AI Article Synopsis
- Inhaled corticosteroids (ICS) have proven to be very effective for treating asthma but show only modest benefits for COPD.
- A study tested whether the size of bronchial airway smooth muscle cells (ASMC) in COPD patients correlates with their responsiveness to ICS.
- Results indicated that patients with high ASMC area (HASMC) experienced significant improvements in lung function when using ICS, while those with low ASMC area (LASMC) did not show considerable benefits, suggesting that ASMC size could help predict treatment outcomes for COPD patients.
Article Abstract
Background: Although inhaled corticosteroids (ICS) are highly effective in asthma, they provide significant, but modest, clinical benefit in COPD. Here, we tested the hypothesis that high bronchial airway smooth muscle cell (ASMC) area in COPD is associated with ICS responsiveness.
Methods: In this investigator-initiated and -driven, double-blind, randomised, placebo-controlled trial (HISTORIC), 190 COPD patients, Global Initiative for Chronic Obstructive Lung Disease stage B-D, underwent bronchoscopy with endobronchial biopsy. Patients were divided into groups A and B, with high ASMC area (HASMC: >20% of the bronchial tissue area) and low ASMC area (LASMC: ≤20% of the bronchial tissue area), respectively, and followed a run-in period of 6 weeks on open-label triple inhaled therapy with aclidinium (ACL)/formoterol (FOR)/budesonide (BUD) (400/12/400 μg twice daily). Subsequently, patients were randomised to receive either ACL/FOR/BUD or ACL/FOR/placebo and followed for 12 months. The primary end-point of the study was the difference in post-bronchodilator forced expiratory volume in 1 s (FEV) over 12 months between patients with LASMC and HASMC receiving or not receiving ICS.
Results: In patients with LASMC, ACL/FOR/BUD did not significantly improve FEV over 12 months, as compared to ACL/FOR/placebo (p=0.675). However, in patients with HASMC, ACL/FOR/BUD significantly improved FEV, as compared to ACL/FOR/placebo (p=0.020). Over 12 months, the difference of FEV change between the ACL/FOR/BUD group and the ACL/FOR/placebo group was 50.6 mL·year within the group of patients with LASMC and 183.0 mL·year within the group of patients with HASMC.
Conclusion: COPD patients with ΗASMC respond better to ICS than patients with LASMC, suggesting that this type of histological analysis may predict ICS responsiveness in COPD patients receiving triple therapy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1183/13993003.00218-2023 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mitochondrial Quality Control: A New Perspective in Skeletal Muscle Dysfunction of Chronic Obstructive Pulmonary Disease.
Aging Dis
December 2024
School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
Skeletal muscle dysfunction (SMD), one of the extrapulmonary complications in patients with chronic obstructive pulmonary disease (COPD), considerably influences patient prognosis. Mitochondria regulates their dynamic networks through a mitochondria quality control (MQC) mechanism, involving mitochondrial biogenesis, mitochondrial dynamics, and mitophagy. The MQC is crucial for mitochondrial homeostasis and health, and disruption of it can lead to mitochondrial damage, which is a key factor in the structural and functional impairment of skeletal muscle in COPD.
View Article and Find Full Text PDFAssessment of lung function in partially edentulous patients using spirometry: A cross-sectional study.
J Indian Prosthodont Soc
January 2025
Department of Dental Materials, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India.
Aim: This study aimed to evaluate the effect of partially edentulous ()PED condition on lung function through spirometry tests and comparison of airflow rates between dentulous and PED subjects.
Settings And Design: The study design was a cross-sectional study conducted in the department of prosthodontics.
Materials And Methods: Twenty-eight dentulous and 28 PED patients with an age range of 25-50 years were included in the study.
Prevalence and predictors of suboptimal peak inspiratory flow rates in the management of chronic obstructive pulmonary disease.
Monaldi Arch Chest Dis
December 2024
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.
This cross-sectional study aimed to investigate the role of peak inspiratory flow rate (PIFR) in the management of inhalation therapy for patients with chronic obstructive pulmonary disease (COPD). Conducted in the Department of Pulmonary Medicine at a tertiary care institute from July 2021 to January 2022, this study included a total of 351 patients who were clinically diagnosed with stable COPD and currently receiving inhaler therapy. Participants underwent comprehensive assessments that included demographic data collection, the use of the ABCD assessment tool to evaluate disease severity, the COPD Assessment Test (CAT) for quality of life measurement, and assessments for adherence to inhaler therapy and inhaler technique proficiency.
View Article and Find Full Text PDFRecording practices of body mass index, overweight and obesity by Dutch general practitioners: an observational study.
BMC Prim Care
January 2025
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Background: Routine body mass index (BMI) recording in electronic health records (EHR) could support general practitioners (GPs) in managing patients with obesity. This study aimed to evaluate recording practices of BMI, overweight, and obesity in adults including subgroup analysis of age, sex, and comorbidities in primary care in the Netherlands.
Methods: An observational study of individuals aged ≥ 18 years and registered between 2007 and 2023, using routine healthcare data from the Extramural LUMC Academic Network (ELAN) in the Netherlands.
Impact of seasonal biometeorological conditions and particulate matter on asthma and COPD hospital admissions.
Sci Rep
January 2025
Department of Water Resources, Climatology and Environmental Management, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
Climate change and air pollution are pressing public health concerns, necessitating monitoring of their impact, particularly on respiratory diseases like obstructive lung diseases. This retrospective study analyzed medical records of patients hospitalized at the Warmia and Mazury Centre for Pulmonary Diseases in Olsztyn, Poland (2012-2021) for asthma and chronic obstructive pulmonary disease (COPD) exacerbations. Data included meteorological factors such as temperature, humidity, wind speed, precipitation, and levels of PM2.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!