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Casara A, Turato G, Marin-Oto M, Semenzato U, Biondini D, Tinè M, Bernardinello N, Cocconcelli E, Cubero P, Balestro E, Spagnolo P, Marin JM, Cosio MG, Saetta M, Bazzan E. Chronic Bronchitis Affects Outcomes in Smokers without Chronic Obstructive Pulmonary Disease (COPD). J Clin Med 2022; 11:jcm11164886. [PMID: 36013126 PMCID: PMC9410001 DOI: 10.3390/jcm11164886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background. Chronic bronchitis (CB) importantly affects outcomes in smokers with COPD, but the effects on smokers without COPD are less well known and less emphasized. The aim of our study was to investigate the possible effects of CB on clinical outcomes in smokers without COPD (noCOPD) and compare them with the effects in smokers with COPD (COPD). Methods. For that purpose, we studied 511 smokers, 302 with and 209 without COPD, followed for 10 years in an academic COPD ambulatory setting. Chronic bronchitis was defined as the presence of cough and sputum production for at least 3 months in each of two consecutive years. All subjects underwent clinical and functional examination with spirometry, diffusion capacity (DLco), 6-min walking test (6MWT), mMRC Dyspnoea Scale, COPD Assessment Test (CAT), and recording of annual frequency of exacerbations. All-cause mortality during follow-up was recorded. Results. 27% of noCOPD and 45% of COPD had CB. noCOPD with CB had lower FEV1 and DLco, worse 6MWT, more dyspnoea, a higher number of exacerbations and lower survival than noCOPD without CB. CB did not affect FEV1 decline in noCOPD but it significantly did in COPD. Conclusions. The presence of chronic bronchitis in smokers without COPD will significantly affect symptoms, quality of life, and survival, underlining the importance of recognizing the condition and managing it accordingly.
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Affiliation(s)
- Alvise Casara
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Graziella Turato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Marta Marin-Oto
- Respiratory Service, Hospital Clinico Universitario, 50009 Zaragoza, Spain
| | - Umberto Semenzato
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Davide Biondini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Mariaenrica Tinè
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Pablo Cubero
- Translational Research Unit (IIS Aragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Paolo Spagnolo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Josè M. Marin
- Translational Research Unit (IIS Aragón), Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
- Department of Medicine, University of Zaragoza School of Medicine, 50009 Zaragoza, Spain
| | - Manuel G. Cosio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Meakins-Christie Laboratories, Respiratory Division, McGill University, Montreal, QU 000004, Canada
| | - Marina Saetta
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Erica Bazzan
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Correspondence:
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Cabal Escandóna V, Montes Monsalve LA, Celis Sarmiento NS, Ortiz Mahecha AL. Grupo de síntomas de enfermedad pulmonar obstructiva crónica y cuidados paliativos: una revisión sistemática. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2022. [DOI: 10.11144/javeriana.ie24.gsep] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
La enfermedad pulmonar obstructiva crónica (EPOC) es una entidad patológica que se caracteriza por una serie de manifestaciones físicas persistentes como tos, fatiga, disnea y producción de esputo; síntomas que generan malestar en el paciente desde el momento del diagnóstico y que, al ser una enfermedad irreversible por el daño tisular que causa, progresivamente va incidiendo de manera negativa en la calidad de vida. De otra parte, se ha reportado presencia de síntomas psicológicos como depresión, inseguridad, ansiedad y alteraciones emocionales en los pacientes diagnosticados con EPOC. Así mismo, los pacientes con este diagnóstico tienden a desarrollar comportamientos que alteran sus relaciones sociales familiares y laborales, por cuanto tienden a aislarse debido a la sintomatología, especialmente física.
La situación planteada genera la necesidad de desarrollar un trabajo de investigación con el objetivo de reconocer el clúster de síntomas físicos, psicológicos y sociales de los pacientes diagnosticados con EPOC, e identificar si se plantea un abordaje desde la atención paliativa. El estudio se desarrolló mediante una revisión sistemática de literatura en la que se identificaron 1776 artículos, de los que se evaluaron 41 para la identificación del clúster de síntomas. Se identificó el binomio disnea y tos, fatiga y expectoración como el clúster de síntomas físicos; la depresión y la ansiedad constituyen el clúster de síntomas psicológicos, y el impacto en la calidad de vida y la percepción de aislamiento o exclusión social.
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Shin SH, Kwon SO, Kim V, Silverman EK, Kim TH, Kim DK, Hwang YI, Yoo KH, Kim WJ, Park HY. Association of body mass index and COPD exacerbation among patients with chronic bronchitis. Respir Res 2022; 23:52. [PMID: 35255901 PMCID: PMC8900381 DOI: 10.1186/s12931-022-01957-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 02/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background and objective Chronic obstructive pulmonary disease (COPD) patients with a body mass index (BMI) < 25 kg/m2 are prone to develop adverse event of pharmacological treatment for frequent exacerbation. As chronic bronchitis (CB) is one of the strong risk factors of exacerbation, we investigated the associations between BMI and COPD exacerbations in patients with CB. Methods Patients with COPD were included from the Korean COPD Subgroup Study (KOCOSS), a multicenter observational cohort study. CB was defined using the St. George’s Respiratory Questionnaire and the participants were categorized according to BMI cut-off of 25 kg/m2. Exacerbations during a 1-year follow-up were compared among four groups: non-CB with BMI ≥ 25 kg/m2, non-CB with BMI < 25 kg/m2, CB with BMI ≥ 25 kg/m2, and CB with BMI < 25 kg/m2. Results Among the 1264 patients with COPD, 451 (35.7%) had CB and 353 (27.9%) had both CB and BMI < 25 kg/m2. The COPD exacerbation risk increased across the non-CB with BMI < 25 kg/m2, CB with BMI ≥ 25 kg/m2, and CB with BMI < 25 kg/m2 groups (adjusted incidence rate ratio [95% confidence interval] 1.21 [0.89–1.62], 1.20 [0.77–1.88], and 1.41 [1.02–1.91], respectively, compared to the non-CB with BMI ≥ 25 kg/m2 group). Conclusions COPD patients having both CB and a BMI < 25 kg/m2 are at higher risk of exacerbations. Considering that a BMI < 25 kg/m2 often limits treatment options preventing exacerbations, modified guidelines might be needed for non-obese CB patients in Asia. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01957-3.
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Gim J, An J, Sung J, Silverman EK, Cho MH, Won S. A Between Ethnicities Comparison of Chronic Obstructive Pulmonary Disease Genetic Risk. Front Genet 2020; 11:329. [PMID: 32373161 PMCID: PMC7187688 DOI: 10.3389/fgene.2020.00329] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 03/20/2020] [Indexed: 12/13/2022] Open
Abstract
Heterogeneity of lung function levels and risk for developing chronic obstructive pulmonary disease (COPD) among people exposed to the same environmental risk factors, such as cigarette smoking, suggest an important role of genetic factors in COPD susceptibility. To investigate the possible role of different genetic factors in COPD susceptibility across ethnicities. We used a population-stratified analysis for: (i) identifying ethnic-specific genetic susceptibility loci, (ii) developing ethnic-specific polygenic risk prediction models using those SNPs, and (iii) validating the models with an independent dataset. We elucidated substantial differences in SNP heritability and susceptibility loci for the disease across ethnicities. Furthermore, the application of three ethnic-specific prediction models to an independent dataset showed that the best performance is achieved when the prediction model is applied to a dataset with the matched ethnic sample. Our study validates the necessity of considering ethnic differences in COPD risk; understanding these differences might help in preventing COPD and developing therapeutic strategies.
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Affiliation(s)
- Jungsoo Gim
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
| | - Jaehoon An
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Joohon Sung
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, South Korea.,Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Edwin K Silverman
- Channing Division of Network Medicine and Division of Pulmonary and Critical Care Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Michael H Cho
- Channing Division of Network Medicine and Division of Pulmonary and Critical Care Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sungho Won
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea.,Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, South Korea.,Institute of Health and Environment, Seoul National University, Seoul, South Korea
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