Background: Introduction of novel therapies for cystic fibrosis (CF) raises the question of whether traditional treatments can be withdrawn. Nebulized hypertonic saline (HS) potentially could be discontinued in patients receiving dornase alfa (DA).
Research Question: In the era before modulators, did people with CF who are F508del homozygous (CF) and who received DA and HS have better preserved lung function than those treated with DA only?
Study Design And Methods: Retrospective analysis of the Cystic Fibrosis Foundation Patient Registry data (2006-2014). Among 13,406 CF with data for at least 2 consecutive years, 1,241 CF had spirometry results and were treated with DA for 1 to 5 years without DA or HS during the preceding (baseline) year. Absolute FEV % predicted change while receiving DA and HS, relative to treatment with DA only, was the main outcome. A marginal structural model was applied to assess the effect of 1 to 5 years of HS treatment while controlling for time-dependent confounding.
Results: Of 1,241 CF, 619 patients (median baseline age, 14.6 years; interquartile range, 6-53 years) received DA only and 622 patients (median baseline age, 14.55 years; interquartile range, 6-48.1 years) were treated with DA and HS for 1 to 5 years. After 1 year, patients receiving DA and HS showed FEV % predicted that averaged 6.60% lower than that in patients treated with DA only (95% CI, -8.54% to -4.66%; P < .001). Lower lung function in the former relative to the latter persisted throughout follow-up, highlighting confounding by indication. After accounting for baseline age, sex, race, DA use duration, baseline and previous year's FEV % predicted, and time-varying clinical characteristics, patients treated with DA and HS for 1 to 5 years were similar to those treated with DA only regarding FEV % predicted (year 1: mean FEV % predicted change, +0.53% [95% CI, -0.66% to +1.71%; P = .38]; year 5: mean FEV % predicted change, -1.82% [95% CI, -4.01% to +0.36%; P = .10]).
Interpretation: In the era before modulators, CF showed no significant difference in lung function when nebulized HS was added to DA for 1 to 5 years.
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http://dx.doi.org/10.1016/j.chest.2023.05.024 | DOI Listing |
Food Res Int
January 2025
Frontiers Science Center for Animal Breeding and Sustainable Production (Huazhong Agricultural University), Ministry of Education, Wuhan 430070, China; Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, Huazhong Agricultural University, Wuhan 430070, China. Electronic address:
Establishing a high-throughput detection technology for amino acid (AA) content in milk using mid-infrared (MIR) spectroscopy has profound implications for enhancing nutritional value of milk, identifying superior milk sources, producing specialty dairy products, and expanding Dairy Herd Improvement (DHI) metrics. The aim of this study was to evaluate the effectiveness of MIR spectroscopy in predicting the content of 15 individual total AA (TAAs) and 16 free AA (FAAs) in bovine milk as well as to investigate the major factors affecting the phenotypic variability of AA content. From March 2023 to March 2024, 513 milk samples were collected from 10 Holstein dairy farms in China and analyzed using Bentley spectrometers for MIR measurements.
View Article and Find Full Text PDFEBioMedicine
December 2024
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Harvard Medical School, Boston, MA, 02115, USA. Electronic address:
Background: Genetic variants and gene expression predict risk of chronic obstructive pulmonary disease (COPD), but their effect on COPD heterogeneity is unclear. We aimed to define high-risk COPD subtypes using genetics (polygenic risk score, PRS) and blood gene expression (transcriptional risk score, TRS) and assess differences in clinical and molecular characteristics.
Methods: We defined high-risk groups based on PRS and TRS quantiles by maximising differences in protein biomarkers in a COPDGene training set and identified these groups in COPDGene and ECLIPSE test sets.
Chest
January 2025
Department of Internal Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Germany; Institute for Lung Health, Cardio-Pulmonary Institute (CPI), Giessen, Germany. Electronic address:
Background: Patients with COPD frequently demonstrate pulmonary hypertension (PH). Severe PH in patients with COPD, identified by pulmonary vascular resistance (PVR) of > 5 Wood units (WU), is closely linked to impaired transplant-free survival. The impact of PH-targeting pharmacotherapy in this context remains unclear.
View Article and Find Full Text PDFBackground: The relationships between spirometric assessment of lung function and symptoms (including exacerbations) in patients with asthma and/or chronic obstructive pulmonary disease (COPD) in a real-life setting are uncertain.
Objectives: To assess the relationships between baseline post-bronchodilator (post-BD) spirometry measures of lung function and symptoms and exacerbations in patients with a physician-assigned diagnosis of asthma and/or COPD.
Design: The NOVEL observational longiTudinal studY (NOVELTY) is a global, prospective, 3-year observational study.
Am J Ind Med
August 2024
Environmental and Occupational Health Sciences Division, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA.
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