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Enríquez-Rodríguez CJ, Casadevall C, Faner R, Castro-Costa A, Pascual-Guàrdia S, Seijó L, López-Campos JL, Peces-Barba G, Monsó E, Barreiro E, Cosío BG, Agustí A, Gea J. COPD: systemic proteomic profiles in frequent and infrequent exacerbators. ERJ Open Res 2024; 10:00004-2024. [PMID: 38529348 PMCID: PMC10962451 DOI: 10.1183/23120541.00004-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 03/27/2024] Open
Abstract
Background Some patients with COPD suffer frequent exacerbations (FE). We hypothesised that their systemic proteomic profile would be different from that of non-frequent exacerbators (NFE). The objective of the present study was to contrast the systemic proteomic profile in FE versus NFE. As a reference, we also determined the systemic proteomic profile of healthy controls (HC) and COPD patients during an actual episode of exacerbation (AE). Methods In the analysis we included 40 clinically stable COPD patients (20 FE and 20 NFE), and 20 HC and 10 AE patients. Their plasma samples were analysed by combining two complementary proteomic approaches: label-free liquid chromatography-tandem mass spectrometry and multiplex immunoassays. Gene Ontology annotation, pathway enrichment and network analyses were used to investigate molecular pathways associated with differentially abundant proteins/peptides (DAPs). Results Compared with HC, we identified 40 DAPs in FE, 10 in NFE and 63 in AE. Also compared to HC, pathway functional and protein-protein network analyses revealed dysregulation of inflammatory responses involving innate and antibody-mediated immunity in COPD, particularly in the FE group, as well as during an AE episode. Besides, we only identified alterations in the complement and coagulation cascades in AE. Conclusion There are specific plasma proteome profiles associated with FE, which are partially shared with findings observed during AE, albeit others are uniquely present during the actual episode of AE.
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Affiliation(s)
- Cesar Jessé Enríquez-Rodríguez
- Servei de Pneumologia, Hospital del Mar – IMIM, MELIS Dept, Universitat Pompeu Fabra and BRN, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- These authors contributed equally
| | - Carme Casadevall
- Servei de Pneumologia, Hospital del Mar – IMIM, MELIS Dept, Universitat Pompeu Fabra and BRN, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- These authors contributed equally
| | - Rosa Faner
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servei de Pneumologia (Institut Clínic de Respiratori), Hospital Clínic – Fundació Clínic per la Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Ady Castro-Costa
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Neumología, Hospital 12 de Octubre, Madrid, Spain
| | - Sergi Pascual-Guàrdia
- Servei de Pneumologia, Hospital del Mar – IMIM, MELIS Dept, Universitat Pompeu Fabra and BRN, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Seijó
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Neumología, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Clínica Universidad de Navarra, Madrid, Spain
| | - José Luis López-Campos
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Seville, Spain
| | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Neumología, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Eduard Monsó
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Neumología, Consorci Sanitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Esther Barreiro
- Servei de Pneumologia, Hospital del Mar – IMIM, MELIS Dept, Universitat Pompeu Fabra and BRN, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Borja G. Cosío
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Neumología, Hospital Son Espases – Instituto de Investigación Sanitaria de Palma, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Alvar Agustí
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Servei de Pneumologia (Institut Clínic de Respiratori), Hospital Clínic – Fundació Clínic per la Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Gea
- Servei de Pneumologia, Hospital del Mar – IMIM, MELIS Dept, Universitat Pompeu Fabra and BRN, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- For a list of the members of the BIOMEPOC group see the Acknowledgements
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2
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Cubillos-Zapata C, Troncoso-Acevedo F, Díaz-García E, Alfaro E, Gotera-Rivera C, Pérez-Warnisher T, Peces-Barba G, Seijo LM, García-Río F. Sleep apnoea increases biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk patients and those with established lung cancer. ERJ Open Res 2024; 10:00777-2023. [PMID: 38375428 PMCID: PMC10875459 DOI: 10.1183/23120541.00777-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 11/15/2023] [Indexed: 02/21/2024] Open
Abstract
Background Intermittent hypoxaemia and obstructive sleep apnoea (OSA) have been linked to lung cancer through as yet unidentified pathophysiological mechanisms. This study evaluates the effect of OSA on serum levels of biomarkers of immunosurveillance, lymphangiogenesis and intrinsic tumour cell aggressiveness in high-risk individuals screened for lung cancer and patients with established lung cancer. Methods Serum samples from individuals participating in a lung cancer screening cohort (SAILS study) or with newly diagnosed lung cancer (SAIL study) were analysed. All patients underwent home sleep apnoea testing. Soluble levels of programmed cell death-1 (PD-1), programmed cell death ligand-1 (PD-L1), cytotoxic T-lymphocyte antigen-4, midkine (MDK), paraspeckle component-1 (PSPC1), transforming growth factor-β1 (TGF-β1), SMAD3, matrix metalloproteinase-2 and co-stimulus receptor of the tumour necrosis factor family of receptors (CD137) were determined by ELISA. Results The presence of moderate-to-severe OSA was associated with increased levels of PSPC1, MDK, PD-L1 and PD-1 in screened individuals, and with higher values of PSPC1, TGF-β1, PD-L1 and PD-1 in patients with established lung cancer. The findings correlated with nocturnal intermittent hypoxaemia indices. Conclusion Moderate-to-severe OSA is associated with increased expression of serum biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk individuals screened for lung cancer and those with established disease.
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Affiliation(s)
- Carolina Cubillos-Zapata
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
| | - Fernanda Troncoso-Acevedo
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Elena Díaz-García
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
| | - Enrique Alfaro
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carolina Gotera-Rivera
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Luis M. Seijo
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Clínica Universidad de Navarra, Madrid, Spain
- L.M. Seijo and F. García-Río contributed equally to this article as lead authors and supervised the work
| | - Francisco García-Río
- Grupo de Enfermedades Respiratorias, Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid, Spain
- Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
- L.M. Seijo and F. García-Río contributed equally to this article as lead authors and supervised the work
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3
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de-Torres JP, Casanova C, Marín JM, Cabrera C, Marín M, Ezponda A, Cosio BG, Martínez C, Solanes I, Fuster A, Calle M, Peces-Barba G, Gotera C, Feu-Collado N, Marin A, Alcaide AB, Sangro M, Bastarrika G, Celli BR. Impact of Applying the Global Lung Initiative Criteria for Airway Obstruction in GOLD Defined COPD Cohorts: The BODE and CHAIN Experience. Arch Bronconeumol 2024; 60:10-15. [PMID: 37925245 DOI: 10.1016/j.arbres.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION The Global Lung Function Initiative (GLI) has proposed new criteria for airflow limitation (AL) and recommends using these to interpret spirometry. The objective of this study was to explore the impact of the application of the AL GLI criteria in two well characterized GOLD-defined COPD cohorts. METHODS COPD patients from the BODE (n=360) and the COPD History Assessment In SpaiN (CHAIN) cohorts (n=722) were enrolled and followed. Age, gender, pack-years history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, history of exacerbations and survival were recorded. CT-detected comorbidities were registered in the BODE cohort. The proportion of subjects without AL by GLI criteria was determined in each cohort. The clinical, CT-detected comorbidity, and overall survival of these patients were evaluated. RESULTS In total, 18% of the BODE and 15% of the CHAIN cohort did not meet GLI AL criteria. In the BODE and CHAIN cohorts respectively, these patients had a high clinical burden (BODE≥3: 9% and 20%; mMRC≥2: 16% and 45%; exacerbations in the previous year: 31% and 9%; 6MWD<350m: 15% and 19%, respectively), and a similar prevalence of CT-diagnosed comorbidities compared with those with GLI AL. They also had a higher rate of long-term mortality - 33% and 22% respectively. CONCLUSIONS An important proportion of patients from 2 GOLD-defined COPD cohorts did not meet GLI AL criteria at enrolment, although they had a significant burden of disease. Caution must be taken when applying the GLI AL criteria in clinical practice.
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Affiliation(s)
- Juan P de-Torres
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Ciro Casanova
- Pulmonary Department-Research Unit, Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
| | - José M Marín
- Pulmonary Department, Hospital Universitario Miguel Servet, IIS Aragon & CIBERES, University of Zaragoza, Zaragoza, Spain
| | - Carlos Cabrera
- Pulmonary Department, Hospital Universitario Doctor Negrín, Las Palmas, Spain
| | - Marta Marín
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain; Hospital Universitario Lozano Blesa, Zaragoza, Spain
| | - Ana Ezponda
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Borja G Cosio
- Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, Mallorca, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Cristina Martínez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA-FINBA), Spain
| | - Ingrid Solanes
- Pulmonary Department, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Antonia Fuster
- Pulmonary Department, Hospital Universitario Son Llatzer, Palma de Mallorca, Spain
| | - Myriam Calle
- Department of Respiratory Medicine, Hospital Clínico San Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Germán Peces-Barba
- Department of Respiratory Medicine, Hospital Universitario Fundación Jiménez Díaz, CIBERES, Madrid, Spain
| | - Carolina Gotera
- Department of Respiratory Medicine, Hospital Universitario Fundación Jiménez Díaz, CIBERES, Madrid, Spain
| | - Nuria Feu-Collado
- Pulmonary Department, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Alicia Marin
- Pulmonary Department, Hospital Universitario German Trias y Pujol, Barcelona, Spain
| | - Ana Belén Alcaide
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Matilde Sangro
- Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gorka Bastarrika
- Radiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Bartolome R Celli
- Pulmonary Department, Brigham and Women's Hospital, Boston, MA, United States
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4
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Figueira‐Gonçalves JM, García-Bello MÁ, Ramallo‐Fariña Y, Méndez R, Latorre Campos A, González-Jiménez P, Peces-Barba G, Molina-Molina M, España PP, García E, Domínguez-Pazos SDJ, García Clemente M, Panadero C, de la Rosa-Carrillo D, Sibila O, Martínez-Pitarch MD, Toledo-Pons N, López-Ramirez C, Almonte-Batista W, Macías-Paredes A, Badenes-Bonet D, Pérez-Rodas EN, Lázaro J, Quirós Fernández S, Cordovilla R, Cano-Pumarega I, Torres A, Menendez R. Persistent Respiratory Failure and Re-Admission in Patients with Chronic Obstructive Pulmonary Disease Following Hospitalization for COVID-19. Int J Chron Obstruct Pulmon Dis 2023; 18:2473-2481. [PMID: 37955022 PMCID: PMC10638925 DOI: 10.2147/copd.s428316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) has been associated with worse clinical evolution/survival during a hospitalization for SARS-CoV2 (COVID-19). The objective of this study was to learn the situation of these patients at discharge as well as the risk of re-admission/mortality in the following 12 months. Methods We carried out a subanalysis of the RECOVID registry. A multicenter, observational study that retrospectively collected data on severe acute COVID-19 episodes and follow-up visits for up to a year in survivors. The data collection protocol includes general demographic data, smoking, comorbidities, pharmacological treatment, infection severity, complications during hospitalization and required treatment. At discharge, resting oxygen saturation (SpO2), dyspnea according to the mMRC (modified Medical Research Council) scale and long-term oxygen therapy prescription were recorded. The follow-up database included the clinical management visits at 6 and 12 months, where re-admission and mortality were recorded. Results A total of 2047 patients were included (5.6% had a COPD diagnosis). At discharge, patients with COPD had greater dyspnea and a greater need for prescription home oxygen. After adjusting for age, sex and Charlson comorbidity index, patients with COPD had a greater risk of hospital re-admission due to respiratory causes (HR 2.57 [1.35-4.89], p = 0.004), with no significant differences in survival. Conclusion Patients with COPD who overcome a serious SARS-CoV2 infection show a worse clinical situation at discharge and a greater risk of re-admission for respiratory causes.
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Affiliation(s)
- Juan Marco Figueira‐Gonçalves
- Pneumology and Thoracic Surgery Service, Unit for Patients with Highly Complex COPD, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
- University Institute of Tropical Disease and Public Health of the Canary Islands, University of La Laguna, Santa Cruz de Tenerife, Spain
| | - Miguel Ángel García-Bello
- Evaluation Unit (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Yolanda Ramallo‐Fariña
- Evaluation Unit (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | - Raúl Méndez
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, University of Valencia, Valencia, Spain
| | - Ana Latorre Campos
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Paula González-Jiménez
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- Medicine Department, University of Valencia, Valencia, Spain
| | | | - María Molina-Molina
- ILD Unit, Respiratory Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain
| | | | - Estela García
- Respiratory Service, Hospital de Cabueñes, Gijón, Spain
| | | | | | | | | | - Oriol Sibila
- Respiratory Service, Hospital Clínic, Barcelona, Spain
| | | | | | - Cecilia López-Ramirez
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | - Javier Lázaro
- Respiratory Service, Hospital Royo Villanova, Zaragoza, Spain
| | | | - Rosa Cordovilla
- Respiratory Service, Hospital de Salamanca, Salamanca, Spain
| | - Irene Cano-Pumarega
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Service, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Antoni Torres
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Service, Hospital Clínic, Barcelona, Spain
| | - Rosario Menendez
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, University of Valencia, Valencia, Spain
| | - On behalf of RECOVID
- Pneumology and Thoracic Surgery Service, Unit for Patients with Highly Complex COPD, University Hospital Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
- University Institute of Tropical Disease and Public Health of the Canary Islands, University of La Laguna, Santa Cruz de Tenerife, Spain
- Evaluation Unit (SESCS), Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
- Pneumology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Respiratory InFections, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Medicine Department, University of Valencia, Valencia, Spain
- Pulmonology Department, Hospital Fundación Jiménez Díaz, Madrid, Spain
- ILD Unit, Respiratory Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain
- Respiratory Service, Hospital de Galdakao-Usansolo, Galdakao, Spain
- Respiratory Service, Hospital de Cabueñes, Gijón, Spain
- Respiratory Service, Hospital Universitario de A Coruña, A Coruña, Spain
- Respiratory Service, Hospital Universitario Central de Asturias, Oviedo, Spain
- Respiratory Service, Hospital de Getafe, Getafe, Spain
- Respiratory Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Respiratory Service, Hospital Clínic, Barcelona, Spain
- Respiratory Service, Hospital Lluís Alcanyís, Játiva, Spain
- Respiratory Service, Hospital Son Espases, Palma, Spain
- Medical Surgical Unit of Respiratory Diseases, Hospital Virgen del Rocío, Sevilla, Spain
- Respiratory Service, Hospital de Albacete, Albacete, Spain
- Respiratory Service, Hospital de Sant Jaume, Calella, Spain
- Respiratory Service, Hospital del Mar, Barcelona, Spain
- Respiratory Service, Hospital Municipal de Badalona, Badalona, Spain
- Respiratory Service, Hospital Royo Villanova, Zaragoza, Spain
- Respiratory Service, Hospital Basurto, Bilbao, Spain
- Respiratory Service, Hospital de Salamanca, Salamanca, Spain
- Respiratory Service, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
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5
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Sanchez-Espirilla S, Pereira-Vega A, Callejón-Leblic B, Díaz-Olivares I, Santana R, Gotera Rivera C, Gómez-Ariza JL, López-Campos JL, Blanco-Orozco AI, Seijo L, Rodríguez M, Padrón Fraysse LA, Herrera-Chilla Á, Peces-Barba G, Barrera TG. Untargeted Metabolomic Study of Lung Cancer Patients after Surgery with Curative Intent. J Proteome Res 2023; 22:3499-3507. [PMID: 37843028 PMCID: PMC10629266 DOI: 10.1021/acs.jproteome.3c00356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Indexed: 10/17/2023]
Abstract
Lung cancer (LC) is a leading cause of mortality, claiming more than 1.8 million deaths per year worldwide. Surgery is one of the most effective treatments when the disease is in its early stages. The study of metabolic alterations after surgical intervention with curative intent could be used to assess the response to treatment or the detection of cancer recurrence. In this study, we have evaluated the metabolomic profile of serum samples (n = 110) from preoperative (PRE) and postoperative (POST) LC patients collected at two different time points (1 month, A; 3-6 months, B) with respect to healthy people. An untargeted metabolomic platform based on reversed phase (RP) and hydrophilic interaction chromatography (HILIC), using ultra-high performance liquid chromatography (UHPLC) and mass spectrometry (MS), was applied (MassIVE ID MSV000092213). Twenty-two altered metabolites were annotated by comparing all the different studied groups. DG(14,0/22:1), stearamide, proline, and E,e-carotene-3,3'-dione were found altered in PRE, and their levels returned to those of a baseline control group 3-6 months after surgery. Furthermore, 3-galactosyllactose levels remained altered after intervention in some patients. This study provides unique insights into the metabolic profiles of LC patients after surgery at two different time points by combining complementary analytical methods.
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Affiliation(s)
- Saida Sanchez-Espirilla
- Department
of Chemistry, Research Center for Natural Resources, Health and the
Environment (RENSMA), Faculty
of Experimental Sciences, University of
Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain
- Department
of Chemistry, Faculty of Sciences, National
University of San Antonio Abad of Cusco, Av. de La Cultura, 773 Cusco, Peru
| | - Antonio Pereira-Vega
- Pneumology
Area of the Juan Ramón Jiménez Hospital, Ronda Norte, s/n, 21005 Huelva, Spain
| | - Belén Callejón-Leblic
- Department
of Chemistry, Research Center for Natural Resources, Health and the
Environment (RENSMA), Faculty
of Experimental Sciences, University of
Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain
| | - Isabel Díaz-Olivares
- Department
of Chemistry, Research Center for Natural Resources, Health and the
Environment (RENSMA), Faculty
of Experimental Sciences, University of
Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain
- Department
of Chemistry, Faculty of Sciences, National
University of San Antonio Abad of Cusco, Av. de La Cultura, 773 Cusco, Peru
- Pneumology
Area of the Juan Ramón Jiménez Hospital, Ronda Norte, s/n, 21005 Huelva, Spain
- IIS
Jiménez Díaz Foundation, ISCIII-CIBERES, Reyes Católicos Ave., 28040 Madrid, Spain
- Medical-Surgical
Unit of Respiratory Diseases, Institute
of Biomedicine of Seville (IBiS), Antonio Maura Montaner, 41013 Seville, Spain
- Virgen del
Rocío University Hospital/University of Seville, Manuel Siurot, s/n, 41013 Sevilla, Spain
- Center
for Biomedical Research in Respiratory Diseases Network (CIBERES), Carlos III Health Institute, Monforte de Lemos Ave., 28029 Madrid, Spain
- University
Clinic of Navarra, Marquesado
de Santa Marta Street, 1, 28027 Madrid, Spain
| | - Rafael Santana
- IIS
Jiménez Díaz Foundation, ISCIII-CIBERES, Reyes Católicos Ave., 28040 Madrid, Spain
| | | | - José Luis Gómez-Ariza
- Department
of Chemistry, Research Center for Natural Resources, Health and the
Environment (RENSMA), Faculty
of Experimental Sciences, University of
Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain
| | - José Luis López-Campos
- Medical-Surgical
Unit of Respiratory Diseases, Institute
of Biomedicine of Seville (IBiS), Antonio Maura Montaner, 41013 Seville, Spain
- Virgen del
Rocío University Hospital/University of Seville, Manuel Siurot, s/n, 41013 Sevilla, Spain
- Center
for Biomedical Research in Respiratory Diseases Network (CIBERES), Carlos III Health Institute, Monforte de Lemos Ave., 28029 Madrid, Spain
| | - Ana Isabel Blanco-Orozco
- Medical-Surgical
Unit of Respiratory Diseases, Institute
of Biomedicine of Seville (IBiS), Antonio Maura Montaner, 41013 Seville, Spain
- Virgen del
Rocío University Hospital/University of Seville, Manuel Siurot, s/n, 41013 Sevilla, Spain
| | - Luis Seijo
- University
Clinic of Navarra, Marquesado
de Santa Marta Street, 1, 28027 Madrid, Spain
| | - María Rodríguez
- University
Clinic of Navarra, Marquesado
de Santa Marta Street, 1, 28027 Madrid, Spain
| | | | - Ángeles Herrera-Chilla
- Pneumology
Area of the Juan Ramón Jiménez Hospital, Ronda Norte, s/n, 21005 Huelva, Spain
| | - Germán Peces-Barba
- IIS
Jiménez Díaz Foundation, ISCIII-CIBERES, Reyes Católicos Ave., 28040 Madrid, Spain
| | - Tamara García Barrera
- Department
of Chemistry, Research Center for Natural Resources, Health and the
Environment (RENSMA), Faculty
of Experimental Sciences, University of
Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain
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6
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Callejón-Leblic B, Sánchez Espirilla S, Gotera-Rivera C, Santana R, Díaz-Olivares I, Marín JM, Macario CC, Cosio BG, Fuster A, García IS, de-Torres JP, Feu Collado N, Cabrera Lopez C, Amado Diago C, Romero Plaza A, Fraysse LAP, Márquez Martín E, Marín Royo M, Balcells Vilarnau E, Llunell Casanovas A, Martínez González C, Galdíz Iturri JB, Lacárcel Bautista C, Gómez-Ariza JL, Pereira-Vega A, Seijo L, López-Campos JL, Peces-Barba G, García-Barrera T. Metallomic Signatures of Lung Cancer and Chronic Obstructive Pulmonary Disease. Int J Mol Sci 2023; 24:14250. [PMID: 37762552 PMCID: PMC10532173 DOI: 10.3390/ijms241814250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Lung cancer (LC) is the leading cause of cancer deaths, and chronic obstructive pulmonary disease (COPD) can increase LC risk. Metallomics may provide insights into both of these tobacco-related diseases and their shared etiology. We conducted an observational study of 191 human serum samples, including those of healthy controls, LC patients, COPD patients, and patients with both COPD and LC. We found 18 elements (V, Al, As, Mn, Co, Cu, Zn, Cd, Se, W, Mo, Sb, Pb, Tl, Cr, Mg, Ni, and U) in these samples. In addition, we evaluated the elemental profiles of COPD cases of varying severity. The ratios and associations between the elements were also studied as possible signatures of the diseases. COPD severity and LC have a significant impact on the elemental composition of human serum. The severity of COPD was found to reduce the serum concentrations of As, Cd, and Tl and increased the serum concentrations of Mn and Sb compared with healthy control samples, while LC was found to increase Al, As, Mn, and Pb concentrations. This study provides new insights into the effects of LC and COPD on the human serum elemental profile that will pave the way for the potential use of elements as biomarkers for diagnosis and prognosis. It also sheds light on the potential link between the two diseases, i.e., the evolution of COPD to LC.
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Affiliation(s)
- Belén Callejón-Leblic
- Department of Chemistry, Research Center for Natural Resources, Health and the Environment (RENSMA), Faculty of Experimental Sciences, University of Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain; (B.C.-L.); (S.S.E.); (J.L.G.-A.)
| | - Saida Sánchez Espirilla
- Department of Chemistry, Research Center for Natural Resources, Health and the Environment (RENSMA), Faculty of Experimental Sciences, University of Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain; (B.C.-L.); (S.S.E.); (J.L.G.-A.)
- Department of Chemistry, Faculty of Sciences, National University of San Antonio Abad of Cusco, Av. de La Cultura, Cusco 773, Peru
| | - Carolina Gotera-Rivera
- IIS-Jiménez Díaz Foundation, ISCIII-CIBERES, Reyes Católicos Ave., 28040 Madrid, Spain; (C.G.-R.); (R.S.)
| | - Rafael Santana
- IIS-Jiménez Díaz Foundation, ISCIII-CIBERES, Reyes Católicos Ave., 28040 Madrid, Spain; (C.G.-R.); (R.S.)
| | - Isabel Díaz-Olivares
- Beturia Andalusian Foundation for Health Research (FABIS), Ronda Norte, s/n, 21005 Huelva, Spain;
| | - José M. Marín
- Miguel Servet Hospital-IIS Aragon, ISCIII-CIBERES, Paseo de Isabel la Católica, 1-3, 50009 Zaragoza, Spain;
| | - Ciro Casanova Macario
- Pulmonary Department—Research Unit, Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Padre Herrera, s/n, 38200 Santa Cruz de Tenerife, Spain;
| | - Borja García Cosio
- Son Espases Hospital, IdISBa, ISCIII-CIBERES, Valldemossa Road, 79, 07120 Palma De Mallorca, Spain;
| | - Antonia Fuster
- Son Llàtzer Hospital, C. de Manacor, 07198 Palma, Spain;
| | - Ingrid Solanes García
- Santa Creu i Sant Pau Hospital, Carrer de St. Antoni Maria Claret, 167, 08025 Barcelona, Spain;
| | - Juan P. de-Torres
- University Clinic of Navarra, Pío XII Ave., 36, 31008 Pamplona, Spain;
| | - Nuria Feu Collado
- Reina Sofía Hospital, Maimonides Institute for Biomedical Research of Córdoba, Menéndez Pidal Ave., s/n, 14004 Córdoba, Spain;
| | - Carlos Cabrera Lopez
- University Hospital of Gran Canaria Dr. Negrín, Respiratory Service, C. Pl. Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canarias, Spain;
| | | | | | | | - Eduardo Márquez Martín
- Virgen del Rocío Hospital, Institute of Biomedicine of Seville (IBiS), ISCIII-CIBERES, Manuel Siurot Ave., s/n, 41013 Seville, Spain;
| | | | - Eva Balcells Vilarnau
- Hospital del Mar, ISCIII-CIBERES, Paseo Marítimo de la Barceloneta, 25, 29, 08003 Barcelona, Spain;
| | | | | | | | | | - José Luis Gómez-Ariza
- Department of Chemistry, Research Center for Natural Resources, Health and the Environment (RENSMA), Faculty of Experimental Sciences, University of Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain; (B.C.-L.); (S.S.E.); (J.L.G.-A.)
| | - Antonio Pereira-Vega
- Pneumology Area of the Juan Ramón Jiménez Hospital, Ronda Norte, s/n, 21005 Huelva, Spain; (L.A.P.F.); (A.P.-V.)
| | - Luis Seijo
- University Clinic of Navarra, ISCIII-CIBERES, Monforte de Lemos Ave., 28029 Madrid, Spain;
| | - José Luis López-Campos
- Medical-Surgical Unit for Respiratory Diseases, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, University of Seville, Manuel Siurot Ave., s/n, 41013 Sevilla, Spain;
- Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Carlos III Health Institute, Av. de Monforte de Lemos, 3–5, 28029 Madrid, Spain
| | - Germán Peces-Barba
- IIS-Jiménez Díaz Foundation, ISCIII-CIBERES, Reyes Católicos Ave., 28040 Madrid, Spain; (C.G.-R.); (R.S.)
| | - Tamara García-Barrera
- Department of Chemistry, Research Center for Natural Resources, Health and the Environment (RENSMA), Faculty of Experimental Sciences, University of Huelva, Campus El Carmen, Fuerzas Armadas Ave., 21007 Huelva, Spain; (B.C.-L.); (S.S.E.); (J.L.G.-A.)
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7
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Menéndez R, Méndez R, Latorre A, González-Jiménez P, Peces-Barba G, Molina M, España PP, García E, Consuegra-Vanegas A, Pando-Sandoval A, Panadero C, Figueira-Gonçalves JM, De la Rosa D, Sibila O, Martínez-Pitarch MD, Toledo N, Cejudo P, Almonte-Batista W, Macías-Paredes A, Badenes D, Pérez-Rodas EN, Lázaro J, Quirós S, Cordovilla R, Cano-Pumarega I, Torres A. Residual pulmonary infiltrates, symptoms and diffusion impairment at one-year after severe COVID-19 infection have different associated factors. J Intern Med 2023. [PMID: 37038609 DOI: 10.1111/joim.13642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
INTRODUCTION After severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, patients may show lung sequelae on radiology and functional impairment at the 1-year follow-up. We aimed to describe the persistence of symptoms, radiological alterations, or reduced diffusing capacity of the lung for carbon monoxide (DLCO ) at 1-year follow-up in patients from the Spanish Registry RECOVID. METHODS RECOVID collected symptom and radiological and functional lung tests data on hospitalised patients with coronavirus disease 2019 during the acute phase and at the 6- and 12-month follow-up visits. RESULTS Of the 2500 enrolled survivors (90% admitted to the ward), 1874 had follow-up visits for up to a year. Of these, 42% continued to present with symptoms, 27% had radiological sequelae, and 31% had reduced DLCO . Independently associated factors included female sex, asthma, and the requirement for invasive or non-invasive mechanical ventilation. Complete radiological resolution was 72.2% at 12 months; associated factors with incomplete recovery were age, male sex, oxygen or respiratory support, corticosteroids and an initial SpO2 /FiO2 <450 or CURB65 ≥2. Reduced DLCO was observed in 31% of patients at 12 months; associated factors were older age, female sex, smoking habit, SpO2 /FiO2 <450 and CURB-65 ≥2, and the requirement of respiratory support. At 12 months, a proportion of the asymptomatic patients showed reduced DLCO (9.5%), radiological findings (25%), or both (11%). CONCLUSIONS The factors associated with symptom persistence, incomplete radiological resolution, and DLCO <80% differed according to age, sex, comorbidities, and respiratory support. The burden of symptoms, reduced DLCO , and incomplete radiological resolution were considerable in patients with SARS-CoV-2 pneumonia at the 1-year follow-up after hospitalisation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rosario Menéndez
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- The University of Valencia, Valencia, Spain
| | - Raúl Méndez
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- The University of Valencia, Valencia, Spain
| | - Ana Latorre
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Paula González-Jiménez
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- The University of Valencia, Valencia, Spain
| | | | - María Molina
- Hospital de Bellvitge, Hospitalet de Llobregat, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Irene Cano-Pumarega
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
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8
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Ruano-Ravina A, Acosta O, Díaz Pérez D, Casanova C, Velasco V, Peces-Barba G, Barreiro E, Cañas A, Castaño A, Cruz Carmona MJ, Diego C, Garcia-Aymerich J, Martínez C, Molina-Molina M, Muñoz X, Sánchez-Íñigo FJ, Candal-Pedreira C. A longitudinal and multidesign epidemiological study to analyze the effect of the volcanic eruption of Tajogaite volcano (La Palma, Canary Islands). The ASHES study protocol. Environ Res 2023; 216:114486. [PMID: 36206927 DOI: 10.1016/j.envres.2022.114486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/05/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Volcanic eruptions emit gases and particulate matter into the atmosphere which, if inhaled, can have an impact on health. The eruption of the volcano situated in the Cumbre Vieja Nature Reserve (La Palma, Canary Islands, Spain) affords a unique opportunity to study the effect of such a phenomenon on health. The aim of the proposed study is to assess the short-, medium- and long-term respiratory health effects of exposure to volcanic emissions from the eruption in three different population groups. METHODS We propose to undertake a multidesign study: an ambispective cohort study to analyze the effect of the eruption on the general population, the highly exposed population, and the childhood population; and a pre-post quasi-experimental study on subjects with previously diagnosed respiratory diseases. The information will be collected using a personal interview, biologic specimens, air pollution data, data from medical records, respiratory tests and imaging tests. The study has an envisaged follow-up of five years, to run from the date of initial recruitment, with annual data-collection. This study has been approved by the Santa Cruz de Tenerife Provincial Research Ethics Committee (Canary Island Health Service) on March 10, 2022. CONCLUSIONS This study will make it possible to advance our knowledge of the effect a volcano eruption has on population health, both short- and long-term, and to assess the potential respiratory injury attributable to volcanic eruptions. It may serve as a model for future studies of new volcanic eruptions in the coming years.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela/IDIS), Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain
| | - Orlando Acosta
- Department of Pulmonology, Canary Islands University Teaching Hospital, La Laguna, Santa Cruz de Tenerife, Spain.
| | - David Díaz Pérez
- Department of Pulmonology and Thoracic Surgery, Nuestra Señora de Candelaria University Teaching Hospital, Santa Cruz de Tenerife, Spain
| | - Ciro Casanova
- Department of Pulmonology/Research Unit, Nuestra Señora de Candelaria University Teaching Hospital, La Laguna University, Tenerife, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - Valle Velasco
- Pediatric Pulmonology, Canary Islands University Teaching Hospital, Tenerife, Spain
| | - Germán Peces-Barba
- Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain; Department of Pulmonology, Fundación Jiménez Díaz University Teaching Hospital, Madrid, Spain
| | - Esther Barreiro
- Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain; Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Del Mar Hospital Medical Research Unit, Parc de Salut Mar, Barcelona Biomedical Research Park, Barcelona, Spain; Department of Medicine and Life Sciences (MELIS), Pompeu Fabra University, Barcelona, Spain
| | - Ana Cañas
- National Environmental Health Center, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Argelia Castaño
- National Environmental Health Center, Instituto de Salud Carlos III, Majadahonda, Spain
| | - María Jesús Cruz Carmona
- Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain; Department of Pulmonology, Vall d'Hebron Hospital, Barcelona, Spain
| | - Carmen Diego
- Department of Pulmonology, Ferrol University Teaching Hospital Complex, Ferrol, Spain
| | - Judith Garcia-Aymerich
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain; ISGlobal, Barcelona, Spain; Department of Medicine and Life Sciences (MELIS), Pompeu Fabra University, Barcelona, Spain
| | - Cristina Martínez
- Principality of Asturias Health Research Institute (ISPA), Oviedo, Spain
| | - María Molina-Molina
- Interstitial Lung Function Unit, Pulmonology, Bellvitge Biomedical Research Institute, Bellvitge University Teaching Hospital, L'Hospitalet de Llobregat, Spain
| | - Xavier Muñoz
- Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain; Department of Pulmonology, Vall d'Hebron Hospital, Barcelona, Spain
| | | | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela/IDIS), Spain
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Izquierdo-Alonso JL, Pérez-Rial S, Rivera CG, Peces-Barba G. N-acetylcysteine for prevention and treatment of COVID-19: Current state of evidence and future directions. J Infect Public Health 2022; 15:1477-1483. [PMID: 36410267 PMCID: PMC9651994 DOI: 10.1016/j.jiph.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/01/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes coronavirus disease 2019 (COVID-19) and can be associated with serious complications, including acute respiratory distress syndrome. This condition is accompanied by a massive release of cytokines, also denominated cytokine storm, development of systemic oxidative stress and a prothrombotic state. In this context, it has been proposed a role for acetylcysteine (NAC) in the management of patients with COVID-19. NAC is a molecule classically known for its mucolytic effect, but it also has direct and indirect antioxidant activity as a precursor of reduced glutathione. Other effects of NAC have also been described, such as modulating the immune and inflammatory response, counteracting the thrombotic state, and having an antiviral effect. The pharmacological activities of NAC and its effects on the mechanisms of disease progression make it a potential therapeutic agent for COVID-19. NAC is safe, tolerable, affordable, and easily available. Moreover, the antioxidant effects of the molecule may even prevent infection and play an important role as a complement to vaccination. Although the clinical efficacy and dosing regimens of NAC have been evaluated in the clinical setting with small series of patients, the results are promising. In this article, we review the pathogenesis of SARS-CoV-2 infection and the current knowledge of the mechanisms of action of NAC across disease stages. We also propose NAC posology strategies to manage COVID-19 patients in different clinical scenarios.
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Affiliation(s)
- José Luis Izquierdo-Alonso
- Servicio de Neumología, Gerencia de Atención Integrada de Guadalajara, Spain,Correspondence to: Gerencia de Atención Integrada de Guadalajara, C/Donante de sangre, s/n, 19002 Guadalajara, Spain
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10
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Merino M, Martín Lorenzo T, Maravilla-Herrera P, Ancochea J, Gómez Sáenz JT, Hass N, Molina J, Peces-Barba G, Trapero-Bertran M, Trigueros Carrero JA, Hidalgo-Vega Á. A Social Return on Investment Analysis of Improving the Management of Chronic Obstructive Pulmonary Disease Within the Spanish National Healthcare System. Int J Chron Obstruct Pulmon Dis 2022; 17:1431-1442. [PMID: 35761956 PMCID: PMC9233487 DOI: 10.2147/copd.s361700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To define a set of proposals that would improve the current management of chronic obstructive pulmonary disease (COPD) within the Spanish National Healthcare System (SNHS) from a comprehensive multidisciplinary perspective and to assess the impact of its implementation from clinical, healthcare, economic, and social perspectives. Patients and Methods A group of 20 stakeholders related to COPD (healthcare professionals, patients, and informal caregivers, among others) participated in an online Delphi process to agree on a set of 15 proposals that would improve the current management of COPD within the SNHS in four areas: diagnosis, risk stratification, management of exacerbations, and management of stable COPD. A one-year forecast-type social return on investment (SROI) analysis was used to estimate the impact that implementing the set of proposals would have in relation to the investment required. A sensitivity analysis was used to test the strength of the model when varying assumption-based data-points. Results The hypothetical implementation of the complete set of 15 proposals would require a €668 million investment and would generate a €2079 million social impact concerning savings for the SNHS and quality of life improvements for patients and their informal caregivers, among others. Accordingly, for every euro invested in the set of proposals, a social return of €3.11 would be generated (€2.71 in the worst-case scenario and €3.62 in the best-case scenario) of both tangible (32.56%) and intangible nature (67.44%). Conclusion Altogether, implementing this set of 15 proposals would generate a positive social impact, threefold the required investment. The results may inform decisions relative to healthcare policy and practice regarding COPD management within the SNHS, further contributing to reduce the large burden of COPD.
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Affiliation(s)
| | | | | | - Julio Ancochea
- Pulmonology Service, La Princesa University Hospital - IIS-Princesa, Madrid, Spain
- Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Respiratory Diseases Networking Biomedical Research Centre - CIBERES, Carlos III Institute of Health - ISCIII, Madrid, Spain
| | | | - Nicole Hass
- Chronic Obstructive Pulmonary Disease Patient and Family Association - APEPOC, Pontevedra, Spain
| | - Jesús Molina
- Francia Health Centre, Fuenlabrada, Madrid, Spain
| | - Germán Peces-Barba
- Pulmonology Service, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Marta Trapero-Bertran
- Basic Sciences Department, University Institute for Patient Care, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Álvaro Hidalgo-Vega
- Department of Economic Analysis and Finances, Universidad de Castilla-La Mancha, Toledo, Spain
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11
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Ruano-Ravina A, Acosta O, Pérez DD, Casanova C, Velasco V, Llanos AB, Peces-Barba G, Barreiro E, Cañas A, Castaño A, Carmona MJC, Diego C, Garcia-Aymerich J, Martínez C, Molina-Molina M, Muñoz X, Sánchez-Íñigo FJ, Candal-Pedreira C. Analysis of Exposure and Respiratory Health Effects of Volcanic Eruption in the Canary Islands (ASHES). A SEPAR study. Arch Bronconeumol 2022; 58:780-782. [DOI: 10.1016/j.arbres.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 11/02/2022]
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12
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Rubio MC, Luis López-Campos J, Luis Izquierdo Alonso J, Pitarch DM, Pascual MI, Navarrete BA, Falcones MV, Inglés MJA, López CC, Martínez CJÁ, Ruiz FO, Golpe R, Gomila AF, Guardia SP, Miranda JAR, Peces-Barba G, García-Río F, Muñiz MÁM, Cosío BG. Consensus on the management of the COPD patient in the COVID-19 setting: COPD Forum Working Group. Arch Bronconeumol 2022; 58:776-779. [PMID: 35697565 PMCID: PMC9116041 DOI: 10.1016/j.arbres.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/02/2022]
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13
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Jiménez-Ruiz CA, Peces-Barba G, Suárez PR, Roza CD, Reina SS, Río FG, Guinot L. [Translated article] Health Respiratory Notoriety and the Health Professionals that Care for it. Arch Bronconeumol 2022. [DOI: 10.1016/j.arbres.2021.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Jiménez-Ruiz CA, Peces-Barba G, Rodríguez Suárez P, Roza CD, Solano Reina S, García Río F, Guinot L. Raising awareness of respiratory health and specialists in respiratory diseases. Arch Bronconeumol 2022; 58:379-380. [PMID: 35312586 DOI: 10.1016/j.arbres.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 11/02/2022]
Affiliation(s)
| | - Germán Peces-Barba
- Vicepresidente Neumólogo de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
| | - Pedro Rodríguez Suárez
- Vicepresidente Cirujano Torácico de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
| | - Carmen Diego Roza
- Secretaria General de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
| | | | - Francisco García Río
- Presidente electo de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
| | - Luis Guinot
- Director general de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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Agustí A, Alcázar B, Ancochea J, Casanova C, Celli B, Cosio B, Echave-Sustaeta JM, Villar AF, Rivero JLG, González C, Izquierdo JL, Lopez-Campos JL, Trigo JMM, Sánchez JM, Miravitlles M, Molina J, Peces-Barba G, Roman M, Cataluña JJS, Villar-Alvarez F. [Translated article] The ANTES Program in COPD: First Year. Arch Bronconeumol 2022. [PMID: 35484017 DOI: 10.1016/j.arbres.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alvar Agustí
- Institut Respiratori, Hospital Clinic, Barcelona, Spain.
| | - Bernardino Alcázar
- Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Julio Ancochea
- Servicio de Neumología, Hospital Universitario La Princesa, Madrid, Spain
| | - Ciro Casanova
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Bartolome Celli
- Brigham and Women's Hospital, Professor of Medicine, Harvard Medical School, Boston, United States
| | - Borja Cosio
- Servei de Pneumologia, Universitari Son Espases, Palma de Mallorca, Spain
| | | | | | | | - Cruz González
- Servicio de Neumología, Hospital Universitario Clínico de Valencia, Spain
| | | | - José Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Marc Miravitlles
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jesús Molina
- Centro de Salud Francia, Fuenlabrada, Madrid, Spain
| | - Germán Peces-Barba
- Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Miguel Roman
- Centro de Salud Son Pisa, Palma de Mallorca, Spain
| | | | - Felipe Villar-Alvarez
- Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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16
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Agustí A, Alcázar B, Ancochea J, Casanova C, Celli B, Cosio B, Echave-Sustaeta JM, Fernandez Villar A, Garcia Rivero JL, González C, Izquierdo JL, Lopez-Campos JL, Marín Trigo JM, Martín Sánchez J, Miravitlles M, Molina J, Peces-Barba G, Roman M, Soler Cataluña JJ, Villar-Alvarez F. The ANTES program in COPD: First year. Arch Bronconeumol 2022; 58:291-294. [PMID: 35312529 DOI: 10.1016/j.arbres.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Alvar Agustí
- Institut Respiratori, Hospital Clinic, Barcelona, España.
| | - Bernardino Alcázar
- Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - Julio Ancochea
- Servicio de Neumología, Hospital Universitario La Princesa, Madrid, España
| | - Ciro Casanova
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - Bartolome Celli
- Brigham and Women's Hospital, Professor of Medicine, Harvard Medical School, Boston, Estados Unidos
| | - Borja Cosio
- Servei de Pneumologia, Universitari Son Espases, Palma de Mallorca, España
| | | | | | | | - Cruz González
- Servicio de Neumología, Hospital Universitario Clínico de Valencia, España
| | | | - José Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/Universidad de Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, España
| | | | | | - Marc Miravitlles
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - Jesús Molina
- Centro de Salud Francia, Fuenlabrada, Madrid, España
| | - Germán Peces-Barba
- Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - Miguel Roman
- Centro de Salud Son Pisa, Palma de Mallorca, España
| | | | - Felipe Villar-Alvarez
- Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
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17
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Baos S, Cremades-Jimeno L, López-Ramos M, de Pedro MÁ, Uriarte SA, Sastre J, González-Mangado N, Rodríguez-Nieto MJ, Peces-Barba G, Cárdaba B. Expression of Macrophage Scavenger Receptor (MSR1) in Peripheral Blood Cells from Patients with Different Respiratory Diseases: Beyond Monocytes. J Clin Med 2022; 11:jcm11051439. [PMID: 35268530 PMCID: PMC8910889 DOI: 10.3390/jcm11051439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Macrophage scavenger receptor 1 (MSR1) has mostly been described in macrophages, but we previously found a significant gene expression increase in peripheral blood mononuclear cells (PBMCs) of asthmatic patients. Objective: To confirm those results and to define its cellular origin in PBMCs. Methods: Four groups of subjects were studied: healthy controls (C), nonallergic asthmatic (NA), allergic asthmatic (AA), and chronic obstructive pulmonary disease (COPD) patients. RNA was extracted from PBMCs. MSR1 gene expression was analyzed by RT-qPCR. The presence of MSR1 on the cellular surface of PBMC cellular subtypes was analyzed by confocal microscopy and flow cytometry. Results: MSR1 gene expression was significantly increased in the three clinical conditions compared to the healthy control group, with substantial variations according to disease type and severity. MSR1 expression on T cells (CD4+ and CD8+), B cells, and monocytes was confirmed by confocal microscopy and flow cytometry. In all clinical groups, the four immune cell subtypes studied expressed MSR1, with a greater expression on B lymphocytes and monocytes, exhibiting differences according to disease and severity. Conclusions: This is the first description of MSR1’s presence on lymphocytes’ surfaces and reinforces the potential role of MSR1 as a player in asthma and COPD.
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Affiliation(s)
- Selene Baos
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - Lucía Cremades-Jimeno
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - María López-Ramos
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - María Ángeles de Pedro
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
| | - Silvia A. Uriarte
- Allergy Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain; (S.A.U.); (J.S.)
| | - Joaquín Sastre
- Allergy Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain; (S.A.U.); (J.S.)
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
| | - Nicolás González-Mangado
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Pulmonology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - María Jesús Rodríguez-Nieto
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Pulmonology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Germán Peces-Barba
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Pulmonology Department, University Hospital Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Blanca Cárdaba
- Immunology Department, IIS-Fundación Jiménez Díaz-UAM, 28040 Madrid, Spain; (S.B.); (L.C.-J.); (M.L.-R.); (M.Á.d.P.)
- Ciber de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain; (N.G.-M.); (M.J.R.-N.); (G.P.-B.)
- Correspondence:
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18
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Menéndez R, Ceccato A, Martín-Loeches I, Motos A, Barbé F, Peces-Barba G, Fernández-Barat L, Bermejo-Martín J, Torres A. Evaluation of Respiratory Sequelae in Patients With COVID-19, Where we are and Where we are Going. CIBERESUCICOVID and RECOVID Studies to Compare Patients Admitted to ICU vs Conventional Ward. Arch Bronconeumol 2022; 58:T115-T116. [PMID: 35185259 PMCID: PMC8843012 DOI: 10.1016/j.arbres.2021.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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19
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Jiménez-Ruiz CA, Valido Morales A, Perez Chica G, Urrutia Landa I, Rodriguez Portal JA, Arnedillo Muñoz A, Cózar Bernal F, Peces-Barba G, Diego Roza C, Solano Reina S, Rodriguez Suarez P, Garcia Rio F, Salas Llinas E, Garcia Clemente MM, Valencia Gallardo JM, Rodriguez Nieto MJ, Martin de Carpi T, Sánchez de Cos Escuin J, Estrada Trigueros G, Godoy Mayoral R, Barbeta Sánchez E, Fernández Villar A, Ros Lucas JA, Martinez Moragón E, Tomás López L. [Key Pulmonology and Thoracic Surgery Issues under Discussion in the COVID-19 Era]. Open Respir Arch 2021; 3:100123. [PMID: 38620959 PMCID: PMC8372421 DOI: 10.1016/j.opresp.2021.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Agustin Valido Morales
- Director del Comité de Relaciones Institucionales de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
| | - Gerardo Perez Chica
- Secretario del Comité de Relaciones Institucionales de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
| | - Isabel Urrutia Landa
- Coordinadora del Año SEPAR por la Calidad del Aire. Cambio Climático y Salud, España
| | | | | | - Fernando Cózar Bernal
- Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Germán Peces-Barba
- Vicepresidente Neumólogo de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
| | - Carmen Diego Roza
- Secretaria General de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
| | | | - Pedro Rodriguez Suarez
- Vice-Presidente Cirujano Torácico de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
| | - Francisco Garcia Rio
- Presidente Electo de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), España
| | | | | | | | | | | | | | | | - Raúl Godoy Mayoral
- Presidente de la Sociedad Castellano-Manchega de Patología Respiratoria (SOCAMPAR), España
| | | | | | - Jose Antonio Ros Lucas
- Presidente de la Sociedad Murciana de Patología del Aparato Respiratorio (SOMUPAR), España
| | | | - Laura Tomás López
- Presidenta de la Sociedad Vasco-Navarra de Patología Respiratoria (SVNPAR), España
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20
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López-Campos JL, Calle Rubio M, Izquierdo Alonso JL, Fernández-Villar A, Abascal-Bolado B, Alcázar B, García-Río F, Peces-Barba G, Serra Batlles J, Martínez Garcerán JJ, Riesco Miranda JA, Figueira-Gonçalves JM, Soler-Cataluña JJ, Temprano M, Ortega Ruiz F, Santos Pérez S, Álvarez Martínez CJ. Forum COPD working group consensus on the diagnosis, treatment and follow-up of COPD. Arch Bronconeumol 2021; 57:596-599. [PMID: 35702916 DOI: 10.1016/j.arbr.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 06/15/2023]
Affiliation(s)
- José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Myriam Calle Rubio
- Departamento de Medicina, Universidad Complutense de Madrid, Hospital Clínico de San Carlos, Madrid, Spain
| | - José Luis Izquierdo Alonso
- Departamento de Medicina y Especialidades, Universidad de Alcalá, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Alberto Fernández-Villar
- Hospital Álvaro Cunqueiro, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, Spain
| | | | - Bernardino Alcázar
- Servicio de Neumología, AIG de Medicina, Hospital de Alta Resolución de Loja, Granada, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Germán Peces-Barba
- Hospital Universitario Fundación Jiménez Díaz, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | | | | | | | - Francisco Ortega Ruiz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Salud Santos Pérez
- Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
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21
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Sevilla-Montero J, Labrousse-Arias D, Fernández-Pérez C, Fernández-Blanco L, Barreira B, Mondéjar-Parreño G, Alfaro-Arnedo E, López IP, Pérez-Rial S, Peces-Barba G, Pichel JG, Peinado VI, Cogolludo Á, Calzada MJ. Cigarette Smoke Directly Promotes Pulmonary Arterial Remodeling and Kv7.4 Channel Dysfunction. Am J Respir Crit Care Med 2021; 203:1290-1305. [PMID: 33306938 DOI: 10.1164/rccm.201911-2238oc] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/10/2020] [Indexed: 01/10/2023] Open
Abstract
Rationale: Cigarette smoke is considered the chief leading cause of chronic obstructive pulmonary disease (COPD). Its impact on the progressive deterioration of airways has been extensively studied, but its direct effects on the pulmonary vasculature are less known. Objectives: To prove that pulmonary arterial remodeling in patients with COPD is not just a consequence of alveolar hypoxia but also due to the direct effects of cigarette smoke on the pulmonary vascular bed. Methods: We have used different molecular and cell biology approaches, as well as traction force microscopy, wire myography, and patch-clamp techniques in human cells and freshly isolated pulmonary arteries. In addition, we relied on in vivo models and human samples to analyze the effects of cigarette smoke on pulmonary vascular tone alterations. Measurements and Main Results: Cigarette smoke extract exposure directly promoted a hypertrophic, senescent phenotype that in turn contributed, through the secretion of inflammatory molecules, to an increase in the proliferative potential of nonexposed cells. Interestingly, these effects were significantly reversed by antioxidants. Furthermore, cigarette smoke extract affected cell contractility and dysregulated the expression and activity of the voltage-gated K+ channel Kv7.4. This contributed to the impairment of vasoconstriction and vasodilation responses. Most importantly, the levels of this channel were diminished in the lungs of smoke-exposed mice, smokers, and patients with COPD. Conclusions: Cigarette smoke directly contributes to pulmonary arterial remodeling through increased cell senescence, as well as vascular tone alterations because of diminished levels and function in the Kv7.4 channel. Strategies targeting these pathways may lead to novel therapies for COPD.
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Affiliation(s)
- Javier Sevilla-Montero
- Biomedical Research Institute La Princesa Hospital, Madrid, Spain
- Department of Medicine, School of Medicine, and
- Doctoral School, Autonoma University of Madrid, Madrid, Spain
| | - David Labrousse-Arias
- Biomedical Research Institute La Princesa Hospital, Madrid, Spain
- Department of Medicine, School of Medicine, and
| | - Cintia Fernández-Pérez
- Biomedical Research Institute La Princesa Hospital, Madrid, Spain
- Department of Medicine, School of Medicine, and
| | - Laura Fernández-Blanco
- Biomedical Research Institute La Princesa Hospital, Madrid, Spain
- Department of Medicine, School of Medicine, and
| | - Bianca Barreira
- Department of Pharmacology and Toxicology, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Gema Mondéjar-Parreño
- Department of Pharmacology and Toxicology, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - Elvira Alfaro-Arnedo
- Lung Cancer and Respiratory Diseases Unit, Biomedical Research Center of La Rioja, Rioja Salud Foundation, Logroño, Spain
| | - Icíar P López
- Lung Cancer and Respiratory Diseases Unit, Biomedical Research Center of La Rioja, Rioja Salud Foundation, Logroño, Spain
| | - Sandra Pérez-Rial
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Respiratory Research Unit, Biomedical Research Unit, Health Research Institute Fundación Jiménez Díaz, Madrid, Spain; and
| | - Germán Peces-Barba
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Respiratory Research Unit, Biomedical Research Unit, Health Research Institute Fundación Jiménez Díaz, Madrid, Spain; and
| | - José G Pichel
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Lung Cancer and Respiratory Diseases Unit, Biomedical Research Center of La Rioja, Rioja Salud Foundation, Logroño, Spain
| | - Víctor Ivo Peinado
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
- Department of Pulmonary Medicine, Hospital August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain
| | - Ángel Cogolludo
- Department of Pharmacology and Toxicology, School of Medicine, Complutense University of Madrid, Madrid, Spain
- Biomedical Research Networking Center in Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain
| | - María J Calzada
- Biomedical Research Institute La Princesa Hospital, Madrid, Spain
- Department of Medicine, School of Medicine, and
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22
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Calle Rubio M, Rodriguez Hermosa JL, de Torres JP, Marín JM, Martínez-González C, Fuster A, Cosío BG, Peces-Barba G, Solanes I, Feu-Collado N, Lopez-Campos JL, Casanova C. COPD Clinical Control: predictors and long-term follow-up of the CHAIN cohort. Respir Res 2021; 22:36. [PMID: 33541356 PMCID: PMC7863480 DOI: 10.1186/s12931-021-01633-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background Control in COPD is a dynamic concept that can reflect changes in patients’ clinical status that may have prognostic implications, but there is no information about changes in control status and its long-term consequences. Methods We classified 798 patients with COPD from the CHAIN cohort as controlled/uncontrolled at baseline and over 5 years. We describe the changes in control status in patients over long-term follow-up and analyze the factors that were associated with longitudinal control patterns and related survival using the Cox hazard analysis. Results 134 patients (16.8%) were considered persistently controlled, 248 (31.1%) persistently uncontrolled and 416 (52.1%) changed control status during follow-up. The variables significantly associated with persistent control were not requiring triple therapy at baseline and having a better quality of life. Annual changes in outcomes (health status, psychological status, airflow limitation) did not differ in patients, regardless of clinical control status. All-cause mortality was lower in persistently controlled patients (5.5% versus 19.1%, p = 0.001). The hazard ratio for all-cause mortality was 2.274 (95% CI 1.394–3.708; p = 0.001). Regarding pharmacological treatment, triple inhaled therapy was the most common option in persistently uncontrolled patients (72.2%). Patients with persistent disease control more frequently used bronchodilators for monotherapy (53%) at recruitment, although by the end of the follow-up period, 20% had scaled up their treatment, with triple therapy being the most frequent therapeutic pattern. Conclusions The evaluation of COPD control status provides relevant prognostic information on survival. There is important variability in clinical control status and only a small proportion of the patients had persistently good control. Changes in the treatment pattern may be relevant in the longitudinal pattern of COPD clinical control. Further studies in other populations should validate our results. Trial registration: Clinical Trials.gov: identifier NCT01122758.
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Affiliation(s)
- Myriam Calle Rubio
- Pulmonology Department, Hospital Clínico San Carlos, C/ Martin Lagos S/N, 28040, Madrid, Spain.,Medical Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan Luis Rodriguez Hermosa
- Pulmonology Department, Hospital Clínico San Carlos, C/ Martin Lagos S/N, 28040, Madrid, Spain. .,Medical Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juan P de Torres
- Respirology and Sleep Division, Queen's University, Kingston, ON, Canada
| | - José María Marín
- Respiratory Department. Hospital, Universitario Miguel Servet and IISAragón, Ciber Enfermedades Respiratorias, Madrid, Spain
| | - Cristina Martínez-González
- Pulmonology Department, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Antonia Fuster
- Pulmonology Department, Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain
| | - Borja G Cosío
- Department of Respiratory Medicine, Hospital Universitario Son Espases-IdISBa and CIBERES, Palma de Mallorca, Spain
| | - Germán Peces-Barba
- Pulmonology Department, IIS-Fundación Jiménez Díaz-CIBERES, Madrid, Spain
| | - Ingrid Solanes
- Pulmonology Department, Hospital de La Santa Creu Y San Pau, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Nuria Feu-Collado
- Pulmonology Department, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Jose Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Universidad de Sevilla, CIBERES, Seville, Spain
| | - Ciro Casanova
- Pulmonology Department, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Tenerife, Spain
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23
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López-Campos JL, Calle Rubio M, Izquierdo Alonso JL, Fernández-Villar A, Abascal-Bolado B, Alcázar B, García-Río F, Peces-Barba G, Serra Batlles J, Martínez Garcerán JJ, Riesco Miranda JA, Figueira-Gonçalves JM, Soler-Cataluña JJ, Temprano M, Ortega Ruiz F, Santos Pérez S, Álvarez Martínez CJ. Forum COPD Working Group Consensus on the Diagnosis, Treatment and Follow-Up of COPD. Arch Bronconeumol 2021:S0300-2896(21)00023-5. [PMID: 33674118 DOI: 10.1016/j.arbres.2020.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Affiliation(s)
- José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/Universidad de Sevilla. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, España.
| | - Myriam Calle Rubio
- Departamento de Medicina. Universidad Complutense de Madrid. Hospital Clínico de San Carlos, Madrid, España
| | - José Luis Izquierdo Alonso
- Departamento de Medicina y Especialidades. Universidad de Alcalá. Hospital Universitario de Guadalajara, Guadalajara, España
| | - Alberto Fernández-Villar
- Hospital Álvaro Cunqueiro. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | | | - Bernardino Alcázar
- Servicio de Neumología. AIG de Medicina. Hospital de Alta Resolución de Loja. Granada. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, España
| | | | - Germán Peces-Barba
- Hospital Universitario Fundación Jiménez Díaz. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, España
| | | | | | | | | | | | | | - Francisco Ortega Ruiz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS). Hospital Universitario Virgen del Rocío/Universidad de Sevilla; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Instituto de Salud Carlos III, Madrid, España
| | - Salud Santos Pérez
- Hospital Universitario de Bellvitge-IDIBELL. Hospitalet de Llobregat, Barcelona, España
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24
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Callejas-González FJ, Peces-Barba G, Agustí A. El programa MENTOR, los jóvenes y el futuro científico de la SEPAR. Arch Bronconeumol 2020; 56:775-776. [DOI: 10.1016/j.arbres.2019.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 10/24/2022]
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25
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Prieto-Pérez L, Fortes J, Soto C, Vidal-González Á, Alonso-Riaño M, Lafarga M, Cortti MJ, Lazaro-Garcia A, Pérez-Tanoira R, Trascasa Á, Antonio A, Córdoba R, Rodríguez-Pinilla SM, Cedeño O, Peces-Barba G, Fernández-Ormaechea I, Díez Medrano MJ, López de Las Heras M, Cabello A, Petkova E, Álvarez B, Carrillo I, Silva AM, Castellanos M, Calpena S, Valverde-Monge M, Fresneda D, Rubio-Martín R, Cornejo I, Astilleros Blanco de Cordova L, de la Fuente S, Recuero S, Górgolas M, Piris MA. Histiocytic hyperplasia with hemophagocytosis and acute alveolar damage in COVID-19 infection. Mod Pathol 2020; 33:2139-2146. [PMID: 32620916 PMCID: PMC7333227 DOI: 10.1038/s41379-020-0613-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 02/04/2023]
Abstract
The spectrum of COVID-19 infection includes acute respiratory distress syndrome (ARDS) and macrophage activation syndrome (MAS), although the histological basis for these disorders has not been thoroughly explored. Post-mortem pulmonary and bone marrow biopsies were performed in 33 patients. Samples were studied with a combination of morphological and immunohistochemical techniques. Bone marrow studies were also performed in three living patients. Bone marrow post-mortem studies showed striking lesions of histiocytic hyperplasia with hemophagocytosis (HHH) in most (16/17) cases. This was also observed in three alive patients, where it mimicked the changes observed in hemophagocytic histiocytosis. Pulmonary changes included a combination of diffuse alveolar damage with fibrinous microthrombi predominantly involving small vessels, in particular the alveolar capillary. These findings were associated with the analytical and clinical symptoms, which helps us understand the respiratory insufficiency and reveal the histological substrate for the macrophage activation syndrome-like exhibited by these patients. Our results confirm that COVID-19 infection triggers a systemic immune-inflammatory disease and allow specific therapies to be proposed.
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Affiliation(s)
- Laura Prieto-Pérez
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain. .,División de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Fundación Jiménez Díaz, Madrid, 28040, Spain.
| | - José Fortes
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Carlos Soto
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Ánxela Vidal-González
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Marina Alonso-Riaño
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Miguel Lafarga
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - María José Cortti
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Alberto Lazaro-Garcia
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Ramón Pérez-Tanoira
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Álvaro Trascasa
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Anabel Antonio
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Raúl Córdoba
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | | | - Oderay Cedeño
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Germán Peces-Barba
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Itziar Fernández-Ormaechea
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - María José Díez Medrano
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Marta López de Las Heras
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Alfonso Cabello
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Elizabet Petkova
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Beatriz Álvarez
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Irene Carrillo
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Andrés M. Silva
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Marina Castellanos
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Silvia Calpena
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Marcela Valverde-Monge
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Diana Fresneda
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Rafael Rubio-Martín
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Ignacio Cornejo
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | | | - Soraya de la Fuente
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Sheila Recuero
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Miguel Górgolas
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
| | - Miguel A. Piris
- Servicio de Medicina Interna, UCI, Hematología, Anatomía Patológica, Fundación Jiménez Díaz, Ciberonc, Madrid, Spain
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26
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Cosío BG, Pascual-Guardia S, Borras-Santos A, Peces-Barba G, Santos S, Vigil L, Soler-Cataluña JJ, Martínez-González C, Casanova C, Marcos PJ, Alvarez CJ, López-Campos JL, Gea J, Garcia-Aymerich J, Molina J, Román M, Moises J, Szabo V, Reagan EA, San José Estépar R, Washko G, Agustí A, Faner R. Phenotypic characterisation of early COPD: a prospective case-control study. ERJ Open Res 2020; 6:00047-2020. [PMID: 33043045 PMCID: PMC7533304 DOI: 10.1183/23120541.00047-2020] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/26/2020] [Indexed: 11/18/2022] Open
Abstract
The phenotypic characteristics of chronic obstructive pulmonary disease (COPD) in individuals younger than 50 years of age (early COPD) are not well defined. This prospective, multicentre, case–control study sought to describe these characteristics and compare them with those of smokers (≥10 pack-years) of similar age with normal spirometry (controls). We studied 92 cases (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7) and 197 controls. Results were contrasted with participants with similar inclusion criteria recruited into the ECLIPSE and COPDGene cohorts. Cases had moderate airflow limitation (FEV1 71.3±20.8%) but were often symptomatic, used healthcare resources frequently, had air trapping (residual volume 150.6±55.5% ref.), had reduced diffusing capacity (84.2±20.7% ref.) and had frequent evidence of computed tomography (CT) emphysema (61%). Of note, less than half of cases (46%) had been previously diagnosed with COPD. Interestingly, they also often reported a family history of respiratory diseases and had been hospitalised because of respiratory problems before the age of 5 years more frequently than controls (12% versus 3%, p=0.009). By and large, these observations were reproduced when available in the ECLIPSE and COPDGene cohorts. These results show that early COPD is associated with substantial health impact and significant structural and functional abnormalities, albeit it is often not diagnosed (hence, treated). The fact that a sizeable proportion of patients with early COPD report a family history of respiratory diseases and/or early-life events (including hospitalisations before the age of 5 years) renders further support to the possibility of early-life origin of COPD. Early COPD is associated with substantial health impact, and structural and functional abnormalities, albeit it is often not diagnosed and hence, not treated. It is frequently associated with family history of respiratory diseases and early-life events.https://bit.ly/2ZtoRkp
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Affiliation(s)
- Borja G Cosío
- Servicio de Neumología, Hospital Universitario Son Espases-IdISBa, Palma de Mallorca, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Sergi Pascual-Guardia
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Germán Peces-Barba
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Fundación Jiménez Díaz, Hospital Universitario, Grupo Quirón, Madrid, Spain
| | - Salud Santos
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Servicio de Neumología, Hospital Universitario de Bellvitge, Barcelona, Spain.,IDIBELL, Universidad de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Vigil
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Servei de Pneumologia, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Juan José Soler-Cataluña
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Servicio de Neumología, Hospital Arnau de Vilanova-LLiria, Valencia, Spain
| | | | - Ciro Casanova
- Servicio de Neumología-Unidad de Investigación Hospital Universitario La Candelaria, Universidad de La Laguna, Tenerife, Spain
| | - Pedro J Marcos
- Dirección de Procesos Asistenciales, Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña, Area Sanitaria de A Coruña, Sergas, Universidade da Coruña, A Coruña, Spain
| | - Carlos J Alvarez
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Servicio Neumología, HU 12 de Octubre, Madrid, Spain.,Departamento de Medicina, Facultad Medicina UCM, Madrid, Spain
| | - José Luis López-Campos
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Joaquim Gea
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Servei de Pneumologia, Hospital del Mar - IMIM, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Judith Garcia-Aymerich
- Universitat Pompeu Fabra, Barcelona, Spain.,ISGlobal, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública, Madrid, Spain
| | - Jesús Molina
- Centro de Salud Francia, DAO, Madrid, Grupo de Respiratorio semFYC, Madrid, Spain
| | - Miguel Román
- Centro de Salud de Son Pisa, Unidad de investigación en enfermedades respiratorias crónicas en atención primaria, IdISBa, Palma de Mallorca, Spain
| | - Jorge Moises
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut Respiratori, Hospital Clinic, Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
| | - Viktoria Szabo
- Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
| | | | - Raúl San José Estépar
- Applied Chest Imaging Laboratory, Dept of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - George Washko
- Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Alvar Agustí
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut Respiratori, Hospital Clinic, Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
| | - Rosa Faner
- CIBER de Enfermedades Respiratorias, Madrid, Spain.,Institut d'Investigacio August Pi i Sunyer, Barcelona, Spain
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27
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Pérez-Rial S, Barreiro E, Fernández-Aceñero MJ, Fernández-Valle ME, González-Mangado N, Peces-Barba G. Early detection of skeletal muscle bioenergetic deficit by magnetic resonance spectroscopy in cigarette smoke-exposed mice. PLoS One 2020; 15:e0234606. [PMID: 32569331 PMCID: PMC7307759 DOI: 10.1371/journal.pone.0234606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 05/29/2020] [Indexed: 12/28/2022] Open
Abstract
Skeletal muscle dysfunction is a common complication and an important prognostic factor in patients with chronic obstructive pulmonary disease (COPD). It is associated with intrinsic muscular abnormalities of the lower extremities, but it is not known whether there is an easy way to predict its presence. Using a mouse model of chronic cigarette smoke exposure, we tested the hypothesis that magnetic resonance spectroscopy allows us to detect muscle bioenergetic deficit in early stages of lung disease. We employed this technique to evaluate the synthesis rate of adenosine triphosphate (ATP) and characterize concomitant mitochondrial dynamics patterns in the gastrocnemius muscle of emphysematous mice. The fibers type composition and citrate synthase (CtS) and cytochrome c oxidase subunit IV (COX4) enzymatic activities were evaluated. We found that the rate of ATP synthesis was reduced in the distal skeletal muscle of mice exposed to cigarette smoke. Emphysematous mice showed a significant reduction in body weight gain, in the cross-sectional area of the total fiber and in the COX4 to CtS activity ratio, due to a significant increase in CtS activity of the gastrocnemius muscle. Taken together, these data support the hypothesis that in the early stage of lung disease, we can detect a decrease in ATP synthesis in skeletal muscle, partly caused by high oxidative mitochondrial enzyme activity. These findings may be relevant to predict the presence of skeletal bioenergetic deficit in the early stage of lung disease besides placing the mitochondria as a potential therapeutic target for the treatment of COPD comorbidities.
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Affiliation(s)
- Sandra Pérez-Rial
- Respiratory Research Unit, Biomedical Research Institute—Fundación Jiménez Díaz, Madrid, Spain
- Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, M.P (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Barreiro
- Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, M.P (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department—Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, Institute of Medical Research of Hospital del Mar, Barcelona Biomedical Research Park, Barcelona, Spain
| | | | | | - Nicolás González-Mangado
- Respiratory Research Unit, Biomedical Research Institute—Fundación Jiménez Díaz, Madrid, Spain
- Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, M.P (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Germán Peces-Barba
- Respiratory Research Unit, Biomedical Research Institute—Fundación Jiménez Díaz, Madrid, Spain
- Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, M.P (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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28
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29
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Millares L, Pascual S, Montón C, García-Núñez M, Lalmolda C, Faner R, Casadevall C, Setó L, Capilla S, Moreno A, Castro-Acosta AA, Alvarez-Martinez CJ, Sibila O, Peces-Barba G, Cosio BG, Agustí A, Gea J, Monsó E. Relationship between the respiratory microbiome and the severity of airflow limitation, history of exacerbations and circulating eosinophils in COPD patients. BMC Pulm Med 2019; 19:112. [PMID: 31234826 PMCID: PMC6591812 DOI: 10.1186/s12890-019-0867-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/30/2019] [Indexed: 01/03/2023] Open
Abstract
Background The respiratory microbiome is altered in COPD patients but its relationship with core components of the disease, such as the severity of airflow limitation, the frequency of exacerbations or the circulating levels of eosinophils, is unclear. Methods Cross-sectional study comprising 72 clinically stable COPD patients (mean age 68 [SD 7.9] years; FEV1 48.7 [SD 20.1]% of reference) who provided spontaneous sputum samples for 16S rRNA gene amplification and sequencing. The microbiome composition was analysed with QIIME. Results We observed that: (1) more severe airflow limitation was associated with reduced relative abundance (RA) of Treponema and an increase in Pseudomonas; (2) patients with ≥2 exacerbations the previous year showed a significantly different bacterial community with respect to non-exacerbators (p = 0.014), with changes in 13 genera, including an increase of Pseudomonas, and finally, (3) peripheral eosinophils levels ≥2% were associated with more diverse microbiome [Chao1 224.51 (74.88) vs 277.39 (78.92) p = 0.006; Shannon 3.94 (1.05) vs 4.54 (1.06) p = 0.020], and a significant increase in the RAs of 20 genera. Conclusion The respiratory microbiome in clinically stable COPD patients varies significantly according to the severity of airflow limitation, previous history of exacerbations and circulating eosinophils levels. Electronic supplementary material The online version of this article (10.1186/s12890-019-0867-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Millares
- Fundació Parc Taulí- Institut d' Investigació i Innovació Parc Taulí (I3PT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
| | - Sergi Pascual
- Respiratory Medicine Department, Hospital del Mar - IMIM, Barcelona, Spain
| | - Concepción Montón
- Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain.,Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain.,Health Services Research on Chronic Diseases Network- REDISSEC, Galdakao, Spain.,Barcelona Respiratory Network, Barcelona, Spain
| | - Marian García-Núñez
- Fundació Parc Taulí- Institut d' Investigació i Innovació Parc Taulí (I3PT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Universitat Autònoma de Barcelona, Esfera UAB, Barcelona, Spain
| | - Cristina Lalmolda
- Fundació Parc Taulí- Institut d' Investigació i Innovació Parc Taulí (I3PT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rosa Faner
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Barcelona Respiratory Network, Barcelona, Spain
| | - Carme Casadevall
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Respiratory Medicine Department, Hospital del Mar - IMIM, Barcelona, Spain.,DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
| | - Laia Setó
- Fundació Parc Taulí- Institut d' Investigació i Innovació Parc Taulí (I3PT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Silvia Capilla
- Department of Microbiology, Hospital Universitari Parc Taulí, Sabadell, Spain
| | - Amàlia Moreno
- Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain
| | - Ady Angélica Castro-Acosta
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Respiratory Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carlos José Alvarez-Martinez
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Respiratory Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Oriol Sibila
- Barcelona Respiratory Network, Barcelona, Spain.,Respiratory Department, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Respiratory Medicine, Fundación Jiménez Díaz, Madrid, Spain
| | - Borja G Cosio
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Respiratory Medicine, Hospital Universitari Son Espases-IdISBa, Mallorca, Spain
| | - Alvar Agustí
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Barcelona Respiratory Network, Barcelona, Spain.,Institut Respiratori, Hospital Clinic, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Joaquim Gea
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Respiratory Medicine Department, Hospital del Mar - IMIM, Barcelona, Spain.,Barcelona Respiratory Network, Barcelona, Spain.,DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
| | - Eduard Monsó
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. .,Department of Respiratory Medicine, Hospital Universitari Parc Taulí, Parc Taulí 1, 08208, Sabadell, Barcelona, Spain. .,Barcelona Respiratory Network, Barcelona, Spain. .,Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
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30
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Seijo LM, Soriano JB, Peces-Barba G. New evidence on the chemoprevention of inhaled steroids and the risk of lung cancer in COPD. Eur Respir J 2019; 53:53/6/1900717. [PMID: 31167885 DOI: 10.1183/13993003.00717-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Luis M Seijo
- Clínica Universidad de Navarra, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
| | - Joan B Soriano
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario La Princesa, Madrid, Spain
| | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain.,IIS - Fundación Jiménez Díaz, Madrid, Spain
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Borràs-Santos A, Garcia-Aymerich J, Soler-Cataluña JJ, Vigil Giménez L, Gea Guiral J, Rodríguez Chiaradía D, Pascual-Guardia S, Marcos Rodríguez PJ, Alvarez Martinez CJ, Casanova Macario C, López-Campos JL, Carrasco Hernández L, Martínez-González C, Santos-Pérez S, Peces-Barba G, Molina Paris J, Román Rodríguez M, Barberà JA, Faner R, Agustí A, Cosío BG. EARLY COPD: determinantes de la aparición y progresión de la enfermedad pulmonar obstructiva crónica en adultos jóvenes. Protocolo de un estudio caso-control con seguimiento. Arch Bronconeumol 2019; 55:312-318. [DOI: 10.1016/j.arbres.2018.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
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Seijo LM, Peces-Barba G. Inhaled Corticosteroids and Lung Cancer in COPD. Arch Bronconeumol 2019; 55:407-408. [PMID: 30837158 DOI: 10.1016/j.arbres.2019.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Luis M Seijo
- Clínica Universidad de Navarra, Madrid, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España
| | - Germán Peces-Barba
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, España; Hospital Fundación Jiménez Díaz, Madrid, España.
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Gea J, Pascual S, Castro-Acosta A, Hernández-Carcereny C, Castelo R, Márquez-Martín E, Montón C, Palou A, Faner R, Furlong LI, Seijo L, Sanz F, Torà M, Vilaplana C, Casadevall C, López-Campos JL, Monsó E, Peces-Barba G, Cosío BG, Agustí A, Admetlló M, Agustí A, Alvarez-Martínez C, Barreiro E, Casadevall C, Casals F, Castelo R, Castro-Acosta A, Córdova R, Cosío BG, Faner R, Furlong LI, García M, Gea J, González-García JG, Hernández-Carcereny C, López-Campos JL, Márquez E, Monsó E, Montón C, Ormaza MJ, Palou A, Pascual S, Peces-Barba G, Puigdevall P, Sanz F, Seijó L, Torà M, Torralba Y, Vilaplana C. The BIOMEPOC Project: Personalized Biomarkers and Clinical Profiles in Chronic Obstructive Pulmonary Disease. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.arbr.2018.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Affiliation(s)
- Sandra Pérez Rial
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, CIBERES, Madrid, España
| | - Germán Peces-Barba
- Servicio de Neumología, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, CIBERES, Madrid, España.
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35
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Gea J, Pascual S, Castro-Acosta A, Hernández-Carcereny C, Castelo R, Márquez-Martín E, Montón C, Palou A, Faner R, Furlong LI, Seijo L, Sanz F, Torà M, Vilaplana C, Casadevall C, López-Campos JL, Monsó E, Peces-Barba G, Cosío BG, Agustí A, Admetlló M, Agustí A, Alvarez-Martínez C, Barreiro E, Casadevall C, Casals F, Castelo R, Castro-Acosta A, Córdova R, Cosío BG, Faner R, Furlong LI, García M, Gea J, González-García JG, Hernández-Carcereny C, López-Campos JL, Márquez E, Monsó E, Montón C, Ormaza MJ, Palou A, Pascual S, Peces-Barba G, Puigdevall P, Sanz F, Seijó L, Torà M, Torralba Y, Vilaplana C. Proyecto de biomarcadores y perfiles clínicos personalizados en la enfermedad pulmonar obstructiva crónica (proyecto BIOMEPOC). Arch Bronconeumol 2019; 55:93-99. [DOI: 10.1016/j.arbres.2018.07.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/16/2018] [Accepted: 07/31/2018] [Indexed: 02/01/2023]
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Pérez-Warnisher MT, Cabezas E, Troncoso MF, Gómez T, Melchor R, Pinillos EJ, El Hachem A, Gotera C, Rodriguez P, Mahíllo I, González-Mangado N, Peces-Barba G, Seijo LM. Sleep disordered breathing and nocturnal hypoxemia are very prevalent in a lung cancer screening population and may condition lung cancer screening findings: results of the prospective Sleep Apnea In Lung Cancer Screening (SAILS) study. Sleep Med 2018; 54:181-186. [PMID: 30580192 DOI: 10.1016/j.sleep.2018.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 09/06/2018] [Accepted: 10/01/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) can influence the appearance and proliferation of some tumors. The Sleep Apnea In Lung Cancer Screening (SAILS) study (NCT02764866) evaluated the prevalence of OSA and nocturnal hypoxemia in a high-risk population enrolled in a lung cancer screening program. METHODS This was a prospective study of the prevalence of OSA in a lung cancer screening program. Subjects met the National Lung Screening Trial (NLST) age and smoking criteria (age 55-75 years; pack-years >30). Participants in the study were offered annual screening with low-dose computed tomography (LDCT) and pulmonary function testing, as well as home sleep apnea testing (HSAT) and a sleep-specific questionnaire. Sleep study-related variables, symptoms, and epidemiologic data were recorded. RESULTS HSAT was offered to 279 subjects enrolled in our lung cancer screening program. HSAT results were available for 236 participants (mean age 63.6 years; mean tobacco exposure: 45 pack-years), of whom 59% were male and 53% were active smokers. Emphysema (74%) and chronic obstructive pulmonary disease (COPD) (62%) were common and in most cases mild in severity. OSA, including moderate to severe disease, was very common in this patient population. AHI distributions were as follows: AHI <5 (22.5%); 5-15 (36.4%); 15-30 (23.3%); and >30 (17.8%). Nocturnal hypoxemia (T90) (p = 0.003), diffusing capacity for carbon monoxide (DLCO) (p = 0.01), tobacco exposure (p = 0.024), and COPD (p = 0.023) were associated with OSA severity. Positive screening findings (nodules ≥6 mm) were associated with nocturnal hypoxemia on multivariate analysis adjusted for confounders (OR = 2.6, 95% CI = 1.12-6.09, p = 0.027). CONCLUSION Moderate to severe OSA is very prevalent in patients enrolled in a lung cancer screening program. Nocturnal hypoxemia more than doubles the risk of positive screening findings.
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Affiliation(s)
| | - E Cabezas
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - M F Troncoso
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain; CIBERes, Madrid, Spain
| | - T Gómez
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - R Melchor
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - E J Pinillos
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - A El Hachem
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - C Gotera
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - P Rodriguez
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - I Mahíllo
- Biostatistics Department, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - N González-Mangado
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain; CIBERes, Madrid, Spain
| | - G Peces-Barba
- Pulmonary Division, Instituto de Investigación Sanitaria, Hospital Fundación Jiménez Díaz, Madrid, Spain; CIBERes, Madrid, Spain.
| | - L M Seijo
- Pulmonary Department, Clínica Universidad de Navarra, Madrid, Spain; CIBERes, Madrid, Spain
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Soriano JB, García-Río F, Vázquez-Espinosa E, Conforto JI, Hernando-Sanz A, López-Yepes L, Galera-Martínez R, Peces-Barba G, Gotera-Rivera CM, Pérez-Warnisher MT, Segrelles-Calvo G, Zamarro C, González-Ponce P, Ramos MI, Jafri S, Ancochea J. A multicentre, randomized controlled trial of telehealth for the management of COPD. Respir Med 2018; 144:74-81. [PMID: 30366588 DOI: 10.1016/j.rmed.2018.10.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/27/2018] [Accepted: 10/10/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Evidence is needed to determine the role of telehealth (TH) in COPD management. METHODS PROMETE II was a multicentre, randomized, 12-month trial. Severe COPD patients in stable condition were randomized to a specific monitoring protocol with TH or routine clinical practice (RCP). The primary objective was to reduce the number of COPD exacerbations leading to ER visits/hospital admissions between groups. RESULTS Overall, 237 COPD patients were screened, and 229 (96.6%) were randomized to TH (n = 115) or RCP (n = 114), with age of 71 ± 8 years and 80% were men. Overall, 169 completed the full follow-up period. There were no statistical differences at one year between groups in the proportion of participants who had a COPD exacerbation (60% in TH vs. 53.5% in RCP; p = 0.321). There was, however, a marked but non-significant trend towards a shorter duration of hospitalization and days in ICU in the TH group (18.9 ± 16.0 and 6.0 ± 4.6 days) compared to the RCP group (22.4 ± 19.5 and 13.3 ± 11.1 days). The number of all-cause deaths was comparable between groups (12 in TH vs. 13 in RCP) as was total resource utilization cost (7912€ in TH vs. 8918€ in RCP). Telehealth was evaluated highly positively by patients and doctors. CONCLUSIONS Remote patient management did not reduce COPD-related ER visits or hospital admissions compared to RCP within 12 months.
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Affiliation(s)
- Joan B Soriano
- Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.
| | - Francisco García-Río
- Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Emma Vázquez-Espinosa
- Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.
| | | | | | | | - Raúl Galera-Martínez
- Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Germán Peces-Barba
- Servicio de Neumología, Fundación Jiménez Díaz, Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | - Carolina María Gotera-Rivera
- Servicio de Neumología, Fundación Jiménez Díaz, Madrid, Spain; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
| | | | | | - Celia Zamarro
- Servicio de Neumología, Hospital Rey Juan Carlos, Móstoles, Spain
| | - Pablo González-Ponce
- Monitoring Centre for Remote Patient Monitoring, Linde Healthcare, Madrid, Spain.
| | | | | | - Julio Ancochea
- Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.
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Cabezas Pastor E, Pérez-Warnisher MT, Troncoso MF, Gómez T, Melchor R, Peces-Barba G, González Mangado N, Seijo L. Prevalence of obstructive sleep apnea (OSA) in patients with lung cancer. Results from the prospective SAIL study Sleep Apnea In Lung Cancer). Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.oa3304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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39
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Perez Warnisher MT, Giraldo-Cadavid LF, Oliveros H, Cabezas E, Troncoso F, Gómez T, Melchor R, Pinillos EJ, El Hachem A, Gotera C, Rodriguez P, González-Mangado N, Peces-Barba G, Seijo LM. Sleep disordered breathing and nocturnal hypoxemia are associated with an increased risk of lung cancer. Lung Cancer 2018. [DOI: 10.1183/13993003.congress-2018.pa2229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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40
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Vallejo-Aparicio LA, Peces-Barba G, Gil A, Huerta Hernandez A. Cost-consequence analysis of fluticasone furoate/vilanterol 92/22 mcg for the management of COPD in the Spanish NHS. Clinicoecon Outcomes Res 2018; 10:501-510. [PMID: 30233222 PMCID: PMC6132231 DOI: 10.2147/ceor.s169154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The Salford Lung Study in Chronic Obstructive Pulmonary Disease (SLS COPD) is a 12-month, open-label randomized clinical trial comparing clinical effectiveness and safety of initiating once-daily fluticasone furoate/vilanterol (FF/VI) 92/22 mcg with continuing usual care (UC) in patients with COPD followed in primary care in the UK. The objective of this analysis is to estimate the economic impact of these results when applied to Spain. MATERIALS AND METHODS An Excel-based cost-consequence model with a one-year time horizon was populated with SLS COPD results, adopting the Spanish National Health System (NHS) perspective. Patients analyzed were diagnosed COPD patients ≥40 years old, currently managed with maintenance treatment and with a history of exacerbations (total number estimated from Spanish data). Mean least squares annual rates of moderate/severe exacerbations after 1 year for the intention-to-treat population from SLS COPD were included in the model (1.50 [FF/VI] and 1.64 [UC]); serious adverse events were excluded from the analysis as no differences between treatment arms were found. Medication and exacerbation management costs in euros were estimated from Spanish public sources for 2016. Model base-case analysis assumed an increased usage of FF/VI from 4% to 10% within 1 year, and a 100% proportion of days covered with study medications. Deterministic sensitivity analyses were performed for mitigating uncertainty. RESULTS At base case, within 50,522 COPD patients analyzed, substitution of UC with FF/VI 92/22 mcg was associated with reduced medication and exacerbation management costs, leading to potential total annual savings of €353,623. Deterministic sensitivity results ranged from €218,333 up to €1,532,366 potential cost savings associated with FF/VI, showing the robustness of base-case results. CONCLUSION The decreased rate of exacerbations with FF/VI 92/22 mcg compared with UC observed in SLS COPD could be translated into potential health care savings for the Spanish NHS. These results may be useful to inform decision-making processes.
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Martínez-González C, Casanova C, de-Torres JP, Marín JM, de Lucas P, Fuster A, Cosío BG, Calle M, Peces-Barba G, Solanes I, Agüero R, Feu-Collado N, Alfageme I, Romero Plaza A, Balcells E, de Diego A, Marín Royo M, Moreno A, Llunell Casanovas A, Galdiz JB, Golpe R, Lacárcel Bautista C, Cabrera C, Marin A, Soriano JB, Lopez-Campos JL. Changes and Clinical Consequences of Smoking Cessation in Patients With COPD. Chest 2018; 154:274-285. [DOI: 10.1016/j.chest.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/27/2017] [Accepted: 02/01/2018] [Indexed: 10/18/2022] Open
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Ancochea J, García-Río F, Vázquez-Espinosa E, Hernando-Sanz A, López-Yepes L, Galera-Martínez R, Peces-Barba G, Pérez-Warnisher MT, Segrelles-Calvo G, Zamarro C, González-Ponce P, Ramos MI, Conforto JI, Jafri S, Soriano JB. Efficacy and costs of telehealth for the management of COPD: the PROMETE II trial. Eur Respir J 2018; 51:13993003.00354-2018. [PMID: 29599185 DOI: 10.1183/13993003.00354-2018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/14/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Julio Ancochea
- Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco García-Río
- Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Emma Vázquez-Espinosa
- Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | - Raúl Galera-Martínez
- Servicio de Neumología, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Germán Peces-Barba
- Centro de Investigación en Red de Enfermedades Respiratorias, Madrid, Spain.,Servicio de Neumología, Fundación Jiménez Díaz, Madrid, Spain
| | - Maria Teresa Pérez-Warnisher
- Centro de Investigación en Red de Enfermedades Respiratorias, Madrid, Spain.,Servicio de Neumología, Fundación Jiménez Díaz, Madrid, Spain
| | | | - Celia Zamarro
- Servicio de Neumología, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - Pablo González-Ponce
- Monitoring Centre for Remote Patient Monitoring, Linde Healthcare, Madrid, Spain
| | | | | | | | - Joan B Soriano
- Servicio de Neumología e Instituto de Investigación, Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain.,Methodological and Scientific Consultant, SEPAR, Spain
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Casanova C, Celli BR, de-Torres JP, Martínez-Gonzalez C, Cosio BG, Pinto-Plata V, de Lucas-Ramos P, Divo M, Fuster A, Peces-Barba G, Calle-Rubio M, Solanes I, Aguero R, Feu-Collado N, Alfageme I, De Diego A, Romero A, Balcells E, Llunell A, Galdiz J, Marin M, Moreno A, Cabrera C, Golpe R, Lacarcel C, Soriano JB, López-Campos JL, Soler-Cataluña JJ, Marin JM. Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD. Eur Respir J 2017; 50:50/5/1701162. [DOI: 10.1183/13993003.01162-2017] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 07/27/2017] [Indexed: 01/21/2023]
Abstract
The impact of blood eosinophilia in chronic obstructive pulmonary disease (COPD) remains controversial.To evaluate the prevalence and stability of a high level of blood eosinophils (≥300 cells·μL–1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis.In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels <300 cells·μL–1. A similar eosinophil blood pattern was observed in controls. Exacerbation rates did not differ in patients with and without eosinophilia. All-cause mortality was lower in patients with high eosinophils compared with those with values <300 cells·μL–1 (15.8% versus 33.7%; p=0.026).In patients with COPD, blood eosinophils ≥300 cells·μL–1 persisting over 2 years was not a risk factor for COPD exacerbations. High eosinophil count was associated with better survival.
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Parrón Collar D, Pazos Guerra M, Rodriguez P, Gotera C, Mahíllo-Fernández I, Peces-Barba G, Seijo LM. COPD is commonly underdiagnosed in patients with lung cancer: results from the RECOIL study (retrospective study of COPD infradiagnosis in lung cancer). Int J Chron Obstruct Pulmon Dis 2017; 12:1033-1038. [PMID: 28408813 PMCID: PMC5383077 DOI: 10.2147/copd.s123426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Introduction Many patients with COPD are underdiagnosed, including patients with coexisting lung cancer. Methods We conducted a retrospective study of COPD prevalence and outcomes among all patients diagnosed with lung cancer at our institution during a 2-year period. Patients with known COPD (group A) were compared with those who received a diagnosis of COPD at the time of their oncologic workup (group B). Results A total of 306 patients were diagnosed with lung cancer during the study period, including 87 with COPD (28.6%). Sixty percent of patients with coexisting lung cancer and COPD were unaware of their obstructive airways disease prior to the lung cancer diagnosis. Patients in group A were older (74+9 vs 69+9 years; P=0.03), had more severe obstruction (% of predicted forced expiratory volume in one second [FEV1%] 55+17 vs 71+13; P=0.04), more emphysema (91% vs 65%; P=0.02), and worse diffusing capacity of the lungs for carbon monoxide 59+19% vs 72+22%; P=0.01) than patients in group B, but the latter had more advanced lung cancer (27.3% vs 13.8% stage IV disease; P=0.01) and consumed more outpatient resources (P=0.03). Overall mortality was similar (56% vs 58%). However, stage-adjusted mortality showed a trend toward greater mortality in group B patients (1.87 [0.91–3.85]; P=0.087). Conclusion COPD infradiagnosis is common in patients with coexisting lung cancer and is associated with more advanced cancer stage, greater outpatient resource consumption, and may be associated with greater stage-adjusted mortality.
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Affiliation(s)
| | | | - Paula Rodriguez
- Pulmonary Department, Universidad Autónoma de Madrid.,Pulmonary Department, Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, CIBERES, Madrid, Spain
| | - Carolina Gotera
- Pulmonary Department, Universidad Autónoma de Madrid.,Pulmonary Department, Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, CIBERES, Madrid, Spain
| | - Ignacio Mahíllo-Fernández
- Pulmonary Department, Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, CIBERES, Madrid, Spain
| | - Germán Peces-Barba
- Pulmonary Department, Universidad Autónoma de Madrid.,Pulmonary Department, Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, CIBERES, Madrid, Spain
| | - Luis M Seijo
- Pulmonary Department, Universidad Autónoma de Madrid.,Pulmonary Department, Instituto de Investigación Sanitaria, Fundación Jiménez Díaz, CIBERES, Madrid, Spain
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45
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Navarrete A, Rupérez FJ, Mendes TO, Pérez-Rial S, Girón-Martínez A, Terrón-Expósito R, Díaz-Gil JJ, Peces-Barba G, Barbas C, García A. A metabolomic approach shows sphingosine 1-phosphate and lysophospholipids as mediators of the therapeutic effect of liver growth factor in emphysema. J Pharm Biomed Anal 2017; 139:238-246. [PMID: 28314215 DOI: 10.1016/j.jpba.2017.02.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 02/18/2017] [Accepted: 02/26/2017] [Indexed: 02/06/2023]
Abstract
Tobacco smoke exposure is the principal cause of lung tissue destruction, which in turn results in emphysema that leads into shortness of breath. Liver growth factor (LGF, a cell and tissue regenerating factor with therapeutic activity in several organs) has antifibrotic and antioxidant properties that could be useful to promote lung tissue regenerating capacity in damaged lungs. The current study has examined differences in metabolite profiles (fingerprints) of plasma from mice (strain C57BL/6J, susceptible to develop emphysema) exposed to tobacco smoke during six months. One group of mice received a treatment with Liver Growth Factor (LGF) after emphysema was established, whereas the other group did not receive the treatment. Age and sex-matched mice not exposed to smoke were also maintained with or without treatment as controls. Metabolic fingerprints (untargeted analysis) of plasma after protein precipitation were obtained by LC-QTOF-MS. The signals were processed and a large number of possible metabolites were found (23944). Multivariate data analysis provided models that highlighted the differences between control and smoke exposed mice in both conditions. Accurate masses of features (possible compounds) representing significant differences were searched using online public databases. Lipid mediators, related to intracellular signaling in inflammation, were found among the metabolites putatively identified as markers of the different conditions and among them, sphingosine, sphingosine 1-phosphate and lysophospholipids point at the relevance of such metabolites in the regulation of the processes related to tissue regeneration mediated by LGF. These results also suggest that metabolomic fingerprinting could potentially guide the characterization of relevant metabolites leading the regeneration of lungs in emphysema disease.
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Affiliation(s)
- A Navarrete
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Campus Montepríncipe, Boadilla del Monte, 28668, Madrid, Spain
| | - F J Rupérez
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Campus Montepríncipe, Boadilla del Monte, 28668, Madrid, Spain
| | - T O Mendes
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Campus Montepríncipe, Boadilla del Monte, 28668, Madrid, Spain
| | - S Pérez-Rial
- Pulmonology Experimental Lab., IIS-Fundación Jiménez Díaz-UAM-CIBERES, Avenida Reyes Católicos 2, 28040, Madrid, Spain
| | - A Girón-Martínez
- Pulmonology Experimental Lab., IIS-Fundación Jiménez Díaz-UAM-CIBERES, Avenida Reyes Católicos 2, 28040, Madrid, Spain
| | - R Terrón-Expósito
- Pulmonology Experimental Lab., IIS-Fundación Jiménez Díaz-UAM-CIBERES, Avenida Reyes Católicos 2, 28040, Madrid, Spain
| | - J J Díaz-Gil
- Pulmonology Experimental Lab., IIS-Fundación Jiménez Díaz-UAM-CIBERES, Avenida Reyes Católicos 2, 28040, Madrid, Spain
| | - G Peces-Barba
- Pulmonology Experimental Lab., IIS-Fundación Jiménez Díaz-UAM-CIBERES, Avenida Reyes Católicos 2, 28040, Madrid, Spain
| | - C Barbas
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Campus Montepríncipe, Boadilla del Monte, 28668, Madrid, Spain
| | - A García
- CEMBIO (Center for Metabolomics and Bioanalysis), Facultad de Farmacia, Universidad CEU San Pablo, Campus Montepríncipe, Boadilla del Monte, 28668, Madrid, Spain.
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Cosio BG, Soriano JB, López-Campos JL, Calle M, Soler JJ, de-Torres JP, Marín JM, Martínez C, de Lucas P, Mir I, Peces-Barba G, Feu-Collado N, Solanes I, Alfageme I. Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort. PLoS One 2016; 11:e0160770. [PMID: 27684372 PMCID: PMC5042557 DOI: 10.1371/journal.pone.0160770] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/25/2016] [Indexed: 01/19/2023] Open
Abstract
Rationale The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes. Objective We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes. Methods We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes. Results Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%); ACOS, 125 (15.0%); FEE, 38 (4.6%); and FECB, 99 (11.9%); additionally 19 (2.3%) COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p<0.05). The FECB phenotype had the highest CAT score (17.1±8.2, p<0.05 compared to the other phenotypes). Frequent exacerbator groups (FEE and FECB) were receiving more pharmacological treatment at baseline, and also experienced more exacerbations the year after (all p<0.05) with no differences in one-year mortality. Most of NE (93%) and half of exacerbators were stable after one year. Conclusions There is an uneven distribution of COPD phenotypes in stable COPD patients, with significant differences in demographics, patient-centered outcomes and health care resources use.
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Affiliation(s)
- Borja G. Cosio
- Department of Respiratory Medicine, Hospital Son Espases-IdISPa, Palma de Mallorca, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- * E-mail:
| | - Joan B. Soriano
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Cátedra UAM-Linde, Madrid, Spain
| | - Jose Luis López-Campos
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Respiratory Medicine, Hospital Universitario Virgen del Rocío- IBiS, Sevilla, Spain
| | - Myriam Calle
- Department of Respiratory Medicine, Hospital Clinico San Carlos, Madrid, Spain
| | - Juan José Soler
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Respiratory Medicine, Hospital Arnau de Vilanova, Valencia, Spain
| | - Juan Pablo de-Torres
- Department of Respiratory Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jose Maria Marín
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Respiratory Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Cristina Martínez
- Department of Respiratory Medicine Hospital Central de Asturias, Oviedo, Spain
| | - Pilar de Lucas
- Department of Respiratory Medicine, Hospital Gregorio Marañon, Madrid, Spain
| | - Isabel Mir
- Department of Respiratory Medicine, Hospital Son Llátzer, Palma de Mallorca, Spain
| | - Germán Peces-Barba
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Respiratory Medicine, Fundación Jimenez Diaz, Madrid, Spain
| | - Nuria Feu-Collado
- Department of Respiratory Medicine, Hospital Universitario Reina Sofía, Cordoba-IMIBIC.UCO, Spain
| | - Ingrid Solanes
- Department of Respiratory Medicine, Hospital San Pablo y la Santa Cruz, Barcelona, Spain
| | - Inmaculada Alfageme
- Department of Respiratory Medicine, Hospital Universitario de Valme, Sevilla, Spain
| | - CHAIN study
- Department of Respiratory Medicine, Hospital Ntra. Sra. de Candelaria, Tenerife, Spain
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Tuñón J, González-Hernández I, Llanos-Jiménez L, Alonso-Martín J, Escudier-Villa JM, Tarín N, Cristóbal C, Sanz P, Pello AM, Aceña Á, Carda R, Orejas M, Tomás M, Beltrán P, Calero Rueda M, Marcos E, Serrano-Antolín JM, Gutiérrez-Landaluce C, Jiménez R, Cabezudo J, Curcio A, Peces-Barba G, González-Parra E, Muñoz-Siscart R, González-Casaus ML, Lorenzo A, Huelmos A, Goicolea J, Ibáñez B, Hernández G, Alonso-Pulpón LM, Farré J, Lorenzo Ó, Mahíllo-Fernández I, Egido J. Design and rationale of a multicentre, randomised, double-blind, placebo-controlled clinical trial to evaluate the effect of vitamin D on ventricular remodelling in patients with anterior myocardial infarction: the VITamin D in Acute Myocardial Infarction (VITDAMI) trial. BMJ Open 2016; 6:e011287. [PMID: 27496232 PMCID: PMC4985833 DOI: 10.1136/bmjopen-2016-011287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Decreased plasma vitamin D (VD) levels are linked to cardiovascular damage. However, clinical trials have not demonstrated a benefit of VD supplements on left ventricular (LV) remodelling. Anterior ST-elevation acute myocardial infarction (STEMI) is the best human model to study the effect of treatments on LV remodelling. We present a proof-of-concept study that aims to investigate whether VD improves LV remodelling in patients with anterior STEMI. METHODS AND ANALYSIS The VITamin D in Acute Myocardial Infarction (VITDAMI) trial is a multicentre, randomised, double-blind, placebo-controlled trial. 144 patients with anterior STEMI will be assigned to receive calcifediol 0.266 mg capsules (Hidroferol SGC)/15 days or placebo on a 2:1 basis during 12 months. PRIMARY OBJECTIVE to evaluate the effect of calcifediol on LV remodelling defined as an increase in LV end-diastolic volume ≥10% (MRI). SECONDARY OBJECTIVES change in LV end-diastolic and end-systolic volumes, ejection fraction, LV mass, diastolic function, sphericity index and size of fibrotic area; endothelial function; plasma levels of aminoterminal fragment of B-type natriuretic peptide, galectin-3 and monocyte chemoattractant protein-1; levels of calcidiol (VD metabolite) and other components of mineral metabolism (fibroblast growth factor-23 (FGF-23), the soluble form of its receptor klotho, parathormone and phosphate). Differences in the effect of VD will be investigated according to the plasma levels of FGF-23 and klotho. Treatment safety and tolerability will be assessed. This is the first study to evaluate the effect of VD on cardiac remodelling in patients with STEMI. ETHICS AND DISSEMINATION This trial has been approved by the corresponding Institutional Review Board (IRB) and National Competent Authority (Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)). It will be conducted in accordance with good clinical practice (International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use - Good Clinical Practice (ICH-GCP)) requirements, ethical principles of the Declaration of Helsinki and national laws. The results will be submitted to indexed medical journals and national and international meetings. TRIAL REGISTRATION NUMBER NCT02548364; Pre-results.
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Affiliation(s)
- José Tuñón
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
- Department of Medicine, Autónoma University, Madrid, Spain
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Joaquín Alonso-Martín
- Department of Cardiology, University Hospital of Getafe, Madrid, Spain
- Department of Medicine, Rey Juan Carlos University, Alcorcón, Spain
| | | | - Nieves Tarín
- Department of Cardiology, University Hospital of Móstoles, Móstoles, Spain
| | - Carmen Cristóbal
- Department of Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Petra Sanz
- Department of Medicine, Rey Juan Carlos University, Alcorcón, Spain
- Department of Cardiology, Hospital Rey Juan Carlos, Madrid, Spain
| | - Ana M Pello
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Álvaro Aceña
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Rocío Carda
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Miguel Orejas
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Marta Tomás
- Department of Radiology, Fundación Jiménez Díaz, Madrid, Spain
| | - Paula Beltrán
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
| | | | - Esther Marcos
- Department of Cardiology, University Hospital of Móstoles, Móstoles, Spain
| | | | | | - Rosa Jiménez
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Jorge Cabezudo
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Alejandro Curcio
- Department of Cardiology, Hospital de Fuenlabrada, Madrid, Spain
| | - Germán Peces-Barba
- Department of Medicine, Autónoma University, Madrid, Spain
- Department of Pneumology, Fundación Jiménez Díaz, Madrid, Spain
| | - Emilio González-Parra
- Department of Medicine, Autónoma University, Madrid, Spain
- Department of Nephrology, Fundación Jiménez Díaz, Madrid, Spain
| | | | | | - Antonio Lorenzo
- Department of Cardiology, University Hospital of Móstoles, Móstoles, Spain
| | - Ana Huelmos
- Department of Cardiology, Fundación Hospital Alcorcón, Madrid, Spain
| | - Javier Goicolea
- Department of Cardiology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Borja Ibáñez
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | | | - Luis M Alonso-Pulpón
- Department of Medicine, Autónoma University, Madrid, Spain
- Department of Cardiology, University Hospital Puerta de Hierro, Madrid, Spain
| | - Jerónimo Farré
- Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
- Department of Medicine, Autónoma University, Madrid, Spain
| | - Óscar Lorenzo
- Department of Medicine, Autónoma University, Madrid, Spain
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
| | | | - Jesús Egido
- Department of Medicine, Autónoma University, Madrid, Spain
- Vascular Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
- Department of Nephrology, Fundación Jiménez Díaz, Madrid, Spain
- CIBERDEM, Madrid, Spain
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48
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Cosío BG, Shafiek H, Iglesias A, Yanez A, Córdova R, Palou A, Rodriguez-Roisin R, Peces-Barba G, Pascual S, Gea J, Sibila O, Barnes PJ, Agusti A. Oral Low-dose Theophylline on Top of Inhaled Fluticasone-Salmeterol Does Not Reduce Exacerbations in Patients With Severe COPD. Chest 2016; 150:123-30. [DOI: 10.1016/j.chest.2016.04.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/29/2016] [Accepted: 04/12/2016] [Indexed: 11/24/2022] Open
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Cosio BG, Soriano JB, López-Campos JL, Calle-Rubio M, Soler-Cataluna JJ, de-Torres JP, Marín JM, Martínez-Gonzalez C, de Lucas P, Mir I, Peces-Barba G, Feu-Collado N, Solanes I, Alfageme I, Casanova C. Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort. Chest 2016; 149:45-52. [PMID: 26291753 DOI: 10.1378/chest.15-1055] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Asthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult. METHODS To identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up was analyzed. We evaluated the presence of specific characteristics associated with asthma in this COPD cohort, divided into major criteria (bronchodilator test > 400 mL and 15% and past medical history of asthma) and minor criteria (blood eosinophils > 5%, IgE > 100 IU/mL, or two separate bronchodilator tests > 200 mL and 12%). We defined ACOS by the presence of one major criterion or two minor criteria. Baseline characteristics, health status (COPD Assessment Test [CAT]), BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, rate of exacerbations, and mortality up to 1 year of follow-up were compared between patients with and without criteria for ACOS. RESULTS Of 831 patients with COPD included,125 (15%) fulfilled the criteria for ACOS, and 98.4% of them sustained these criteria after 1 year. Patients with ACOS were predominantly male (81.6%), with symptomatic mild to moderate disease (67%), who were receiving inhaled corticosteroids (63.2%). There were no significant differences in baseline characteristics, and only survival was worse in patients with non-ACOS COPD after 1 year of follow-up (P < .05). CONCLUSIONS The proposed ACOS criteria are present in 15% of a cohort of patients with COPD and these patients show better 1-year prognosis than clinically similar patients with COPD with no ACOS criteria. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.
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Affiliation(s)
- Borja G Cosio
- Department of Respiratory Medicine, Hospital Son Espases-IdISPa, Palma de Mallorca, Mallorca, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Joan B Soriano
- Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid (UAM), Cátedra UAM-Linde, Madrid, Spain
| | - Jose Luis López-Campos
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Respiratory Medicine, Hospital Universitario Virgen del Rocío-IBiS, Sevilla, Spain
| | - Myriam Calle-Rubio
- Department of Respiratory Medicine, Hospital Clinico San Carlos, Madrid, Spain
| | - Juan José Soler-Cataluna
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Respiratory Medicine, Hospital Arnau de Vilanova, Valencia, Spain
| | - Juan P de-Torres
- Department of Respiratory Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jose M Marín
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Respiratory Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Pilar de Lucas
- Department of Respiratory Medicine, Hospital Gregorio Marañon, Madrid, Spain
| | - Isabel Mir
- Department of Respiratory Medicine, Hospital Son Llátzer, Palma de Mallorca, Spain
| | - Germán Peces-Barba
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Department of Respiratory Medicine, Fundación Jimenez Diaz, Madrid, Spain
| | - Nuria Feu-Collado
- Department of Respiratory Medicine, Hospital Universitario Reina Sofía, Cordoba-IMIBIC.UCO, Spain
| | - Ingrid Solanes
- Department of Respiratory Medicine, Hospital San Pablo y la Santa Cruz, Barcelona, Spain
| | - Inmaculada Alfageme
- Department of Respiratory Medicine, Hospital Universitario deValme, Sevilla, Spain
| | - Ciro Casanova
- Department of Respiratory Medicine, Hospital Ntra. Sra. de Candelaria, Tenerife, Spain
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50
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Girón-Martínez Á, Pérez-Rial S, Terrón-Expósito R, Díaz-Gil JJ, González-Mangado N, Peces-Barba G. Proliferative activity of liver growth factor is associated with an improvement of cigarette smoke-induced emphysema in mice. PLoS One 2014; 9:e112995. [PMID: 25401951 PMCID: PMC4234533 DOI: 10.1371/journal.pone.0112995] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/17/2014] [Indexed: 01/06/2023] Open
Abstract
Cigarette smoke (CS)-induced emphysema is a major component of chronic obstructive pulmonary disease (COPD). COPD treatment is based on the administration of bronchodilators and corticosteroids to control symptoms and exacerbations, however, to date, there are no effective therapies to reverse disease progression. Liver growth factor (LGF) is an albumin-bilirubin complex with mitogenic properties, whose therapeutic effects have previously been reported in a model of emphysema and several rodent models of human disease. To approach the therapeutic effect of LGF in a model of previously established emphysema, morphometric and lung function parameters, matrix metalloproteinase (MMP) activity and the expression of several markers, such as VEGF, PCNA, 3NT and Nrf2, were assessed in air-exposed and CS-exposed C57BL/6J male mice with and without intraperitoneal (i.p.) injection of LGF. CS-exposed mice presented a significant enlargement of alveolar spaces, higher alveolar internal area and loss of lung function that correlated with higher MMP activity, higher expression of 3NT and lower expression of VEGF. CS-exposed mice injected with LGF, showed an amelioration of emphysema and improved lung function, which correlated with lower MMP activity and 3NT expression and higher levels of VEGF, PCNA and Nrf2. Taken together, this study suggests that LGF administration ameliorates CS-induced emphysema, highlights the ability of LGF to promote alveolar cell proliferation and may be a promising strategy to revert COPD progression.
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Affiliation(s)
- Álvaro Girón-Martínez
- Respiratory Research Group, Instituto de Investigación Sanitaria - Fundación Jiménez Díaz - CIBERES, Universidad Autónoma de Madrid (IIS-FJD-CIBERES-UAM), Madrid, Spain
- * E-mail:
| | - Sandra Pérez-Rial
- Respiratory Research Group, Instituto de Investigación Sanitaria - Fundación Jiménez Díaz - CIBERES, Universidad Autónoma de Madrid (IIS-FJD-CIBERES-UAM), Madrid, Spain
| | - Raúl Terrón-Expósito
- Respiratory Research Group, Instituto de Investigación Sanitaria - Fundación Jiménez Díaz - CIBERES, Universidad Autónoma de Madrid (IIS-FJD-CIBERES-UAM), Madrid, Spain
| | - Juan José Díaz-Gil
- Respiratory Research Group, Instituto de Investigación Sanitaria - Fundación Jiménez Díaz - CIBERES, Universidad Autónoma de Madrid (IIS-FJD-CIBERES-UAM), Madrid, Spain
| | - Nicolás González-Mangado
- Respiratory Research Group, Instituto de Investigación Sanitaria - Fundación Jiménez Díaz - CIBERES, Universidad Autónoma de Madrid (IIS-FJD-CIBERES-UAM), Madrid, Spain
| | - Germán Peces-Barba
- Respiratory Research Group, Instituto de Investigación Sanitaria - Fundación Jiménez Díaz - CIBERES, Universidad Autónoma de Madrid (IIS-FJD-CIBERES-UAM), Madrid, Spain
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