Many people with chronic obstructive pulmonary disease (COPD) have several other health issues like heart disease, diabetes, and osteoporosis. COPD also impacts people who are poor or belong to a racial or ethnic minority group more than those who are affluent or White. These patterns may not be due to random chance. COPD may cluster with other health issues through a process called a syndemic. A syndemic is when 2 or more health problems occur together and interact in ways that make each problem worse, especially in a community or population facing social or economic hardships. These combined health issues, along with factors such as poverty, create a greater burden on a person’s well-being than each issue would on its own.

To more successfully treat people with COPD, doctors and other health care providers need to focus not only on COPD but also on the other health issues that the person might have. They also need to be aware of social and economic challenges that the person might face. Researchers and health systems need to learn from and improve existing programs that try to accomplish this balanced treatment approach. They also need to involve individuals from poor and minority communities in research and problem-solving to address factors like poverty that increase people’s risk for diseases like COPD.

Inhaling toxins or pollutants, especially by smoking cigarettes, can cause chronic obstructive pulmonary disease (COPD). Only some smokers develop COPD. Why that happens is unknown. Learning why could lead to new treatments for COPD. Most studies have recruited only older people already living with COPD.

This article describes SOURCE, a new study of younger smokers. SOURCE collects questionnaires, lung function testing, chest imaging, and multiple samples from participants (like blood, urine, and mucus among others). Each participant undergoes 2 study visits 3 years apart. SOURCE is supported by the National Heart Lung and Blood Institute and the COPD Foundation. Its goal is to discover new information that can be used to develop new treatments.

Acute exacerbations or flare-ups of chronic obstructive pulmonary disease (COPD) are a major cause of hospital admissions, and despite treatment, they can further worsen the patient's condition, resulting in a higher risk of death. At present, it is still difficult to identify how severe a patient’s exacerbation will be and their risk of dying.

To address the above issues, we reviewed 322 cases of patients experiencing acute exacerbations from January 2012 to December 2018. We pulled 90 different patient characteristics from the electronic medical records database. Through a rigorous selection process, a set of 34 key features to study were identified. We then used these features to develop and train 7 machine learning models focused on predicting the need for intensive care unit admission and the likelihood a patient would die in the hospital.

Our study reveals that machine learning models can provide personalized evaluations of patients’ risks during an exacerbation. This approach could help personalize treatments for COPD patients experiencing acute exacerbations and this could potentially lead to improved patient results.

Patients with chronic obstructive pulmonary disease (COPD) often have additional health conditions, which suggests that COPD may affect other areas of the body beyond the lungs.

In this study, we checked real-world data available in a large health care database to investigate the relationship between 3 conditions that exist along with COPD and their impact on patients over a 5-year follow-up period. The conditions investigated were gastroesophageal reflux disease (where stomach acid flows back up from the stomach), diabetes, and osteoporosis (which affects bone health). We found that patients with COPD were more likely to also have these other conditions than patients without COPD. In addition, patients who had COPD and also one of these other conditions had a greater risk of COPD flare-ups or exacerbations and were more likely to have emergency department visits and hospital stays than patients who did not have one of these other conditions.

Our research shows the need to better understand how COPD affects the body beyond the lungs and how treatment affects the whole body, to reduce the frequency of COPD flare-ups.

Imagine our lungs as a community with 2 important cell groups: fibroblasts (builders) and bronchial epithelial cells (protective layer). In chronic obstructive pulmonary disease (COPD), these cells do not work well together.

Our research discovered how they communicate during COPD. We took fibroblasts from mice and humans and found that interleukin-17A turns the builder cells into overdrive. Overactive fibroblasts release C-X-C motif chemokine ligand 12 (a messenger causing inflammation). This messenger connects with C-X-C motif chemokine receptor 4, telling protective cells to act like builders, disrupting airway structure and making breathing harder. However, we found hope by neutralizing (making ineffective) interleukin-17A or the chemokine ligand 12 messengers. This reduces harmful effects, turning down the disruptive signals. In experiments with mice exposed to cigarette smoke, reducing these signals helped protective cells return to their normal function, improving airway structure.

Our findings enhance the understanding of COPD and suggest new ways to improve lung health by targeting these specific signals.

Individuals with COPD are at high risk for poor outcomes or results following a COVID-19 infection. Social distancing early in the COVID-19 pandemic helped lessen the spread of the virus. The broad availability of vaccines against the COVID-19 virus allowed individuals to begin to socialize again. However, how the vaccine rollout affected COPD individuals’ mental health, their social determinants of health (nonmedical factors that affect health like the conditions or environments where people are born, live, are educated, and age), and their attitudes is unknown.

Individuals with COPD participating in a clinical trial were asked questions about their respiratory symptoms, anxiety and depression symptoms, social isolation, the type of support they had from friends and family, and their attitudes and actions related to the COVID-19 pandemic. Changes in responses were compared between the prevaccine (May−December 2020) and postvaccine (May 2021−September 2022) periods.

Participants' answers to the questions showed that they closely followed the COVID-19 prevention measures into the postvaccine period. However, fewer respondents viewed governmental health care individuals/groups as trustworthy. Despite a trend towards less social isolation following the COVID-19 vaccines, individuals with COPD reported worse respiratory symptoms and greater anxiety and depression symptoms. We did not expect to learn of worsening respiratory and mental health symptoms after the vaccine was available. This suggests that periods of prolonged social isolation may have an ongoing negative impact on the physical and mental health of individuals with COPD.

Alpha-1 antitrypsin deficiency is an inherited disease that causes an enzyme in the lungs to be overly active and uncontrolled (because of the lack of the protein, alpha-1 antitrypsin, which normally controls this enzyme). Over time, this leads to damage to lung tissue, most often as chronic obstructive pulmonary disease (COPD). Bronchiectasis is a form of lung tissue damage that causes a widening of the airways and increased phlegm or mucus production. It is unclear whether there is a direct link between alpha-1 antitrypsin deficiency and bronchiectasis, or whether bronchiectasis is simply related to COPD of any cause.

In our study, we found that bronchiectasis is unrelated to a COPD diagnosis but was more likely in individuals with lower alpha-1 antitrypsin levels in their blood. This suggests there is a direct link between the 2 diseases: bronchiectasis and alpha-1 antitrypsin deficiency. Patients with bronchiectasis were more likely to have more severe shortness of breath. Therefore, appropriate treatment of bronchiectasis in alpha-1 antitrypsin deficiency patients is essential. However, bronchiectasis was not associated with changes in lung function decline or exacerbations, possibly because bronchiectasis is usually mild in alpha-1 antitrypsin deficiency patients.

This study explored the impact of a quality improvement (QI) program, delivered by clinical pharmacists. The program focused on health care usage by individuals with chronic obstructive pulmonary disease (COPD). Over 6 months, the number of COPD-related emergency department visits, hospitalizations, and prescription fills were compared between those enrolled in the digital program versus those who were not.

Individuals in the digital QI program had nearly two-thirds fewer COPD-related emergency department visits and hospitalizations compared to those not in the program. Additionally, there was a 47% reduction in general emergency department visits and hospitalizations. Participants in the digital QI program also filled their COPD-related prescriptions and saw their nonemergency health care providers more often than those not in the program.

COPD is a progressive lung disease that places a significant financial burden on the health care system, mainly due to emergency visits and hospitalizations. This research was needed to explore how combining digital health platforms with clinical care can reduce that burden. The findings suggest that digital health programs may help shift COPD care toward more regular and less costly health care options.

COPD is a long-term condition that causes breathing difficulties and can lead to unexpected health declines, known as exacerbations or flare-ups. Our study examined how body mass index (BMI) affects the risk of exacerbations in people with COPD.

We reviewed 11 studies that explored the link between BMI and COPD flare-ups. Our findings suggest that underweight people have nearly double the risk of experiencing these flare-ups compared to those who have a normal BMI. Our review highlights that being underweight is a significant risk factor for COPD flare-ups and managing body weight might be important for reducing the risk of flare-ups. However, being overweight or obese did not seem to increase the risk of flare-ups

The findings call for more research to understand why underweight individuals are at greater risk and to develop better strategies for managing COPD based on a patient's BMI. These insights could lead to more personalized care and improved outcomes for people living with COPD.

Bronchoscopic lung volume reduction (BLVR) is a newer procedure approved for patients with advanced chronic obstructive pulmonary disease (COPD). The procedure works by placing valves inside the lung, causing the diseased parts of the lung to collapse, and allowing the healthier parts to work more effectively. This has been shown to improve quality of life, breathlessness, and how far patients can walk. Initial studies about this procedure were all performed at large, urban centers even though patients in rural areas have double the incidence of COPD and have known worse health outcomes or results.

Developing a pneumothorax (an air leak in the lungs that causes air to be trapped between the lungs and the chest wall) is a complication or problem that can develop after a BLVR. Reviewing how often a pneumothorax happens or how severe the pneumothoraces are following BLVR procedures is one way to measure how safely a hospital is performing the procedure. This is the first study to look at pneumothorax rates in a rural hospital. The study was a retrospective review of all patients who underwent the BLVR procedure at a hospital which is located in a town with a census of 5,461 residents. The pneumothorax rate of 25% (11 of 44 patients), was similar to the original BLVR trials which had pneumothorax rates of 26.6% and 29.2%.

This study suggests that the procedure can be done safely in a rural, community hospital. This study will hopefully increase access to the procedure for patients in rural areas, as this study shows that the pneumothorax rate is similar to the rate in urban centers.

During the COVID-19 pandemic, individuals living in rural areas experienced higher cases and deaths related to a COVID-19 infection. Patients with chronic obstructive pulmonary disease (COPD) are at higher risk for poorer outcomes or results associated with COVID-19.

We performed a one-time telephone survey to compare behaviors, access to care, and health outcomes among veterans with COPD living in rural versus urban areas during the pandemic. We did not find differences between rural and urban veterans with COPD related to their perceptions/opinions and practices for preventing COVID-19 (face mask, hand washing, avoiding sick contacts, social distancing, and receiving vaccinations), their ability to obtain medical care, and COPD exacerbations or flare-ups of their disease during the pandemic.

The lack of difference between rural and urban veterans with COPD in our study might be explained by the longstanding practice of the Veterans Health Administration to deliver health care remotely or by increased use of preventive practices (face masks, handwashing, social distancing, etc) in individuals with underlying lung diseases during the pandemic.