COPD in Chinese nonsmokers

Zhou, Yumin; Yao, Weimin; Chen, P.; Kang, Jian; Huang, Shaoguang; Chen, B.; Wang, C.; Ni, Dian-tao; Wang, X.; Wang, D.; Liu, S.; Lü, Jiachun; Zheng, Jinping; Zhong, Nanshan; Ran, Pixin

doi:10.1183/09031936.00084408

Cited by 141 publications

(144 citation statements)

References 43 publications

(52 reference statements)

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“…33 People exposed to biomass smoke have an odds ratio of 2.44 (95% CI 1.9 -3.3) for developing COPD relative to those not exposed to biomass smoke. 34 In our study, 38.7% of subjects were exposed to biomass smoke.…”

Section: Discussionmentioning

confidence: 99%

A COPD Health Management Program in a Community-Based Primary Care Setting: A Randomized Controlled Trial

Lou¹,

Chen²,

Zhang³

et al. 2014

Respir Care

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BACKGROUND: A number of effective strategies have been developed to improve the quality of life in patients with COPD. However, few have been implemented in patients with COPD at all stages in a community setting. This study evaluated the efficacy of a complex COPD health management intervention in rural communities in China. METHODS: A randomized controlled trial including 8,217 subjects with COPD was implemented from May 2008 to May 2012 in 14 community health-care centers. The control group of subjects received usual care, whereas the management group of subjects participated in a health management program that included assessing the subjects' health status, giving regular health lectures, smoking cessation counseling, encouraging regular exercise, providing rehabilitative training and psychological counseling, and regular followup. As a primary outcome, we examined the changes in the BODE index. Secondary outcomes included depression and anxiety rates, current smoking rate, awareness of COPD, mortality, risk factors, respiratory medication use, hospital admissions, and emergency department visits. RESULTS: After 4 y, the mean cumulative value of the BODE index increased by 0.7 per subject in the control group and decreased by 0.4 per subject in the health management group (difference of 1.1, 95% CI 0.2-2.0, P < .001). Health management reduced anxiety symptoms by 4.8%, depression symptoms by 6.6%, current smoking by 14.3%, mortality due to all causes by 9.0%, hospitalizations due to all causes by 16.1%, and emergency department visits due to all causes by 18.1% (P < .05 for all). However, it increased immunomodulator use by 58.9%, respiratory medication use by 14.1-21.9%, and awareness scores for COPD by 57.2% (P < .05 for all). CONCLUSIONS: The health management program is an effective community-based strategy for the prevention and management of COPD in China, increasing awareness and knowledge among patients and practitioners and improving management within the limitations of access to pharmacotherapy.

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Section: Discussionmentioning

confidence: 99%

A COPD Health Management Program in a Community-Based Primary Care Setting: A Randomized Controlled Trial

Lou¹,

Chen²,

Zhang³

et al. 2014

Respir Care

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“…The age-dependent increase in the prevalence of COPD (9)(10)(11) suggests that changes related to aging may contribute to COPD pathogenesis (12). This association between COPD and aging is relevant and important because by 2050, approximately 22% of the U.S. population will be over 60 years old (13), and this increase will almost certainly bring about a concomitant epidemic of chronic diseases such as COPD.…”

mentioning

confidence: 99%

The Aging Immune System and Its Relationship to the Development of Chronic Obstructive Pulmonary Disease

Sharma¹,

Hanania²,

Shim³

2009

Proceedings of the American Thoracic Society

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Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the lungs that usually manifests late in life. Physiologic and immunologic changes that occur in COPD often mimic changes seen in the aging lung. This has led some to characterize COPD as an ''accelerated aging phenotype.'' At the molecular level, COPD and aging share common mechanisms and are associated with significant dysregulation of the immune systems. Aging and COPD are characterized by increases in proinflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor (TNF)-a, which are implicated in aging-related inflammatory diseases and correlate with degree of obstruction in COPD. There is an age-dependent decline in naïve T cells with oligoclonal expansion of CD8 1 CD28 null T cells from chronic antigenic stimulation. The increase in CD8 1 CD28 null T regulatory cells inhibits antigen-specific CD4 1 T cell responses, leading to a decline in adaptive immune response. To compensate for the decline in the adaptive immune function there is a paradoxical up-regulation of innate immune system resulting in a proinflammatory state. The dysregulated adaptive immune system with activated innate immune responses seen with aging results in recruitment and retention of neutrophils, macrophages, and CD4 1 and CD8 1 T cells in the lungs of smokers with COPD. Once the inflammation is triggered, there is a selfperpetuating cascade of inflammation and lung parenchymal damage. This review will focus on how the aging immune system may contribute to COPD development later in life in susceptible individuals.

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“…Более того, от 14,7 до 68,6 % пациентов, страдающих ХОБЛ, никогда не курили [1]. Причины заболевания у них обусловлены длительным контактом с производственной пылью и химикатами, перенесенной в раннем детстве тя желой респираторной инфекцией, вдыханием дыма биоорганического топлива [4,5].…”

Section: оригинальные исследованияunclassified

Changes in T-lymphocyte population containing chemokine receptors in patients with chronic obstructive pulmonary disease

Кадушкин¹,

Шман²,

Белевцев³

et al. 2013

Pulʹmonologiâ (Mosk.)

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SummaryChronic obstructive pulmonary disease (COPD) is a difficult to treat progressive disease. About 14.7-68.6 % of COPD cases are not related to smoking. We examined 21 nonsmokers with COPD, 20 smokers with COPD, 20 healthy nonsmokers and 21 healthy smokers. Relative number of peripheral blood T lymphocytes containing CCR5 and CXCR3 chemokine receptors was determined by flow cytometry. CXCR3 + and CCR5 + T cell per cent number was increased in non smokers with COPD compared with healthy non smokers. A higher proportion of T cells containing CCR5 and CXCR3 receptors on the cell surface was also observed in blood of smokers with COPD compared both to healthy smokers and non smokers. Our findings suggest similar mechanism of T cells migration from blood into the airways both in non smoking and smoking patients.

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COPD in Chinese nonsmokers

Cited by 141 publications

References 43 publications

A COPD Health Management Program in a Community-Based Primary Care Setting: A Randomized Controlled Trial

A COPD Health Management Program in a Community-Based Primary Care Setting: A Randomized Controlled Trial

The Aging Immune System and Its Relationship to the Development of Chronic Obstructive Pulmonary Disease

Changes in T-lymphocyte population containing chemokine receptors in patients with chronic obstructive pulmonary disease

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