Abstract:
BACKGROUND:The identification of smoking-related lung disease in current and former smokers with normal FEV1 is complex, leading to debate regarding using a ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) of less than 0.70 versus the predicted lower limit of normal (LLN) for diagnosis of airflow obstruction. We hypothesized that the discordant group of ever-smokers with FEV1/FVC between the LLN and 0.70 is heterogeneous, and aimed to characterize the burden of smoking-related lung disease in this group. METHODS:We compared spirometry, chest CT characteristics, and symptoms between 161 ever-smokers in the discordant group and 940 ever-smokers and 190 never-smokers with normal FEV1 and FEV1/FVC > 0.70 in the SPIROMICS cohort. We also estimated sensitivity and specificity for diagnosing objective radiographic evidence of chronic obstructive pulmonary disease (COPD) using different FEV1/FVC criteria thresholds. RESULTS:The discordant group had more CT defined emphysema and non-emphysematous gas trapping, lower post-bronchodilator FEV1 and FEF25-75, and higher respiratory medication use compared with the other two groups. Within the discordant group, 44% had radiographic CT evidence of either emphysema or non-emphysematous gas trapping; an FEV1/FVC threshold of 0.70 has greater sensitivity but lower specificity compared with LLN for identifying individuals with CT abnormality. CONCLUSIONS:Ever-smokers with normal FEV1 and FEV1/FVC < 0.70 but > LLN are a heterogeneous group that includes significant numbers of individuals with and without radiographic evidence of smoking-related lung disease. These findings emphasize the limitations of diagnosing COPD based on spirometric criteria alone.
journal_name
Respir Resjournal_title
Respiratory researchauthors
Pirozzi CS,Gu T,Quibrera PM,Carretta EE,Han MK,Murray S,Cooper CB,Tashkin DP,Kleerup EC,Barjaktarevic I,Hoffman EA,Martinez CH,Christenson SA,Hansel NN,Graham Barr R,Bleecker ER,Ortega VE,Martinez FJ,Kanner RE,Painedoi
10.1186/s12931-018-0911-zsubject
Has Abstractpub_date
2018-11-20 00:00:00pages
223issue
1eissn
1465-9921issn
1465-993Xpii
10.1186/s12931-018-0911-zjournal_volume
19pub_type
杂志文章,多中心研究abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) is associated with chronic inflammation and impaired immune response to pathogens leading to bacteria-induced exacerbation of the disease. A defect in Th17 cytokines in response to Streptococcus pneumoniae, a bacteria associated with COPD exacerbations, has been r...
journal_title:Respiratory research
pub_type: 杂志文章
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abstract:BACKGROUND:Several studies have implicated a role of inflammation in the pathogenesis of lung damage in idiopathic pulmonary fibrosis (IPF). Parenchymal lung damage leads to defects in mechanics and gas exchange and clinically manifests with exertional dyspnea. Investigations of inflammatory cells in IPF have shown tha...
journal_title:Respiratory research
pub_type: 临床试验,杂志文章
doi:10.1186/1465-9921-6-81
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abstract:BACKGROUND:Heightened inflammation, including expression of COX-2, is associated with COPD pathogenesis. RelB is an NF-κB family member that attenuates COX-2 in response to cigarette smoke by a mechanism that may involve the miRNA miR-146a. There is no information on the expression of RelB in COPD or if RelB prevents C...
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doi:10.1186/s12931-015-0214-6
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journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/1465-9921-8-90
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journal_title:Respiratory research
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND:Influenza virus binds to cell receptors via sialic acid (SA) linked glycoproteins. They recognize SA on host cells through their haemagglutinins (H). The distribution of SA on cell surfaces is one determinant of host tropism and understanding its expression on human cells and tissues is important for underst...
journal_title:Respiratory research
pub_type: 杂志文章
doi:10.1186/1465-9921-8-73
更新日期:2007-10-25 00:00:00
abstract:BACKGROUND:Long-term lung allograft survival is limited by bronchiolitis obliterans syndrome (BOS). Mannose binding lectin (MBL) belongs to the innate immune system, participates in complement activation, and may predispose to graft rejection. We investigated mannose binding (MBL) during cold ischemia and in tissue sam...
journal_title:Respiratory research
pub_type: 杂志文章
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journal_title:Respiratory research
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doi:10.1186/1465-9921-10-55
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更新日期:2009-07-06 00:00:00
abstract::Transposable elements (TEs) are a class of mobile genetic elements (MGEs) that were long regarded as junk DNA, which make up approximately 45% of the genome. Although most of these elements are rendered inactive by mutations and other gene silencing mechanisms, TEs such as long interspersed nuclear elements (LINEs) ar...
journal_title:Respiratory research
pub_type: 杂志文章,评审
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doi:10.1186/1465-9921-7-42
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doi:10.1186/s12931-014-0128-8
更新日期:2014-11-07 00:00:00
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doi:10.1186/s12931-019-0981-6
更新日期:2019-01-21 00:00:00
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journal_title:Respiratory research
pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究
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更新日期:2017-08-10 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究
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