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Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD
STUDY OBJECTIVES: Patients with COPD experience lower airway and systemic inflammation, and an accelerated decline in FEV(1). There is no evidence on whether this inflammation changes over time, or if it is associated with a faster decline in FEV(1). PATIENTS AND DESIGN: A cohort of 148 COPD patient...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The American College of Chest Physicians. Published by Elsevier Inc.
2005
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172405/ https://www.ncbi.nlm.nih.gov/pubmed/16236847 http://dx.doi.org/10.1378/chest.128.4.1995 |
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author | Donaldson, Gavin C. Seemungal, Terence A.R. Patel, Irem S. Bhowmik, Angshu Wilkinson, Tom M.A. Hurst, John R. MacCallum, Peter K. Wedzicha, Jadwiga A. |
author_facet | Donaldson, Gavin C. Seemungal, Terence A.R. Patel, Irem S. Bhowmik, Angshu Wilkinson, Tom M.A. Hurst, John R. MacCallum, Peter K. Wedzicha, Jadwiga A. |
author_sort | Donaldson, Gavin C. |
collection | PubMed |
description | STUDY OBJECTIVES: Patients with COPD experience lower airway and systemic inflammation, and an accelerated decline in FEV(1). There is no evidence on whether this inflammation changes over time, or if it is associated with a faster decline in FEV(1). PATIENTS AND DESIGN: A cohort of 148 COPD patients (100 men) was monitored daily for a median of 2.91 years (interquartile range [IQR], 2.1 to 4.8). At recruitment, median age was 68.5 years (IQR, 62.5 to 73.6) and FEV(1) as percentage of predicted (FEV(1)%Pred) was 38.5% (IQR, 27.7 to 50.3). RESULTS: During the study, the patients experienced 1,389 exacerbations, a median of 2.52/yr (IQR, 1.48 to 3.96) and FEV(1) declined by 40.2 mL/yr or as FEV(1)%Pred by 1.5%/yr. Concerning inflammatory markers, sputum interleukin (IL)-6 rose by 9 pg/mL/yr, sputum neutrophil count rose by 1.64 × 10(6) cells per gram sputum per year, an plasma fibrinogen rose by 0.10 g/L/yr (all p < 0.05). Patients with frequent exacerbations (≥ 2.52/yr) had a faster rise over time in plasma fibrinogen and sputum IL-6 of 0.063 g/L/yr (p = 0.046, n = 130) and 29.5 pg/mL/yr (p < 0.001, n = 98), respectively, compared to patients with infrequent exacerbations (< 2.52/yr). Using the earliest stable (nonexacerbation) measured marker, patients whose IL-6 exceeded the group median had a faster FEV(1)%Pred decline of 0.42%/yr (p = 0.018). Similarly, a high neutrophil count or fibrinogen were associated with a faster FEV(1)%Pred decline of 0.97%/yr (p = 0.001) and 0.40%/yr (p = 0.014), respectively. CONCLUSIONS: In COPD, airway and systemic inflammatory markers increase over time; high levels of these markers are associated with a faster decline in lung function. |
format | Online Article Text |
id | pubmed-7172405 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2005 |
publisher | The American College of Chest Physicians. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-71724052020-04-22 Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD Donaldson, Gavin C. Seemungal, Terence A.R. Patel, Irem S. Bhowmik, Angshu Wilkinson, Tom M.A. Hurst, John R. MacCallum, Peter K. Wedzicha, Jadwiga A. Chest Clinical Investigations STUDY OBJECTIVES: Patients with COPD experience lower airway and systemic inflammation, and an accelerated decline in FEV(1). There is no evidence on whether this inflammation changes over time, or if it is associated with a faster decline in FEV(1). PATIENTS AND DESIGN: A cohort of 148 COPD patients (100 men) was monitored daily for a median of 2.91 years (interquartile range [IQR], 2.1 to 4.8). At recruitment, median age was 68.5 years (IQR, 62.5 to 73.6) and FEV(1) as percentage of predicted (FEV(1)%Pred) was 38.5% (IQR, 27.7 to 50.3). RESULTS: During the study, the patients experienced 1,389 exacerbations, a median of 2.52/yr (IQR, 1.48 to 3.96) and FEV(1) declined by 40.2 mL/yr or as FEV(1)%Pred by 1.5%/yr. Concerning inflammatory markers, sputum interleukin (IL)-6 rose by 9 pg/mL/yr, sputum neutrophil count rose by 1.64 × 10(6) cells per gram sputum per year, an plasma fibrinogen rose by 0.10 g/L/yr (all p < 0.05). Patients with frequent exacerbations (≥ 2.52/yr) had a faster rise over time in plasma fibrinogen and sputum IL-6 of 0.063 g/L/yr (p = 0.046, n = 130) and 29.5 pg/mL/yr (p < 0.001, n = 98), respectively, compared to patients with infrequent exacerbations (< 2.52/yr). Using the earliest stable (nonexacerbation) measured marker, patients whose IL-6 exceeded the group median had a faster FEV(1)%Pred decline of 0.42%/yr (p = 0.018). Similarly, a high neutrophil count or fibrinogen were associated with a faster FEV(1)%Pred decline of 0.97%/yr (p = 0.001) and 0.40%/yr (p = 0.014), respectively. CONCLUSIONS: In COPD, airway and systemic inflammatory markers increase over time; high levels of these markers are associated with a faster decline in lung function. The American College of Chest Physicians. Published by Elsevier Inc. 2005-10 2016-02-27 /pmc/articles/PMC7172405/ /pubmed/16236847 http://dx.doi.org/10.1378/chest.128.4.1995 Text en © 2005 The American College of Chest Physicians Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Clinical Investigations Donaldson, Gavin C. Seemungal, Terence A.R. Patel, Irem S. Bhowmik, Angshu Wilkinson, Tom M.A. Hurst, John R. MacCallum, Peter K. Wedzicha, Jadwiga A. Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD |
title | Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD |
title_full | Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD |
title_fullStr | Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD |
title_full_unstemmed | Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD |
title_short | Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD |
title_sort | airway and systemic inflammation and decline in lung function in patients with copd |
topic | Clinical Investigations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172405/ https://www.ncbi.nlm.nih.gov/pubmed/16236847 http://dx.doi.org/10.1378/chest.128.4.1995 |
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