Pulmonary pharmacology & therapeutics最新文献

Drug Repurposing Tactics in the USA: Known Active Pharmaceutical Ingredients in New Indications. 美国的药物再利用策略：新适应症中的已知活性药物成分。

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2025-03-01 DOI: 10.1016/j.pupt.2025.102348

Thomas P Dooley

引用次数: 0

Bispecific domain antibody attenuates airway hyperresponsiveness and pulmonary inflammation in ovalbumin-lipopolysaccharide induced asthma model by inhibiting IL-23 and TNF-α

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2025-03-01 DOI: 10.1016/j.pupt.2025.102347

Chirag Ketan Gala , Sandeep , Abhay H. Pande , Shyam Sunder Sharma

Asthma, a chronic multi-factorial pulmonary inflammatory condition with a high morbidity rate, is characterized by airway hyperresponsiveness and persistent pulmonary inflammation. There is a need to develop more effective treatment(s) for the management of asthma. In this study, we have investigated the therapeutic potential of BiSpekDAb (an engineered bispecific antibody comprising an anti-IL-23 domain antibody and an anti-TNF-α domain antibody fused together via flexible linkers to a half-life extension partner) in asthma. Asthma was established by sensitization and challenge of female Wistar rats with the combination of ovalbumin and lipopolysaccharide and the efficacy of BiSpekDAb was investigated by its subcutaneous administration for 11 days on each alternative day (6 doses) during the challenge phase. Significant deterioration of pulmonary functions, enhanced airway hyperresponsiveness, increase in the number of immune cells such as lymphocytes, eosinophils, neutrophils in blood circulation as well as in lungs, enhanced production of inflammatory cytokines (IL-23, TNF-α, IL-1β, IL-6, IL-22), allergic IgE antibodies, oxidative stress markers, and histopathological changes (thickening of epithelial lining, infiltration of immune cells, mast cell degranulation, and overproduction of mucus) were observed in asthma animals, and administration of BiSpekDAb attenuated airway hyperresponsiveness (AHR), pulmonary inflammation and other pathological changes. BiSpekDAb significantly inhibited IL-23 and TNF-α levels in the lungs of asthmatic rats. Our results suggest that targeting IL-23 and TNF-α simultaneously opens a new therapeutic window for biologics development aimed at mitigating pulmonary inflammation such as asthma.

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引用次数: 0

Novel synergistic therapeutic approach in idiopathic pulmonary fibrosis: Combining the antifibrotic nintedanib with the anti-inflammatory baricitinib

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2025-02-25 DOI: 10.1016/j.pupt.2025.102346

Qin Wan , Dongdong Li , Shu Shang , Haifeng Wu , Faxiu Chen , Qiugen Li

Background

Baricitinib and nintedanib can target inflammation and fibrosis respectively, which are the two most important processes in idiopathic pulmonary fibrosis (IPF). However, it is still unknown whether targeting these two processes simultaneously can synergistically improve the therapeutic effect of IPF. Therefore, it is necessary to predict the possible translational potential through preclinical studies.

Methods

We evaluated both the in vitro and in vivo efficacy of a drug combination, nintedanib with baricitinb, a JAK1/JAK2 inhibitor. We first examined the fibroblast proliferation and myofibroblast differentiation of single agents or combinations by the MTT assay. Then we determined the migration of the fibroblasts by a wound healing assay. Meanwhile, we quantified the protein level of related growth factor or cytokines in the cell supernatant by ELISA. Finally, we investigated the therapeutic potential and mechanism in a bleomycin-induced mouse model.

Results

Our results showed that the combination of nintedanib and baricitinib was more effective in suppressing fibroblast proliferation, myofibroblast transformation and fibroblast migration compared to either agent alone. In a bleomycin-induced IPF mouse model, the combination therapy resulted in a higher survival rate, increased body weight, and a lower lung/body weight ratio compared to the individual drugs. Moreover, both drugs improved lung functions in mice, but their combined administration led to superior outcomes. Histopathological analysis also revealed that the combination therapy mitigated pulmonary inflammation and fibrosis to a greater extent than the individual compounds. Mechanistically, baricitinib appears to orchestrate the effects of nintedanib in IPF by modulating the expression of genes such as il-6, tgf-β, col1α1 and fibronectin.

Conclusion

The synergistic targeting of inflammation by baricitinib and fibrosis by nintedanib preclinically improves IPF outcomes, thus suggesting their potential as a novel combination therapy for this condition.

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引用次数: 0

Real-life impact of genotype and severity of lung disease on efficacy of elexacaftor-tezacaftor-ivacaftor in people with cystic fibrosis

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2025-02-18 DOI: 10.1016/j.pupt.2025.102345

Shahid Sheikh , Melissa Holtzlander , Mariah Eisner , Courtney Gushue , Sabrina Palacios , Kavitha Kotha , Sehyr Imran , Karen S. McCoy

Background

Elexacaftor-tezacaftor-ivacaftor (ETI) therapy has shown improvement in lung function, BMI and reduction in pulmonary exacerbations but the impact of genotype and severity of lung disease on heterogeneity of ETI efficacy in real life is not known.

Methods

This is a prospective observational study. Clinical data at baseline and at one-year of therapy were compared for the total cohort and for two subgroups; genotype [homozygous vs. heterozygous for F508del], and severity of lung disease at ETI initiation (ppFEV₁ <80 % vs. ≥80 %).

Results

Among the total cohort of 115 pwCF, median age of 23 (17, 32) years, 66 (58 %) were homozygous, 76 (66 %) had ppFEV₁ <80 %. Significant increases in mean ppFEV₁ and mean BMI and decrease in MRSA and Pa culture positivity on sputum/throat swab were observed at one year of ETI therapy in the total cohort, and in groups based on either genotype or disease severity (p < 0.05 in all). Comparing one-year prior to one-year on ETI therapy, significant improvements were noted in pulmonary exacerbations, hospital admissions, antibiotic courses, number of pwCF receiving daily chest therapy, dornase alfa and hypertonic saline in the total cohort and in all four subgroups (p < 0.05 for all). Though improvements were not dependent on genotype, we noted larger mean differences in ppFEV₁, BMI, pulmonary exacerbations and antibiotic use in the group with more severe lung disease (ppFEV₁ <80 %) after one year of ETI therapy.

Conclusion

ETI therapy improved clinical outcomes in pwCF which were impacted by severity of underlying lung disease.

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引用次数: 0

IL-10RA promotes lung cancer cell proliferation by increasing fatty acid oxidation via STAT3 signaling pathway

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2025-01-30 DOI: 10.1016/j.pupt.2025.102344

Wei Du , Yuqing Ouyang , Xiaofan Feng , Chunyan Yu, Haoke Zhang, Siqi Chen, Zixuan Liu, Bo Wang, Xueying Li, Zihe Liu, Weimin Deng

Metabolic reprogramming in tumor cells plays a crucial role in promoting cell proliferation and metastasis, and is currently recognized as a significant marker of tumor progression. Interleukin-10 receptor subunit alpha (IL-10RA), a member of the type II cytokine receptor family, is predominantly expressed on macrophages and T cells and plays a crucial role in regulating immune cell metabolism and immune response. However, its role in the energy metabolic pathways of tumor cells remains unclear. In this study, we found increased expression of IL-10RA in human non-small cell lung cancer (NSCLC), and a correlation between increased IL-10RA expression and tumor stage, tumor size, and short overall survival of patients with NSCLC. IL-10RA overexpression significantly promoted the proliferation of NSCLC cell lines and enhanced glycolysis and fatty acid oxidation (FAO), thereby boosting energy production. Correspondingly, the downregulation of IL-10RA inhibited proliferation, glycolysis, and FAO in NSCLC cell lines. Bioinformatic analyses indicated that IL-10RA upregulates the signal transducer and activator of transcription 3 (STAT3) signaling pathway. STAT3 inhibitor effectively blocked the increase in FAO levels and cell proliferation induced by IL-10RA overexpression. These findings suggest that IL-10RA accelerates NSCLC cell proliferation by increasing FAO levels via the STAT3 pathway, highlighting IL-10RA as a potential therapeutic target for NSCLC.

{"title":"IL-10RA promotes lung cancer cell proliferation by increasing fatty acid oxidation via STAT3 signaling pathway","authors":"Wei Du , Yuqing Ouyang , Xiaofan Feng , Chunyan Yu, Haoke Zhang, Siqi Chen, Zixuan Liu, Bo Wang, Xueying Li, Zihe Liu, Weimin Deng","doi":"10.1016/j.pupt.2025.102344","DOIUrl":"10.1016/j.pupt.2025.102344","url":null,"abstract":"<div><div>Metabolic reprogramming in tumor cells plays a crucial role in promoting cell proliferation and metastasis, and is currently recognized as a significant marker of tumor progression. Interleukin-10 receptor subunit alpha (IL-10RA), a member of the type II cytokine receptor family, is predominantly expressed on macrophages and T cells and plays a crucial role in regulating immune cell metabolism and immune response. However, its role in the energy metabolic pathways of tumor cells remains unclear. In this study, we found increased expression of IL-10RA in human non-small cell lung cancer (NSCLC), and a correlation between increased IL-10RA expression and tumor stage, tumor size, and short overall survival of patients with NSCLC. IL-10RA overexpression significantly promoted the proliferation of NSCLC cell lines and enhanced glycolysis and fatty acid oxidation (FAO), thereby boosting energy production. Correspondingly, the downregulation of IL-10RA inhibited proliferation, glycolysis, and FAO in NSCLC cell lines. Bioinformatic analyses indicated that IL-10RA upregulates the signal transducer and activator of transcription 3 (STAT3) signaling pathway. STAT3 inhibitor effectively blocked the increase in FAO levels and cell proliferation induced by IL-10RA overexpression. These findings suggest that IL-10RA accelerates NSCLC cell proliferation by increasing FAO levels via the STAT3 pathway, highlighting IL-10RA as a potential therapeutic target for NSCLC.</div></div>","PeriodicalId":20799,"journal":{"name":"Pulmonary pharmacology & therapeutics","volume":"88 ","pages":"Article 102344"},"PeriodicalIF":3.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Corrigendum to "Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat" [Pulm. Pharmacol. Therapeut. (88), March 2025, 102342]. 《吸入皮质类固醇治疗马哮喘的临床疗效：一项荟萃分析和需要治疗的数量》的更正[Pulm]。杂志。Therapeut。（88）， 2025年3月，102342]。

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2024-12-19 DOI: 10.1016/j.pupt.2024.102343

Elena Pistocchini, Alicia Maria Carrillo Heredero, Melissa Mazan, Laurent Couetil, Simone Bertini, Luigino Calzetta

引用次数: 0

Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat 吸入皮质类固醇治疗马哮喘的临床疗效：一项荟萃分析和治疗所需的数量。

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2024-12-05 DOI: 10.1016/j.pupt.2024.102342

Elena Pistocchini , Alicia Maria Carrillo Heredero , Melissa Mazan , Laurent Couetil , Simone Bertini , Luigino Calzetta

Equine asthma, a prevalent chronic inflammatory condition affecting the equine population, significantly compromises the performance and quality of life in affected horses. Inhaled corticosteroids (ICS) are often the first-line pharmacological intervention due to their potent anti-inflammatory properties. This meta-analysis investigates the clinical efficacy of ICS in treating equine asthma, emphasizing the number needed to treat (NNT) and the likelihood of achieving a clinical response. A comprehensive literature search identified relevant studies comparing ICS with placebo (PCB) controlled treatments. Data were synthesized from four clinical trials involving 252 asthmatic horses. Results indicate an overall NNT of 3.2 (95 % CI 2.3–4.7), meaning that approximately three horses must be treated with ICS for one to achieve a significant clinical response. Additionally, the relative risk of achieving clinical improvement with ICS versus PCB was 1.73 (95 % CI 1.47–2.02), demonstrating a marked increase in therapeutic effectiveness. Subgroup analysis revealed an NNT of 3.0 for severe cases, underscoring the efficacy of ICS across different severity levels. Despite potential biases noted in some studies, sensitivity analyses confirmed the robustness of these findings. The GRADE assessment rated the quality of evidence as high. These results highlight the therapeutic value of ICS in managing equine asthma, providing evidence-based recommendations for their clinical use. Future research should explore long-term outcomes and potential synergistic effects of ICS combined with other treatments to enhance clinical efficacy in managing equine asthma.

马哮喘是一种影响马群的普遍慢性炎症性疾病，严重影响马的表现和生活质量。吸入皮质类固醇（ICS）通常是第一线的药物干预，由于其有效的抗炎特性。本荟萃分析调查了ICS治疗马哮喘的临床疗效，强调了治疗所需的数量（NNT）和实现临床反应的可能性。综合文献检索确定了比较ICS与安慰剂（PCB）对照治疗的相关研究。数据来自252匹哮喘马的四项临床试验。结果显示总体NNT为3.2 (95% CI 2.3 - 4.7)，这意味着大约三匹马必须接受ICS治疗才能获得显著的临床反应。此外，ICS与PCB实现临床改善的相对风险为1.73 (95% CI 1.47-2.02)，表明治疗效果显着提高。亚组分析显示，重症病例的NNT为3.0，强调了ICS在不同严重程度上的疗效。尽管在一些研究中指出了潜在的偏差，但敏感性分析证实了这些发现的稳健性。GRADE评估将证据质量评为高。这些结果突出了ICS在治疗马哮喘方面的治疗价值，为其临床应用提供了循证建议。未来的研究应探索ICS联合其他治疗方法的长期疗效和潜在的协同效应，以提高治疗马哮喘的临床疗效。

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引用次数: 0

ALDH2 attenuates radiation-induced lung injury by inhibiting ROS and epithelial-mesenchymal transition mediated by the TGF-β1/Smad pathway ALDH2通过抑制ROS和TGF-β1/Smad通路介导的上皮-间质转化，减轻辐射诱导的肺损伤。

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2024-12-01 DOI: 10.1016/j.pupt.2024.102334

Enping Li , Jianliang Huang , Jiale Huang , Fuying Zhang , Chengyou Li , Mingkai Xia , Zhuo Li , Bo Peng , Ying Liu , Jinan Ma , Mingsheng Lei

Radiation-induced lung injury is a significant complication of thoracic malignant tumor radiotherapy, yet effective treatments remain scarce. Aldehyde dehydrogenase 2 (ALDH2) possesses antioxidant and anti-inflammatory properties, but its specific role in radiation-induced lung injury is not well understood. This study aimed to investigate the impact of ALDH2 on radiation-induced lung injury and elucidate the underlying mechanisms. Through analysis of radiation-induced lung injury datasets, intervention with ALDH2 agonists and inhibitors in an in vivo radiation-induced lung injury model, and establishment of an in vitro radiation-induced lung injury model using A549 stable cells with varying ALDH2 expressions, we discovered that ALDH2 expression is reduced in radiation-induced lung injury. Enrichment analysis suggested that ALDH2 may mitigate radiation-induced lung injury by modulating oxidative stress and inflammation levels. Additionally, single-cell data analysis reveals that ALDH2 is primarily localized in myeloid macrophages within the lungs, with its expression also being reduced in lung cancer patients. Subsequent examination of mouse pathological sections, reactive oxygen species (ROS), and inflammatory factor levels confirmed that ALDH2 can lessen radiation-induced lung injury by suppressing ROS and inflammatory factors. Both in vivo and in vitro Western blot analysis further validated that ALDH2 can attenuate epithelial-mesenchymal transition and inhibit the TGF-β1/Smad pathway. Therefore, ALDH2 shows promise in reducing radiation-induced lung injury by inhibiting ROS and TGF-mediated epithelial-mesenchymal transition, making it a potential target for the treatment of radiation-induced lung injury.

放射性肺损伤是胸部恶性肿瘤放射治疗的重要并发症，但有效的治疗方法仍然很少。醛脱氢酶2 （ALDH2）具有抗氧化和抗炎作用，但其在辐射性肺损伤中的具体作用尚不清楚。本研究旨在探讨ALDH2对辐射性肺损伤的影响并阐明其机制。通过对辐射肺损伤数据集的分析，对体内辐射肺损伤模型进行ALDH2激动剂和抑制剂的干预，以及使用不同ALDH2表达的A549稳定细胞建立体外辐射肺损伤模型，我们发现ALDH2在辐射肺损伤中表达降低。富集分析表明，ALDH2可能通过调节氧化应激和炎症水平来减轻辐射引起的肺损伤。此外，单细胞数据分析显示ALDH2主要定位于肺内的髓系巨噬细胞，其在肺癌患者中的表达也有所降低。随后对小鼠病理切片、活性氧（ROS）和炎症因子水平的检测证实，ALDH2可以通过抑制ROS和炎症因子来减轻辐射引起的肺损伤。体内和体外Western blot分析进一步验证了ALDH2可以减弱上皮-间质转化，抑制TGF-β1/Smad通路。因此，ALDH2有望通过抑制ROS和tgf介导的上皮-间质转化来减轻辐射诱导的肺损伤，使其成为治疗辐射诱导肺损伤的潜在靶点。

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引用次数: 0

Triple inhaled therapy in asthma: Beliefs, behaviours and doubts 哮喘的三联吸入疗法：信念、行为和疑虑。

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2024-12-01 DOI: 10.1016/j.pupt.2024.102333

D. Bagnasco , I. Ansotegui , I. Baiardini , A. Benfante , J.A. Bernstein , A. Bikov , B. Bondi , L.P. Boulet , C. Panaitescu , G.W. Canonica , H. Chong-Neto , L. Dubuske , R. El-Owaidy , M. Ferraris , M. Filipovic , F.J. Gonzalez-Barcala , G. Guidos Fogelbach , J.C. Ivancevich , E. Jusufovic , K. Kowal , F. Braido

Long-acting muscarinic antagonists (LAMA) in association with inhaled corticosteroids (ICS) plus long-acting beta-2 agonists (LABA) are recommended by the GINA report as further option in step 4 and first choice in step 5 treatment. Despite consistent evidence of its efficacy and safety, inhaled triple therapy (ITT) is still not largely used in patients with asthma.

With the aim to explore belief and behaviours of asthma specialists, an ad hoc survey has been developed by a panel of Interasma Scientific Network (INESnet) experts and subsequently defined by two Delphi rounds among an international group of physicians. The questionnaire has been distributed through Interasma social media between June and September 2023.

Besides a descriptive analysis, to assess the responses gathered from the questionnaire, Spearman's non-parametric statistical method was employed.

Totally, three hundred fourteen questionnaires were completed. Clinicians' attitudes and behaviours toward timing and methodologies adopted in prescribing ITT, were analysed. 35.7 % specialists consider ITT as a relevant therapeutic option, 61.8 % that is second option after reaching high dose of ICS-LABA and 89.2 % agreed that optimization of inhaled therapy should be attempted before the use of biological drugs. Persistent flow limitation and high reversibility are considered predictive factors of response.

Specialists consider ITT a resource in asthma management. Although its efficacy in decreasing exacerbation rate and improving lung function were well known, the survey revealed persistent uncertainties among clinicians in positioning it highlighting the need for further measures to effectively integrate research findings into day-to-day clinical practice.

GINA 报告建议，长效毒蕈碱拮抗剂（LAMA）与吸入皮质类固醇（ICS）加长效β-2 受体激动剂（LABA）联合使用，作为第 4 步治疗的进一步选择和第 5 步治疗的首选。尽管吸入三联疗法（ITT）的疗效和安全性得到了一致的证明，但仍未在哮喘患者中得到广泛应用。为了探索哮喘专科医生的信念和行为，Interasma 科学网络（INESnet）专家小组制定了一项特别调查，随后在国际医生小组中进行了两轮德尔菲调查。调查问卷已于 2023 年 6 月至 9 月间通过 Interasma 社交媒体发布。除了描述性分析外，还采用了斯皮尔曼非参数统计方法来评估从问卷中收集到的答复。总共完成了 34 份问卷。调查分析了临床医生对开具 ITT 处方的时间和方法的态度和行为。35.7%的专家认为 ITT 是一种相关的治疗选择，61.8%的专家认为 ITT 是在使用大剂量 ICS-LABA 后的第二种选择，89.2%的专家同意在使用生物药物前应尝试优化吸入疗法。持续性血流受限和高可逆性被认为是预测反应的因素。专家认为 ITT 是哮喘治疗的一种资源。虽然 ITT 在降低哮喘加重率和改善肺功能方面的疗效众所周知，但调查显示临床医生对 ITT 的定位一直存在不确定性，这突出表明有必要采取进一步措施，将研究成果有效融入日常临床实践中。

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引用次数: 0

Prevalence and clinical significance of pre- and post-bronchodilator airflow obstruction in COPD patients 慢性阻塞性肺病患者使用支气管扩张剂前后气流阻塞的发生率和临床意义。

IF 3.3 3区医学 Q2 PHARMACOLOGY & PHARMACY

Pulmonary pharmacology & therapeutics

Pub Date : 2024-11-17 DOI: 10.1016/j.pupt.2024.102332

Hyun Woo Lee , Jung-Kyu Lee , Youlim Kim , June Hong Ahn , Chang Youl Lee , Yong Bum Park , Hyoung Kyu Yoon , Ji Ye Jung , Kwang Ha Yoo , Deog Kyeom Kim

Background

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation. This study investigates the prevalence and clinical significance of pre-bronchodilator (PREO) and post-bronchodilator (POSTO) airflow obstruction in COPD.

Methods

This retrospective cohort study analyzed data from 3252 COPD patients aged ≥40 years, registered from January 2012 to December 2019 at 54 medical centers in South Korea. Patients were categorized into three groups: PREO & post-bronchodilator non-obstruction (POSTN), pre-bronchodilator non-obstruction (PREN) & POSTO, and PREO & POSTO. The primary outcome was moderate-to-severe exacerbation over 3 years. Secondary outcomes included GOLD group progression and rapid FEV₁ decline.

Results

The majority of patients (96.2 %) were in the PREO & POSTO group, with smaller proportions in the PREO & POSTN (2.8 %) and PREN & POSTO (1.0 %) groups. During the 3-year observation, 21.6 % of patients experienced moderate-to-severe exacerbations, 6.2 % exhibited GOLD group progression, and 20.0 % showed rapid FEV₁ decline. The PREO & POSTO group had a higher risk of exacerbations compared to the PREO & POSTN group (odds ratio = 8.33 [95 % CI = 1.53–45.4], P-value = 0.014), but this was not statistically significant in multivariable analysis. Post-bronchodilator spirometry patterns did not significantly impact GOLD group progression or FEV₁ decline.

Conclusion

PREO & POSTO was common among COPD patients, while isolated PREO & POSTN was rare, supportingpre-bronchodilator spirometry as a screening tool. Although patients with PREO & POSTO showed higher exacerbation risks in univariable analysis, statistical significance disappeared after adjustment. GOLD group progression or FEV₁ decline did not significantly differ by post-bronchodilator spirometry patterns.

背景：慢性阻塞性肺疾病（COPD）是一种以持续气流受限为特征的进行性呼吸系统疾病。本研究探讨了慢性阻塞性肺疾病患者支气管扩张剂前（PREO）和支气管扩张剂后（POSTO）气流阻塞的患病率和临床意义：这项回顾性队列研究分析了2012年1月至2019年12月期间在韩国54家医疗中心登记的3252名年龄≥40岁的慢性阻塞性肺病患者的数据。患者被分为三组：PREO 和支气管扩张剂后无阻塞（POSTN）组、支气管扩张剂前无阻塞（PREN）和 POSTO 组以及 PREO 和 POSTO 组。主要结果是 3 年内中度至重度病情加重。次要结果包括 GOLD 组进展和 FEV₁ 快速下降：大多数患者（96.2%）属于 PREO & POSTO 组，PREO & POSTN 组（2.8%）和 PREN & POSTO 组（1.0%）所占比例较小。在 3 年的观察期间，21.6% 的患者出现中度至重度病情加重，6.2% 的患者出现 GOLD 组进展，20.0% 的患者出现 FEV₁ 快速下降。与 PREO & POSTN 组相比，PEO & POSTO 组的病情加重风险更高（几率比=8.33 [95% CI=1.53-45.4]，P 值=0.014），但在多变量分析中并无统计学意义。支气管扩张剂后肺活量测量模式对 GOLD 组的进展或 FEV₁ 下降没有显著影响：PREO和POSTO在慢性阻塞性肺病患者中很常见，而孤立的PREO和POSTN则很少见，这支持将支气管扩张前肺活量测定作为一种筛查工具。虽然在单变量分析中，PEO & POSTO 患者的病情恶化风险较高，但经过调整后，统计学意义消失了。GOLD组的进展或FEV₁的下降在支气管舒张术后肺活量测量模式上没有显著差异。

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引用次数: 0