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Wang X, Wang J, He S, Li J, Chen X, Ma T, Liu L, Zhang L, Bu X. The clinical characteristics of non-cystic fibrosis bronchiectasis patients with positive serum tumor markers: a retrospective study. BMC Pulm Med 2024; 24:20. [PMID: 38191360 PMCID: PMC10775564 DOI: 10.1186/s12890-023-02816-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Serum tumor markers (STM), extensively used for the diagnosis, monitoring and prognostic assessment of tumors, can be increased in some non-malignant lung diseases. To date, there is a paucity of studies regarding the clinical characteristics of non-cystic fibrosis bronchiectasis patients with positive STMs. OBJECTIVE To investigate the clinical characteristics and indicators of bronchiectasis with positive STMs. METHODS The clinical data of 377 bronchiectasis patients was retrospectively collected from January 2017 to December 2019 from Beijing Chaoyang Hospital. Patients were divided into the STM negative group, the single STM positive group and the ≥2 STMs positive group according to the number of the positive STMs. The clinical characteristics are described and compared separately. The multivariate logistic regression analysis model was used to investigate the indicators regarding positive STMs. RESULTS Patients in the ≥2 STMs positive group were older (P = 0.015), had higher mMRC scores (P < 0.001) and developed higher fever (P = 0.027). Additionally, these patients also had lower Albumin/Globulin Ratio (A/G), albumin (ALB), prealbumin (PAB) (P < 0.001, P < 0.001, P < 0.001, respectively) and higher CRP, ESR and Fbg (P < 0.001, P < 0.001 and P < 0.001, respectively). Age (OR 1.022, 95%CI 1.003-1.042; P = 0.026) and the number of affected lobes (OR 1.443, 95%CI 1.233-1.690; P < 0.001) were independently associated with one and ≥ 2 positive STMs in bronchiectasis patients. CONCLUSION The ≥2 positive STMs are associated with a higher inflammation status and severer radiologic manifestations in bronchiectasis patients.
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Affiliation(s)
- Xiaoyue Wang
- Department of Respiratory and Critical Care Medicine, Chuiyangliu Hospital affiliated to Tsinghua University, Beijing, China
| | - Juan Wang
- Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Siqi He
- Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoting Chen
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Tianyuan Ma
- Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lu Liu
- Department of Respiratory and Critical Care Medicine, Fengtai rehabilitation hospital of Beijing Municipality (Tieying hospital), Beijing, China
| | - Lei Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Fangshan Liangxiang Hospital, Beijing, China
| | - Xiaoning Bu
- Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Madhavan V, Muthu V, Sehgal IS, Dhooria S, Prasad KT, Aggarwal AN, Agarwal R. Malnutrition in Allergic Bronchopulmonary Aspergillosis complicating asthma. Lung India 2023; 40:563-566. [PMID: 37961971 PMCID: PMC10723196 DOI: 10.4103/lungindia.lungindia_360_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/21/2023] [Accepted: 09/10/2023] [Indexed: 11/15/2023] Open
Affiliation(s)
- Venkateshan Madhavan
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Valliappan Muthu
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India E-mail:
| | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India E-mail:
| | - Sahajal Dhooria
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India E-mail:
| | - Kuruswamy Thurai Prasad
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India E-mail:
| | - Ashutosh Nath Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India E-mail:
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India E-mail:
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Adiponectin Increase in Patients Affected by Chronic Obstructive Pulmonary Disease with Overlap of Bronchiectasis. Life (Basel) 2023; 13:life13020444. [PMID: 36836801 PMCID: PMC9959162 DOI: 10.3390/life13020444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is characterized by respiratory symptoms and non-reversible airflow limitation with recurrent episodes of acute exacerbations. The concurrent presence of bronchiectasis in patients with COPD is associated with reduced respiratory function as well as increased exacerbation risk. Adiponectin is a promising biomarker in COPD, as greater high molecular weight (HMW) oligomer levels have been observed among COPD patients. Here, we investigate adiponectin levels in two groups of COPD patients characterized by the presence or absence of bronchiectasis (BCO), comparing both groups to healthy controls. We evaluated serum adiponectin levels in COPD patients, those with BCO, and healthy subjects and characterized the pattern of circulating adiponectin oligomers. We found that forced volume capacity % (FVC%) and forced expiratory volume % (FEV1%) were lower for BCO patients than for COPD patients. COPD patients had higher levels of adiponectin and its HMW oligomers than healthy controls. Interestingly, BCO patients had higher levels of adiponectin than COPD patients. We showed that expression levels of IL-2, -4, and -8, IFN-γ, and GM-CSF were significantly higher in BCO patients than in healthy controls. Conversely, IL-10 expression levels were lower in BCO patients. Our data suggest that the increased levels of adiponectin detected in the cohort of BCO patients compared to those in COPD patients without bronchiectasis might be determined by their worse airway inflammatory state. This hypothesis suggests that adiponectin could be considered as a biomarker to recognize advanced COPD patients with bronchiectasis.
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Qi H, Liu H, Zheng P, He J. Lack of association between leptin concentrations and cystic fibrosis: A meta-analysis and regression. Front Endocrinol (Lausanne) 2023; 14:1126129. [PMID: 36992806 PMCID: PMC10040884 DOI: 10.3389/fendo.2023.1126129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Leptin (LEP) acts as a proinflammatory cytokine and may play an important role in the pathophysiology of cystic fibrosis (CF). This review aimed to assess the quantitative difference in leptin status between CF patients and non-CF controls. METHODS In this study, the researchers conducted systematic searches of various databases, such as PubMed, Excerpta Medica Database, Google Scholar, Web of Science, and the China National Knowledge Infrastructure. The data collected from the above databases were assessed using the Stata 11.0 and R 4.1.3 software. The correlation coefficients and the Standardized Mean Differences (SMD) were employed to assess the effect size. A combination analysis was also carried out with the help of either a fixed-effects or random-effects model. In addition, the single-cell sequencing GSE193782 dataset was obtained to determine the mRNA expression levels of LEP and leptin receptor (LEPR) in the bronchoalveolar lavage fluid, to verify the different leptin expression between the CF patients and healthy controls. RESULTS A total of 919 CF patients and 397 controls from 14 articles were included in this study. CF patients and non-CF controls showed similar serum/plasma leptin levels. Gender, specimen testing, age, and study design were all taken into account for carrying out subgroup analyses. The results revealed no variations in serum/plasma leptin levels between the controls and CF patients in the various subgroups. Female CF patients exhibited higher leptin concentrations compared to male CF patients, and male healthy individuals showed lower leptin levels than female healthy participants. Aside from the fact that serum/plasma leptin appeared to be favorably linked to fat mass and BMI, the findings in this study also indicated that serum/plasma concentrations were not associated with Forced Expiratory Volume in the first second (FEV1). No statistically significant differences were observed in the leptin and leptin receptor mRNA expression levels between the healthy controls and CF patients. The leptin receptor and leptin expression levels in alveolar lavage fluid were low in various cells, without any distinctive distribution patterns. CONCLUSIONS The current meta-analysis indicated the absence of significant differences in leptin levels between CF patients and healthy individuals. Gender, fat mass, and BMI may all be correlated with leptin concentrations. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42022380118.
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Affiliation(s)
- Hong Qi
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Geriatric Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Hairong Liu
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Geriatric Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Pengcheng Zheng
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
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Peripheral Neutrophil-to-Lymphocyte Ratio in Bronchiectasis: A Marker of Disease Severity. Biomolecules 2022; 12:biom12101399. [PMID: 36291608 PMCID: PMC9599714 DOI: 10.3390/biom12101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson's P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis.
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Sánchez-Torralvo FJ, Porras N, Ruiz-García I, Maldonado-Araque C, García-Olivares M, Girón MV, Gonzalo-Marín M, Olveira C, Olveira G. Usefulness of Muscle Ultrasonography in the Nutritional Assessment of Adult Patients with Cystic Fibrosis. Nutrients 2022; 14:3377. [PMID: 36014883 PMCID: PMC9415857 DOI: 10.3390/nu14163377] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Muscle ultrasonography of the quadriceps rectus femoris (QRF) is a technique on the rise in the assessment of muscle mass in application of nutritional assessment. The aim of the present study is to assess the usefulness of muscle ultrasonography in patients with cystic fibrosis, comparing the results with other body composition techniques such as anthropometry, bioelectrical impedance analysis (BIA), dual-energy X-ray absorptiometry (DXA), and handgrip strength (HGS). At the same time, we intend to assess the possible association with the nutritional and respiratory status. Methods: This was a prospective observational study in adult patients with cystic fibrosis in a clinically stable situation. Muscle ultrasonography of the QRF was performed, and the results were compared with other measures of body composition: anthropometry, BIA, and DXA. HGS was used to assess muscle function. Respiratory parameters were collected, and nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria. Results: A total of 48 patients were included, with a mean age of 34.1 ± 8.8 years. In total, 24 patients were men, and 24 patients were women. Mean BMI was 22.5 ± 3.8 kg/m2. Mean muscular area rectus anterior (MARA) was 4.09 ± 1.5 cm2, and mean muscular circumference rectus was 8.86 ± 1.61 cm. A positive correlation was observed between the MARA and fat-free mass index (FFMI) determined by anthropometry (r = 0.747; p < 0.001), BIA (r = 0.780; p < 0.001), and DXA (r = 0.678; p < 0.001), as well as muscle function (HGS: r = 0.790; p < 0.001) and respiratory parameters (FEV1; r = 0.445, p = 0.005; FVC: r = 0.376, p = 0.02; FEV1/FVC: r = 0.344, p = 0.037). A total of 25 patients (52.1%) were diagnosed with malnutrition according to GLIM criteria. Differences were observed when comparing the MARA based on the diagnosis of malnutrition (4.75 ± 1.65 cm2 in normo-nourished vs. 3.37 ± 1.04 in malnourished; p = 0.014). Conclusions: In adults with cystic fibrosis, the measurements collected by muscle ultrasound of the QRF correlate adequately with body composition techniques such as anthropometry, BIA, DXA, and handgrip strength. Muscle ultrasound measurements, particularly the MARA, are related to the nutritional status and respiratory function of these patients.
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Affiliation(s)
- Francisco José Sánchez-Torralvo
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Malaga, Spain
| | - Nuria Porras
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
| | - Ignacio Ruiz-García
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
| | - Cristina Maldonado-Araque
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
| | - María García-Olivares
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
| | - María Victoria Girón
- Unidad de Gestión Clínica de Neumología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - Montserrat Gonzalo-Marín
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
| | - Casilda Olveira
- Unidad de Gestión Clínica de Neumología, Hospital Regional Universitario de Málaga, 29010 Malaga, Spain
| | - Gabriel Olveira
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29007 Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Plataforma Bionand, 29010 Malaga, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Malaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Comes A, Wong AW, Fisher JH, Morisset J, Johannson KA, Farrand E, Fell CD, Kolb M, Manganas H, Cox G, Gershon AS, Halayko AJ, Hambly N, Khalil N, Sadatsafavi M, Shapera S, To T, Wilcox PG, Collard HR, Ryerson CJ. Association of BMI and Change in Weight With Mortality in Patients With Fibrotic Interstitial Lung Disease. Chest 2022; 161:1320-1329. [PMID: 34788669 DOI: 10.1016/j.chest.2021.11.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Mortality risk assessment in interstitial lung disease (ILD) is challenging. Our objective was to determine the prognostic significance of BMI and change in weight in the most common fibrotic ILD subtypes. RESEARCH QUESTION Could BMI and weight loss over time be reliable prognostic indicators in patients with fibrotic ILD? STUDY DESIGN AND METHODS This observational retrospective multicenter cohort study enrolled patients with fibrotic ILD from the six-center CAnadian REgistry for Pulmonary Fibrosis (CARE-PF, derivation) and the ILD registry at the University of California, San Francisco (UCSF, validation). Patients were subcategorized as underweight (BMI < 18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), or obese (BMI > 30). Annual change in weight was calculated for all years of follow-up as the slope of best fit using the least square method based on every available measurement. Separate multivariable analyses evaluated the associations of BMI and change in weight with mortality, adjusting for common prognostic variables. RESULTS The derivation and validation cohorts included 1,786 and 1,779 patients, respectively. Compared with patients with normal BMI, mortality was highest in patients who were underweight (hazard ratio [HR], 3.19; 95% CI, 1.88-5.43; P < .001) and was lowest in those who were overweight (HR, 0.52; 95% CI, 0.36-0.75; P < .001) or obese (HR, 0.55; 95%CI, 0.37-0.83; P < .001) in the analysis adjusted for the ILD-GAP (gender, age, physiology) Index. Patients who had a weight loss of at least 2 kg within 1 year had increased risk of death in the subsequent year (HR, 1.41; 95% CI, 1.01-1.97; P = .04) after adjustment for the ILD-GAP Index and baseline BMI category, with a plateau in risk for patients with greater weight loss. Consistent results were observed in the validation cohort. INTERPRETATION Both BMI and weight loss are independently associated with 1-year mortality in fibrotic ILD. BMI and weight loss may be clinically useful prognostic indicators in fibrotic ILD.
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Affiliation(s)
- Alessia Comes
- Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.
| | - Alyson W Wong
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jolene H Fisher
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julie Morisset
- Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | | | - Erica Farrand
- Department of Medicine, University of California San Francisco, CA
| | - Charlene D Fell
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Martin Kolb
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Hélène Manganas
- Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Gerard Cox
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Andrea S Gershon
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrew J Halayko
- Departments of Internal Medicine and Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Nathan Hambly
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nasreen Khalil
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Mohsen Sadatsafavi
- Respiratory Evaluation Sciences Program, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Shane Shapera
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Teresa To
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Pearce G Wilcox
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Harold R Collard
- Department of Medicine, University of California San Francisco, CA
| | - Christopher J Ryerson
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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Verma U, Gupta A, Verma A, Chaudhary S, Lal N, Singh N, Shrivastava A, Kant S. A retrospective correlative profiling of lung functions, microbiological, radiological, periodontal, hematological parameters in noncystic fibrosis bronchiectasis patients of North India. Natl J Maxillofac Surg 2022; 13:44-53. [PMID: 35911797 PMCID: PMC9326207 DOI: 10.4103/njms.njms_386_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/10/2021] [Accepted: 09/13/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Noncystic fibrosis bronchiectasis (NCFB) is a neglected debilitating condition with scarce epidemiological literature explaining its geographical heterogeneity, especially in lower and middle-income countries. This study aimed to assess and correlate the functional profile of NCFB patients and evaluate the correlation of body mass index (BMI) with several disease variables. Methods: This mixed-method retrospective research study was conducted on 124 radiologically confirmed NCFB patients in terms of various qualitative and quantitative variables. Results: Restrictive ventilatory defect was the most common type with the preponderance of male former smokers. Mean platelet lymphocyte ratio (PLR; 104.08 ± 73.59) revealed certain degree of systemic inflammatory burden with a slightly higher mean peripheral leukocyte count (10665.19 ± 4268.81 cell/mm3) and eosinophilia of >2%. Almost all patients had periodontal disease with a higher prevalence of chronic periodontitis (54.83%). Moderately severe and predominantly cystic radiological type was encountered with 61.2% patients positive for Pseudomonas aeruginosa. Bronchiectasis aetiology comorbidity index (BACI) i.e., 2.34 ± 2.37 represented an intermediate mortality risk in our patients. On basis of BMI, majority were young underweights with poor pulmonary functions while PLR skewed toward overweight patients (nonsignificant P > 0.05). Forced expiratory volume/forced vital capacity displayed a negative weak moderately significant correlation with BACI (r = −0.24; P = 0.008). Peripheral lymphocyte count demonstrated a weak negative but significant correlation with modified Reiff score (r = −0.20; P = 0.023) while serum neutrophil count had a weak negative moderately significant correlation with hemoglobin (r = −0.20; P = 0.023). Conclusions: NCFB bears great heterogeneity with distinct geographical phenotypes and should be correlated thoroughly in terms of peripheral leukocytes count, pulmonary functions, radiology, BMI, and coexisting comorbidities for adequate management.
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Alsharkawy A, Fouda E, Mujahed A, Elgendy Y. Nutritional assessment and rehabilitation in children with bronchiectasis and childhood interstitial lung diseases: effects on pulmonary functions and clinical severity. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2021. [DOI: 10.1186/s43054-021-00090-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nutrition is recognized as a modifiable contributor to bronchiectasis and interstitial lung diseases (ChILD) development and progression. Nutritional interventions have great potential in reducing respiratory illness related morbidity and mortality. The study was done to assess nutritional state and body composition of children with bronchiectasis and interstitial lung diseases (ChILD) and to study the effect of short course nutritional intervention program on their growth, clinical symptoms, pulmonary functions and frequency of acute exacerbations and hospitalization. Seventeen patients with bronchiectasis and thirteen patients with interstitial lung diseases and 40 healthy children as controls were enrolled. Nutritional status, chest symptoms, anthropometry, body composition, and spirometric pulmonary function were evaluated. A short course nutritional intervention program was done for patients and then they were re-evaluated.
Results
In total, 56.67% of studied patients were moderately malnourished and 23.33% were severely malnourished. A total of 66.7% of studied patients were underweight and 50% of patients had stunted growth. Anthropometric indices were significantly lower than control groups (P < 0.05). Body composition indices were lower in patients than control but not with a statistical significance. Forced vital capacity was positively correlated to body mass index (P = 0.045). Nutritional rehabilitation significantly improved patient anthropometry (weight, body mass index, height, triceps skin-fold thickness, mid arm circumference), body composition (body fat, fat free mass, and muscle mass), respiratory symptoms, and FEV1. Needs to asthma rescue medications, school absence, acute exacerbation attacks, and hospitalization were reduced.
Conclusion
Patients with bronchiectasis and interstitial lung diseases (ChILD) have malnutrition and body composition changes that improved significantly after short nutritional intervention program with significant improvement in FEV1, frequency of acute exacerbations, and hospitalization.
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Sami R, Zohal M, Marhamati KHamene A, Rajabi S, Shokri-Mashhadi N. 25-Hydroxy vitamin D and body composition are associated with pulmonary function in non-cystic fibrosis bronchiectasis: A cross-sectional study. Clin Nutr ESPEN 2021; 46:527-531. [PMID: 34857245 DOI: 10.1016/j.clnesp.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/08/2021] [Accepted: 08/11/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have emphasized the effects of vitamin D on the lung function of cystic fibrosis (CF) adult patients. The main aim of the present study sought to determine the association between circulating 25-hydroxyvitamin D (25-OH D) concentration and clinical outcomes in non-cystic fibrosis (non-CF) bronchiectasis subjects. Secondary, we assessed the possible relationship between body composition and respiratory dysfunction in these patients. MATERIALS AND METHODS Sixty-two non-CF bronchiectasis patients (24 male/38 female), aged 18-72, were recruited in this cross-sectional study. Anthropometric indices, lung function tests, and bronchiectasis severity valuations were determined. Body composition, including Mid-arm muscle circumference (MAMC, cm) was calculated using triceps skinfold (TSF,mm) and mid-arm circumference (MAC,cm) under the reference formula. Then serum 25-hydroxyvitamin D concentration and C-reactive protein level were measured. The correlation between vitamin D level and pulmonary function and disease exacerbation tests was primarily assessed. Additionally, we evaluated the correlation between body composition and lung function tests. RESULTS Circulating 25-hydroxyvitamin D status positively was correlated with lung function tests, including FEV1 (r = 0.30, p value = 0.035) and FVC (r = 0.36, p value = 0.011), and also be associated with the extent of pulmonary involvement (r = -0.34, p value = 0.03). There was a significant negative correlation between percentage body fat and respiratory function, FEV1/FVC ratio (r = -0.43, p value < 0.001). In contrast, there was a strong correlation between skeletal muscle mass and pulmonary function tests (r = 0.26, p value = 0.04). CONCLUSION There is a positive association between low 25-hydroxyvitamin D status and lung dysfunction in participants with non-CF bronchiectasis. The pulmonary dysfunction also correlated with more percentage body fat and low skeletal muscle mass in these patients. Therefore, the evaluation of body composition and serum vitamin D are suggested in the disease management of the patients with non-CF bronchiectasis. However, these associations should be interpreted with caution due to the likelihood of reverse causation. More high-quality prospective studies are warranted to confirm our observations and determine the mechanisms underlying these findings.
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Affiliation(s)
- Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadali Zohal
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Alireza Marhamati KHamene
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Soode Rajabi
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nafiseh Shokri-Mashhadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Contreras-Bolívar V, Olveira C, Ruiz-García I, Porras N, García-Olivares M, Sánchez-Torralvo FJ, Girón MV, Alonso-Gallardo SP, Olveira G. Handgrip Strength: Associations with Clinical Variables, Body Composition, and Bone Mineral Density in Adults with Cystic Fibrosis. Nutrients 2021; 13:nu13114107. [PMID: 34836360 PMCID: PMC8622157 DOI: 10.3390/nu13114107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Loss of fat-free mass (FFM) is associated with an increase in morbidity and mortality in cystic fibrosis (CF) patients. Handgrip strength (HGS) measures muscle function and may be associated with clinical parameters with prognostic value. Our objectives were to evaluate muscle strength through HGS in CF patients and to determine if there are any associations with respiratory clinical variables, FFM, and bone mineral density (BMD). Methods: A cross-sectional study conducted in clinically stable patients. We evaluated muscle function through HGS, respiratory function—forced expiratory volume in 1 s (FEV1) (%), forced vital capacity (FVC) (%), bronchorrhea, annual exacerbations, and body composition (FFM and FFM index, FFMI: fat-free mass in kg/height in m2) and Bone Mineral Density (BMD) through densitometry (DXA). Results: The study included 53 CF patients (58.5% females, mean age 28.3 ± 8.1, body mass index (BMI) 21.7 ± 3.4). The mean values for dynamometry were 40.2 ± 8.1 kg in males and 23.1 ± 7.0 kg in women, being 20.8% below the 10th percentile. Patients with lower muscle strength showed significantly more exacerbations and lower FEV1% and FVC%, as well as lower BMI, worse BMD (g/cm2), T-score, and Z-score. A significant and positive correlation was found between the mean and maximum dynamometry values and age, FVC%, BMI, FFMI, FFM (kg), and BMD. Conclusions: For adults with CF, HGS is a practical tool for assessment of health status. Low values reflect poor nutritional status and are associated with poor respiratory function, low fat-free mass and low bone mineral density.
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Affiliation(s)
- Victoria Contreras-Bolívar
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
- Servicio de Endocrinología y Nutrición, Hospital Universitario Clínico San Cecilio, Instituto de Investigación Biosanitaria (Ibs, Granada), 18016 Granada, Spain
| | - Casilda Olveira
- Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (C.O.); (M.V.G.)
| | - Ignacio Ruiz-García
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
| | - Nuria Porras
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
| | - Maria García-Olivares
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
| | - Francisco José Sánchez-Torralvo
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
| | - Maria Victoria Girón
- Servicio de Neumología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (C.O.); (M.V.G.)
| | - Silvia P. Alonso-Gallardo
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
| | - Gabriel Olveira
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain; (V.C.-B.); (I.R.-G.); (N.P.); (M.G.-O.); (F.J.S.-T.); (S.P.A.-G.)
- Centro de Investigación Biomédica en Red-Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 08036 Barcelona, Spain
- Correspondence:
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Congrete S, Metersky ML. Telemedicine and Remote Monitoring as an Adjunct to Medical Management of Bronchiectasis. Life (Basel) 2021; 11:life11111196. [PMID: 34833072 PMCID: PMC8622988 DOI: 10.3390/life11111196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
The limited resources and the practice of social distancing during the COVID pandemic create a paradigm shift in the utilization of telemedicine in healthcare. However, the implementation of best practices is hampered in part by a lack of literature devoted to telehealth in bronchiectasis. In this commentary, we examine multiple approaches to structuring of telemedicine care for patients with bronchiectasis, highlight current evidence-based interventions that can be incorporated into the management of bronchiectasis, and describe our experience with telemedicine at the University of Connecticut Center for Bronchiectasis Care during the COVID-19 pandemic. The structural model must be adapted to different local dynamics and available technologies with careful attention to patient characteristics and access to technology to avoid the potential paradoxical effects of increasing patients’ burden and healthcare disparities in underserved populations.
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13
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McDonald CM, Alvarez JA, Bailey J, Bowser EK, Farnham K, Mangus M, Padula L, Porco K, Rozga M. Academy of Nutrition and Dietetics: 2020 Cystic Fibrosis Evidence Analysis Center Evidence-Based Nutrition Practice Guideline. J Acad Nutr Diet 2021; 121:1591-1636.e3. [PMID: 32565399 PMCID: PMC8542104 DOI: 10.1016/j.jand.2020.03.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Indexed: 12/13/2022]
Abstract
The Academy of Nutrition and Dietetics Evidence Analysis Center conducted a systematic review of the literature to develop an evidence-based practice guideline for primary nutrition issues in cystic fibrosis (CF). This guideline is designed to complement and build upon existing evidence-based CF nutrition guidelines. The objective of this guideline was to provide recommendations for registered dietitian nutritionists in the United States delivering medical nutrition therapy to individuals with CF and their families that fill gaps in current evidence-based guidelines on topics that are crucial in order to improve health and prevent disease progression. This guideline provides 28 nutrition recommendations to guide medical nutrition therapy, including nutrition screening, nutrition assessment, and dietary intake. For topics outside the scope of this guideline, practitioners are referred to external, evidence-based recommendations. The CF landscape is evolving rapidly with breakthroughs in cystic fibrosis transmembrane regulator modulators changing CF at a cellular level. Medical nutrition therapy for individuals with CF from infancy through advanced age requires novel and individualized approaches. The Academy Evidence Analysis Library CF guidelines provide a framework for expanding upon current knowledge to determine effective nutrition strategies for individuals with CF through long and healthy futures.
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14
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Ju S, Jeong JH, Heo M, Heo IR, Kim TH, Kim HC, Yoo JW, Cho YJ, Jeong YY, Lee JD, Lee SJ. Serum albumin is a predictor of respiratory hospitalization in patients with bronchiectasis. Chron Respir Dis 2021; 18:14799731211017548. [PMID: 34032131 PMCID: PMC8155784 DOI: 10.1177/14799731211017548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
We evaluated serum albumin as an index for predicting respiratory hospitalization in patients with bronchiectasis. We retrospectively reviewed the medical records of 177 patients with bronchiectasis, categorized them into low and normal albumin groups, and compared their clinical characteristics. The prediction of respiratory hospitalization by factors such as serum albumin level, bronchiectasis severity index (BSI), and FACED score (an acronym derived from five variables of forced expiratory volume in 1 s; FEV1, age, chronic colonization of Pseudomonas aeruginosa, extent of bronchiectasis, and dyspnea) was assessed. There were 15 and 162 patients categorized in the low and normal albumin groups, respectively. The low albumin group had lower body mass index and forced expiratory volume in 1 s, and higher age, frequency of previous respiratory hospitalization, percentage of Pseudomonas colonization, number of affected lobes, BSI and FACED scores, and C-reactive protein (CRP) level, than the normal albumin group. The areas under the receiver operating characteristic curve of serum albumin level and BSI and FACED scores for predicting respiratory hospitalization were 0.732 (95% confidence interval (CI), 0.647-0.816), 0.873 (95% CI, 0.817-0.928), and 0.708 (95% CI, 0.618-0.799), respectively. Albumin level, CRP, modified Medical Research Council score, and chronic Pseudomonas aeruginosa (and other organisms) colonization were independent risk factors for respiratory hospitalization. Low serum albumin level was associated with worse clinical condition, higher severity scores, and respiratory hospitalization in patients with bronchiectasis.
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Affiliation(s)
- Sunmi Ju
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Jong Hwan Jeong
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Manbong Heo
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - I Re Heo
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Tae Hoon Kim
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Ho Cheol Kim
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Republic of Korea
| | - Jung-Wan Yoo
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Yu Ji Cho
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Yi Yeong Jeong
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Jong Deog Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Seung Jun Lee
- Division of Pulmonology and Allergy, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
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15
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Girón Moreno RM, Martínez-Vergara A, Martínez-García MÁ. Personalized approaches to bronchiectasis. Expert Rev Respir Med 2021; 15:477-491. [PMID: 33511899 DOI: 10.1080/17476348.2021.1882853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Interest in bronchiectasis is increasing due to its rising prevalence, associated with aging populations and the extended use of high-resolution chest tomography (HRCT), and the resulting high morbidity, mortality, and demand for resources.Areas covered: This article provides an extensive review of bronchiectasis as a complex and heterogeneous disease, as well as examining the difficulty of establishing useful clinical phenotypes. In keeping with the aims of 'precision medicine', we address the disease of bronchiectasis from three specific perspectives: severity, activity, and impact. We used PubMed to search the literature for articles including the following keywords: personalized medicine, bronchiectasis, biomarkers, phenotypes, precision medicine, treatable traits. We reviewed the most relevant articles published over the last 5 years.Expert opinion: This article reflects on the usefulness of these three dimensions in 'control panels' and clinical fingerprinting, as well as approaches to personalized medicine and the treatable features of bronchiectasis non-cystic fibrosis.
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Affiliation(s)
- Rosa Maria Girón Moreno
- Pneumology Department, Hospital Universitario La Princesa. Instituto De Investigación Sanitaria La Princesa, Madrid, Spain
| | - Adrián Martínez-Vergara
- Pneumology Department, Hospital Universitario La Princesa. Instituto De Investigación Sanitaria La Princesa, Madrid, Spain
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Liu Y, Huang X, Chen D, Chen F, Mo C, Guo Y, Xie C, Liu G, Zeng H, Sun Y, Yang Z. The detrimental qualitative and quantitative alterations of circulating endothelial progenitor cells in patients with bronchiectasis. Respir Med 2020; 176:106270. [PMID: 33302144 DOI: 10.1016/j.rmed.2020.106270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Bronchiectasis is an independent risk factor for cardiovascular disease(CVD)and cardiac dysfunction. Endothelial progenitor cells (EPCs) play a crucial role in maintaining endothelial function, and is inversely correlated with cardiovascular risk factors or cardiac dysfunction. However, the relationship between EPCs and bronchiectasis is unknown. METHODS Twenty-nine patients with stable bronchiectasis and 15 healthy controls were recruited. Fasting venous blood were collected for determining circulating EPC number and activity as well as systemic inflammatory cytokines. RESULTS The number and migratory or proliferative activity of circulating EPCs in bronchiectasis patients were significantly reduced (p < 0.001). In high E-FACED group, the number of circulating EPCs evaluated by cell culture assay and EPC proliferation were decreased (p < 0.05). Similarly, the number and function of circulating EPCs were both reduced in low forced expiratory volume in 1 s (FEV1) or high mMRC group (p < 0.05). There was a significant correlation between circulating EPCs and bronchiectasis disease severity, according to the E-FACED score (p < 0.05), particularly to FEV1 (p < 0.05) and mMRC dyspnea score (p < 0.05). The count and activity of EPCs inversely correlated with hsCRP levels and IL-6 levels (p < 0.01). CONCLUSIONS Deficiencies in the number and function of circulating EPCs are present in patients with bronchiectasis. The changes are related to disease severity and may be partly attributed to systemic inflammation. The current findings may provide novel surrogate evaluation biomarkers and potential therapeutic target for bronchiectasis.
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Affiliation(s)
- Yangli Liu
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Xinyan Huang
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Dubo Chen
- Laboratory Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Fengjia Chen
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Chengqiang Mo
- Department of Urology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Yubiao Guo
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Canmao Xie
- Division of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, Province Guangdong, PR China
| | - Gexiu Liu
- Institute of Hematology, School of Basic Medicine, Jinan University, Guangzhou, 510632, PR China
| | - Haitao Zeng
- Center for Reproductive Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, PR China
| | - Yunwei Sun
- Guangzhou Development District Hospital, Guangzhou, 510730, Province Guangdong, PR China.
| | - Zhen Yang
- Division of Emergency Medicine, Department of Emergency Intensive Care Unit, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, PR China; NHC Key Laboratory on Assisted Circulation, Sun Yat-Sen University, Guangzhou, 510080, PR China.
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Girón RM, Martínez-Vergara A, Oscullo Yépez G, Martinez-García MA. Las bronquiectasias como enfermedad compleja. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Oxidative and inflammatory effects of pulmonary rehabilitation in patients with bronchiectasis. A prospective, randomized study. NUTR HOSP 2020; 37:6-13. [PMID: 31960695 DOI: 10.20960/nh.02763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: systemic inflammation and oxidative stress are important factors in the pathogenesis of bronchiectasis. Pulmonary rehabilitation (PR) is recommended for bronchiectasis, but there is no data about its effect on the inflammatory and REDOX status of these patients. Aims: to investigate the effect of PR in non-cystic-fibrosis bronchiectasis (NCFB) patients, and to compare it with the effect of PR plus a hyperproteic oral nutritional supplement (PRS) enriched with beta-hydroxy-beta-methylbutyrate (HMB) on serum inflammatory and oxidative biomarkers. Materials and methods: this was an open randomized, controlled trial. Thirty individuals (65 years old or younger with a body mass index over 18.5, older than 65 years with a body mass index over 20) were recruited from September 2013 to September 2014, and randomly assigned to receive PR or PRS. Total neutrophils, and inflammatory and oxidative biomarker levels were measured at baseline, and then at 3 and 6 months. Results: in the PRS group neutrophil levels were decreased from baseline at 6 months. A significantly different fold change was found between the PR and PRS groups. In the PR group, IL-6 and adiponectin were increased by the end of the study while TNFα levels were decreased from baseline at 6 months. REDOX biomarkers remained stable throughout the study except for 8-isoprostane levels, which were increased from baseline at 6 months in both groups of patients. Conclusions: a PR program induced a pro-oxidative effect accompanied by changes in circulating inflammatory cytokine levels in NCFB patients. Our results would also suggest a possible beneficial effect of the HMB enriched supplement on neutrophil level regulation in these patients. The information provided in this study could be useful for choosing the right therapeutic approach in the management of bronchiectasis.
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The Efficacy of Therapeutic Respiratory Muscle Training Interventions in People with Bronchiectasis: A Systematic Review and Meta-Analysis. J Clin Med 2020; 9:jcm9010231. [PMID: 31952338 PMCID: PMC7019679 DOI: 10.3390/jcm9010231] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Respiratory muscle dysfunction is an important health problem with high morbidity and mortality and associated costs in patients with bronchiectasis (BC). The aim of this study was to analyse the effects of therapeutic respiratory muscle training (RMT) interventions on improving sputum clearance, ventilator function, muscle strength and functional capacity in BC. Methods: Systematic review and meta-analysis were conducted following PRISMA guidelines. Two independent investigators searched using several electronic databases. The methodological quality of nine studies was assessed using the PEDro scale. Study selection/eligibility criteria: The following were included: randomised controlled trials, randomised crossover trials and pilot studies of patients with BC that used the intervention as RMT (inspiratory/expiratory) and evaluations of respiratory muscle strength (maximal expiratory pressure/maximal inspiratory pressure). This systematic review was registered in PROSPERO (CRD42017075101). Nine studies were included, five of which obtained an A recommendation grade, three with B, and one with C. Study quality was poor to good (mean PEDro Score of 6.375 out of 10). Studies had small sample sizes (8–98). Results show improvements on PImax in favour of therapeutic respiratory muscle training intervention (MD = 6.08; 95% CI = 1.38, 10.77; p < 0.01; I2 = 92%). However, high heterogeneity was identified on meta-analysis.
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Zhang Y, Chen L, Wu P, Lang J, Chen L. Intervention with erythropoietin in sarcopenic patients with femoral intertrochanteric fracture and its potential effects on postoperative rehabilitation. Geriatr Gerontol Int 2019; 20:150-155. [PMID: 31837195 DOI: 10.1111/ggi.13845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/04/2019] [Accepted: 11/22/2019] [Indexed: 01/08/2023]
Abstract
AIM To explore the intervention with erythropoietin (EPO) in sarcopenic patients with femoral intertrochanteric fractures, and its potential effects on postoperative rehabilitation. METHODS A total of 141 patients with femoral intertrochanteric fracture were selected from January 2018 to January 2019. Patients (aged ≥60 years) with indications for EPO use, but without significant medical history, were selected in the present study. All patients were screened for sarcopenia, and divided into the intervention group and control group according to whether they took EPO. The intervention groups received EPO postoperatively every day for 10 days, whereas the control groups received an equal dose of normal saline. Patients' handgrip strength, appendicular skeletal muscle, duration of hospitalization and postoperative infection rate were assessed by analysis. RESULTS Among sarcopenic women, the handgrip strength was higher in the intervention group than in the control group after a week (P < 0.05). However, no significant effect was found in men (P > 0.05). The appendicular skeletal muscle increment of the intervention group with sarcopenia was markedly increased regardless of sex (P < 0.001). In addition, the postoperative infection rate was lower in the intervention group than the control group (P < 0.05), accompanied by a shorter hospital stay due to EPO administration (P < 0.05). CONCLUSIONS EPO can improve the muscle strength of female patients with sarcopenia during the perioperative period, and increase muscle mass both of women and men. It can improve the symptoms of sarcopenia, but cannot reverse sarcopenia. Additionally, it can reduce the postoperative complications of patients with hip fracture and shorten the length of hospital stay. Therefore, postoperative administration of EPO might potentially promote rapid postoperative rehabilitation. Geriatr Gerontol Int 2020; 20: 150-155.
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Affiliation(s)
- Yiou Zhang
- Wenzhou Medical University Affiliated Cixi Hospital, Ningbo, China
| | - Li Chen
- University of Melbourne Medical School, Melbourne, Victoria, Australia
| | - Peng Wu
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junzhe Lang
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei Chen
- Department of Orthopedics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Osteopenia and Osteoporosis in Patients with Bronchiectasis: Association with Respiratory Parameters, Body Composition, Muscle Strength and Bone Remodeling Biomarkers. Sci Rep 2019; 9:14496. [PMID: 31601899 PMCID: PMC6787189 DOI: 10.1038/s41598-019-51069-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/20/2019] [Indexed: 01/02/2023] Open
Abstract
The prevalence of osteopenia/osteoporosis has not been sufficiently studied in people with bronchiectasis not due to cystic fibrosis (BC), nor has its relationship with other variables (clinical, body composition and bone turnover and inflammation markers) been sufficiently studied. Our aim was to determine the prevalence of osteopenia and osteoporosis and related factors in patients with BC. We did a cross-sectional study in people with BC in a clinically stable state. Spirometric parameters, annual exacerbations and analysis with bone turnover markers (BTM) and inflammation markers were evaluated. Densitometry (DXA) was performed for body composition, bone mineral density (BMD) and handgrip strength. 123 patients were studied (65% women, mean age 49.6 ± 18.8, Body Mass Index (BMI) 24.8 ± 4.7 kg/m2). 62.8% and 62.5% of men and women, respectively, had normal bone mineral density, 30.2% and 22.2% osteopenia and 7% and 15% osteoporosis. 52 patients (56.2%) had low fat-free mass: 68.9% women and 28.6% men. Patients with decreased bone mass had significantly lower muscle strength, maximum expiratory volume in the first second (FEV1%), vitamin D, higher levels of C-terminal telopeptide of type 1 collagen (CTX) and total osteocalcin and underarboxylated osteocalcin (ucOC). We observed significant and negative correlations between BMD and the number of serious exacerbations per year CTX and undercarboxylated osteocalcin. We observed significant positive correlations between BMD, fat free mass index (FFMI) and handgrip dynamometry. The study suggest that the prevalence of osteoporosis was high in relation to the demographic characteristics. Respiratory parameters, body composition, muscle strength and bone remodeling markers were associated with a lower bone mineral density.
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Cakmak A, Inal-Ince D, Sonbahar-Ulu H, Bozdemir-Ozel C, Ozalp O, Calik-Kutukcu E, Saglam M, Vardar-Yagli N, Arikan H, Selcuk ZT, Coplu L. Physical activity of patients with bronchiectasis compared with healthy counterparts: A cross-sectional study. Heart Lung 2019; 49:99-104. [PMID: 31530430 DOI: 10.1016/j.hrtlng.2019.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND A few studies have implied that patients with bronchiectasis have a more inactive lifestyle than healthy counterparts do. The main objective of this study was to compare physical activity (PA) levels subjectively and objectively between patients with bronchiectasis and healthy individuals using an accelerometer and a questionnaire. METHODS The study included 41 patients with bronchiectasis aged 18-65 years and 35 healthy age- and sex-matched control subjects. The PA level was assessed objectively using a multisensorial PA monitor, the SenseWear Armband (SWA), and subjectively with the International Physical Activity Questionnaire (IPAQ). All participants performed the incremental shuttle walk test (ISWT) for the assessment of exercise capacity. Pulmonary function, dyspnea, severity of bronchiectasis, respiratory and peripheral muscle strength, and quality of life were assessed. RESULTS The pulmonary function test parameters, respiratory and peripheral muscle strength, exercise capacity, step count, moderate- and vigorous-intensity PA duration were significantly lower in patients with bronchiectasis than in the healthy control group (p < 0.05). Sedentary, moderate, vigorous, and total PA duration measured using the SWA were higher than those obtained using the IPAQ (p < 0.05). CONCLUSIONS Patients with bronchiectasis have a reduced PA level compared with healthy counterparts. The IPAQ (based on the subjective estimation of PA) outcomes differed from the SWA outcomes, reinforcing the necessity for a disease-specific PA questionnaire. IPAQ underestimates the physical activity level compared with objective measurements.
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Affiliation(s)
- Aslihan Cakmak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey.
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Hazal Sonbahar-Ulu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Cemile Bozdemir-Ozel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Ozge Ozalp
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Cyprus International University, Lefkosa, Cyprus
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Hulya Arikan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Samanpazari, Ankara, Turkey
| | - Ziya Toros Selcuk
- Faculty of Medicine, Department of Chest Diseases, Hacettepe University, Ankara, Turkey
| | - Lutfi Coplu
- Faculty of Medicine, Department of Chest Diseases, Hacettepe University, Ankara, Turkey
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Hill AT, Sullivan AL, Chalmers JD, De Soyza A, Elborn SJ, Floto AR, Grillo L, Gruffydd-Jones K, Harvey A, Haworth CS, Hiscocks E, Hurst JR, Johnson C, Kelleher PW, Bedi P, Payne K, Saleh H, Screaton NJ, Smith M, Tunney M, Whitters D, Wilson R, Loebinger MR. British Thoracic Society Guideline for bronchiectasis in adults. Thorax 2019; 74:1-69. [PMID: 30545985 DOI: 10.1136/thoraxjnl-2018-212463] [Citation(s) in RCA: 225] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Adam T Hill
- Respiratory Medicine, Royal Infirmary of Edinburgh and University of Edinburgh, Edinburgh, UK
| | - Anita L Sullivan
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust (Queen Elizabeth Hospital), Birmingham, UK
| | - James D Chalmers
- Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital, Dundee, UK
| | - Anthony De Soyza
- Institute of Cellular Medicine, NIHR Biomedical Research Centre for Aging and Freeman Hospital Adult Bronchiectasis service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Stuart J Elborn
- Royal Brompton Hospital and Imperial College London, and Queens University Belfast
| | - Andres R Floto
- Department of Medicine, University of Cambridge, Cambridge UK.,Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge UK
| | | | | | - Alex Harvey
- Department of Clinical Sciences, Brunel University London, London, UK
| | - Charles S Haworth
- Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge UK
| | | | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | | | - Peter W Kelleher
- Centre for Immunology and Vaccinology, Chelsea &Westminster Hospital Campus, Department of Medicine, Imperial College London.,Host Defence Unit, Department of Respiratory Medicine, Royal Brompton Hospital and Harefield NHS Foundation Trust, London.,Chest & Allergy Clinic St Mary's Hospital, Imperial College Healthcare NHS Trust
| | - Pallavi Bedi
- University of Edinburgh MRC Centre for Inflammation Research, Edinburgh, UK
| | | | | | | | - Maeve Smith
- University of Alberta, Edmonton, Alberta, Canada
| | - Michael Tunney
- School of Pharmacy, Queens University Belfast, Belfast, UK
| | | | - Robert Wilson
- Host Defence Unit, Department of Respiratory Medicine, Royal Brompton Hospital and Harefield NHS Foundation Trust, London
| | - Michael R Loebinger
- Host Defence Unit, Department of Respiratory Medicine, Royal Brompton Hospital and Harefield NHS Foundation Trust, London
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Xu B, Mao Y, Wan X, Chen J, Ye M, Zhan M, Xu L, Zhao L, Li B, Zhang Z, Liu Y, Chu H. Prognostic Value of Concomitant Bronchiectasis in Newly Diagnosed Diffuse Panbronchiolitis Patients on a Maintenance Therapy with Macrolides. Can Respir J 2019; 2019:4913814. [PMID: 30984318 PMCID: PMC6431487 DOI: 10.1155/2019/4913814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/24/2019] [Indexed: 12/27/2022] Open
Abstract
Background Factors determining the prognosis of diffuse panbronchiolitis (DPB) remain unclear at present. The objective of this study was to identify the prognostic value of concomitant bronchiectasis in the macrolide treatment efficacy and exacerbation risk in DPB patients. Methods Data of patients initially diagnosed with DPB at the Shanghai Pulmonary Hospital between January 2007 and December 2017 were retrospectively collected and analyzed. The patients were divided into two groups according to the existence of bronchiectasis. Clinical manifestations, laboratory findings, microbiological culture results, as well as exacerbation risks and treatment outcomes, were compared between these two groups. The survival curve and Cox regression analysis models were additionally constructed to further demonstrate the predicting role of bronchiectasis in DPB exacerbation. Results Baseline data revealed more respiratory symptoms, lower body mass index (BMI), and forced expiratory volume in one second (FEV1) as well as increased isolates of Pseudomonas aeruginosa (P. aeruginosa) in DPB subjects with bronchiectasis than those without. Furthermore, bronchiectasis was associated with a lower rate of responsiveness to macrolides and increased exacerbation frequency during follow-up. The survival curve and Cox regression analysis showed that comorbid bronchiectasis was linked to increased time to episode relapse, which remained significant even after controlling for BMI, FEV1, and P. aeruginosa culture results. Conclusion The coexistence of bronchiectasis predicted a poor outcome of maintenance macrolide therapy and an increased exacerbation risk in DPB subjects, possibly through its impacts on nutritional status, pulmonary function, and P. aeruginosa infections.
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Affiliation(s)
- Benyong Xu
- Tongji University School of Medicine, Shanghai 200092, China
| | - Yanhua Mao
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Xiaoyu Wan
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Jianhui Chen
- Tongji University School of Medicine, Shanghai 200092, China
| | - Meiping Ye
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Mengling Zhan
- Tongji University School of Medicine, Shanghai 200092, China
| | - Liyun Xu
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Lan Zhao
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Bing Li
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Zhemin Zhang
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Yang Liu
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Haiqing Chu
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
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25
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Pulmonary Rehabilitation Only Versus With Nutritional Supplementation in Patients With Bronchiectasis. J Cardiopulm Rehabil Prev 2018; 38:411-418. [DOI: 10.1097/hcr.0000000000000341] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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26
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Chang AB, Bush A, Grimwood K. Bronchiectasis in children: diagnosis and treatment. Lancet 2018; 392:866-879. [PMID: 30215382 DOI: 10.1016/s0140-6736(18)31554-x] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/28/2018] [Accepted: 06/29/2018] [Indexed: 12/12/2022]
Abstract
Bronchiectasis is conventionally defined as irreversible dilatation of the bronchial tree. Bronchiectasis unrelated to cystic fibrosis is an increasingly appreciated cause of chronic respiratory-related morbidity worldwide. Few randomised controlled trials provide high-level evidence for management strategies to treat the children affected by bronchiectasis. However, both decades-old and more recent studies using technological advances support the notion that prompt diagnosis and optimal management of paediatric bronchiectasis is particularly important in early childhood. Although considered to be of a non-reversible nature, mild bronchiectasis determined by radiography might be reversible at any age if treated early, and the lung function decline associated with disease progression could then be halted. Although some management strategies are extrapolated from cystic fibrosis or adult-based studies, or both, non-cystic fibrosis paediatric-specific data to help diagnose and manage these children still need to be generated. We present current knowledge and an updated definition of bronchiectasis, and review controversies relating to the management of children with bronchiectasis, including applying the concept of so-called treatable traits.
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Affiliation(s)
- Anne B Chang
- Child Health Division, Menzies School of Health Research, Casuarina, NT, Australia; Department of Respiratory Medicine, Children's Health Queensland, Brisbane, QLD, Australia; Queensland University of Technology, Brisbane, QLD, Australia.
| | - Andrew Bush
- Head of Section (Paediatrics), Imperial College London, London, UK; National Heart and Lung Institute, London, UK; Royal Brompton Harefield NHS Foundation Trust, London, UK
| | - Keith Grimwood
- Royal Brompton Harefield NHS Foundation Trust, London, UK; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia; Department of Infectious Diseases and Department of Paediatrics, Gold Coast Health, Gold Coast, QLD, Australia
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Gea J, Sancho-Muñoz A, Chalela R. Nutritional status and muscle dysfunction in chronic respiratory diseases: stable phase versus acute exacerbations. J Thorac Dis 2018; 10:S1332-S1354. [PMID: 29928517 PMCID: PMC5989104 DOI: 10.21037/jtd.2018.02.66] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/22/2018] [Indexed: 12/22/2022]
Abstract
Nutritional abnormalities are frequent in different chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis (CF), interstitial fibrosis and lung cancer, having important clinical consequences. However, nutritional abnormalities often remained underdiagnosed due to the relative lack of awareness of health professionals. Therefore, systematic anthropometry or even better, assessment of body composition, should be performed in all patients with chronic respiratory conditions, especially following exacerbation periods when malnutrition becomes more accentuated. Nutritional abnormalities very often include the loss of muscle mass, which is an important factor for the occurrence of muscle dysfunction. The latter can be easily detected with the specific assessment of muscle strength and endurance, and also negatively influences patients' quality of life and prognosis. Both nutritional abnormalities and muscle dysfunction result from the interaction of several factors, including tobacco smoking, low physical activity-sedentarism, systemic inflammation and the imbalance between energy supply and requirements, which essentially lead to a negative balance between protein breakdown and synthesis. Therapeutic approaches include improvements in lifestyle, nutritional supplementation and training. Anabolic drugs may be administered in some cases.
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Affiliation(s)
- Joaquim Gea
- Respiratory Medicine Department, Hospital del Mar (IMIM), DCEXS, Universitat Pompeu Fabra, CIBERES, ISCIII, Barcelona, Spain
| | - Antoni Sancho-Muñoz
- Respiratory Medicine Department, Hospital del Mar (IMIM), DCEXS, Universitat Pompeu Fabra, CIBERES, ISCIII, Barcelona, Spain
| | - Roberto Chalela
- Respiratory Medicine Department, Hospital del Mar (IMIM), DCEXS, Universitat Pompeu Fabra, CIBERES, ISCIII, Barcelona, Spain
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28
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Doña E, Olveira C, Palenque FJ, Porras N, Dorado A, Martín-Valero R, Godoy AM, Espíldora F, Contreras V, Olveira G. Body Composition Measurement in Bronchiectasis: Comparison between Bioelectrical Impedance Analysis, Skinfold Thickness Measurement, and Dual-Energy X-ray Absorptiometry before and after Pulmonary Rehabilitation. J Acad Nutr Diet 2018; 118:1464-1473. [PMID: 29656933 DOI: 10.1016/j.jand.2018.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 01/16/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND In individuals with bronchiectasis, fat-free mass depletion may be common despite a low prevalence of underweight and is considered a risk factor for increased morbidity and mortality. Techniques to adequately estimate fat-free mass and its changes over time are needed. OBJECTIVE The purpose of this study was to assess agreement among values obtained with three different body composition techniques: skinfold thickness measurement (STM), bioelectrical impedance analysis (BIA), and dual-energy x-ray absorptiometry (DXA). DESIGN The study was a secondary analysis of data from a randomized controlled trial. PARTICIPANTS/SETTING A respiratory rehabilitation program was administered for 3 months to individuals with bronchiectasis from the bronchiectasis unit of the Regional University Hospital in Malaga, Spain, from September 2013 to September 2014. Individuals with a body mass index (calculated as kg/m2) >18.5 who were aged 65 years or younger and those with a body mass index >20 who were older than 65 years were included. MAIN OUTCOME MEASURES At baseline and at 3 and 6 months, body composition was determined by DXA and STM. STATISTICAL ANALYSES PERFORMED Statistical concordance was assessed with the intraclass correlation coefficient (ICC), kappa coefficient, and the degree of agreement using the Bland Altman method. For comparison of the quantitative variables at baseline vs at 3 months and 6 months, the paired sample t test (or the Wilcoxon test) was used. RESULTS Thirty participants were included. Strong agreement was observed between body composition values determined by BIA and DXA in fat mass (ICC: 0.92) and fat-free mass (ICC: 0.87). Strong agreement was observed between STM and DXA in the values for fat-free mass (ICC: 0.91) and fat mass (ICC: 0.94), and lower agreement was observed for the longitudinal data and in the regional values. The mean difference between fat-free mass determined by BIA and DXA was + 4.7 with a standard deviation of 2.4 kg in favor of BIA. The mean difference between fat-free mass determined by STM and DXA was +2.3 with a standard deviation of 2.7 kg in favor of STM. Six individuals were classified as having a low fat-free mass index (20%) by DXA vs four by STM (13%; kappa: 0.76) and only two by BIA (6.6%; kappa: 0.44) compared with DXA. CONCLUSIONS Despite good statistical agreement among values obtained with DXA, STM, and BIA, the study findings indicate that STM and BIA, above all, tended to overestimate fat-free mass compared with DXA.
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de Camargo AA, Boldorini JC, Holland AE, de Castro RAS, Lanza FDC, Athanazio RA, Rached SZ, Carvalho-Pinto R, Cukier A, Stelmach R, Corso SD. Determinants of Peripheral Muscle Strength and Activity in Daily Life in People With Bronchiectasis. Phys Ther 2018; 98:153-161. [PMID: 29237078 DOI: 10.1093/ptj/pzx123] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 12/07/2017] [Indexed: 02/09/2023]
Abstract
BACKGROUND Bronchiectasis is characterized by a progressive structural lung damage, recurrent infections and chronic inflammation which compromise the exertion tolerance, and may have an impact on skeletal muscle function and physical function. OBJECTIVE The purpose of this study was to compare peripheral muscle strength, exercise capacity, and physical activity in daily life between participants with bronchiectasis and controls and to investigate the determinants of the peripheral muscle strength and physical activity in daily life in bronchiectasis. DESIGN This study used a cross-sectional design. METHODS The participants' quadriceps femoris and biceps brachii muscle strength was measured. They performed the incremental shuttle walk test (ISWT) and cardiopulmonary exercise testing, and the number of steps/day was measured by a pedometer. RESULTS Participants had reduced quadriceps femoris muscle strength (mean difference to control group = 7 kg, 95% CI = 3.8-10.1 kg), biceps brachii muscle strength (2.1 kg, 95% CI = 0.7-3.4 kg), ISWT (227 m, 95% CI = 174-281 m), peak VO2 (6.4 ml/Kg/min, 95% CI = 4.0-8.7 ml/Kg/min), and number of steps/day (3,332 steps/day, 95% CI = 1,758-4,890 steps/day). A lower quadriceps femoris strength is independently associated to an older age, female sex, lower body mass index (BMI), higher score on the modified Medical Research Council scale, and shorter distance on the ISWT (R2 = 0.449). Biceps brachii strength is independently associated with sex, BMI, and dyspnea (R2 = 0.447). The determinants of number of daily steps were dyspnea and distance walked in ISWT, explaining only 27.7% of its variance. LIMITATIONS Number of steps per day was evaluated by a pedometer. CONCLUSIONS People with bronchiectasis have reduced peripheral muscle strength, and reduced aerobic and functional capacities, and they also are less active in daily life. Modifiable variables such as BMI, dyspnea, and distance walked on the ISWT are associated with peripheral muscle strength and physical activity in daily life.
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Affiliation(s)
- Anderson Alves de Camargo
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Rua Vergueiro, 235/249 - 2o subsolo, 01504-001, São Paulo, -Brazil
| | | | - Anne E Holland
- Alfred Health, Melbourne, Victoria, Australia. Physiotherapy, La Trobe University, Melbourne, Australia and Institute for Breathing and Sleep, Heidelberg, Australia
| | | | | | - Rodrigo A Athanazio
- Pulmonary Division, Heart Insitute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Samia Z Rached
- Pulmonary Division, Heart Insitute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
| | - Regina Carvalho-Pinto
- Pulmonary Division, Heart Insitute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
| | - Alberto Cukier
- Pulmonary Division, Heart Insitute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
| | - Rafael Stelmach
- Pulmonary Division, Heart Insitute (InCor), Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo
| | - Simone Dal Corso
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE
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Olveira C, Padilla A, Dorado A, Contreras V, Garcia-Fuentes E, Rubio-Martin E, Porras N, Doña E, Carmona A, Olveira G. Inflammation and Oxidation Biomarkers in Patients with Cystic Fibrosis: The Influence of Azithromycin. Eurasian J Med 2017. [PMID: 28638254 DOI: 10.5152/eurasianjmed.2017.17010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In addition to their antibiotic effect, macrolides appear to modulate the inflammatory response in cystic fibrosis (CF) and could influence oxidative stress. The objective of this study was to assess oxidation biomarkers and levels of inflammation and to determine whether there is an association between these parameters and the intake of macrolides. MATERIALS AND METHODS The subjects included in this cross-sectional study were, on the one hand, clinically stable patients with CF and, on the other, healthy controls. The following serum and plasma inflammatory and oxidative stress biomarkers were measured: interleukin-6 (IL-6), reactive C protein (RCP), tumor necrosis alpha (TNF-α), glutathione peroxidase (GPx), total antioxidant capacity (TAC), catalase (CAT), and superoxide dismutase (SOD), together with markers of lipid peroxidation (8-isoprostanes and thiobarbituric acid reactive substances [TBARS]). Clinical, anthropometric, lung function, radiological, and analytical variables (albumin, prealbumin, vitamins, and zinc) were also recorded. RESULTS We studied 36 adults with CF and 41 controls. No differences were observed in age, gender, or anthropometric variables. The patients had significantly higher levels of IL-6, TNF-α, RCP, TBARS, and isoprostanes, and lower levels of SOD than the controls. Twenty-three of the patients were treated with azithromycin, and they had more severe clinical and radiological parameters than those who were not but nevertheless presented significantly lower levels of TNF-α. No differences were observed in the markers of oxidation. CONCLUSION Inflammation and oxidation biomarkers were increased in patients with CF compared with controls. The use of azithromycin was associated with reduced TNF-α levels and did not influence oxidation parameters.
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Affiliation(s)
- Casilda Olveira
- Pneumology Service, IBIMA (Institute of Biomedical Research in Malaga), Regional University of Málaga, Málaga, Spain
| | - Alicia Padilla
- Pneumology Unit, The Costa del Sol Health Agency, Málaga, Spain
| | - Antonio Dorado
- Pneumology Service, Hospital Regional University of Málaga, Málaga, Spain
| | - Victoria Contreras
- Endocrinology and Nutrition Unit, IBIMA (Institute of Biomedical Research in Malaga), Regional University Hospital of Málaga University, Málaga, Spain
| | - Eduardo Garcia-Fuentes
- Endocrinology and Nutrition Unit, IBIMA (Institute of Biomedical Research in Malaga), Regional University Hospital of Málaga University, Málaga, Spain
| | - Elehazara Rubio-Martin
- Endocrinology and Nutrition Unit, IBIMA (Institute of Biomedical Research in Malaga), Regional University Hospital of Málaga University, Málaga, Spain
| | - Nuria Porras
- Endocrinology and Nutrition Unit, IBIMA (Institute of Biomedical Research in Malaga), Regional University Hospital of Málaga University, Málaga, Spain
| | - Esperanza Doña
- Pneumology Unit, High Resolution Hospital of Benalmádena, Málaga, Spain
| | - Ana Carmona
- Department of Medicine and Dermatology, Málaga University Faculty of Medicine, Málaga, Spain
| | - Gabriel Olveira
- Endocrinology and Nutrition Unit, IBIMA (Institute of Biomedical Research in Malaga), Regional University Hospital of Málaga University, Málaga, Spain.,CIBERDEM (CIBER of Diabetes and Associated Metabolic Diseases)
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Olveira G. Reply – Letter to the Editor – Pulmonary rehabilitation and oral nutritional supplement enriched with beta-hydroxy-beta-methylbutyrate for bronchiectasis participants: A prospective, randomised study. Clin Nutr 2016; 35:769. [DOI: 10.1016/j.clnu.2016.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
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Olveira G, Olveira C, Doña E, Palenque FJ, Porras N, Dorado A, Godoy AM, Rubio-Martínez E, Rojo-Martínez G, Martín-Valero R. Oral supplement enriched in HMB combined with pulmonary rehabilitation improves body composition and health related quality of life in patients with bronchiectasis (Prospective, Randomised Study). Clin Nutr 2015; 35:1015-22. [PMID: 26522923 DOI: 10.1016/j.clnu.2015.10.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/02/2015] [Accepted: 10/03/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND & AIMS Pulmonary Rehabilitation (PR) is recommended for bronchiectasis but there is no data about its effect on body composition. The aim of this study is to assess the effect of Pulmonary Rehabilitation (PR) for 12 weeks in normally-nourished non-cystic-fibrosis bronchiectasis patients compared with the effect of PR plus a hyperproteic oral nutritional supplement enriched with beta-hydroxy-beta-methylbutyrate (HMB) on body composition, muscle strength, quality of life and serum biomarkers. METHODS single center randomized controlled trial, parallel treatment design: Participants were randomly assigned to receive PR for 12 weeks or PR plus ONS (PRONS) (one can per day). Outcome assessments were performed at baseline, 12 weeks and 24 weeks: body composition (Dual-energy X-Ray Absorptiometry (DEXA), mid-arm muscle circumference (MAMC), phase angle by Bio-impedance), health related quality of life (Spanish QOL-B-V3.0, Physical Functioning Scale), handgrip strength, diet questionnaire, and plasma levels of prealbumin, myostatin and somatomedin-c. RESULTS Thirty patients were randomized (15 per group) without differences in clinical and respiratory variables. In the PRONS group bone mineral density (BMD), mean and maximum handgrip dynamometry, MAMC, QOLB and prealbumin were significantly increased from baseline at 12 and 24 weeks and Fat free Mass (FFM) and FFM index, at 12 weeks. In the PR group only mean handgrip dynamometry and prealbumin were significantly increased at 12 and 24 weeks. In both groups plasma myostatin was reduced at 12 weeks (without significant differences). CONCLUSION The addition of a hyperproteic ONS enriched with HMB to Pulmonary Rehabilitation could improve body composition, BMD, muscle strength and health related quality of life in bronchiectasis patients. Clinical Trials Number NCT02048397.
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Affiliation(s)
- Gabriel Olveira
- UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases (CB07/08/0019), Instituto de Salud Carlos III, Spain.
| | - Casilda Olveira
- UGC de Neumología, IBIMA (instituto de Biomedicina de Málaga), Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain, Avenida Carlos Haya, Málaga 29010, Spain.
| | - Esperanza Doña
- Neumología, Hospital de Alta resolución de Benalmádena, Spain.
| | | | - Nuria Porras
- UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain.
| | - Antonio Dorado
- UGC de Neumología, IBIMA (instituto de Biomedicina de Málaga), Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain, Avenida Carlos Haya, Málaga 29010, Spain.
| | - Ana M Godoy
- UGC Rehabilitación, Hospital Regional Universitario de Málaga, Spain.
| | - Elehazara Rubio-Martínez
- UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases (CB07/08/0019), Instituto de Salud Carlos III, Spain.
| | - Gemma Rojo-Martínez
- UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases (CB07/08/0019), Instituto de Salud Carlos III, Spain.
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Qi Q, Li T, Li JC, Li Y. Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. ACTA ACUST UNITED AC 2015; 48:715-24. [PMID: 26176309 PMCID: PMC4541691 DOI: 10.1590/1414-431x20154135] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 03/18/2015] [Indexed: 01/22/2023]
Abstract
The objective of this observational, multicenter study was to evaluate the
association of body mass index (BMI) with disease severity and prognosis in patients
with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142
males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed
tomography were classified into four groups: underweight (BMI<18.5
kg/m2), normal weight (18.5≤BMI<25.0 kg/m2), overweight
(25.0≤BMI<30.0 kg/m2), and obese (BMI≥30.0 kg/m2). Clinical
variables expressing disease severity were recorded, and acute exacerbations,
hospitalizations, and survival rates were estimated during the follow-up period. The
mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all
patients. BMI was negatively correlated with acute exacerbations, C-reactive protein,
erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic
colonization by P. aeruginosa and positively correlated with
pulmonary function indices. BMI was a significant predictor of hospitalization risk
independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival
rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with
decreasing BMI (χ2=35.16, P<0.001). The arterial carbon dioxide partial
pressure, inspiratory capacity, age, BMI, and predicted percentage of forced
expiratory volume in 1 s independently predicted survival in the Cox proportional
hazard model. In conclusion, an underweight status was highly prevalent among
patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were
prone to developing more acute exacerbations, worse pulmonary function, amplified
systemic inflammation, and chronic colonization by P. aeruginosa.
BMI was a major determinant of hospitalization and death risks. BMI should be
considered in the routine assessment of patients with non-cystic fibrosis
bronchiectasis.
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Affiliation(s)
- Q Qi
- Department of Respirology, Qilu Hospital, Shandong University, Shandong Province, Jinan, China
| | - T Li
- Department of Respirology, Qilu Hospital, Shandong University, Shandong Province, Jinan, China
| | - J C Li
- Neurosurgical Intensive Care Unit, First Affiliated Hospital,, Sun Yat-sen University, Guangdong Province, Guangzhou, China
| | - Y Li
- Department of Respirology, Qilu Hospital, Shandong University, Shandong Province, Jinan, China
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Burtin C, Hebestreit H. Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis. Respiration 2015; 89:181-9. [DOI: 10.1159/000375170] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Ayhan G, Tas D, Yilmaz I, Okutan O, Demirer E, Ayten O, Kartaloglu Z. Relation between inflammatory cytokine levels in serum and bronchoalveolar lavage fluid and gene polymorphism in young adult patients with bronchiectasis. J Thorac Dis 2014; 6:684-93. [PMID: 24976991 DOI: 10.3978/j.issn.2072-1439.2014.04.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 03/27/2014] [Indexed: 11/14/2022]
Abstract
AIM Bronchiectasis develops as a result of genetic and environmental factors and its etiopathogenesis is not still clear. Recent studies have revealed that inflammatory cytokines, which are formed as a result of chronic infection and inflammation, play a role in the pathogenesis of bronchiectasis. For this purpose, the level of inflammatory cytokines in bronchiectasis and the presence or absence of a genetic predisposition with the gene polymorphism of these cytokines was investigated. MATERIAL AND METHODS A total of 60 patients, 40 study cases and 20 controls, which were monitored with the diagnosis of bronchiectasis were included in the study. In these individuals, cytokine levels [interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α] in serum and bronchoalveolar lavage (BAL) fluid, along with the routine blood tests, were determined. Furthermore, the polymorphism in IL-6, IL-8, IL-10, and TNF-α cytokine genes and its frequency were studied in the obtained DNA by the automatic sequence analysis method and the results were compared. FINDINGS It was found that in serum and BAL fluid of the patient group, the IL-8 level was high, whereas the IL-10 level was low (P<0.05). No significant difference was detected in the other cytokines (P>0.05). It was found that in cytokine gene polymorphisms IL-8 -251 A/T, IL-10 -592 A/C, and IL-10 -819 T/C genotypes are associated with increased risk of bronchiectasis. It was detected that the IL-8 -251 A/T genotype increased the risk of having the disease by 4.19 fold. (OR =4.19, 95% CI =1.24-14.17, P=0.021). The IL-10 -592 C/A genotype increased the risk of having the disease by 5.71 fold (OR = 5.71, 95% CI =1.35-24.06, P=0.017) and the IL-10 -819 T/C genotype increased the risk of having the disease by 5.06 fold (OR =5.06, 95% CI =1.20-21.27, P=0.048). No significant correlation was found between the other polymorphisms and bronchiectasis. CONCLUSIONS The IL-8, IL-10 levels and the gene polymorphism of these cytokines differ. In addition to detecting higher levels of pro-inflammatory IL-8 and lower levels of anti-inflammatory IL-10, detection of gene polymorphism related to these two cytokines in bronchiectasis gives rise to the thought that cytokines may have role in a predisposition to bronchiectasis. However, as the number of patients is small, precise remarks could not be made on this subject. There is need for further studies include a larger number of patients.
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Affiliation(s)
- Gulhan Ayhan
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Dilaver Tas
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Ismail Yilmaz
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Oguzhan Okutan
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Ersin Demirer
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Omer Ayten
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
| | - Zafer Kartaloglu
- 1 Department of Chest Diseases, 2 Department of Pathology, GATA Haydarpasa Training Hospital, Istanbul, Turkey
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Validation of a Quality of Life Questionnaire for Bronchiectasis: psychometric analyses of the Spanish QOL-B-V3.0. Qual Life Res 2013; 23:1279-92. [DOI: 10.1007/s11136-013-0560-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2013] [Indexed: 12/14/2022]
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