Mechanisms of asthma and allergic inflammationComputed tomographic scan–diagnosed chronic obstructive pulmonary disease–emphysema: Eotaxin-1 is associated with bronchodilator response and extent of emphysema
Section snippets
Study subjects
Subjects with COPD were recruited based on chest CT scan evidence of emphysema, pulmonary function studies, and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) clinical evaluation (history of chronic cough, sputum production, and dyspnea).10 They also completed a standardized COPD questionnaire (ie, St George Questionnaire; possible score, 0-100).11 Healthy individuals were nonsmokers who had no evidence of disease on history and physical examination and had a normal chest CT
COPD study subject CT scan results, pulmonary function test results, and clinical characteristics
The subjects with COPD (n = 16) had evidence of significant emphysema based on their chest CT scan results and FEV1 values (Fig 1). In contrast, none of the subjects in either the healthy nonsmoking group (n = 7) or the current smoker group (n = 8) had evidence of COPD on chest CT scan or abnormalities of pulmonary function (Fig 1).
Subjects with COPD-E had a significantly higher chest CT scan score (36.8% ± 4.0% voxels < −920 HU) compared with those of either the healthy nonsmoking group (3.3%
Discussion
In this study we have demonstrated that subjects with GOLD stage III moderate-to-severe COPD-E (enrolled on the basis of CT scan evidence of emphysema rather than pulmonary function testing) express a biomarker profile (ECP-1 and eotaxin-1) associated with bronchodilator responsiveness and also correlated with the extent of emphysema on CT scanning. The significant correlation between BAL fluid ECP level and the extent of emphysema on chest CT scanning raises the possibility that activated
References (20)
- et al.
Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial
Lancet
(2000) - et al.
Density mask. An objective method to quantitate emphysema using computed tomography
Chest
(1988) - et al.
Eosinophilic inflammation is associated with elevation of interleukin-5 in the airways of patients with spontaneous symptomatic asthma
J Allergy Clin Immunol
(1995) - et al.
Expression of IFN-gamma-inducible protein; monocyte chemotactic proteins 1, 3, and 4; and eotaxin in TH1- and TH2-mediated lung diseases
J Allergy Clin Immunol
(2001) - et al.
Characteristics of airway inflammation and bronchodilator reversibility in COPD. A potential guide to treatment
Chest
(2004) Chronic obstructive pulmonary disease
N Engl J Med
(2000)- et al.
Asthma
N Engl J Med
(2001) - et al.
Bronchodilator response in chronic obstructive pulmonary disease
Am Rev Respir Dis
(1986) - et al.
Differences in airway inflammation in patients with fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease
Am J Respir Crit Care Med
(2003) - et al.
Factors associated with persistent airflow limitation in severe asthma
Am J Respir Crit Care Med
(2001)
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Novel pharmacological strategies to treat cognitive dysfunction in chronic obstructive pulmonary disease
2022, Pharmacology and TherapeuticsCitation Excerpt :Studies have reported increases in eosinophils in pulmonary biopsies (Pesci et al., 1998; Pesci, Majori, et al., 1998; Saetta et al., 1994) and that eosinophils are associated with a reduction of lung function in COPD patients, as evidenced by reductions in FEV1 (Pesci, Majori, et al., 1998). Moreover, people with COPD displaying chronic bronchitis and emphysema presented with increased levels of activated eosinophils in the large-airway subepithelia and broncho alveolar lavage fluid respectively (Lams, Sousa, Rees, & Lee, 2000; Miller et al., 2007). Therefore, eosinophils could potentially be contributing to obstructive phenotypes observed in patients with COPD.
Eosinophils in COPD: just another biomarker?
2017, The Lancet Respiratory MedicineAre asthma and COPD a continuum of the same disease?
2015, Journal of Allergy and Clinical Immunology: In PracticeThe role of CT scanning in multidimensional phenotyping of COPD
2011, ChestCitation Excerpt :However, these differences could be accounted for by differences in study design. Interestingly, Miller and colleagues42 found close correlations between eosinophil degradation products and EM score in a group of well-characterized patients with COPD, suggesting that these may contribute to the progression of EM. In this study, we have shown that FEV1 using regression model analysis was not predictive for the identification of EM, BE, or BWT on CT scan.
Persistent airway inflammation and emphysema progression on CT scan in ex-smokers observed for 4 years
2011, ChestCitation Excerpt :In brief, subjects with COPD-E were recruited based on clinical evaluation and chest CT scan evidence of emphysema, which had to be present to be included in the study, whereas control subjects were required to have no clinical evidence of COPD and a normal chest CT scan.16 Subjects also completed pulmonary function studies, clinical evaluation (history of chronic cough, sputum production, dyspnea), and a standardized COPD questionnaire (ie, St. George Questionnaire).16 The COPD-E cohort (n = 10) we enrolled was composed of subjects with GOLD (Global Initiative for Chronic Lung Disease) stage IIb moderately severe COPD (FEV1 30%-50%), with chest CT scan evidence of significant emphysema.16
Biomarkers in COPD
2010, Pulmonary Pharmacology and TherapeuticsCitation Excerpt :Levels of eosinophil cationic protein (ECP), myeloperoxidase, and IL-8 are frequently increased in patients with COPD and in healthy smokers compared with healthy non-smokers, an observation suggesting that smoking, rather COPD itself, induces the changes [3]. It has been reported that BAL neutrophil markers [49], and both BAL and epithelial cell CD8+ T cell numbers [46] were inversely associated with FEV1, while ECP and eotaxin-1 levels were positively associated with bronchodilator response and the extent of radiographic emphysema [50]. Recently, it has been documented that in the BAL fluid compartment of COPD patients, the total recovered lipid metabolite amount, particularly prostaglandin D2 and eicosapentaenoic acid show a remarkable linear correlation with lung function [51].
Supported by National Institutes of Health grants HL72342 and GCRC MO1RR000827.
Disclosure of potential conflict of interest: M. Miller, J. Ramsdell, P. J. Friedman, J. Y. Cho, M. Renvall, and D. H. Broide have received grant support from the National Institutes of Health.