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COPD, Asthma, Pulmonary Function Tests

Indranil Mukhopadhyay, Abhay Kulkarni, Neelima Khairatkar-Joshi
Transient Receptor Potential Ankyrin 1 (TRPA1) ion channel is expressed abundantly on the C fibers that innervate almost entire respiratory tract starting from oral cavity and oropharynx, conducting airways in the trachea, bronchi, terminal bronchioles, respiratory bronchioles and upto alveolar ducts and alveoli. Functional presence of TRPA1 on non-neuronal cells got recognized recently. TRPA1 plays a well-recognized role of "chemosensor", detecting presence of exogenous irritants and endogenous pro-inflammatory mediators that are implicated in airway inflammation and sensory symptoms like chronic cough, asthma, chronic obstructive pulmonary disease (COPD), allergic rhinitis and cystic fibrosis...
November 5, 2016: Pharmaceuticals
F Braido, N Scichilone, F Lavorini, O S Usmani, L Dubuske, L P Boulet, R Mosges, C Nunes, M Sanchez-Borges, I J Ansotegui, M Ebisawa, F Levi-Schaffer, L J Rosenwasser, J Bousquet, T Zuberbier, G Walter Canonica, A Cruz, A Yanez, A Yorgancioglu, D Deleanu, G Rodrigo, J Berstein, K Ohta, P Vichyanond, R Pawankar, S N Gonzalez-Diaz, S Nakajima, T Slavyanskaya, A Fink-Wagner, C Baez Loyola, D Ryan, G Passalacqua, J Celedon, J C Ivancevich, K Dobashi, M Zernotti, M Akdis, S Benjaponpitak, S Bonini, W Burks, L Caraballo, Z Awad El-Sayed, S Fineman, P Greenberger, E Hossny, J A Ortega-Martell, H Saito, M Tang, L Zhang
Evidence that enables us to identify, assess, and access the small airways in asthma and chronic obstructive pulmonary disease (COPD) has led INTERASMA (Global Asthma Association) and WAO to take a position on the role of the small airways in these diseases. Starting from an extensive literature review, both organizations developed, discussed, and approved the manifesto, which was subsequently approved and endorsed by the chairs of ARIA and GA(2)LEN. The manifesto describes the evidence gathered to date and defines and proposes issues on small airway involvement and management in asthma and COPD with the aim of challenging assumptions, fostering commitment, and bringing about change...
2016: World Allergy Organization Journal
Caroline Anne Mitchell, Alice Pitt, Joe Hulin, Rod Lawson, Fleur Ashby, Ivan Appelqvist, Brigitte Delaney
OBJECTIVES: Increased rates of illicit drug inhalation are thought to expose opiate misusers (OMUs) to an enhanced risk of respiratory health problems. This pilot study aimed to determine the feasibility of undertaking respiratory screening of OMUs in a community clinic. SETTING: Single-centre UK community substance misuse clinic. PARTICIPANTS: All clinic attendees receiving treatment for opiate misuse were eligible to participate. 36 participants (mean age=37) were recruited over a 5-week period...
October 14, 2016: BMJ Open
Feng-Jia Chen, Xin-Yan Huang, Yang-Li Liu, Geng-Peng Lin, Can-Mao Xie
BACKGROUND: Fractional exhaled nitric oxide (FeNO) is an easy, sensitive, reproducible, and noninvasive marker of eosinophilic airway inflammation. Accordingly, FeNO is extensively used to diagnose and manage asthma. Patients with COPD who share some of the features of asthma have a condition called asthma-COPD overlap syndrome (ACOS). The feasibility of using FeNO to differentiate ACOS patients from asthma and COPD patients remains unclear. METHODS: From February 2013 to May 2016, patients suspected with asthma and COPD through physician's opinion were subjected to FeNO measurement, pulmonary function test (PFT), and bronchial hyperresponsiveness or bronchodilator test...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Dhamotharan Pattarayan, Rajesh K Thimmulappa, Vilwanathan Ravikumar, Subbiah Rajasekaran
Lack of markers of subclinical disease state and clinical phenotype other than pulmonary function test has made the diagnosis and interventions of environmental respiratory diseases a major challenge. MicroRNAs (miRNAs), small non-coding single stranded RNAs, have emerged as potential disease-modifier in various environmental respiratory diseases. They can also be found in various body fluids and are remarkably stable. Because of their high stability, disease-specific expression, and the ease to detect and quantify them have raised the potential of miRNAs in body fluids to be useful clinical diagnostic biomarkers for lung disease phenotyping...
September 27, 2016: Clinical Reviews in Allergy & Immunology
Chiharu Yoshii, Soushi Uchida, Shingo Noguchi, Ryo Torii, Ikuko Shimabukuro, Kazuhiro Yatera
Although chronic obstructive pulmonary disease (COPD) affects one in several smokers, only a few patients are correctly diagnosed compared to the estimated number of patients. Several recent reports indicate that the development of rotator cuff tears is related to smoking. In this study, we investigated smoking status in patients with rotator cuff tears and evaluated the possibility of undiagnosed COPD by a pulmonary function test. The subjects were 150 consecutive patients over 40 years old, who had been diagnosed with rotator cuff tears and had been examined by a pulmonary function test before surgery in our orthopedic department between April 2011 and June 2015...
September 2016: Journal of UOEH
Sevket Ozkaya, Adem Dirican, Tibel Tuna
Airway obstruction is variable in asthma, while it is progressive and persistent in chronic bronchitis and emphysema. However, some of the patients presenting with symptoms of chronic airway diseases have clinical features of both asthma and COPD. The group with "Asthma-COPD Overlap Syndrome" (ACOS) phenotype was characterized by definitely irreversible airway obstruction accompanied by symptoms and signs of reversibility. In this study, we aimed to classify obstructive airway diseases by clinical, radiological, and pulmonary function tests...
2016: International Journal of Chronic Obstructive Pulmonary Disease
P Ning, Y F Guo, T Y Sun, H S Zhang, D Chai, X M Li
OBJECTIVE: To study the distinct clinical phenotype of chronic airway diseases by hierarchical cluster analysis and two-step cluster analysis. METHODS: A population sample of adult patients in Donghuamen community, Dongcheng district and Qinghe community, Haidian district, Beijing from April 2012 to January 2015, who had wheeze within the last 12 months, underwent detailed investigation, including a clinical questionnaire, pulmonary function tests, total serum IgE levels, blood eosinophil level and a peak flow diary...
September 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Paul Enright Md
Measurement of diffusing capacity of the lungs for carbon monoxide (DLCO), also known as transfer factor, is the second most important pulmonary function test (PFT), after spirometry. Previously available only in hospital-based PFT labs, DLCO testing is now available at outpatient clinics using a portable device. Compared to spirometry tests, assessments with these devices require very little effort. The patient breathes quietly, inhales the test gas, holds the breath for ten seconds, and then exhales. In adult smokers with post-bronchodilator airway obstruction, a low DLCO greatly increases the probability of the emphysema phenotype of COPD due to cigarette smoking, while a normal DLCO makes chronic asthma more likely...
September 2016: Respiratory Investigation
B Schullcke, S Krueger-Ziolek, B Gong, U Mueller-Lisse, K Moeller
Besides the application of EIT in the intensive care unit it has recently also been used in spontaneously breathing patients suffering from asthma bronchiole, cystic fibrosis (CF) or chronic obstructive pulmonary disease (COPD). In these cases large thorax excursions during deep inspiration, e.g. during lung function testing, lead to artifacts in the reconstructed images. In this paper we introduce a new approach to compensate for image artifacts resulting from excursion induced changes in boundary voltages...
September 2016: Physiological Measurement
Roland Buhl, Carl-Peter Criée, Peter Kardos, Claus Vogelmeier, Nadine Lossi, Claudia Mailänder, Heinrich Worth
INTRODUCTION: Randomized interventional trials generally recruit highly selected patients. In contrast, long-term, noninterventional studies can reflect standard of care of real-life populations. DACCORD (Die ambulante Versorgung mit langwirksamen Bronchodilatatoren: COPD-Register in Deutschland [Outpatient Care With Long-Acting Bronchodilators: COPD Registry in Germany]) is an ongoing observational study, conducted in primary and secondary care in Germany, aiming to describe the impact of disease and treatments on real-life patients with chronic obstructive pulmonary disease (COPD)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Katarzyna Gorska, Piotr Korczynski, Michal Mierzejewski, Justyna Kosciuch, Malgorzata Zukowska, Marta Maskey-Warzechowska, Rafal Krenke
INTRODUCTION: Airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) results in bronchial wall thickening. Bronchial wall thickness (BWT) can be assessed in high-resolution computed tomography (HRCT) and endobronchial ultrasound (EBUS). AIMS: To compare BWT measured by EBUS and HRCT in patients with mild-to-moderate asthma and COPD, and to evaluate the relationship between the BWT and pulmonary function. METHODS: The study included patients with mild-to-moderate asthma (n = 24), COPD (n = 36) and controls (n = 12)...
August 2016: Respiratory Medicine
Julia H Barton, Alex Ireland, Meghan Fitzpatrick, Cathy Kessinger, Danielle Camp, Renee Weinman, Deborah McMahon, Joseph K Leader, Fernando Holguin, Sally E Wenzel, Alison Morris, Matthew R Gingo
BACKGROUND: Airflow obstruction, which encompasses several phenotypes, is common among HIV-infected individuals. Obesity and adipose-related inflammation are associated with both COPD (fixed airflow obstruction) and asthma (reversible airflow obstruction) in HIV-uninfected persons, but the relationship to airway inflammation and airflow obstruction in HIV-infected persons is unknown. The objective of this study was to determine if adiposity and adipose-associated inflammation are associated with airway obstruction phenotypes in HIV-infected persons...
2016: BMC Pulmonary Medicine
Marija Vukoja, Ivan Kopitovic, Dragana Milicic, Olivera Maksimovic, Zora Pavlovic-Popovic, Miroslav Ilic
INTRODUCTION: Nocturnal symptoms are common and important in both asthma and COPD but the relationship between sleep quality and diseases' characteristics has not been fully studied. OBJECTIVE: To compare sleep quality and daytime sleepiness in asthma and COPD patients and to explore its relation to diseases' characteristics. METHODS: In this cross-sectional study we examined 217 consecutive asthma and COPD patients who underwent pulmonary function tests at The Center for Pathophysiology of Breathing and Sleep Medicine of The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia between July 2014 and January 2015...
July 12, 2016: Clinical Respiratory Journal
Yoshiaki Kitaguchi, Masanori Yasuo, Masayuki Hanaoka
BACKGROUND: This study was conducted in order to investigate the differences in the respiratory physiology of patients with chronic obstructive pulmonary disease (COPD), asthma-COPD overlap syndrome (ACOS), and asthma with airflow limitation (asthma FL(+)). METHODS: The medical records for a series of all stable patients with persistent airflow limitation due to COPD, ACOS, or asthma were retrospectively reviewed and divided into the COPD group (n=118), the ACOS group (n=32), and the asthma FL(+) group (n=27)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Antonio Carlos Maneira Godinho Netto, Túlio Gonçalves Dos Reis, Cássia Franco Matheus, Beatriz Julião Vieira Aarestrup, Fernando Monteiro Aarestrup
OBJECTIVE: To assess the value of fraction of exhaled nitric oxide (FeNO) measurements in the diagnosis of asthma in elderly patients. METHODS: The clinical symptoms of 202 elderly patients were assessed with the asthma module of the International Study of Asthma and Allergies in Childhood test, which had been modified for the elderly patients, and the diagnostic routine for chronic obstructive pulmonary disease (COPD), which was based on the Global initiative for chronic Obstructive Lung Disease criteria...
2016: Clinical Interventions in Aging
Mengshuang Xie, Wei Wang, Shuang Dou, Liwei Cui, Wei Xiao
BACKGROUND: The diagnostic criteria of asthma-COPD overlap syndrome (ACOS) are controversial. Emphysema is characteristic of COPD and usually does not exist in typical asthma patients. Emphysema in patients with asthma suggests the coexistence of COPD. Quantitative computed tomography (CT) allows repeated evaluation of emphysema noninvasively. We investigated the value of quantitative CT measurements of emphysema in the diagnosis of ACOS. METHODS: This study included 404 participants; 151 asthma patients, 125 COPD patients, and 128 normal control subjects...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Henrik Watz
Symptomatic patients with airflow limitation need to have a diagnostic follow-up to distinguish chronic obstructive pulmonary disease (COPD) from asthma. In the majority of cases this can be easily done based on symptoms, exposition to e. g. allergens or cigarette smoke, measures of allergy, and extensive lung function testing. In a minority of patients, however, it is difficult to distinguish between asthma and COPD. The term "asthma-copd-overlap-syndrome" has been proposed fur such cases. The current problem with this proposal is the lack of studies that all used the same criteria to better characterize this syndrome...
May 2016: Deutsche Medizinische Wochenschrift
Prescott G Woodruff, R Graham Barr, Eugene Bleecker, Stephanie A Christenson, David Couper, Jeffrey L Curtis, Natalia A Gouskova, Nadia N Hansel, Eric A Hoffman, Richard E Kanner, Eric Kleerup, Stephen C Lazarus, Fernando J Martinez, Robert Paine, Stephen Rennard, Donald P Tashkin, MeiLan K Han
BACKGROUND: Currently, the diagnosis of chronic obstructive pulmonary disease (COPD) requires a ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) of less than 0.70 as assessed by spirometry after bronchodilator use. However, many smokers who do not meet this definition have respiratory symptoms. METHODS: We conducted an observational study involving 2736 current or former smokers and controls who had never smoked and measured their respiratory symptoms using the COPD Assessment Test (CAT; scores range from 0 to 40, with higher scores indicating greater severity of symptoms)...
May 12, 2016: New England Journal of Medicine
Shu-Yi Huang, Pai-Chien Chou, Tsai-Yu Wang, Yu-Lun Lo, Wen-Ching Joa, Li-Fei Chen, Te-Fang Sheng, Kian Fan Chung, Chun-Hua Wang, Han-Pin Kuo
Asthmatic patients with fixed airway obstruction (FAO) and patients with chronic obstructive pulmonary disease (COPD) share similarities in terms of irreversible pulmonary function impairment. Exhaled nitric oxide (eNO) has been documented as a marker of airway inflammation in asthma, but not in COPD. To examine whether the basal eNO level and the change after exercise may differentiate asthmatics with FAO from COPD, 27 normal subjects, 60 stable asthmatics, and 62 stable COPD patients were studied. Asthmatics with FAO (n = 29) were defined as showing a postbronchodilator FEV1/forced vital capacity (FVC) ≤70% and FEV1 less than 80% predicted after inhaled salbutamol (400 μg)...
April 2016: Medicine (Baltimore)
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