chronic obstructive pulmonary disease

The literature on the potential protective role of serum bilirubin levels in the development of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) has produced conflicting findings. This study aimed to investigate the potential relationship between serum total and direct bilirubin levels and the risk of acute exacerbation in COPD.  Over a period of 18 months, a total of 99 patients were recruited from two major hospitals in Mashhad, Iran, comprising 49 individuals with stable COPD and 50 with AECOPD. After obtaining informed consent and conducting a comprehensive medical history and physical examination, both groups underwent an assessment of various laboratory indices, such as total and direct bilirubin levels. Appropriate statistical analysis was applied to assess the potential associations between bilirubin concentrations and the risk of AECOPD.  The study population had a mean age of 64.97±10.12 years, and there was no significant difference in gender distribution (p=0.546). The majority of subjects (55.6%) were male. The serum levels of AST and ALT were significantly higher in the AECOPD group (p<0.001). Additionally, although there were no significant differences in total bilirubin levels between the two groups (p=0.323), there was a significantly higher level of direct bilirubin in the AECOP group (p<0.001).  Serum direct bilirubin levels were higher in COPD patients with acute exacerbation. It may be an independent biomarker for screening the COPD patients with and without acute exacerbation. Further studies are required to validate the findings.

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are prevalent respiratory disorders with significant societal and healthcare impacts. This study will be conducted on the participants of the Persian Cohort study at Mashhad University of Medical Sciences (POCM) to determine the prevalence of asthma and COPD and to explore their relationship with dietary patterns, urban structure, lifestyle, and the severity in Iran.  A comprehensive assessment will be employed in this cohort study, including lifestyle factors, dietary patterns, anthropometry, spirometry, depression and stress levels, sleep quality, and physical activity. Individual-level analysis will utilize multivariate logistic regression to assess associations between outcome variables and potential predictors like air quality, smoking, occupation, socioeconomic status, and nutritional status. Adjustments for gender, age, chronic health conditions, and other potential confounders will be incorporated.  This study will investigate the most closely associated factors influencing the prevalence and severity of asthma and chronic obstructive pulmonary disease.  The final outcomes will delineate the relationship between the prevalence of asthma and COPD and various lifestyle factors, including socioeconomic status, air pollution, and physical activity.

In the present study, we aimed to evaluate the effects of medroxyprogesterone on hospital short clinical outcomes and ABG parameters in patients with chronic obstructive pulmonary disease (COPD) exacerbation under treatments with noninvasive ventilation (NIV) treated with progesterone 15 mg in comparison with placebo.

This is a double‑blinded clinical trial that was performed in 2020–2021 in Isfahan, Iran, on 60 patients with COPD exacerbation that require NIV. All patients received short‑acting beta‑agonists, short‑acting anticholinergics, systemic corticosteroids, and NIV. Patients in the intervention group received tablets of progesterone 15 mg, every 6 h for 5 days and the control group received a placebo; patients in both groups received routine clinical cares. We collected data regarding the days requiring NIV, hospitalization duration, intubation, intensive care unit (ICU) admission, and death. Furthermore, blood pH, PCO2, O2 saturation, dyspnea score, and NIV hours usage per day were evaluated at the time of admission, 3 and 5 days during admission.

Hospital short clinical outcomes were not differently distributed between the two groups (P > 0.05). Comparing two groups during hospitalization in terms of short clinical outcomes including duration hospitalization, using NIV per day, ICU admission rate, and need to intubation showed that they are comparable (P > 0.05). PH in both groups improved during follow‑up (P < 0.001) and patients in intervention groups showed higher improvement (P = 0.006). Mean PCO2 decreased significantly in the intervention group (P < 0.001) but not in the control group (P = 0.198) and totally intervention showed significant improvement in PCO2 compared with the control group (P = 0.047). Although mean O2 saturation was increased in both groups during follow‑up period (P < 0.001, for both groups), two groups showed comparable (P = 0.910). Mean NIV using (hours/day) was decreased significantly in the intervention group (P = 0.023); however, it was not significantly higher than that was seen in the control group (P = 0.706). The mean dyspnea score was decreased in both groups (P < 0.001), although a greater decrease was seen in the intervention group (P < 0.001).

Administration of medroxyprogesterone in patients with COPD exacerbation that required NIV was associated with significant improvements in blood pH, PCO2, dyspnea, and daily duration of NIV using after 3 and 5 days following hospitalization.

The primary objective of the study was to scrutinize the neutrophil to lymphocyte ratio (NLR) in patients afflicted with chronic obstructive pulmonary disease (COPD). This study, conducted at Mashhad University of Medical Sciences in Iran between 2021-2022, aimed to analyze the NLR. Data were collected from medical records, laboratory reports, and personal interviews, focusing on demographic data, clinical histories, and various laboratory and clinical parameters. The severity of COPD was assessed using several clinical scales and spirometry measurements. Statistical analysis was performed using SPSS and R software. In this study, a cohort of 49 patients with COPD was analyzed, with a majority being male (59%) and having an average age of 62.3 years. The mean NLR was 2.1. The correlation analysis showed a moderate negative correlation between Ejection Fraction and NLR (rho = -0.30, p = 0.03), and a weak positive correlation between Erythrocyte Sedimentation Rate and NLR (rho = 0.28, p = 0.04). Comparative analysis of NLR with COPD clinical scales showed a significant rise in NLR from category 0 to 2 in AECOPD cases (p=0.04). Concurrent ROC analysis indicates a diagnostic power of 0.68, establishing an NLR cutoff value of 1.67, with a sensitivity of 0.67 and a specificity of 0.71. NLR may serve as a marker for mild to moderate exacerbations in COPD patients (categories 1 and 2); however, its predictive value for severe exacerbations (category 3) remains unclear. Further research is needed to explore the underlying mechanisms and its utility across the full spectrum of exacerbation severity.

Cytokines are important in many pathobiological processes of chronic obstructive pulmonary disease (COPD). This study aimed to determine the relationship between serum levels of interleukin-33 (IL- 33) and the severity of COPD disease.

In this cross-sectional research, the study population consisted of all COPD patients referring to the pulmonary clinic of Imam-Ali Hospital of Zahedan city. Sixty patients were selected using the available sampling method. Serum IL-33 levels were measured by the quantitative ELISA method.

Of 60 patients, 23 (38.3%) and 37 (61.7%) subjects were male and female, respectively. Analysis shows a significant difference between serum IL-33 of the two groups with regard to the severity of COPD disease. There was a statistically significant negative relationship between the serum level of IL-33 and the severity (decrease of forced expiratory volume in one second (FEV1)) of COPD disease.

Our results indicate a systemic release of IL-33 correlated with the severity of COPD.

The current study tried to assess the effects of CKD on the severity and outcome of COPD in a population of patients who referred to our tertiary center in Tehran through a 3-year time section.
Through a retrospective cross-sectional design, the current study tried to assess the effects of chronic kidney disease (CKD) on the health situation and some spirometric and para-clinical parameters as well as their outcomes in patients who had been hospitalized for COPD. The participants had already COPD and we separate them into two groups with or without CKD.
Regarding the outcome of hospitalizations, 94% of the COPD and 77.9% of the COPD+CKD group were discharged in good health condition while 6% and 22.1% deceased, respectively. This shows significantly higher death rate in the latter group and the findings obtained the odds ratio of 4.5 for CKD to raise this rate.
The current study could suggest an absolute relationship between CKD and COPD in terms of respiratory and blood parameters as well as the mutual effects of the diseases on the outcome of each.

Inhaled corticosteroids (ICSs) have been widely used in the maintenance therapy of chronic obstructive pulmonary disease (COPD). Eosinophilic airway inflammation is a recognized inflammatory endotype in COPD. Nevertheless, the benefits and risks of ICS treatment remain controversial.

Therefore, in this study, we determine the frequency of eosinophilia in COPD patients and compare the effects of ICSs in patients with and without eosinophilia referring to the lung clinics of Zahedan University of Medical Sciences.

In this study, 58 COPD patients were examined. Peripheral blood smears (PBS) were collected from all patients, and they were randomly divided into 2 groups. First, a 6-minute walking test (6MWT) was performed on all patients. Thereafter, two groups of patients received standard treatment with the Symbicort spray for 3 months. They were followed for this period, and the 6MWT was performed again at the end of the 3 months.

The mean results of the 6MWT test before and after intervention in the eosinophilia-positive group were 164.02 meters and 192.11 meters, respectively. Therefore, there was a significant difference in patient activity levels before and after ICSs (P = 0.017). In the eosinophilia-negative group, there was a significant difference in patient activity levels based on the 6MWT test before and after taking ICSs (P < 0.001). However, there was no difference in activity levels between the two groups before and after the intervention (P = 0.68 and P = 0.36).

Our finding showed that treatment with inhaled β2-agonists plus corticosteroids did not affect the response to this treatment in subjects' groups with and without eosinophilia compared to the pre-treatment conditions.

Chronic Obstructive Pulmonary Disease (COPD) exacerbation is characterized by both airway and systemic inflammation. The present study aimed to investigate the relationship between serum levels of some inflammatory biomarkers and the phenotypes of COPD exacerbation.
This study includes known COPD patients, presenting to a hospital with acute exacerbation of COPD. Serum levels of CRP, ESR, CBC, TNF-α, IL-8, and IL-6 were measured at the time of admission. According to the previously done HRCT, the patients were divided into two groups including emphysema and chronic bronchitis. Levels of serum biomarkers were compared in the two groups. The relationships between biomarkers and duration of hospitalization were assessed too.
  Comparison of quantitative CRP levels, WBC, and platelet counts did not show a statistically significant difference between emphysema and chronic bronchitis but it was significantly higher than control subjects. Although not statistically significant, ESR level was higher in emphysema. TNF-alpha was 6.0±1.5 ng / ml and 1.5 ng / ml in the emphysema and chronic bronchitis groups, respectively. TNF-α had no significant difference compared to the groups. Although higher than the control group, IL-6 and IL-8 did not show significant differences between emphysema and chronic bronchitis. The two groups did not statistically differ in terms of hospital stay but patients with higher serum TNF-α tended to have longer hospitalization and ICU admission. The present study showed predictably higher inflammatory biomarkers in COPD exacerbation but no significant difference between the two phenotypes of COPD and these two entities could not be discriminated based on inflammatory bio-factors.

Chronic obstructive pulmonary disease (COPD) is one of the most common pulmonary diseases. The current therapeutic outcomes are not satisfactory and may cause adverse events such as cardiovascular complications. In this study, we aimed to discuss some effective medicinal herbs for the management of COPD.

In this review, we looked for effective medicinal herbs for productive cough with thick and sticky mucus in Persian medicine sources such as Qanoon fi al-Teb, Exir Azam, and Zakhire Kharazmshahi. Then, to find relevant evidence about them, the data sources (PubMed and Google Scholar) were searched in the English language without time restriction from inception up to March 2022.

We found that Zataria multiflora, Thymus vulgaris L, Glycyrrhiza glabra L., Crocus sativus L., Nepeta bracteata Benth., and Hyssopus officinalis have beneficial effects on COPD due to their properties including anti-inflammatory and antioxidant activity. In addition, considering asthma COPD overlap (ACO), medicinal herbs including Cordia myxa, Adiantum capillus-veneris, Cinnamomum verum, Viola odorata, Borago officinalis, Linum usitatissimum and Vitis viniferia L. were found to have useful effects on asthma.

Considering the mentioned beneficial mechanisms of action of these medicinal herbs, they could be used as a complementary therapy in COPD and asthma. However, more experimental and clinical research should be done to confirm their clinical effects.

Chronic obstructive pulmonary disease (COPD) has become a global public health problem due to its high mortality. So there is an urgent need to find an effective treatment

The targeting relationship among circABCB10, miR-130a and PTEN was predicted by  the targetscan database. The lung condition was detected by CT(Computed Tomograph). The expression levels of circABCB10, miR-130a and PTEN in lung tissues were determined by qRT-PCR. The COPD model was established by stimulating normal and silenced 16HBE cells in circABCB10 genes with cigarette smoke extract (CSE) at different concentrations. qRT-PCR was conducted for the expression levels of circABCB10, miR-130a and PTEN, WB for the expression levels of apoptotic proteins,ELISA for the content of inflammatory factors,and CCK8 for the effect of CSE on the proliferation of cells.

CircABCB10 expression increased in lung tissues from patients with COPD and in 16HBE cells treated with CSE. The stimulation on cells with CSE increased the expression of inflammatory factors, while knocking down circABCB10 could reverse this response. The inflammatory response to the knockdown of circABCB10 was reversed by miR-130a inhibitor, which increased the expression of c-caspase 3. The targetscan database predicted the target factor downstream miR-130a was PTEN. Transfecting OE-PTEN reversed the inflammation of knocking down circABCB10, and increased the apoptosis and inflammation.

CircABCB10 can cause the inflammatory response by targeting miR-130a/PTEN axis, which is a mechanism that may lead to the occurrence and development of COPD.

To compare the effect of telephone and SMS follow-up of an empowerment program on quality of life (QOL) and fatigue in patients with chronic obstructive pulmonary disease (COPD).

Non-blind randomized clinical trial (RCT). Two hospitals and clinics in Shahrekord. 105 patients with COPD grades 2 and 3 were recruited and, after implementation in empowerment sessions, were randomly assigned to three control, telephone follow-up, and SMS follow-up groups (35 individuals in each group). First, the pulmonary empowerment program was designed and implemented for six 90-minute sessions. Then, the patients were randomly assigned to three groups using a random number table. Follow-up ended after three months, and the control group received routine care. Data were collected in the first and sixth sessions of the empowerment program and at the end of the follow-up period using demographic (QOL) and fatigue questionnaires. Eventually, they were analyzed through correlation coefficient and analysis of variance (ANOVA) tests in the SPSS software (Version 20).

The study results on QOL showed that the groups were not statistically significantly different before and after the empowerment (respectively: P=0.29 and P=0.56). However, the groups showed statistically significant differences at the end of the quarterly follow-up period (P<0.001). ANOVA results for fatigue indicated no statistically significant differences between the groups before and after the empowerment (respectively: P=0.10 and P=0.32). The results of this study showed that follow-up by SMS and telephone improved patients’ QOL, and SMS had a greater effect in this regard.

The findings suggest using follow-up as an essential approach to empowerment using various technology methods and designing more comprehensive empowerment to reduce patient fatigue.

Asthma and chronic obstructive pulmonary disease (COPD) are the most common chronic diseases with a high global burden of disease. Today, the use of complementary and alternative medicine (CAM) has become more popular. In general, in developing countries, easy access and low cost of traditional medicine, and in developed countries, more access to health information, the prevalence of old age and the increase in chronic diseases are the reasons for this increasing use of traditional medicine. This study aimed to determine the rate and pattern of CAM used and their relationships with demographic characteristics among asthmatic and COPD patients. This research was a cross-sectional study performed on asthma and COPD patients (n=357) referring to the Pulmonary Diseases affiliated with Ardabil University of Medical Sciences, Ardabil, Iran from 2019 to 2020. Data were collected by using semi-structured questionnaires including open and closed questions and face-to-face interviews. Three hundred and thirty-nine patients (95%) used at least one type of CAM in the last year of study. About half of the patients (49.9%) used more than two types of CAM during the last 12 months. Three hundred and four patients (85.2%) used medicinal plants. Few patients reported with the use of CAM to their physician or health care providers (16.1%, 12.5%, and 16.7% of the users of medicinal plants, bloodletting, and dry cupping respectively). Relatives and friends (77.9%) were with the most common sources of recommendation of CAM to the patients. The present study showed the high prevalence of using different types of CAM, especially herbal medicines in Iranian asthmatic and COPD patients. The main incentive for using CAM was for friends and family members, not health care providers. The use of CAM is associated with age patients age, family size, habitat, education, and occupation.

Context: 

A wide range of complications, including chronic respiratory diseases, asthma attacks, cardiovascular diseases (CDs), various cancers (blood, lung, and brain), and even death, can result from air pollution. It is essential to assess the health effects on humans caused by environmental air pollutants and non-communicable diseases (NCDs), including coronavirus disease 2019 (COVID-19). The purpose of this review study was to investigate the synergistic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and air pollutants on the risk factors for chronic obstructive pulmonary disease (COPD), CDs, and respiratory diseases (RDs).

Evidence Acquisition: 

An extensive literature review was conducted. A total of 1 005 articles were retrieved from sources, including Google Scholar, Springer, PubMed, Web of Science, and Springer databases. In the final stage of the literature review, a significant association between mortality related to COVID-19 and air pollution emissions was identified, contributing to the risk factors associated with CDs and RDs.

The result showed that air pollution can have synergistic effects on the transmission of SARS-CoV-2 viruses and has an increasing effect on the incidence of RDs [such as SARS and Middle East respiratory syndrome (MERS)] and CDs. According to the findings, exposure to toxic air pollutants, whether chronic or acute, can have severe effects, including a decrease in airway ciliary function, damage to the mucous membrane, reduced air sac elasticity, decreased lung capacity, and an increased risk of CDs.

COVID-19 and air pollutants pose a serious threat to human and animal health. Epidemiological studies have shown that in addition to environmental conditions, individual sensitivity plays a key role in the development of conditions such as COPD, CDs, RDs, cancer, and mortality.