Panlobular emphysema is associated with COPD disease severity: A study of emphysema subtype by computed tomography

Wilgus, M.L.; Abtin, Fereidoun; Markovic, Daniela; Tashkin, Donald P.; Phillips, Jonathan E.; Buhr, Russell G.; Flynn, Matt; Dembek, M.; Cooper, Christopher B.

doi:10.1016/j.rmed.2021.106717

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…28,29 In addition, some emphysema phenotypes, such as panlobular emphysema, were associated with greater airflow obstruction. 14 In contrast, there was no significant difference in CT-quantified emphysema between FEs and NFEs in this study, possibly because there was also no difference in spirometry or severity of COPD. Our findings partly support and explain the findings of others in terms of the nonlinear relationship between emphysema percentage and exacerbation frequency.…”

Section: Discussioncontrasting

confidence: 67%

“…As disease severity (GOLD stage) increases, exacerbations of COPD become more frequent. 12 Emphysema is associated with COPD disease severity, 14 and airway thickening is associated with lung function in subjects with severe emphysema. 15 In summary, differences in disease severity, especially differences in spirometry between FE group and NFE group, should be considered when identifying frequent exacerbator phenotyperelated causes.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Airway Thickening and Serum Cytokines in COPD Patients with Frequent Exacerbations: A Heart of the Matter

Lin,

Sang,

Wang

et al. 2023

COPD

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Background: Differences in lung function for Chronic Obstructive Pulmonary Disease (COPD) cause bias in the findings when identifying frequent exacerbator phenotype-related causes. The aim of this study was to determine whether computed tomographic (CT) biomarkers and circulating inflammatory biomarkers were associated with the COPD frequent exacerbator phenotype after eliminating the differences in lung function between a frequent exacerbator (FE) group and a non-frequent exacerbator (NFE) group. Methods: A total of 212 patients with stable COPD were divided into a FE group (n=106) and a NFE group (n=106) according to their exacerbation history. These patients were assessed by spirometry, quantitative CT measurements and blood sample measurements during their stable phase. Univariate and multivariate logistic regression were used to assess the association between airway thickening or serum cytokines and the COPD frequent exacerbator phenotype. Receiver operating characteristic (ROC) curves were calculated for Pi10, WA%, IL-1β and IL-4 to identify frequent exacerbators. Results: Compared with NFE group, FE group had a greater inner perimeter wall thickness of a 10 mm diameter bronchiole (Pi10), a greater airway wall area percentage (WA%) and higher concentrations of IL-1β and IL-4 (p<0.001). After adjusting for sex, age, BMI, FEV1%pred and smoking pack-years, Pi10, WA%, IL-β and IL-4 were independently associated with a frequent exacerbator phenotype (p<0.001). Additionally, there was an increase in the odds ratio of the frequent exacerbator phenotype with increasing Pi10, WA%, IL-4, and IL-1β (p for trend <0.001). The ROC curve demonstrated that IL-1β had a significantly larger calculated area under the curve (p < 0.05) than Pi10, WA% and IL-4. Conclusion: Pi10, WA%, IL-4, and IL-1β were independently associated with the frequent exacerbator phenotype among patients with stable COPD, suggesting that chronic airway and systemic inflammation contribute to the frequent exacerbator phenotype. Trial Registration: This trial was registered in Chinese Clinical Trial Registry (https://www.chictr.org.cn). Its registration number is ChiCTR2000038700, and date of registration is September 29, 2020.

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Section: Discussioncontrasting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Analysis of Airway Thickening and Serum Cytokines in COPD Patients with Frequent Exacerbations: A Heart of the Matter

Lin,

Sang,

Wang

et al. 2023

COPD

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“…The activated in ammatory cells including neutrophils, macrophages, and T lymphocytes produce pro-in ammatory cytokines, reactive oxygen species, and tissue degrading proteases, which further expand the in ammation and cause tissue damage [23] . Wilgus et al's study discovered that panlobular emphysema was associated with greater extent of emphysema and elevated systemic in ammation compared to centrilobular emphysema [24] . Several studies have revealed several proin ammatory cytokines including IL-1β and IL-6 was associated with the severity of emphysema [25,26] ,…”

Section: Discussionmentioning

confidence: 97%

Decreased serum IL-35 and IL-37 in COPD patients with severe emphysema

Yang,

Wei,

Yan

et al. 2024

Preprint

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Background Chronic obstructive pulmonary disease(COPD) is a heterogeneous syndrome and chronic persistent inflammation has been discovered to play critical role in the structural damage leading to the progression of emphysema. IL-35 and IL-37 are both immune-suppressing cytokines which exert inhibitory effects on a lot of inflammatory disorders. This study aimed to determine the correlation between serum levels of IL-35 and IL-37 with the severity of emphysema and clinical parameters of COPD patients. Methods We detected the serum levels of IL-35, IL-37 and IL-33 from 64 Chinese patients with stable COPD by using an enzyme-linked immunosorbent assay and examined the association of their concentrations with COPD patients’ clinical parameters. Results The serum levels of IL-35 and IL-37 were significantly decreased in the COPD patients with severe emphysema subtype compared to non-emphysema or mild-to-moderate emphysema subtype. The serum level of IL-35 was correlated with body mass index(BMI), modified Medical Research Council(mMRC) score and the concentrations of IL-33 and IL-37. The lower IL-35 group exhibited decreased BMI, lower FEV1/FVC, severe extent of emphysema and worse mMRC. Multivariable regression showed that lower FEV1/FVC, worse mMRC score and decreased serum levels of IL-35 were independently associated with severe emphysema. Conclusions We found that the serum IL-35 and IL-37 levels were decreased in severe emphysema subtype. The lower level of IL-35 was correlated with lower BMI and worse mMRC score. IL-35 concentrations, FEV1/FVC and mMRC score were independently associated with the extent of emphysema.

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“…We analyzed data from the COPD Phenotyping Study, a collaboration between the University of California Los Angeles (UCLA) and AMGEN (Thousand Oaks, CA). 6 This prospective, observational cohort study was performed at UCLA from October 2015 to September 2018. The study was approved by the UCLA Institutional Review Board (IRB 14–000748), and written informed consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

Three-Month Variability of Commonly Evaluated Biomarkers in Clinically Stable COPD

Park¹,

Saiphoklang²,

Phillips³

et al. 2023

COPD

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Introduction Clinical decisions in chronic obstructive pulmonary disease (COPD) treatment often utilize serially assessed physiologic parameters and biomarkers. To better understand the reliability of these tests, we evaluated changes in commonly assessed biomarkers over 3 months in patients with clinically stable COPD. Methods We performed an observational prospective cohort study of 89 individuals with clinically stable COPD, defined as no exacerbation history within 3 months of enrollment. Biomarkers included lung function and functional performance status, patient-reported outcomes of symptoms and health status, and blood markers of inflammation. The correlation between testing at baseline and at 3-month follow-up was reported as the intraclass correlation coefficient (ICC). “Outliers” had significant variability between tests, defined as >1.645 standard deviations between the two measurements. Differences in clinical features between outliers and others were compared. Results Participants with COPD (n = 89) were 70.5 ± 6.7 years old, 54 (61%) male, had a 40 pack-year smoking history with 24.7% being current smokers, and postbronchodilator forced expiratory volume in one second (FEV 1 ) 62.3 ± 22.7% predicted. The biomarkers with excellent agreement between the initial and the follow-up measurements were FEV 1 (ICC = 0.96), Saint George’s Respiratory Questionnaire (SGRQ) (ICC = 0.98), COPD Assessment Test (CAT) (ICC = 0.93) and C-reactive protein (CRP) (ICC = 0.90). By contrast, parameters showing less robust agreement were 6-minute walking distance (ICC = 0.75), eosinophil count (ICC = 0.77), erythrocyte sedimentation rate (ICC = 0.75) and white blood cell count (ICC = 0.48). Individuals with greater variability in biomarkers reported chronic bronchitis more often and had higher baseline SGRQ and CAT scores. Conclusion Our study evaluated the stability of commonly assessed biomarkers in clinically stable COPD and showed excellent agreement between baseline and three-month follow-up values for FEV 1 , SGRQ, CAT and CRP. Individuals with chronic bronchitis and more symptomatic disease at baseline demonstrated greater variability in 3-month interval biomarkers.

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Panlobular emphysema is associated with COPD disease severity: A study of emphysema subtype by computed tomography

Cited by 12 publications

References 29 publications

Analysis of Airway Thickening and Serum Cytokines in COPD Patients with Frequent Exacerbations: A Heart of the Matter

Analysis of Airway Thickening and Serum Cytokines in COPD Patients with Frequent Exacerbations: A Heart of the Matter

Decreased serum IL-35 and IL-37 in COPD patients with severe emphysema

Three-Month Variability of Commonly Evaluated Biomarkers in Clinically Stable COPD

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