scholarly journals Asthma‐chronic obstructive pulmonary disease overlap: A clinical entity?

2020 ◽  
Vol 3 (1) ◽  
pp. 2-8
Author(s):  
Robert A. Wise
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Middle Age ◽  
Clinical Manifestations ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Neutrophilic Inflammation ◽  
Normal Lung Function

Asthma and COPD are easily recognizable clinical entities in their characteristic presentations. Asthma is an early-onset disorder characterized by Type 2, eosinophil-predominant, inflammation of the airways and is associated with atopy. COPD presents in middle age and is characterized by neutrophilic inflammation of the airways and is associated with cigarette smoking or biomass fuel exposure. Between exacerbations, asthma typically has normal lung function whereas COPD has incompletely reversible lung function. Approximately one in five patients with either of these disorders will show some features of both COPD and Asthma. This overlap is far more common than can be accounted for by chance concurrence of two common diseases. There are likely genetic and environmental susceptibilities to both disorders, but there is no single pathobiological mechanism that identifies all such overlap patients. Most likely there are numerous predispositions that lead to Asthma-COPD overlap that may be grounded in early childhood or even pre-natal events. Thus, Asthma-COPD overlap is best considered a family of diseases with overlapping clinical manifestations. The future elucidation of these different pathways to Asthma-COPD overlap, in conjunction with highly targeted therapies will aid clinicians in treating these patients.

scholarly journals Correlation between Level of Autophagy and Amount of CD8+T Cells in Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Songming Zhuo ◽  
Hong Zhuang ◽  
Na Li ◽  
Sida Chen ◽  
Wugen Zhan ◽  
...  
Keyword(s):  
T Cells ◽  
T Cell ◽  
Lung Function ◽  
Normal Lung ◽  
Stable Phase ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Normal Lung Function ◽  
Healthy Control ◽  
Function Group

Abstract Background: This study aimed to shed light on the correlation between the amounts of CD8+ T cells and autophagy level in COPD. Results: The objects (n = 90) were divided into three groups: COPD group (patients in the stable phase; n = 30), SN group (healthy control of smoking with normal lung function group; n = 30), and NSN groups (healthy control of non-smoking with normal lung function group; n = 30). The amounts of CD8+ (32.33 ± 4.23%), CD8+ effector (25.63 ± 8.57%) and CD8+memory (11.94 ± 5.77%) T cell in the COPD group were significantly higher those in the other two groups, while the apoptotic rate was lower in the COPD group (P < 0.05). Significant linear correlations were found of P62/GAPDH (‰) with CD8+, CD8+effector, and CD8+ memory- T cell amounts (P<0.001). Conclusions: Autophagy level is positively and linearly associated with the amounts of CD8+ T cells, suggesting that cell autophagy might be involved in COPD pathogenesis.

scholarly journals AGGRAVATING EFFECT OF ARTERIAL HYPERTENSION ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PATIENTS WITH COMORBID PATHOLOGY

2021 ◽  
Vol 74 (4) ◽  
pp. 973-976
Author(s):  
Viktoriia V. Rodionova ◽  
Olha O. Boiko
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Arterial Hypertension ◽  
Middle Age ◽  
Clinical Manifestations ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Group I ◽  
Male Patients ◽  
Group Ii

The aim: To study the effect of arterial hypertension on the course of chronic obstructive pulmonary disease in patients with comorbid pathology. Materials and methods: The prospective study included 61 patients with COPD: 32 stable male patients with COPD with comorbid arterial hypertension of stage II 1-3 degrees and 29 stable outpatients of men with COPD of clinical groups A-D with impaired respiratory function II-IV according to GOLD. All patients, in accordance with the goals and objectives of the study, were divided into 2 groups: group I consisted of men with isolated COPD, middle age – 56.0 (8.5) years, average duration of the disease – 16.2 (1.3) years, Group II consisted of male patients with COPD and arterial hypertension (AH), middle age – 59.5 (7.5). The patients underwent a general clinical examination, which included an assessment of complaints, anamnestic data, and a physical examination. The severity of COPD was determined on the basis of the frequency of exacerbations during the year, assessment of dyspnea using the mMRS scale, spirographic data. Statistical materials were processed using the STATISTICA 10.0 program. Results: In group I, 20 patients (69%) complained of dyspnea during exercise, in group II – 25 patients (78%) (p = 0.4), 28 patients (96.5%) complained of cough with vague sputum. group and 30 patients in group II (93.8%) (p = 0.09). When assessing the number of exacerbations over the past year, it was determined that patients with isolated COPD had an average of 1.0 (1.0; 2.0) exacerbations, and patients with COPD and AH – 2.0 (1.0; 3.0 ) (p = 0.06). According to the CAT questionnaire, the following data were obtained: in group I – 9.0 (8.0; 11.0) points, and in group II – 17.5 (10.0; 20.0) points (p = 0.02). When conducting spirographic studies, a statistically significant more expressive bronchial obstruction was found in patients with COPD and comorbid hypertension. Conclusions: The presence of comorbid arterial hypertension leads to the intermittent effect of diseases: according to the results of mMRC and SAT test, ailments for COPD were examined, they have a more severe course of underlying seizure in the presence of concomitant arterial hypertension. Clinical manifestations in patients with COPD and H are more severe compared to clinical manifestations in patients without aggravated diseases of the cardiovascular system. Concomitant arterial hypertension enhances the manifestations of bronchial obstruction, in the same way as with patients with isolated COPD.

scholarly journals Expiratory reactance abnormalities in patients with expiratory dynamic airway collapse: a new application of impulse oscillometry

2018 ◽  
Vol 4 (4) ◽  
pp. 00080-2018 ◽  
Author(s):  
David I. Fielding ◽  
Justin Travers ◽  
Phan Nguyen ◽  
Michael G. Brown ◽  
Gunter Hartel ◽  
...  
Keyword(s):  
Lung Function ◽  
Regression Tree ◽  
Classification And Regression Tree ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Stepwise Logistic Regression ◽  
Impulse Oscillometry ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Normal Lung Function

Expiratory dynamic airways collapse (EDAC) is a condition that affects the central airways; it is not well characterised physiologically, with relatively few studies. We sought to characterise impulse oscillometry (IOS) features of EDAC in patients with normal spirometry. Expiratory data were hypothesised to be the most revealing. In addition, we compared IOS findings in chronic obstructive pulmonary disease (COPD) patients with and without EDAC.EDAC was identified at bronchoscopy as 75–100% expiratory closure at the carina or bilateral main bronchi. Four patient groups were compared: controls with no EDAC and normal lung function; lone EDAC with normal lung function; COPD-only patients; and COPD patients with EDAC.38 patients were studied. Mean IOS data z-scores for EDAC compared to controls showed significantly higher reactance (X) values including X at 5 Hz, resonance frequency and area under the reactance curve (AX). EDAC showed significantly greater expiratory/inspiratory differences in all IOS data compared to controls. Stepwise logistic regression showed that resonant frequency best discriminated between EDAC and normal control, whereas classification and regression tree analysis found AX ≥3.523 to be highly predictive for EDAC in cases with normal lung function (14 out of 15 cases, and none out of eight controls).These data show a new utility of IOS: detecting EDAC in patients with normal lung function.

scholarly journals Incidence of fractures among patients receiving medications for type 2 diabetes or chronic obstructive pulmonary disease and glucocorticoid users according to the National Claims Database in Japan

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Saeko Fujiwara ◽  
Shigeyuki Ishii ◽  
Takahiko Hamasaki ◽  
Nobukazu Okimoto
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hip Fracture ◽  
Vertebral Fractures ◽  
Japanese Population ◽  
Middle Age ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Claims Database

Abstract Summary According to information from the National Health Insurance and Claims database, the risk for hip, radius, and clinical vertebral fractures was higher among patients receiving medication for type 2 diabetes, COPD, or glucocorticoids than among the whole Japanese population after middle age. Purpose The aim of this study was to determine the incidence of fractures among patients receiving medications for type 2 diabetes or chronic obstructive pulmonary disease (COPD) and using glucocorticoids (GC) according to the National Database of Health Insurance Claims (NDB) in Japan. Methods We obtained data on the number of fractures and patients receiving medications for type 2 diabetes, COPD, or GC from the NDB. The claims data included sex, age group, injury/illness name, hospitalization, outpatient, surgery/medical treatment, and drugs used between January and December 2017. Results The risk of hip fracture was higher among patients receiving medications for diabetes or COPD and GC users than in the Japanese population, with standardized incidence ratios (SIRs) of 1.71 (95% confidence interval [CI]1.6–1.75), 1.35 (95% CI 1.28–1.42), and 1.62 (95% CI 1.53–1.71) in men and 1.81 (95% CI 1.79–1.84), 1.67 (95% CI 1.54–1.80), and 1.71 (95% CI 1.66–1.76) in women, respectively. There was also a significantly higher incidence of radial fractures in women and clinical vertebral fractures in both men and women. A greater risk of hip fracture was found among diabetic patients starting in their late 40 s. Conclusions Real-world data revealed that the incidence of hip, radius, and clinical vertebral fractures was significantly higher among patients receiving medications for diabetes or COPD and GC users than in the Japanese population after middle age.

scholarly journals Enhanced neutrophil response in chronic obstructive pulmonary disease

Thorax ◽  
2001 ◽  
Vol 56 (6) ◽  
pp. 432-437
Author(s):  
A Noguera ◽  
S Batle ◽  
C Miralles ◽  
J Iglesias ◽  
X Busquets ◽  
...  
Keyword(s):  
Lung Function ◽  
Surface Expression ◽  
Mean Difference ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Mrna Levels ◽  
Obstructive Pulmonary Disease ◽  
Normal Lung Function ◽  
The Difference ◽  
Neutrophil Response

BACKGROUNDNeutrophils are likely to play a major role in the inflammatory response seen in chronic obstructive pulmonary disease (COPD). This study sought to address the hypothesis that an enhanced neutrophil response to proinflammatory agents in COPD may contribute to their recruitment and activation in the lungs.METHODSCirculating neutrophils were obtained from 10 patients with COPD, eight long term smokers with normal lung function, and eight healthy never smoking controls. The in vitro production of reactive oxygen species (ROS) was measured by the NADPH oxidase method (respiratory burst) and the surface expression of several adhesion molecules (Mac-1, LFA-1 andl-selectin) was measured by flow cytometry. Measurements were obtained under basal conditions and after stimulation with phorbol myristate acetate (PMA) and tumour necrosis factor alpha (TNFα). mRNA levels of p22-phox (a subunit of NADPH oxidase) and Mac-1 (CD11b) were also determined by reverse transcriptase polymerase chain reaction (RT-PCR).RESULTSPatients with COPD showed enhanced respiratory burst compared with smokers with normal lung function, both under basal conditions (mean (SE) fluorescence intensity (MFI) 15.1 (0.5) v 11.6 (0.5); mean difference –3.4 (95% CI of the difference –5.1 to –1.8), p<0.01) and after PMA stimulation (MFI 210 (7) v 133 (10); mean difference –77 (95% CI of the difference –102 to –52), p<0.01). Mac-1 surface expression was also enhanced in patients with COPD, both under basal conditions (MFI 91 (5)v 45 (3); mean difference –46 (95% CI of the difference –61 to –31), p<0.001) and after stimulation with TNFα (MFI 340 (15) v 263 (11); mean difference –77 (95% CI of the difference –119 to –34), p=0.001). These differences were also apparent when patients with COPD were compared with non-smokers (p<0.05). The mRNA levels of p22-phox and Mac-1 (CD11b) were similar in patients with COPD and smokers with normal lung function, suggesting that the observed differences were due to post-transcriptional regulation.CONCLUSIONSThese results demonstrate an enhanced neutrophil response to proinflammatory agents in patients with COPD which may contribute to their enhanced recruitment and activation in the lungs of these patients. These findings support those of other studies which have indicated that the neutrophil is likely to play a major role in the pathogenesis of this disease.

scholarly journals Correlation between level of autophagy and frequency of CD8+ T cells in patients with chronic obstructive pulmonary disease

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095263
Author(s):  
Hong Zhuang ◽  
Na Li ◽  
Sida Chen ◽  
Yan Shen ◽  
Wugen Zhan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
T Cells ◽  
T Cell ◽  
Cell Subset ◽  
T Cell Subsets ◽  
Normal Lung ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Normal Lung Function

Objective The pathogenesis of chronic obstructive pulmonary disease (COPD) remains elusive. Here, we assessed the correlation between CD8+ T cell frequencies and autophagy in COPD patients. Methods Subjects were divided into three groups (n = 30 patients/group): (1) COPD patients in the stable phase; (2) smokers with normal lung function; and (3) non-smokers with normal lung function. Flow cytometry was used to enumerate CD8+ T cell subsets (CD8+, CD8+ effector, and CD8+ memory T cells) and quantitate T-cell apoptosis. RT-PCR and western blotting were used to measure levels of LC3 and p62. Results Frequencies of CD8+ T cell subsets and expression of p62 and LC3 II/I were significantly higher in COPD patients compared with the other two groups, while the rate of apoptosis was lower. In COPD patients, LC3 II/I and p62 expression were positively correlated with CD8+ T cell subset frequencies. Moreover, a significant correlation was observed between LC3 II/I and p62 expression and T cell subset frequencies. Conclusion Autophagy level is positively correlated with the frequencies of CD8+ T cells, suggesting that autophagy might be involved in COPD pathogenesis.

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