scholarly journals Pulmonary comorbidities associated with chronic obstructive pulmonary disease

Author(s):  
Fabrizio Luppi ◽  
Bianca Beghè ◽  
Pietro Roversi

Introduction Chronic obstructive pulmonary disease (COPD) is characterized by a relatively irreversible airflow limitation caused by chronic inflammation, in most cases tobacco-related. The impact of COPD on morbidity and mortality at the single-patient level depends upon the severity of COPD symptoms and the existence of other types of systemic and/or pulmonary disease, also known as co-morbid conditions.Materials and methods This review examines the pulmonary diseases commonly associated with COPD, in terms of their prevalence, clinical features, pathogenic mechanisms, prognoses, and implications for management of COPD.Results The incidence and prevalence of various pulmonary diseases are significantly increased in patients with COPD. These conditions include symptomatic bronchiectasis, combined pulmonary fibrosis and emphysema, lung cancer, sleep-related respiratory disorders, and pulmonary embolism. Some of these concomitant respiratory diseases have an independent negative impact on the prognosis of COPD patients, and their presence has important implications for treatment of these patients.Conclusions Physicians treating patients with COPD need to be aware of these coexisting pulmonary diseases. All patients with COPD should be carefully evaluated to identify pulmonary comorbidities, since they not only influence the prognosis but also have an impact on disease management. The treatment of COPD is no longer restricted exclusively to inhaled therapy. The therapeutic approach to this disease is becoming increasingly multidimensional in view of the fact that successful management of comorbidities might positively affect the course of COPD itself.

Author(s):  
Kaushlendra Pratap Narayan ◽  
S. K. Verma ◽  
Surya Kant ◽  
R. A. S. Kushwaha ◽  
Santosh Kumar ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.


Genes ◽  
2019 ◽  
Vol 10 (10) ◽  
pp. 783 ◽  
Author(s):  
Ozretić ◽  
da Silva Filho ◽  
Catalano ◽  
Sokolović ◽  
Vukić-Dugac ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a chronic disease characterized by a progressive decline in lung function due to airflow limitation, mainly related to IL-1β-induced inflammation. We have hypothesized that single nucleotide polymorphisms (SNPs) in NLRP genes, coding for key regulators of IL-1β, are associated with pathogenesis and clinical phenotypes of COPD. We recruited 704 COPD individuals and 1238 healthy controls for this study. Twenty non-synonymous SNPs in 10 different NLRP genes were genotyped. Genetic associations were estimated using logistic regression, adjusting for age, gender, and smoking history. The impact of genotypes on patients’ overall survival was analyzed with the Kaplan–Meier method with the log-rank test. Serum IL-1β concentration was determined by high sensitivity assay and expression analysis was done by RT-PCR. Decreased lung function, measured by a forced expiratory volume in 1 s (FEV1% predicted), was significantly associated with the minor allele genotypes (AT + TT) of NLRP1 rs12150220 (p = 0.0002). The same rs12150220 genotypes exhibited a higher level of serum IL-1β compared to the AA genotype (p = 0.027) in COPD patients. NLRP8 rs306481 minor allele genotypes (AG + AA) were more common in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition of group A (p = 0.0083). Polymorphisms in NLRP1 (rs12150220; OR = 0.55, p = 0.03) and NLRP4 (rs12462372; OR = 0.36, p = 0.03) were only nominally associated with COPD risk. In conclusion, coding polymorphisms in NLRP1 rs12150220 show an association with COPD disease severity, indicating that the fine-tuning of the NLRP1 inflammasome could be important in maintaining lung tissue integrity and treating the chronic inflammation of airways.


2015 ◽  
Vol 93 (6) ◽  
pp. 574-580 ◽  
Author(s):  
Bożena Bukowska ◽  
Paulina Sicińska ◽  
Aneta Pająk ◽  
Aneta Koceva-Chyla ◽  
Tadeusz Pietras ◽  
...  

The study indicates, for the first time, the changes in both ATPase and AChE activities in the membrane of red blood cells of patients diagnosed with COPD. Chronic obstructive pulmonary disease (COPD) is one of the most common and severe lung disorders. We examined the impact of COPD on redox balance and properties of the membrane of red blood cells. The study involved 30 patients with COPD and 18 healthy subjects. An increase in lipid peroxidation products and a decrease in the content of -SH groups in the membrane of red blood cells in patients with COPD were observed. Moreover, an increase in the activity of glutathione peroxidase and a decrease in superoxide dismutase, but not in catalase activity, were found as well. Significant changes in activities of erythrocyte membrane enzymes in COPD patients were also evident demonstrated by a considerably lowered ATPase activity and elevated AChE activity. Changes in the structure and function of red blood cells observed in COPD patients, together with changes in the activity of the key membrane enzymes (ATPases and AChE), can result from the imbalance of redox status of these cells due to extensive oxidative stress induced by COPD disease.


2010 ◽  
Vol 119 (3) ◽  
pp. 143-149 ◽  
Author(s):  
Hiroshi Kanazawa ◽  
Toyoki Kodama ◽  
Kazuhisa Asai ◽  
Saeko Matsumura ◽  
Kazuto Hirata

It has been reported that small airway inflammation is closely associated with the severity of airflow limitation in COPD (chronic obstructive pulmonary disease). We tested a new method of measurement of biochemical constituents in ELF (epithelial lining fluid) obtained separately from the central or peripheral airways using a bronchoscopic microsampling technique. The present study was designed to determine the validity of measuring CML [Nε-(carboxymethyl)lysine] levels in ELF for the assessment of small airway inflammation in COPD. Ten non-smokers, ten current smokers and 16 COPD patients were included in the present study. Concentrations of CML, 8-isoprostane and IL-8 (interleukin-8) were measured in ELF separately from the central or peripheral airways. CML levels in central airways did not differ significantly, but were markedly higher in peripheral than in central airways in the three groups. However, CML levels in peripheral airways of COPD patients were significantly higher than those in non-smokers and current smokers. In COPD patients, the CML level in peripheral airways was significantly correlated with FEV1 (forced expiratory volume in 1 s) (r=−0.82, P=0.002) and FEV1/FVC (forced vital capacity) (r=−0.57, P=0.03). Moreover, CML levels in peripheral airways were significantly correlated with levels of both 8-isoprostane (r=0.76, P=0.003) and IL-8 (r=0.67, P=0.01). In conclusion, these findings suggest that elevated levels of CML in ELF from peripheral airways were observed in COPD patients, and this parameter was correlated with the severity of airflow limitation.


2019 ◽  
Vol 7 (21) ◽  
pp. 3568-3573
Author(s):  
Daniela Buklioska Ilievska ◽  
Jordan Minov ◽  
Nade Kochovska Kamchevska ◽  
Biljana Prgova Veljanova ◽  
Natasha Petkovikj ◽  
...  

Objective. To compare frequency of echocardiographic changes in patients with chronic obstructive pulmonary disease (COPD) and non-COPD controls and to assess their relation to the level of airflow limitation. Methods. Study population included 120 subjects divided in two groups. Group 1 included 60 patients with COPD (52 male and 8 female, aged 40 to 80 years) initially diagnosed according to the actual recommendations. Group 2 included 60 subjects in whom COPD was excluded serving as a control. The study protocol consisted of completion of a questionnaire , pulmonary evaluation (dyspnea severity assessment, baseline and post-bronchodilator spirometry, gas analyses, and chest X-ray) and two dimensional (2D) Doppler echocardiography. Results. We found significantly higher mean right ventricle end-diastolic dimension (RVEDd) in COPD patients as compared to its dimension in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000). Pulmonary hypertension (PH) was more frequent in COPD patients than in controls (28.0 ± 4.8 vs. 24.4 ± 4.3; P = 0.0000) showing linear relationship with severity of airflow limitation. The mean value of left ventricular ejection fraction (LVEF%) was significantly lower in COPD patients than its mean value in controls (57.4 ± 6.9% vs. 64.8 ± 2.7; P = 0.0000) with no correlation with severity of airflow limitation.       Conclusion. Frequency of echocardiographic changes in COPD patients was significantly higher as compared to their frequency in controls in the most cases being significantly associated with severity of airflow limitation. Echocardiography enables early, noninvasive, and accurate diagnosis of cardiac changes in COPD patients giving time for early intervention. Key words: airflow limitation, chronic obstructive pulmonary disease, Doppler echocardiography, pulmonary hypertension, ventricular dysfunction.  


Author(s):  
Babulal Bansiwal ◽  
Anees K. V. ◽  
Maneesha Jelia ◽  
Satyam Agarwal

Background: Chronic obstructive pulmonary disease is preventable and treatable disease with progressive persistent airflow limitation and enhanced chronic inflammatory response in the airways. Indian council of medical research conducted a study and found that total burden of COPD in India has more than doubled to about 14.84 million in 2011 from about 6.45 million in 1971Methods: It was an open label cross sectional study. It was conducted on patients attending the outpatient department of respiratory medicine, new medical college and hospital, Kota, over a period of one year. 100 COPD patients attending the respiratory outpatient department of GMC, Kota and fulfilling the inclusion criteria’s were included in the study. A diagnosis and severity of COPD was established by clinical symptoms and spirometric data as per GOLD guideline (ratio of FEV1 and forced vital capacity <0.7).Results: We found a significant negative correlation (Pearson correlation coefficient r = -0.664, p< 0.001) between 6 MWD and BODE index in study population.Conclusions: Thus, we concluded that the functional exercise capacity of COPD patients measured by 6MWT deteriorates linearly with severity of the disease assessed by the GOLD staging criteria. Hence we can use 6 MWT for assessing the severity of COPD in place of spirometry where the facility of spirometry is not feasible.


2021 ◽  
Vol 12 ◽  
Author(s):  
Anaëlle Muggeo ◽  
Jeanne-Marie Perotin ◽  
Audrey Brisebarre ◽  
Sandra Dury ◽  
Valérian Dormoy ◽  
...  

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by airflow limitation. This chronic respiratory disease represents the third leading cause of death worldwide. Alteration of the airway microbiota has been reported to be associated with exacerbation frequency in COPD, but its role on the symptoms in patients at stable state is still incompletely described. This study aimed to determine whether bacteria isolated in sputum can be associated with the clinical features of COPD patients within stable state. Our study highlights, for the first time, that altered microbiota with Enterobacterales is associated with pejorative clinical symptoms in stable COPD patients. The airway microbiota of 38 patients was analyzed using an extended culture approach and mass spectrometry identification. Cluster analysis by principal coordinate analysis of the bacterial communities showed that the patients could be classified into three distinct clusters in our cohort. The clusters showed no differences in proportions of the phylum, but one of them was associated with a high prevalence of Enterobacterales (71.4% in cluster 1 vs. 0% in cluster 3), loss of microbiota diversity, and higher bacterial load (107 vs. 105 CFU/ml, respectively) and characterized by predominant cough and impact on mental health. These novel findings, supported by further studies, could lead to modifying the processing of COPD sputum in the everyday practice of clinical microbiology laboratories.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Iva Hlapčić ◽  
Andrea Hulina-Tomašković ◽  
Anita Somborac-Bačura ◽  
Marija Grdić Rajković ◽  
Andrea Vukić Dugac ◽  
...  

Abstract Extracellular adenosine triphosphate (eATP)-driven inflammation was observed in chronic obstructive pulmonary disease (COPD) but was not investigated in patients’ blood. Therefore, this study aimed to investigate eATP concentration in plasma of COPD patients and its association with disease severity and smoking. Study included 137 patients with stable COPD and 95 control subjects. eATP concentration was determined in EDTA plasma by luminometric method, and mRNA expression of eATP receptors P2X7R and P2Y2R was analysed by quantitative polymerase chain reaction (qPCR). eATP concentration was increased in COPD patients compared to controls (P < 0.001). Moreover, it was increasing with disease severity (GOLD 2–4) as well as symptoms burden and exacerbations history (GOLD A–D) (P < 0.05). eATP in healthy smokers differed from healthy non-smokers (P < 0.05) but was similar to GOLD 2 and GOLD A patients. eATP showed great diagnostic performances (OR = 12.98, P < 0.001) and correctly classified 79% of study participants. It demonstrated association with FEV1 and multicomponent indices (ADO, BODEx, BODCAT, CODEx, DOSE). Regarding gene expression, P2Y2R was increased in the blood of COPD patients. Plasma eATP could become a diagnostic and/or prognostic biomarker in COPD, as it seems to be associated with patients’ condition, quality of life and disease progression.


2020 ◽  
Vol 22 (4) ◽  
pp. 223-227
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Pant

Obstructive lung disease is a group of disorders comprising Chronic Obstructive Pulmonary Disease (COPD) and asthma. It is one of the most common causes of morbidity and mortality worldwide. COPD is a preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation, whereas asthma is reversible episodes of recurrent wheezing, cough, breathlessness, and chest tightness. It is sometimes difficult to distinguish COPD from asthma when COPD patients present with significant post-bronchodilator reversibility. Spirometry is the gold standard test to diagnose obstructive airway disease. We carried out a hospital-based cross-sectional study in Nepal Medical College Teaching Hospital from January 2018 to December 2018. One hundred and ninety eight patients who met the inclusion criteria underwent spirometry. Basal and post-bronchodilator FEV1, FVC, FEV1/FVC, and reversibility of FEV1 were measured. The majority of the patients enrolled in the study were males (n=100). The mean age of the patients was 49.3±17.0 years. Most of the patients were above 60 years of age (n=68). Clinical diagnosis of asthma was made in 113 (57%) and COPD in 85 (43%) patients. Post-bronchodilator reversibility was observed in 48 (42%) asthmatic and 19 (22%) COPD patients. Post-bronchodilator reversibility was statistically significant in asthmatic patients (p=0.032). Post-bronchodilator reversibility was observed in COPD patients as well. Therefore, post-bronchodilator reversibility alone may have a limited role in differentiating COPD from bronchial asthma. However, spirometry is mandatory to diagnose a patient with obstructive lung disease.


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