Imaging Features of Chronic Bronchitis with Preserved Ratio and Impaired Spirometry (PRISm)

Wei, Xia; Ding, Qi; Ye, Nan; Mi, Jiuyun; Ren, Jingting; Li, Jie; Xu, Shudi; Gao, Yanzhong; Guo, Youmin

doi:10.1007/s00408-018-0162-2

“…(34,35) Many of these excluded individuals have PRISm, and although they do not meet the diagnostic spirometric criteria for COPD they exhibit similar changes such as small airways disease, emphysema and gas trapping. (4,36,37) Little focus has been given to whether asthma contributes to PRISm, despite high rates of selfreported asthma in other PRISm cohorts (21% in COPDgene (2) ) and in this UKBB cohort reported asthma among PRISm was 18.4%. (4) There are many plausible ways asthma could contribute to both PRISm and airflow obstruction.…”

Section: Discussionmentioning

confidence: 86%

“…(34, 35) Many of these excluded individuals have PRISm, and although they do not meet the diagnostic spirometric criteria for COPD they exhibit similar changes such as small airways disease, emphysema and gas trapping. (4, 36, 37)…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Genetics of Preserved Ratio Impaired SpiroMetry (PRISm): An Analysis of UK Biobank

Higbee¹,

Granell²,

Smith

³

et al. 2020

Preprint

0

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Rationale Preserved ratio impaired spirometry (PRISm) is defined as Forced Expiratory Volume in one second <80% predicted with a FEV1/Forced Vital Capacity of >0.70. It may be a precursor of COPD and has been associated with increased respiratory symptoms and comorbidities. Current understanding of PRISm is based on small selective cohorts and genetic determinants remain unknown. Objectives Identify the prevalence, risk factors, co-morbidity, and genetics of PRISm in a large cohort to improve power and generalizability. Methods The UKBiobank, provides a large cohort of genotyped individuals. Regression analysis determined risk factors for and associated co-morbidities of PRISm. Genome wide association studies, conditional, and gene-based analyses were performed with a PheWAS and literature search conducted on the results. Measurements and Main Results PRISm has a similar prevalence to airflow obstruction (8% vs 7.8%) and is associated with increased cardiovascular co-morbidity, OR of 1.26 (95%CI 1.20-1.31) after adjusting for BMI, smoking status, age, diabetes, and sex. Genetic analysis discovered four associated single nucleotide polymorphisms and eight genes. Two SNPs have not been described with respiratory disease before. Other genetic loci identified are known to increase risk of asthma and COPD, and influence response to inhaled steroids. Conclusions PRISm affects 8% of adults of whom ~40% report cardiovascular comorbidity. Detailed analysis reveals that PRISm has shared genetic associations with asthma and COPD. These findings highlight the need for research into the potential therapeutic strategies and screening for individuals with PRISm, in particular whether this may reduce transition to COPD and reduce cardiovascular disease.

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“…e PRISm group showed decreased lung capacity and higher mean lung density [25]. Kirby et al found small airway pathological changes in early/ mild COPD patients using CT total airway count, but their lung function parameters (such as FEV1 and FVC) are still in the normal range, suggesting that small airway impairment is appeared before lung function damage [26].…”

Section: Discussionmentioning

confidence: 98%

Small Airway Dysfunction in Chronic Bronchitis with Preserved Pulmonary Function

Ding

¹

,

Mi

²

,

Wei

³

et al. 2022

Canadian Respiratory Journal

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Impairment of pulmonary function was evaluated in chronic bronchitis patients with preserved ratio impaired spirometry (PRISm). We retrospectively collected clinical data from 157 chronic bronchitis (CB) and 186 chronic obstructive pulmonary disease (COPD) patients between October 2014 and September 2017. These patients were assigned to three groups: control (normal pulmonary function), PRISm (forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] ≥ 0.7, FEV1 < 80% of predicted value), and COPD (FEV1/FVC <0.7) groups. Because small airway function was the main focus, in the COPD group, only patients in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1 and 2 were included. Evaluation of pulmonary function (including impulse oscillometry) was performed and compared among these groups. Compared with the control group, the PRISm and COPD groups showed statistically significant differences in the predicted FEV1% p < 0.001 , maximal expiratory flow (MEF) 25% p < 0.001 , MEF50% p < 0.001 , maximal midexpiratory flow (MMEF) 25–75% p < 0.001 , residual volume (RV)/total lung capacity (TLC; p < 0.001 ), FVC% p < 0.001 , total respiratory resistance and proximal respiratory resistance (R5-R20; p < 0.001 ), respiratory system reactance at 5 Hz (X5; p < 0.001 ), resonant frequency (Fres; p < 0.001 ), and area of reactance (Ax; p < 0.001 ). However, the predicted FEV1% and RV/TLC were similar between the PRISm and COPD groups ( p = 0.992 and 0.122, respectively). PRISm is a nonspecific pattern of pulmonary function that indicates small airway dysfunction and may increase the risk of transformation to obstructive ventilation dysfunction. This trial is registered with ChiCTR-OCH-14004904.

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“…Risk factors include age, female sex, a history of smoking, diabetes mellitus, and obesity 5,7,15,16 . Moreover, increased dyspnoea, reduced 6-min walk distance 1 , and reduced health-related quality of life 17,18 have been reported in individuals with PRISm.The Genetic Epidemiology of COPD (COPDGene) study and other reports discussing PRISm 1-3,8,18 have explained the condition using medical data 4,6,9 . However, few studies have focused on community-dwelling individuals 7 .…”

mentioning

confidence: 99%

“…The Genetic Epidemiology of COPD (COPDGene) study and other reports discussing PRISm 1-3,8,18 have explained the condition using medical data 4,6,9 . However, few studies have focused on community-dwelling individuals 7 .…”

mentioning

confidence: 99%

Physical performance in relation to preserved ratio impaired spirometry: a cross-sectional study of community-dwelling older Japanese adults

Anami

¹

,

Murata

²

,

Nakano

³

et al. 2021

Sci Rep

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Preserved ratio impaired spirometry (PRISm) is associated with an increased mortality rate; however, its characteristics have not been clearly identified in Japan. This cross-sectional study of community-dwelling older adults compared physical function between people with PRISm and those with no respiratory issues, from 2014 to 2019. We collected demographic data through interviews and measured respiratory and physical functions. We included 668 older adults (male, 23.5%; mean age, 72.8 ± 5.6 years); the prevalence of PRISm was 12%, while the prevalence of obstruction was 6.9%. Propensity score matching was used to identify control subjects with normal spirometry (n = 80) while minimizing the effects of confounders during comparisons with the PRISm population (n = 80). Compared with community-dwelling older adults with normal lung capacity, older adults with PRISm had a lower forced vital capacity (%FVC; 68.7 ± 9.1% vs. 92.5 ± 12.7%, p < 0.001), lower core muscle endurance (sit-up test: 6.7 ± 5.8 vs. 8.7 ± 6.0, p = 0.032), and a longer one-leg stance duration (52.4 ± 41.1 s vs. 36.4 ± 34.1 s, p = 0.008). In multivariable logistic regression, %FVC and increased one-leg stance were independent predictors of PRISm status. The prevalence of PRISm among community-dwelling elderly Japanese exceeds that of obstructive lung disease and is associated with reduced %FVC and better performance on balance testing.

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Imaging Features of Chronic Bronchitis with Preserved Ratio and Impaired Spirometry (PRISm)

Cited by 17 publications

References 21 publications

Epidemiology and Genetics of Preserved Ratio Impaired SpiroMetry (PRISm): An Analysis of UK Biobank

Epidemiology and Genetics of Preserved Ratio Impaired SpiroMetry (PRISm): An Analysis of UK Biobank

Small Airway Dysfunction in Chronic Bronchitis with Preserved Pulmonary Function

Physical performance in relation to preserved ratio impaired spirometry: a cross-sectional study of community-dwelling older Japanese adults

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