Natural History Of Asymptomatic Smokers With Normal Spirometry And Reduced Diffusion Capacity: Do They Develop COPD?

Harvey, Ben-Gary; Gordon, Cynthia; Dvořák, Anna; Crystal, Ronald G.

doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1531

Cited by 2 publications

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“…Hyperpolarized gas diffusion-weighted magnetic resonance imaging has also been used to identify emphysema, with a correlation of elevated levels of the apparent diffusion coefficient with decreased DL CO (91). We have observed that smokers with normal spirometry and low DL CO are at higher risk for the development of COPD as defined by the GOLD criteria than are smokers with normal spirometry and normal DL CO (92), but there was no direct correlation of emphysema with EMP levels or DL CO . This was not surprising, as healthy smokers with normal spirometry and normal DL CO without any clinical evidence of emphysema showed increased EMP levels as well, indicating that the complexity of the correlation between EMP and smoking-induced early vascular lung endothelium damage may not exclusively rely on the presence of emphysema as detailed by conventional clinical parameters such as DL CO and/or chest HRCT.…”

Section: Early Detection Of Lung Destructionmentioning

confidence: 89%

Circulating Endothelial Microparticles as a Measure of Early Lung Destruction in Cigarette Smokers

Gordon

Gudi

Krause

et al. 2011

Am J Respir Crit Care Med

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Rationale: There is increasing evidence that emphysema is associated with primary loss of pulmonary capillary endothelium. Plasma levels of endothelial microparticles (EMPs), small vesicles released from activated or apoptotic endothelial cells, are elevated in vascularrelated disorders. Objectives: To evaluate whether plasma EMP levels are elevated in smokers with early lung destruction as assessed by normal spirometry but reduced diffusing capacity of the lung for carbon monoxide (DL CO ). Methods: Lung health was assessed by pulmonary function tests (PFTs: spirometry, total lung capacity, DL CO ) and chest X-ray; smoking status was assessed by urine nicotine and cotinine. EMP levels (CD42b 2 CD31 1 microparticles) were quantified as activated or apoptotic. The initial cohort (n 5 92) included healthy nonsmokers (normal PFTs), healthy smokers (normal PFTs), and smokers with early evidence of lung destruction (normal spirometry, low DL CO ). Two prospective cohorts were then tested: a group similar to the initial cohort and an HIV1 1 cohort. Measurements and Main Results: Healthy smokers had mildly increased levels of EMPs. Strikingly, 95% of smokers with normal spirometry, low DL CO had increased EMPs, with reduced CD62 1 / CD31 1 ratios (P , 10 24 ) and elevated CD42b 2 CD31 1 annexin V 1 EMPs (P , 10 24 ), suggesting derivation from endothelial apoptosis. Most elevated EMPs were angiotensin-converting enzyme positive, suggesting derivation from pulmonary capillaries. Both prospective cohorts confirmed the initial cohort data. Conclusions: Plasma EMPs with apoptotic characteristics are elevated in smokers with normal spirometry but reduced DL CO , consistent with the concept that emphysema is associated, in part, with capillary endothelium apoptosis, suggesting that the early development of emphysema might be monitored with plasma EMP levels.

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Section: Early Detection Of Lung Destructionmentioning

confidence: 89%

Circulating Endothelial Microparticles as a Measure of Early Lung Destruction in Cigarette Smokers

Gordon

Gudi

Krause

et al. 2011

Am J Respir Crit Care Med

Self Cite

204

173

View full text Add to dashboard Cite

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“…Moreover, DLCO seems to have a role in the evaluation of at-risk subjects, in early stages of lung disease or when they have not yet developed it 7. Thus, some evidence suggests that a reduced DLCO predicts a future decline in forced expiratory volume in 1 s (FEV 1 ),8 9 and it has been reported that, in smokers with normal spirometry, a low DLCO increases the risk of developing COPD 10. Even a DLCO below 85% predicted has been found to be a significant predictor of all-cause mortality 11…”

Section: Introductionmentioning

confidence: 99%

Prevalence of reduced lung diffusing capacity and CT scan findings in smokers without airflow limitation: a population-based study

et al. 2023

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BackgroundPopulation distribution of reduced diffusing capacity of the lungs for carbon monoxide (DLCO) in smokers and main consequences are not properly recognised. The objectives of this study were to describe the prevalence of reduced DLCO in a population-based sample of current and former smoker subjects without airflow limitation and to describe its morphological, functional and clinical implications.MethodsA sample of 405 subjects aged 40 years or older with postbronchodilator forced expiratory volume in 1 s/forced vital capacity (FVC) >0.70 was obtained from a random population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, exhaled carbon monoxide (CO) measurement, spirometry, DLCO determination, 6 min walk test, routine blood analysis and low-dose CT scan with evaluation of lung density and airway wall thickness.ResultsIn never, former and current smokers, prevalence of reduced DLCO was 6.7%, 14.4% and 26.7%, respectively. Current and former smokers with reduced DLCO without airflow limitation were younger than the subjects with normal DLCO, and they had greater levels of dyspnoea and exhaled CO, greater pulmonary artery diameter and lower spirometric parameters, 6 min walk distance, daily physical activity and plasma albumin levels (all p<0.05), with no significant differences in other chronic respiratory symptoms or CT findings. FVC and exhaled CO were identified as independent risk factors for low DLCO.ConclusionReduced DLCO is a frequent disorder among smokers without airflow limitation, associated with decreased exercise capacity and with CT findings suggesting that it may be a marker of smoking-induced early vascular damage.Trial registration numberNCT03028207.

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Natural History Of Asymptomatic Smokers With Normal Spirometry And Reduced Diffusion Capacity: Do They Develop COPD?

Cited by 2 publications

References 0 publications

Circulating Endothelial Microparticles as a Measure of Early Lung Destruction in Cigarette Smokers

Circulating Endothelial Microparticles as a Measure of Early Lung Destruction in Cigarette Smokers

Prevalence of reduced lung diffusing capacity and CT scan findings in smokers without airflow limitation: a population-based study

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