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Pulmonary Emphysema subtype

James C Ross, Peter J Castaldi, Michael H Cho, Junxiang Chen, Yale Chang, Jennifer G Dy, Edwin K Silverman, George R Washko, Raul San Jose Estepar
We introduce a novel Bayesian nonparametric model that uses the concept of disease trajectories for disease subtype identification. Although our model is general, we demonstrate that by treating fractions of tissue patterns derived from medical images as compositional data, our model can be applied to study distinct progression trends between population subgroups. Specifically, we apply our algorithm to quantitative emphysema measurements obtained from chest CT scans in the COPDGene Study and show several distinct progression patterns...
January 2017: IEEE Transactions on Medical Imaging
Li Gao, Sheng Xie, Hui Liu, Pingping Liu, Yan Xiong, Jiping Da, Chengli Que, Huaping Dai, Chen Wang
OBJECTIVE: Combined pulmonary fibrosis and emphysema (CPFE) is a newly defined entity that comprises upper lobe emphysema and lower lobe fibrosis. Patients with CPFE are at high risk for lung cancer and have poor prognoses. To investigate the clinical and pathological characteristics of lung cancer with CPFE, lung cancers with CPFE and Non-CPFE interstitial lung disease (ILD) were reevaluated by 2015 WHO classification and compared. METHODS: A total of 60 patients with histologically proven lung cancer were selected from the database of two institutional medical centers...
October 21, 2016: Clinical Respiratory Journal
Kristoffer Ostridge, Nicholas Williams, Viktoriya Kim, Stephen Harden, Simon Bourne, Ngaire A Coombs, Paul T Elkington, Raul San Jose Estepar, George Washko, Karl J Staples, Tom M A Wilkinson
BACKGROUND: Emphysema is characterised by distinct pathological sub-types, but little is known about the divergent underlying aetiology. Matrix-metalloproteinases (MMPs) are proteolytic enzymes that can degrade the extracellular matrix and have been identified as potentially important in the development of emphysema. However, the relationship between MMPs and emphysema sub-type is unknown. We investigated the role of MMPs and their inhibitors in the development of emphysema sub-types by quantifying levels and determining relationships with these sub-types in mild-moderate COPD patients and ex/current smokers with preserved lung function...
July 26, 2016: Respiratory Research
Álvaro Mena, Héctor Meijide, Pedro J Marcos
The widespread use of HAART for persons living with HIV since 1996 has resulted in a dramatic decline in AIDS-related mortality. However, other comorbidities are increasing, such as metabolic disturbances or cancers, including solid organ malignancies. Among the latest, lung cancer, especially the adenocarcinoma subtype, is on the rise. HIV infection, even controlling for smoking, is an independent risk factor for developing lung cancer. HIV could promote lung cancers through immunosuppression, chronic inflammation, and a direct oncogenic effect...
July 2016: AIDS Reviews
Asger Dirksen, Mathilde M W Wille
Computed tomography (CT) is an obvious modality for subclassification of COPD. Traditionally, the pulmonary involvement of chronic obstructive pulmonary disease (COPD) in smokers is understood as a combination of deleterious effects of smoking on small airways (chronic bronchitis and small airways disease) and distal to the airways with destruction and loss of lung parenchyma (emphysema). However, segmentation of airways is still experimental; with contemporary high-resolution CT (HRCT) we can just see the "entrance" of small airways, and until now changes in airway morphology that have been observed in COPD are subtle...
April 2016: Annals of the American Thoracic Society
Rola Harmouche, James C Ross, Alejandro A Diaz, George R Washko, Raul San Jose Estepar
RATIONALE AND OBJECTIVES: We propose a novel single index for the quantification of emphysema severity based on an aggregation of multiple computed tomographic features evident in the lung parenchyma of smokers. Our goal was to demonstrate that this single index provides complementary information to the current standard measure of emphysema, percent emphysema (percent low attenuation areas [LAA%]), and may be superior in its association with clinically relevant outcomes. MATERIALS AND METHODS: The inputs to our algorithm were objective assessments of multiple emphysema subtypes (normal tissue; panlobular; paraseptal; and mild, moderate, and severe centrilobular emphysema)...
April 2016: Academic Radiology
B Storbeck, T H Schröder, M Oldigs, K F Rabe, C Weber
UNLABELLED: Chronic obstructive pulmonary disease (COPD) is characterized by two entities, the more airway-predominant type ("bronchitis") on the one hand, and emphysema-predominant type on the other. Imaging via high-resolution computed tomography plays an important role in phenotyping COPD. For patients with advanced lung emphysema, new endoscopic lung volume reduction therapies (ELVR) have been developed. Proper selection of suitable patients requires thin-section reconstruction of volumetric CT image data sets also in coronal and sagittal orientation are required...
July 2015: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
David A Lynch, John H M Austin, James C Hogg, Philippe A Grenier, Hans-Ulrich Kauczor, Alexander A Bankier, R Graham Barr, Thomas V Colby, Jeffrey R Galvin, Pierre Alain Gevenois, Harvey O Coxson, Eric A Hoffman, John D Newell, Massimo Pistolesi, Edwin K Silverman, James D Crapo
The purpose of this statement is to describe and define the phenotypic abnormalities that can be identified on visual and quantitative evaluation of computed tomographic (CT) images in subjects with chronic obstructive pulmonary disease (COPD), with the goal of contributing to a personalized approach to the treatment of patients with COPD. Quantitative CT is useful for identifying and sequentially evaluating the extent of emphysematous lung destruction, changes in airway walls, and expiratory air trapping. However, visual assessment of CT scans remains important to describe patterns of altered lung structure in COPD...
October 2015: Radiology
Tetsuro Araki, Mizuki Nishino, Oscar E Zazueta, Wei Gao, Josée Dupuis, Yuka Okajima, Jeanne C Latourelle, Ivan O Rosas, Takamichi Murakami, George T O'Connor, George R Washko, Gary M Hunninghake, Hiroto Hatabu
OBJECTIVE: To investigate the prevalence and distribution of paraseptal emphysema on chest CT images in the Framingham Heart Study (FHS) population, and assess its impact on pulmonary function. Also pursued was the association with interstitial lung abnormalities. MATERIALS AND METHODS: We assessed 2633 participants in the FHS for paraseptal emphysema on chest CT. Characteristics of the participants, including age, sex, smoking status, clinical symptoms, and results of pulmonary function tests, were compared between those with and without paraseptal emphysema...
July 2015: European Journal of Radiology
Stephen I Rennard, Nicholas Locantore, Bruno Delafont, Ruth Tal-Singer, Edwin K Silverman, Jørgen Vestbo, Bruce E Miller, Per Bakke, Bartolomé Celli, Peter M A Calverley, Harvey Coxson, Courtney Crim, Lisa D Edwards, David A Lomas, William MacNee, Emiel F M Wouters, Julie C Yates, Ignacio Coca, Alvar Agustí
RATIONALE: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that likely includes clinically relevant subgroups. OBJECTIVES: To identify subgroups of COPD in ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints) subjects using cluster analysis and to assess clinically meaningful outcomes of the clusters during 3 years of longitudinal follow-up. METHODS: Factor analysis was used to reduce 41 variables determined at recruitment in 2,164 patients with COPD to 13 main factors, and the variables with the highest loading were used for cluster analysis...
March 2015: Annals of the American Thoracic Society
Hayrettin Gocmen, Dane Ediger, Esra Uzaslan, Selim Doganay, Nevin Ay Guney, Ercument Ege
OBJECTIVE: Malnutrition, which is a complication frequently observed in chronic obstructive pulmonary disease (COPD) and negatively affects prognosis, has become a parameter that must be monitored. Even though various methods are applied to assess malnutrition, biochemical parameters, especially serum prealbumin levels, are useful. MATERIALS AND METHODS: The relationships between serum prealbumin levels, which we used as an indicator of malnutrition, with the severity of disease and the parameters predicting emphysema in stable COPD patients with no additional health problems were determined in this prospective study...
December 2010: Eurasian Journal of Medicine
Kelly Suzanne Burrowes, Tom Doel, Chris Brightling
Asthma and chronic obstructive pulmonary disease (COPD) are characterized by airway obstruction and airflow imitation and pose a huge burden to society. These obstructive lung diseases impact the lung physiology across multiple biological scales. Environmental stimuli are introduced via inhalation at the organ scale, and consequently impact upon the tissue, cellular and sub-cellular scale by triggering signaling pathways. These changes are propagated upwards to the organ level again and vice versa. In order to understand the pathophysiology behind these diseases we need to integrate and understand changes occurring across these scales and this is the driving force for multiscale computational modeling...
November 28, 2014: Journal of Translational Medicine
Steven M Kawut, Hooman D Poor, Megha A Parikh, Katja Hueper, Benjamin M Smith, David A Bluemke, João A C Lima, Martin R Prince, Eric A Hoffman, John H M Austin, Jens Vogel-Claussen, R Graham Barr
BACKGROUND: The classic cardiovascular complication of chronic obstructive pulmonary disease (COPD) is cor pulmonale or right ventricular (RV) enlargement. Most studies of cor pulmonale were conducted decades ago. OBJECTIVES: This study sought to examine RV changes in contemporary COPD and emphysema using cardiac magnetic resonance (CMR) imaging. METHODS: We performed a case-control study nested predominantly in 2 general population studies of 310 participants with COPD and control subjects 50 to 79 years of age with ≥10 pack-years of smoking who were free of clinical cardiovascular disease...
November 11, 2014: Journal of the American College of Cardiology
Craig P Hersh, Barry J Make, David A Lynch, R Graham Barr, Russell P Bowler, Peter M A Calverley, Peter J Castaldi, Michael H Cho, Harvey O Coxson, Dawn L DeMeo, Marilyn G Foreman, MeiLan K Han, Benjamin J Harshfield, John E Hokanson, Sharon Lutz, Joe W Ramsdell, Elizabeth A Regan, Stephen I Rennard, Joyce D Schroeder, Frank C Sciurba, Robert M Steiner, Ruth Tal-Singer, Edwin van Beek, Edwin K Silverman, James D Crapo
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been classically divided into blue bloaters and pink puffers. The utility of these clinical subtypes is unclear. However, the broader distinction between airway-predominant and emphysema-predominant COPD may be clinically relevant. The objective was to define clinical features of emphysema-predominant and non-emphysematous COPD patients. METHODS: Current and former smokers from the Genetic Epidemiology of COPD Study (COPDGene) had chest computed tomography (CT) scans with quantitative image analysis...
October 24, 2014: BMC Pulmonary Medicine
Jin Hwa Lee, Michael H Cho, Merry-Lynn N McDonald, Craig P Hersh, Peter J Castaldi, James D Crapo, Emily S Wan, Jennifer G Dy, Yale Chang, Elizabeth A Regan, Megan Hardin, Dawn L DeMeo, Edwin K Silverman
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by marked phenotypic heterogeneity. Most previous studies have focused on COPD subjects with FEV1 < 80% predicted. We investigated the clinical and genetic heterogeneity in subjects with mild airflow limitation in spirometry grade 1 defined by the Global Initiative for chronic Obstructive Lung Disease (GOLD 1). METHODS: Data from current and former smokers participating in the COPDGene Study (NCT00608764) were analyzed...
October 2014: Respiratory Medicine
Emily S Wan, Peter J Castaldi, Michael H Cho, John E Hokanson, Elizabeth A Regan, Barry J Make, Terri H Beaty, MeiLan K Han, Jeffrey L Curtis, Douglas Curran-Everett, David A Lynch, Dawn L DeMeo, James D Crapo, Edwin K Silverman
BACKGROUND: Preserved Ratio Impaired Spirometry (PRISm), defined as a reduced FEV1 in the setting of a preserved FEV1/FVC ratio, is highly prevalent and is associated with increased respiratory symptoms, systemic inflammation, and mortality. Studies investigating quantitative chest tomographic features, genetic associations, and subtypes in PRISm subjects have not been reported. METHODS: Data from current and former smokers enrolled in COPDGene (n = 10,192), an observational, cross-sectional study which recruited subjects aged 45-80 with ≥10 pack years of smoking, were analyzed...
August 6, 2014: Respiratory Research
Mathilde Marie Winkler Wille, Laura H Thomsen, Asger Dirksen, Jens Petersen, Jesper Holst Pedersen, Saher B Shaker
OBJECTIVES: To evaluate interobserver agreement and time-trend in chest CT assessment of emphysema, airways, and interstitial abnormalities in a lung cancer screening cohort. METHODS: Visual assessment of baseline and fifth-year examination of 1990 participants was performed independently by two observers. Results were standardised by means of an electronic score sheet; kappa and time-trend analyses were performed. RESULTS: Interobserver agreement was substantial in early emphysema diagnosis; highly significant (p < 0...
November 2014: European Radiology
Jörg Menche, Amitabh Sharma, Michael H Cho, Ruth J Mayer, Stephen I Rennard, Bartolome Celli, Bruce E Miller, Nick Locantore, Ruth Tal-Singer, Soumitra Ghosh, Chris Larminie, Glyn Bradley, John H Riley, Alvar Agusti, Edwin K Silverman, Albert-László Barabási
BACKGROUND: An important step toward understanding the biological mechanisms underlying a complex disease is a refined understanding of its clinical heterogeneity. Relating clinical and molecular differences may allow us to define more specific subtypes of patients that respond differently to therapeutic interventions. RESULTS: We developed a novel unbiased method called diVIsive Shuffling Approach (VIStA) that identifies subgroups of patients by maximizing the difference in their gene expression patterns...
2014: BMC Systems Biology
Olívia Meira Dias, Bruno Guedes Baldi, André Nathan Costa, Carlos Roberto Ribeiro Carvalho
Combined pulmonary fibrosis and emphysema (CPFE) has been increasingly recognized in the literature. Patients with CPFE are usually heavy smokers or former smokers with concomitant lower lobe fibrosis and upper lobe emphysema on chest HRCT scans. They commonly present with severe breathlessness and low DLCO, despite spirometry showing relatively preserved lung volumes. Moderate to severe pulmonary arterial hypertension is common in such patients, who are also at an increased risk of developing lung cancer. Unfortunately, there is currently no effective treatment for CPFE...
May 2014: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Fumio Kurosaki, Masashi Bando, Masayuki Nakayama, Naoko Mato, Takakiyo Nakaya, Hideaki Yamasawa, Taichiro Yoshimoto, Noriyoshi Fukushima, Yukihiko Sugiyama
OBJECTIVE: We retrospectively investigated the clinical features of pulmonary aspergillosis associated with interstitial pneumonia. METHODS: We reviewed the medical records of all patients treated for interstitial pneumonia with or without pulmonary aspergillosis at our institution between April 2006 and August 2012 and evaluated the clinical features as well as risk and prognostic factors for pulmonary aspergillosis associated with interstitial pneumonia. RESULTS: Among 539 patients with interstitial pneumonia, 15 who suffered from pulmonary aspergillosis were identified...
2014: Internal Medicine
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