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Pan Y, Wang D, Chaudhary MFA, Shao W, Gerard SE, Durumeric OC, Bhatt SP, Barr RG, Hoffman EA, Reinhardt JM, Christensen GE. Robust Measures of Image-Registration-Derived Lung Biomechanics in SPIROMICS. J Imaging 2022; 8:309. [PMID: 36422058 PMCID: PMC9693030 DOI: 10.3390/jimaging8110309] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is an umbrella term used to define a collection of inflammatory lung diseases that cause airflow obstruction and severe damage to the lung parenchyma. This study investigated the robustness of image-registration-based local biomechanical properties of the lung in individuals with COPD as a function of Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage. Image registration was used to estimate the pointwise correspondences between the inspiration (total lung capacity) and expiration (residual volume) computed tomography (CT) images of the lung for each subject. In total, three biomechanical measures were computed from the correspondence map: the Jacobian determinant; the anisotropic deformation index (ADI); and the slab-rod index (SRI). CT scans from 245 subjects with varying GOLD stages were analyzed from the SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS). Results show monotonic increasing or decreasing trends in the three biomechanical measures as a function of GOLD stage for the entire lung and on a lobe-by-lobe basis. Furthermore, these trends held across all five image registration algorithms. The consistency of the five image registration algorithms on a per individual basis is shown using Bland-Altman plots.
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Affiliation(s)
- Yue Pan
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA 52242, USA
| | - Di Wang
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA 52242, USA
| | - Muhammad F. A. Chaudhary
- The Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
| | - Wei Shao
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Sarah E. Gerard
- The Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
| | - Oguz C. Durumeric
- Department of Mathematics, University of Iowa, Iowa City, IA 52242, USA
| | - Surya P. Bhatt
- UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - R. Graham Barr
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Eric A. Hoffman
- The Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
- Department of Radiology, University of Iowa, Iowa City, IA 52242, USA
| | - Joseph M. Reinhardt
- The Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
- Department of Radiology, University of Iowa, Iowa City, IA 52242, USA
| | - Gary E. Christensen
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA 52242, USA
- Department of Radiology, University of Iowa, Iowa City, IA 52242, USA
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Zhang WZ, Hoffman KL, Schiffer KT, Oromendia C, Rice MC, Barjaktarevic I, Peters SP, Putcha N, Bowler RP, Wells JM, Couper DJ, Labaki WW, Curtis JL, Han MK, Paine R, Woodruff PG, Criner GJ, Hansel NN, Diaz I, Ballman KV, Nakahira K, Choi ME, Martinez FJ, Choi AMK, Cloonan SM. Association of plasma mitochondrial DNA with COPD severity and progression in the SPIROMICS cohort. Respir Res 2021; 22:126. [PMID: 33902556 PMCID: PMC8074408 DOI: 10.1186/s12931-021-01707-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 01/27/2021] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is a lack of mechanism-driven, clinically relevant biomarkers in chronic obstructive pulmonary disease (COPD). Mitochondrial dysfunction, a proposed disease mechanism in COPD, is associated with the release of mitochondrial DNA (mtDNA), but plasma cell-free mtDNA has not been previously examined prospectively for associations with clinical COPD measures. METHODS P-mtDNA, defined as copy number of mitochondrially-encoded NADH dehydrogenase-1 (MT-ND1) gene, was measured by real-time quantitative PCR in 700 plasma samples from participants enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort. Associations between p-mtDNA and clinical disease parameters were examined, adjusting for age, sex, smoking status, and for informative loss to follow-up. RESULTS P-mtDNA levels were higher in participants with mild or moderate COPD, compared to smokers without airflow obstruction, and to participants with severe COPD. Baseline increased p-mtDNA levels were associated with better CAT scores in female smokers without airflow obstruction and female participants with mild or moderate COPD on 1-year follow-up, but worse 6MWD in females with severe COPD. Higher p-mtDNA levels were associated with better 6MWD in male participants with severe COPD. These associations were no longer significant after adjusting for informative loss to follow-up. CONCLUSION In this study, p-mtDNA levels associated with baseline COPD status but not future changes in clinical COPD measures after accounting for informative loss to follow-up. To better characterize mitochondrial dysfunction as a potential COPD endotype, these results should be confirmed and validated in future studies. TRIAL REGISTRATION ClinicalTrials.gov NCT01969344 (SPIROMICS).
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Affiliation(s)
- William Z Zhang
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Katherine L Hoffman
- Department of Population Health Science, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA
| | - Kristen T Schiffer
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Clara Oromendia
- Department of Population Health Science, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA
| | - Michelle C Rice
- Division of Nephrology and Hypertension, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, University of California Los Angeles Medical Center, Los Angeles, CA, USA
| | - Stephen P Peters
- Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nirupama Putcha
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Russell P Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
| | | | - David J Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wassim W Labaki
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Meilan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Robert Paine
- Section of Pulmonary and Critical Care Medicine, Salt Lake City Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | | | - Gerard J Criner
- Department of Pulmonary & Critical Care Medicine, Temple University, Philadelphia, PA, USA
| | - Nadia N Hansel
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ivan Diaz
- Department of Population Health Science, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA
| | - Karla V Ballman
- Department of Population Health Science, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA
| | - Kiichi Nakahira
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Mary E Choi
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
- Division of Nephrology and Hypertension, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Augustine M K Choi
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Suzanne M Cloonan
- Division of Pulmonary and Critical Care Medicine, Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland and Tallaght University Hospital, Dublin, Ireland.
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, New York, USA.
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Fawzy A, Woo H, Balasubramanian A, Barjaktarevic I, Barr RG, Bowler RP, Comellas AP, Cooper CB, Couper D, Criner GJ, Dransfield MT, Han MK, Hoffman EA, Kanner RE, Krishnan JA, Martinez FJ, McCormack M, Paine Iii R, Peters S, Wise R, Woodruff PG, Hansel NN, Putcha N. Polycythemia is Associated with Lower Incidence of Severe COPD Exacerbations in the SPIROMICS Study. Chronic Obstr Pulm Dis 2021; 8:326-335. [PMID: 34197703 DOI: 10.15326/jcopdf.2021.0216] [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] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Secondary polycythemia has long been recognized as a consequence of chronic pulmonary disease and hypoxemia and is associated with lower mortality and fewer hospitalizations among individuals with chronic obstructive pulmonary disease (COPD)-prescribed long-term oxygen therapy. This study investigates the association of polycythemia with COPD severity, phenotypic features, and respiratory exacerbations in a contemporary and representative sample of individuals with COPD. Current and former smokers with COPD (forced expiratory volume in 1 second [FEV1] to forced vital capacity [FVC] ratio <70%) without a history of hematologic/oncologic disorders were selected from the SubPopulations and InteRmediate Outcomes Measures In COPD Study (SPIROMICS), a multi-center observational cohort. Participants with polycythemia (hemoglobin ≥15g/dL [females] or ≥17g/dL [males]), were compared to individuals without anemia (hemoglobin ≥12g/dL [females] or ≥13g/dL [males]). Cross-sectional outcomes including percent predicted FEV1, respiratory symptoms, quality of life, exercise tolerance, and percentage and distribution of emphysema (voxels<-950 Hounsfield units [HU] at total lung capacity) were evaluated using linear or logistic regression. Longitudinal acute exacerbation of COPD (AECOPD) and severe AECOPD (requiring an emergency department visit or hospitalization) were assessed using zero-inflated negative binomial models. Among 1261 participants, 148 (11.7%) had polycythemia. Average follow-up was 4.2±1.7 years and did not differ by presence of polycythemia. In multivariate analysis, compared to participants with normal hemoglobin, polycythemia was associated with a reduced rate of severe AECOPD (adjusted incidence rate ratio 0.57, 95% CI: 0.33-0.98), lower percent predicted FEV1, lower resting oxygen saturation, increased upper to lower lobe ratio of emphysema, and a greater degree of emphysema, though the latter was attenuated after adjusting for lung function. There were no significant differences in total AECOPD, patient-reported outcomes, or exercise tolerance. These findings suggest that polycythemia, while associated with less favorable physiologic parameters, is not independently associated with symptoms, and is associated with fewer severe exacerbations. Future studies should explore the potentially protective role of increased hemoglobin beyond the correction of anemia.
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Affiliation(s)
- Ashraf Fawzy
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Han Woo
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Aparna Balasubramanian
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Igor Barjaktarevic
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, United States
| | - R Graham Barr
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, United States
| | - Russell P Bowler
- Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, United States
| | - Alejandro P Comellas
- Division of Pulmonary, Critical Care, and Occupational Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Christopher B Cooper
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, United States
| | - David Couper
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Gerard J Criner
- Department of Thoracic Surgery and Medicine, Temple University, Philadelphia, Pennsylvania, United States
| | - Mark T Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Eric A Hoffman
- Department of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States
| | - Richard E Kanner
- Division of Respiratory, Critical Care and Occupational Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Fernando J Martinez
- Division of Pulmonology and Critical Care Medicine, Weill-Cornell Medical Center, Cornell University, New York, New York, United States
| | - Meredith McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Robert Paine Iii
- Division of Respiratory, Critical Care and Occupational Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Stephen Peters
- Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University, Winston-Salem, North Carolina, United States
| | - Robert Wise
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Francisco, San Francisco, California, United States
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Nirupama Putcha
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
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4
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Cooper CB, Paine R, Curtis JL, Kanner RE, Martinez CH, Meldrum CA, Bowler R, O'Neal W, Hoffman EA, Couper D, Quibrera M, Criner G, Dransfield MT, Han MK, Hansel NN, Krishnan JA, Lazarus SC, Peters SP, Barr RG, Martinez FJ, Woodruff PG. Novel Respiratory Disability Score Predicts COPD Exacerbations and Mortality in the SPIROMICS Cohort. Int J Chron Obstruct Pulmon Dis 2020; 15:1887-1898. [PMID: 32821092 PMCID: PMC7417644 DOI: 10.2147/copd.s250191] [Citation(s) in RCA: 1] [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] [Received: 02/17/2020] [Accepted: 07/03/2020] [Indexed: 12/24/2022] Open
Abstract
Rationale Some COPD patients develop extreme breathlessness, decreased exercise capacity and poor health status yet respiratory disability is poorly characterized as a distinct phenotype. Objective To define respiratory disability in COPD based on available functional measures and to determine associations with risk for exacerbations and death. Methods We analyzed baseline data from a multi-center observational study (SPIROMICS). This analysis includes 2332 participants (472 with severe COPD, 991 with mild/moderate COPD, 726 smokers without airflow obstruction and 143 non-smoking controls). Measurements We defined respiratory disability by ≥4 of 7 criteria: mMRC dyspnea scale ≥3; Veterans Specific Activity Questionnaire <5; 6-minute walking distance <250 m; St George’s Respiratory Questionnaire activity domain >60; COPD Assessment Test >20; fatigue (FACIT-F Trial Outcome Index) <50; SF-12 <20. Results Using these criteria, respiratory disability was identified in 315 (13.5%) participants (52.1% female). Frequencies were severe COPD 34.5%; mild-moderate COPD 11.2%; smokers without obstruction 5.2% and never-smokers 2.1%. Compared with others, participants with disability had more emphysema (13.2 vs. 6.6%) and air-trapping (37.0 vs. 21.6%) on HRCT (P<0.0001). Using principal components analysis to derive a disability score, two factors explained 71% of variance, and a cut point −1.0 reliably identified disability. This disability score independently predicted future exacerbations (ß=0.34; CI 0.12, 0.64; P=0.003) and death (HR 2.97; CI 1.54, 5.75; P=0.001). Thus, participants with disability by this criterion had almost three times greater mortality compared to those without disability. Conclusion Our novel SPIROMICS respiratory disability score in COPD was associated with worse airflow obstruction as well as airway wall thickening, lung parenchymal destruction and certain inflammatory biomarkers. The disability score also proved to be an independent predictor of future exacerbations and death. These findings validate disability as an important phenotype in the spectrum of COPD.
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Affiliation(s)
- Christopher B Cooper
- Departments of Medicine and Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert Paine
- Section of Pulmonary and Critical Care Medicine, Department of Veterans Affairs Medical Center, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey L Curtis
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.,Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Richard E Kanner
- Section of Pulmonary and Critical Care Medicine, Department of Veterans Affairs Medical Center, University of Utah, Salt Lake City, UT, USA
| | - Carlos H Martinez
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Catherine A Meldrum
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Russell Bowler
- National Jewish Health, University of Colorado School of Medicine, Denver, CO, USA
| | - Wanda O'Neal
- University of North Carolina Marisco Lung Institute, Chapel Hill, NC, USA
| | - Eric A Hoffman
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - David Couper
- University of North Carolina Marisco Lung Institute, Chapel Hill, NC, USA
| | - Miguel Quibrera
- University of North Carolina Marisco Lung Institute, Chapel Hill, NC, USA
| | - Gerald Criner
- Department of Pulmonary and Critical Care Medicine, Temple University, Philadelphia, PA, USA
| | - Mark T Dransfield
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - MeiLan K Han
- Pulmonary and Critical Care Medicine Division, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
| | - Nadia N Hansel
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jerry A Krishnan
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Stephen C Lazarus
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Fernando J Martinez
- Joan and Sanford I Weill Department of Medicine, Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Prescott G Woodruff
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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5
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Barjaktarevic IZ, Buhr RG, Wang X, Hu S, Couper D, Anderson W, Kanner RE, Paine Iii R, Bhatt SP, Bhakta NR, Arjomandi M, Kaner RJ, Pirozzi CS, Curtis JL, O'Neal WK, Woodruff PG, Han MK, Martinez FJ, Hansel N, Wells JM, Ortega VE, Hoffman EA, Doerschuk CM, Kim V, Dransfield MT, Drummond MB, Bowler R, Criner G, Christenson SA, Ronish B, Peters SP, Krishnan JA, Tashkin DP, Cooper CB. Clinical Significance of Bronchodilator Responsiveness Evaluated by Forced Vital Capacity in COPD: SPIROMICS Cohort Analysis. Int J Chron Obstruct Pulmon Dis 2019; 14:2927-2938. [PMID: 31908441 PMCID: PMC6930016 DOI: 10.2147/copd.s220164] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 10/31/2019] [Indexed: 12/26/2022] Open
Abstract
Objective Bronchodilator responsiveness (BDR) is prevalent in COPD, but its clinical implications remain unclear. We explored the significance of BDR, defined by post-bronchodilator change in FEV1 (BDRFEV1) as a measure reflecting the change in flow and in FVC (BDRFVC) reflecting the change in volume. Methods We analyzed 2974 participants from a multicenter observational study designed to identify varying COPD phenotypes (SPIROMICS). We evaluated the association of BDR with baseline clinical characteristics, rate of prospective exacerbations and mortality using negative binomial regression and Cox proportional hazards models. Results A majority of COPD participants exhibited BDR (52.7%). BDRFEV1 occurred more often in earlier stages of COPD, while BDRFVC occurred more frequently in more advanced disease. When defined by increases in either FEV1 or FVC, BDR was associated with a self-reported history of asthma, but not with blood eosinophil counts. BDRFVC was more prevalent in subjects with greater emphysema and small airway disease on CT. In a univariate analysis, BDRFVC was associated with increased exacerbations and mortality, although no significance was found in a model adjusted for post-bronchodilator FEV1. Conclusion With advanced airflow obstruction in COPD, BDRFVC is more prevalent in comparison to BDRFEV1 and correlates with the extent of emphysema and degree of small airway disease. Since these associations appear to be related to the impairment of FEV1, BDRFVC itself does not define a distinct phenotype nor can it be more predictive of outcomes, but it can offer additional insights into the pathophysiologic mechanism in advanced COPD. Clinical trials registration ClinicalTrials.gov: NCT01969344T4.
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Affiliation(s)
- Igor Z Barjaktarevic
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Russell G Buhr
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Xiaoyan Wang
- Department of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott Hu
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - David Couper
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Wayne Anderson
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Richard E Kanner
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Robert Paine Iii
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Surya P Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nirav R Bhakta
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Mehrdad Arjomandi
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Robert J Kaner
- Department of Medicine, Weill Cornell Weill Cornell Medical Center, New York, NY, USA
| | - Cheryl S Pirozzi
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey L Curtis
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA.,Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Wanda K O'Neal
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Prescott G Woodruff
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - MeiLan K Han
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Fernando J Martinez
- Department of Medicine, Weill Cornell Weill Cornell Medical Center, New York, NY, USA
| | - Nadia Hansel
- Department of Medicine, John Hopkins University, Baltimore, MD, USA
| | - James Michael Wells
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor E Ortega
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eric A Hoffman
- Department of Medicine, University of Iowa, Iowa City, IA, USA
| | - Claire M Doerschuk
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Victor Kim
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Mark T Dransfield
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M Bradley Drummond
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Russell Bowler
- Department of Medicine, National Jewish Health Systems, Denver, CO, USA
| | - Gerard Criner
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | | | - Bonnie Ronish
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Stephen P Peters
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jerry A Krishnan
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Donald P Tashkin
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Christopher B Cooper
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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6
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Li X, Ortega VE, Ampleford EJ, Graham Barr R, Christenson SA, Cooper CB, Couper D, Dransfield MT, Han MLK, Hansel NN, Hoffman EA, Kanner RE, Kleerup EC, Martinez FJ, Paine R, Woodruff PG, Hawkins GA, Bleecker ER, Meyers DA. Genome-wide association study of lung function and clinical implication in heavy smokers. BMC Med Genet 2018; 19:134. [PMID: 30068317 PMCID: PMC6090900 DOI: 10.1186/s12881-018-0656-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/25/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study is to identify genetic loci associated with post-bronchodilator FEV1/FVC and FEV1, and develop a multi-gene predictive model for lung function in COPD. METHODS Genome-wide association study (GWAS) of post-bronchodilator FEV1/FVC and FEV1 was performed in 1645 non-Hispanic White European descent smokers. RESULTS A functional rare variant in SERPINA1 (rs28929474: Glu342Lys) was significantly associated with post-bronchodilator FEV1/FVC (p = 1.2 × 10- 8) and FEV1 (p = 2.1 × 10- 9). In addition, this variant was associated with COPD (OR = 2.3; p = 7.8 × 10- 4) and severity (OR = 4.1; p = 0.0036). Heterozygous subjects (CT genotype) had significantly lower lung function and higher percentage of COPD and more severe COPD than subjects with the CC genotype. 8.6% of the variance of post-bronchodilator FEV1/FVC can be explained by SNPs in 10 genes with age, sex, and pack-years of cigarette smoking (P < 2.2 × 10- 16). CONCLUSIONS This study is the first to show genome-wide significant association of rs28929474 in SERPINA1 with lung function. Of clinical importance, heterozygotes of rs28929474 (4.7% of subjects) have significantly reduced pulmonary function, demonstrating a major impact in smokers. The multi-gene model is significantly associated with CT-based emphysema and clinical outcome measures of severity. Combining genetic information with demographic and environmental factors will further increase the predictive power for assessing reduced lung function and COPD severity.
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Affiliation(s)
- Xingnan Li
- Division of Genetics, Genomics and Precision Medicine, Department of Medicine, University of Arizona, BioScience Research Lab, Room 253, 1230 N. Cherry Avenue, PO Box 210242, Tucson, AZ 85721 USA
| | - Victor E. Ortega
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina USA
| | - Elizabeth J. Ampleford
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina USA
| | - R. Graham Barr
- Department of Medicine, Columbia University, New York, NY USA
| | - Stephanie A. Christenson
- Division of Pulmonary, Critical Care, Sleep & Allergy, Department of Medicine and Cardiovascular Research Institute, University of California at San Francisco, San Francisco, California USA
| | - Christopher B. Cooper
- Department of Medicine, University of California at Los Angeles, Los Angeles, California USA
| | - David Couper
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA
| | - Mark T. Dransfield
- Division of Pulmonary, Allergy & Critical Care Medicine, Lung Health Center, University of Alabama at Birmingham, Birmingham, AL USA
| | - Mei Lan K. Han
- Division of Pulmonary & Critical Care, University of Michigan, Ann Arbor, MI USA
| | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Eric A. Hoffman
- Department of Radiology, University of Iowa, Iowa City, Iowa USA
| | - Richard E. Kanner
- Department of Internal Medicine/Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT USA
| | - Eric C. Kleerup
- Department of Medicine, University of California at Los Angeles, Los Angeles, California USA
| | - Fernando J. Martinez
- Department of Medicine, Weill Cornell Medical College of Cornell University, New York, NY USA
| | - Robert Paine
- Department of Internal Medicine/Pulmonary and Critical Care Medicine, University of Utah, Salt Lake City, UT USA
| | - Prescott G. Woodruff
- Division of Pulmonary, Critical Care, Sleep & Allergy, Department of Medicine and Cardiovascular Research Institute, University of California at San Francisco, San Francisco, California USA
| | - Gregory A. Hawkins
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina USA
| | - Eugene R. Bleecker
- Division of Genetics, Genomics and Precision Medicine, Department of Medicine, University of Arizona, BioScience Research Lab, Room 253, 1230 N. Cherry Avenue, PO Box 210242, Tucson, AZ 85721 USA
| | - Deborah A. Meyers
- Division of Genetics, Genomics and Precision Medicine, Department of Medicine, University of Arizona, BioScience Research Lab, Room 253, 1230 N. Cherry Avenue, PO Box 210242, Tucson, AZ 85721 USA
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