Parameters In Chronic Obstructive Pulmonary Disease Patients Research Articles

Association between exposure to specific PM2.5 constituents and environment, lifestyle, and clinical parameters in patients with COPD

ABSTRACT This study investigated the correlation between the individual chemical constituents of particulate matter 2.5 μm (PM2.5) and respiratory parameters as well as the living environment and daily behaviors in patients with chronic obstructive pulmonary disease (COPD). Data were obtained from prospective COPD panel conducted in South Korea. Following collection via a microPEM, 18 metallic elements were determined using energy-dispersive X-ray fluorescence spectroscopy. All participants completed detailed questionnaires on living environments and lifestyle practices. Eighty-nine stable COPD patients (mean age 68.1 years; 94.4% male) were analyzed. Several constituents (titanium, aluminum, bromine, and silicone) were significantly associated with respiratory outcomes. Copper and manganese concentrations were significantly associated with the living environment. Increased ventilation time and air purifier operation were associated with lower concentrations of copper, silicone, barium, and titanium. These findings suggest varying relationships between PM2.5 constituents and clinical parameters in COPD patients, providing a basis for personalized interventions and future research.

Assessment of rehabilitation effectiveness in patients with COPD as part of the project "PulmoRehab – Access to healthcare services through a personalized care system for patients with COPD, including remote monitoring and tele-rehabilitation based on Artificial Intelligence methods"

Introduction. In the project “PulmoRehab – Access to Healthcare Services through a Personalized Patient Care System for COPD including Remote Monitoring and Tele-rehabilitation Based on Artificial Intelligence Methods,” SP ZOZ Specialized Hospital Ministry of Internal Affairs and Administration in Głuchołazy and 10 partners conducted research on tele-rehabilitation for people suffering from Chronic Obstructive Pulmonary Disease (COPD). The tele-rehabilitation program, based on personalized approach and technology, allowed patients to use therapy at home or a convenient location. The project aimed to reduce social inequalities in healthcare by providing remote access to health services for COPD patients. Materials and Methods. The study involved 80 patients aged 50 to 76 years, hospitalized at Ministry of Internal Affairs and Administration’s Specialist Hospital of St. John Paul II, meeting specific criteria. Qualification for the tele-rehabilitation program took into account the assessment of exercise tolerance, dyspnea, fatigue, lung ventilatory function, and saturation. The program included exercises adapted to the individual needs of the patients. Results. Analysis of the results conducted using XLSTAT software 2021.2.2 showed statistically significant differences between spirometric values before and after rehabilitation. Similarly, significant improvement was observed in the results of the 6MWT test and blood saturation. The tele-rehabilitation program proved effective in improving respiratory health parameters in COPD patients. Conclusions. 1. The tele-rehabilitation program improves lung ventilatory function in people with COPD. It reduces the feeling of dyspnea, decreases fatigue, improves SpO2, and increases exercise tolerance, demonstrating the beneficial effects of the rehabilitation applied. 2. The obtained results encourage further research on a representative group with the use of randomization.

Cesium exposure and pulmonary function decline: Potential mediating role of oxidative stress in chronic obstructive pulmonary disease patients

Cesium (Cs) is one of alkali metals. Persistent low-dose Cs exposure damages pulmonary function in the general population. However, the associations between Cs exposure and pulmonary function alternation are inconsistent in chronic obstructive pulmonary disease (COPD) patients. Thus, the goal of this study was to estimate the association between blood Cs concentration and pulmonary function alternation and the potential role of oxidative stress in this association. Serum 8-iso-prostaglandin F2α (8-iso-PGF2α) and blood Cs were measured. A generalized additive model and smoothed curve fitting found a non-linear relationship between blood Cs concentration and pulmonary function in COPD patients. Under the inflection point of blood Cs, per 1-unit increase of blood Cs was related with reductions of 0.592 L (95% CI: −1.181, −0.004) in FVC and 32.479% (95% CI: −55.278, −9.680) in predicted FEV1% with adjustment for confounding variables. Smoking status aggravated Cs-caused pulmonary function reduction in COPD patients. Sensitivity analyses hinted that our results remained robust. Moreover, a negatively linear correlation (β = 0.232; 95% CI: 0.105, 0.359) between blood Cs within a certain range and serum 8-iso-PGF2α was observed. Further investigation elucidated serum 8-iso-PGF2α was inversely correlated with pulmonary function parameters in COPD patients. Additionally, mediation analysis suggested that 8-iso-PGF2α mediated 6.70% and 8.36% of the associations between blood Cs with the reductions of FEV1 and predicted FEV1%, respectively. Consequently, blood Cs was inversely associated with pulmonary function parameters, but positively related with serum 8-iso-PGF2α. Oxidative stress may exert an important role in mediating Cs exposure-associated pulmonary function reduction in COPD patients.

The Effect of Education and Motivational Interviewing on COPD Management and Outcome Parameters in COPD Patients.

Chronic obstructive pulmonary disease (COPD) is an important health problem. The disease management consists of avoiding risk factors, therapy for maintenance of disease stability, and prevention and treatment of exacerbations. Patient education and motivational interviewing are thought to be effective approaches in disease management. This study aimed to investigate the effects of repeated education and motivational interviewing conducted by a multidisciplinary team, and the outcomes in COPD patients. This was a randomized controlled study. The study included 40 COPD patients (21 cases and 19 controls) hospitalized for exacerbation of COPD between June 2015 and June 2017. The patients were randomized in a ratio of 1 : 1 based on age, gender, and socioeconomic status. After a baseline assessment for all patients, patients in the study group were subjected to a total of 3 educational sessions and 4 motivational interview sessions through intermittent invitations over a period of one year. At the end of the first year, baseline assessment tests, the technique of drug use, the number of moderate/severe COPD exacerbations, and mortality status were evaluated for all patients. There was no difference between the groups in terms of age, gender, and pulmonary function tests (FEV1%, FEV1/FVC) and partial oxygen and carbon dioxide pressures (pO2 and pCO2). At the end of the 12 months, there was a statistically significant difference between the groups in terms of the levels of theoretical knowledge of COPD and the Morisky scale scores. All patients in the study group survived, whereas 4 patients died in the control group, with a statistically significant difference between the 2 groups. One-to-one education and motivational interviews (MI) on COPD, which are based on a multidisciplinary approach, are proposed, because they increase the level of knowledge of the disease and adherence to treatment, and have positive effects on mortality rates.

Activation of immune cell proteasomes in peripheral blood of smokers and COPD patients: implications for therapy.

BackgroundImmune cells contain a specialised type of proteasome, i.e. the immunoproteasome, which is required for intracellular protein degradation. Immunoproteasomes are key regulators of immune cell differentiation, inflammatory activation and autoimmunity. Immunoproteasome function in peripheral immune cells might be altered by smoking and in chronic obstructive pulmonary disease (COPD), thereby affecting immune cell responses.MethodsWe analysed the expression and activity of proteasome complexes in peripheral blood mononuclear cells (PBMCs) isolated from healthy male young smokers as well as from patients with severe COPD and compared them with matching controls.ResultsProteasome expression was upregulated in COPD patients as assessed by quantitative reverse transcriptase-PCR and mass spectrometry-based proteomic analysis. Proteasome activity was quantified using activity-based probes and native gel analysis. We observed distinct activation of immunoproteasomes in the peripheral blood cells of young male smokers and severely ill COPD patients. Native gel analysis and linear regression modelling confirmed robust activation and elevated assembly of 20S proteasomes, which correlated significantly with reduced lung function parameters in COPD patients. The immunoproteasome was distinctly activated in COPD patients upon inflammatory cytokine stimulation of PBMCs in vitro. Inhibition of the immunoproteasome reduced pro-inflammatory cytokine expression in COPD-derived blood immune cells.ConclusionsGiven the crucial role of chronic inflammatory signalling and the emerging involvement of autoimmune responses in COPD, therapeutic targeting of the immunoproteasome might represent a novel therapeutic concept for COPD.

FEV1 is independently related with impaired left atrial strain in chronic obstructive pulmonary disease patients: A speckle tracking study.

Atrial fibrillation (AF) is common in chronic obstructive pulmonary disease (COPD) patients. It is known that impaired forced expiratory volume in 1s (FEV1) is one of the risk factors of cardiovascular disease. Two-dimensional speckle tracking echocardiography (2D-STE) can detect deterioration of left atrial mechanical functions in the subclinical stage. We hypothesized that reduced lung functions, measured by FEV1 in COPD patients, may be associated with impaired left atrial (LA) mechanical functions. Present study included 127 consecutive COPD patients. We divided study population into two groups: patients with normal LA strain (n = 20) or with impaired LA strain (n = 107). In univariate logistic regression analysis, age (p: 0.001), FEV1% (p < 0.001), FEV1 (p < 0.001), FEV1/forced vital capacity (FVC) (p: 0.014), white blood cell (p: 0.012), LA Max vol (p: 0.026), C-reactive protein (p :0.001), arterial oxygen pressure (PaO2 ) (p: 0.019), arterial oxygen saturation (SO2 ) (p: 0.021), left ventricle ejection fraction (LVEF) (p: 0.042), and mitral A-wave velocity (p: 0.017) were associated with impaired LA-strain. In multivariate logistic regression analysis, age (p: 0.043), FEV1 (p < 0.001), LA Max vol (p: 0.004), and LVEF (p: 0.004) were independently associated with impaired LA strain. FEV1 is associated with impaired left atrial strain independently of arterial blood gas and left ventricular diastolic dysfunction parameters in COPD patients with preserved left ventricular systolic function.

Computerized Tomography Image Feature under Convolutional Neural Network Algorithm Evaluated for Therapeutic Effect of Clarithromycin Combined with Salmeterol/Fluticasone on Chronic Obstructive Pulmonary Disease.

This study was to explore the use of convolutional neural network (CNN) for the classification and recognition of computerized tomography (CT) images of chronic obstructive pulmonary disease (COPD) and the therapeutic effect of clarithromycin combined with salmeterol/fluticasone. First, the clinical data of COPD patients treated in hospital from September 2018 to December 2020 were collected, and CT and X-ray images were also collected. CT-CNN and X ray-CNN single modal models were constructed based on the LeNet-5 model. The randomized fusion algorithm was introduced to construct a fused CNN model for the diagnosis of COPD patients, and the recognition effect of the model was verified. Subsequently, the three-dimensional reconstruction of the patient's bronchus was performed using the classified CT images, and the changes of CT quantitative parameters in COPD patients were compared and analyzed. Finally, COPD patients were treated with salmeterol/fluticasone (COPD-C) and combined with clarithromycin (COPD-T). In addition, the differences between patients' lung function indexes, blood gas indexes, St. George respiratory questionnaire (SGRQ) scores, and the number of acute exacerbations (AECOPD) before and after treatment were evaluated. The results showed that the randomized fusion model under different iteration times and batch sizes always had the highest recognition rate, sensitivity, and specificity compared to the two single modal CNN models, but it also had longer training time. After CT images were used to quantitatively evaluate the changes of the patient's bronchus, it was found that the area of the upper and lower lung lobes of the affected side of COPD patients and the ratio of the area of the tube wall to the bronchus were significantly changed. The lung function, blood gas index, and SGRQ score of COPD-T patients were significantly improved compared with the COPD-C group (P < 0.05), but there was no considerable difference in AECOPD (P > 0.05). In summary, the randomized fusion-based CNN model can improve the recognition rate of COPD, and salmeterol/fluticasone combined with clarithromycin therapy can significantly improve the clinical treatment effect of COPD patients.

Microalbuminuria and serum CRP: potential biomarkers for cardiovascular risk among stable COPD

Background: Cardiovascular disease is one of the major causes of mortality in chronic obstructive pulmonary disease (COPD) patients. Both microalbuminuria (MAB) and raised serum C-reactive protein (CRP) levels have strong association with cardiovascular events as they reflect generalized endothelial vascular dysfunction. The objectives of the study are (i) to assess the prevalence of MAB and serum CRP levels in stable COPD patients and (ii) to find out the relationship of MAB and serum CRP with clinical and physiological parameters in COPD patients. Methods: This comparative cross-sectional study was carried out on COPD patients attending OPD at Institute of Respiratory Diseases, Jaipur during the year from 2019 to 2020. Forty stable COPD patients and 40 healthy controls were enrolled in the study. Spot urinary albumin/creatinine ratio, serum CRP levels, smoking history, spirometry, blood gases, body mass index, and BMI, Obstruction (FEV1% predicted), Dyspnea (mMRC grading), Exercise Capacity (6 MWD) (BODE) index were assessed. Results: Out of 40 cases, 23(56%) had MAB and 38 (95%) had serum CRP levels >3 mg/L. There was a negative correlation between forced expiratory volume in one second (FEV1), partial pressure of oxygen in arterial blood (PaO2) levels and 6 MWD with both MAB levels and S.CRP levels respectively. There was a positive correlation between BODE Index and modified British Medical Research Council grading with both MAB levels and serum C reactive protein (S.CRP) levels respectively. There was a positive correlation between BODE index and modified British Medical Research Council grading with both MAB and S.CRP levels. Conclusion: COPD patients of varying severity should be screened regularly with MAB and serum CRP levels to determine the risk and progression of cardiovascular consequences so that adequate decision of interventional strategies can be taken out to prolong survival in COPD patients.

Lipid profile and atherogenic indices in patients with stable chronic obstructive pulmonary disease

Background and aimsLimited number of studies investigated lipid profile in chronic obstructive pulmonary disease (COPD) with inconsistent results. This study aimed to investigate lipid parameters in sera of patients with stable COPD and their associations with disease severity, smoking, comorbidities and therapy. Methods and resultsThe study included 137 COPD patients and 95 controls. Triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed. Non-HDL-C (NHC), atherogenic coefficient (AC), TG/HDL-C, atherogenic index of plasma (AIP), Castelli's risk index I and II (CRI-I, CRI-II), and monocyte to HDL ratio (MHR) were calculated.HDL-C and MHR were increased, while other lipid parameters and indices were decreased in COPD patients compared to healthy individuals. Smoking did not influence lipid parameters. However, lipid profile was altered only in more severe disease stages. AC, CRI-I and CRI-II showed positive association with lung function parameters in COPD patients, and negative with COPD multicomponent indices (ADO, BODCAT, BODEx, CODEx and DOSE). Combined model that included CRI-II, C-reactive protein, fibrinogen and white blood cells showed great diagnostic performances, and correctly classified 72% of study participants with an AUC of 0.800 (0.742–0.849), P < 0.001. Bronchodilator monotherapy and statins have opposite impact on TC, LDL-C and NHC, while TG, TG/HDL-C and AIP were increased in COPD patients with cardiovascular diseases. ConclusionLipid disbalance is present in COPD, and it seems to occur later as the disease progresses. Further studies are needed to illuminate the underlying mechanism of dyslipidaemia.

Combining Bioimpedance and Myographic Signals for the Assessment of COPD During Loaded Breathing.

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic conditions. The current assessment of COPD requires a maximal maneuver during a spirometry test to quantify airflow limitations of patients. Other less invasive measurements such as thoracic bioimpedance and myographic signals have been studied as an alternative to classical methods as they provide information about respiration. Particularly, strong correlations have been shown between thoracic bioimpedance and respiratory volume. The main objective of this study is to investigate bioimpedance and its combination with myographic parameters in COPD patients to assess the applicability in respiratory disease monitoring. We measured bioimpedance, surface electromyography and surface mechanomyography in forty-three COPD patients during an incremental inspiratory threshold loading protocol. We introduced two novel features that can be used to assess COPD condition derived from the variation of bioimpedance and the electrical and mechanical activity during each respiratory cycle. These features demonstrate significant differences between mild and severe patients, indicating a lower inspiratory contribution of the inspiratory muscles to global respiratory ventilation in the severest COPD patients. In conclusion, the combination of bioimpedance and myographic signals provides useful indices to noninvasively assess the breathing of COPD patients.

The incidence of polyneuropthy and its relation with disease parameters in chronic obstructive pulmonary disease

Objective: Chronic Obstructive Pulmonary Disease (COPD) is accompanied by several concomitant conditions due to its systemic effects. Hypoxia and oxidative stress associated with COPD are also believed to contribute to the disease course through the effects of several inflammatory mediators. Major causative agents causing of peripheral neuropathy are age, hypoxia, duration and severity of COPD, hypercapnia and smoking. The present study aimed to investigate the incidence of polyneuropathy and its relation with disease parameters in COPD patients. Methods: Of a total number of 45 patients who had been followed up between January 1, 2015 and December 31, 2016 with a diagnosis of COPD at Ufuk University School of Medicine were enrolled retrospectively. All patients underwent electroneuromyography, arterial blood gas measurements and pulmonary function tests. Patients were divided as those with or without neuropathy, and factors contributing to the development of neuropathy were investigated based on clinical and laboratory findings. Results: Eleven (24.4%) patients were women and 34 (74.6%) were men, and the mean age was 73.2 years. Mean PaO2 was 58.2 mmHg, pCO2 was 41.2 mmHg, and FEV1 was 45.3%. Neuropathy was diagnosed in twenty (44.4%) patients. Significant differences were found in pO2, pCO2, SO2, mMRC, smoking status and number of exacerbations per year (p &amp;lt; 0.05). Conclusions: Patients who experience frequent exacerbations and those with hypoxemia or hypercapnia as demonstrated should be taken into more careful clinical assessments with respect to polyneuropathy.

Association between blood pressure, inflammation and spirometry parameters in chronic obstructive pulmonary disease.

Background/AimsMany systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction.MethodsWe included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups.ResultsIn COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV1%). Diastolic blood pressure was associated with pH and HCO3 levels. The mean night time, day time pulse pressures and 24- hour pulse per minute values were also associated with all the parameters except FEV1%.ConclusionsIn this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.

Left ventricular dysfunction in relation with systemic inflammation in chronic obstructive pulmonary disease patients.

Background/AimsMost important cause of mortality in chronic obstructive pulmonary disease (COPD) patients is known to be cardiovascular disease (CVD). The objective of the present study was to evaluate the echocardiographic parameters in COPD patients with or without pre-diagnosed CVD and to investigate the relationship between echocardiographic parameters and systemic inflammation markers.MethodsA total of 60 stable COPD patients (23 patients with CVD, group 1; 37 patients without CVD, group 2) and 21 healthy controls (group 3) were included in the study. Six-minute walking test (6MWT), COPD assessment test (CAT), and Body mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index results were recorded. High-sensitivity C-reactive protein (HsCRP), interleukin 8 (IL-8), fetuin-A, Clara cell protein (CCL-16), N-terminal pro-brain natriuretic peptide levels were studied in serum. Parameters of left and right ventricular systolic and diastolic function were measured by echocardiography.ResultsPatients with COPD had higher levels of systemic inflammation markers and lower level of inflammation inhibitor fetuin-A. When three groups were compared, group 1 had lower 6MWT result. HsCRP was highest in group 2 while other inflammatory markers were similar in groups 1 and 2. Regarding echocardiographic parameters, left ventricular ejection fraction (LVEF) was lower and left ventricle end-diastolic diameter (LVED), left ventricle end-systolic diameter (LVES) diameters were higher in group 1. The aortic diameter was higher in COPD patients. Fetuin-A was correlated with diameter of aorta and LVES. LVEF, LVED, and LVES were found to be correlated with functional parameters of COPD cases.ConclusionsIn COPD, left ventricular functions are affected as well as right ventricle before prominent clinical findings of cardiac disease and these echocardiographic parameters correlate with functional parameters of COPD patients.

The Impact of Pursed-lips Breathing Maneuver on Cardiac, Respiratory, and Oxygenation Parameters in COPD Patients.

BACKGROUND:Respiratory system, together with the cardiovascular and central nervous system, is responsible for all processes related to oxygenation and hemodynamics and the defect in the functioning of each of these systems, along with ageing, can have mutual effects on their performance and physiological symptoms. The use of Pursed-lips Breathing (PLB) training is an essential part of the treatment of patients with the obstructive pulmonary disease, PLB stimulates the autonomic nervous system and causes relaxation and improvement of physiological parameters.AIM:This study was conducted to evaluate the effect of PLB on cardiac, pulmonary and oxygenation level in patients with Chronic Obstructive Pulmonary Disease (COPD).METHODS:A three-group clinical trial study with experimental and control which was purposefully conducted with the participation of patients with COPD and healthy individuals referring to Madani hospital Khoy, in 2017. The sample size was selected to be 60 subjects. The patients were randomly allocated to two groups of intervention and control with 20 patients, and 20 healthy subjects were assigned to the healthy intervention group. The demographic, anthropometric information form and checklist recording changes in levels of oxygenation, respiration, temperature, heart rate and blood pressure with cardiopulmonary follow up in three stages before, during and after PLB were used for data collection. Data were analysed using descriptive statistics, repeated measure test, ANOVA, and Chi-square.RESULTS:On evaluation within the COPD patient intervention group in Saturation of Peripheral Oxygen (SPO2) index with the mean difference of 2.05 percent, Respiratory Rate(RR)-0.65 minute and Pulse Rate(PR)-1.6 bpm was significant (p ≤ 0.05), and systolic blood pressure index in healthy subjects was increased (3.35 mmHg).CONCLUSION:The results of this study indicated that using effective PLB as an easy, inexpensive, non- invasive and non-pharmacological method is considered as an important factor in improving the status of oxygenation and physiological indicators in patients with COPD and should be considered as an important part of rehabilitation programs for these patients.

Echocardiographic Findings in Chronic Obstructive Pulmonary Disease Patients

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is parenchymal lung disease with systemic effects and hemodynamic alteration more so in pulmonary circulation. In COPD, right ventricular (RV) after load increases due to structural and mechanical changes in the pulmonary vascular bed leading to increase in pulmonary arterial pressure which also leads to alteration in structure and function of RV. In COPD, congestive cardiac failure and ventricular dysfunction may coexist and demands proper assessment and management of dual condition.Objectives: This study was aimed to study the effect of COPD in cardiac anatomical and functional parameters in COPD patients in Shree Birendra Hospital.Methodology: This study was a retrospective review of hospital data on echocardiographic findings in 86 COPD patients visiting the outpatient department (OPD) in six months from June 2016 to December 2016. Available data was entered, edited and analyzed using Statistical package for social sciences (SPSS) version 22.Results: Among 86 cases studied, 43% had dilated RA and 41% with dilated RV, 24% with dilated LA and dilated LV in 22%. Normal pulmonary artery pressure was present in 41 (48%) cases and 45(52 %) individuals were having PAH. Among valvular disorder tricuspid regurgitation was commonest (50%). Left ventricle abnormalities like dilated left ventricles, LVDD, concentric ventricular hypertrophy, LVSD were also presented in significant number of COPD patients counting 22%, 37%, 7%, 30% respectively. Among the various factors analyzed in echocardiogram; there was significant association between the PAH with right atrial dilatation, right ventricular dilatation, left atrial dilatation, LVDD, tricuspid regurgitation (p&lt;0.05) while rest of the parameters were not statistically significant association.Conclusion: COPD in most instances associated with some form of cardiac abnormalities like PAH, LVDD, LVSD, TR, dilated cardiac chambers so echocardiographic evaluation in timely basis has pivotal role in COPD cases to detect hemodynamic and mechanical alterations. BJHS 2018;3(1)5 : 342-345

Expression of Toll-like Receptor 2 and 4 in Peripheral Blood Neutrophil Cells from Patients with Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality around the world. Preliminary studies have evaluated the association between innate immunity including Toll-like receptors (TLRs) and airway samples of patients with COPD. The role of TLRs in peripheral blood neutrophils is poorly understood. Hence, this study aimed to investigate the role of TLR2 and TLR4 in peripheral blood neutrophils of COPD patients. A total of 101 COPD cases and an equal number of healthy controls participated in this case-control study. Peripheral blood neutrophils were isolated from all participants and cultured for 24 hours through lipopolysaccharide (LPS) stimulation. The gene expressions of TLR2 and TLR4 were assessed by real-time polymerase chain reaction. The protein levels of interleukin (IL)-8 and matrix metalloproteinase (MMP)-9 were measured in neutrophils cell culture supernatants using enzyme-linked immunosorbent assay (ELISA). The levels of IL-8 and MMP-9 were significantly higher in patients with COPD compared to healthy controls. Similarly, the gene expression of TLR2 and TLR4 were increased in LPS stimulated peripheral blood neutrophils of patients with COPD. Smoke pack years was positively correlated with IL-8 levels and negatively correlated with forced expiratory volume in the first second % (r = -0.33; p = 0.023) and FEV1/forced vital capacity (FVC) (r = -0.27; p = 0.011). The increased expression of TLR2 and TLR4 suggests its role in disease pathogenesis of COPD. Smoke pack years was negatively associated with spirometric parameters in COPD patients. This may help to predict the smokers without COPD who risk developing the condition in the future.

The impact of concomitant syndrome of somatopsychic dysfunction on the quality of patients with chronic obstructive pulmonary disease life

The aim – to estimate the quality of life (QOL) parameters in patients with chronic obstructive pulmonary disease (COPD), depending on the type and severity of concomitant clinically significant integrative syndrome of somatopsychic dysfunction (SPD). Materials and м ethods. 306 COPD patients (224 (73.2 %) men and 82 (26.8 %) women, average age (65.3 ± 0.6) years) were examined by conventional methods in pulmonology practice. Among them clinical group A had 38 (12.4 %) patients, group B – 122 (39.9 %), group C – 28 (9.2 %), and a clinical group D – 118 (38.5 %) patients. The control group consisted of 100 healthy individuals and was representative to the main by age and gender. Psychic status of respondents was determined by the complex of standardized questionnaire method. QOL was assessed using the International Ukrainian version of the QOL questionnaire MOS SF-36. Statistical analysis of the data was made using statistical software package SPSS 20.0 for Windows. Results. It has been established that the prevalence of clinically significant integrative syndrome of SPD in COPD patients was 68 (22.2 %) patients and in the group of healthy individuals – 2 (2.0 %) persons. It has been found that patients with COPD had statistically significantly lower mean scores on all QOL parameters compared with healthy individuals (p < 0.001). The average values of all QOL parameters in COPD patients with clinically significant syndrome of SPD were statistically significantly lower than those in patients with insignificant disorders and compared with the average values in the entire cohort of COPD patients (p < 0.001). It has been established that in COPD patients with the same severity of the disease course the mean values of the QOL parameters were significantly decreased in the presence of a clinically significant SPD syndrome (p < 0.05). Conclusions. Thus, patients with COPD in the presence of clinically significant SPD syndrome are characterized by significantly lower average values of QOL parameters by indicators of physical, mental and social status, and this demonstrates the presence of maladaptation to the society in these patients.

Effects of Combined Aerobic-Strength Training vs Fitness Education Program in COPD Patients.

We compared the effects of a new physical activity education program approach (EDU), based on a periodically supervised protocol of different exercise modalities vs traditionally supervised combined strength-endurance training (CT) on health-related factors in patients with stable chronic obstructive pulmonary disease (COPD). Twenty-eight COPD patients without comorbidities were randomly assigned to receive either EDU or CT. CT was continuously supervised to combine strength-endurance training; EDU was taught to progressively increase the rate of autonomous physical activity, through different training modalities such as Nordic walking, group classes and circuit training. Body composition, walking capacity, muscle strength, flexibility and balance, total daily energy expenditure and quality of life were evaluated at baseline, after 28 weeks training period (3d/week) and after a 14-week follow-up. No adverse events occurred during the interventions. After training, CT and EDU similarly improved walking capacity, body composition and quality of life. However, after 14 weeks of follow-up, such improvements were not maintained. Only in CT, muscle strength and flexibility improved after training but returned to baseline after follow-up. EDU, similar to CT, can effectively and safely improve health-related parameters in COPD patients. EDU could be an attractive alternative to traditional supervised training for improving quality of life in COPD patients.

Relationship of the Content of Systemic and Endobronchial Soluble Molecules of CD25, CD38, CD8, and HLA-I-CD8 and Lung Function Parameters in COPD Patients.

The definition of new markers of local and systemic inflammation of chronic obstructive pulmonary disease (COPD) is one of the priority directions in the study of pathogenesis and diagnostic methods improvement for this disease. We investigated 91 patients with COPD and 21 healthy nonsmokers. The levels of soluble CD25, CD38, CD8, and HLA-I-CD8 molecules in the blood serum and exhaled breath condensate (EBC) in moderate-to-severe COPD patients during exacerbation and stable phase were studied. An unidirectional change in the content of sCD25, sCD38, and sCD8 molecules with increasing severity of COPD was detected. The correlations between the parameters of lung function and sCD8, sCD25, and sHLA-I-CD8 levels in the blood serum and EBC were discovered in patients with severe COPD. The findings suggest a pathogenetic role of the investigated soluble molecules of the COPD development and allow considering the content of sCD8, sCD25, and sHLA-I-CD8 molecules as additional novel systemic and endobronchial markers of the progression of chronic inflammation of this disease.

Prediction of exacerbation onset in chronic obstructive pulmonary disease patients

The objective of this study was to develop an algorithm for prediction of exacerbation onset in Chronic Obstructive Pulmonary Disease (COPD) patients based on continuous self-monitoring of physiological parameters from telehome-care monitoring. 151 physiological parameters of COPD patients were monitored on a daily/weekly basis for up to 2 years. Data were segmented in 30-day periods leading up to an exacerbation (exacerbation episode) and starting from a 14-day recovery period post-exacerbation (control episode) and tested in 6 intervals to predict exacerbation onset using k-nearest neighbour (k = 1, 3, 5). A classifier with sensitivity of 73%, specificity of 74%, positive predictive value of 69%, negative predictive value of 78% and an accuracy of 74% was achieved using data intervals consisting of 5 days. Intelligent processing of physiological recordings have potential for predicting exacerbation onset.