Update in Chronic Obstructive Pulmonary Disease 2016

Allinson, James P.

doi:10.1164/rccm.201703-0588up

Cited by 10 publications

(7 citation statements)

References 59 publications

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“…Although there are few studies that assess the effect on risk of exacerbations, one study demonstrated a clear impact on the number needed to treat using ICS/LABA combination therapy [ 29 ]. Dual bronchodilator therapy was recommended for exacerbation reduction based on one comparative therapeutic trial [ 30 ] and inhaled LABA/LAMA/ICS as step-up therapy based on several comparative studies [ 31 – 33 ]. Further clinical phenotyping in chronic bronchitis was highlighted with response to roflumilast in patients with at least one respiratory hospitalisation in the prior year [ 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Precision medicine in COPD: where are we and where do we need to go?

2018

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Chronic obstructive pulmonary disease (COPD) was the fourth leading cause of death worldwide in 2015. Current treatments for patients ease discomfort and help decrease disease progression; however, none improve lung function or change mortality. COPD is heterogeneous in its molecular and clinical presentation, making it difficult to understand disease aetiology and define robust therapeutic strategies. Given the complexity of the disease we propose a precision medicine approach to understanding and better treating COPD. It is possible that multiOMICs can be used as a tool to integrate data from multiple fields. Moreover, analysis of electronic medical records could aid in the treatment of patients and in the predictions of outcomes. The Precision Medicine Initiative created in 2015 has made precision medicine approaches to treat disease a reality; one of these diseases being COPD.

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Section: Introductionmentioning

confidence: 99%

Precision medicine in COPD: where are we and where do we need to go?

2018

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“…The clinical history of these elderly chronic patients is characterized by periods of stable conditions interrupted by respiratory symptom (mostly dyspnoea) exacerbations, which may lead to hospitalization [5,6,13]. For patients with chronic obstructive disease or heart failure, hospitalization is associated with a downward clinical trajectory that accelerates with each subsequent admission [14,15].…”

Section: Introductionmentioning

confidence: 99%

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

et al. 2018

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Background: In elderly smokers, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) usually present with dyspnoea. COPD and CHF are associated almost invariably with concomitant chronic diseases, which contribute to severity and prognosis. Objectives: We investigated similarities and differences in the clinical presentation, concomitant chronic diseases and risk factors for mortality and hospitalization at 3-year follow-up in elderly smokers/ex-smokers with a primary diagnosis of COPD or CHF recruited and followed in specialized centers. Methods: We examined 144 patients with COPD and 96 with CHF, ≥65 years, ≥20 pack/years, and measured COPD Assessment Test (CAT) score, modified Medical Research Council, NYHA, and Charlson Index, routine blood test, estimated glomerular filtration rate, HRCT scan, 6-min walk test. In addition, in each patient we actively searched for CHF, COPD, peripheral vascular disease, and metabolic syndrome. Results: COPD and CHF patients had mild to moderate disease, but the majority was symptomatic. Comorbidities were highly prevalent and often unrecognized in both groups. COPD and CHF patients had a similar risk of hospitalization and death at 3 years. Lower glomerular filtration rate, shorter 6MWT, and ascending aorta calcification score ≥2 were independent predictors of mortality in COPD, whereas previous 12 months hospitalizations, renal disease, and heart diameter were in CHF patients. Lower glomerular filtration rate value, higher CAT score, and lower FEV₁/FVC ratio were associated with hospitalization in COPD, while age, lower FEV₁% predicted, and peripheral vascular disease were in CHF. Conclusions: There are relevant similarities and differences between patients with COPD and CHF even when admitted to specialized outpatient centers, suggesting that these patients should be manage in multidisciplinary units.

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“…On the other hand, the data suggest that cannabis oil extract would be contraindicated in diseases that are characterized by an aberrant Th2 immune response profile, such as asthma and allergy. It also would not be useful for subsets of COPD patients with asthma-like features, e.g., ACOS (Gold Reports 2018; Allinson and Wedzicha 2017;Hines and Peebles 2017). As a final note, the results of this study, which employed a preparation intended for oral delivery of cannabinoids, likely would not apply to ingestion of cannabinoids via smoking, which is deleterious to COPD patients.…”

Section: Resultsmentioning

confidence: 96%

“…In fact, there are two competing hypotheses (termed the British hypothesis and the Dutch hypothesis) relating to the pathophysiology of these diseases (Ghebre et al 2015). These differences in scientific consensus are addressed in part through an overlapping condition called asthma-COPD overlap syndrome, or ACOS (Gold Reports 2018; Allinson and Wedzicha 2017;Hines and Peebles 2017). ACOS provides a rationale for subsets of COPD patients with asthma-like features and vice versa (Christenson et al 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Whereas, in COPD the cumulative effects of cigarette smoke and other chemical irritants result in a pro-inflammatory cell-mediated immune response facilitated by cytokines such as IL-1 beta, IL-6, tumor necrosis factor (TNF) alpha and a variety of T helper 1 (Th1) related chemotactic factors (Barnes 2016(Barnes , 2009Schuijs et al 2013;Barnes 2017). While there is, to date, no cure for COPD, there are various standard treatment drugs available, notably, bronchodilators and corticosteroids (Gold Reports 2018; Allinson and Wedzicha 2017;Hines and Peebles 2017;Rosenberg and Kalhan 2017). However, such treatments have variable effectiveness and often have potentially serious side effects.…”

Section: Introductionmentioning

confidence: 99%

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Effects of cannabis oil extract on immune response gene expression in human small airway epithelial cells (HSAEpC): implications for chronic obstructive pulmonary disease (COPD)

et al. 2020

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Background: Chronic obstructive pulmonary disease (COPD) is commonly associated with both a pro-inflammatory and a T-helper 1 (Th1) immune response. It was hypothesized that cannabis oil extract can alleviate COPD symptoms by eliciting an anti-inflammatory Th2 immune response. Accordingly, the effects of cannabis oil extract on the expression of 84 Th2 and related immune response genes in human small airways epithelial cells (HSAEpC) were investigated.

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Update in Chronic Obstructive Pulmonary Disease 2016

Cited by 10 publications

References 59 publications

Precision medicine in COPD: where are we and where do we need to go?

Precision medicine in COPD: where are we and where do we need to go?

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

Effects of cannabis oil extract on immune response gene expression in human small airway epithelial cells (HSAEpC): implications for chronic obstructive pulmonary disease (COPD)

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