among the items, the highest score (mean 4.54, SD 0.77) was for continued WeChat management, followed by the effective management of Baduanjin exercise (mean 4.46, SD 0.87). The patients in the WeChat group showed much higher enthusiasm for and compliance with Baduanjin exercise, resulting in better life quality and lung function. The patients were very satisfied with the WeChat management because of the obvious curative effect and home feeling. CONCLUSIONS The WeChat platform provided a feasible, effective, and sustainable management plan for Baduanjin rehabilitation. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR1900028248; http://www.chictr.org.cn/showprojen.aspx?proj=46995

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Regression analysis to estimate the response of the respiratory organs to exposure of air microtoxicants in chronic obstructive pulmonary disease

Bulletin physiology and pathology of respiration ◽

10.36604/1998-5029-2021-82-45-52 ◽

2021 ◽

pp. 45-52

Author(s):

T. I. Vitkina ◽

L. V. Veremchuk ◽

T. A. Gvozdenko ◽

E. E. Mineeva

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Respiratory Failure ◽

Lung Function ◽

Respiratory System ◽

Toxic Metals ◽

Regression Models ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

The City

Inroduction. The assessment of the respiratory system is of particular importance in the context of increasing impact of anthropogenic factors on human health. Aim. Evaluation the response of the lung function indices to the effects of micro-suspensions and toxic metals in patients with chronic obstructive pulmonary disease (COPD), using regression models. Materials and methods. The study involved 60 patients with stable mild-to-moderate COPD and 30 healthy people (the control group). The analysis of lung function was carried out by spirometry and body plethysmography. Arterial oxygen saturation (SaO2 ) was measured by pulse oximetry. Exhaled CO2 concentration and blood carboxyhemoglobin (COHb%) concentration were assessed using a portable analyzer MicroCO Meter. The pollution of the city atmosphere was assessed by aerosol suspensions of solid particles in the areas of residence of the examined patients. Fractional composition of suspended particles (0-1, 1-10, 10-50, 50-100, 100-400, 400-700,> 700 μm; %) were analyzed in the areas of residence of the examined patients. Toxic metal (Pb, Cr, Mn, Fe, Co, Ni, Cu, Zn; μg/L) levels in the air samples were determined. The statistical module "Multiple regression" was used for assessing the response of functional parameters of the respiratory system. Results. The analysis of one-factor and multi-factor regression models made it possible to identify both trigger factors of dust and technogenic air pollution and the synergistic effect of the influence of dominant factors. It has been shown that multifactorial reactions to technogenic impact manifest as altered blood oxygen saturation and carboxyhemoglobin level and thereby contribute to the development of respiratory failure. Conclusion. Patients with COPD exhibited increased bronchial resistance to the effect of the trigger factor (Pb – 1 hazard class) associated with high motorization of the city. The response of pulmonary gas exchange (SaO2 ) to Pb in the control group indicates prolonged exposure to toxic metals can cause developing respiratory failure even in the healthy population of the city.

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Application of Dejian Psychosomatic Therapy to Smokers with Stable Chronic Obstructive Pulmonary Disease

Tobacco Regulatory Science ◽

10.18001/trs.7.6.4 ◽

2021 ◽

Vol 7 (6) ◽

pp. 5103-5107

Author(s):

Liu Xin

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Treatment Group ◽

Lung Function ◽

Pulmonary Disease ◽

Statistical Significance ◽

Good Effect ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Group Control Group

To explore the intervention effect of Dejian psychosomatic therapy on chronic obstructive pulmonary disease (COPD) in elderly smokers, in as to improve clinical impact of COPD in smokers who are the aged. Forty elderly smokers with COPD were comprise of treatment group, control group, which are trained for 45 days to test the following indicators. Vital mass Index (VMI), forced Vital capacity (FVC), Maximum Chase air volume (MVV) and so on showed significant improvement in lung function indicators in both the treatment group and the control group (P < 0.05). Improvement impact of control group was not better than that of the treatment group, with statistical significance (P < 0.01). Dejian psychosomatic therapy has a systematic good effect on copd smokers, promoting the improvement and promotion of lung function, and strengthening the physical function of copd smokers in stable stage.

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The Impact of Short-term Combination of Limb Training and Pursed-lip Breathing in Chronic Obstructive Pulmonary Disease

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.3890 ◽

2020 ◽

Vol 8 (B) ◽

pp. 479-483

Author(s):

Amira Permatasari Tarigan ◽

Fannie Rizki Ananda ◽

Pandiaman Pandia ◽

Trisno Susilo ◽

Maryaningsih Maryaningsih ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Obstructive Pulmonary Disease ◽

Functional Capacity ◽

Chronic Obstructive ◽

P Value ◽

Short Term ◽

Obstructive Pulmonary Disease ◽

Lung Functions ◽

The Impact

AIM: The aim of this study is to determine the impact of short-term combination of upper and lower limb training on lung functions, functional capacity, and quality of life in stable chronic obstructive pulmonary disease (COPD). METHODS: This quasi-experimental study held in 2017 and included 20 participants diagnosed with COPD (forced expiratory volume in 1 second/forced volume capacity [FEV1/FVC] ≤70%). Combination of limb training with pursed-lip breathing held twice a week for 8 weeks. Lung functions, functional capacity, dyspnea scale, and quality of life were measured before, 1 month, and 2 months after training. RESULTS: In this study, there was a significant improvement of FVC after 2 months after training (p-value: 0.04), but not in FEV1. There was a significant improvement of CAT (p-value: 0.00) and modified medical research council (p-value: 0.04) after 1 month of training. There was a significant improvement of 6-min walking test mean after 2 months of training (p-value: 0.00). CONCLUSIONS: Short-term combination of limb training and pursed-lip breathing impacted positively on FVC, functional capacity, dyspnea scale, and quality of life in patients with COPD, but not in FEV1.

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Tiotropium Bromide Attenuates Mucus Hypersecretion in Patients with Stable Chronic Obstructive Pulmonary Disease

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1341644 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Suyun Yu ◽

Caili Zhang ◽

Zhijun Yan ◽

Qingqing Fang ◽

Xiwen Gao

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Treatment Group ◽

Lung Function ◽

Pulmonary Function ◽

Tiotropium Bromide ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Mucus Hypersecretion ◽

Acid Glycoprotein

Background. Patients with stable chronic obstructive pulmonary disease (COPD) have been observed to benefit from tiotropium bromide. However, there are few studies of tiotropium bromide on sputum and sputum viscosity. To evaluate the effect of tiotropium bromide on mucus hypersecretion, a randomized, double-blind controlled trial was performed. Methods. 120 cases of patients with pulmonary function grade II were divided into two groups, which include the treatment group given tiotropium bromide powder inhalation (18 μg, inhalation, QD) and the control group given formoterol fumarate powder inhalation (12 μg, inhalation, BID) plus ambroxol hydrochloride tablets (60 mg, oral, TID). After 3 months of treatment, the pulmonary function and α1-acid glycoprotein (α1-AGP) in sputum were detected, and the changes of glycoprotein and Ca2+ content were evaluated by Miller classification. Results. Three patients (2 cases in the treatment group and 1 case in the control group) were dropped due to loss of follow-up, and 117 cases of patients were enrolled in this study. After 3 months of treatment, the sputum character score, α1-acid glycoprotein, Ca2+ content, and lung function of the two groups were significantly improved; group comparison analyses revealed that there was no significant difference in the content of α1-AGP, Ca2+ in sputum, and lung function between the two groups ( P > 0.05 ), but the improvement of sputum properties was significant ( P < 0.05 ), and the treatment group was better than the control group ( t = − 2.77 ; P = 0.007 ). Conclusions. Inhaled tiotropium bromide can effectively inhibit the mucus hypersecretion in stable COPD patients, improve the sputum properties and lung function of patients, and improve the quality of life of patients.

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Physical Benefit of Postoperative Exercise Training on Lung Cancer Patients Comorbid with COPD: A Randomized Controlled Trial

10.21203/rs.3.rs-810116/v1 ◽

2021 ◽

Author(s):

Zhonghua Yu ◽

Guosheng Xie ◽

Hongchen He

Keyword(s):

Lung Cancer ◽

Chronic Obstructive Pulmonary Disease ◽

Lung Function ◽

Exercise Training ◽

Cancer Patients ◽

Exercise Group ◽

Control Group ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Lung Cancer Patients

Abstract Background: The prognosis of lung cancer is heavily affected by the comorbidity of chronic obstructive pulmonary disease. The aim of this trial is to investigate whether postoperative exercise training can improve physical function and lung function of lung cancer patients comorbid with chronic obstructive pulmonary disease.Methods: Both groups were given standard postoperative rehabilitation for one week. After that, oxygen therapy (if needed) and nebulization were given to control group, while patients in exercise group started to participate in exercise programs on the basis of receiving oxygen therapy and nebulization as same as in control group. The exercise programs consisted of 24 training sessions. Cardiopulmonary exercise test and 6-minute walk test were used to assess the physical capacity. Data in pulmonary function test like force vital capacity and forced expiratory volume in first second were used to assess the overall lung function.Results: In both groups, the functional status and the result of pulmonary function test decreased from baseline to endpoint. But after surgery and intervention program, both the maximal oxygen consumption in Cardiopulmonary Exercise Test and walking distance in 6-Minute Walk Test in exercise group were significantly better than control group [13.09(±1.46) mL/kg/min vs 11.89(±1.38) mL/kg/min, P=0.033; 297(46) m vs 243(43) m, P=0.041]. FVC and FEV1 in exercise group were better than control group, but the differences didn’t meet statistically significant level [1.76(±0.19) L vs 1.60(±0.28) L, P=0.084; 1.01(±0.17) L vs 0.96(±0.21) L, P=0.467].Conclusions: Postoperative exercise training program can facilitate recovery of functional capacity of lung cancer patients with comorbidity of chronic obstructive pulmonary disease. Postoperative lung function appears superior in patients who participated in exercise training, only fails to reach a statistically meaningful level.Trial registration: Chinese Clinical Trial Registry, ChiCTR2100042867, Registered 13 May 2021, https://www.chictr.org.cn/index.aspx.

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Roflumilast in Severely Ill Patients with Chronic Obstructive Pulmonary Disease with Frequent Exacerbations: Risk of Pneumonia Hospitalization and Severe Exacerbations

Journal of Clinical Medicine ◽

10.3390/jcm9051442 ◽

2020 ◽

Vol 9 (5) ◽

pp. 1442 ◽

Cited By ~ 1

Author(s):

Imane Achir Alispahic ◽

Rikke Sørensen ◽

Josefin Eklöf ◽

Pradeesh Sivapalan ◽

Anders Løkke ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Bacterial Infections ◽

Animal Experiments ◽

Control Group ◽

Chronic Obstructive ◽

P Value ◽

Obstructive Pulmonary Disease ◽

Severe Acute Exacerbation

Roflumilast is given as an add-on to inhalation medication in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Animal experiments have documented deleterious effects of roflumilast in bacterial infections, but trials have not reported the risk of bacterial infections in patients. The objective of this study is to determine, among outpatients with severe COPD in a two-year follow-up period, the risk of hospitalization-requiring pneumonia, severe acute exacerbation in COPD (AECOPD-hosp), and death. Patients with COPD using roflumilast (roflumilast users) were compared to a propensity score-matched COPD control group not using roflumilast (non-roflumilast users). Roflumilast users had an increased 2-year risk of hospitalization-requiring pneumonia (HR 1.5, 95% CI 1.3 to 1.8, p-value < 0.0001) compared to controls, and of AECOPD-Hosp (hazard ratio(HR) 1.6, 95%, confidence interval (CI) 1.5 to 1.8, p-value < 0.0001) and. When adding an active comparator (theophylline) as a matching variable, the signal was largely unchanged. In conclusion, roflumilast was associated with an increased number of hospitalizations for pneumonia and for AECOPD. Since trials have not reported risks of bacterial complications and data regarding severe exacerbations in roflumilast users are sparse and diverging, these data are concerning. Trials focused on the risk of pneumonia, AECOPD, and other bacterial infections in roflumilast users are needed urgently.

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Relationship between gut microbiota and lung function decline in patients with chronic obstructive pulmonary disease: a 1-year follow-up study

Respiratory Research ◽

10.1186/s12931-022-01928-8 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Yu-Chi Chiu ◽

Shih-Wei Lee ◽

Chi-Wei Liu ◽

Tzuo-Yun Lan ◽

Lawrence Shih-Hsin Wu

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Lung Function ◽

Gut Microbiota ◽

Control Group ◽

Chronic Obstructive ◽

Lung Function Decline ◽

Obstructive Pulmonary Disease ◽

Stool Samples ◽

Function Group

Abstract Objective Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by a persistent limitation in airflow. Gut microbiota is closely correlated with lung inflammation. However, gut microbiota has not been studied in patients with declining lung function, due to chronic lung disease progression. Subjects and methods Stool samples were obtained from 55 patients with COPD that were in stable condition at enrolment (stage 1) and at a 1-year follow-up (stage 2). After extracting stool DNA, we performed next generation sequencing to analyse the distribution of gut microbiota. Results Patients were divided to control and declining lung function groups, based on whether the rate of forced expiratory volume in 1 s (FEV1) had declined over time. An alpha diversity analysis of initial and follow-up stool samples showed a significant difference in the community richness of microbiota in the declining function group, but not in the control group. At the phylum level, Bacteroidetes was more abundant in the control group and Firmicutes was more abundant in the declining function group. The Alloprevotella genus was more abundant in the control group than in the declining function group. At 1-year follow-up, the mean proportions of Acinetobacter and Stenotrophomonas significantly increased in the control and declining function groups, respectively. Conclusion Some community shifts in gut microbiota were associated with lung function decline in COPD patients under regular treatment. Future studies should investigate the mechanism underlying alterations in lung function, due to changes in gut bacterial communities, in COPD.

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