International Journal of Chronic Obstructive Pulmonary Disease最新文献

Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and persistent respiratory symptoms. Molecular and cellular changes identified in red blood cells (RBCs) of COPD patients may contribute to the pathophysiology of COPD, impacting oxygen transport and systemic inflammation.

Methods: We performed a comparative proteomic analysis on RBCs from 15 male COPD patients and 15 age- and sex-matched control subjects. For the proteomic analysis, individual samples were randomly pooled into 3 biological replicates per group (n = 3). Total RBC proteins were analyzed using tandem mass tag (TMT) labeling followed by LC-MS/MS. Differentially abundant proteins (DAPs) were identified and subjected to Gene Ontology (GO), KEGG pathway, and protein-protein interaction (PPI) network analyses.

Results: We identified 160 DAPs (70 up-regulated, 90 down-regulated) in the RBCs of COPD patients. GO analysis revealed enrichment in processes related to protein stability regulation and immune response. KEGG pathway analysis showed that up-regulated proteins were most significantly enriched in the proteasome pathway, while down-regulated proteins were enriched in complement and coagulation cascades. Notably, a PPI network analysis highlighted a core complex of 10 up-regulated proteins that are all components of the proteasome regulatory particle.

Conclusion: This study provides the in-depth RBC protein profile in COPD, identifying proteasome activation as a key molecular signature. These findings reveal novel biomarkers linked to RBC dysfunction that may contribute to the systemic pathology of COPD and offer potential new therapeutic targets.

Background: This study aimed to determine the frequency of fear of falling (FOF) in individuals with chronic obstructive pulmonary disease (COPD) and to evaluate its relationship with demographic, clinical, and functional parameters.

Material and methods: Eighty COPD patients followed in a university hospital between May 2021 and December 2022 were included in this cross-sectional study. Perceived fear of falling was assessed with the Falls Efficacy Scale (FES), and functional balance was evaluated using the Berg Balance Scale (BBS). Physical performance was measured using the Timed Up and Go (TUG) test and Six-Minute Walk Test (6MWT). Symptoms were assessed with the COPD Assessment Test (CAT) and modified Medical Research Council Dyspnea Scale (mMRC). Respiratory function was measured using spirometric parameters including Forced Expiratory Volume in 1 second (FEV₁), Forced Vital Capacity (FVC), and the FEV₁/FVC ratio. Data analysis was conducted using SPSS.

Results: The mean age of participants was 64.98±8.13 years, and 91.25% were male. FES scores were significantly higher in patients with fall history (45 [64-73] vs 20 [12-32], p<0.001). FOF was also significantly higher in those with comorbidities, especially hypertension (p=0.024) and heart failure (p=0.036). FOF differed across COPD groups, with Group E patients showing significantly higher FES scores than Groups A and B (59 [28-71.5] vs 16 [10-25] and 29 [14-45], respectively; p<0.001). Based on FEV₁, patients in Stages 3 and 4 had higher FOF than those in Stages 1 and 2 (p<0.05). FES scores positively correlated with age, COPD duration, CAT, mMRC, and TUG; and negatively with FEV₁, FVC, BBS, and 6MWT. All 10 patients with FES ≥70 had moderate fall risk by BBS. Among those with FES ≤70, 22.8% had moderate to high objective fall risk.

Conclusion: FOF in COPD is associated with age, disease duration, symptom severity, balance, and physical capacity. Balance-focused interventions should be integrated into pulmonary rehabilitation.

Objective: Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition characterized by persistent respiratory symptoms and airflow limitation, which may involve mechanisms that are also implicated in lung carcinogenesis. This meta-analysis aimed to evaluate the association between COPD and the risk of developing lung cancer.

Methods: A systematic literature search was conducted from database inception to March 20, 2022 across PubMed, Embase, Web of Science, and the Cochrane Library. Studies were independently screened by two reviewers, and relative risks (RRs) with 95% confidence intervals (CIs) were extracted and synthesized.

Results: Nine studies were included in the final meta-analysis. A significantly increased risk of lung cancer was observed among individuals with COPD, with a pooled relative risk (RR) of 3.79 and a 95% confidence interval (CI) ranging from 3.60 to 3.98. Among individuals with COPD who did not use inhaled corticosteroids (ICS), the relative risk of lung cancer was 1.26 (95% CI: 1.20-1.33). The relative risk for females was 1.02 (95% CI: 0.99-1.05), suggesting no statistically significant difference in lung cancer risk by gender. The meta-analysis identified a moderate but statistically significant association between COPD and an increased risk of lung cancer.

Conclusion: The results of this study are consistent with those of previous studies, further verifying that patients with COPD have a higher risk of lung cancer and providing stronger support for this finding. These findings underscore the need for enhanced surveillance and tailored preventive strategies among individuals diagnosed with COPD. Moving beyond traditional research paradigms to more refined, multidimensional approaches may improve the understanding of the link between COPD and lung cancer.

Purpose: Chronic Obstructive Pulmonary Disease (COPD) is a major global health issue, significantly impacting healthcare systems. Effective nursing interventions are crucial for improving patient outcomes and reducing hospitalizations. This study conducts a bibliometric analysis of nursing interventions and research in the management of COPD to identify key trends, contributors, and emerging research directions.

Material and methods: We analyzed 1390 articles published before 2024, sourced from the Web of Science Core Collection (SCI-Expanded). Using R Bibliometrix, VOSviewer, and CiteSpace, we assessed publication trends, identified influential authors and institutions, and mapped research hotspots and collaborations. The analysis included quantitative metrics such as citation counts and co-citation networks, as well as qualitative assessments of thematic evolution.

Results: The analysis revealed a significant increase in research output on COPD nursing interventions, particularly after 2001, with a peak in publications around 2021, likely due to the COVID-19 pandemic. The United States, the United Kingdom, and China were the top contributors, accounting for over 45% of the total publications. Key research hotspots included acute exacerbations, quality of life, evidence-based nursing, and pulmonary rehabilitation. The study highlighted a shift from symptom management to more holistic, patient-centered care models.

Conclusion: This study emphasizes the critical role of nursing interventions in managing COPD and reducing its global burden. The identified research trends and emerging topics offer valuable insights for future research, underscoring the need for innovation in nursing practices and interdisciplinary collaboration. These findings aim to inform the development of more effective COPD nursing strategies and enhance clinical practice.

Background: Previous epidemiological studies revealed a potential correlation between educational imbalance and chronic obstructive pulmonary disease (COPD) incidence and hospitalization. However, such studies were susceptible to confounding factors and lacked strong causal evidence. The purpose of this study was to utilize Mendelian randomization (MR) to explore the causal relationship between educational attainment (EA) and the onset and hospitalization of COPD, as well as the mediating mechanism of EA on COPD through multivariable MR (MVMR) and two-step MR.

Methods: Based on data from genome-wide association studies (GWASs), this study used single nucleotide polymorphisms (SNPs) as instrumental variables (IVs) for EA and COPD. Two-sample MR, MVMR and two-step MR analysis were conducted. The impact of each variable on the outcome was analysed, and the overall mediating effects of smoking, body mass index (BMI) and generalized allergic reactions were assessed.

Results: MR analysis suggested that greater EA significantly reduced the incidence (OR = 0.22, 95% CI = 0.12-0.41) and hospitalization (OR = 0.28, 95% CI = 0.18-0.44) of COPD. The MVMR findings suggested that the impact of EA (OR = 0.53, 95% CI = 0.29-0.99) on COPD still existed after adjusting mediators. Combined MVMR and two-step MR analysis revealed that smoking, BMI and allergies mediate 47.9% of the relationship between EA and COPD.

Conclusion: High levels of education may have potentially causal protective effect on the onset and hospitalization of COPD. Reducing smoking, obesity and preventing allergic reactions are candidate approaches to prevent COPD, especially in individuals with lower levels of education.

Background: The association between the body roundness index (BRI) and the prevalence of chronic obstructive pulmonary disease (COPD) in US adults remains unclear. This study aims to investigate the association between BRI and the likelihood of developing COPD.

Methods: This study was conducted based on data from the 2013-2018 National Health and Nutrition Examination Survey. Participants were classified as having COPD if they met any of the following criteria: (i) self-reported physician diagnosis of COPD; (ii) physician-confirmed diagnosis of emphysema; or (iii) physician-confirmed diagnosis of chronic bronchitis. Those who responded "no" to all of the above were categorized as non-COPD. To assess the association between BRI and COPD, weighted logistic regression models, subgroup analyses, and interaction tests were employed. The dose-response relationship was investigated using a restricted cubic spline (RCS) model.

Results: A total of 14,254 individuals were included. The overall weighted prevalence of COPD was 8.3%. After adjusting for multiple confounders, continuous BRI was found to be positively associated with COPD (odds ratio [OR] = 1.140, 95% confidence interval [CI]: 1.033-1.259, P = 0.012). The RCS analysis confirmed a linear dose-response relationship between BRI and COPD. Subgroup analyses demonstrated substantial heterogeneity across sex, hypertension, and cardiovascular disease subgroups, indicating that the association between BRI and COPD may be impacted by these factors.

Conclusion: Higher BRI levels were positively associated with an increased likelihood of developing COPD among US adults. Our study suggests that BRI holds promise as a tool for assessing the odds of having COPD.

Introduction: Nuclear factor erythroid 2-related factor 2 (Nrf2), a key regulator of oxidative stress responses, is downregulated in patients with GOLD stage III-IV chronic obstructive pulmonary disease (COPD). However, the mechanisms underlying the epigenetic regulation of Nrf2 in COPD remain poorly understood.

Methods: Protein levels of Nrf2, heme oxygenase-1 (HO-1), ten-eleven translocation methylcytosine dioxygenase 1 (TET1), and DNA methyltransferase 1 (DNMT1) were assessed by Western blotting in peripheral lung tissue and primary bronchial epithelial cells obtained from patients with COPD, never-smokers (control-NS), and smokers without COPD (control-S). CSE-treated human bronchial epithelial (HBE) cells were used as an in vitro model. Nrf2 promoter methylation was evaluated using bisulfite sequencing. Apoptosis of HBE cells was measured by flow cytometry. Chromatin immunoprecipitation (ChIP) was performed to assess the binding of TET1 to the Nrf2 promoter. Malondialdehyde (MDA) and superoxide dismutase (SOD) activity assays were used to quantify oxidative stress and antioxidant capacity.

Results: Nrf2 and HO-1 expression was significantly reduced in both lung tissue and primary epithelial cells from patients with COPD. In vitro, CSE exposure increased Nrf2 promoter methylation in HBE cells. Overexpression of Nrf2 mitigated oxidative stress, increased SOD activity, and reduced apoptosis in response to CSE. TET1 expression was decreased in COPD lungs, and TET1 was shown to bind the Nrf2 promoter and enhance its transcription. TET1 overexpression reduced oxidative damage and apoptosis via Nrf2 upregulation.

Conclusion: Reduced Nrf2 expression in COPD may result from promoter hypermethylation. TET1 directly binds and demethylates the Nrf2 promoter, restoring its expression and attenuating CSE-induced HBE cells apoptosis. These findings identify a potential epigenetic mechanism contributing to COPD pathogenesis and suggest TET1 as a novel therapeutic target.

Background: Chronic obstructive pulmonary disease (COPD) involves progressive lung function decline, with hypoxia playing a key pathogenic role. However, systematic investigations focusing on hypoxia-related genes (HRGs) in COPD remain limited.

Methods: We applied machine learning to identify HRG-associated diagnostic biomarkers and evaluated their performance via Receiver Operating Characteristic (ROC) analysis. Mendelian randomization (MR) was conducted to assess causal relationships between candidate genes and COPD. A nomogram model was constructed to evaluate clinical utility, and a ceRNA network was developed using ENCORI database.

Results: Six HRG-based diagnostic biomarkers were identified, including SLC2A1, which demonstrated strong diagnostic value (AUC > 0.8). MR analysis revealed a significant causal effect of SLC2A1 expression on COPD risk (OR = 1.32, 95% CI: 1.02-1.71, P < 0.05). Functional evidence suggests SLC2A1 promotes hypoxia-induced metabolic reprogramming in airway epithelial cells. The constructed nomogram showed good clinical applicability. ceRNA analysis highlighted MALAT1, NEAT1, and XIST as potential upstream regulators.

Conclusion: Our findings identify SLC2A1 as a causal and diagnostically relevant gene in COPD, offering novel insight into hypoxia-driven disease mechanisms and supporting future personalized therapeutic strategies.

Purpose: Older adults with chronic obstructive pulmonary disease (COPD) have a higher risk of falls than their peers without COPD. Home-based exercise programs can improve balance and strength and reduce falls in older adults and could be an option for older adults with COPD who access virtual care. We pilot tested a 6-month home-based balance and strength exercise program with virtual care support aimed at improving strength and balance in people with COPD aged 50 years and over.

Patients and methods: Adults aged 50 years and over with COPD who access a virtual care service were invited to participate in an exercise program designed to improve balance and strength and reduce fall risk.

Results: Thirteen people enrolled in the pilot program (mean age 72 ± SD 7 years, 9 females). Six participants (46%) reported having one or more falls in the 12-months prior to the study. A mixed model for repeated measures and Bonferroni correction for post hoc pairwise comparisons showed significant improvement in the Short Physical Performance Battery (SPPB) score between baseline and 6-months, effect size of 2.01; 95% CI [0.45-3.58], and between 3-months and 6-months, effect size of 1.65; 95% CI [0.48 to 2.81]. The alternate step test improved by more than 3 seconds between baseline and 3-months, effect size of -3.30; 95% CI [-5.94 to -0.66] and improved by 4 seconds between baseline and 6-months, effect size of -4.01; 95% CI [-7.42 to -0.61]. There was no significant difference in fear of falling between between baseline, 3 months or 6 months. The program had a high level of acceptability, with all participants intending to continue to do the exercises and 10/12 (83%) participants stating that they would recommend the program to other people with COPD. The program was feasible to implement, with 12/13 participants remaining in the program and attending exercise sessions.

Conclusion: On average, participants completed the exercises twice per week rather than the recommended 3 times per week. Despite this, the home-based exercise program improved strength and balance, as measured by the SPPB. The program was acceptable to participants and feasible to implement and has the potential to reduce the risk of falls in older people with COPD.

Background: Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of coronary artery disease (CAD). However, the role of emphysema, which represents an important structural subtype of COPD, in the development of CAD remains insufficiently clarified. This study aimed to evaluate whether quantitatively assessed emphysema on high-resolution computed tomography (HRCT) independently predicts CAD in COPD patients.

Methods: This retrospective cohort study included 392 COPD patients with no prior history of CAD between 2015 and 2020. All participants underwent HRCT for automated emphysema quantification using 3D Slicer software. Emphysema extent was quantified as the percentage of low attenuation areas (LAA%) below -950 Hounsfield units, with severe emphysema defined as LAA% >16.95%. Logistic regression and restricted cubic spline (RCS) analysis were employed to assess the relationship between emphysema index and CAD, including subgroup and interaction analyses. The ability of the emphysema index to predict CAD was evaluated using receiver operating characteristic (ROC) curves.

Results: Severe emphysema was independently associated with a higher risk of CAD in COPD patients (OR = 2.08, 95% CI: 1.30-3.34; p = 0.002). This association remained robust even after adjusting for confounders (adjusted OR= 2.28, p = 0.005). RCS analysis indicates that the risk of CAD increases with the rise of the emphysema (p for nonlinearity =0.031). The area under the ROC curve for the predictive model was 0.81 (95% CI 0.77, 0.86). Additionally, patients with severe emphysema exhibited significantly more complex coronary lesions, reflected by higher SYNTAX scores (median 10.00 vs 16.29; p = 0.013).

Conclusion: Quantitative HRCT-based emphysema independently predicts CAD in COPD and demonstrates additive risk with traditional cardiovascular factors. Integrating emphysema quantification with clinical risk assessment improves CAD risk stratification in COPD patients.