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https://www.readbyqxmd.com/read/28929906/the-important-role-of-primary-care-providers-in-the-detection-of-alpha-1-antitrypsin-deficiency
#1
Jorge E Lascano, Michael A Campos
OBJECTIVE: Alpha-1 antitrypsin deficiency (AATD) is an underrecognized genetic disorder that can cause chronic obstructive pulmonary disease (COPD) and liver cirrhosis, two clinical conditions commonly seen by primary care physicians. AATD is estimated to affect 1/4000-1/5000 people in the United States and 1-2% of all COPD cases. METHODS: PubMed was searched for relevant articles using AAT/AATD-related terms. RESULTS: Unfortunately, <10% of symptomatic individuals have been properly diagnosed primarily due to the underdiagnosis of COPD and the lack of awareness of AATD as a possible underlying cause...
September 20, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28929109/genetic-variants-in-the-hedgehog-interacting-protein-gene-are-associated-with-the-fev1-fvc-ratio-in-southern-han-chinese-subjects-with-chronic-obstructive-pulmonary-disease
#2
Zili Zhang, Jian Wang, Zeguang Zheng, Xindong Chen, Xiansheng Zeng, Yi Zhang, Defu Li, Jiaze Shu, Kai Yang, Ning Lai, Lian Dong, Wenju Lu
BACKGROUND: Convincing evidences have demonstrated the associations between HHIP and FAM13a polymorphisms and COPD in non-Asian populations. Here genetic variants in HHIP and FAM13a were investigated in Southern Han Chinese COPD. METHODS: A case-control study was conducted, including 989 cases and 999 controls. The associations between SNPs genotypes and COPD were performed by a logistic regression model; for SNPs and COPD-related phenotypes such as lung function, COPD severity, pack-year of smoking, and smoking status, a linear regression model was employed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28919731/sensitization-to-aspergillus-fumigatus-as-a-risk-factor-for-bronchiectasis-in-copd
#3
Stephanie Everaerts, Katrien Lagrou, Adriana Dubbeldam, Natalie Lorent, Kristina Vermeersch, Erna Van Hoeyveld, Xavier Bossuyt, Lieven J Dupont, Bart M Vanaudenaerde, Wim Janssens
BACKGROUND: Bronchiectasis-chronic obstructive pulmonary disease (COPD) overlap presents a possible clinical phenotype of COPD, but it is unclear why it develops in a subset of patients. We hypothesized that sensitization to Aspergillus fumigatus (A fum) is associated with bronchiectasis in COPD and occurs more frequently in vitamin D-deficient patients. METHODS: This observational study investigated sensitization to A fum in an outpatient clinical cohort of 300 COPD patients and 50 (ex-) smoking controls...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28915894/cardiovascular-risk-in-patients-with-alpha-1-antitrypsin-deficiency
#4
Sebastian Fähndrich, Frank Biertz, Annika Karch, Björn Kleibrink, Armin Koch, Helmut Teschler, Tobias Welte, Hans-Ulrich Kauczor, Sabina Janciauskiene, Rudolf A Jörres, Timm Greulich, Claus F Vogelmeier, Robert Bals
BACKGROUND: Alpha-1-antitrypsin deficiency (AATD) is a rare inherited condition caused by mutations of the SERPINA1 gene that is associated with the development of a COPD like lung disease. The comorbidities in patients with AATD-related lung diseases are not well defined. The aim of this study was to analyze the clinical phenotype of AATD patients within the German COPD cohort study COSYCONET ("COPD and SYstemic consequences-COmorbidities NETwork") cohort focusing on the distribution of comorbidities...
September 15, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28910816/mediastinal-and-subcutaneous-chest-fat-are-differentially-associated-with-emphysema-progression-and-clinical-outcomes-in-smokers
#5
Jon Grace, Joseph K Leader, Seyed M Nouraie, Jiantao Pu, Divay Chandra, Yingze Zhang, Frank C Sciurba, Jessica Bon
BACKGROUND: Studies have demonstrated both positive and negative effects of obesity on clinical outcomes in chronic obstructive pulmonary disease (COPD). In other chronic diseases, fat location is differentially associated with disease outcomes; however, this relationship has not been well studied in COPD. OBJECTIVE: To determine if fat location explains the differential association of body mass index (BMI) with clinical outcome measures in smokers. METHODS: Baseline and 6-year chest computed tomography scans from 68 current and former smokers were used to quantify mediastinal and subcutaneous fat...
September 15, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28906034/small-airway-disease-a-different-phenotype-of-early-stage-copd-associated-with-biomass-smoke-exposure
#6
Dongxing Zhao, Yumin Zhou, Changbin Jiang, Zhuxiang Zhao, Fang He, Pixin Ran
BACKGROUND AND OBJECTIVE: Chronic exposure to biomass smoke (BS) can significantly compromise pulmonary function and lead to chronic obstructive pulmonary disease (COPD). To determine whether BS exposure induces a unique phenotype of COPD from an early stage, with different physiopathological features compared with COPD associated with smoking (cigarette-smoke (CS) COPD), we assessed the physiopathology of early COPD associated with BS exposure (BS COPD) by incorporating spirometry, high-resolution computed tomography (HRCT) imaging, bronchoscopy and pathological examinations...
September 14, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28893134/mepolizumab-for-eosinophilic-chronic-obstructive-pulmonary-disease
#7
Ian D Pavord, Pascal Chanez, Gerard J Criner, Huib A M Kerstjens, Stephanie Korn, Njira Lugogo, Jean-Benoit Martinot, Hironori Sagara, Frank C Albers, Eric S Bradford, Stephanie S Harris, Bhabita Mayer, David B Rubin, Steven W Yancey, Frank C Sciurba
Background Patients with chronic obstructive pulmonary disease (COPD) with an eosinophilic phenotype may benefit from treatment with mepolizumab, a monoclonal antibody directed against interleukin-5. Methods We performed two phase 3, randomized, placebo-controlled, double-blind, parallel-group trials comparing mepolizumab (100 mg in METREX, 100 or 300 mg in METREO) with placebo, given as a subcutaneous injection every 4 weeks for 52 weeks in patients with COPD who had a history of moderate or severe exacerbations while taking inhaled glucocorticoid-based triple maintenance therapy...
September 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28891938/time-course-of-the-phenotype-of-blood-and-bone-marrow-monocytes-and-macrophages-in-the-lung-after-cigarette-smoke-exposure-in-vivo
#8
Camila Oliveira da Silva, Andréa Monte-Alto-Costa, Mariana Renovato-Martins, Filipe Jorge Viana Nascimento, Samuel Dos Santos Valença, Vincent Lagente, Luís Cristóvão Pôrto, Tatiana Victoni
Alveolar macrophages play a central role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Monocytes are recruited from blood during inflammation and then mature into alveolar macrophages. The aim of this study was to investigate the effect of cigarette smoke (CS) at different times in lung macrophages and monocytes from blood and bone marrow in mice. Male mice (C57BL/6, n = 45) were divided into groups: control, CS 5 days, CS 14 days and CS 30 days. Five days' CS exposure induced a pronounced influx of neutrophils and macrophages in the lung associated with increased levels of keratinocyte chemoattractant (KC), tumor necrosis factor-α (TNF-α), nitric oxide (NO) and matrix metalloproteinase (MMP)-12...
September 9, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28872030/what-does-endotyping-mean-for-treatment-in-chronic-obstructive-pulmonary-disease
#9
REVIEW
Alvar Agustí, Bartolome Celli, Rosa Faner
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease, both at the clinical and biological level. However, COPD is still diagnosed and treated according to simple clinical measures (level of airflow limitation, symptoms, and frequency of previous exacerbations). To address this clinical and biological complexity and to move towards precision medicine in COPD, we need to integrate (bioinformatics) and interpret (clinical science) the vast amount of high-throughput information that existing technology provides (systems biology and network medicine) so diagnosis, stratification, and treatment of patients with COPD can occur on the basis of their pathobiological mechanism (ie, endotypes)...
September 2, 2017: Lancet
https://www.readbyqxmd.com/read/28863927/the-role-of-non-invasive-modalities-for-assessing-inflammation-in-patients-with-non-cystic-fibrosis-bronchiectasis
#10
Stamatoula Tsikrika, Katerina Dimakou, Andriana I Papaioannou, Georgios Hillas, Loukas Thanos, Kostantinos Kostikas, Stelios Loukides, Spyros Papiris, Nickolaos Koulouris, Petros Bakakos
INTRODUCTION: Bronchiectasis is a heterogeneous entity, taking into account clinical characteristics, inflammatory response, effectiveness of treatment and frequency of exacerbations. In stable state non-cystic fibrosis (non-CF) bronchiectasis, little is known about non-invasive techniques used for evaluating airway inflammation in obstructive airway diseases. OBJECTIVES: We sought to evaluate the associations between induced sputum and clinical/radiologic characteristics, and the differences between biomarkers expressing Th1 and Th2 response in patients with non-CF bronchiectasis and to compare our findings with a previously studied population of patients with asthma and COPD...
August 29, 2017: Cytokine
https://www.readbyqxmd.com/read/28860828/the-evolving-role-of-tiotropium-in-asthma
#11
REVIEW
Emma R McIvor, R Andrew McIvor
Tiotropium is a long-acting muscarinic antagonist (LAMA) that exerts its bronchodilatory effect by blocking endogenous acetylcholine receptors in the airways. Its safety and efficacy are well established for the treatment of COPD, and it is now being recognized for its role in improving lung function and control in asthma. This review discusses the evolving role of tiotropium delivered by the Respimat(®) in patients across the range of asthma severities and ages, and provides an overview of safety and efficacy data...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28842670/the-cellular-and-molecular-determinants-of-emphysematous-destruction-in-copd
#12
Masaru Suzuki, Marc A Sze, Joshua D Campbell, John F Brothers, Marc E Lenburg, John E McDonough, W Mark Elliott, Joel D Cooper, Avrum Spira, James C Hogg
The introduction of microCT has made it possible to show that the terminal bronchioles are narrowed and destroyed before the onset of emphysematous destruction in COPD. This report extends those observations to the cellular and molecular level in the centrilobular phenotype of emphysematous destruction in lungs donated by persons with very severe COPD (n = 4) treated by lung transplantation with unused donor lungs (n = 4) serving as controls. These lung specimens provided companion samples to those previously examined by microCT (n = 61) that we examined using quantitative histology (n = 61) and gene expression profiling (n = 48)...
August 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28841671/microbiome-balance-in-sputum-determined-by-pcr-stratifies-copd-exacerbations-and-shows-potential-for-selective-use-of-antibiotics
#13
Koirobi Haldar, Mona Bafadhel, Kelvin Lau, Adam Berg, Brenda Kwambana, Tatiana Kebadze, Mohammadali Yavari Ramsheh, Bethan Barker, Pranabashis Haldar, Sebastian Johnston, Julian M Ketley, Christopher E Brightling, Michael R Barer
BACKGROUND: While a subgroup of patients with exacerbations of chronic obstructive pulmonary disease (COPD) clearly benefit from antibiotics, their identification remains challenging. We hypothesised that selective assessment of the balance between the two dominant bacterial groups (Gammaproteobacteria (G) and Firmicutes (F)) in COPD sputum samples might reveal a subgroup with a bacterial community structure change at exacerbation that was restored to baseline on recovery and potentially reflects effective antibiotic treatment...
2017: PloS One
https://www.readbyqxmd.com/read/28828380/small-airway-imaging-phenotypes-in-biomass-and-tobacco-smoke-exposed-patients-with-copd
#14
Lalita Fernandes, Nandani Gulati, Yasmin Fernandes, Anthony Menezes Mesquita, Mahesh Sardessai, Jan-Willem J Lammers, Firdaus A Mohamed Hoesein, Nick H T Ten Hacken, Maarten van den Berge, Craig J Galbán, Salman Siddiqui
Biomass and functional small airway disease http://ow.ly/gXu730abpKu.
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28822449/-cytokine-profiles-of-cd4-t-memory-cells-in-asthma-and-their-relationship-with-asthma-severity
#15
C L Du, K Xu, Z H Min, D D Li, H L Yuan, C Liu, Z H Chen
Objective: To study the phenotype of memory CD4(+) T cells in peripheral blood of asthmatics and its relationship with asthma severity. Methods: From Dec 2014 to Aug 2015, thirty-three asthmatics, twenty-six chronic obstructive pulmonary disease (COPD) patients and twenty-two healthy volunteers were enrolled in Respiratory Clinics of Zhongshan Hospital, Fudan University. Peripheral blood mononuclear cells (PBMCs) were isolated from peripheral blood. Cell surface markers (CD45RO, CRTH2, CD62L, and CCR7) and intracellular protein[interleukin (IL)-5, IL-17, interferon (IFN)-γ]staining was performed using flow-cytometric techniques...
August 8, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28814851/effect-of-allergic-phenotype-on-treatment-response-to-inhaled-bronchodilators-with-or-without-inhaled-corticosteroids-in-patients-with-copd
#16
Shih-Lung Cheng, Hsu Hui Wang, Ching-Hsiung Lin
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder encompassing different phenotypes with different responses to treatment. The present 1-year, two-center hospital-based study investigated whether the plasma immunoglobulin E (IgE) level and/or eosinophil cell count could be used as biomarkers to stratify patients with COPD according to predicted responses to inhaled corticosteroids (ICS)-based therapy. METHODS: A hospital-data based cohort study of COPD patients treated at two territory hospital centers was conducted for 1 year...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28812906/recent-advances-in-ct-imaging-in-chronic-obstructive-pulmonary-disease
#17
Sandeep Bodduluri, Joseph M Reinhardt, Eric A Hoffman, John D Newell, Surya P Bhatt
Lung imaging is increasingly being used to diagnose, quantify and phenotype chronic obstructive pulmonary disease (COPD). Although spirometry is the gold standard for the diagnosis of COPD and for severity staging, the role of computed tomography (CT) imaging has expanded in both clinical practice and research. COPD is a heterogeneous disease with considerable variability in clinical features, radiographic disease, progression and outcomes. Recent studies have examined the utility of CT imaging in enhancing diagnostic certainty, improving phenotyping, predicting disease progression and prognostication, patient selection for intervention, and also in furthering our understanding of the complex pathophysiology of this disease...
August 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28790809/clinical-characteristics-of-chronic-bronchitic-emphysematous-and-acos-phenotypes-in-copd-patients-with-frequent-exacerbations
#18
Yusheng Cheng, Xiongwen Tu, Linlin Pan, Shuai Lu, Ming Xing, Linlin Li, Xingwu Chen
PURPOSE: Chronic bronchitis (CB), emphysematous (EM) and asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) phenotypes in COPD are well recognized. This study aimed to investigate distinguishing characteristics of these phenotypes in COPD patients with frequent exacerbations (FE). PATIENTS AND METHODS: A retrospective study was carried out. COPD patients with acute exacerbations were consecutively reviewed from November 2015 to October 2016...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28762936/-the-phenotype-of-chronic-obstructive-pulmonary-disease-with-frequent-exacerbations-in-the-aspect-of-long-term-percutaneous-coronary-intervention-results
#19
V K Zafiraki, A M Namitokov, K V Skaletsky, E D Kosmacheva, L V Shulzhenko, J M Ramazanov, A A Omarov, I V Pershukov
OBJECTIVE: To evaluate the results of percutaneous coronary interventions (PCI) in patients with coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD), depending on the frequency of exacerbations of COPD. MATERIALS AND METHODS: We enrolled in this prospective study 103 patients with CHD and COPD who underwent PCI (n=103) including 25 who satisfied criteria of COPD phenotype with frequent exacerbations (main group). Analysis included comparison of rates and times to major adverse cardiac events (MACE - myocardial infarction, stroke, cardiac death, repeat revascularization) in the main group and other patients...
March 2017: Kardiologiia
https://www.readbyqxmd.com/read/28740378/active-smoking-and-copd-phenotype-distribution-and-impact-on-prognostic-factors
#20
Juan Antonio Riesco, Bernardino Alcázar, Juan Antonio Trigueros, Anna Campuzano, Joselín Pérez, José Luis Lorenzo
PURPOSE: Smoking can affect both the phenotypic expression of COPD and factors such as disease severity, quality of life, and comorbidities. Our objective was to evaluate if the impact of active smoking on these factors varies according to the disease phenotype. PATIENTS AND METHODS: This was a Spanish, observational, cross-sectional, multicenter study of patients with a diagnosis of COPD. Smoking rates were described among four different phenotypes (non-exacerbators, asthma-COPD overlap syndrome [ACOS], exacerbators with emphysema, and exacerbators with chronic bronchitis), and correlated with disease severity (body mass index, obstruction, dyspnea and exacerbations [BODEx] index and dyspnea grade), quality of life according to the COPD assessment test (CAT), and presence of comorbidities, according to phenotypic expression...
2017: International Journal of Chronic Obstructive Pulmonary Disease
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