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RationaleGenome-wide association studies (GWAS) of chronic obstructive pulmonary disease (COPD) have identified disease-susceptibility loci, mostly in subjects of European descent.ObjectivesWe hypothesized that by studying Hispanic populations we would be able to identify unique loci that contribute to COPD pathogenesis in Hispanics but remain undetected in GWAS of non-Hispanic populations.MethodsWe conducted a metaanalysis of two GWAS of COPD in independent cohorts of Hispanics in Costa Rica and the United States (Multi-Ethnic Study of Atherosclerosis [MESA]). We performed a replication study of the top single-nucleotide polymorphisms in an independent Hispanic cohort in New Mexico (the Lovelace Smokers Cohort). We also attempted to replicate prior findings from genome-wide studies in non-Hispanic populations in Hispanic cohorts.Measurements and main resultsWe found no genome-wide significant association with COPD in our metaanalysis of Costa Rica and MESA. After combining the top results from this metaanalysis with those from our replication study in the Lovelace Smokers Cohort, we identified two single-nucleotide polymorphisms approaching genome-wide significance for an association with COPD. The first (rs858249, combined P value = 6.1 × 10(-8)) is near the genes KLHL7 and NUPL2 on chromosome 7. The second (rs286499, combined P value = 8.4 × 10(-8)) is located in an intron of DLG2. The two most significant single-nucleotide polymorphisms in FAM13A from a previous genome-wide study in non-Hispanics were associated with COPD in Hispanics.ConclusionsWe have identified two novel loci (in or near the genes KLHL7/NUPL2 and DLG2) that may play a role in COPD pathogenesis in Hispanic populations.

A study was conducted to evaluate the association between a greater extent of computed tomography (CT)-defined emphysema and more severe airflow obstruction and decrements in the left ventricular volume and cardiac output. Results indicated that these were linearly related and did lead to significant decrements in left ventricular filling and cardiac output.

The prevalence of asthma has increased dramatically over the last 25 years in the United States and in other nations as a result of ill-defined changes in living conditions in [...]

People who work at microwave popcorn factories may develop a lung disease called bronchiolitis obliterans if they work in areas that contain high amounts of butter flavoring in the air. These areas include the area where popcorn flavorings are mixed and the area where the popcorn is packaged.

Smoking cessation programs may slow the age-related decline in lung function accelerated by smoking in middle-aged patients with early symptoms of chronic obstructive pulmonary disease (COPD). COPD is a progressive lung disease that may occur in smokers. Between October 1986 and April 1994, researchers measured the lung function of 5887 smokers between the ages of 35 and 60 who had mild COPD. A total of 1962 patients participated in a smoking cessation program, 1961 participated in a smoking cessation program and inhaled the bronchodilator ipratropium three times per day, and 1964 did not participate in any intervention. During the five-year study period, patients in both smoking cessation groups had smaller declines in lung function measured by forced expiratory volume in one second (FEV1) than non-intervention patients. The strongest lung function benefits occurred during the first year of the study and were most pronounced in patients who quit smoking early in the intervention and did not resume smoking. Mild benefits were associated with bronchodilator use which disappeared once the bronchodilator was discontinued., Objective.--To determine whether a program incorporating smoking intervention and use of an inhaled bronchodilator can slow the rate of decline in forced expiratory volume in 1 second (FE[V.sub.1]) in smokers aged 35 to 60 years who have mild obstructive pulmonary disease. Design.--Randomized clinical trial. Participants randomized with equal probability to one of the following groups: (1) smoking intervention plus bronchodilator, (2) smoking intervention plus placebo, or (3) no intervention. Setting.--Ten clinical centers in the United States and Canada. Participants.--A total of 5887 male and female smokers, aged 35 to 60 years, with spirometric signs of early chronic obstructive pulmonary disease. Interventions.--Smoking intervention: intensive 12-session smoking cessation program combining behavior modification and use of nicotine gum, with continuing 5-year maintenance program to minimize relapse. Bronchodilator: ipratropium bromide prescribed three times daily (two puffs per time) from a metered-dose inhaler. Main Outcome Measures.--Rate of change and cumulative change in FE[V.sup.1] over a 5-year period. Results.--Participants in the two smoking intervention groups showed significantly smaller declines in FE[V.sub.1] than did those in the control group. Most of this difference occurred during the first year following entry into the study and was attributable to smoking cessation, with those who achieved sustained smoking cessation experiencing the largest benefit. The small noncumulative benefit associated with use of the active bronchodilator vanished after the bronchodilator was discontinued at the end of the study. Conclusions.--An aggressive smoking intervention program significantly reduces the age-related decline in FE[V.sub.1] in middle-aged smokers with mild airways obstruction. Use of an inhaled anticholinergic bronchodilator results in a relatively small improvement in FE[V.sub.1] that appears to be reversed after the drug is discontinued. Use of the bronchodilator did not influence the long-term decline of FE[V.sub.1]. (JAMA. 1994;272:1497-1505)

Cigarette smoking appears to reduce lung function among the elderly. Smoking is already known to impair lung function in younger adults. Because smokers are more likely to die prematurely or to stop smoking when they become ill, elderly smokers may be a healthy subset of an initially larger cohort of smokers. Among 5,201 people over 65, 10% of the white men were current smokers, 19% of the black men were current smokers, 13% of the white women were current smokers and 17% of the black women were current smokers. Over 50% of the men were former smokers and about 25% of the women were former smokers. People who had never smoked had better lung function than current and former smokers. Lung function among people who quit before age 40 was similar to that of never smokers. Among former smokers, lung function declined as age at quitting increased. Because poor lung function is associated with cardiovascular disease and lung cancer, elderly smokers should be encouraged to quit., Objective.--To investigate relationships between cigarette smoking and pulmonary function in elderly men and women. Design.--Cross-sectional analysis of baseline data from a prospective, population-based study of risk factors, proclinical, and overt cardiovascular and pulmonary disease. Setting.--Defined communities in Forsyth County, North Carolina; Pittsburgh, Pa; Sacramento County, California; and Washington County, Maryland. Population.--A total of 5201 noninstitutionalized men and women 65 years of age and older. Main Outcome Measures.--Pulmonary function; means of forced expiratory volume in 1 second [FEV.sub.1]) and forced vital capacity and prevalence of low [FEV.sub.1] levels. Results.--Prevalence of cigarette smoking was 10% to 20% and higher in women than men and in blacks than whites. Forced vital capacity and [FEV.sub.1] levels were related positively to height and white race and negatively to age and waist girth. Age- and height-adjusted [FEV.sub.1] means were 23% and 18% lower in male and female current smokers, respectively, than in never smokers but not reduced in never smokers currently living with a smoker. Smokers who quit before age 40 years had [FEV.sub.1] levels similar to never smokers, but [FEV.sub.1] levels were lower by 7% and 14% in smokers who quit at ages 40 to 60 years and older than 60 years, respectively. Lung function was related inversely to pack-years of cigarette use. Prevalence rates of impaired lung function were highest in current smokers and lowest in never smokers. Regression coefficients for the smoking variables were smaller in persons without cardiovascular or respiratory conditions than in the total cohort. Conclusions.--Cigarette smoking is associated with reduced pulmonary function in elderly men and women. However, smokers who quit, even after age 60 years, have better pulmonary function than continuing smokers. (JAMA. 1993;269:2741-2748)