scholarly journals Serum laminin levels in eosinophilic and non-eosinophilic chronic obstructive pulmonary disease patients

2021 ◽  
Keyword(s):  
Disease Severity ◽  
Chronic Obstructive Lung Disease ◽  
Control Group ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
History Of ◽  
Global Initiative ◽  
Complete Blood Counts

Aim: To compare serum laminin levels in eosinophilic and non-eosinophilic (neutrophilic) COPD patients and to define its association with disease severity. Material and Method: This prospective study included patients with mild, moderate, severe, and very severe stable COPD and a control group of patients with a history of smoking but with no signs or symptoms of COPD. Spirometric measurements and Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, was used to define the disease severity. Blood eosinophil percentage was recorded from complete blood counts. Serum laminin levels were measured in all patients. Results: A total of 216 patients were included in the study. Ninety were in the eosinophilic COPD, 90 were in the non-eosinophilic COPD and 36 were in the control groups. In both COPD groups, serum laminin levels were significantly higher than in the control group (P = 0.001). In the eosinophilic COPD group, serum laminin levels were significantly higher than the non-eosinophilic COPD group (P = 0.001). With an increase in COPD severity, laminin levels were higher in both COPD groups (P = 0.001). In correlation analysis performed in all COPD patients, laminin levels were positively correlated with eosinophilia percentage (r = 0.316, P = 0.001) and negatively correlated with the FEV1/FVC ratio (r = -0.160, P = 0. 032). Conclusion: Laminin has an important role in eosinophilic COPD and increased serum laminin levels are associated with an increase in serum eosinophilia percentage and a decrease in respiratory capacity.

scholarly journals High prevalence of undiagnosed COPD among patients evaluated for suspected myocardial ischaemia

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000848 ◽  
Author(s):  
Andreas Jönsson ◽  
Artur Fedorowski ◽  
Gunnar Engström ◽  
Per Wollmer ◽  
Viktor Hamrefors
Keyword(s):  
Myocardial Ischaemia ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Clinical Factors ◽  
Obstructive Pulmonary Disease ◽  
Presenting Symptoms ◽  
High Prevalence ◽  
History Of ◽  
Artery Disease ◽  
Global Initiative

ObjectiveChronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia.MethodsAmong 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry. Of these, a total of 400 subjects (age 66 years; 45% women) had no previous COPD diagnosis and were included in the current study. We compared the prevalence of previously undiagnosed COPD according to spirometry criteria from The Global Initiative for Chronic Obstructive Lung Disease (GOLD) or lower limit of normal (LLN) and reversible myocardial ischaemia according to symptoms and clinical factors.ResultsA total of 134 (GOLD criteria; 33.5 %) or 46 patients (LLN criteria; 11.5%) had previously undiagnosed COPD, whereas 55 patients (13.8 %) had reversible myocardial ischaemia. The presenting symptoms (chest discomfort, dyspnoea) did not differ between COPD, myocardial ischaemia and normal findings. Except for smoking, no clinical factors were consistently associated with previously undiagnosed COPD.ConclusionsAmong middle-aged outpatients evaluated due to suspected myocardial ischaemia, previously undiagnosed COPD is at least as common as reversible myocardial ischaemia and the presenting symptoms do not differentiate between these entities. Patients going through a coronary ischaemia evaluation should be additionally tested for COPD, especially if there is a positive history of smoking.

scholarly journals The stability of blood Eosinophils in chronic obstructive pulmonary disease

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabriella H. Long ◽  
Thomas Southworth ◽  
Umme Kolsum ◽  
Gavin C. Donaldson ◽  
Jadwiga A. Wedzicha ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive Lung Disease ◽  
Predictive Biomarker ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Global Initiative ◽  
The Stability ◽  
Blood Eosinophils

AbstractBlood eosinophils are a predictive biomarker of inhaled corticosteroid response in chronic obstructive pulmonary disease (COPD). We investigated blood eosinophil stability over 1 year using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 thresholds of < 100, 100- < 300 and ≥ 300 eosinophils/μL in 225 patients from the COPDMAP cohort. Blood eosinophils showed good stability (rho: 0.71, p < 0.001, ICC 0.84), and 69.3% of patients remained in the same eosinophil category at 1 year. 85.3% of patients with eosinophils < 100 cells/μL had stable counts. The majority of blood eosinophil counts remain stable over 1 year using the GOLD 2019 thresholds.

scholarly journals The patients with severe Chronic Obstructive Pulmonary Disease and chronic respiratory insufficiency

2016 ◽  
Vol 67 (3) ◽  
Author(s):  
N. Ambrosino ◽  
M. Di Giorgio ◽  
A. Di Paco
Keyword(s):  
Exercise Capacity ◽  
Chronic Obstructive Lung Disease ◽  
Supplemental Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Chronic Respiratory Insufficiency ◽  
Global Initiative ◽  
End Stage

Caring for patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure is difficult independent of whether the target is survival or quality of life (QOL). The role of inhaled drug therapy in this specific set of very severe COPD patients has not previously been assessed. The only drug able to prolong survival in these patients is long term oxygen therapy, whereas there is little evidence to indicate long term domiciliary mechanical ventilation in the routine management of stable hypercapnic patients. Supplemental oxygen during exercise reduces exercise breathlessness and improves exercise capacity of the hypoxaemic patient. Pulmonary rehabilitation including nutritional supplementation is a significant component of therapy, even in these severe patients. Relief of dyspnoea with drugs such as morphine should not be denied to severely disabled patients who share poor QOL with cancer patients. Non-invasive ventilation has been used as a palliative treatment to reduce dyspnoea. Lung Volume Reduction Surgery may improve mortality, exercise capacity, and QOL in selected patients, but is associated with significant morbidity and an early mortality rate in the most severe patients. Lung transplantation is a final step in end-stage patients, but short- and long-term outcomes remain significantly inferior in relation to other “solid” organs recipients.

Triple Therapy in COPD

2019 ◽  
Vol 15 (2) ◽  
pp. 102-111 ◽  
Author(s):  
Claudio Micheletto ◽  
Alice Sparacino
Keyword(s):  
Triple Therapy ◽  
Treatment Options ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Glycopyrronium Bromide ◽  
Copd Patients ◽  
Global Initiative ◽  
Long Acting ◽  
The Impact

: Triple inhaled therapy for Chronic Obstructive Pulmonary Disease (COPD) includes an inhaled corticosteroid (ICS), a long-acting b2-agonist (LABA) and a long-acting muscarinic antagonist (LAMA) taken in combination. Triple therapy is recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) for patients who experience recurrent exacerbations despite treatment with either a dual bronchodilator or LABA/ICS combination. There is consistent evidence that the LABA/LAMA/ICS combination has significantly greater effects on trough FEV1, symptoms, quality of life, and exercise performance compared to comparator treatments. : The role of triple therapy in reducing exacerbations in COPD patients is debatable, but recent trials have revealed some intriguing insights. : Three pivotal studies, namely TRILOGY, TRINITY and TRIBUTE have been conducted to evaluate the safety and efficacy of extrafine Beclomethasone/Formoterol Fumarate/Glycopyrronium Bromide (BDP/FF/GB) versus different treatment options for COPD. Extrafine BDP/FF/GB has been compared to an ICS/LABA (BDP/FF) combination in the TRILOGY study, to a LAMA monotherapy (Tiotropium-TIO) and an extemporary triple combination of ICS/LABA + LAMA (BDP/FF + TIO) in the TRINITY study, and to one inhalation of LABA/LAMA per day (Indacaterol/ Glycopyrronium - IND/GLY) in the TRIBUTE study. : Another triple therapy with Fluticasone Furoate/Umeclidinium/Vilanterol (FF/UMEC/VI) was recently tested in two further studies that included patients with COPD. The FULFIL study compared the efficacy of the triple FF/UMEC/VI therapy to the ICS/LABA association budesonide/formoterol, while the IMPACT study compared the rate of moderate and severe exacerbations between singleinhaler FF/UMEC/VI and single-inhaler FF/VI or UMEC/VI.

Narrative Literature Review Guided Approach of Inhaled Corticosteroid de-escalation in Chronic Obstructive Pulmonary Disease

2021 ◽  
pp. 089719002110537
Author(s):  
Anamarie Tomaich ◽  
Shawnee Klatt ◽  
Michael W. Nagy
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Inhaled Corticosteroid ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Long Acting

Objective To review the 2020 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report recommendations and create an algorithm to assist clinicians in determining which chronic obstructive pulmonary disease (COPD) patients qualify for inhaled corticosteroid (ICS) de-escalation. Data Sources: A literature search of MEDLINE/PubMed from 2002 to August 2021 was conducted using the search terms inhaled corticosteroids, chronic obstructive pulmonary disease, and de-escalation and review of the reference lists of identified articles for pertinent citations. Study Selection and Data Extraction Relevant studies and articles were included if they focused on the utilization of ICS in COPD. Data Synthesis The 2020 GOLD report only recommends triple therapy with ICS, long acting beta agonists, and long acting muscarinic antagonists for patients with frequent exacerbations, frequent hospitalizations, or elevated blood eosinophil counts. Despite this clear framework, patients are prescribed ICS without these characteristics. Available evidence suggests that these patients can be de-escalated from ICS therapy without concern for worsening lung function or exacerbations. Relevance to Patient Care and Clinical Practice: Patients with COPD may be experiencing more risk than benefit on ICS therapy. Clinicians should be knowledgeable on how to evaluate patient therapy for appropriateness and know how to safely deprescribe ICS given their limited efficacy in many COPD patients. Conclusion There remains no specific guidance on how to de-escalate patients off an ICS when the therapy is not indicated. Use of clinical evidence with stepwise algorithms can be models to approach de-escalation of ICS in patients with COPD.

scholarly journals Endothelial damage and functional state of the vascular wall in chronic obstructive pulmonary disease.

2018 ◽  
Vol 96 (6) ◽  
pp. 527-536
Author(s):  
N. A. Karoli ◽  
A. P. Rebrov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive Lung Disease ◽  
Vascular Wall ◽  
Endothelial Damage ◽  
Biologically Active ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Global Initiative

Chronic obstructive pulmonary disease (COPD) creates conditions for endothelial damage with the development of endothelial dysfunction: hypoxia, an increase in biologically active substances, including cytokines, leukotrienes, etc. Previous studies have been conducted in COPD patients with a combination of arterial hypertension and coronary heart disease. The aim of the study was to evaluate the endothelial damage and the vasoregulatory function of the vascular wall in patients with COPD of varying severity. Material and methods. The study included 76patients with COPD (men, mean age 51.14 ± 0.97years). COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (2013) guidelines. The patients were divided into two groups according to COPD severity: the 1st group (GOLD I-II) included 27 patients, the 2nd group (GOLD III-IV) included 49 patients. Antithrombogenic, vasoregulatory function of the endothelium, synthesis of nitric oxide (NO) in blood plasma by the level of stable NO metabolites (nitrates and nitrites) was studied. The number of desquamated endotheliocytes, von Willebrand factors in the blood was determined. As a result of the study, a significant damage to the endothelium, an increase in the thickness of the wall of the brachial artery, a decrease in the total plasma concentration of stable NO metabolites, a violation of the antithrombogenic and vasoregulatory activity of the vascular wall in COPD patients compared with healthy people. The most significant changes were found in patients with severe COPD.

scholarly journals INDACO project: a pilot study on incidence of comorbidities in COPD patients referred to pneumology units

2013 ◽  
Vol 8 ◽  
Author(s):  
Giorgio Fumagalli ◽  
Fabrizio Fabiani ◽  
Silvia Forte ◽  
Massimiliano Napolitano ◽  
Paolo Marinelli ◽  
...  
Keyword(s):  
Pilot Study ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Copd Patients ◽  
High Prevalence ◽  
Global Initiative ◽  
The Impact

Background: Chronic Obstructive Pulmonary Disease (COPD) is often associated with comorbidities, especially cardiovascular, that have a heavy burden in terms of hospitalization and mortality. Since no conclusive data exist on the prevalence and type of comorbidities in COPD patients in Italy, we planned the INDACO observational pilot study to evaluate the impact of comorbidities in patients referred to the outpatient wards of four major hospitals in Rome. Methods: For each patient we recorded anthropometric and anamnestic data, smoking habits, respiratory function, GOLD (Global initiative for chronic Obstructive Lung Disease) severity stage, Body Mass Index (BMI), number of acute COPD exacerbations in previous years, presence and type of comorbidities, and the Charlson Comorbidity Index (CCI). Results: Here we report and discuss the results of the first 169 patients (124 males, mean age 74±8 years). The prevalence of patients with comorbidities was 94.1% (25.2% of cases presented only one comorbidity, 28.3% two, 46.5% three or more). There was a high prevalence of arterial hypertension (52.1%), metabolic syndrome (20.7%), cancers (13.6%) and diabetes (11.2%) in the whole study group, and of anxiety-depression syndrome in females (13%). Exacerbation frequency was positively correlated with dyspnea score and negatively with BMI. Use of combination of bronchodilators and inhaled corticosteroids was more frequent in younger patients with more severe airways obstruction and lower CCI. Conclusions: These preliminary results show a high prevalence of comorbidities in COPD patients attending four great hospitals in Rome, but they need to be confirmed by further investigations in a larger patients cohort.

scholarly journals Co-morbidities in 99 COPD patients: A case series from Syria

2015 ◽  
Vol 3 (4) ◽  
pp. 167-170
Author(s):  
Yousser Mohammad ◽  
Fatima Yassine ◽  
Mais Khadouj
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Lung Disease ◽  
Case Series ◽  
Chronic Obstructive Lung Disease ◽  
University Hospital ◽  
Disease Stage ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Global Initiative

Abstract Objectives: To assess the most frequent co-morbidities in chronic obstructive pulmonary disease (COPD) patients. Patients and Methods: We studied 99 patients, including 72 males and 67 smokers, presented to our University Hospital in Lattakia, Syria in 2012, with a mean age of 63 years. Results: Overall, there were 61% hypertension, 37% ischemic heart disease, 25% diabetes, 45% anemia, and 47% pulmonary hypertension. Other diseases were less significant. Patients who had more severe Global Initiative for Chronic Obstructive Lung Disease stage had a greater number of co-morbidities. Conclusions: We recommend as a general practice, to assess cardiac co-morbidities, hypertension, and other co-morbidities in all COPD patients and vice versa. We also recommend performing spirometry in smokers complaining of chronic cough, sputum, or dyspnea for early diagnosis of COPD.

scholarly journals Evaluation of severity of chronic obstructive pulmonary disease using bronchial obstruction, dyspnea, exercise index and global initiative for chronic obstructive lung disease classification and it’s correlation with physical quality of life measured by St. George’s respiratory disease questionnaire score

2020 ◽  
Vol 7 (4) ◽  
pp. 608
Author(s):  
Snehal Daga ◽  
Vrushali Khadke ◽  
Deepak Phalgune ◽  
Abbas Chopadawala
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Copd Patients ◽  
Gold Classification ◽  
Global Initiative

Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) criteria classified chronic obstructive pulmonary disease (COPD) by severity into four stages. Recently, Body mass index (BMI), Bronchial Obstruction, Dyspnea, Exercise (BODE) index, was proposed to provide useful prognostic information of COPD patients. Health-related quality of life (HRQOL) is measured by St. George’s Respiratory disease Questionnaire (SGRQ). Study was undertaken to assess correlations between BODE index and GOLD classification with SGRQ score.Methods: Fifty five COPD patients were included. Spirometry was performed in all patients. Modified Medical Research Council (mMRC) scale was used to label severity of dyspnea. Six-minute walking distance (6 MWD) was performed. BODE index was calculated by giving points to BMI, forced expiratory volume in one minute (FEV1), 6 MWD, and mMRC. SGRQ was used to determine HRQOL. Correlation analysis was done using Pearson’s method.Results: Mean symptoms, mean activity, mean impacts and mean total SGRQ score were significantly higher in patients having mMRC scale 0-1, patients who could walk ≤149 meters, and in patients who had GOLD III and IV class. Lesser the FEV1, higher the mMRC grade, and lesser the 6 MWD, worse was the quality of life. BODE index (r = 0.72) and GOLD classification (r =0.59) were significantly and positively correlated with symptoms score, activity score, impacts score and total SGRQ score.Conclusions: BODE index correlated better than the Gold classification with SGRQ score implying that apart from the airflow limitation, functional impairment measured by the 6MWT and mMRC also affect HRQOL.

scholarly journals Spirometric Values of Greek People and Comparison with ECSC and GLI Values in COPD People

2018 ◽  
Vol 12 (1) ◽  
pp. 29-38
Author(s):  
Nikolaos Tatsis ◽  
Sotirios Kakavas ◽  
Evgenios Metaxas ◽  
Evangelos Balis ◽  
George Tatsis ◽  
...  
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Forced Expiratory Volume ◽  
Greek Population ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference ◽  
Global Initiative ◽  
Predicted Values

Background: During the past few years, the use of criteria introduced by Global Initiative for Chronic Obstructive Lung Disease (GOLD) is recommended for the diagnosis and classification of Chronic Obstructive Pulmonary Disease(COPD),taking into account the values of a Forced Expiratory Volume In 1 second (FEV1) and a Forced Expiratory Volume In 1 second (FEV1) to Forced Vital Capacity (FVC) ratio. In Europe, the reference values of the European Coal and Steel Community (ECSC), that were originally developed in 1993 are still used. Aim of the Study: The study aimed to carry out measurement of spirometric values in a healthy, non smoking Greek population, development of local equations and comparison with ECSC and Global Lung Initiative(GLI) equations, in order to see if there is a need for separate ones in everyday use. Methods: Normal predicted values for FEV1 and FEV1/FVC% were obtained from a group of 500 healthy subjects, aged 18-89 years. In addition, a group of 124 COPD patients, with no other comorbidities was studied. Patients were classified according to GOLD criteria in four groups with ECSC, GLI predicted values or with our own predicted values. Results: The statistical analysis has revealed that there is no significant difference among the three sets of predicted values and no statistical difference was detected among the classification of COPD patients. Conclusion: It is shown that the 3 sets of predicted values are almost identical, despite the fact that they have been collected from different study populations.Αccording to the study, there is no need in recalculating values for Greek population.

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