Author Affiliations

1. Editor in Chief, Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
2. Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Alabama, United States

Address correspondence to:

Mark Dransfield, MD
Email: mdransfield@uabmc.edu

Abstract

This article does not contain an abstract.

Citation

Citation: Dransfield M. Editorial: Thank you all, now onwards and upwards! J COPD F. 2021; 8(3): 303-305. doi: http://doi.org/10.15326/jcopdf.8.3.2021.0247

Keywords

There are no keywords for this article.

Full Text

Click to read Thank You All, Now Onwards and Upwards!

PDF Download

PDF Version (229KB)

Author Affiliations

1. Lung Health Center, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama, Birmingham, Alabama, United States
2. Denver, Colorado

Address correspondence to:

Takudzwa Mkorombindo, MD
Email: tmkorombindo@uabmc.edu

Abstract

This article does not contain an abstract.

Citation

Citation: Mkorombindo T, Balkissoon R. Journal club: respiratory impact of wildfire smoke. J COPD F. 2021; 8(3): 408-413. doi: http://doi.org/10.15326/jcopdf.8.3.2021.0244

Keywords

wildfire smoke, environmental-related respiratory events

Full Text

Click to read Journal Club: Respiratory Impact of Wildfire Smoke

PDF Download

PDF Version (162KB)

Author Affiliations

1. Florida Lung Asthma and Sleep Specialists, Kissimmee, Florida, United States

Address correspondence to:

Fortune O. Alabi, MD
3480 Polynesian Isles Blvd.
Kissimmee, FL 34746
Phone: 407-507-2615
Email: Falabi@floridalungdoctors.com

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with differing clinical presentations, which range from an asymptomatic obstructive defect on spirometry to symptomatic normal spirometry. The current standard for diagnosis requires exposure history and the presence of an obstructive ventilatory defect (forced expiratory volume in 1 second [FEV₁] to forced vital capacity [FVC] ratio < 70%) on spirometry. In this real-world study, we analyzed patients with physician-diagnosed COPD, described their characteristics, and evaluated the diagnostic sensitivity of Global initiative for chronic Obstructive Lung Disease (GOLD) criteria in this population.

Methods: We retrospectively analyzed the charts of 2115 patients for eligibility. A total of 1224 patients with physician-diagnosed COPD were selected for this study. The average age was 68.4±11.5 years, with 51% being female. Of the 1224 patients, 18% did not have a history of smoking, 73% had bronchodilator testing, and a significant response of ≥12% was noted in 23% of the COPD patients. Moreover, 43% of the patients met the GOLD criteria for the diagnosis of COPD, whereas the Global Lung Function Initiative (GLI) and lower limit of normal (LLN)criteria were only able to identify 26%.

Discussion: COPD-related mortality is continuing to rise, and it is currently ranked as the third leading cause of death, globally, after cardiovascular diseases and strokes. Despite this alarming statistic, COPD diagnosis is delayed in most cases and can remain undiagnosed, even in smokers. This is partly due to the restrictive GOLD diagnostic criteria, which requires the presence of FEV₁/FVC ratio<70.

Conclusion: The recently proposed COPD Genetic Epidemiology (COPDGene^®) 2019 definition for COPD will improve and enhance our ability to diagnose COPD earlier and more accurately.

Citation

Citation: Alabi FO, Alkhateeb HA, DeBarros KM, et al. The heterogeneity of COPD patients in a community-based practice and the inadequacy of the Global Initiative for Chronic Obstructive Lung Disease criteria: a real-world experience. J COPD F. 2021; 8(3): 396-407. doi: http://doi.org/10.15326/jcopdf.8.3.2021.0229

Keywords

chronic obstructive pulmonary disease, spirometry, GOLD, COPDGene, pulmonary function test

Full Text

Click to read The Heterogeneity of COPD Patients in a Community-Based Practice and the Inadequacy of the Global Initiative for Chronic Obstructive Lung Disease Criteria: A Real-World Experience

PDF Download

PDF Version (3222KB)

Author Affiliations

1. Pulmonary and Critical Care Division, Department of Internal Medicine, UF Health-Shands Hospital, University of Florida, Gainesville, Florida, United States
2. Advent Health Medical Group, Central Florida Division, Orlando, Florida, United States
3. Pulmonary and Critical Care Division, Department of Internal Medicine, University of Miami Health Systems, Miami, Florida, United States

*medical student

Address correspondence to:

Jason B. Katz
MD-candidate
College of Medicine
University of Florida
Phone : (727)288-8356
Email : jasonbkatz@ufl.edu

Abstract

Purpose: Endothelial and platelet microparticles (eMPs and pMPs), markers of cellular activation, dysfunction, or apoptosis, have been associated with multiple cardiovascular conditions. Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular comorbidities and platelet/endothelial dysfunction. We analyzed whether eMPs and pMPs are associated with COPD status and/or severity.

Patients and Methods: A total of 58 COPD patients and 19 controls were enrolled and followed for an average of 1.17 years. Characterization of COPD included lung function, Body mass index-airflow Obstruction-Dyspnea-Exercise (BODE) scores, health-related quality of life, exacerbations, comorbidities, and mortality. Plasma collection to measure eMPs and pMPs via flow cytometry was performed at enrollment as well as during acute exacerbation in 17 participants. We measured pMPs (CD31+, CD41+31+, CD 62P+), eMPs (ULEX lectin+, CD51+, CD54+, CD62E+), the apoptotic CD62E+/CD31+ ratio, and Annexin V MP.

Results: As a group, COPD participants had no difference in all MP levels studied compared with controls. No significant correlations with diffusion capacity for carbon monoxide, quality of life, and exacerbation status were found in all MPs studied. However, the eMP ULEX and the pMP CD 62P+ were higher among COPD Global initiative for chronic Obstructive Lung Disease (GOLD) stage 3 patients compared to controls. The CD62E+/CD31+ ratio was lower in controls and GOLD stage 1 COPD participants compared with GOLD stage 2/3 COPD participants, suggesting increased apoptosis. eMP ULEX lectin+ decreased during acute exacerbations and pMP41+31+ significantly increased as BODE score increased.

Conclusion: After adjusting for comorbidities, most eMPs and pMPs studied do not correlate significantly with COPD status or severity.

Citation

Citation: Lascano J, Katz J, Cearras M, Campos M.Association of systemic endothelial-derived and platelet-derived microparticles with clinical outcomes in chronic obstructive pulmonary disease. J COPD F. 2021; 8(3): 382-395. doi: http://doi.org/10.15326/jcopdf.8.3.2021.0211

Keywords

COPD, Lung, endothelium, platelets, microparticles

Full Text

Click to read Association of Systemic Endothelial-Derived and Platelet-Derived Microparticles With Clinical Outcomes in Chronic Obstructive Pulmonary Disease

PDF Download

PDF Version (4492KB)

Author Affiliations

1. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States
2. Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, United States
3. Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, United States
4. Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colorado, United States
5. Division of Pulmonary, Critical Care, and Occupational Medicine, College of Medicine, University of Iowa, Iowa City, Iowa, United States
6. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
7. Department of Thoracic Surgery and Medicine, Temple University, Philadelphia, Pennsylvania, United States
8. Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
9. Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, United States
10. Department of Radiology, Medicine and Biomedical Engineering, University of Iowa, Iowa City, Iowa, United States
11. Division of Respiratory, Critical Care and Occupational Medicine, University of Utah, Salt Lake City, Utah, United States
12. Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, Chicago, Illinois, United States
13. Division of Pulmonology and Critical Care Medicine, Weill-Cornell Medical Center, Cornell University, New York, New York, United States
14. Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University, Winston-Salem, North Carolina, United States
15. Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Francisco, San Francisco, California, United States

Address correspondence to:

Ashraf Fawzy, MD, MPH
5501 Hopkins Bayview Circle
Baltimore, MD 21224
Email: afawzy1@jhmi.edu

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.

Citation

Citation: Fawzy A, Woo H, Balasubramanian A, et al. Polycythemia is associated with lower incidence of severe COPD exacerbations in the SPIROMICS study. J COPD F. 2021; 8(3): 326-335. doi: http://doi.org/10.15326/jcopdf.8.3.2021.0216

Keywords

acute exacerbation of COPD, SPIROMICS, polycythemia

Full Text

Click to read Polycythemia is Associated with Lower Incidence of Severe COPD Exacerbations in the SPIROMICS Study

PDF Download

PDF Version (3103KB)

Author Affiliations

1. University of Minnesota, Minneapolis, Minnesota, United States
2. HealthPartners Institute, Bloomington, Minnesota, United States
3. RespirTech, a Philips company, St. Paul, Minnesota, United States

Address correspondence to:

Charlene McEvoy, MD, MPH
HealthPartners Institute
8170 33rd Avenue South, MS23301A
Bloomington, MN 55425
Email: Charlene.E.McEvoy@HealthPartners.com
Phone: (612) 845-6711

Abstract

Purpose: To assess whether the presence or absence of bronchiectasis has an impact on the patient-reported symptoms of chronic obstructive pulmonary disease (COPD) patients.

Methods: The study included participants from the COPD Genetic Epidemiology Study (COPDGene^®) cohort with available high-resolution chest tomography reporting the presence or absence of bronchiectasis (BE+/BE-) and survey data reporting the presence or absence of chronic bronchitis symptoms (CB+/CB-). Patient symptoms based on the St George’s Respiratory Questionnaire (SGRQ) were then compared for the different groups.

Results: The study population included 7976 participants, mean age 60, Global initiative for chronic Obstructive Lung Disease (GOLD) stages 0 to 4, 18.8% BE+, and 19.5% CB+. The presence or absence of radiographic bronchiectasis was not associated with higher frequency of chronic bronchitis (GOLD 0 group odds ratio [OR] 1.01 [0.78,1.31], GOLD 1–2 group OR 1.19 [0.95, 1.50], GOLD 3–4 group OR 1.26 [0.99, 1.60]). Similarly, CB+ participants had higher SGRQ scores than CB- participants regardless of the presence of BE.

Conclusions: Across all GOLD stages, chronic bronchitis symptoms are associated with worse pulmonary symptoms and significant impairment in quality of life. For patients with chronic bronchitis, the presence or absence of bronchiectasis is not associated with a significant difference in SGRQ symptom scores. Symptoms of chronic bronchitis impose a heavy burden on patients and should be treated regardless of the presence or absence of underlying bronchiectasis.

Citation

Citation: Bohn O, Xi M, Woodruff NK, Hansen GL, McEvoy CE; COPDGene investigators. Chronic bronchitis in COPD patients creates worse symptom burden regardless of the presence of bronchiectasis in the COPDGene cohort. J COPD F. 2021; 8(3): 350-359. doi: http://doi.org/10.15326/jcopdf.8.3.2021.0202

Keywords

chronic bronchitis, GOLD, bronchiectasis, St George’s Respiratory Questionnaire, Global initiative for chronic Lung Disease

Full Text

Click to read Chronic Bronchitis in COPD Patients Creates Worse Symptom Burden Regardless of the Presence of Bronchiectasis in the COPDGene Cohort

PDF Download

PDF Version (3571KB)