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Bronchiectasis and COPD

Cecilia Andersson, Sara J Bonvini, Peter Horvath, Eduardo Marquez, Imran Satia, Paul Kirkham, Florence Schleich, Marco Idzko, Reinoud Gosens, Jose Luis Lopez-Campos, Apostolos Bossios, Omar Usmani, Antonio Spanevello, Ian M Adcock, Alexander G Mathioudakis
For another year, high-quality research studies from around the world transformed the annual ERS International Congress into a vivid platform to discuss trending research topics, to produce new research questions and to further push the boundaries of respiratory medicine and science. This article reviews only some of the high-quality research studies on asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and chronic cough that were presented during the congress through the Airway Diseases Assembly (ERS Assembly 5) and places them into the context of current knowledge and research challenges...
January 2018: ERJ Open Research
Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Theerasuk Kawamatawong, Jitsupa Onnipa, Thitiporn Suwatanapongched
Background: The prevalence rate of bronchiectasis in COPD is variable. Coexisting bronchiectasis and COPD may influence COPD severity and exacerbation. Objective: We investigated whether bronchiectasis is associated with frequent or severe COPD exacerbation. Lower airway bacterial and mycobacterial infections are a possible mechanism for bronchiectasis. Materials and methods: A cross-sectional study was conducted in 2013-2014. COPD exacerbations and hospitalizations were reviewed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Shuang Dou, Chunyan Zheng, Xiuli Ji, Wei Wang, Mengshuang Xie, Liwei Cui, Wei Xiao
Background: Pulmonary vascular disease, especially pulmonary hypertension, is an important complication of COPD. Bronchiectasis is considered not only a comorbidity of COPD, but also a risk factor for vascular diseases. The main pulmonary artery to aorta diameter ratio (PA:A ratio) has been found to be a reliable indicator of pulmonary vascular disease. It is hypothesized that the co-existence of COPD and bronchiectasis may be associated with relative pulmonary artery enlargement (PA:A ratio >1)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Dorota Wyrostkiewicz, Monika Szturmowicz, Iwona Bartoszuk, Izabela Siemion-Szcześniak, Lilia Jakubowska, Ewa Augustynowicz-Kopeć, Jan Kuś
Mycobacterial lung disease is caused by nontuberculous mycobacteria (NTM), also known as atypical mycobacteria. NTM are widely distributed in the environment, particularly in soil and water; they may colonize the airways, gastrointestinal tract and genitourinary system, without the apparent signs of disease. Nevertheless, in some risk groups such as patients with chronic lung diseases or with immunodeficiency, mycobacterial lung disease is identified. Recently, increased recognition of mycobacterial lung disease in chronic obstructive pulmonary disease (COPD) patients has been observed, especially in those treated with high doses of inhaled corticosteroids...
2018: Advances in Respiratory Medicine
Michal Shteinberg, Emilia Hardak, Matthew Koslow, Dario Prais, Malena Cohen-Cymberkno, David Shoseyov, Adi Dagan, Yochai Adir, David Shitrit
Bronchiectasis is anatomically defined by irreversible distortion of the bronchi. Clinically, its manifestations are cough with sputum production and a predisposition to pulmonary infections. Unlike asthma and COPD, where ample clinical data are present regarding the course and effective treatment, knowledge of bronchiectasis has yet to evolve. Lately, bronchiectasis is gaining renewed attention among the medical community, with growing basic and clinical research-based data. In Israel, no registered treatments exist for bronchiectasis, which makes it difficult to treat these patients...
February 2018: Harefuah
Robert Palmér, Jukka Mäenpää, Alexandra Jauhiainen, Bengt Larsson, John Mo, Muir Russell, James Root, Susanne Prothon, Ligia Chialda, Pablo Forte, Torbjörn Egelrud, Kristina Stenvall, Philip Gardiner
Neutrophil serine proteases (NSPs), such as neutrophil elastase (NE), are activated by dipeptidyl peptidase 1 (DPP1) during neutrophil maturation. High NSP levels can be detrimental, particularly in lung tissue, and inhibition of NSPs is therefore an interesting therapeutic opportunity in multiple lung diseases, including chronic obstructive pulmonary disease (COPD) and bronchiectasis. We conducted a randomized, placebo-controlled, first-in-man study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of single and multiple oral doses of the DPP1 inhibitor AZD7986 in healthy subjects...
February 27, 2018: Clinical Pharmacology and Therapeutics
A Perciaccante, P Charlier, C Negri, A Coralli, O Appenzeller, R Bianucci
A1AT deficiency- a genetically inherited autosomal codominant disease with more than 120 identified alleles- was first identified by Laurell and Eriksson in 1963. The most common hereditary disorder in adults, A1AT causes an increased risk of developing pulmonary emphysema and liver disease. In A1AT patients, lung disease generally presents at a younger age than "usual" chronic obstructive pulmonary disease (COPD) and it may be misdiagnosed as asthma. Because A1AT deficiency patients can show the same clinical features as non-deficient COPD (including increased evidence of bronchiectasis, frequent exacerbations, impaired health status and a degree of reversibility of airflow obstruction), the World Health Organization recommend to test every patient with a diagnosis of COPD or adult-onset asthma for A1AT deficiency...
February 2018: COPD
Mieczysław Szyszkowicz, Termeh Kousha, Jessica Castner, Robert Dales
Increasing evidence suggests that ambient air pollution is a major risk factor for both acute and chronic respiratory disease exacerbations and emergencies. The objective of this study was to determine the association between ambient air pollutants and emergency department (ED) visits for respiratory conditions in nine districts across the province of Ontario in Canada. Health, air pollutant (PM2.5 , NO2 , O3 , and SO2 ), and meteorological data were retrieved from April 2004 to December 2011. Respiratory diseases were categorized as: chronic obstructive pulmonary disease (COPD, including bronchiectasis) and acute upper respiratory diseases...
February 16, 2018: Environmental Research
Stephanie Everaerts, Katrien Lagrou, Kristina Vermeersch, Lieven J Dupont, Bart M Vanaudenaerde, Wim Janssens
The role of Aspergillus fumigatus in the airways of chronic obstructive pulmonary disease (COPD) patients with bronchiectasis is currently unclear. We searched for a sensitive and noninvasive method for A. fumigatus detection in the sputum of COPD patients and addressed potential risk factors for its presence. Induced sputum samples of 18 COPD patients and 17 COPD patients with bronchiectasis were analyzed for the presence of A. fumigatus by culture, galactomannan detection, and PCR. Of the patients with COPD-bronchiectasis overlap, 23...
February 9, 2018: International Journal of Molecular Sciences
Jianmin Jin, Shuling Li, Wenling Yu, Xiaofang Liu, Yongchang Sun
Background: Pulmonary tuberculosis (PTB) is a risk factor for COPD, but the clinical characteristics and the chest imaging features (emphysema and bronchiectasis) of COPD with previous PTB have not been studied well. Methods: The presence, distribution, and severity of emphysema and bronchiectasis in COPD patients with and without previous PTB were evaluated by high-resolution computed tomography (HRCT) and compared. Demographic data, respiratory symptoms, lung function, and sputum culture of Pseudomonas aeruginosa were also compared between patients with and without previous PTB...
2018: International Journal of Chronic Obstructive Pulmonary Disease
Carol Kelly, Seamus Grundy, Dave Lynes, David Jw Evans, Sharada Gudur, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a long term respiratory condition with an increasing rate of diagnosis. It is associated with persistent symptoms, repeated infective exacerbations, and reduced quality of life, imposing a burden on individuals and healthcare systems. The main aims of therapeutic management are to reduce exacerbations and improve quality of life. Self-management interventions are potentially important for empowering people with bronchiectasis to manage their condition more effectively and to seek care in a timely manner...
February 7, 2018: Cochrane Database of Systematic Reviews
J Benzaquen, J Pradelli, B Padovani, C H Marquette, S Leroy
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a common condition that may initially look simple but may conceal other diseases capable of accelerating its natural history or even simulating it. We describe four cases presenting as COPD with emphysema that were reclassified on the basis of certain clinical characteristics and the radiological pattern. CASE REPORTS: A 52 year old never smoking woman presenting with emphysema was eventually diagnosed as having lymphangioleiomyomatosis on the basis of an abdominal CT scan showing kidney angiomyolipomas...
January 2018: Revue des Maladies Respiratoires
David Mayhew, Nathalie Devos, Christophe Lambert, James R Brown, Stuart C Clarke, Viktoriya L Kim, Michal Magid-Slav, Bruce E Miller, Kristoffer K Ostridge, Ruchi Patel, Ganesh Sathe, Daniel F Simola, Karl J Staples, Ruby Sung, Ruth Tal-Singer, Andrew C Tuck, Stephanie Van Horn, Vincent Weynants, Nicholas P Williams, Jeanne-Marie Devaster, Tom M A Wilkinson
BACKGROUND: Alterations in the composition of the lung microbiome associated with adverse clinical outcomes, known as dysbiosis, have been implicated with disease severity and exacerbations in COPD. OBJECTIVE: To characterise longitudinal changes in the lung microbiome in the AERIS study (Acute Exacerbation and Respiratory InfectionS in COPD) and their relationship with associated COPD outcomes. METHODS: We surveyed 584 sputum samples from 101 patients with COPD to analyse the lung microbiome at both stable and exacerbation time points over 1 year using high-throughput sequencing of the 16S ribosomal RNA gene...
January 31, 2018: Thorax
James D Chalmers, Stefano Aliberti, Anna Filonenko, Michal Shteinberg, Pieter C Goeminne, Adam T Hill, Thomas C Fardon, Dusanka Obradovic, Christoph Gerlinger, Giovanni Sotgiu, Elisabeth Operschall, Robert M Rutherford, Katerina Dimakou, Eva Polverino, Anthony De Soyza, Melissa J McDonnell
RATIONALE: Exacerbations are key events in the natural history of bronchiectasis, but clinical predictors and outcomes of frequently exacerbating patients are not well described. OBJECTIVES: To establish if there is a "frequent exacerbator phenotype" in bronchiectasis and the impact of exacerbations on long-term clinical outcomes. METHODS: We studied bronchiectasis patients enrolled from 10 clinical centres in Europe and Israel, with up to 5-years follow-up...
January 22, 2018: American Journal of Respiratory and Critical Care Medicine
Ellen Tufvesson, Hanna Markstad, Gracijela Bozovic, Marie Ekberg, Leif Bjermer
The presence of bacteria in the lower airways in COPD results in inflammation, further airway structural damage, and might lead to repeated exacerbations. We have previously shown that chronic colonization of Haemophilus influenzae during stable disease is related to increased inflammation, and we now aimed to relate previous findings of bacterial colonization and inflammation to the degree of radiological findings of bronchiectasis and emphysema. Thirty-nine patients with COPD were included in their stable state, and a high-resolution computed tomography of the lung was performed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
George M Solomon, Lianwu Fu, Steven M Rowe, James F Collawn
Airways diseases, especially chronic obstructive pulmonary disease (COPD) and asthma, are common causes of morbidity and mortality worldwide. There is an ongoing unmet need for novel and effective therapies. There is an established pathophysiological link and phenotypic similarity between the chronic bronchitis phenotype of COPD and cystic fibrosis (CF). New evidence suggests that CFTR dysfunction may play a role in other common airways diseases such as COPD, non-atopic asthma and non-CF bronchiectasis. Newly approved and investigational drugs that target both mutant and wild-type CFTR channels have provided a new treatment opportunity addressing the mucus defect in pulmonary diseases that share the same pathophysiology with CF...
June 2017: Current Opinion in Pharmacology
Alison J Dicker, Megan L Crichton, Andrew J Cassidy, Gill Brady, Adrian Hapca, Roger Tavendale, Gisli G Einarsson, Elizabeth Furrie, J Stuart Elborn, Stuart Schembri, Sara E Marshall, Colin N A Palmer, James D Chalmers
BACKGROUND: In cystic fibrosis and bronchiectasis, genetic mannose binding lectin (MBL) deficiency is associated with increased exacerbations and earlier mortality; associations in COPD are less clear. Preclinical data suggest MBL interferes with phagocytosis of Haemophilus influenzae, a key COPD pathogen. We investigated whether MBL deficiency impacted on clinical outcomes or microbiota composition in COPD. METHODS: Patients with COPD (n=1796) underwent MBL genotyping; linkage to health records identified exacerbations, lung function decline and mortality...
November 3, 2017: Thorax
Jordan Minov, Saso Stoleski, Dragan Mijakoski, Kristin Vasilevska, Aneta Atanasovska
There is evidence that coexisting bronchiectasis (BE) in patients with chronic obstructive pulmonary disease (COPD) aggravates the course of the disease. In this study, we aimed to evaluate the frequency and severity of bacterial exacerbations in COPD patients with BE. The frequency and duration of bacterial exacerbations treated in a 12-month period, as well as the duration of the exacerbation-free interval, were evaluated in 54 patients with COPD (Group D) who were diagnosed and assessed according to official recommendations...
April 11, 2017: Medical Sciences: Open Access Journal
Rong-Bao Zhang, Fei Yuan, Xing-Yu Tan, Quan-Ying He
OBJECTIVE: To investigate the presence of previously undiagnosed radiographic bronchiectasis in stable chronic obstructive pulmonary disease (COPD) patients using high resolution computed tomography (HRCT) and to evaluate the effect of radiographic bronchiectasis on the symptoms and risks in stable COPD patients. METHODS: From May 2012 to April 2014, there were 347 patients enrolled in COPD database. Data describing the general conditions, the frequency of acute exacerbations the year before, COPD assessment test, modified medical research council (mMRC) score, spirometric classification, and HRCT were collected...
September 2017: Chronic diseases and translational medicine
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