1
|
Chang HC, Liu SF. Impact of Smoking Cessation and Charlson Comorbidity Index on Influenza Vaccination Efficacy in COPD Patients. Microorganisms 2024; 12:1437. [PMID: 39065205 PMCID: PMC11278861 DOI: 10.3390/microorganisms12071437] [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: 05/20/2024] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) patients are particularly susceptible to respiratory infections like influenza, which exacerbate symptoms and increase healthcare utilization. While smoking cessation and influenza vaccination are recommended preventive measures, their combined impact on healthcare resource utilization is underexplored. The Charlson Comorbidity Index (CCI) assesses comorbidity burden in COPD patients and may influence healthcare outcomes. We conducted a retrospective analysis of 357 COPD patients, evaluating smoking cessation success over one year and influenza vaccination receipt, stratifying patients by CCI scores. Healthcare utilization outcomes included emergency room visits, hospitalizations, and medical expenses. Results showed that 51.82% of patients quit smoking and 59.66% received influenza vaccination, with higher comorbidity prevalence in advanced COPD stages (p = 0.002). Both smoking cessation and influenza vaccination independently correlated with decreased emergency room visits, hospital admissions, days, and costs. Patients who both quit smoking and received influenza vaccination exhibited the lowest healthcare utilization rates. In conclusion, smoking cessation and influenza vaccination significantly reduce healthcare resource utilization in COPD patients, with the combination yielding synergistic benefits, particularly in those with lower CCI scores. Integrating these interventions and comorbidity management in COPD strategies is essential for optimizing patient outcomes and healthcare efficiency.
Collapse
Affiliation(s)
- Hui-Chuan Chang
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
| | - Shih-Feng Liu
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, #123, Ta-Pei Road, Niaosong District, Kaohsiung 833, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| |
Collapse
|
2
|
Pezzuto A, Ricci A, D’Ascanio M, Moretta A, Tonini G, Calabrò N, Minoia V, Pacini A, De Paolis G, Chichi E, Carico E, Tammaro A. Short-Term Benefits of Smoking Cessation Improve Respiratory Function and Metabolism in Smokers. Int J Chron Obstruct Pulmon Dis 2023; 18:2861-2865. [PMID: 38059013 PMCID: PMC10697086 DOI: 10.2147/copd.s423148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/30/2023] [Indexed: 12/08/2023] Open
Abstract
Background Cigarette smoke exposure is the main preventable cause of chronic obstructive pulmonary disease (COPD). Airflow limitation is closely associated with smoking exposure. Smoking could also interfere with lipid metabolism. Aim To determine the respiratory functional and metabolic changes after smoking cessation in smokers in the short term. Methods All patients were current smokers. They were assessed by spirometry and questionnaires such as COPD assessment test(CAT), modified Medical Research Council (mMRC) test for dyspnea, Fagestrom's test for nicotine dependence. Exhaled CO was detected in order to evaluate smoking exposure and smoking cessation (normal value<7 ppm). A blood sampling was eventually taken for vitamin D and cholesterol assay. All patients underwent therapy with counselling and varenicline as first-line treatment according to its schedule. Detection time: at baseline and one month after smoking cessation. Results All patients quit smoking during treatment. The mean age was 62 with a prevalence of males. The analysis revealed the following mean values at baseline: CAT mean score was 15, pack-years 35.5, Fagestrom's Test mean score 5.0. The West's value was 8.5, whereas Body mass index (BMI) was 25.5.Cigarette daily consumption mean value was 22.5. The comparison before and at follow up one month after smoking cessation about functional and metabolic parameters, show us the following results: FEV 1 was increased by 200 mL (p<0.02), FEF 25/75 was improved as well as mMRC test. The eCO was dropped to as low as 8 ppM. Interestingly the vitamin D level was increased from 25 to 28 ng/mL without any support therapy. The cholesterol total level was reduced and CAT value and DLCO were also significantly improved. Conclusion Quit smoking is useful to improve symptoms, respiratory function and metabolic parameters in the short term.
Collapse
Affiliation(s)
- Aldo Pezzuto
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Alberto Ricci
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Michela D’Ascanio
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Alba Moretta
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Giuseppe Tonini
- Oncology Department, Campus Bio-Medico University, Rome, Italy
| | - Noemi Calabrò
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Valeria Minoia
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Alessia Pacini
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Giuliana De Paolis
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Eleonora Chichi
- Department of Cardiovascular and Respiratory Sciences, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Elisabetta Carico
- Clinical and Molecular Medicine Department, S Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonella Tammaro
- Department of Neuroscience- NESMOS, S.Andrea Hospital, Sapienza University, Rome, Italy
| |
Collapse
|
3
|
Feng X, Deng J, Li X, Zhang H, Wei X, Ma T, Tang S, Zhang J. RNA Sequencing and Related Differential Gene Expression Analysis in a Mouse Model of Emphysema Induced by Tobacco Smoke Combined with Elastin Peptides. Int J Chron Obstruct Pulmon Dis 2023; 18:2147-2161. [PMID: 37810372 PMCID: PMC10559798 DOI: 10.2147/copd.s397400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/30/2023] [Indexed: 10/10/2023] Open
Abstract
Objective To establish a model of emphysema induced by tobacco smoke combined with elastin peptides (EP), explore the biochemical metabolic processes and signal transduction pathways related to emphysema occurrence and development at the transcriptional level, and identify new targets and signaling pathways for emphysema prevention and treatment. Methods Mice were randomly divided into the air pseudoexposure group (NORMAL group) and the tobacco smoke + EP group (EP group). The differentially expressed genes (DEGs) in lung tissue between the two groups were identified by RNA-seq, and functional annotation and Gene Ontology (GO)/ Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed. The differential expression of the selected genes were verified using qRT‒PCR and immunohistochemistry (IHC). Results EP group mice showed emphysema-like changes. The expression levels of 1159 genes in the EP group differed significantly (529 up-regulated and 630 down-regulated) from those in the NORMAL group. GO enrichment analysis showed that the DEGs were significantly enriched in the terms immune system, adaptive immune response, and phosphorylation, while KEGG pathway enrichment analysis showed that the DEGs were enriched mainly in the pathways cytokine‒cytokine receptor interaction, T-cell receptor signaling pathway, MAPK signaling pathway, Rap1 signaling pathway, endocytosis, chemokine signaling pathway, Th17 cell differentiation, and Th1 and Th2 cell differentiation. The differential expression of the selected DEGs were verified by qRT‒PCR and IHC, and the expression trends of these genes were consistent with those identified by RNA-seq. Conclusion Emphysema may be related to the inflammatory response, immune response, immune regulation, oxidative stress injury, and other biological processes. The Bmp4-Smad-Hoxa5/Acvr2a signaling pathway may be involved in COPD/ emphysema occurrence and development.
Collapse
Affiliation(s)
- Xin Feng
- Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, 518000, People’s Republic of China
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Jiehua Deng
- Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, 518000, People’s Republic of China
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Xiaofeng Li
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Hui Zhang
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Xuan Wei
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Tingting Ma
- Department of Respiratory and Critical Medicine, Zhuhai People’s Hospital, Zhuhai, Guangdong, 519099, People’s Republic of China
| | - Shudan Tang
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China
| | - Jianquan Zhang
- Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, 518000, People’s Republic of China
| |
Collapse
|
4
|
Chen G, Mu Q, Meng ZJ. Cigarette Smoking Contributes to Th1/Th2 Cell Dysfunction via the Cytokine Milieu in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2023; 18:2027-2038. [PMID: 37720875 PMCID: PMC10504905 DOI: 10.2147/copd.s426215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
Background Dysregulation and pyroptosis of T-helper (Th) cells and inflammatory cytokines have been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, the immune response mechanisms as a consequence of tobacco smoke exposure are not fully understood. We hypothesized that cigarette smoke-induced inflammation could be modulated through the cytokine milieu and T-cell nicotinic acetylcholine receptors (nAChRs). Methods The proportions of peripheral blood Th1 and Th2 cells from patients with COPD, smokers without airway obstruction and healthy nonsmokers were analyzed using flow cytometry. The levels of plasma proinflammatory cytokines and their potential association with pulmonary function were also measured. The influence of cigarette smoke extract (CSE) on the conditioned differentiation of T helper cell subsets was further examined in vitro. Results Significantly higher Th1 cell and plasma IFN-γ and IL-18 levels but lower levels of Th2 cells were found in the peripheral blood from patients with COPD. The increased plasma levels of IFN-γ and IL-18 were negatively correlated with pulmonary function (FEV1% predicted value). Pyroptosis participates in COPD development probably through the activation of the NLRP3 inflammasome upon exposure to CSE. CSE does not directly induce the differentiation of T helper cells; however, under conditioned medium, CSE promotes Th1 development through α7 nAChR modification, while it does not substantially interfere with Th2 differentiation. Conclusion The differences in the cytokine milieu play a key role in the effects of CSE on the immune response in patients with COPD.
Collapse
Affiliation(s)
- Gang Chen
- Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Qing Mu
- Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Zhao-Ji Meng
- Department of Immune Allergy, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| |
Collapse
|
5
|
Liu Y, Tang J, Sun Y. Impact of Interstitial Lung Abnormalities on Disease Expression and Outcomes in COPD or Emphysema: A Systematic Review. Int J Chron Obstruct Pulmon Dis 2023; 18:189-206. [PMID: 36890863 PMCID: PMC9987235 DOI: 10.2147/copd.s392349] [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: 10/09/2022] [Accepted: 02/15/2023] [Indexed: 03/05/2023] Open
Abstract
Background Both COPD and interstitial lung abnormalities (ILAs) are conditions associated with smoking and age. The impact of coexistent ILAs on the manifestations and outcomes of COPD or emphysema awaits evaluation. Methods We searched PubMed and Embase using Medical Subject Headings terms in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Eleven studies were included in the review. The sample size of the studies ranged from 30 to 9579. ILAs were reported in 6.5% to 25.7% of the patients with COPD/emphysema, higher than that reported in the general populations. COPD/emphysema patients with ILAs were older, mostly male, and had a higher smoking index than those without ILAs. Hospital admission and mortality were increased in COPD patients with ILAs compared to those without ILAs, whereas the frequency of COPD exacerbations was discrepant in 2 of the studies. The FEV1 and FEV1% predicted tended to be higher in the group with ILAs, but not significantly in most of the studies. Conclusion ILAs were more frequent in subjects with COPD/emphysema than in the general population. ILAs may have a negative impact on hospital admission and mortality of COPD/emphysema. The impact of ILAs on lung functions and exacerbations of COPD/emphysema was discrepant in these studies. Further prospective studies are warranted to provide high-quality evidence of the association and interaction between COPD/emphysema and ILAs.
Collapse
Affiliation(s)
- Yujia Liu
- Department of Respiratory and Critical Medicine, Peking University Third Hospital, Beijing, People's Republic of China.,Department of Respiratory and Critical Medicine, Peking University International Hospital, Beijing, People's Republic of China
| | - Jingyun Tang
- Blood Research Laboratory, Chengdu Blood Center, Chengdu, Sichuan, People's Republic of China
| | - Yongchang Sun
- Department of Respiratory and Critical Medicine, Peking University Third Hospital, Beijing, People's Republic of China
| |
Collapse
|
6
|
Functional Benefit of Smoking Cessation and Triple Inhaler in Combustible Cigarette Smokers with Severe COPD: A Retrospective Study. J Clin Med 2022; 12:jcm12010234. [PMID: 36615032 PMCID: PMC9821177 DOI: 10.3390/jcm12010234] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022] Open
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is the third cause of mortality and it is smoking-related. It is characterized by a non-reversible airflow limitation and a progressive worsening of the respiratory function. Objective: The aim of this study is to point out the benefit of smoking cessation combined with a single inhaler triple therapy in terms of clinical and functional outcome in this setting. Methods: A retrospective analysis was performed in patients affected by severe COPD and at least one exacerbation a year, who underwent a smoking cessation program. All patients underwent a 6 min walking test, body plethysmography, and an exhaled test for carbon monoxide. The modified medical research council test (mMRC) test, the Fagestrom nicotine dependency test (FTND) and the COPD assessment test (CAT) questionnaire were also administered. All patients were checked at the baseline and in the six-month follow-up after the start of the treatment. Results: Smoking cessation was achieved by 51% of patients within a month and it was confirmed by eCO measure (<7 ppm). Patients who quit smoking reported better results after six months compared with patients who did not. The increase in FEV1 within the group of quitters was 90 mL (p < 0.05) and the walking test improved by 90 m (p < 0.01); eCO decreased by 15 ppm (p < 0.01) while FVC increased by 70 mL (p < 0.05). No significant changes were recorded within the group of sustainers. The difference in functional changes between groups was significant with regard to FEV1, cCO, and WT. Conclusions: Smoking cessation enhances the efficacy of single inhaler triple therapy, improving clinical and functional variables after six months from the start.
Collapse
|
7
|
Effects of tiotropium on the risk of coronary heart disease in patients with COPD: a nationwide cohort study. Sci Rep 2022; 12:16674. [PMID: 36198721 PMCID: PMC9535029 DOI: 10.1038/s41598-022-21038-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/22/2022] [Indexed: 11/08/2022] Open
Abstract
Inhaled long-acting muscarinic antagonist (LAMA) is recommended for the treatment of chronic obstructive pulmonary disease (COPD). However, there is still concern that LAMA may cause cardiovascular adverse events in COPD patients. Therefore, this study aimed to determine whether the administration of tiotropium, the first commercially available LAMA, could increase the risk of coronary heart disease (CHD) in COPD patients through a nationwide cohort study. We used the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database between 2002 and 2014 for the analysis. We applied a washout period of COPD diagnosis during 2002–2003 and excluded the patients who used an inhaler before the diagnosis of COPD. We also excluded patients who were diagnosed with CHD before inhaler use. Among a total of 5787 COPD patients, 1074 patients were diagnosed with CHD. In the Cox regression models with time-dependent tiotropium usage, we found that tiotropium significantly increased the risk of CHD in a subgroup of age \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$\ge \hspace{0.17em}$$\end{document}≥55 years compared to non-users of tiotropium (adjusted hazard ratio [aHR], 1.24; 95% confidence interval [CI], 1.003–1.54). When analyzed by dividing into tertiles (high/middle/low) according to the cumulative tiotropium exposure, the high tertile exposure group of tiotropium was associated with a higher risk of CHD compared with the low tertile exposure group of tiotropium. Additionally, the risk of CHD was higher in the high tertile exposure group of tiotropium in the age 55 and older group and in the never smoker group. When prescribing tiotropium for COPD patients, particularly those over 55 years of age and never-smokers, it is desirable to evaluate the risk of CHD in advance and closely follow-up for CHD occurrence.
Collapse
|
8
|
Pezzuto A, Trabalza Marinucci B, Ricci A, Ciccozzi M, Tonini G, D'Ascanio M, Guerrieri G, Chianese M, Castelli S, Rendina EA. Predictors of respiratory failure after thoracic surgery: a retrospective cohort study with comparison between lobar and sub-lobar resection. J Int Med Res 2022; 50:3000605221094531. [PMID: 35768901 PMCID: PMC9251996 DOI: 10.1177/03000605221094531] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Only approximately 15% of patients with lung cancer are suitable for surgery and clinical postoperative outcomes vary. The aim of this study was to investigate variables associated with post-surgery respiratory failure in this patient cohort. Methods Patients who underwent surgery for lung cancer were retrospectively studied for respiratory function. All patients had undergone lung resection by a mini-thoracotomy approach. The study population was divided into two subgroups for comparison: lobectomy group, who underwent lobar resection; and sub-lobar resection group. Results A total of 85 patients were included, with a prevalence of lung cancer stage IA and adenocarcinoma histotype. Lobectomy (versus sub-lobar resection), the presence of chronic obstructive pulmonary disease (COPD), and a COPD assessment test (CAT) score >10, were all associated with an increased risk of respiratory failure. The partial pressure of arterial oxygen decreased more in the lobectomy group than in the sub-lobar resection group following surgery, with a significant postoperative between-group difference in values. Postoperative CAT scores were also better in the sub-lobar resection group. Conclusions Post-surgical variations in functional parameters were greater in the group treated by lobectomy. COPD, high CAT score and surgery type were associated with postoperative development of respiratory failure.
Collapse
Affiliation(s)
- Aldo Pezzuto
- Department of Cardiovascular and Respiratory Sciences, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | | | - Alberto Ricci
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Massimo Ciccozzi
- Department of Epidemiology, Campus Bio-Medico University, Rome, Italy
| | - Giuseppe Tonini
- Department of Oncology, Campus Bio-Medico University, Rome, Italy
| | - Michela D'Ascanio
- Department of Cardiovascular and Respiratory Sciences, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Giulio Guerrieri
- Department of Cardiovascular and Respiratory Sciences, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Maria Chianese
- Department of Cardiovascular and Respiratory Sciences, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Silvia Castelli
- Department of Cardiovascular and Respiratory Sciences, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Erino Angelo Rendina
- Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| |
Collapse
|
9
|
Bernabeu-Mora R, Valera-Novella E, Sánchez-Martínez MP, Medina-Mirapeix F. Improving the Reliability Between the BODE Index and the BODS Index in Which the 6-Min Walk Test Was Replaced with the Five-Repetition Sit-to-Stand Test. Int J Chron Obstruct Pulmon Dis 2022; 17:643-652. [PMID: 35378838 PMCID: PMC8976496 DOI: 10.2147/copd.s347696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/28/2022] [Indexed: 12/01/2022] Open
Abstract
Purpose The BODS index has been confirmed to have predictive properties similar to the original BODE index for mortality in COPD. We evaluated the agreement between the BODS index and the BODE and explored with an updated BODS how this agreement could be improved and its ability to correctly discriminate individual participants’ mortality in a prospective cohort study. Patients and Methods We included prospectively a consecutive sample of 137 patients with COPD, between 40 and 80 years, during 2014 and followed for 5 years (2014–2019) in the Pneumology section of a public university hospital in Spain. They participated in the baseline data collection, which included BODE- and BODS-related measurements and prognostic factors, and were followed up for 5-year mortality. We used Bland–Altman plots and the kappa coefficient to analyze the agreement between both the original and updated BODS and the BODE index, and we used the areas under ROC curves (AUC) to compare their discriminative abilities for 5-year all-cause mortality. Results The original BODS index scores and quartiles had weak agreement with the BODE index, and our updated BODS strengthened these agreements (a small, statistically nonsignificant mean bias [<0.03] with LoAs<2 points, and a substantial Kappa coefficient [k =0.63; IC 95%: 0.53–0.73]). In addition, the updated BODS index scores had better summarized ability than the BODS index in discriminating participants’ mortality during the following 5 years (AUC: 0.768 versus 0.736; p=0.04). Conclusion The updated BODS index scores and quartiles may provide prognostic information similar to that provided by the BODE index in COPD. Future research should focus on index improvement through external validation, as well as the assessment of safety and effectiveness in clinical practice by means of impact studies.
Collapse
Affiliation(s)
- Roberto Bernabeu-Mora
- Department of Pneumology, Hospital General Universitario Morales Meseguer, Murcia, Spain
- Department of Internal Medicine, University of Murcia, Murcia, Spain
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Correspondence: Roberto Bernabeu-Mora, Department of Pneumology, Hospital General Universitario Morales Meseguer, Avda Marqués de los Vélez s/n, Murcia, 30008, Spain, Tel +34 968 360 900, Fax +34 968 360 994, Email
| | - Elisa Valera-Novella
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Department of Physical Therapy, University of Murcia, Murcia, Spain
| | - María Piedad Sánchez-Martínez
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Department of Physical Therapy, University of Murcia, Murcia, Spain
| | - Francesc Medina-Mirapeix
- Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria-Virgen de La Arrixaca (IMIB), Murcia, Spain
- Department of Physical Therapy, University of Murcia, Murcia, Spain
| |
Collapse
|
10
|
Zakiyah N, Purwadi FV, Insani WN, Abdulah R, Puspitasari IM, Barliana MI, Lesmana R, Amaliya A, Suwantika AA. Effectiveness and Safety Profile of Alternative Tobacco and Nicotine Products for Smoking Reduction and Cessation: A Systematic Review. J Multidiscip Healthc 2021; 14:1955-1975. [PMID: 34326646 PMCID: PMC8315778 DOI: 10.2147/jmdh.s319727] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/02/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Alternative tobacco and nicotine products such as electronic cigarettes (EC), smokeless tobacco, and nicotine replacement therapy (NRT) are currently being assessed as options in tobacco harm reduction due to their potential role in smoking reduction and smoking cessation. OBJECTIVE To provide the current evidence on the effectiveness and safety of various alternative tobacco and nicotine products for smoking reduction and cessation. METHODS A systematic review using databases from MEDLINE (PubMed), EMBASE, and The Cochrane Library was conducted up to December 2020 to identify eligible experimental and observational studies assessing the use of alternative tobacco and nicotine products on smoking reduction and smoking cessation and the safety of these products. The Cochrane Risk of Bias 2 (RoB 2) and ROBINS-I tools were used to assess the risk of bias of the included studies. Results were described through a narrative synthesis of the evidence. RESULTS From 1955 retrieved references, 44 studies (31 randomized controlled trials/RCTs and 13 prospective cohort studies) met the inclusion criteria and were included in the review. Twenty-nine studies were assessing EC, one study evaluated heat-not-burn (HNB) product, five studies were focused on snus, and nine studies assessed NRT in the form of nicotine patch, gum, etc. The overall results suggested that alternative tobacco and nicotine products in the form of EC, snus, and NRT can moderately reduce daily cigarette consumption and has potential to assist smoking cessation attempts, with fewer adverse events. CONCLUSION The findings suggested that alternative tobacco and nicotine products have a potential role in assisting smoking reduction and cessation, highlighting their role in the tobacco harm reduction approach. Further studies should focus on investigating long-term outcomes, safety, and effectiveness of alternative tobacco and nicotine products to better inform smoking reduction/cessation policy. PROSPERO REGISTRATION NUMBER CRD42020205830.
Collapse
Affiliation(s)
- Neily Zakiyah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Febby V Purwadi
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Widya N Insani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Irma M Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Melisa I Barliana
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Department of Biological Pharmacy, Biotechnology Pharmacy Laboratory, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Ronny Lesmana
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Division of Physiology, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Division of Biological Activity, Central Laboratory, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Amaliya Amaliya
- Department of Periodontics, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Auliya A Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, West Java, Indonesia
- Center for Health Technology Assessment, Universitas Padjadjaran, Bandung, West Java, Indonesia
| |
Collapse
|
11
|
Dos Santos Arcas C, Lin-Wang HT, Umeda IIK, de Sousa MG, Utiyama DMO, de Padua Mansur A, Macchione M, Hirata MH, Nakagawa NK. Smoking load reduction is insufficient to downregulate miR-301b, a lung cancer promoter. Sci Rep 2020; 10:21112. [PMID: 33273694 PMCID: PMC7713348 DOI: 10.1038/s41598-020-78242-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 11/20/2020] [Indexed: 12/23/2022] Open
Abstract
Several circulating miRNAs identified in the plasma of smokers have been implicated as promoters of nasopharyngeal and lung carcinoma. To investigate the plasma profile of miRNAs in subjects who reduces the number of smoked cigarettes and who quit after six months. We accompanied 28 individuals enrolled in a Smoking Cessation Program over 6 months. At Baseline, clinical characteristics, co-morbidities, and smoking history were similar among subjects. After 6 months, two groups were defined: who successfully quitted smoking (named "quitters", n = 18, mean age 57 years, 11 male) and who reduced the number of cigarettes smoked (20-90%) but failed to quit smoking (named "smokers", n = 10, mean age 52 years, 3 male). No significant clinical changes were observed between groups at baseline and after a 6-month period, however, quitters showed significant downregulations in seven miRNAs at baseline: miR-17 (- 2.90-fold, p = 0.029), miR-20a (- 3.80-fold, p = 0.021); miR-20b (- 4.71-fold, p = 0.027); miR-30a (- 3.95-fold, p = 0.024); miR-93 (- 3.63-fold, p = 0.022); miR-125a (- 1.70-fold, p = 0.038); and miR-195 (- 5.37-fold, p = 0.002), and after a 6-month period in 6 miRNAs: miR-17 (- 5.30-fold, p = 0.012), miR-20a (- 2.04-fold, p = 0.017), miR-20b (- 5.44-fold, p = 0.017), miR-93 (- 4.00-fold, p = 0.041), miR-101 (- 4.82-fold, p = 0.047) and miR-125b (- 3.65-fold, p = 0.025). Using time comparisons, only quitters had significant downregulation in miR-301b (- 2.29-fold, p = 0.038) after 6-month. Reductions in the number of smoked cigarettes was insufficient to change the plasma profile of miRNA after 6 months. Only quitting smoking (100% reduction) significantly downregulated miR-301b related to hypoxic conditions, promotion of cell proliferation, decreases in apoptosis, cancer development, and progression as increases in radiotherapy and chemotherapy resistance.
Collapse
Affiliation(s)
- Camila Dos Santos Arcas
- Department of Physiotherapy, LIM-54, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 room 1150, São Paulo, São Paulo, 01246-930, Brazil
| | - Hui Tzu Lin-Wang
- Dante Pazzanese Institute of Cardiology São Paulo State, São Paulo, Brazil
| | - Iracema Ioco Kikuchi Umeda
- Department of Physiotherapy, LIM-54, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 room 1150, São Paulo, São Paulo, 01246-930, Brazil
- Dante Pazzanese Institute of Cardiology São Paulo State, São Paulo, Brazil
| | | | | | - Antonio de Padua Mansur
- Department of Cardiopneumology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mariangela Macchione
- Department of Pathology, LIM05, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mario Hiroyuki Hirata
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, Universidade de São Paulo, São Paulo, Brazil
| | - Naomi Kondo Nakagawa
- Department of Physiotherapy, LIM-54, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 room 1150, São Paulo, São Paulo, 01246-930, Brazil.
| |
Collapse
|
12
|
Pezzuto A, D'Ascanio M, Ricci A, Pagliuca A, Carico E. Expression and role of p16 and GLUT1 in malignant diseases and lung cancer: A review. Thorac Cancer 2020; 11:3060-3070. [PMID: 32945604 PMCID: PMC7606016 DOI: 10.1111/1759-7714.13651] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 12/17/2022] Open
Abstract
Non‐small cell lung cancer (NSCLC) is the leading cause of cancer death and in most cases it is often diagnosed at an advanced stage. Many genetic and microenvironmental factors are able to modify the cell cycle inducing carcinogenesis and tumor growth. Among the metabolic and genetic factors that come into play in carcinogenesis and tumor cell differentiation and growth there are two different proteins that should be considered which are glucose transporters (GLUTs) and p16INK4 The first are glucose transporters which are strongly involved in tumor metabolism, notably accelerating cancer cell metabolism both in aerobic and anaerobic conditions. There are different subtypes of GLUT family factors of which GLUT 1 is the most important and widely expressed. By contrast, p16 is mainly a tumor‐suppressor protein that acts on cyclin‐dependent kinase favoring cell cycle arrest in the G1 phase. Our search focused on the action of the aforementioned factors.
Collapse
Affiliation(s)
- Aldo Pezzuto
- Cardiovascular-Pulmonary Science Department, Sant' Andrea Hospital-Sapienza University, Rome, Italy
| | - Michela D'Ascanio
- Clinical and Molecular Medicine Department, Sant' Andrea Hospital- Sapienza University, Rome, Italy
| | - Alberto Ricci
- Clinical and Molecular Medicine Department, Sant' Andrea Hospital- Sapienza University, Rome, Italy
| | - Alessandra Pagliuca
- Cardiovascular-Pulmonary Science Department, Sant' Andrea Hospital-Sapienza University, Rome, Italy
| | - Elisabetta Carico
- Clinical and Molecular Medicine Department, Sant' Andrea Hospital- Sapienza University, Rome, Italy
| |
Collapse
|
13
|
Mycoplasmas-Host Interaction: Mechanisms of Inflammation and Association with Cellular Transformation. Microorganisms 2020; 8:microorganisms8091351. [PMID: 32899663 PMCID: PMC7565387 DOI: 10.3390/microorganisms8091351] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 08/28/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
Mycoplasmas are the smallest and simplest self-replicating prokaryotes. Located everywhere in nature, they are widespread as parasites of humans, mammals, reptiles, fish, arthropods, and plants. They usually exhibiting organ and tissue specificity. Mycoplasmas belong to the class named Mollicutes (mollis = soft and cutis = skin, in Latin), and their small size and absence of a cell wall contribute to distinguish them from other bacteria. Mycoplasma species are found both outside the cells as membrane surface parasites and inside the cells, where they become intracellular residents as "silent parasites". In humans, some Mycoplasma species are found as commensal inhabitants, while others have a significant impact on the cellular metabolism and physiology. Mollicutes lack typical bacterial PAMPs (e.g., lipoteichoic acid, flagellin, and some lipopolysaccharides) and consequently the exact molecular mechanisms of Mycoplasmas' recognition by the cells of the immune system is the subjects of several researches for its pathogenic implications. It is well known that several strains of Mycoplasma suppress the transcriptional activity of p53, resulting in reduced apoptosis of damaged cells. In addition, some Mycoplasmas were reported to have oncogenic potential since they demonstrated not just accumulation of abnormalities but also phenotypic changes of the cells. Aim of this review is to provide an update of the current literature that implicates Mycoplasmas in triggering inflammation and altering critical cellular pathways, thus providing a better insight into potential mechanisms of cellular transformation.
Collapse
|
14
|
Xiao J, Kuang X, Dai L, Zhang L, He B. Anti-tumour effects of Keratin 6A in lung adenocarcinoma. CLINICAL RESPIRATORY JOURNAL 2020; 14:667-674. [PMID: 32162441 DOI: 10.1111/crj.13182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/13/2020] [Accepted: 03/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND To examine the effects of Keratin 6A (KRT6A) protein on the proliferation, migration and invasion abilities of lung adenocarcinoma cells, and to analyse the relationship between the expression level of KRT6A protein and the survival prognosis of lung adenocarcinoma patients. METHODS Western Blot was used to detect the expression of KRT6A protein in lung adenocarcinoma cell lines. CCK-8 experiment and colony formation assays were performed to detect the proliferation ability. Wound healing assay and transwell migration assay were conducted to detect the migration ability. Transwell invasion assay was conducted to detect the invasion ability. Immunohistochemistry was used to detect the expression of KRT6A protein in lung adenocarcinoma tissues. RESULTS We first found that the expression of KRT6A protein in lung adenocarcinoma cell lines was low. After overexpressed KRT6A protein in lung adenocarcinoma cells, we then found that KRT6A protein could not only inhibit the proliferation ability of lung adenocarcinoma cells but also inhibit them migration and invasion abilities. In addition, we also found that there had obvious difference in the expression of KRT6A protein in between patients. And through further analysis, we finally discovered that high expression of KRT6A protein was related to favourable prognosis in lung adenocarcinoma patients. CONCLUSIONS KRT6A protein inhibits the proliferation, migration and invasion abilities of lung adenocarcinoma cells, and high expression of KRT6A protein is a predictor of good prognosis in patients with lung adenocarcinoma.
Collapse
Affiliation(s)
- Jian Xiao
- Department of Geriatrics, Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Xiao Kuang
- Department of Geriatrics, Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Longxia Dai
- Department of Geriatrics, Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Lihai Zhang
- Department of Geriatrics, Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Bixiu He
- Department of Geriatrics, Respiratory Medicine, Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
15
|
Initiating drug therapy in early stage chronic obstructive pulmonary disease: does it impact the course and outcome? Curr Opin Pulm Med 2020; 25:132-137. [PMID: 30461533 DOI: 10.1097/mcp.0000000000000553] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Early chronic obstructive pulmonary disease (COPD) is emerging in importance for the clinical and research settings. This review will highlight a proposed definition of early COPD, examine early and midlife factors that lead to development of early COPD and review the literature pertaining to the treatment of mild COPD to gain insight into potential therapeutic approaches for early disease. RECENT FINDINGS Early COPD can be defined as disease occurring in patients younger than 50 years in age with a 10-pack-year or more smoking history and abnormal spirometry, imaging or lung function decline. Childhood exposures (maternal smoking and recurrent respiratory infections), childhood and adult asthma, and smoking affect middle-age lung function. Multiple studies of long-acting muscarinic antagonists (LAMAs) in mild COPD have shown improvements in lung function and symptoms scores. Smoking cessation also has a beneficial effect on longitudinal lung function. SUMMARY Early COPD is an important manifestation of COPD, with a newly proposed definition and associated risk factors identified. Inferring from studies on mild COPD cohorts, LAMAs and smoking cessation may have a positive effect on longitudinal lung function and symptomatic improvement.
Collapse
|
16
|
Role of Mycoplasma Chaperone DnaK in Cellular Transformation. Int J Mol Sci 2020; 21:ijms21041311. [PMID: 32075244 PMCID: PMC7072988 DOI: 10.3390/ijms21041311] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/04/2020] [Accepted: 02/12/2020] [Indexed: 12/25/2022] Open
Abstract
Studies of the human microbiome have elucidated an array of complex interactions between prokaryotes and their hosts. However, precise bacterial pathogen-cancer relationships remain largely elusive, although several bacteria, particularly those establishing persistent intra-cellular infections, like mycoplasmas, can alter host cell cycles, affect apoptotic pathways, and stimulate the production of inflammatory substances linked to DNA damage, thus potentially promoting abnormal cell growth and transformation. Consistent with this idea, in vivo experiments in several chemically induced or genetically deficient mouse models showed that germ-free conditions reduce colonic tumor formation. We demonstrate that mycoplasma DnaK, a chaperone protein belonging to the Heath shock protein (Hsp)-70 family, binds Poly-(ADP-ribose) Polymerase (PARP)-1, a protein that plays a critical role in the pathways involved in recognition of DNA damage and repair, and reduces its catalytic activity. It also binds USP10, a key p53 regulator, reducing p53 stability and anti-cancer functions. Finally, we showed that bystander, uninfected cells take up exogenous DnaK-suggesting a possible paracrine function in promoting cellular transformation, over and above direct mycoplasma infection. We propose that mycoplasmas, and perhaps certain other bacteria with closely related DnaK, may have oncogenic activity, mediated through the inhibition of DNA repair and p53 functions, and may be involved in the initiation of some cancers but not necessarily involved nor necessarily even be present in later stages.
Collapse
|
17
|
Batista R, Vinagre N, Meireles S, Vinagre J, Prazeres H, Leão R, Máximo V, Soares P. Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review. Diagnostics (Basel) 2020; 10:diagnostics10010039. [PMID: 31941070 PMCID: PMC7169395 DOI: 10.3390/diagnostics10010039] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/13/2022] Open
Abstract
Bladder cancer (BC) ranks as the sixth most prevalent cancer in the world, with a steady rise in its incidence and prevalence, and is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type. Diagnosis and monitoring of BC is mainly performed by invasive tests, namely periodic cystoscopies; this procedure, although a reliable method, is highly uncomfortable for the patient and it is not exempt of comorbidities. Currently, there is no formal indication for the use of molecular biomarkers in clinical practice, even though there are several tests available. There is an imperative need for a clinical non-invasive testing for early detection, disease monitoring, and treatment response in BC. In this review, we aim to assess and compare different tests based on molecular biomarkers and evaluate their potential role as new molecules for bladder cancer diagnosis, follow-up, and treatment response monitoring.
Collapse
Affiliation(s)
- Rui Batista
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- U-Monitor Lda, 4200-135 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Nuno Vinagre
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Sara Meireles
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Oncology, Hospital Centre of S. João, 4200-319 Porto, Portugal
| | - João Vinagre
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- U-Monitor Lda, 4200-135 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Hugo Prazeres
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- U-Monitor Lda, 4200-135 Porto, Portugal
- Pathology Service, Portuguese Institute of Oncology Francisco Gentil (IPO-Coimbra), 3000-075 Coimbra, Portugal
| | - Ricardo Leão
- Urology department, Hospital de Braga, 4710-243 Braga, Portugal;
- Urology department, Hospital CUF Coimbra, 3000-600 Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal
| | - Valdemar Máximo
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Paula Soares
- i3S–Instituto de Investigação e Inovação em Saúde, 4200-135 Porto, Portugal; (R.B.); (N.V.); (S.M.); (J.V.); (H.P.); (V.M.)
- Institute of Molecular Pathology and Immunology of the University of Porto-IPATIMUP, 4200-135 Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence: ; Tel.: +351-225-570-700
| |
Collapse
|
18
|
Changes in Body Composition During Adjuvant FOLFOX Chemotherapy and Overall Survival in Non-Metastatic Colon Cancer. Cancers (Basel) 2019; 12:cancers12010060. [PMID: 31878325 PMCID: PMC7016804 DOI: 10.3390/cancers12010060] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 12/03/2019] [Accepted: 12/19/2019] [Indexed: 12/30/2022] Open
Abstract
The impact of longitudinal anthropometric changes during adjuvant chemotherapy on long-term survival in non-metastatic colon cancer is unclear. Herein, we analyzed the prognostic significance of computed tomography (CT)-measured body composition changes in colon cancer patients who underwent surgery followed by adjuvant FOLFOX (folinic acid, 5-fluorouracil, oxaliplatin) chemotherapy. Data of 167 patients with stage III or high-risk stage II colon cancer were analyzed. Skeletal muscle index (SMI), skeletal muscle radiodensity (SMR), visceral fat index (VFI), subcutaneous fat index (SFI), and total fat index (TFI) changes during chemotherapy were calculated using preoperative and postchemotherapy CT image data. The Cox proportional hazard model was used to determine the correlation between changes in anthropometric values and overall survival (OS). The median changes (%) in SMI, SMR, VFI, SFI, and TFI over 210 days during chemotherapy were 8.7% (p < 0.001), 3.4% (p = 0.001), -19% (p < 0.001), -3.4% (p = 0.936), and -11.9% (p < 0.001), respectively. Cut-off values of changes in SMI (skeletal muscle index change, SMIC) and SMR (skeletal muscle radiodensity change, SMRC) were defined at -2% and -2 Hounsfield units (HU) respectively, whereas those of changes in VFI (visceral fat index change, VFIC), SFI (subcutaneous fat index change, SFIC), and TFI (total fat index change, TFIC) were based on values that provided the largest χ2 on the Mantel-Cox test. Multivariable analysis revealed that low SMR measured on a postchemotherapy CT scan (hazard ratio, HR: 0.32, 95% confidence interval, CI: 0.15-0.70, p = 0.004) and visceral fat loss of at least 46.57% (HR: 0.31, 95% CI: 0.14-0.69, p = 0.004) were independent poor prognostic factors for OS. Severe visceral fat loss during FOLFOX chemotherapy and low skeletal muscle radiodensity measured on postchemotherapy CT scans are associated with poor OS in stage III and high-risk stage II colon cancer patients.
Collapse
|
19
|
Pezzuto A, Carico E. Effectiveness of smoking cessation in smokers with COPD and nocturnal oxygen desaturation: Functional analysis. CLINICAL RESPIRATORY JOURNAL 2019; 14:29-34. [PMID: 31613417 DOI: 10.1111/crj.13096] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/03/2019] [Accepted: 10/11/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is the fourth cause of mortality and it's frequently associated with breathing sleep disorders. OBJECTIVE The aim of the study is to point out the benefit of smoking cessation over three months in terms of improvement of respiratory functional variables. METHODS A retrospective analysis was performed evaluating the impact of smoking cessation on 145 patients with COPD and nocturnal oxygen desaturation. For this purpose, for all patients, overnight pulse oxymetry detection on room air, arterial blood sampling, plethysmography and exhaled test for carbon monoxide were performed at baseline and 3 months after the beginning. Smoking cessation was achieved by varenicline plus individual counselling. RESULTS About 51% of patients quit smoking which was established by exhaledcarbon monoxide (eCO) measure (cut-off 5 ppm). Patients who quit smoking displayed notably better results compared with patients who did not. The eCO significantly decreased by 16 ppm versus 4 (P = 0.01), oxygen desaturation index (ODI) was reduced by 3 points versus 0.8 (P = 0.01) and forced expiratory in 1 second volume increased by 7% of predicted value versus 1% (P = 0.01). The walking test was improved by 102 m versus 25 in sustainers (P = 0.01). The CAT score was also improved by 10 versus 8 in sustainers (P = 0.01) and PaO2 increased by 5 mm Hg versus 0.5 (P = 0.04). The percentage of SaO2 < 90% was improved by 6.7 versus 2.1 (P = 0.04).The logistic regression analysis displayed the possible influence of CAT (P = 0.02) and modified medical research council dyspnea test (P = 0.05) on ODI value. CONCLUSIONS Smoking cessation notably improves pulmonary functional parameters in quitters reporting nocturnal oxygen desaturation.
Collapse
Affiliation(s)
- Aldo Pezzuto
- Cardiovascular-Pulmonary Science Department, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Elisabetta Carico
- Clinical and Molecular Medicine Department, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| |
Collapse
|
20
|
Pezzuto A, D'Ascanio M, Grieco A, Ricci A. Functional benefit of smoking cessation in severe COPD patients undergoing bronchial valve implantation. Eur J Intern Med 2019; 68:55-59. [PMID: 31387842 DOI: 10.1016/j.ejim.2019.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tobacco smoke is the leading cause of chronic obstructive pulmonary disease. The aim of this study is to highlight the effectiveness of smoking cessation along with bronchial valve implantation in subjects with severe COPD. METHODS A sample of 25 patients, current smokers, affected by severe COPD and heterogeneous emphysema who quit smoking were compared with a group of 15 patients who did not quit smoking. MEASUREMENTS AND MAIN RESULTS Patients performed plethysmography, 6 minute walking test (WT), haemogasanalysis, exhaled CO test (eCO), COPD assessment test (CAT) together with the mMRC test. A clearer improvement of examined parameters was registered in the group of patients who quit smoking by varenicline and counselling. In particular, we observed a significant increase of FEV1 by 350 ml in the abstainers group compared with 100 ml increase in the non-abstainers(p < .05) group. We noticed that the RV% decreased by 30% compared with the 10% in the non-abstainers(p < .001). The CAT value decreased by 20 compared with 10 in current smokers(p < .001) as well as the mMRC score (p < .001) was more improved in abstainers. The total resistances were reduced by 30% versus 10% (p < .01)and notably there was a higher improvement of walking test (30 m versus 5) (p < .001). The eCO was clearly reduced in abstainers, 14 versus 8 (p < .002),. PaO2 increased by 4 mmHg versus 1(p < .0001). CONCLUSIONS Smoking cessation treatment by varenicline strengthens the effects of bronchial valve implantation and shows up its crucial therapeutic role in severe COPD.
Collapse
Affiliation(s)
- Aldo Pezzuto
- Cardiovascular-Respiratory Science Department, Sant'Andrea Hospital-Sapienza University, Via di Grottarossa, 1035/39, 00189 Rome, Italy.
| | - Michela D'Ascanio
- Cardiovascular-Respiratory Science Department, Sant'Andrea Hospital-Sapienza University, Via di Grottarossa, 1035/39, 00189 Rome, Italy
| | - Alessio Grieco
- Cardiovascular-Respiratory Science Department, Sant'Andrea Hospital-Sapienza University, Via di Grottarossa, 1035/39, 00189 Rome, Italy
| | - Alberto Ricci
- Cardiovascular-Respiratory Science Department, Sant'Andrea Hospital-Sapienza University, Via di Grottarossa, 1035/39, 00189 Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza University, Via di Grottarossa, 1035/39, 00189 Rome, Italy
| |
Collapse
|
21
|
彭 显, 黄 敏, 赵 文, 袁 亚, 李 博, 叶 艳, 粱 健, 朱 顺, 刘 来, 蔡 绍, 赵 海. [Delayed diagnosis is associated with greater disease severity of chronic obstructive pulmonary disease]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:1448-1452. [PMID: 30613012 PMCID: PMC6744208 DOI: 10.12122/j.issn.1673-4254.2018.12.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the association of the time of initial diagnosis with the severity of chronic obstructive pulmonary disease (COPD). METHODS A total of 803 patients who were diagnosed to have COPD for the first time in our hospital between May 2015 to February 2018 were enrolled in this study.The diagnoses of COPD and asthma COPD overlap (ACO) were made according GOLD guidelines and european consensus definition.Lung function of the patients was graded according to the GOLD guidelines. RESULTS The patients with COPD had a mean age of 61.8±9.9 years,including 726 male and 77 female patients.The course of the patients (defined as the time from symptom onset to the establishment of a diagnosis) was 3(0.5,8) years.Among these patients,85.2% had a moderate disease severity (FEV1%<80%),and 48.3% had severe or very severe conditions (FEV1%<50%);47.0% of them were positive for bronchial dilation test.In the overall patients,295(36.7%) were also diagnosed to have ACO,and the mean disease course of ACO[3(1,9) years]was similar to that of COPD[3(0.5,8) years](P>0.05).A significant correlation was found between the disease course and the lung function of the patients.Multiple linear regression analysis showed that an older age and a longer disease course were associated with poorer lung functions and a greater disease severity. CONCLUSIONS The delay of the initial diagnosis is significantly related to the severity of COPD.
Collapse
Affiliation(s)
- 显如 彭
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 敏於 黄
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 文驱 赵
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 亚飞 袁
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 博厚 李
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 艳梅 叶
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 健鹏 粱
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 顺芳 朱
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 来昱 刘
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 绍曦 蔡
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 海金 赵
- />南方医科大学南方医院呼吸与危重症医学科,慢性气道疾病实验室,广东 广州 510515Laboratory of Chronic Airway Diseases, Department of Respiratory and Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| |
Collapse
|
22
|
Peiffer G, Underner M, Perriot J. [COPD and smoking cessation: Patients' expectations and responses of health professionals]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:375-390. [PMID: 30455124 DOI: 10.1016/j.pneumo.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The importance of smoking cessation in the management of COPD is well-established: the benefit of quitting smoking as regards morbidity and mortality outcomes in patients, is unquestioned. The smoking cessation in COPD patients is difficult: high levels of consumption, the duration of smoking, high dependence level, psychological co-morbidities such as anxiety and depression, lower socio-economic and intellectual level, constitute barriers. Studies have shown that patients often minimize the risks of smoking, that others do not believe in the benefits of quitting or doubt their ability to quit smoking. The patients' experience, and expectations with regard to smoking cessation are incompletely satisfied: are considered, the smoking characteristics of these patients, the understanding of the tobacco dependence, the beliefs and ideas of smokers, the knowledge of smoking cessation methods, the role of validated aids and alternative treatments, failure management. The answers of the health professionals can be in several directions: establishment of a better communication patient-doctor (empathy), more centered on the needs of the smoker, the role of the motivation and the place of the motivational interview, the understanding of the mechanisms of addiction, a better individualisation of therapeutics, the necessity of a extended follow-up, the contribution of modern technologies, the electronic cigarette, the smoking cessation in respiratory rehabilitation, guidelines that address smoking cessation treatment.
Collapse
Affiliation(s)
- G Peiffer
- Service de pneumologie, hôpital de Mercy, CHR Metz-Thionville, 57038 Metz, France.
| | - M Underner
- Centre hospitalier Henri Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - J Perriot
- Dispensaire Emile Roux - CLAT 63, 11, rue Vaucanson, 63100 Clermont-Ferrand, France
| |
Collapse
|