Chronic obstructive pulmonary disease in non-smokers

Hopkinson, Nicholas S; Polkey, Michael I.

doi:10.1016/s0140-6736(09)62115-2

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…While this may be very region specific, it does support the observation that COPD prevalence is high even in a low-smoking region, suggesting that other non-smoking-related factors may be more important. Air pollution and use of biomass fuel in poorly ventilated households are well-recognised additional risk factors [9,12,26].…”

Section: Discussionmentioning

confidence: 99%

“…Cigarette smoking is the major cause of COPD worldwide. However, in developing countries exposure to air pollution responsible for non-tobacco-smoking COPD might predominate [8][9][10][11][12][13]. Recent studies have described non-tobacco-smoking COPD due to indoor pollution resulting from the use of biomass fuel and open fires for domestic purposes in poorly ventilated households [12,14].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania

Magitta

Walker

Apte³

et al. 2018

Eur Respir J

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Chronic obstructive pulmonary disease (COPD) causes substantial burden of disease in developed countries, but there are limited data from Africa. We aimed to estimate the prevalence of COPD in Tanzania and identify the risk factors associated with it.This was a cross-sectional descriptive survey involving adults aged ≥35 years. We collected data on symptoms and risk factors using the Burden of Obstructive Lung Diseases questionnaire. Spirometry was performed and COPD diagnosed based on post-bronchodilator forced expiratory volume in 1 s/forced vital capacity <70%. We also measured indoor and outdoor carbon monoxide (CO) levels.A total of 869 participants (49.1% females) completed the questionnaires. Of these, 57.1% completed post-bronchodilator spirometry. Of the 25.2% ever-smokers, only 5.4% were current smokers. COPD prevalence was estimated at 17.5% (21.7% in males and 12.9% in females). COPD was associated with a history of cough, phlegm production and wheezing. 51.7% of COPD patients reported cough and 85% had mild to moderate airway limitation. Females had a higher rate of exacerbation. Pulmonary tuberculosis (TB) was reported in 10% of patients. Only 1.7% of patients who were diagnosed as COPD had ever received any medication, with only one female COPD patient having received an inhaler. 99.5% of the population used biomass fuels for cooking. The majority of households had CO levels up to 20 ppm.The prevalence of COPD in Tanzania is high, with a peak at a relatively young age and a preponderance in males. A history of TB, cigarette smoking and male sex are important risk factors. Indoor air pollution coupled with use of biomass fuel for cooking and heating may be an important risk factor for developing COPD in rural Tanzania. However, these factors need to be studied further.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania

Magitta

Walker

Apte³

et al. 2018

Eur Respir J

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“…Findings from two recent population-based studies conducted in rural settings in Uganda and Tanzania have indicated the comparable prevalence rates of 16.2% and 17.5% respectively [4,5]. In both studies, exposure to biomass fuel was reported in nearly all respondents; representing the major risk factor associated with COPD in Africa [6][7][8].…”

Section: Introductionmentioning

confidence: 94%

Prevalence and characteristics of COPD among residents in an urban informal settlement in Dar es Salaam, Tanzania

Magitta

Shimwela²,

Madas³

et al. 2019

Preprint

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Background: COPD is an important public health problem globally. To-date, indoor air pollution resulting from biomass fuel use is an important risk factor for COPD, particularly in Africa. The poor communities in informal settlements in major cities are likely to be exposed to higher pollution rates and could disproportionately develop COPD. Methods: We collected demographic data, respiratory symptoms and exposure history to air pollution using BOLD validated questionnaire and further performed spirometry using NDD EasyOneTM spirometer, with COPD diagnosed based on a post-bronchodilator FEV1/FVC <70%. The study was approved by the National Ethics committee. Results: A total of 1021 participants completed the questionnaire and had acceptable post-bronchodilator spirometry [(861 female, 66.70%)], with mean age of 52.16 ± 11.59 years. About 15.48% of respondents were smokers, of whom 6.46% were current smokers and 16.67% had significant nicotine dependency. Of all respondents, 11.71% reported living with a smoker and 5.31% reported a history of tuberculosis. The overall prevalence of COPD was estimated at 8.13% [(14.2% male, 5.14% female)], and found to be associated with age (p =0.005), gender (p=0.001), BMI (p=0.001) and smoking status (p=0.001). Over 98% of respondents reported significant exposure to biomass fuel. Over 78% of COPD patients had mild to moderate obstruction and the female had comparatively severe obstruction.Conclusion: In this population, COPD is relatively low compared to previous reports in Africa. Though multiple risk factors are responsible for COPD development, indoor pollution remains the most important factor. In this regard, access to affordable clean energy for domestic use is the most important strategy for COPD control.

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“…COPD pathogenetic mechanisms are constantly revisited and now include some novel aspects, e.g. shifts in lung microflora (Sze et al 2012), autoimmune component of the disease (Cosio et al 2002) and other than cigarette smoke environmental risk factors, that include indoor and outdoor air pollution, dust and fumes (Forbes et al 2009;Hopkinson and Polkey 2015). Scientific community still lacks a holistic understanding of COPD development and only several mechanisms are well described and generally recognized, i.e.…”

Section: Introductionmentioning

confidence: 99%

Native matrix-based human lung alveolar tissue model in vitro: studies of the reparatory actions of mesenchymal stem cells

et al. 2016

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Studies of lung diseases in vitro often rely on flat, plastic-based monocultures, due to short lifespan of primary cells, complicated anatomy, lack of explants, etc. We hereby present a native 3D model with cues for repopulating epithelial cells. Abilities of mesenchymal stem cells (MSC) to modulate bacterial lipopolysaccharide (LPS) and cigarette smoke-induced injury to pulmonary epithelium were tested in our model. Post-mortem human lung tissue was sliced, cut and decellularized. Resulting matrix pads were reseeded with pulmonary epithelium (A549 line). Markers of the layer integrity and certain secreted proteins in the presence of cigarette smoke extract (CSE) and LPS were assessed via Western blot, ELISA and RT-PCR assays. In parallel, the effects of MSC paracrine factors on exposed epithelial cells were also investigated at gene and protein levels. When cultured on native 3D matrix, A549 cells obtain dual, type I-and II-like morphology. Exposure to CSE and LPS leads to downregulation of several epithelial proteins and suppressed proliferation rate. MSC medium added to the model restores proliferation rate and some of the epithelial proteins, i.e. e-cadherin and beta-catenin. CSE also increases secretion of proinflammatory cytokines by epithelial cells and upregulates transcription factor NFjB. Some of these effects might be counteracted by MSC in our model. We introduce repopulated decellularized lung matrix that highly resembles in vivo situation and is convenient for studies of disease pathogenesis, cytotoxicology and for exploring therapeutic strategies in the human lung context in vitro. MSC paracrine products have produced protecting effects in our model.

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Chronic obstructive pulmonary disease in non-smokers

Cited by 9 publications

References 5 publications

Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania

Prevalence, risk factors and clinical correlates of COPD in a rural setting in Tanzania

Prevalence and characteristics of COPD among residents in an urban informal settlement in Dar es Salaam, Tanzania

Native matrix-based human lung alveolar tissue model in vitro: studies of the reparatory actions of mesenchymal stem cells

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