COPD phenotypes in biomass smoke- versus tobacco smoke-exposed Mexican women

Camp, Pat G.; Ramírez‐Venegas, Alejandra; Sansores, Raúl H; Alva, Luis F; McDougall, Jill E; Sin, Don D.; Paré, Peter D.; Müller, Néstor L.; Silva, C Isabela S; Rojas, Cristián Guerra; Coxson, Harvey O.

doi:10.1183/09031936.00206112

Cited by 164 publications

(181 citation statements)

References 30 publications

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“…Consistent with this is the reported increased prevalence of an overlap between asthma and COPD [74]. Systemic and pulmonary inflammation is similar to cigarette smoke-induced disease [75,76], with less emphysema [77] and less rapid FEV1 decline [78]. Patients decline more slowly if the biomass exposure is reduced [28], but is not clear whether inhaled therapies used for "usual COPD" are of similar efficacy.…”

Section: Subgroups With Implications For Treatmentsupporting

confidence: 64%

Clinically relevant subgroups in COPD and asthma

Turner

Tamási

Schleich³

et al. 2015

Eur Respir Rev

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As knowledge of airways disease has grown, it has become apparent that neither chronic obstructive pulmonary disease (COPD) nor asthma is a simple, easily defined disease. In the past, treatment options for both diseases were limited; thus, there was less need to define subgroups. As treatment options have grown, so has our need to predict who will respond to new drugs. To date, identifying subgroups has been largely reported by detailed clinical characterisation or differences in pathobiology. These subgroups are commonly called "phenotypes"; however, the problem of defining what constitutes a phenotype, whether this should include comorbid diseases and how to handle changes over time has led to the term being used loosely.In this review, we describe subgroups of COPD and asthma patients whose clinical characteristics we believe have therapeutic or major prognostic implications specific to the lung, and whether these subgroups are constant over time. Finally, we will discuss whether the subgroups we describe are common to both asthma and COPD, and give some examples of how treatment might be tailored in patients where the subgroup is clear, but the label of asthma or COPD is not. @ERSpublications Summary of subgroups of airways disease that can be found in COPD and asthma, and their management

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Section: Subgroups With Implications For Treatmentsupporting

confidence: 64%

Clinically relevant subgroups in COPD and asthma

Turner

Tamási

Schleich³

et al. 2015

Eur Respir Rev

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show abstract

“…Therefore, considering that asymptomatic smokers with COPD have been previously described in subjects with emphysema using lung imaging [27], CT may become the only strategy to detect early COPD. Therefore, although females have an airway disease-dominant phenotype [26,28], the data of HARDIN et al [25] show that women with early-onset COPD have equivalent emphysema with fewer pack-years of smoking, which should motivate us to incorporate the gender perspective and need for early diagnosis into our clinical practice. Gender selection for the development of COPD may be enhanced by disadvantages encountered during childhood [3,29].…”

mentioning

confidence: 99%

COPD in women: susceptibility or vulnerability?

Sansores

Ramírez‐Venegas

2015

Eur Respir J

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@ERSpublicationsWomen are both more susceptible and more vulnerable than men when it comes to COPD http://ow.ly/UhMQ3The concepts of susceptibility and vulnerability are intertwined because vulnerability is sometimes a consequence of being susceptible. Women are more likely to be susceptible to chronic obstructive pulmonary disease (COPD) than men [1]. As many women continue to smoke during pregnancy, the impact of tobacco in women can begin before birth [2], because maternal smoking during pregnancy may increase the risk of childhood respiratory diseases [3] and reduce lung function [2]. Indeed, this susceptibility starts before women become smokers. For example, women with specific genotype variants are at a significantly increased risk of becoming heavy smokers [4], while those women with the haplotype TAS2R38 ( proline-alanine-valine) have a genetic propensity to experience heightened bitter taste perception and an increased preference for menthol cigarettes [5]. Recent findings of the Global Youth Tobacco survey on adolescents aged 13-15 years showed that young girls smoke as much as young boys [6]. The early onset of smoking may have a greater deleterious impact on lung function among girls [7] because their lungs are smaller than those of males. Accordingly, the same exposure to a given number of cigarettes smoked can lead to more deleterious effects in women [8]. In this regard, once young females become smokers, addiction may be reinforced by both nicotine and the sensory and social contexts of smoking. Motivations associated with gender can provoke women to have different cues for smoking compared with males [9]; therefore, women are more vulnerable to the social context of smoking and can easily become involved in the nicotine addictive process, along with consequent disease risks.However, the risk for COPD in women has been associated with both gender and sex biology. For instance, biomass exposure associated to COPD has been linked to gender [10] and the levels of oestrogen [8], and thus to sex biology, as in tobacco smoking. Sex differences associated with oestrogen trigger a search for femininity and body image in young women, and this search is exploited by tobacco companies. These companies sponsor promotions in which public smoking is portrayed by attractive models and movie stars to associate tobacco use with glamour, which more easily targets young women [11]. In young women, oestrogen induces lung differentiation and maturation [8]. However, by the age of menopause, levels of oestrogen and progesterone decline, and there is an important loss of lung function and reduced forced expiratory volume in 1 s (FEV1) that are associated with smoking [8].Approximately 20% of the smoking population worldwide are women [6]. This estimate has modified overall vital statistics by increasing the COPD prevalence for women and increasing the frequency of deaths due to COPD [12,13]. A recent analysis of mortality across three time-periods (1959-1965, 1982-1988 and 2000-2010) showed that the risk of death fr...

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“…In this issue of the European Respiratory Journal, CAMP et al [8] describe, for the first time, significant phenotypic differences between COPD due to tobacco smoke and biomass smoke exposure in age-and FEV1-matched females. In this study, 21 female never-smokers with COPD and biomass exposure were compared with 22 female ex-cigarette smokers without biomass exposure.…”

mentioning

confidence: 99%

“…CAMP et al [8] acknowledge that much of the biomass smoke exposure group lived in rural communities and were of indigenous descent, as opposed to the tobacco smoke exposure group born in urban communities who more often had Spanish ancestry. Height, for instance, was the only significant predictor of computed tomography lung density ratio in the multivariate model.…”

mentioning

confidence: 99%

The "other" COPD

Han

2014

European Respiratory Journal

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COPD phenotypes in biomass smoke- versus tobacco smoke-exposed Mexican women

Cited by 164 publications

References 30 publications

Clinically relevant subgroups in COPD and asthma

Clinically relevant subgroups in COPD and asthma

COPD in women: susceptibility or vulnerability?

The "other" COPD

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