275 results on '"Airway Obstruction"'
Search Results
2. Age and Small Airway Imaging Abnormalities in Subjects with and without Airflow Obstruction in SPIROMICS
- Author
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Martinez, Carlos H, Diaz, Alejandro A, Meldrum, Catherine, Curtis, Jeffrey L, Cooper, Christopher B, Pirozzi, Cheryl, Kanner, Richard E, Paine, Robert, Woodruff, Prescott G, Bleecker, Eugene R, Hansel, Nadia N, Barr, R Graham, Marchetti, Nathaniel, Criner, Gerard J, Kazerooni, Ella A, Hoffman, Eric A, Ross, Brian D, Galban, Craig J, Cigolle, Christine T, Martinez, Fernando J, and Han, MeiLan K
- Subjects
Lung ,Clinical Research ,Biomedical Imaging ,Chronic Obstructive Pulmonary Disease ,Respiratory ,Adult ,Aged ,Aged ,80 and over ,Aging ,Airway Obstruction ,Cohort Studies ,Cross-Sectional Studies ,Female ,Forced Expiratory Volume ,Humans ,Male ,Middle Aged ,Multicenter Studies as Topic ,Multivariate Analysis ,Pulmonary Emphysema ,Smoking ,Spirometry ,Tomography ,X-Ray Computed ,Vital Capacity ,spirometry ,imaging analysis ,aging ,geriatrics ,lung function ,SPIROMICS Investigators ,Medical and Health Sciences ,Respiratory System - Abstract
RationaleAging is associated with reduced FEV1 to FVC ratio (FEV1/FVC), hyperinflation, and alveolar enlargement, but little is known about how age affects small airways.ObjectivesTo determine if chest computed tomography (CT)-assessed functional small airway would increase with age, even among asymptomatic individuals.MethodsWe used parametric response mapping analysis of paired inspiratory/expiratory CTs to identify functional small airway abnormality (PRMFSA) and emphysema (PRMEMPH) in the SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) cohort. Using adjusted linear regression models, we analyzed associations between PRMFSA and age in subjects with or without airflow obstruction. We subdivided participants with normal spirometry based on respiratory-related impairment (6-minute-walk distance 25, respiratory events requiring treatment [antibiotics and/or steroids or hospitalization] in the year before enrollment).Measurements and main resultsAmong 580 never- and ever-smokers without obstruction or respiratory impairment, PRMFSA increased 2.7% per decade, ranging from 3.6% (ages 40-50 yr) to 12.7% (ages 70-80 yr). PRMEMPH increased nonsignificantly (0.1% [ages 40-50 yr] to 0.4% [ages 70-80 yr]; P = 0.34). Associations were similar among nonobstructed individuals with respiratory-related impairment. Increasing PRMFSA in subjects without airflow obstruction was associated with increased FVC (P = 0.004) but unchanged FEV1 (P = 0.94), yielding lower FEV1/FVC ratios (P
- Published
- 2017
3. Phenotype of Normal Spirometry in an Aging Population
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Fragoso, Carlos A Vaz, McAvay, Gail, Van Ness, Peter H, Casaburi, Richard, Jensen, Robert L, MacIntyre, Neil, Gill, Thomas M, Yaggi, H Klar, and Concato, John
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Lung ,Emphysema ,Clinical Research ,Chronic Obstructive Pulmonary Disease ,Respiratory ,Aged ,Aged ,80 and over ,Airway Obstruction ,Diagnostic Errors ,Female ,Humans ,Male ,Middle Aged ,Models ,Statistical ,Phenotype ,Pulmonary Disease ,Chronic Obstructive ,Pulmonary Emphysema ,Quality of Life ,Spirometry ,COPDGene ,phenotype ,normal spirometry ,COPD ,emphysema ,Medical and Health Sciences ,Respiratory System ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
RationaleIn aging populations, the commonly used Global Initiative for Chronic Obstructive Lung Disease (GOLD) may misclassify normal spirometry as respiratory impairment (airflow obstruction and restrictive pattern), including the presumption of respiratory disease (chronic obstructive pulmonary disease [COPD]).ObjectivesTo evaluate the phenotype of normal spirometry as defined by a new approach from the Global Lung Initiative (GLI), overall and across GOLD spirometric categories.MethodsUsing data from COPDGene (n = 10,131; ages 45-81; smoking history, ≥10 pack-years), we evaluated spirometry and multiple phenotypes, including dyspnea severity (Modified Medical Research Council grade 0-4), health-related quality of life (St. George's Respiratory Questionnaire total score), 6-minute-walk distance, bronchodilator reversibility (FEV1 % change), computed tomography-measured percentage of lung with emphysema (% emphysema) and gas trapping (% gas trapping), and small airway dimensions (square root of the wall area for a standardized airway with an internal perimeter of 10 mm).Measurements and main resultsAmong 5,100 participants with GLI-defined normal spirometry, GOLD identified respiratory impairment in 1,146 (22.5%), including a restrictive pattern in 464 (9.1%), mild COPD in 380 (7.5%), moderate COPD in 302 (5.9%), and severe COPD in none. Overall, the phenotype of GLI-defined normal spirometry included normal adjusted mean values for dyspnea grade (0.8), St. George's Respiratory Questionnaire (15.9), 6-minute-walk distance (1,424 ft [434 m]), bronchodilator reversibility (2.7%), % emphysema (0.9%), % gas trapping (10.7%), and square root of the wall area for a standardized airway with an internal perimeter of 10 mm (3.65 mm); corresponding 95% confidence intervals were similarly normal. These phenotypes remained normal for GLI-defined normal spirometry across GOLD spirometric categories.ConclusionsGLI-defined normal spirometry, even when classified as respiratory impairment by GOLD, included adjusted mean values in the normal range for multiple phenotypes. These results suggest that among adults with GLI-defined normal spirometry, GOLD may misclassify normal phenotypes as having respiratory impairment.
- Published
- 2015
4. Impact of Using Pre- and Post-Bronchodilator Spirometry Reference Values in a Chinese Population.
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Huang K, Han X, Pan Z, Xu J, Zhao J, Zhang X, Song Y, Kang J, Ran P, Zhou Y, Shen H, Wen F, Huang K, Chen Y, Guo Y, Shan G, Wu S, Guan T, Yang T, and Wang C
- Abstract
Rationale: Spirometry reference equations that are derived from a large, nationally representative, general population are warranted in China and the impact of using pre- and post-BD spirometry reference values has yet to be assessed in Chinese populations., Objectives: To present both the pre-BD and post-BD spirometry reference values for Chinese adults using the China Pulmonary Health (CPH) study., Methods: A reference population of 17969 healthy, non-smoking participants in the CPH study was used to calculate the pre- and post-BD reference values for the forced expiratory volume in 1 s (FEV
1 ), forced vital capacity (FVC) and FEV1 /FVC. Both pre- and post-BD reference values were applied to the entire CPH population (50991 individuals) to illustrate the divergence between the use of references in determining the disease prevalence and severity grading., Measurements and Main Results: The prevalence of airflow limitation was 5.36% using pre-BD reference and 8.02% using the post-BD reference. Individuals who had post-BD FEV1 /FVC below post-BD but higher than pre-BD reference values were found to have significantly higher rates of self-reported respiratory symptoms, and significantly lower values in spirometry indicators than those above post-BD reference values. An additional 3.51% of participants were identified as grade II-IV COPD using the post-BD FEV1 predicted values., Conclusion: This study generated and applied pre- and post-bronchodilator spirometry reference values in a nationally representative Chinese adult population. Post-BD reference values may serve as an additional criterion in identifying individuals at risk for obstructive pulmonary diseases, its diagnostic and prognostic values should be further investigated.- Published
- 2024
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5. Unadjusted Lower Limit of Normal for Airflow Obstruction.
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Bhatt SP, Bodduluri S, Nakhmani A, and Oelsner EC
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- Humans, Forced Expiratory Volume, Spirometry, Pulmonary Disease, Chronic Obstructive diagnosis, Airway Obstruction
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- 2024
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6. Severity of Airflow Obstruction Based on FEV 1 /FVC vs FEV 1 % of Predicted in the General US Population.
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Backman H, Vanfleteren LEGW, Mannino DM, and Ekström M
- Abstract
Rationale: According to GOLD, the ratio of FEV
1 /FVC is used to confirm airflow obstruction in COPD diagnosis, whereas FEV1 % of predicted (FEV1 %pred) is used for severity grading. STaging of Airflow obstruction by the FEV1 /FVC Ratio (STAR) and its prediction of adverse outcomes has not been evaluated in general populations., Objective: To compare the STAR (FEV1 /FVC) versus GOLD (FEV1 %pred) classification for the severity of airflow limitation in terms of exertional breathlessness and mortality in the general US population., Methods: Severity stages according to STAR and GOLD were applied to the multi-ethnic National Health and Nutrition Examination Survey (NHANES) 2007-2012 survey including ages 18-80 years, using post-bronchodilatory FEV1 /FVC<0.70 to define airflow obstruction in both staging systems. Prevalence of severity stages STAR 1-4 and GOLD 1-4 was calculated and associations with breathlessness and mortality were analyzed by multinomial logistic regression and Cox regression, respectively., Results: STAR versus GOLD severity staging of airflow obstruction showed similar associations with breathlessness and all-cause mortality, regardless of ethnicity/race. In those with airflow obstruction, the correlation between the two classification systems was 0.461 (p<0.001). STAR reclassified 59% of GOLD stage 2 as having mild airflow obstruction (STAR 1). STAR 1 was more clearly differentiated from the non-obstructive compared to GOLD stage 1 in terms of both breathlessness and mortality., Conclusions: FEV1 /FVC and FEV1 %pred as measures of severity of airflow limitation show similar prediction of breathlessness and mortality in the adult US population across ethnicity groups. However, stage 1 differed more clearly from non-obstructive based on FEV1/FVC than FEV1%pred. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).- Published
- 2024
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7. Early Evidence of Chronic Obstructive Pulmonary Disease Obscured by Race-Specific Prediction Equations.
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Regan EA, Lowe ME, Make BJ, Curtis JL, Chen QG, Crooks JL, Wilson C, Oates GR, Gregg RW, Baldomero AK, Bhatt SP, Diaz AA, Benos PV, O'Brien JK, Young KA, Kinney GL, Conrad DJ, Lowe KE, DeMeo DL, Non A, Cho MH, Kallet J, Foreman MG, Westney GE, Hoth K, MacIntyre NR, Hanania NA, Wolfe A, Amaza H, Han M, Beaty TH, Hansel NN, McCormack MC, Balasubramanian A, Crapo JD, Silverman EK, Casaburi R, and Wise RA
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- Humans, Nutrition Surveys, Cross-Sectional Studies, Dyspnea diagnosis, Spirometry, Forced Expiratory Volume, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology, Airway Obstruction
- Abstract
Rationale: The identification of early chronic obstructive pulmonary disease (COPD) is essential to appropriately counsel patients regarding smoking cessation, provide symptomatic treatment, and eventually develop disease-modifying treatments. Disease severity in COPD is defined using race-specific spirometry equations. These may disadvantage non-White individuals in diagnosis and care. Objectives: Determine the impact of race-specific equations on African American (AA) versus non-Hispanic White individuals. Methods: Cross-sectional analyses of the COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) cohort were conducted, comparing non-Hispanic White ( n = 6,766) and AA ( n = 3,366) participants for COPD manifestations. Measurements and Main Results: Spirometric classifications using race-specific, multiethnic, and "race-reversed" prediction equations (NHANES [National Health and Nutrition Examination Survey] and Global Lung Function Initiative "Other" and "Global") were compared, as were respiratory symptoms, 6-minute-walk distance, computed tomography imaging, respiratory exacerbations, and St. George's Respiratory Questionnaire. Application of different prediction equations to the cohort resulted in different classifications by stage, with NHANES and Global Lung Function Initiative race-specific equations being minimally different, but race-reversed equations moving AA participants to more severe stages and especially between the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 0 and preserved ratio impaired spirometry groups. Classification using the established NHANES race-specific equations demonstrated that for each of GOLD stages 1-4, AA participants were younger, had fewer pack-years and more current smoking, but had more exacerbations, shorter 6-minute-walk distance, greater dyspnea, and worse BODE (body mass index, airway obstruction, dyspnea, and exercise capacity) scores and St. George's Respiratory Questionnaire scores. Differences were greatest in GOLD stages 1 and 2. Race-reversed equations reclassified 774 AA participants (43%) from GOLD stage 0 to preserved ratio impaired spirometry. Conclusions: Race-specific equations underestimated disease severity among AA participants. These effects were particularly evident in early disease and may result in late detection of COPD.
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- 2024
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8. Reversible Airflow Obstruction Predicts Future Chronic Obstructive Pulmonary Disease Development in the SPIROMICS Cohort: An Observational Cohort Study
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Russell G. Buhr, Igor Z. Barjaktarevic, P. Miguel Quibrera, Lori A. Bateman, Eugene R. Bleecker, David J. Couper, Jeffrey L. Curtis, Brett A. Dolezal, MeiLan K. Han, Nadia N. Hansel, Jerry A. Krishnan, Fernando J. Martinez, William McKleroy, Robert Paine, Stephen I. Rennard, Donald P. Tashkin, Prescott G. Woodruff, Richard E. Kanner, Christopher B. Cooper, Neil E. Alexis, Wayne H. Anderson, Mehrdad Arjomandi, R. Graham Barr, Surya P. Bhatt, Richard C. Boucher, Russell P. Bowler, Stephanie A. Christenson, Alejandro P. Comellas, Gerard J. Criner, Ronald G. Crystal, Claire M. Doerschuk, Mark T. Dransfield, Brad Drummond, Christine M. Freeman, Craig Galban, Annette T. Hastie, Eric A. Hoffman, Yvonne Huang, Robert J. Kaner, Eric C. Kleerup, Lisa M. LaVange, Stephen C. Lazarus, Deborah A. Meyers, Wendy C. Moore, John D. Newell, Laura Paulin, Stephen P. Peters, Cheryl Pirozzi, Nirupama Putcha, Elizabeth C. Oelsner, Wanda K. O’Neal, Victor E. Ortega, Sanjeev Raman, J. Michael Wells, and Robert A. Wise
- Subjects
Airway Obstruction ,Cohort Studies ,Pulmonary and Respiratory Medicine ,Pulmonary Disease, Chronic Obstructive ,Spirometry ,Forced Expiratory Volume ,Vital Capacity ,Humans ,Critical Care and Intensive Care Medicine ,Asthma ,Bronchodilator Agents - Published
- 2022
9. Going Down, Dooby Doo Down, Down: Identifying Rapid Spirometry Decline.
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Bush A
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- Humans, Adult, Spirometry, Respiratory Physiological Phenomena, Lung, Airway Obstruction
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- 2023
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10. Lung Function Trajectories and Associated Mortality among Adults with and without Airway Obstruction.
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Backman H, Blomberg A, Lundquist A, Strandkvist V, Sawalha S, Nilsson U, Eriksson-Ström J, Hedman L, Stridsman C, Rönmark E, and Lindberg A
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- Adult, Humans, Lung, Forced Expiratory Volume, Vital Capacity, Spirometry, Prednisone, Pulmonary Disease, Chronic Obstructive, Airway Obstruction
- Abstract
Rationale: Spirometry is essential for diagnosis and assessment of prognosis in patients with chronic obstructive pulmonary disease (COPD). Objectives: To identify FEV
1 trajectories and their determinants on the basis of annual spirometry measurements among individuals with and without airway obstruction (AO) and to assess mortality in relation to trajectories. Methods: From 2002 through 2004, individuals with AO (FEV1 /VC < 0.70, n = 993) and age- and sex-matched nonobstructive (NO) referents were recruited from population-based cohorts. Annual spirometry until 2014 was used in joint-survival latent-class mixed models to identify lung function trajectories. Mortality data were collected during 15 years of follow-up. Measurements and Main Results: Three trajectories were identified among the subjects with AO and two among the NO referents. Trajectory membership was driven by baseline FEV1 % predicted (FEV1 %pred) in both groups and also by pack-years in subjects with AO and current smoking in NO referents. Longitudinal FEV1 %pred depended on baseline FEV1 %pred, pack-years, and obesity. The trajectories were distributed as follows: among individuals with AO, 79.6% in AO trajectory 1 (FEV1 high with normal decline), 12.8% in AO trajectory 2 (FEV1 high with rapid decline), and 7.7% in AO trajectory 3 (FEV1 low with normal decline) (mean, 27, 72, and 26 ml/yr, respectively) and, among NO referents, 96.7% in NO trajectory 1 (FEV1 high with normal decline) and 3.3% in NO trajectory 2 (FEV1 high with rapid decline) (mean, 34 and 173 ml/yr, respectively). Hazard for death was increased for AO trajectories 2 (hazard ratio [HR], 1.56) and 3 (HR, 3.45) versus AO trajectory 1 and for NO trajectory 2 (HR, 2.99) versus NO trajectory 1. Conclusions: Three different FEV1 trajectories were identified among subjects with AO and two among NO referents, with different outcomes in terms of FEV1 decline and mortality. The FEV1 trajectories among subjects with AO and the relationship between low FVC and trajectory outcome are of particular clinical interest.- Published
- 2023
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11. Investigating Associations of Omega-3 Fatty Acids, Lung Function Decline, and Airway Obstruction.
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Patchen BK, Balte P, Bartz TM, Barr RG, Fornage M, Graff M, Jacobs DR Jr, Kalhan R, Lemaitre RN, O'Connor G, Psaty B, Seo J, Tsai MY, Wood AC, Xu H, Zhang J, Gharib SA, Manichaikul A, North K, Steffen LM, Dupuis J, Oelsner E, Hancock DB, and Cassano PA
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- Adult, Humans, Longitudinal Studies, Lung, Docosahexaenoic Acids, Fatty Acids, Omega-3, Pulmonary Disease, Chronic Obstructive genetics, Airway Obstruction
- Abstract
Rationale: Inflammation contributes to lung function decline and the development of chronic obstructive pulmonary disease. Omega-3 fatty acids have antiinflammatory properties and may benefit lung health. Objectives: To investigate associations of omega-3 fatty acids with lung function decline and incident airway obstruction in a diverse sample of adults from general-population cohorts. Methods: Complementary study designs: 1 ) longitudinal study of plasma phospholipid omega-3 fatty acids and repeated FEV
1 and FVC measures in the NHLBI Pooled Cohorts Study and 2 ) two-sample Mendelian randomization (MR) study of genetically predicted omega-3 fatty acids and lung function parameters. Measurements and Main Results: The longitudinal study found that higher omega-3 fatty acid levels were associated with attenuated lung function decline in 15,063 participants, with the largest effect sizes for the most metabolically downstream omega-3 fatty acid, docosahexaenoic acid (DHA). An increase in DHA of 1% of total fatty acids was associated with attenuations of 1.4 ml/yr for FEV1 (95% confidence interval [CI], 1.1-1.8) and 2.0 ml/yr for FVC (95% CI, 1.6-2.4) and a 7% lower incidence of spirometry-defined airway obstruction (95% CI, 0.89-0.97). DHA associations persisted across sexes and smoking histories and in Black, White, and Hispanic participants, with associations of the largest magnitude in former smokers and Hispanic participants. The MR study showed similar trends toward positive associations of genetically predicted downstream omega-3 fatty acids with FEV1 and FVC. Conclusions: The longitudinal and MR studies provide evidence supporting beneficial effects of higher levels of downstream omega-3 fatty acids, especially DHA, on lung health.- Published
- 2023
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12. The Protective Effect of Omega-3 Fatty Acids in Attenuating Lung Function Decline.
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Sun Y and Ye K
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- Humans, Lung, Fatty Acids, Omega-3 therapeutic use, Cognition Disorders, Airway Obstruction
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- 2023
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13. Obstructive Apneas in a Mouse Model of Congenital Central Hypoventilation Syndrome
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Boris Matrot, Gabriel Pitollat, Maud Ringot, Christophe Delclaux, Stéphane Dauger, Jorge Gallego, Thomas Bourgeois, Marie-Pia d'Ortho, Laura Cardoit, Muriel Thoby-Brisson, Amélia Madani, Nelina Ramanantsoa, Eléonore Sizun, Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-SFR Bordeaux Neurosciences-Centre National de la Recherche Scientifique (CNRS), Hôpital Robert Debré, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Matrot, Boris
- Subjects
hypoglossal nerve ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Hypoglossal nucleus ,[SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Central apnea ,[SDV.GEN] Life Sciences [q-bio]/Genetics ,Congenital central hypoventilation syndrome ,Critical Care and Intensive Care Medicine ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Dysgenesis ,Mice ,Interquartile range ,Internal medicine ,Sleep hypoventilation ,[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,medicine ,Animals ,Humans ,[SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,Respiratory system ,airway obstruction ,Homeodomain Proteins ,[SDV.GEN]Life Sciences [q-bio]/Genetics ,business.industry ,Editorials ,Sleep apnea ,Hypoventilation ,Airway obstruction ,medicine.disease ,Sleep Apnea, Central ,newborn animals ,Disease Models, Animal ,Phox2b ,Animals, Newborn ,Mutation ,Cardiology ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] ,medicine.symptom ,business ,Hypoglossal nerve ,PHOX2B gene ,Transcription Factors - Abstract
RationaleCongenital Central Hypoventilation Syndrome (CCHS) is characterized by life-threatening sleep hypoventilation, and is caused by PHOX2B gene mutations, most frequently the PHOX2B27Ala/+ mutation, with patients requiring lifelong ventilatory support. It is unclear whether obstructive apneas are part of the syndrome.ObjectivesTo determine whether Phox2b27Ala/+ mice, which present the main symptoms of CCHS and die within hours after birth, also express obstructive apneas, and to investigate potential underlying mechanisms.MethodsApneas were classified as central, obstructive or mixed by using a novel system combining pneumotachography and laser detection of abdominal movement immediately after birth. Several respiratory nuclei involved in airway patency were examined by immunohistochemistry and electrophysiology in brainstem-spinal cord preparation.Measurements and Main ResultsThe median (interquartile range) of obstructive apnea frequency was 2.3/min (1.5-3.3) in Phox2b27Ala/+ pups versus 0.6/min (0.4-1.0) in wildtypes (P < 0.0001). Obstructive apnea duration was 2.7s (2.3-3.9) in Phox2b27Ala/+ pups versus 1.7s (1.1-1.9) in wildtypes (P < 0.0001). Central and mixed apneas presented similar, significant differences. In Phox2b27Ala/+ preparations, the hypoglossal nucleus had fewer (P < 0.05) and smaller (P < 0.01) neurons, compared to wildtypes. Importantly, coordination of phrenic and hypoglossal motor activities was disrupted, as evidenced by the longer and variable delay of hypoglossal with respect to phrenic activity onset (P < 0.001).ConclusionsThe Phox2b27Ala/+ mutation predisposed pups not only to hypoventilation and central apneas, but also to obstructive and mixed apneas, likely due to hypoglossal dysgenesis. These results thus demand attention towards obstructive events in infants with CCHS.
- Published
- 2021
14. Ivacaftor and Airway Inflammation in Preschool Children with Cystic Fibrosis
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Sarath Ranganathan, Barry Linnane, André Schultz, Graham L. Hall, Paul McNally, Yuliya V. Karpievitch, S. Stick, and Daryl Butler
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,biology ,business.industry ,Airway inflammation ,Inflammation ,Airway obstruction ,Critical Care and Intensive Care Medicine ,medicine.disease ,Cystic fibrosis ,Gastroenterology ,Broncho-alveolar lavage ,Cystic fibrosis transmembrane conductance regulator ,Ivacaftor ,Internal medicine ,medicine ,biology.protein ,Respiratory system ,medicine.symptom ,business ,medicine.drug - Published
- 2021
15. Phase-Contrast Magnetic Resonance Imaging of Inhaled Xenon Reveals the Relationship between Airflow and Obstruction in Obstructive Sleep Apnea.
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Xiao Q, Stewart N, Willmering M, McConnell K, Woods J, Fleck R, Amin R, and Bates A
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- Humans, Respiratory Physiological Phenomena, Magnetic Resonance Imaging methods, Sleep Apnea, Obstructive complications, Sleep Apnea, Obstructive diagnostic imaging, Airway Obstruction
- Published
- 2023
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16. Double Trouble: Airflow and Pulmonary Vascular Obstruction
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Todd M. Bull, Michael H. Lee, and Brian B. Graham
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Airflow ,Critical Care and Intensive Care Medicine ,Airflow obstruction ,medicine.disease ,Pulmonary hypertension ,Airway Obstruction ,Forced Expiratory Volume ,Internal medicine ,Correspondence ,Cardiology ,Humans ,Medicine ,business ,Vascular obstruction - Published
- 2021
17. Upper and Lower Airway Dysanapsis and Airflow Obstruction among Older Adults
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Benjamin M. Smith, Andrew Wiemken, Eric A. Hoffman, Brendan T. Keenan, Norrina B. Allen, Alain G. Bertoni, David R. Jacobs, Erin D. Michos, Karol E. Watson, Susan Redline, Richard J. Schwab, R. Graham Barr, and Susan R. Heckbert
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Pulmonary and Respiratory Medicine ,Airway Obstruction ,Pulmonary Disease, Chronic Obstructive ,Vital Capacity ,Humans ,Critical Care and Intensive Care Medicine ,Lung ,Aged - Published
- 2022
18. The Site of Airway Collapse in Sleep Apnea, Its Associations with Disease Severity and Obesity, and Implications for Mechanical Interventions
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Sang Chul Lim, Chung Man Sung, Hyung Chae Yang, Min-Ho Shin, Hong Chan Kim, Shi Nee Tan, and Jongho Lee
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Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Psychological intervention ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Sleep Apnea Syndromes ,Disease severity ,Risk Factors ,Correspondence ,medicine ,Humans ,Obesity ,Intensive care medicine ,Collapse (medical) ,business.industry ,Sleep apnea ,Middle Aged ,medicine.disease ,Respiration, Artificial ,Airway Obstruction ,Female ,medicine.symptom ,Airway ,business ,Body mass index - Published
- 2021
19. Electrical Impedance Tomography to Detect Airway Closure Heterogeneity in Asymmetrical Acute Respiratory Distress Syndrome
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Clément Boisselier, Laurent Brochard, Alexandre Ouattara, Hadrien Rozé, Virginie Perrier, Benjamin Repusseau, and Eline Bonnardel
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Pulmonary and Respiratory Medicine ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Acute respiratory distress ,Airway obstruction ,Critical Care and Intensive Care Medicine ,medicine.disease ,Internal medicine ,Cardiology ,Medicine ,business ,Prospective cohort study ,Electrical impedance tomography ,Airway closure - Published
- 2021
20. Designer Receptors Exclusively Activated by Designer Drugs Approach to Treatment of Sleep-disordered Breathing
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Vsevolod Y. Polotsky, Huy Pho, Lenise Jihe Kim, Carla Freire, Jordi Bonaventura, Luiz G.S. Branco, Mateus R. Amorim, Michael Michaelides, Luiz Ubirajara Sennes, Michael J Brennick, Alan R. Schwartz, Rachel Lee, Meaghan E Cabassa, Stone R Streeter, Richard G. Spencer, David D. Fuller, Kenneth Fishbein, and Thomaz Fleury Curado
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Male ,Pulmonary and Respiratory Medicine ,Hypoglossal Nerve ,Receptors, Drug ,Critical Care and Intensive Care Medicine ,Designer Drugs ,Mice ,Muscle tone ,Tongue ,medicine ,Animals ,Humans ,Sleep Apnea, Obstructive ,Genioglossus ,business.industry ,Respiration ,Editorials ,Sleep apnea ,Airway obstruction ,medicine.disease ,Obstructive sleep apnea ,Disease Models, Animal ,medicine.anatomical_structure ,Anesthesia ,Pharyngeal Muscles ,Breathing ,business ,Airway - Abstract
Rationale: Obstructive sleep apnea is recurrent upper airway obstruction caused by a loss of upper airway muscle tone during sleep. The main goal of our study was to determine if designer receptors exclusively activated by designer drugs (DREADD) could be used to activate the genioglossus muscle as a potential novel treatment strategy for sleep apnea. We have previously shown that the prototypical DREADD ligand clozapine-N-oxide increased pharyngeal diameter in mice expressing DREADD in the hypoglossal nucleus. However, the need for direct brainstem viral injections and clozapine-N-oxide toxicity diminished translational potential of this approach, and breathing during sleep was not examined.Objectives: Here, we took advantage of our model of sleep-disordered breathing in diet-induced obese mice, retrograde properties of the adeno-associated virus serotype 9 (AAV9) viral vector, and the novel DREADD ligand J60.Methods: We administered AAV9-hSyn-hM3(Gq)-mCherry or control AAV9 into the genioglossus muscle of diet-induced obese mice and examined the effect of J60 on genioglossus activity, pharyngeal patency, and breathing during sleep.Measurements and Main Results: Compared with control, J60 increased genioglossus tonic activity by greater than sixfold and tongue uptake of 2-deoxy-2-[18F]fluoro-d-glucose by 1.5-fold. J60 increased pharyngeal patency and relieved upper airway obstruction during non-REM sleep.Conclusions: We conclude that following intralingual administration of AAV9-DREADD, J60 can activate the genioglossus muscle and improve pharyngeal patency and breathing during sleep.
- Published
- 2021
21. Venoarterial Extracorporeal Membrane Oxygenation Support Rescue of Obstructive Shock Caused by Bulky Compressive Mediastinal Cancer
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Matthieu Schmidt, Nicolas Bréchot, Alain Combes, Stéphanie Nguyen, Guillaume Hékimian, Patricia Villie, Guillaume Lebreton, Simon Bourcier, Charles-Edouard Luyt, and Pierre Demondion
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,Critical Illness ,medicine.medical_treatment ,Treatment outcome ,Shock, Cardiogenic ,Critical Care and Intensive Care Medicine ,Mediastinal Neoplasms ,Risk Assessment ,Sampling Studies ,Young Adult ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,Internal medicine ,Extracorporeal membrane oxygenation ,medicine ,Humans ,Retrospective Studies ,business.industry ,Follow up studies ,Cancer ,030208 emergency & critical care medicine ,medicine.disease ,Airway Obstruction ,Survival Rate ,Intensive Care Units ,Treatment Outcome ,030228 respiratory system ,Obstructive shock ,Shock (circulatory) ,Cardiology ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Follow-Up Studies - Published
- 2020
22. Optical Coherence Tomography Intensity Correlates with Extracellular Matrix Components in the Airway Wall
- Author
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Jouke T. Annema, Annika W.M. Goorsenberg, Orestes A Carpaij, Daniel M. de Bruin, Janette K. Burgess, Martijn C. Nawijn, Peter I. Bonta, Julia N S d'Hooghe, Maarten van den Berge, Richard M. van den Elzen, Graduate School, AII - Inflammatory diseases, Pulmonology, Biomedical Engineering and Physics, Urology, ACS - Atherosclerosis & ischemic syndromes, APH - Personalized Medicine, APH - Quality of Care, and Groningen Research Institute for Asthma and COPD (GRIAC)
- Subjects
Pulmonary and Respiratory Medicine ,medicine.diagnostic_test ,business.industry ,Respiratory System ,Critical Care and Intensive Care Medicine ,Extracellular Matrix ,Intensity (physics) ,Airway Obstruction ,Extracellular matrix ,Bronchoscopy ,Optical coherence tomography ,Airway wall ,medicine ,Humans ,Tomography ,business ,Biomarkers ,Tomography, Optical Coherence ,Biomedical engineering - Published
- 2020
23. Novel Rare Genetic Variants Associated with Airflow Obstruction in the General Population
- Author
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Judith M. Vonk, Cleo C. van Diemen, K. Joeri van der Velde, Diana A van der Plaat, Najaf Amin, Ivana Nedeljkovic, Cornelia M. van Duijn, Maaike de Vries, H. Marike Boezen, Groningen Research Institute for Asthma and COPD (GRIAC), Life Course Epidemiology (LCE), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), and Epidemiology
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,Population ,Respiratory System ,Computational biology ,Critical Care and Intensive Care Medicine ,Airflow obstruction ,Pulmonary Disease, Chronic Obstructive ,Critical Care Medicine ,General & Internal Medicine ,Medicine ,Humans ,COPD ,Genetic Predisposition to Disease ,education ,11 Medical and Health Sciences ,Aged ,Aged, 80 and over ,education.field_of_study ,Science & Technology ,business.industry ,Environmental exposures ,Genetic variants ,Genetic Variation ,Middle Aged ,Never smokers ,Airway Obstruction ,Genes ,Susceptibility ,Female ,business ,Life Sciences & Biomedicine - Published
- 2020
24. Chronic Obstructive Pulmonary Disease and Breathlessness in Older Workers Predict Economic Inactivity. A Prospective Cohort Study
- Author
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Joanna Szram, Paul Cullinan, Annette Woods, Anthony Newman Taylor, and Susie Schofield
- Subjects
Employment ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pulmonary disease ,Critical Care and Intensive Care Medicine ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,Intensive care medicine ,Prospective cohort study ,business.industry ,Age Factors ,Editorials ,Middle Aged ,Airway obstruction ,medicine.disease ,Dyspnea ,Chronic disease ,030228 respiratory system ,Female ,business - Abstract
Rationale: There is an aspiration to retain increasing numbers of older workers in employment, and strategies to achieve this need to make provision for the increasing prevalence of chronic disease...
- Published
- 2019
25. Exercise Tolerance according to the Definition of Airflow Obstruction in Smokers
- Author
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J. Alberto Neder, Kathryn M. Milne, Danilo C. Berton, Juan P. de-Torres, Dennis Jensen, Wan C. Tan, Jean Bourbeau, Denis E. O’Donnell, J. Bourbeau, W. C. Tan, D. Jensen, S. D. Aaron, D. D. Sin, K. R. Chapman, F. Maltais, P. Hernandez, and D. Marciniuk
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,COPD ,Exercise Tolerance ,medicine.diagnostic_test ,business.industry ,Smoking ,Editorials ,Middle Aged ,Critical Care and Intensive Care Medicine ,medicine.disease ,Airflow obstruction ,Airway Obstruction ,Pulmonary Disease, Chronic Obstructive ,Internal medicine ,Cardiology ,medicine ,Humans ,Female ,business ,Lung ,Lung function ,Aged - Published
- 2020
26. Intranasal Leptin Relieves Sleep-disordered Breathing in Mice with Diet-induced Obesity
- Author
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Huy Pho, Alan R. Schwartz, Rexford S. Ahima, Haris Younas, Frederick Anokye-Danso, Thomaz Fleury-Curado, Slava Berger, Shannon Bevans-Fonti, Mi Kyung Shin, Lynn W. Enquist, Vsevolod Y. Polotsky, Jonathan C. Jun, and David Mendelowitz
- Subjects
Leptin ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Critical Care and Intensive Care Medicine ,Alveolar hypoventilation ,Mice ,Sleep Apnea Syndromes ,Internal medicine ,Respiration ,medicine ,Animals ,Humans ,Obesity ,business.industry ,digestive, oral, and skin physiology ,Editorials ,Original Articles ,respiratory system ,Airway obstruction ,medicine.disease ,Diet ,Hypoventilation ,Mice, Inbred C57BL ,Endocrinology ,Models, Animal ,Sleep disordered breathing ,Receptors, Leptin ,Nasal administration ,Nasal Absorption ,medicine.symptom ,Sleep ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Rationale: Leptin treats upper airway obstruction and alveolar hypoventilation in leptin-deficient ob/ob mice. However, obese humans and mice with diet-induced obesity (DIO) are resistant to leptin because of poor permeability of the blood–brain barrier. We propose that intranasal leptin will bypass leptin resistance and treat sleep-disordered breathing in obesity. Objectives: To assess if intranasal leptin can treat obesity hypoventilation and upper airway obstruction during sleep in mice with DIO. Methods: Male C57BL/6J mice were fed with a high-fat diet for 16 weeks. A single dose of leptin (0.4 mg/kg) or BSA (vehicle) were administered intranasally or intraperitoneally, followed by either sleep studies (n = 10) or energy expenditure measurements (n = 10). A subset of mice was treated with leptin daily for 14 days for metabolic outcomes (n = 20). In a separate experiment, retrograde viral tracers were used to examine connections between leptin receptors and respiratory motoneurons. Measurements and Main Results: Acute intranasal, but not intraperitoneal, leptin decreased the number of oxygen desaturation events in REM sleep, and increased ventilation in non-REM and REM sleep, independently of metabolic effects. Chronic intranasal leptin decreased food intake and body weight, whereas intraperitoneal leptin had no effect. Intranasal leptin induced signal transducer and activator of transcription 3 phosphorylation in hypothalamic and medullary centers, whereas intraperitoneal leptin had no effect. Leptin receptor–positive cells were synaptically connected to respiratory motoneurons. Conclusions: In mice with DIO, intranasal leptin bypassed leptin resistance and significantly attenuated sleep-disordered breathing independently of body weight.
- Published
- 2019
27. Postobstructive Pulmonary Edema after Nonlethal Suicidal Hanging
- Author
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Wei-Ting Chen, Chun-Ta Huang, Sheng-Yuan Ruan, and Jerry Shu-Hung Kuo
- Subjects
Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Pulmonary Edema ,Suicide, Attempted ,Computed tomography ,Airway obstruction ,Critical Care and Intensive Care Medicine ,medicine.disease ,Pulmonary edema ,Pleural pressure ,Airway Obstruction ,medicine ,Humans ,Female ,Radiology ,Tomography, X-Ray Computed ,business - Published
- 2021
28. Interalveolar pores increase in aging and severe airway obstruction
- Author
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Arne Neyrinck, Geert Verleden, Maximilian Ackermann, J. Kaes, Arno Vanstapel, Laurens J. Ceulemans, Robin Vos, Bart M. Vanaudenaerde, Stijn E. Verleden, and Birgit Weynand
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Male ,medicine.medical_specialty ,Aging ,business.industry ,medicine.medical_treatment ,Airway obstruction ,Middle Aged ,Critical Care and Intensive Care Medicine ,medicine.disease ,Pulmonary Alveoli ,Internal medicine ,medicine ,Cardiology ,Linear Models ,Lung transplantation ,Humans ,Female ,Human medicine ,business ,Bronchiolitis Obliterans ,Aged - Published
- 2021
29. Upper and Lower Airway Dysanapsis and Airflow Obstruction among Older Adults.
- Author
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Smith BM, Wiemken A, Hoffman EA, Keenan BT, Allen NB, Bertoni AG, Jacobs DR Jr, Michos ED, Watson KE, Redline S, Schwab RJ, Barr RG, and Heckbert SR
- Subjects
- Aged, Humans, Lung, Vital Capacity, Airway Obstruction, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology
- Published
- 2022
- Full Text
- View/download PDF
30. Charcot–Leyden Crystals in Rapidly Progressing Plastic Bronchitis
- Author
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Kota Ikari, Shigeharu Ueki, Takuya Oda, Masaru Kawamura, Junichiro Tezuka, Tsubasa Matsumoto, and Moeri Tsuji
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Plastic bronchitis ,Bronchi ,Eosinophil Extracellular Traps ,Critical Care and Intensive Care Medicine ,Influenza A Virus, H1N1 Subtype ,Influenza, Human ,medicine ,Humans ,Bronchitis ,Glycoproteins ,business.industry ,Influenza a ,Airway obstruction ,medicine.disease ,Eosinophils ,Mucus ,Child, Preschool ,Disease Progression ,Crystallization ,Lysophospholipase ,Charcot–Leyden crystals ,business ,Biomarkers - Published
- 2021
31. Association between Inhaled Corticosteroids and Expiratory Central Airway Collapse in Smokers
- Author
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Sandeep Bodduluri, Mark T. Dransfield, Tamer Hudali, and Surya P. Bhatt
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,MEDLINE ,Inhaled corticosteroids ,Critical Care and Intensive Care Medicine ,Cigarette Smoking ,Pulmonary Disease, Chronic Obstructive ,Adrenal Cortex Hormones ,Risk Factors ,Internal medicine ,Forced Expiratory Volume ,Administration, Inhalation ,Correspondence ,medicine ,Central airway ,Humans ,Collapse (medical) ,Aged ,business.industry ,Middle Aged ,Asthma ,Airway Obstruction ,Exhalation ,Female ,medicine.symptom ,business - Published
- 2020
32. Reply to Janssen and Wouters: Loss of Alveolar Attachments as a Pathomechanistic Link between Small Airway Disease and Emphysema
- Author
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James C. Hogg, MeiLan K. Han, Fernando J. Martinez, Dragoş M. Vasilescu, Jeffrey L. Curtis, and Tillie-Louise Hackett
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Pulmonary emphysema ,MEDLINE ,Pulmonary disease ,Critical Care and Intensive Care Medicine ,Pulmonary Disease, Chronic Obstructive ,Correspondence ,medicine ,Humans ,Aged ,Aged, 80 and over ,Emphysema ,business.industry ,X-Ray Microtomography ,Middle Aged ,Airway Obstruction ,Cross-Sectional Studies ,Airway disease ,Pulmonary Emphysema ,Female ,business ,Biomarkers - Published
- 2019
33. Infection Is Not Required for Mucoinflammatory Lung Disease in CFTR-Knockout Ferrets
- Author
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Chandler W. Jensen-Cody, Yalan Li, Xingshen Sun, T. Idil Apak Evans, J. Kirk Harris, Scott R. Tyler, Nicholas W. Keiser, Weihong Zhou, Yulong Zhang, John F. Engelhardt, Anthony M. Swatek, Kai Wang, Bradley H. Rosen, Pavana G. Rotti, Nan He, Preston J. Anderson, Bo Liang, R. Marshall Pope, Katherine N. Gibson-Corley, Eric A. Hoffman, Leonard A Brooks, Shashanna R. Moll, Jaimie S. Gray, Kalpaj R. Parekh, and Maheen Rajput
- Subjects
Lung Diseases ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,Inflammatory response ,Cystic Fibrosis Transmembrane Conductance Regulator ,Inflammation ,Infections ,Critical Care and Intensive Care Medicine ,Cystic fibrosis ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Animals ,Lung ,Respiratory Tract Infections ,business.industry ,Disease progression ,Ferrets ,Airway obstruction ,medicine.disease ,Mucus ,Disease Models, Animal ,030104 developmental biology ,030228 respiratory system ,Lung disease ,Immunology ,medicine.symptom ,business - Abstract
Classical interpretation of cystic fibrosis (CF) lung disease pathogenesis suggests that infection initiates disease progression, leading to an exuberant inflammatory response, excessive mucus, and ultimately bronchiectasis. Although symptomatic antibiotic treatment controls lung infections early in disease, lifelong bacterial residence typically ensues. Processes that control the establishment of persistent bacteria in the CF lung, and the contribution of noninfectious components to disease pathogenesis, are poorly understood.To evaluate whether continuous antibiotic therapy protects the CF lung from disease using a ferret model that rapidly acquires lethal bacterial lung infections in the absence of antibiotics.CFTR (cystic fibrosis transmembrane conductance regulator)-knockout ferrets were treated with three antibiotics from birth to several years of age and lung disease was followed by quantitative computed tomography, BAL, and histopathology. Lung disease was compared with CFTR-knockout ferrets treated symptomatically with antibiotics.Bronchiectasis was quantified from computed tomography images. BAL was evaluated for cellular differential and features of inflammatory cellular activation, bacteria, fungi, and quantitative proteomics. Semiquantitative histopathology was compared across experimental groups. We demonstrate that lifelong antibiotics can protect the CF ferret lung from infections for several years. Surprisingly, CF animals still developed hallmarks of structural bronchiectasis, neutrophil-mediated inflammation, and mucus accumulation, despite the lack of infection. Quantitative proteomics of BAL from CF and non-CF pairs demonstrated a mucoinflammatory signature in the CF lung dominated by Muc5B and neutrophil chemoattractants and products.These findings implicate mucoinflammatory processes in the CF lung as pathogenic in the absence of clinically apparent bacterial and fungal infections.
- Published
- 2018
34. Cleaning at Home and at Work in Relation to Lung Function Decline and Airway Obstruction
- Author
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Deborah Jarvis, Nicole Probst-Hensch, Jan Paul Zock, Dan Norbäck, Josep M. Antó, Theodore Lytras, Isabel Urrutia, Bénédicte Leynaert, Mathias Holm, Randi Jacobsen Bertelsen, Stein Håkon Låstad Lygre, Nicole Le Moual, Manolis Kogevinas, José M. García-García, Bertil Forsberg, Cecilie Svanes, José Antonio Gullón, Trude Duelien Skorge, Simona Villani, Jesus Moratalla, Øistein Svanes, Torben Sigsgaard, Anne E. Carsin, Joachim Heinrich, Mario Olivieri, Dennis Nowak, Isabelle Pin, Vivi Schlünssen, and Medical Research Council (MRC)
- Subjects
Male ,SYMPTOMS ,occupational medicine ,Respiratory System ,spirometry ,Critical Care and Intensive Care Medicine ,IMMUNOLOGY ,Cohort Studies ,0302 clinical medicine ,Risk Factors ,Forced Expiratory Volume ,PULMONARY-DISEASE ,Longitudinal Studies ,030212 general & internal medicine ,Respiratory system ,Lung ,11 Medical and Health Sciences ,Lung function ,lung diseases ,GENERAL-POPULATION ,medicine.diagnostic_test ,SPRAYS ,Middle Aged ,Respiratory Function Tests ,medicine.anatomical_structure ,Chemical agents ,Female ,Life Sciences & Biomedicine ,Adult ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Detergents ,Occupational medicine ,03 medical and health sciences ,Critical Care Medicine ,General & Internal Medicine ,Occupational Exposure ,medicine ,Humans ,EXPOSURE ,Intensive care medicine ,Asthma ,Science & Technology ,business.industry ,Airway obstruction ,medicine.disease ,REFERENCE VALUES ,PRODUCTS ,Airway Obstruction ,030228 respiratory system ,CLEANERS ,business - Abstract
RATIONALE: Cleaning tasks may imply exposure to chemical agents with potential harmful effects to the respiratory system, and increased risk of asthma and respiratory symptoms among professional cleaners and in persons cleaning at home has been reported. Long-term consequences of cleaning agents on respiratory health are, however, not well described.OBJECTIVES: This study aimed to investigate long-term effects of occupational cleaning and cleaning at home on lung function decline and airway obstruction.METHODS: The European Community Respiratory Health Survey (ECRHS) investigated a multicenter population-based cohort at three time points over 20 years. A total of 6,235 participants with at least one lung function measurement from 22 study centers, who in ECRHS II responded to questionnaire modules concerning cleaning activities between ECRHS I and ECRHS II, were included. The data were analyzed with mixed linear models adjusting for potential confounders.MEASUREMENTS AND MAIN RESULTS: As compared with women not engaged in cleaning (ΔFEV1 = -18.5 ml/yr), FEV1 declined more rapidly in women responsible for cleaning at home (-22.1; P = 0.01) and occupational cleaners (-22.4; P = 0.03). The same was found for decline in FVC (ΔFVC = -8.8 ml/yr; -13.1, P = 0.02; and -15.9, P = 0.002; respectively). Both cleaning sprays and other cleaning agents were associated with accelerated FEV1 decline (-22.0, P = 0.04; and -22.9, P = 0.004; respectively). Cleaning was not significantly associated with lung function decline in men or with FEV1/FVC decline or airway obstruction.CONCLUSIONS: Women cleaning at home or working as occupational cleaners had accelerated decline in lung function, suggesting that exposures related to cleaning activities may constitute a risk to long-term respiratory health.
- Published
- 2018
35. Total Airway Count on Computed Tomography and the Risk of Chronic Obstructive Pulmonary Disease Progression. Findings from a Population-based Study
- Author
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Miranda Kirby, Naoya Tanabe, Wan C. Tan, Guohai Zhou, Ma’en Obeidat, Cameron J. Hague, Jonathon Leipsic, Jean Bourbeau, Don D. Sin, James C. Hogg, Harvey O. Coxson, J. Mark FitzGerald, D. D. Marciniuk, D. E. O’Donnell, Paul Hernandez, Kenneth R. Chapman, Robert Cowie, Shawn Aaron, F. Maltais, Jonathon Samet, Milo Puhan, Qutayba Hamid, Carole Baglole, Carole Jabet, Palmina Mancino, Yvan Fortier, Don Sin, Sheena Tam, Jeremy Road, Joe Comeau, Adrian Png, Harvey Coxson, Cameron Hague, Mohsen Sadatsafavi, Teresa To, Andrea Gershon, Pei-Zhi Li, Jean-Francois Duquette, Andrea Benedetti, Denis Jensen, Denis O’Donnell, Christine Lo, Sarah Cheng, Cindy Fung, Nancy Ferguson, Nancy Haynes, Junior Chuang, Licong Li, Selva Bayat, Amanda Wong, Zoe Alavi, Catherine Peng, Bin Zhao, Nathalie Scott-Hsiung, Tasha Nadirshaw, David Latreille, Jacinthe Baril, Laura Labonte, Kenneth Chapman, Patricia McClean, Nadeen Audisho, Ann Cowie, Curtis Dumonceaux, Lisette Machado, Scott Fulton, Kristen Osterling, Kathy Vandemheen, Gay Pratt, Amanda Bergeron, Matthew McNeil, Kate Whelan, Francois Maltais, Cynthia Brouillard, Darcy Marciniuk, Ron Clemens, and Janet Baran
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Spirometry ,Canada ,medicine.medical_specialty ,Pulmonary disease ,Computed tomography ,Disease ,Critical Care and Intensive Care Medicine ,Risk Assessment ,Severity of Illness Index ,Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Forced Expiratory Volume ,Hounsfield scale ,Image Interpretation, Computer-Assisted ,Humans ,Medicine ,Longitudinal Studies ,030212 general & internal medicine ,Aged ,COPD ,medicine.diagnostic_test ,business.industry ,Smoking ,Middle Aged ,respiratory system ,Prognosis ,medicine.disease ,Obstructive lung disease ,respiratory tract diseases ,Airway Obstruction ,Logistic Models ,030228 respiratory system ,Multivariate Analysis ,Disease Progression ,Female ,Radiology ,Tomography, X-Ray Computed ,business ,Airway - Abstract
Studies of excised lungs show that significant airway attrition in the "quiet" zone occurs early in chronic obstructive pulmonary disease (COPD).To determine if the total number of airways quantified in vivo using computed tomography (CT) reflects early airway-related disease changes and is associated with lung function decline independent of emphysema in COPD.Participants in the multicenter, population-based, longitudinal CanCOLD (Canadian Chronic Obstructive Lung Disease) study underwent inspiratory/expiratory CT at visit 1; spirometry was performed at four visits over 6 years. Emphysema was quantified as the CT inspiratory low-attenuation areas below -950 Hounsfield units. CT total airway count (TAC) was measured as well as airway inner diameter and wall area using anatomically equivalent airways.Participants included never-smokers (n = 286), smokers with normal spirometry at risk for COPD (n = 298), Global Initiative for Chronic Obstructive Lung Disease (GOLD) I COPD (n = 361), and GOLD II COPD (n = 239). TAC was significantly reduced by 19% in both GOLD I and GOLD II compared with never-smokers (P 0.0001) and by 17% in both GOLD I and GOLD II compared with at-risk participants (P 0.0001) after adjusting for low-attenuation areas below -950 Hounsfield units. Further analysis revealed parent airways with missing daughter branches had reduced inner diameters (P 0.0001) and thinner walls (P 0.0001) compared with those without missing daughter branches. Among all CT measures, TAC had the greatest influence on FEVTAC may reflect the airway-related disease changes that accumulate in the "quiet" zone in early/mild COPD, indicating that TAC acquired with commercially available software across various CT platforms may be a biomarker to predict accelerated COPD progression.
- Published
- 2018
36. Effect of Fluticasone Furoate and Vilanterol on Exacerbations of Chronic Obstructive Pulmonary Disease in Patients with Moderate Airflow Obstruction
- Author
-
Courtney Crim, Nicholas J. Cowans, Robert D. Brook, Peter M.A. Calverley, Dennis E. Niewoehner, Julie C. Yates, Jørgen Vestbo, Julie A. Anderson, Bartolome R. Celli, David E. Newby, Mark T. Dransfield, Sally Kilbride, and Fernando J. Martinez
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Chlorobenzenes ,Critical Care and Intensive Care Medicine ,Placebo ,Fluticasone propionate ,law.invention ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,Adrenal Cortex Hormones ,law ,Forced Expiratory Volume ,Internal medicine ,Administration, Inhalation ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Benzyl Alcohols ,Aged ,COPD ,business.industry ,Airway obstruction ,medicine.disease ,Confidence interval ,Bronchodilator Agents ,Airway Obstruction ,Androstadienes ,Treatment Outcome ,030228 respiratory system ,chemistry ,Anesthesia ,Female ,Vilanterol ,business ,medicine.drug - Abstract
Inhaled corticosteroids have been shown to decrease exacerbations in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Their effects in patients with milder airflow obstruction remain unclear.This was an analysis of exacerbations in the SUMMIT (Study to Understand Mortality and Morbidity) study.In a double-blind, randomized controlled trial, once-daily inhaled placebo, fluticasone furoate (FF; 100 μg), vilanterol (VI; 25 μg), or the combination of FF/VI was administered. The primary outcome was all-cause mortality. Exacerbations of COPD were an additional predefined endpoint. A total of 1,368 centers in 43 countries and 16,485 patients with moderate COPD and heightened cardiovascular risk were included in the study.Compared with placebo, FF/VI reduced the rate of moderate and/or severe exacerbations by 29% (95% confidence interval [CI], 22-35; P 0.001) and the rate of hospitalized exacerbations by 27% (95% CI, 13-39; P 0.001). These relative effects were similar regardless of whether subjects had a history of exacerbation in the year before the study or an FEVPatients with moderate chronic airflow obstruction experienced a reduction in exacerbations with FF/VI compared with placebo, irrespective of a history of exacerbations or baseline FEV
- Published
- 2017
37. What’s in a Name: Introduction to the BART Index
- Author
-
Gerard J. Criner, Sameer K. Avasarala, and Atul C. Mehta
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,Respiratory Distress Syndrome ,Index (economics) ,business.industry ,Middle Aged ,Critical Care and Intensive Care Medicine ,Body Mass Index ,Airway Obstruction ,Pulmonary Disease, Chronic Obstructive ,Terminology as Topic ,Correspondence ,Humans ,Medicine ,Female ,business ,Aged ,Demography - Published
- 2020
38. Upper-Airway Collapsibility and Loop Gain Predict the Response to Oral Appliance Therapy in Patients with Obstructive Sleep Apnea
- Author
-
Christopher Andara, Scott A. Sands, David P. White, Bradley A. Edwards, Garun S. Hamilton, Simon A. Joosten, Andrew Wellman, Shane A. Landry, and Robert L. Owens
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Polysomnography ,medicine.medical_treatment ,Oral appliance ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Airway resistance ,Orthodontic Appliances ,stomatognathic system ,Internal medicine ,Humans ,Medicine ,Continuous positive airway pressure ,Sleep Apnea, Obstructive ,Cross-Over Studies ,medicine.diagnostic_test ,business.industry ,Airway Resistance ,respiratory system ,Middle Aged ,Airway obstruction ,medicine.disease ,Crossover study ,nervous system diseases ,respiratory tract diseases ,Airway Obstruction ,Obstructive sleep apnea ,Treatment Outcome ,030228 respiratory system ,Anesthesia ,Cardiology ,Pharynx ,Original Article ,Female ,Airway ,business ,030217 neurology & neurosurgery - Abstract
Oral appliances (OAs) are commonly used as an alternative treatment to continuous positive airway pressure for patients with obstructive sleep apnea (OSA). However, OAs have variable success at reducing the apnea-hypopnea index (AHI), and predicting responders is challenging. Understanding this variability may lie with the recognition that OSA is a multifactorial disorder and that OAs may affect more than just upper-airway anatomy/collapsibility.The objectives of this study were to determine how OA alters AHI and four phenotypic traits (upper-airway anatomy/collapsibility and muscle function, loop gain, and arousal threshold), and baseline predictors of which patients gain the greatest benefit from therapy.In a randomized crossover study, 14 patients with OSA attended two sleep studies with and without their OA. Under each condition, AHI and the phenotypic traits were assessed. Multiple linear regression was used to determine independent predictors of the reduction in AHI.OA therapy reduced the AHI (30 ± 5 vs. 11 ± 2 events/h; P 0.05), which was driven by improvements in upper-airway anatomy/collapsibility under passive (1.9 ± 0.7 vs. 4.7 ± 0.6 L/min; P 0.005) and active conditions (2.4 ± 0.9 vs. 6.2 ± 0.4 L/min; P 0.001). No changes were seen in muscle function, loop gain, or the arousal threshold. Using multivariate analysis, baseline passive upper-airway collapsibility and loop gain were independent predictors of the reduction in AHI (rOur findings suggest that OA therapy improves the upper-airway collapsibility under passive and active conditions. Importantly, a greater response to therapy occurred in those patients with a mild anatomic compromise and a lower loop gain.
- Published
- 2016
39. The Well-Known Gene HHIP and Novel Gene MECR Are Implicated in Small Airway Obstruction
- Author
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Ivana Nedeljkovic, Lies Lahousse, H. Marike Boezen, Kim de Jong, Alen Faiz, Dirkje S. Postma, Diana A van der Plaat, Ma'en Obeidat, Najaf Amin, Cornelia M. van Duijn, Judith M. Vonk, Cleo C. van Diemen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Life Course Epidemiology (LCE), and Epidemiology
- Subjects
0301 basic medicine ,Pulmonary and Respiratory Medicine ,Adult ,Male ,Pathology ,medicine.medical_specialty ,Oxidoreductases Acting on CH-CH Group Donors ,Adolescent ,Respiratory System ,Disease ,Critical Care and Intensive Care Medicine ,Bioinformatics ,DISEASE ,Novel gene ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Text mining ,Critical Care Medicine ,General & Internal Medicine ,medicine ,Humans ,Gene ,11 Medical and Health Sciences ,Aged ,Aged, 80 and over ,Science & Technology ,Membrane Glycoproteins ,business.industry ,Airway obstruction ,Middle Aged ,medicine.disease ,Airway Obstruction ,030104 developmental biology ,030228 respiratory system ,Female ,business ,Carrier Proteins ,Life Sciences & Biomedicine - Published
- 2016
40. Listen Carefully: The Hairy Polyp as an Unusual Cause of Neonatal Stridor
- Author
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Dominik Funken, Danny Jonigk, Anna-Maria Dittrich, Ulrich Baumann, Ursula Schmidtmayer, and Martin Durisin
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,Stridor ,Infant, Newborn ,Pharyngeal Diseases ,Choristoma ,Critical Care and Intensive Care Medicine ,medicine.disease ,Airway Obstruction ,Dyspnea ,Bronchoscopy ,medicine ,Humans ,Laryngomalacia ,Female ,Ear, External ,medicine.symptom ,Hypoxia ,business ,Respiratory Sounds - Published
- 2019
41. Recurrent Respiratory Papillomatosis and Bevacizumab Treatment
- Author
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Rodrigo Soto, Macarena R. Vial, Hiren J. Mehta, Michael A. Jantz, Gonzalo Labarca, Adnan Majid, Mauricio Burotto, and Sebastian Fernandez-Bussy
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Bevacizumab ,MEDLINE ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Bronchoscopy ,Humans ,Medicine ,030223 otorhinolaryngology ,Respiratory Tract Infections ,Human papilloma virus ,Papilloma ,Respiratory tract infections ,medicine.diagnostic_test ,business.industry ,Papillomavirus Infections ,Airway obstruction ,medicine.disease ,Surgery ,030228 respiratory system ,Recurrent Respiratory Papillomatosis ,business ,medicine.drug - Published
- 2018
42. Bloody Bronchial Cast-Aftermath of Hemoptysis
- Author
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Srinadh Annangi and Kevin H. Smith
- Subjects
Pulmonary and Respiratory Medicine ,Suction (medicine) ,medicine.medical_specialty ,Hemoptysis ,medicine.diagnostic_test ,business.industry ,General surgery ,Thrombosis ,Middle Aged ,Suction ,Critical Care and Intensive Care Medicine ,Bloody ,Airway Obstruction ,Imaging, Three-Dimensional ,Bronchoscopy ,medicine ,Humans ,Female ,business - Published
- 2019
43. Exercise-induced Laryngeal Obstruction
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J. Tod Olin and Elizabeth M. Fan
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Pulmonary and Respiratory Medicine ,Adult ,Aged, 80 and over ,Male ,medicine.medical_specialty ,business.industry ,General surgery ,MEDLINE ,Middle Aged ,Critical Care and Intensive Care Medicine ,Breathing Exercises ,Laryngeal Obstruction ,Airway Obstruction ,Text mining ,Vocal Cord Dysfunction ,Practice Guidelines as Topic ,medicine ,Humans ,Female ,business ,Aged - Published
- 2019
44. Airflow Limitation and Endothelial Dysfunction. Unrelated and Independent Predictors of Atherosclerosis
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Jessica Bon, Aman Gupta, William A. Slivka, Patrick J. Strollo, Kevin E. Kip, Frank C. Sciurba, Ali Shoushtari, Steven E. Reis, Carl R. Fuhrman, Joseph K. Leader, Divay Chandra, and Jennifer Avolio
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Brachial Artery ,Endothelium ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Risk Assessment ,Pulmonary function testing ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Forced Expiratory Volume ,Internal medicine ,medicine.artery ,Odds Ratio ,medicine ,Humans ,Endothelial dysfunction ,Brachial artery ,HeartScore ,Lung ,Aged ,business.industry ,Odds ratio ,Middle Aged ,respiratory system ,Atherosclerosis ,medicine.disease ,Confidence interval ,respiratory tract diseases ,Airway Obstruction ,medicine.anatomical_structure ,030228 respiratory system ,Cardiovascular Diseases ,Respiratory Physiological Phenomena ,Cardiology ,Female ,Original Article ,Endothelium, Vascular ,business - Abstract
Lower FEV1 is associated with increased prevalence of atherosclerosis; however, causal mechanisms remain elusive.To determine if systemic endothelial dysfunction mediates the association between reduced FEV1 and increased atherosclerosis.Brachial artery endothelial function, pulmonary function, coronary artery calcium, and carotid plaque were assessed in 231 Pittsburgh SCCOR (Specialized Centers for Clinically Oriented Research) study participants; peripheral arterial endothelial function, pulmonary function, and coronary artery calcium were assessed in 328 HeartSCORE (Heart Strategies Concentrating on Risk Evaluation) study participants.Lower FEV1 was independently associated with increased atherosclerosis in both cohorts (per 25% lower % predicted FEV1: odds ratio [OR], 1.76; 95% confidence interval [CI], 1.30-2.40; P 0.001 for carotid plaque in SCCOR participants) (per 25% lower % predicted FEV1: OR, 1.35; 95% CI, 1.02-1.77; P = 0.03 for coronary artery calcium in HeartSCORE participants). Similarly, reduced endothelial function was independently associated with increased atherosclerosis in both cohorts (per SD lower endothelial function: OR, 1.30; 95% CI, 1.01-1.67; P = 0.04 for carotid plaque in SCCOR participants) (per SD lower endothelial function: OR, 1.38; 95% CI, 1.09-1.76; P = 0.008 and OR, 1.41; 95% CI, 1.07-1.86; P = 0.01 for coronary artery calcium in SCCOR and HeartSCORE participants, respectively). However, there was no association between endothelial dysfunction and FEV1, FEV1/FVC, low-attenuation area/visual emphysema, and diffusing capacity in SCCOR participants, and between endothelial dysfunction and FEV1 or FEV1/FVC in HeartSCORE participants (all P 0.05). Adjusting the association between FEV1 and atherosclerosis for endothelial dysfunction had no impact.Endothelial dysfunction does not mediate the association between airflow limitation and atherosclerosis. Instead, airflow limitation and endothelial dysfunction seem to be unrelated and mutually independent predictors of atherosclerosis.
- Published
- 2016
45. Morphometric Analysis of Explant Lungs in Cystic Fibrosis
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François Vermeulen, Marc Decramer, Geert Verleden, Kris De Boeck, Barbara Bosch, Elise Lammertyn, Joel D. Cooper, Johny Verschakelen, Erik Verbeken, Mariette Kemner-van de Corput, Bart M. Vanaudenaerde, Lieven Dupont, John E. McDonough, Marijke Proesmans, Dirk Van Raemdonck, Cindy Mai, Mieke Boon, Stijn E. Verleden, Harm A.W.M. Tiddens, James C. Hogg, Radiology & Nuclear Medicine, and Pediatrics
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Male ,Pathology ,Cystic Fibrosis ,medicine.medical_treatment ,Vital Capacity ,Critical Care and Intensive Care Medicine ,Cystic fibrosis ,0302 clinical medicine ,Forced Expiratory Volume ,Medicine ,Lung volumes ,030212 general & internal medicine ,Respiratory system ,Pneumonectomy ,Lung ,medicine.diagnostic_test ,Organ Size ,Middle Aged ,respiratory system ,Plethysmography ,Residual Volume ,medicine.anatomical_structure ,Airway Remodeling ,Female ,Lung Transplantation ,Adult ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.medical_specialty ,Bronchi ,Maximal Midexpiratory Flow Rate ,Young Adult ,03 medical and health sciences ,Multidetector Computed Tomography ,Humans ,Lung transplantation ,Bronchioles ,Aged ,business.industry ,Total Lung Capacity ,X-Ray Microtomography ,Airway obstruction ,medicine.disease ,respiratory tract diseases ,Airway Obstruction ,030228 respiratory system ,Case-Control Studies ,Human medicine ,business ,Airway - Abstract
RATIONALE: After repeated cycles of lung infection and inflammation, patients with cystic fibrosis (CF) evolve to respiratory insufficiency. Although histology and imaging have provided descriptive information, a thorough morphometric analysis of end-stage CF lung disease is lacking. OBJECTIVES: To quantify the involvement of small and large airways in end-stage CF. METHODS: Multidetector computed tomography (MDCT) and micro-CT were applied to 11 air-inflated CF explanted lungs and 7 control lungs to measure, count, and describe the airway and parenchymal abnormalities in end-stage CF lungs. Selected abnormalities were further investigated with thin section histology. MEASUREMENTS AND MAIN RESULTS: On MDCT, CF explanted lungs showed an increased median (interquartile range) number (631 [511-710] vs. 344 [277-349]; P = 0.003) and size of visible airways (cumulative airway diameter 217 cm [209-250] vs. 91 cm [80-105]; P < 0.001) compared with controls. Airway obstruction was seen, starting from generation 6 and increasing to 40 to 50% of airways from generation 9 onward. Micro-CT showed that the total number of terminal bronchioles was decreased (2.9/ml [2.6-4.4] vs. 5.3/ml [4.8-5.7]; P < 0.001); 49% were obstructed, and the cross-sectional area of the open terminal bronchioles was reduced (0.093 mm(2) [0.084-0.123] vs. 0.179 mm(2) [0.140-0.196]; P < 0.001). On micro-CT, 41% of the obstructed airways reopened more distally. This remodeling was confirmed on histological analysis. Parenchymal changes were also seen, mostly in a patchy and peribronchiolar distribution. CONCLUSIONS: Extensive changes of dilatation and obstruction in nearly all airway generations were observed in end-stage CF lung disease. ispartof: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE vol:193 issue:5 pages:516-526 ispartof: location:United States status: published
- Published
- 2016
46. Obstructive Apneas in a Mouse Model of Congenital Central Hypoventilation Syndrome.
- Author
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Madani A, Pitollat G, Sizun E, Cardoit L, Ringot M, Bourgeois T, Ramanantsoa N, Delclaux C, Dauger S, d'Ortho MP, Thoby-Brisson M, Gallego J, and Matrot B
- Subjects
- Animals, Animals, Newborn, Disease Models, Animal, Homeodomain Proteins genetics, Humans, Mice, Mutation, Transcription Factors genetics, Hypoventilation congenital, Hypoventilation diagnosis, Hypoventilation genetics, Hypoventilation physiopathology, Sleep Apnea, Central congenital, Sleep Apnea, Central diagnosis, Sleep Apnea, Central genetics, Sleep Apnea, Central physiopathology
- Abstract
Rationale: Congenital central hypoventilation syndrome (CCHS) is characterized by life-threatening sleep hypoventilation and is caused by PHOX2B gene mutations, most frequently the PHOX2B
27Ala/+ mutation, with patients requiring lifelong ventilatory support. It is unclear whether obstructive apneas are part of the syndrome. Objectives: To determine if Phox2b27Ala/+ mice, which present the main symptoms of CCHS and die within hours after birth, also express obstructive apneas, and to investigate potential underlying mechanisms. Methods: Apneas were classified as central, obstructive, or mixed by using a novel system combining pneumotachography and laser detection of abdominal movement immediately after birth. Several respiratory nuclei involved in airway patency were examined by immunohistochemistry and electrophysiology in brainstem-spinal cord preparations. Measurements and Main Results: The median (interquartile range) of obstructive apnea frequency was 2.3 (1.5-3.3)/min in Phox2b27Ala/+ pups versus 0.6 (0.4-1.0)/min in wild types ( P < 0.0001). Obstructive apnea duration was 2.7 seconds (2.3-3.9) in Phox2b27Ala/+ pups versus 1.7 seconds (1.1-1.9) in wild types ( P < 0.0001). Central and mixed apneas presented similar significant differences. In Phox2b27Ala/+ preparations, the hypoglossal nucleus had fewer ( P < 0.05) and smaller ( P < 0.01) neurons, compared with wild-type preparations. Importantly, coordination of phrenic and hypoglossal motor activities was disrupted, as evidenced by the longer and variable delay of hypoglossal activity with respect to phrenic activity onset ( P < 0.001). Conclusions: The Phox2b27Ala/+ mutation predisposed pups not only to hypoventilation and central apneas, but also to obstructive and mixed apneas, likely because of hypoglossal dysgenesis. These results thus demand attention toward obstructive events in infants with CCHS.- Published
- 2021
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47. Phenotype of Normal Spirometry in an Aging Population
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Robert L. Jensen, John Concato, H. Klar Yaggi, Gail McAvay, Thomas M. Gill, Peter H. Van Ness, Richard Casaburi, Neil R. MacIntyre, and Carlos A. Vaz Fragoso
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Male ,Respiratory System ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,Medical and Health Sciences ,Pulmonary Disease, Chronic Obstructive ,Quality of life ,Models ,Bronchodilator ,80 and over ,Respiratory system ,Lung ,Aged, 80 and over ,COPD ,medicine.diagnostic_test ,Respiratory disease ,Statistical ,Middle Aged ,respiratory system ,Obstructive lung disease ,Phenotype ,medicine.anatomical_structure ,Pulmonary Emphysema ,Respiratory ,Original Article ,Female ,Pulmonary and Respiratory Medicine ,Spirometry ,Chronic Obstructive ,medicine.medical_specialty ,phenotype ,medicine.drug_class ,Chronic Obstructive Pulmonary Disease ,Pulmonary Disease ,COPDGene ,Clinical Research ,Internal medicine ,medicine ,Humans ,Diagnostic Errors ,Aged ,Emphysema ,Models, Statistical ,business.industry ,medicine.disease ,normal spirometry ,respiratory tract diseases ,Airway Obstruction ,Quality of Life ,Physical therapy ,business - Abstract
RationaleIn aging populations, the commonly used Global Initiative for Chronic Obstructive Lung Disease (GOLD) may misclassify normal spirometry as respiratory impairment (airflow obstruction and restrictive pattern), including the presumption of respiratory disease (chronic obstructive pulmonary disease [COPD]).ObjectivesTo evaluate the phenotype of normal spirometry as defined by a new approach from the Global Lung Initiative (GLI), overall and across GOLD spirometric categories.MethodsUsing data from COPDGene (n = 10,131; ages 45-81; smoking history, ≥10 pack-years), we evaluated spirometry and multiple phenotypes, including dyspnea severity (Modified Medical Research Council grade 0-4), health-related quality of life (St. George's Respiratory Questionnaire total score), 6-minute-walk distance, bronchodilator reversibility (FEV1 % change), computed tomography-measured percentage of lung with emphysema (% emphysema) and gas trapping (% gas trapping), and small airway dimensions (square root of the wall area for a standardized airway with an internal perimeter of 10 mm).Measurements and main resultsAmong 5,100 participants with GLI-defined normal spirometry, GOLD identified respiratory impairment in 1,146 (22.5%), including a restrictive pattern in 464 (9.1%), mild COPD in 380 (7.5%), moderate COPD in 302 (5.9%), and severe COPD in none. Overall, the phenotype of GLI-defined normal spirometry included normal adjusted mean values for dyspnea grade (0.8), St. George's Respiratory Questionnaire (15.9), 6-minute-walk distance (1,424 ft [434 m]), bronchodilator reversibility (2.7%), % emphysema (0.9%), % gas trapping (10.7%), and square root of the wall area for a standardized airway with an internal perimeter of 10 mm (3.65 mm); corresponding 95% confidence intervals were similarly normal. These phenotypes remained normal for GLI-defined normal spirometry across GOLD spirometric categories.ConclusionsGLI-defined normal spirometry, even when classified as respiratory impairment by GOLD, included adjusted mean values in the normal range for multiple phenotypes. These results suggest that among adults with GLI-defined normal spirometry, GOLD may misclassify normal phenotypes as having respiratory impairment.
- Published
- 2015
48. Mucin Concentrations and Peripheral Airway Obstruction in Chronic Obstructive Pulmonary Disease
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Mehmet Kesimer, Benjamin M. Smith, Agathe Ceppe, Amina A. Ford, Wayne H. Anderson, R. Graham Barr, Wanda K. O’Neal, Richard C. Boucher, Prescott G. Woodruff, MeiLan K. Han, Eric A. Hoffman, Fernando Martinez, Jeffrey L. Curtis, Robert Paine, Christopher B. Cooper, and Eugene R. Bleecker
- Subjects
Pulmonary and Respiratory Medicine ,Spirometry ,Pathology ,medicine.medical_specialty ,Pulmonary disease ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Text mining ,X ray computed ,Correspondence ,medicine ,Humans ,030212 general & internal medicine ,Lung ,medicine.diagnostic_test ,business.industry ,Mucin ,Mucins ,Airway Obstruction ,030228 respiratory system ,business ,Tomography, X-Ray Computed ,Airway closure - Published
- 2018
49. Visualizing Heterogeneous Pulmonary Ventilation. Respiratory Failure due to an Anterior Mediastinal Mass
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Shaf Keshavjee, Antoine Desilets, and Ewan C. Goligher
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Mediastinal mass ,Airway obstruction ,Critical Care and Intensive Care Medicine ,medicine.disease ,Prognosis ,Mediastinal Neoplasms ,Risk Assessment ,Severity of Illness Index ,Airway Obstruction ,Positive-Pressure Respiration ,Treatment Outcome ,Respiratory failure ,Internal medicine ,Preoperative Care ,medicine ,Cardiology ,Humans ,Radiography, Thoracic ,business ,Tomography, X-Ray Computed ,Electrical impedance tomography - Published
- 2018
50. The Heterogeneity of Exercise-induced Laryngeal Obstruction
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Astrid Sandnes, John-Helge Heimdal, Thomas Halvorsen, Maria Vollsæter, Ola Drange Røksund, Magnus Hilland, and Hege Clemm
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Pulmonary and Respiratory Medicine ,Adult ,Laryngoscopy ,MEDLINE ,Critical Care and Intensive Care Medicine ,Laryngeal Diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Text mining ,medicine ,Humans ,Young adult ,030223 otorhinolaryngology ,Exercise ,Physical conditioning ,medicine.diagnostic_test ,business.industry ,Laryngeal Obstruction ,Airway Obstruction ,030228 respiratory system ,Anesthesia ,Female ,business ,Physical Conditioning, Human - Published
- 2018
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