Relationships Among Bacteria, Upper Airway, Lower Airway, and Systemic Inflammation in COPD

Hurst, John R.; Wilkinson, Tom; Perera, Wayomi R.; Donaldson, Gavin; Wedzicha, Jadwiga A.

doi:10.1016/s0012-3692(15)34470-6

Cited by 74 publications

(102 citation statements)

References 35 publications

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“…There were more signs of nasal inflammation in the patients with COPD than in the controls, though the assessor was not blinded to the presence or absence of disease. As with the study by Hurst et al, 16 the concentrations of inflammatory markers in the nose were not significantly related either to indices of airflow obstruction or to the severity of nasal symptoms.…”

Section: Nasal Inflammation In Copdsupporting

confidence: 71%

“…26 There was also a significant correlation between the severity of nasal airway and pulmonary airflow obstruction, 26 the magnitude of which was similar to that described between upper and lower airway IL8 concentrations. 16 This therefore provides further evidence that nasal involvement in COPD is similar in effect and magnitude to that occurring in the lung.…”

Section: Nasal Airway Obstruction In Copdsupporting

confidence: 52%

“…16 Even following smoking cessation, COPD was associated with greater nasal inflammation than that present in an ex-smoking or neversmoking control group of similar age and sex distribution. Moreover, the degree of nasal inflammation reflected that present in the lung, as evidenced by a significant correlation between the concentration of interleukin 8 (IL8) in matched nasal wash and sputum samples (fig 2).…”

Section: Nasal Inflammation In Copdmentioning

confidence: 88%

“…Thirdly, bronchoconstrictor neuronal responses may play a role, though the existence of nasobronchial reflexes remains controversial. 29 Finally, the relationship between postnasal drip and lower airway bacterial colonisation 16 suggests that direct passage of mediators or pathogens along the respiratory mucosa may be important. These concepts are summarised in fig 3. …”

Section: Mechanisms Of Interaction Between the Upper And Lower Airwaymentioning

confidence: 99%

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Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hurst

2009

Thorax

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This review presents the evidence that chronic obstructive pulmonary disease (COPD) is associated with significant sinonasal symptoms, inflammation and airway obstruction. Upper airway symptoms in COPD cause impairment to quality of life. The severity of upper airway involvement relates to that present in the lower airway, suggesting that the nose may be used to model the lung in COPD. More importantly, relationships between upper and lower airway bacteria and inflammation, and the association between sinusitis and treatment failure at exacerbation raise the possibility that nasal intervention in COPD may not only improve health status but may also affect important clinical outcomes such as exacerbation frequency.

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Section: Nasal Inflammation In Copdsupporting

confidence: 71%

Section: Nasal Airway Obstruction In Copdsupporting

confidence: 52%

Section: Nasal Inflammation In Copdmentioning

confidence: 88%

Section: Mechanisms Of Interaction Between the Upper And Lower Airwaymentioning

confidence: 99%

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Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Hurst

2009

Thorax

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“…However, whenever a person inhales smoke from tobacco or biomass fuels, the smoke penetrates into the whole airway from nose to distant alveoli. We have previously described the presence of chronic nasal and respiratory symptoms in COPD patients 6 , the relationship of the upper airway to lower airway bacteria 7 , the impact of nasal symptoms on quality of life 8 and the correlation of systemic inflammation both in upper and lower airways during exacerbation 9 . The concept that COPD is a "pan-airway" disease in COPD is gaining support with different groups publishing data that strengthen the epidemiological evidence 10,11 .…”

mentioning

confidence: 99%

Upper Respiratory Symptoms Worsen over Time and Relate to Clinical Phenotype in Chronic Obstructive Pulmonary Disease

et al. 2015

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Paranasal sinus opacification at MRI in lower airway disease (the HUNT study-MRI)

Hansen

Helvik

Thorstensen

et al. 2015

Eur Arch Otorhinolaryngol

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The study builds on the concept of united airways, which describes the link between the upper and lower airways. Explorations of this concept have mainly related to asthma and less to chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate paranasal sinus opacification at magnetic resonance imaging (MRI) in COPD, self-reported asthma and respiratory symptoms. In this cross-sectional study, 880 randomly selected participants in the Nord-Trøndelag health survey (HUNT) (mean age 57.7 years, range 50-66 years, 463 women) were investigated using MRI of the paranasal sinuses. Participants were allocated to four mutually exclusive groups: (1) COPD (n = 20), (2) asthma (n = 89), (3) respiratory symptoms (n = 199), and (4) reference group (n = 572). Paranasal sinus opacifications were categorised as mucosal thickening, polyps and retention cysts, and fluid. In each participant, measurements ≥1 mm from all sinuses were summed to give a total for each category of opacities. The sums for these three categories were further added together, and referred to as the total sum. Using the 75th percentile cut-off values, the likelihood of having paranasal sinus opacifications was more than six times higher in participants with COPD and twice as high in participants with asthma than among the reference group. Respiratory symptoms were only associated with mucosal thickening. The present study shows that paranasal sinus opacification is associated not only with asthma, but also with COPD and respiratory symptoms. This is in accordance with the united airways hypothesis, and should be kept in mind when handling patients with these conditions.

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Relationships Among Bacteria, Upper Airway, Lower Airway, and Systemic Inflammation in COPD

Cited by 74 publications

References 35 publications

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Upper airway. 3: Sinonasal involvement in chronic obstructive pulmonary disease

Upper Respiratory Symptoms Worsen over Time and Relate to Clinical Phenotype in Chronic Obstructive Pulmonary Disease

Paranasal sinus opacification at MRI in lower airway disease (the HUNT study-MRI)

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