The Importance of Early Chronic Obstructive Pulmonary Disease: A Lecture from 2022 Asian Pacific Society of Respirology

Sin, Don D.

doi:10.4046/trd.2023.0005

Cited by 12 publications

(6 citation statements)

References 50 publications

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“…Additional studies may provide insights into the physiological factors underlying the negative correlation between the PIFR and RV/TLC%. For instance, it would be helpful to measure the total lung capacity across more patients, analyse small and large airway abnormalities using other techniques such as computed tomography or oscillometry, and verify conditions linked to the inspiratory strength (such as muscle strength) 22 , 23 . It may also be the case that superoptimal PIFR reflects the individuals underlying fitness and thus the effects of delivery of inhaled medication to the lungs becomes less relevant.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of chronic obstructive pulmonary disease patients with superoptimal peak inspiratory flow rate

Kim,

Moon,

Park

et al. 2024

Sci Rep

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Characteristics of chronic obstructive pulmonary disease (COPD) patients with superoptimal peak inspiratory flow rates (PIFR) has not been thoroughly investigated. This study aimed to compare the characteristics between COPD patients with superoptimal PIFR and those with optimal and sub-optimal PIFR. PIFR was measured using In-Check DIAL G16 and categorized into sub-optimal (PIFR lower than that required by the patient’s device), optimal, and superoptimal (peak PIFR ≥ 90 L/min). Considering COPD patients with sub-optimal PIFR as the reference group, analyses were performed to identify PIFR-related factors. Subgroup analysis was performed according to the forced expiratory volume in 1 s (FEV1) % of the predicted value (%pred). Among 444 post-bronchodilator-confirmed COPD patients from seven tertiary hospitals in South Korea, 98, 223, and 123 were classified into the sub-optimal, optimal, and superoptimal PIFR groups, respectively. The superoptimal PIFR group were younger, had an increased proportion of males, a higher body mass index, lowest number of comorbidities and less frequent exacerbation in the previous year, as well as the highest forced vital capacity %pred. The adjusted odds ratio for frequent exacerbation in the previous year was lower in the superoptimal PIFR group than in the sub-optimal PIFR group and was more pronounced in patients with an FEV1%pred of < 70%. COPD patients with superoptimal PIFR have clinical characteristics different from those patients with the sub-optimal and optimal PIFR. Having a high inspiratory flow may be a favorable trait in COPD.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of chronic obstructive pulmonary disease patients with superoptimal peak inspiratory flow rate

Kim,

Moon,

Park

et al. 2024

Sci Rep

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“…Aside from smoking cessation for active smokers, there are no disease modifying therapies for COPD ( Sin, 2023 ). By the time patients develop spirometric obstruction, they have lost nearly half of their small airways and a third of their gas-exchanging units ( Koo et al, 2018 ) and their disease is “fixed” and cannot be modified ( Stolz et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Breathlessness and “exacerbation” questions predictive for incident COPD (MARKO study): data after two years of follow-up

Vrbica,

Steiner,

Labor

et al. 2023

PeerJ

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Aims To determine the predictability of the MARKO questionnaire and/or its domains, individually or in combination with other markers and characteristics (age, gender, smoking history, lung function, 6-min walk test (6 MWT), exhaled breath temperature (EBT), and hsCRP for the incident chronic obstructive pulmonary disease (COPD) in subjects at risk over 2 years follow-up period). Participants and Methods Patients, smokers/ex-smokers with >20 pack-years, aged 40–65 years of both sexes were recruited and followed for 2 years. After recruitment and signing the informed consent at the GP, a detailed diagnostic workout was done by the pulmonologist; they completed three self-assessment questionnaires—MARKO, SGRQ and CAT, detailed history and physical, laboratory (CBC, hsCRP), lung function tests with bronchodilator and EBT. At the 2 year follow-up visit they performed: the same three self-assessment questionnaires, history and physical, lung function tests and EBT. Results A sample of 320 subjects (41.9% male), mean (SD) age 51.9 (7.4) years with 36.4 (17.4) pack-years of smoking was reassessed after 2.1 years. Exploratory factor analysis of MARKO questionnaire isolated three distinct domains (breathlessness and fatigue, “exacerbations”, cough and expectorations). We have determined a rate for incident COPD that was 4.911/100 person-years (95% CI [3.436–6.816]). We found out that questions about breathlessness and “exacerbations”, and male sex were predictive of incident COPD after two years follow-up (AUC 0.79, 95% CI [0.74–0.84], p < 0.001). When only active smokers were analyzed a change in EBT after a cigarette (ΔEBT) was added to a previous model (AUC 0.83, 95% CI [0.78–0.88], p < 0.001). Conclusion Our preliminary data shows that the MARKO questionnaire combined with EBT (change after a cigarette smoke) could potentially serve as early markers of future COPD in smokers.

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“…COPD was diagnosed when post-bronchodilator forced expiratory volume in 1 second (FEV 1 )/forced vital capacity (FVC) was less than 0.7. Young COPD was defined as the COPD subject being younger than 50 years old [ 6 ]. PRISM was defined as post-bronchodilator FEV 1 <80% predicted and FEV 1 /FVC ≥0.7 [ 7 ].…”

Section: Methodsmentioning

confidence: 99%

Roles of Inflammatory Biomarkers in Exhaled Breath Condensates in Respiratory Clinical Fields

Choi,

Lee,

Byun

et al. 2024

Tuberc Respir Dis

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Background: Exhaled condensates contain inflammatory biomarkers; however, their roles in the clinical field have been under-investigated.Methods: We prospectively enrolled subjects admitted to pulmonology clinics. We collected exhaled breath condensates (EBC) and analysed the levels of six and 12 biomarkers using conventional and multiplex enzyme-linked immunosorbent assay, respectively.Results: Among the 123 subjects, healthy controls constituted the largest group (81 participants; 65.9%), followed by the preserved ratio impaired spirometry group (21 patients; 17.1%) and the chronic obstructive pulmonary disease (COPD) group (21 patients; 17.1%). In COPD patients, platelet derived growth factor-AA exhibited strong positive correlations with COPD assessment test (ρ=0.5926, p=0.0423) and COPD-specific version of St. George’s Respiratory Questionnaire (SGRQ-C) score (total, ρ=0.6725, p=0.0166; activity, ρ=0.7176, p=0.0086; and impacts, ρ=0.6151, p=0.0333). Granzyme B showed strong positive correlations with SGRQ-C score (symptoms, ρ=0.6078, p=0.0360; and impacts, ρ=0.6007, p=0.0389). Interleukin 6 exhibited a strong positive correlation with SGRQ-C score (activity, ρ=0.4671, p=0.0378). The absolute serum eosinophil and basophil counts showed positive correlations with pro-collagen I alpha 1 (ρ=0.6735, p=0.0164 and ρ=0.6295, p=0.0283, respectively). In healthy subjects, forced expiratory volume in 1 second (FEV1)/forced vital capacity demonstrated significant correlation with CC chemokine ligand 3 (CCL3)/macrophage inflammatory protein 1 alpha (ρ=0.3897 and p=0.0068). FEV1 exhibited significant correlation with CCL11/eotaxin (ρ=0.4445 and p=0.0017).Conclusion: Inflammatory biomarkers in EBC might be useful to predict quality of life concerning respiratory symptoms and serologic markers. Further studies are needed.

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The Importance of Early Chronic Obstructive Pulmonary Disease: A Lecture from 2022 Asian Pacific Society of Respirology

Cited by 12 publications

References 50 publications

Clinical characteristics of chronic obstructive pulmonary disease patients with superoptimal peak inspiratory flow rate

Clinical characteristics of chronic obstructive pulmonary disease patients with superoptimal peak inspiratory flow rate

Breathlessness and “exacerbation” questions predictive for incident COPD (MARKO study): data after two years of follow-up

Roles of Inflammatory Biomarkers in Exhaled Breath Condensates in Respiratory Clinical Fields

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