Chronic Obstructive Pulmonary Disease Cases Research Articles

A Yoga-based pulmonary rehabilitation for the management of Chronic obstructive pulmonary disease: A Randomized controlled trial

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity, mortality, and health care use. COPD -Chronic obstructive pulmonary Disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to the noxious particles or gases. Objectives: To evaluate the effectiveness of Yoga Therapy in the management of dyspnea and fatigue in patients with COPD. Inclusion criteria: 1. Age > 18 years. 2. History, examination and PFT consistent with COPD as per GOLD guidelines. PFT showing: -FEV1/FVC < 0.70 -irreversible bronchial obstructions (<12% and /or <200ml increase in FEV1 or FVC, 20 minutes after the administration of 200μg of inhaled salbutamol). Exclusion criteria: 1. History of acute respiratory tract infection in the past 4 weeks prior to study. 2. History of medication with antibiotics and /or steriods (oral, injection or inhalation) in the previous 4 weeks prior to study. 3. Patients with cardiovascular disease, diabetes mellitus, Neuro -masculo-skeletal deficits, tuberculosis, hepatic or renal diseases. 4. Pregnant and lactating females. 5. History of thyroid disorders, parathyroid disorder and thyroidectomy. Materials and methods: A randomised controlled trial at New Delhi India hospital a Tertiary care unit:Sixty COPD patients (18 to 60years) ,both male and female were recruited. The yoga group received an intervention Yoga module for COPD that included asanas, loosening practices, breathing practices, pranayama, meditation, yogic counseling and lectures 45 min/day, 3days/weeks on alternate days for 12 weeks. Primary and secondary outcomes: Measurements of dyspnea and fatigue on the spirometry, exercise capacity by the 6 min walk test, COPD QUESSIONAIRE, and C –Reactive protein (CRP) for inflammatory response were made before and after the intervention.Results: Statistically significant within group reductions in dyspnea (P <0.001), COPD quessionaire (P <0.001) scores, CRP (P <0.001), and 6 min walk distance (P <0.001) were observed in the yoga group; all except the last were significant compared to controls (P <0.001). Conclusions: Findings indicate that yoga benefits patients with COPD. Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation to most cases of COPD can be prevented by Yoga programs for COPD patients.

Genetic biomarkers for risk prediction of chronic obstructive pulmonary disease (COPD) in smokers and non-smokers

Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease and not fully reversible. It is the 3rd major cause of death worldwide and ranks 2nd in India. Although the primary etiopathogenic factor is chronic exposure to tobacco smoke, it has been observed that all smokers do not develop COPD and many non-smokers suffer from the disease. This difference in susceptibility can be attributed to individual genetic variations. Therefore, the present study was conducted to analyze the association of genetic variants in candidate genes with COPD susceptibility among smokers and non-smokers. A total of 500 subjects were enrolled in the study (250 each of controls and cases) after ethical approval and informed consent. Fifteen single nucleotide polymorphisms (SNPs) in eight genes viz.IL-1RN, IL-1B, IL-6, TNF-A, SOD2, CAT, ADAM33 and AQP5 were genotyped by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR–RFLP). Data was analyzed using SPSS (ver 21.0) and association with smoking status was determined. Among 250 healthy controls enrolled, 119 were non-smokers and 131 were smokers. Out of 250 COPD cases, only 34 were non-smokers and rest 216 were smokers. The genotypic frequencies of IL-1RN intron2 86 bp VNTR (I,II), IL-1β -511 T/C, IL-6 -597A/G, TNF-α -308G/A, SOD2 + 47C/T, CAT − 21A/T and AQP5 promoter G/A were significantly associated with smoking. Among 07 ADAM33 SNPs, the genotype frequencies of V4exon22C/G and F + 1intron6C/T were significantly associated in smokers, while V1exon22G/T, S2exon19G/C, S1exon19A/G and Q1intron16A/G were associated with non-smokers. The genetic variants (SNPs) in smokers and non-smokers showing differential association with the risk of COPD can be identified as predictive biomarkers.

Deep learning on graphs for multi-omics classification of COPD.

Network approaches have successfully been used to help reveal complex mechanisms of diseases including Chronic Obstructive Pulmonary Disease (COPD). However despite recent advances, we remain limited in our ability to incorporate protein-protein interaction (PPI) network information with omics data for disease prediction. New deep learning methods including convolution Graph Neural Network (ConvGNN) has shown great potential for disease classification using transcriptomics data and known PPI networks from existing databases. In this study, we first reconstructed the COPD-associated PPI network through the AhGlasso (Augmented High-Dimensional Graphical Lasso Method) algorithm based on one independent transcriptomics dataset including COPD cases and controls. Then we extended the existing ConvGNN methods to successfully integrate COPD-associated PPI, proteomics, and transcriptomics data and developed a prediction model for COPD classification. This approach improves accuracy over several conventional classification methods and neural networks that do not incorporate network information. We also demonstrated that the updated COPD-associated network developed using AhGlasso further improves prediction accuracy. Although deep neural networks often achieve superior statistical power in classification compared to other methods, it can be very difficult to explain how the model, especially graph neural network(s), makes decisions on the given features and identifies the features that contribute the most to prediction generally and individually. To better explain how the spectral-based Graph Neural Network model(s) works, we applied one unified explainable machine learning method, SHapley Additive exPlanations (SHAP), and identified CXCL11, IL-2, CD48, KIR3DL2, TLR2, BMP10 and several other relevant COPD genes in subnetworks of the ConvGNN model for COPD prediction. Finally, Gene Ontology (GO) enrichment analysis identified glycosaminoglycan, heparin signaling, and carbohydrate derivative signaling pathways significantly enriched in the top important gene/proteins for COPD classifications.

Chronic Obstructive Pulmonary Disease and Work: The Continuing Narrative

It has long been recognized that harmful inhaled workplace exposures can contribute to the development of chronic obstructive pulmonary disease (COPD). This article, intended for the clinician, summarizes some of this evidence and some areas of controversy. Current estimates based on pooled epidemiological analyses of population-based studies identify that approximately 14% of the burden of COPD (and 13% of the burden of chronic bronchitis) is attributable to such exposures. In addition to these approaches, various studies implicate specific exposures as contributing. Certain of these relating to cadmium, coal, and respirable crystalline silica are discussed in more detail. Despite this amassed evidence to date supporting associations between COPD and workplace exposures, there have been surprisingly few studies that have attempted to assess the attribution by experts of an occupational cause in cases of COPD. One study, using hypothetical cases of COPD, noted that while expert physicians were willing to make such an occupational link, this was only likely in cases with light smoking histories and a priori defined heavy occupational exposures. Relatively recent data relating to computed tomography (CT) scan appearances may give the clinician a further guide. Several studies from populations have now linked potentially harmful occupational exposures specifically with the presence of emphysema on CT scanning. It will be of interest to see if this finding, along with other clinical attributes of cases such as smoking and family histories, exclusion of asthma, genetic data, and the nature of workplace exposures, will increase the future diagnosis by clinicians of occupational COPD. In the interim, while better diagnostic approaches are developed, we suggest that consideration of an occupational cause is an important part of the clinical investigation of cases of COPD. Finally, we suggest that evidence-based workplace preventive strategies for occupational COPD should be informed by knowledge of which exposures are most important to reduce, and whether and when intervention to reduce exposure at an individual worker level is warranted.

Inference of chronic obstructive pulmonary disease with deep learning on raw spirograms identifies new genetic loci and improves risk models.

Chronic obstructive pulmonary disease (COPD), the third leading cause of death worldwide, is highly heritable. While COPD is clinically defined by applying thresholds to summary measures of lung function, a quantitative liability score has more power to identify genetic signals. Here we train a deep convolutional neural network on noisy self-reported and International Classification of Diseases labels to predict COPD case-control status from high-dimensional raw spirograms and use the model's predictions as a liability score. The machine-learning-based (ML-based) liability score accurately discriminates COPD cases and controls, and predicts COPD-related hospitalization without any domain-specific knowledge. Moreover, the ML-based liability score is associated with overall survival and exacerbation events. A genome-wide association study on the ML-based liability score replicates existing COPD and lung function loci and also identifies 67 new loci. Lastly, our method provides a general framework to use ML methods and medical-record-based labels that does not require domain knowledge or expert curation to improve disease prediction and genomic discovery for drug design.

Undiagnosed and ‘overdiagnosed’ COPD using postbronchodilator spirometry in primary healthcare settings: a systematic review and meta-analysis

BackgroundDespite chronic obstructive pulmonary disease (COPD) being a major global cause of mortality and hospitalisation, it is often undiagnosed or inaccurately diagnosed in clinical settings.ObjectiveTo systematically synthesise all peer-reviewed papers...

Study of Electrocardiographic Abnormalities in Patients with Chronic Obstructive Pulmonary Disease and its Correlation With Severity

Introduction: The current study aimed to identify the electrocardiographic (ECG) changes in chronic obstructive pulmonary disease (COPD) patients and their correlation to severity. Methods: A prospective observational study was conducted on 100 patients with COPD with expiratory volume in the first second (FEV1)<0.7. Patients were categorized according to GOLD criteria and underwent Spirometry and ECG. Results: Among the COPD cases, 40% belonged to severe airflow limitation followed by very severe (32%), moderate (22%), and mild (6%) categories. The mean forced FEV1% in mild, moderate, severe, and very severe COPD was 81.3+0.57, 63.9+6.28, 41.15±4.59, and 25.625±2.41, respectively (P<0.05). The higher risk factor for COPD is smoking in 80% with a mean pack of 20.67±6.5 years. The most ECG abnormality in COPD patients was right ventricular hypertrophy (RVH) (52%), followed by right bundle branch block (RBBB) in 40% of patients, right axis deviation (34%), P pulmonale (32%), and atrial fibrillation in 22% of COPD cases, respectively. Furthermore, there was a strong association between ECG abnormalities and COPD severity. COPD patients with a poor FEV1/FVC% ratio had more ECG abnormalities, and the ECG abnormalities were shown to be highly correlated with the severity, duration, and length of symptoms. Conclusion: COPD is a common condition in patients with a smoking history of>20 pack-years, being more common in males in their 5th decade of life. Moreover, low FEV1 values were associated with ECG abnormalities. As the duration/severity of the disease rises, ECG abnormalities become more common. To avoid cardiac mortality and morbidity, all COPD patients should undergo cardiac examination through ECG for the management of co-morbidities.

Circulating liver function markers and the risk of COPD in the UK Biobank.

To investigate the associations of circulating liver function marker levels with the risk of chronic obstructive pulmonary disease (COPD). We leveraged the data of 372,056 participants from the UK Biobank between 2006 and 2010. The assessed circulating liver function markers included alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), albumin (ALB), and total protein (TP). Incident COPD was identified through linkage to the National Health Service registries. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up period of 12.3 (interquartile range:11.4-13.2) years, we documented 10,001 newly diagnosed COPD cases. Lower levels of ALT, TBIL, ALB, and TP and higher levels of GGT and ALP were nonlinearly associated with elevated COPD risk. The HR (95% CI) for decile 10 vs. 1 was 0.92 (0.84-1.01) for ALT, 0.82 (0.75-0.89) for TBIL, 0.74 (0.67-0.81) for ALB, 0.96 (0.88-1.04) for TP, 1.45 (1.31-1.62) for GGT, and 1.31 (1.19-1.45) for ALP. Restricted cubic spline analyses suggested a U-shaped relationship between AST levels and COPD risk (P for nonlinearity <0.05). We observed that all seven circulating liver function markers were nonlinearly associated with the risk of COPD, indicating the importance of liver function in COPD.

Heated Tobacco Products and Chronic Obstructive Pulmonary Disease: A Narrative Review of Peer-Reviewed Publications

An estimated 65 million people worldwide have moderate or severe chronic obstructive pulmonary disease (COPD), an umbrella term used to describe a group of progressive lung diseases that obstruct airflow such as emphysema and chronic bronchitis. Smoking contributes to an estimated 90% of COPD cases, as the harmful chemicals produced during tobacco combustion damage the lungs and airways. Although smoking cessation is the only intervention shown to improve COPD prognosis in smokers, many patients who try to quit continue to smoke. The continued use of conventional cigarettes exacerbates COPD symptoms, and globally more than 3 million people die from the disease every year. The last two decades have seen the introduction of combustion-free nicotine delivery alternatives that produce significantly lower levels of the harmful components in cigarette smoke, and researchers have begun to assess the impact of switching from cigarettes to these products. Several studies have examined how patients with COPD use e-cigarettes as assistance for quitting, but few have examined how heated tobacco products (HTP) may reduce risk. This narrative review summarises results from pre-clinical, clinical, and real-world evidence studies showing possible harm reduction benefits for patients with COPD who switch to HTPs rather than continuing to smoke cigarettes. Epidemiological studies, real-world data analyses, and randomised clinical trials must be conducted to determine whether switching from cigarettes to HTPs can improve health outcomes in patients with COPD who would otherwise continue to smoke combustible cigarettes.

Short-Term Effects of Carbon Monoxide on Morbidity of Chronic Obstructive Pulmonary Disease With Comorbidities in Beijing.

The association between CO and chronic obstructive pulmonary disease (COPD) has been widely reported; however, the association among patients with type 2 diabetes mellitus (T2DM) or hypertension has remained largely unknown in China. Over-dispersed generalized additive model was adopted to quantity the associations between CO and COPD with T2DM or hypertension. Based on principal diagnosis, COPD cases were identified according to the International Classification of Diseases (J44), and a history of T2DM and hypertension was coded as E12 and I10-15, O10-15, P29, respectively. A total of 459,258 COPD cases were recorded from 2014 to 2019. Each interquartile range uptick in CO at lag 03 corresponded to 0.21% (95%CI: 0.08%-0.34%), 0.39% (95%CI: 0.13%-0.65%), 0.29% (95%CI: 0.13%-0.45%) and 0.27% (95%CI: 0.12%-0.43%) increment in admissions for COPD, COPD with T2DM, COPD with hypertension and COPD with both T2DM and hypertension, respectively. The effects of CO on COPD with T2DM (Z=0.77, P=0.444), COPD with hypertension (Z=0.19, P=0.234) and COPD with T2DM and hypertension (Z=0.61, P=0.543) were insignificantly higher than that on COPD. Stratification analysis showed that females were more vulnerable than males except for T2DM group (COPD: Z=3.49, P<0.001; COPD with T2DM: Z=0.176, P=0.079; COPD with hypertension: Z=2.48, P=0.013; COPD with both T2DM and hypertension: Z=2.44, P=0.014); No statistically significant difference could be found between age groups (COPD: Z=1.63, P=0.104; COPD with T2DM: Z=0.23, P=0.821; COPD with hypertension: Z=0.53, P=0.595; COPD with both T2DM and hypertension: Z=0.71, P=0.476); Higher effects appeared in cold seasons than warm seasons on COPD (Z=0.320, P<0.001). This study demonstrated an increased risk of COPD with comorbidities related to CO exposure in Beijing. We further provided important information on lag patterns, susceptible subgroups, and sensitive seasons, as well as the characteristics of the exposure-response curves.

Incidence of the Atrial Fibrillation in Patients with Chronic Obstructive Pulmonary Disease (COPD) in Sindh, Pakistan

Chronic obstructive pulmonary disease (COPD) is a major public health problem and leading cause of death globally. COPD fails to receive adequate attention from the health care community and government officials, with these concerns in mind we designed our study. Objective: To find out the incidence of atrial fibrillation in patients with COPD. Methods: A cross-sectional study was conducted from 12th February 2019 to August, 2020 at the Department of Pulmonology, Ghulam Muhammad Maher Medical College teaching Hospital, Sukkur. N=150 patients with chronic obstructive lung disease were involved in this study. The Criterion for the selection of patients for the study was those patients who was a diagnosed case of COPD. The exclusion criteria were known asthmatic patients and the case of restrictive lung diseases; history of ischemic heart disease, already on cardiac medication, patients with hyperthyroidism whereas the percentages, mean and Standard deviation were computed for study variables. Results: During One year and six months phase, patients who had COPD for &gt; 3-Year duration were explored and study. The mean, SD for age (years) of citizens of Sindh Rural and Urban was 59.52 ± 7.81. Regarding gender, male 64 % and female 36 % individuals whereas the Atrial Fibrillation (AF) was identified in 62 % patients of COPD. Conclusions: High risk of AF has been identified among the COPD patients in Pakistani Populace. Hypertension and CHF among the COPD patients were notable as self-sufficient hazard features for new beginning of AF.

HEART FAILURE AS AN IN-HOSPITAL MORTALITY PREDICTING FACTOR IN COPD PATIENTS: AN OBSERVATIONAL STUDY

INRODUCTION: Chronic obstructive pulmonary disease (COPD) and heart failure are two major causes of mortality, globally. Coexistence of both conditions cause diagnostic difficulties because of similarities in symptoms and signs. Most patients with both conditions are characterized by high mortality.Age,sex and comorbidities are considered to be the major predictors of mortality in patients with COPD and heart failure alone.Undiagnosed heart failure in patients of COPD has catastrophic consequences.AIM OF STUDY:To describe prevalence of heart failure in COPD patients and its impact on in hospital mortality.MATERIAL AND METHODS:An observational study was conducted on 100 diagnosed cases of COPD for a period of 6 months,admitted in medicine ward and medical intensive care unit at Jhalawar Medical College.RESULTS: Out of the 100 patients studied,72 (72%) were males and 28 (28%) were females.23 patients (23%) were diagnosed with coexisting heart failure. In hospital mortality was 12%, mortality among coexisting heart failure patients was higher (30.43%) in comparison to patients with only COPD (6.49%)- odd ratio 6.3 (95% CI 1.77-22.41). CONCLUSION: Heart failure has an important impact on in hospital mortality in patients with COPD. Heart failure and other comorbidities should be recognized early and properly treated in order to improve survival in patients with COPD

Exposure to occupational risk factors is associated with the severity and progression of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) results from a complex interaction between genes and the environment, and occupational exposures are an underappreciated risk factor. Until now, little research attention has been paid to the potential impact of occupational risk factor exposure on the COPD in China. The aim of this retrospective study was to analyze the role of occupational risk factor exposure on the severity and progression of COPD for exploring new prevention strategies for this disease. This study adopted a random cluster-sampling method. Five grade-A tertiary hospitals that met the inclusion criteria were selected as the survey sites, and patients with COPD hospitalized in these hospitals from January 1, 2019, to December 31, 2019, were selected as the research subjects. Data of the patients diagnosed with COPD met the Global Initiative for Chronic Obstructive Lung Disease (2019) criteria and were collected from the computerized medical record databases. Among 4082 investigated COPD patients, 1063 (26%) were found to have occupational risk factor exposure history. The top 3 industries with a large COPD case number and a history of occupational risk factor exposure ranked in the order of agriculture (including farming, forestry, animal husbandry, and fishery), manufacturing, and mining. Further multivariate logistic regression analysis indicated that when setting a low exposure level as a reference, medium and high exposure levels were correlated with the severity of COPD (odds ratio values were 2.837 and 6.201, respectively, P < .05). Linear regression analysis showed that cumulative exposure to occupational risk factors was negatively correlated with the forced expiratory volume in 1-second percentage of COPD patients, with a correlation coefficient of 0.68. Our results indicated that occupational risk factor exposure levels were related to the severity of COPD significantly. The incubation period of COPD in the exposure group was significantly shorter than that in the non-exposure group. To prevent worked-related COPD, special attention and control efforts should be taken to reduce the level of occupational risk factors such as organic dust, irritating chemicals, etc in the work environments, especially in the industries of agriculture, forestry, animal husbandry and fishery, manufacturing, and mining.

Lipid profile patterns in chronic obstructive pulmonary disease and its correlation with the severity of disease

This cross-sectional study was conducted to determine the serum lipid profiles in chronic obstructive pulmonary disease (COPD) patients and its correlation with the severity of COPD in the Department of Respiratory Medicine at Bangabandhu Sheikh Mujib Medical University. A total of 100 spirometric-confirmed cases of COPD were included. Fasting blood samples for lipid profiles were collected. To identify the association between severity of COPD with lipid profiles Pearson’s correlation was used. Further multiple linear regression was done to identify the relation. The mean (standard deviation) age of the patients was 59.0 (10.7)years. The ratio of males and females was 19:1. The mean forced expiratory volume (liters) in 1 second (FEV1) was 55.1 (18.1). Most of the patients had stage II (48%) and stage III (36%) airflow obstruction. Plasma level of total cholesterol and triglyceride tend to increase, statistically non-significant, with stages of COPD. However, the association of plasma lipids becomes statistically significant with FEV1 when the effects of age, BMI, pack-year smoking, duration of illness are accounted in multiple linear regression analysis.

Biological and Genetic Mechanisms of COPD, Its Diagnosis, Treatment, and Relationship with Lung Cancer.

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic adult diseases, with significant worldwide morbidity and mortality. Although long-term tobacco smoking is a critical risk factor for this global health problem, its molecular mechanisms remain unclear. Several phenomena are thought to be involved in the evolution of emphysema, including airway inflammation, proteinase/anti-proteinase imbalance, oxidative stress, and genetic/epigenetic modifications. Furthermore, COPD is one main risk for lung cancer (LC), the deadliest form of human tumor; formation and chronic inflammation accompanying COPD can be a potential driver of malignancy maturation (0.8-1.7% of COPD cases develop cancer/per year). Recently, the development of more research based on COPD and lung cancer molecular analysis has provided new light for understanding their pathogenesis, improving the diagnosis and treatments, and elucidating many connections between these diseases. Our review emphasizes the biological factors involved in COPD and lung cancer, the advances in their molecular mechanisms' research, and the state of the art of diagnosis and treatments. This work combines many biological and genetic elements into a single whole and strongly links COPD with lung tumor features.

Healthful and Unhealthful Plant-Based Diets and Chronic Obstructive Pulmonary Disease in U.S. Adults: Prospective Study.

Despite the potential protective effect of a plant-based diet against chronic obstructive pulmonary disease (COPD), it remains unknown whether intake of different types of plant foods is beneficial for COPD. Our aims were to determine whether adherence to the healthful version of a plant-based diet (healthful Plant-based Diet Index (hPDI)) is associated with a lower COPD risk, whereas adherence to the unhealthful version (unhealthful Plant-based Diet Index (uPDI)) is associated with a higher COPD risk. 46,948 men from the Health Professionals Follow-up Study, 73,592 women from the Nurses' Health Study, and 85,515 women from the Nurses' Health Study II who completed biennial questionnaires from 1984-2018. We derived diet scores from repeated validated food frequency questionnaires. Among 5,661,994 person-years of follow-up, we documented 2605 validated COPD cases between 1984-2018. After tight control for smoking and other potential confounders, COPD risk was 46% lower among participants with the highest hPDI score compared to those with the lowest score. Conversely, COPD risk was 39% higher among participants with the highest uPDI. Further adjustment for processed meat intake led to similar results. These findings provide further evidence for consuming a diet that emphasizes healthful plant foods to optimize lung health.

Responsiveness to pulmonary rehabilitation in COPD is associated with changes in microbiota

BackgroundPulmonary Rehabilitation (PR) is one of the most cost-effective therapies for chronic obstructive pulmonary disease (COPD) management. There are, however, people who do not respond to PR and reasons for non-response are mostly unknown. PR is likely to change the airway microbiota and this could play a role in its responsiveness. In this study we have explored the association between PR effectiveness and specific alterations in oral microbiota and inflammation.MethodsA prospective longitudinal study was conducted. Data on exercise capacity, dyspnoea, impact of disease and 418 saliva samples were collected from 76 patients, half of whom participated in a 12-weeks PR programme. Responders and non-responders to PR (dyspnoea, exercise-capacity and impact of disease) were defined based on minimal clinically important differences.ResultsChanges in microbiota, including Prevotella melaninogenica and Streptococcus were observed upon PR. Prevotella, previously found to be depleted in severe COPD, increased during the first month of PR in responders. This increase was negatively correlated with Streptococcus and Lautropia, known to be enriched in severe cases of COPD. Simultaneously, an anti-inflammatory commensal of the respiratory tract, Rothia, correlated strongly and negatively with several pro-inflammatory markers, whose levels were generally boosted by PR. Conversely, in non-responders, the observed decline in Prevotella correlated negatively with Streptococcus and Lautropia whose fluctuations co-occurred with several pro-inflammatory markers.ConclusionsPR is associated with changes in oral microbiota. Specifically, PR increases salivary Prevotella melaninogenica and avoids the decline in Rothia and the increase in Streptococcus and Lautropia in responders, which may contribute to the benefits of PR.

Weather reactions in persons with respiratory diseases who lives in conditions of the marine climate of Vladivostok

Introduction. The high prevalence of respiratory diseases is largely due to climate change. Violation of the adaptive-compensatory capabilities of the body, causing an inadequate response of homeostatic systems, is largely determined by a person’s short-term meteorological response to dramatically changing weather conditions. Materials and methods. The study included a control group (one hundred sixty three people), individuals with bronchial asthma (BA) (221 case) and chronic obstructive pulmonary disease (COPD) (148 patients). Short-term (± 1 day) meteor reaction of the respiratory function, cardiovascular and immune systems was assessed. The day of the examination was evaluated as a synchronous meteorological reaction, 1 day before the examination - a follow-up and 1 day after - a signal reaction. There was calculated an integral indicator (Dm%) which determines the percentage of correlations (r at p&lt;0.05) relative to the total amount (r) in the correlation matrix. Results. The compensatory capabilities of the cardio-respiratory and immune systems under the influence of weather conditions in the healthy population of the city are significantly higher than in COPD and BA cases. Day-to-day changes in weather conditions have the greatest negative impact on the respiratory system, especially in BA and COPD patients The least resistance of the organism was noted under the synchronous action of meteorological components. The greatest compensatory response was established during the signal meteoreaction. Limitations. A limitation is that the study identified a meteorological response in a specific area under a maritime monsoonal climate. Conclusion. The healthy population of the city is the most adapted to the local climate. In persons with respiratory diseases, the system of external respiratory is the most vulnerable. In the short-term consideration of the weather-induced reaction, the synchronous position exhibits the greatest negative effect on the main functional systems.

Causal association between iron deficiency anemia and chronic obstructive pulmonary disease: A bidirectional two-sample Mendelian randomization study

BackgroundObservational studies have found an association between iron deficiency anemia (IDA) and chronic obstructive pulmonary disease (COPD) risk. However, whether IDA plays a role in COPD development remains unclear. ObjectivesThis study was performed to explore the causal association between IDA and COPD. MethodsWe obtained summary statistics for IDA from 6087 cases and 211,115 controls of European ancestry in an open genome-wide association study (GWAS) to select strongly associated single nucleotide polymorphisms that could serve as instrumental variables for IDA (P < 5 × 10–8). Additional summary statistics for COPD were obtained from 6915 COPD cases and 186,723 controls of European ancestry from a publicly available GWAS. A bidirectional Mendelian randomization analysis was performed using inverse variance weighting as the primary method of analysis. The reliability of the results was verified by heterogeneity and sensitivity analysis. ResultsIDA increased the risk of COPD, with an odds ratio (OR) of 1.15 (95% confidence interval (CI: 1.04–1.25, p = 0.002). There was no evidence of a causal effect of COPD on IDA risk, with an OR of 0.99 (95% CI: 0.87–1.13, p = 0.91). The sensitivity analysis showed no evidence of heterogeneity or horizontal pleiotropy. ConclusionsWe found that IDA increases the risk of COPD. Additionally, there was no evidence that COPD increases the risk of IDA. Therefore, IDA should be considered in future COPD risk studies and reintroduced as a potential therapeutic target. The relationship between COPD and IDA risk requires further study using indirect mechanisms.

Bone metabolism characteristics and gender differences in patients with COPD: a cross-sectional study

BackgroundGender differences in bone metabolism of people with chronic obstructive pulmonary disease (COPD) remain unclear. We aim to explore the characteristics of bone metabolism and its clinical significance for patients with COPD.MethodsA total of 564 cases (282 COPD cases and 282 controls) were preselected. Clinical and analytical characteristics of these cases were assessed. After excluding patients with other conditions known to disturb calcium metabolism, 333 patients (152 COPD cases and 181 controls) were identified. The medical records, indexes of bone turnover markers, serum calcium and phosphorus of the 333 patients were collected and their correlation was analyzed.ResultsThe 152 cases with COPD were 82.61 ± 7.745 years, 78.3% males, and the 181 age- and sex-matched control cases were 79.73 ± 11.742 years, 72.4% males. Levels of total procollagen type I amino-terminal propeptide (tPINP), osteocalcin (OC), serum calcium and phosphate were significantly lower (P < 0.001) while the level of parathormone (PTH) was significantly higher (P = 0.004) in COPD than in controls. The 25-hydroxycholecalciferol (25(OH)D3) was below the lower limit of normal value (LLN) in both groups, which was significantly lower in COPD males than in control males (P = 0.026). In COPD group, PTH level was significantly higher in females (P = 0.006), and serum P was lower in males (P = 0.006). The adjusted linear regression analysis showed that the levels of tPINP, OC and serum Ca were decreasing greatly in COPD group [β (95%CI) − 8.958 (− 15.255 to − 2.662), P = 0.005; − 4.584 (− 6.627 to − 2.542), P < 0.001; − 0.065 (− 0.100 to − 0.031), P < 0.001]. Besides, smoke exposure, gender (male) were also related to hypocalcemia [β (95%CI) − 0.025 (− 0.045 to − 0.005), P = 0.017; − 0.041 (− 0.083 to − 0.001), P = 0.047], and 25(OH)D3 was correlated with serum calcium, phosphorus, and PTH [β (95%CI) 15.392(7.032–23.753), P < 0.001; − 7.287 (− 13.450 to − 1.124), P = 0.021; − 0.103(− 0.145 to − 0.061), P < 0.001], and female was more likely to have secondary hyperparathyroidism [β (95%CI) 12.141 (4.047–20.235), P = 0.002].ConclusionCOPD patients have remarkably low bone turnover (indicated by OC) and impaired bone formation (low tPINP), and they are also more prone to low calcium. Smoking and male may play roles in the formation of hypocalcemia, and the secondary hyperparathyroidism is more significant in COPD women. There may be gender differences in bone metabolism abnormalities and their mechanisms of COPD. The conclusion above still need further research and demonstration.