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Acute exacerbation of chronic obstructive lung disease

Rosa Faner, Patricia Sobradillo, Aina Noguera, Cristina Gomez, Tamara Cruz, Alejandra López-Giraldo, Eugeni Ballester, Nestor Soler, Juan I Arostegui, Pablo Pelegrín, Roberto Rodriguez-Roisin, Jordi Yagüe, Borja G Cosio, Manel Juan, Alvar Agustí
Chronic obstructive pulmonary disease (COPD) is characterised by pulmonary and systemic inflammation that bursts during exacerbations of the disease (ECOPD). The NLRP3 inflammasome is a key regulatory molecule of the inflammatory response. Its role in COPD is unclear. We investigated the NLRP3 inflammasome status in: 1) lung tissue samples from 38 patients with stable COPD, 15 smokers with normal spirometry and 14 never-smokers; and 2) sputum and plasma samples from 56 ECOPD patients, of whom 41 could be reassessed at clinical recovery...
July 2016: ERJ Open Research
Hyun Jung Kwak, Dong Won Park, Jee Eun Kim, Min Kyung Park, Gun Woo Koo, Tai Sun Park, Ji-Yong Moon, Tae Hyung Kim, Jang Won Sohn, Ho Joo Yoon, Dong Ho Shin, Sang-Heon Kim
Exacerbations of chronic obstructive pulmonary disease (COPD) lead to high morbidity and mortality. Respiratory virus infection is considered as one of the important causes of COPD exacerbations. The aim of this study was to assess the prevalence of respiratory virus infection in COPD exacerbations and to find the factors associated with susceptibility to viral infections. Furthermore, we tried to examine if COPD exacerbations caused by viral infections have more severe clinical outcomes in comparison with those with non-viral causes...
2016: Tohoku Journal of Experimental Medicine
Shih-Lung Cheng, Ching-Hsiung Lin
BACKGROUND: Blood eosinophil counts have been documented as a good biomarker for patients with chronic obstructive pulmonary disease (COPD) using inhaled corticosteroid (ICS) therapy. However, the effectiveness and safety of prescribing high or medium dose of ICS for patients with different eosinophil counts are unknown. METHODS: A post hoc analysis of a previous prospective randomized study was performed for COPD patients using higher dose (HD: Fluticasone 1,000 μg/day) or medium dose (MD: Fluticasone 500 μg/day) of ICS combined with Salmeterol (100 μg/day)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Feng-Sen Li, Yan-Li Zhang, Zheng Li, Dan Xu, Chun-Yan Liao, Huan Ma, Li Gong, Jun Su, Qi Sun, Qian Xu, Zhen Gao, Ling Wang, Jing Jing, Jing Wang, Min Jiang, Ge Tian, Bilal Hasan
In traditional Chinese medicine (TCM), the Yiqigubiao pill is commonly used to enhance physical fitness. The current clinical trial was designed to evaluate the efficacy and safety of the Yiqigubiao pill as an adjuvant therapy for patients with stable chronic obstructive pulmonary disease (COPD). The current trial was a randomized, double-blind, placebo-controlled superiority trial. The participants were recruited from outpatients at the Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University (Ürümqi, China) between February and September 2012...
October 2016: Experimental and Therapeutic Medicine
Breda Cushen, Niamh McCormack, Kerrie Hennigan, Imran Sulaiman, Richard W Costello, Brenda Deering
BACKGROUND: One-third of patients with an exacerbation of Chronic Obstructive Pulmonary Disease(COPD) are re-hospitalised at 90 days. Exacerbation recovery is associated with reductions in lung hyperinflation and improvements in symptoms and physical activity. We assessed the feasibility of monitoring these clinical parameters in the home. We hypothesised that the degree of change in spirometry and lung volumes differs between those who had an uneventful recovery and those who experienced a further exacerbation...
October 2016: Respiratory Medicine
L Sakhri, C Saint-Raymond, S Quetant, C Pison, E Lagrange, R Hamidfar Roy, J-P Janssens, C Maindet-Dominici, M Garrouste-Orgeas, M Levy-Soussan, N Terzi, A-C Toffart
The issue of intensive and palliative care in patients with chronic disease frequently arises. This review aims to describe the prognostic factors of chronic respiratory diseases in stable and in acute situations in order to improve the management of these complex situations. The various laws on patients' rights provide a legal framework and define the concept of unreasonable obstinacy. For patients with chronic obstructive pulmonary disease, the most robust decision factors are good knowledge of the respiratory disease, the comorbidities, the history of previous exacerbations and patient preferences...
September 14, 2016: Revue des Maladies Respiratoires
Wenxin Wu, Wei Zhang, J Leland Booth, David C Hutchings, Xiaoqiu Wang, Vicky L White, Houssein Youness, Cory D Cross, Ming-Hui Zou, Dennis Burian, Jordan P Metcalf
BACKGROUND: Cigarette smoking (CS) is the main risk factor for the development of chronic obstructive pulmonary disease (COPD) and most COPD exacerbations are caused by respiratory infections including influenza. Influenza infections are more severe in smokers. The mechanism of the increased risk and severity of infections in smokers is likely multifactorial, but certainly includes changes in immunologic host defenses. METHODS: We investigated retinoic acid-inducible protein I (RIG-I) and interferon (IFN) induction by influenza A virus (IAV) in human bronchial epithelial cells (HBEC) isolated from smokers or nonsmokers...
2016: Respiratory Research
Bülent Serhan Yurtlu, Bengü Köksal, Volkan Hancı, Işıl Özkoçak Turan
Non-invasive ventilation is an accepted treatment modality in both acute exacerbations of respiratory diseases and chronic obstructive lung disease. It is commonly utilized in the intensive care units, or for postoperative respiratory support in post-anesthesia care units. This report describes intraoperative support in non-invasive ventilation to neuroaxial anesthesia for an emergency upper abdominal surgery.
September 2016: Brazilian Journal of Anesthesiology
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]
Zhiyue Wang, Xuesong Chen, Kouying Liu, Weiping Xie, Hong Wang, Yongyue Wei, Lijun Tang, Yinsu Zhu
The morphologic alterations of pulmonary small vessels measured by computed tomography (CT) have been used to evaluate chronic obstructive pulmonary disease (COPD). However, the relationship between small pulmonary vascular alteration and acute exacerbations of COPD (AECOPD) is not well understood. The aim of this study was to evaluate the cross-sectional area (CSA) of small pulmonary vessel alterations measured on CT images and investigate its relationship with the COPD severity staged by the degree of airflow limitation and the occurrence of AECOPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Lyle L Pritchard
Cystic fibrosis (CF) is an autosomal recessive genetic disease that occurs in approximately 1 in 2,500 white live births. It is less common in nonwhite individuals. A dysfunctional epithelial chloride channel leads to excessively thick mucus affecting multiple organ systems. Common issues include mucous plugging of the airway, lung inflammation, chronic pulmonary infections, intestinal malabsorption, and malnutrition. Universal screening of newborns for CF is recommended in many countries. CF can be diagnosed based on clinical evidence of disease along with genetic testing or other laboratory evidence of chloride channel dysfunction...
September 2016: FP Essentials
Mark T Dransfield, Ken M Kunisaki, Matthew J Strand, Antonio Anzueto, Surya P Bhatt, Russell P Bowler, Gerard J Criner, Jeffrey L Curtis, Nicola A Hanania, Hrudaya Nath, Nirupama Putcha, Sarah E Roark, Emily S Wan, George R Washko, J Michael Wells, Christine H Wendt, Barry J Make
Background Acute exacerbations of chronic obstructive pulmonary disease (COPD) increase the risk of death and drive healthcare costs, but whether they accelerate loss of lung function remains controversial. Whether exacerbations in subjects with mild COPD or similar acute respiratory events in smokers without airflow obstruction affect lung function decline is unknown. Methods We examined data on the first 2,000 subjects who returned for a second COPDGene visit 5 years after enrolment. Baseline data included demographics, smoking history and CT emphysema...
August 24, 2016: American Journal of Respiratory and Critical Care Medicine
Francesca Polverino, Leen J M Seys, Ken R Bracke, Caroline A Owen
Chronic inflammatory responses in the lungs contribute to the development and progression of chronic obstructive pulmonary disease (COPD). Although research studies focused initially on the contributions of the innate immune system to the pathogenesis of COPD, more recent studies have implicated adaptive immune responses in COPD. In particular, studies have demonstrated increases in B cell counts and increases in the number and size of B cell-rich lymphoid follicles in COPD lungs that correlate directly with COPD severity...
October 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Hiroyuki Kishi, Masamichi Sato, Yoko Shibata, Kento Sato, Sumito Inoue, Shuichi Abe, Tomomi Kimura, Michiko Nishiwaki, Keiko Yamauchi, Takako Nemoto, Akira Igarashi, Yoshikane Tokairin, Osamu Nakajima, Isao Kubota
BACKGROUND: Chemokine C-C motif ligand 1 (CCL1) accumulates C-C motif chemokine receptor 8 positive leukocytes to the inflammatory sites. Single-nucleotide polymorphisms in the chemokine CCL1 gene are associated with exacerbation of chronic obstructive lung disease. However, it is unclear whether CCL1 has immunomodulatory functions during pulmonary inflammation. This study aimed to elucidate this issue using newly generated transgenic mice that express CCL1 in the lungs (SPC-CCL1 mice)...
2016: SpringerPlus
Elodie Ehrmann, Anne Jolivet-Gougeon, Martine Bonnaure-Mallet, Thierry Fosse
INTRODUCTION: Capnocytophaga genus was recently known to highly contribute to the beta-lactam (BL) and macrolide-lincosamide-streptogramin (MLS) resistance gene reservoir in the oral microbiota (BL: blaCSP-1 and blaCfxA; MLS: erm(F) and erm(C)). But fluoroquinolone (FQ) resistance remains uncommon in literature, without available data on resistance mechanisms. CASE REPORT: For the first time, a case of acute exacerbation of chronic obstructive pulmonary disease (COPD) was described in a 78-year-old immunocompetent patient due to a multidrug-resistant Capnocytophaga gingivalis isolate with significant microbiological finding...
August 13, 2016: Anaerobe
Georgina Casey
CHRONIC OBSTRUCTIVE pulmonary diseases (COPD) affect 14 per cent of the population over 40 years of age. With an ageing population, the number of those requiring care for COPD is expected to increase, having a significant effect on health-care resources. COPD is projected to become the third leading cause of death globally by 2020. This disease has a major impact on economic and social well-being, and on quality of life. It is regarded as largely preventable but, once developed, is a progressive and complex condition characterised by frequent exacerbations and co-morbidities...
June 2016: Nursing New Zealand, Kai Tiaki
Галина С Хайменова, Людмила Н Шилкина, Марина Ю Бабанина, Григорий В Волченко, Максим В Ткаченко, Вячеслав Н Ждан
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a disease that is characterized by chronic airflow limitation, a variety of pathological changes in the lungs, significant extrapulmonary manifestations, and severe comorbidities which may further aggravate the course of COPD [GOLD, 2013]. Intensity of systemic manifestations increases with the progression of obstruction, therefore the abovementioned symptoms are often overlooked and become apparent in the later stages of the disease...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Georgios Hillas, Fotis Perlikos, Nikolaos Tzanakis
Chronic obstructive pulmonary disease (COPD) is one of the top five major causes of morbidity and mortality worldwide. Despite worldwide health care efforts, costs, and medical research, COPD figures demonstrate a continuously increasing tendency in mortality. This is contrary to other top causes of death, such as neoplasm, accidents, and cardiovascular disease. A major factor affecting COPD-related mortality is the acute exacerbation of COPD (AECOPD). Exacerbations and comorbidities contribute to the overall severity in individual patients...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Jie Jia, Thomas M Conlon, Carolina Ballester Lopez, Michael Seimetz, Mariola Bednorz, Zhe Zhou-Suckow, Norbert Weissmann, Oliver Eickelberg, Marcus A Mall, Ali Önder Yildirim
Epidemiological evidence demonstrates a strong link between postnatal cigarette smoke (CS) exposure and increased respiratory morbidity in young children. However, how CS induces early onset airway disease in young children, and how it interacts with endogenous risk factors, remains poorly understood. We, therefore, exposed 10-day-old neonatal wild-type and β-epithelial sodium ion channel (β-ENaC)-transgenic mice with cystic fibrosis-like lung disease to CS for 4 days. Neonatal wild-type mice exposed to CS demonstrated increased numbers of macrophages and neutrophils in the bronchoalveolar lavage fluid (BALF), which was accompanied by increased levels of Mmp12 and Cxcl1 BALF from β-ENaC-transgenic mice contained greater numbers of macrophages, which did not increase following acute CS exposure; however, there was significant increase in airway neutrophilia compared with filtered air transgenic and CS-exposed wild-type controls...
September 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
Heino Stass, Johannes Nagelschmitz, Dominik Kappeler, Knut Sommerer, Claudius Kietzig, Boris Weimann
BACKGROUND: Ciprofloxacin dry powder for inhalation (Ciprofloxacin DPI) is in development as long-term intermittent therapy to reduce the frequency of acute exacerbations in noncystic fibrosis bronchiectasis (NCFB) patients with respiratory bacterial pathogens. There is no approved therapy in this indication. Reliable, reproducible lung deposition is a prerequisite for inhaled drugs. METHODS: In this phase I study, six patients with NCFB, six with chronic obstructive pulmonary disease (COPD), and 12 healthy volunteers (HVs), received one dose of (99m)Tc-Ciprofloxacin DPI 32...
July 22, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
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