Paired CT Measures of Emphysema and Small Airways Disease and Lung Function and Exercise Capacity in Smokers with Radiographic Bronchiectasis

Martínez, Carlos H.; Okajima, Yuka; Yen, Andrew; Maselli, Diego J.; Nardelli, Pietro; Rahaghi, F.N.; Young, Kendra A.; Kinney, Gregory L.; Hatt, Charles R.; Galbán, Craig J.; Washko, George R.; Han, MeiLan K.; Estépar, Raúl San Jośe; Díaz, Alejandro A.

doi:10.1016/j.acra.2020.02.013

Cited by 13 publications

(5 citation statements)

References 34 publications

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“…We had quantitative assessment of emphysema for 102 participants. In contrast with M artinez et al [ 7 ], we did not see increased emphysema in patients with radiological bronchiectasis. Radiological bronchiectasis was predominantly present in the lower lobes (47%), and less likely to be presented in the lingula (5.5%) and the right middle lobe (13.2%) ( supplementary table S2 ).…”

Section: Resultscontrasting

confidence: 99%

“…FDR of 0.1 and log 2 fold change (logFC) of 0.25 were used to filter significantly differentially expressed genes. The functional analysis of the differentially expressed genes was performed using the STRING database 7 . Heatmaps were used to visualize the data and identify unsupervised clusters of participants using the "Ward.D2" algorithm.…”

Section: Supplemental Figuresmentioning

confidence: 99%

“…In the present study, we used the term radiological bronchiectasis to refer to participants with CT features compatible with bronchiectasis and without physician-diagnosed disease. Although the clinical and epidemiological aspects remain to be determined, we have shown previously that smokers with radiological bronchiectasis have an increased burden of emphysema on CT and lower airflow and exercise capacity [ 7 ]. Furthermore, in smokers with radiological bronchiectasis, structural damage to lung parenchyma and small airways correlated with a higher number of exacerbations over time [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Bronchial gene expression alterations associated with radiological bronchiectasis

Díaz

Duan

et al. 2022

Eur Respir J

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ObjectivesDiscovering airway gene expression alterations associated with radiographic bronchiectasis (BE) may improve the understanding of the pathobiology of early-stage BE.MethodsPresence of radiographic BE in 173 individuals without a clinical diagnosis of BE was evaluated. Bronchial brushings from these individuals were transcriptomically profiled and analysed. Single-cell deconvolution was performed to estimate changes in cellular landscape that may be associated with early disease progression.Results20 participants have widespread radiographic BE (≥3 lobes). Transcriptomic analysis reflects biologic processes associated with BE including decreased expression of genes involved in cell adhesion and increased expression of genes involved in inflammatory pathways (655 genes FDR<0.1, log2fold-change>0.25). Deconvolution analysis suggests that radiographic BE is associated with an increased proportion of ciliated and deuterosomal cells, and a decreased proportion of basal cells. Gene expression pattens separated participants into three clusters: normal, intermediate, and bronchiectatic. The bronchiectatic cluster was enriched by participants with more lobes of radiographic BE (p<0.0001), more symptoms (p=0.002), higher SERPINA1 mutation rates (p=0.03), and higher CT-derived BE scores (p<0.0001).ConclusionsGenes involved in cell adhesion, WNT signaling, ciliogenesis, and IFN-γ pathways had altered expression in the bronchus of participants with widespread radiographic BE, possibly associated with decreased basal and increased ciliated cells. This gene expression pattern not only is highly enriched among individuals with radiographic BE, but also associated with airway-related symptoms in those without discernable radiographic BE, suggesting that it reflects a BE-associated but non-BE specific lung pathophysiogic process.

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Section: Resultscontrasting

confidence: 99%

Section: Supplemental Figuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bronchial gene expression alterations associated with radiological bronchiectasis

Díaz

Duan

et al. 2022

Eur Respir J

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“…In adults, bronchiectasis has been associated with chronic obstructive pulmonary disease, which is mainly caused by cigarette smoking 11 . Since e‐cigarette use is a relatively new delivery system for inhaled substances, the long‐term effects are yet to be scientifically established.…”

Section: Discussionmentioning

confidence: 99%

Bronchiectasis associated with electronic cigarette use: A case series

Mull

Shell

Adler

et al. 2020

Pediatric Pulmonology

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Bronchiectasis (BE) is defined as a permanent, irreversible dilation of the bronchial tree. In the pediatric population, this disease process is most commonly associated with patients with cystic fibrosis (CF). However, BE unrelated to CF is increasingly noted as a cause of chronic respiratory related morbidity worldwide. Chronic inflammation and recurrent infection result in cellular cascades that lead to irreversible structural changes of the airways. When these architectural changes occur, they confer extensive risks to morbidity usually due to continued infections. In the adult population, BE has been associated with chronic obstructive pulmonary disease, which is mainly caused by cigarette smoking. In this report, the authors reviewed various cases of BE in the pediatric population at our institution. After a comprehensive case by case review, we compiled details of three cases of newly diagnosed BE where the most likely inciting factor was the electronic cigarette use. Common features of the three cases included at least a year of e‐cigarette use with conjunction of tetrahydrocannabinol and radiologic findings of BE, ground glass opacities, and nodule formation.

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“… 59 , 60 Bronchiectasis was also found to be associated with increased emphysema in smokers and those with both bronchiectasis and emphysema had lower FEV 1 and 6MWD. 17 In current or former smokers, the low attenuation area on low-dose CT imaging ordered as part of routine lung cancer screening may be able to detect quantitative emphysema and diagnose subjects with early COPD, allowing clinicians to monitor patients closely and perhaps initiate appropriate treatment when needed. 61 These findings suggest that PRM could allow clinicians to further understand the variable disease progression of COPD, resulting in better-tailored treatments.…”

Section: Commercial Platformsmentioning

confidence: 99%

CT-Based Commercial Software Applications: Improving Patient Care Through Accurate COPD Subtyping

Wang¹,

Ram²,

Labaki³

et al. 2022

COPD

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Chronic obstructive pulmonary disease (COPD) is heterogenous in its clinical manifestations and disease progression. Patients often have disease courses that are difficult to predict with readily available data, such as lung function testing. The ability to better classify COPD into well-defined groups will allow researchers and clinicians to tailor novel therapies, monitor their effects, and improve patient-centered outcomes. Different modalities of assessing these COPD phenotypes are actively being studied, and an area of great promise includes the use of quantitative computed tomography (QCT) techniques focused on key features such as airway anatomy, lung density, and vascular morphology. Over the last few decades, companies around the world have commercialized automated CT software packages that have proven immensely useful in these endeavors. This article reviews the key features of several commercial platforms, including the technologies they are based on, the metrics they can generate, and their clinical correlations and applications. While such tools are increasingly being used in research and clinical settings, they have yet to be consistently adopted for diagnostic work-up and treatment planning, and their full potential remains to be explored.

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Paired CT Measures of Emphysema and Small Airways Disease and Lung Function and Exercise Capacity in Smokers with Radiographic Bronchiectasis

Cited by 13 publications

References 34 publications

Bronchial gene expression alterations associated with radiological bronchiectasis

Bronchial gene expression alterations associated with radiological bronchiectasis

Bronchiectasis associated with electronic cigarette use: A case series

CT-Based Commercial Software Applications: Improving Patient Care Through Accurate COPD Subtyping

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