Article
Critical Care Medicine
Shuen Yee Lee, Ma Shwe Zin Nyunt, Qi Gao, Xinyi Gwee, Denise Qian Ling Chua, Keng Bee Yap, Shiou Liang Wee, Tze Pin Ng
Summary: Physical frailty is associated with disability and mortality in COPD. Combining physical frailty with FEV1 percent predicted and dyspnea increases the risk of disability and death. A summary score can effectively evaluate the risk of COPD.
Article
Sport Sciences
Devin B. Phillips, J. Alberto Neder, Amany F. Elbehairy, Kathryn M. Milne, Matthew D. James, Sandra G. Vincent, Andrew G. Day, Juan P. DE-Torres, Katherine A. Webb, Denis E. O'Donnell
Summary: In patients with COPD, reporting descriptors related to unsatisfied inspiration are associated with increased likelihood of critical inspiratory mechanical constraint and reduced exercise capacity, providing additional insight into exercise intolerance beyond traditional assessments of dyspnea during CPET.
MEDICINE & SCIENCE IN SPORTS & EXERCISE
(2021)
Article
Oncology
David Hui, Donald A. Mahler, Liliana Larsson, Jimin Wu, Saji Thomas, Carol A. Harrison, Kenneth Hess, Juan Lopez-Mattei, Kara Thompson, Daniel Gomez, Melenda Jeter, Steven Lin, Karen Basen-Engquist, Eduardo Bruera
Summary: This study found that high-flow oxygen can improve exertional dyspnea and prolong exercise duration in nonhypoxemic cancer patients, while high-flow air has a lower effect. The interventions were well tolerated among patients without significant adverse effects.
Article
Rehabilitation
Hugo L. Pereira, Danielle S. Vieira, Raquel R. Britto, Lailane S. Da Silva, Giane A. Ribeiro-Samora, Bianca L. Carmona, Guilherme A. Fregonezi, Veronica F. Parreira
Summary: The study showed that in patients with COPD, the use of 7.5 cmH(2)O EPAP was associated with reduced exercise tolerance and increased dyspnea during a constant cycle ergometer exercise test.
PHYSIOTHERAPY THEORY AND PRACTICE
(2022)
Article
Immunology
Mingming Deng, Yan Yin, Qin Zhang, Xiaoming Zhou, Gang Hou
Summary: This study aimed to identify effective biomarkers for COPD through differential expressed genes analysis and weighted co-expression network analysis. The results suggest that Lp-PLA2 may be a potential biomarker for assessing exercise tolerance in COPD patients.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Critical Care Medicine
J. Alberto Neder, Miranda Kirby, Giles Santyr, Marina Pourafkari, Reginald Smyth, Devin B. Phillips, Sophie Crinion, Juan Pablo de-Torres, Denis E. O'Donnell
Summary: In patients with COPD, impaired gas-exchange efficiency, caused by abnormal alveolar ventilation or capillary perfusion, leads to dyspnea and exercise intolerance. Treatment options targeting the increased neurochemical afferent activity resulting from gas-exchange inefficiency are limited. This review proposes two clinical research focuses to deepen the understanding of pulmonary gas-exchange inefficiency and activity-related dyspnea in COPD and evaluate pharmacologic treatments for improvement.
Article
Respiratory System
Michele Vitacca, Mara Paneroni, Antonio Spanevello, Mauro Maniscalco, Aldo Diasparra, Maria Aliani, Nicolino Ambrosino
Summary: This study aimed to investigate the impact of pulmonary rehabilitation (PR) on COPD patients. The results showed that after PR, CAT scores significantly improved for all patients, with better improvement observed in male patients, patients with chronic respiratory failure (CRF), and younger patients.
Article
Respiratory System
Yasuhiko Tsujimura, Ayumu Akiyama, Tetsuo Hiramatsu, Kotaro Mikawa, Kazuyuki Tabira
Summary: This study investigated whether adding step-feedback to pulmonary rehabilitation programs could increase physical activity in low-activity patients with severe COPD, and found that step-feedback improved physical activity in these patients.
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(2023)
Review
Nutrition & Dietetics
Angela Tramontano, Paolo Palange
Summary: Chronic Obstructive Pulmonary Disease (COPD) is a global epidemic causing numerous deaths annually. It is characterized by progressive and often irreversible airflow obstruction with varying clinical manifestations. Malnutrition is commonly observed in COPD patients and can worsen respiratory function and prognosis. Nutritional impairment is associated with reduced exercise tolerance and impact on patient-perceived quality of life. However, there is limited data on the best strategies to manage malnutrition in COPD patients. This review highlights the importance of COPD-related malnutrition on muscle function, exercise tolerance, and dyspnea.
Article
Critical Care Medicine
Chris Garvey
Summary: Pulmonary rehabilitation is highly effective but underused in the treatment of COPD. Lack of reimbursement and poor access, especially in rural areas, are major challenges. Virtual PR may improve access, but there is uncertainty about Medicare coverage and considerable heterogeneity in virtual PR models.
Article
Biochemistry & Molecular Biology
Michela D'Ascanio, Fausta Viccaro, Dario Pizzirusso, Giulio Guerrieri, Alessandra Pagliuca, Simone Guerrini, Marta Innammorato, Claudia De Vitis, Salvatore Raffa, Aldo Pezzuto, Alberto Ricci
Summary: This study aimed to explore the relationship between surfactant protein B (Sp-B) serum levels and clinical, radiological, and functional pulmonary parameters in COPD patients. The researchers found a significant difference in plasma Sp-B levels between COPD patients and the control group, and a negative correlation between the change in Sp-B levels and the change in FEV1 after 12 months. In conclusion, Sp-B can be considered as a useful marker in COPD assessment and provides prognostic information on lung functional decline.
Article
Cardiac & Cardiovascular Systems
Marie Waatevik, Bente Frisk, Francisco Gomez Real, Jon Andrew Hardie, Per Bakke, Tomas Mikal Eagan, Ane Johannessen
Summary: Emphysema was found to increase the risk of new and repeated desaturation, with a one percent increase in emphysema corresponding to a 10% increase in relative risk for new desaturation and a 20% increase for repeated desaturation. In dominance analysis, emphysema ranked as the most important risk factor for desaturation, outweighing FEV1% predicted and resting saturation.
RESPIRATORY MEDICINE
(2021)
Article
Critical Care Medicine
Nafeez Syed, Min Hyung Ryu, Satvir Dhillon, Michele R. Schaeffer, Andrew H. Ramsook, Janice M. Leung, Christopher J. Ryerson, Christopher Carlsten, Jordan A. Guenette
Summary: Contrary to our hypothesis, it was the healthy control participants, rather than the former smokers with and without COPD, who were negatively impacted by TRAP during exercise.
Article
Physiology
Devin B. Phillips, Matthew D. James, Conor D. O'Donnell, Sandra G. Vincent, Katherine A. Webb, Juan P. de-Torres, J. Alberto Neder, Denis E. O'Donnell
Summary: Low resting inspiratory capacity (IC) is closely associated with exertional dyspnea, exercise limitation, and poor survival in COPD. Meanwhile, maximal inspiratory pressure (MIP) has no significant impact on these variables. Resting IC is a stronger predictor of peak oxygen uptake (VO2peak) compared to MIP. Low resting IC remains independently associated with worse survival in COPD after accounting for airway obstruction, inspiratory muscle strength, and diffusing capacity.
JOURNAL OF APPLIED PHYSIOLOGY
(2022)
Article
Physiology
Hayley Lewthwaite, Pei Zhi Li, Denis E. O'Donnell, Dennis Jensen
Summary: This study compared the multidimensional breathlessness response during incremental cardiopulmonary cycle exercise testing in people with COPD, healthy older adults, and younger adults. The findings showed that individuals with COPD rated all sensations of breathlessness higher than healthy older adults and younger adults, and differences remained significant when related to inspiratory reserve volume. This study provides further insight into differences in exertional symptom perceptions among individuals with and without COPD.
RESPIRATORY PHYSIOLOGY & NEUROBIOLOGY
(2021)
Editorial Material
Respiratory System
Dave Singh
Article
Pharmacology & Pharmacy
Peter T. Daley-Yates, Noushin Brealey, Sebin Thomas, Daren Austin, Shaila Shabbir, Tim Harrison, Dave Singh, Neil Barnes
Summary: This study compared the airway potency, systemic activity, and therapeutic index of three inhaled corticosteroids. Fluticasone furoate (FF) showed greater airway potency and less systemic activity compared to fluticasone propionate (FP) and budesonide (BUD), suggesting that FF may provide better protection against airway hyperresponsiveness with a wider therapeutic index.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Review
Respiratory System
Dave Singh
Summary: Pharmacological treatment for COPD has moved towards a personalized approach, integrating clinical and biomarker information to optimize treatment decisions for individuals. Blood eosinophil counts have been adopted as a biomarker to predict responses to ICS in COPD patients. The development of novel inhaled combination treatments has provided valuable evidence to guide the use of different classes of combination treatments.
Article
Pharmacology & Pharmacy
Dave Singh, Rainard Fuhr, Nicholas P. Bird, Sarah Mole, Kelly Hardes, Yau Lun Man, Anthony Cahn, Steven W. Yancey, Isabelle J. Pouliquen
Summary: The humanized anti-interleukin (IL)-5 monoclonal antibody GSK3511294 demonstrated good tolerability and dose-proportional pharmacokinetics in patients with asthma, leading to significant reductions in blood eosinophil count that were sustained with increasing doses.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Medicine, Research & Experimental
Thomas Southworth, Zala Jevnikar, Christopher McCrae, Dave Singh
Summary: This study validated the efficacy of a sputum 6-gene signature in identifying different endotypes in chronic obstructive pulmonary disease. The gene expression levels were found to correlate with eosinophil and neutrophil percentages, allowing for distinction between patient subgroups and prediction of exacerbation history. The 6GS may have applications in clinical practice and patient stratification for clinical trials.
BIOMARKERS IN MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Dave Singh, Simon Lea, Alexander G. Mathioudakis
Summary: Phosphodiesterase (PDE) 4 inhibitors can reduce inflammation, with inhaled PDE4 inhibitors showing potential for clinical benefits in the lungs. While orally administered PDE4 inhibitors can decrease exacerbation rates in COPD patients, systemic exposure may lead to adverse effects. Inhaled PDE inhibitors have shown positive findings in early phase clinical trials, but longer term trials are needed to confirm their clinical benefits.
Review
Medicine, Research & Experimental
Dave Singh, Gabriel Garcia, Kittipong Maneechotesuwan, Peter Daley-Yates, Elvis Irusen, Bhumika Aggarwal, Isabelle Boucot, Norbert Berend
Summary: This article discusses the different dosing regimens of inhaled corticosteroid (ICS) therapies for asthma management. It highlights the importance of adherence to the prescribed therapy and compares the efficacy and systemic activity profiles of different dosing patterns. The findings have implications for clinicians in selecting the most suitable treatment option for patients with asthma.
ADVANCES IN THERAPY
(2022)
Editorial Material
Critical Care Medicine
Cindy T. McEvoy, Eliot R. Spindel
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Correction
Medicine, Research & Experimental
Dave Singh, Gabriel Garcia, Kittipong Maneechotesuwan, Peter Daley-Yates, Elvis Irusen, Bhumika Aggarwal, Isabelle Boucot, Norbert Berend
ADVANCES IN THERAPY
(2022)
Article
Critical Care Medicine
Dave Singh, Alvar Agusti, Fernando J. Martinez, Alberto Papi, Ian D. Pavord, Jadwiga A. Wedzicha, Claus F. Vogelmeier, David M. G. Halpin
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Respiratory System
Philip J. Thompson, Gerard J. Criner, Mark T. Dransfield, David M. G. Halpin, MeiLan K. Han, David A. Lipson, Ghassan J. Maghzal, Fernando J. Martinez, Dawn Midwinter, Dave Singh, Lee Tombs, Robert A. Wise
Summary: This study explores the relationship between chronic mucus hypersecretion (CMH) and treatment response. The results show that FF/UMEC/VI treatment has similar improvements in health status and lung function, regardless of CMH status. However, in CMH patients, FF/UMEC/VI has a better effect on exacerbation relief compared to other treatments.
Editorial Material
Medicine, Research & Experimental
Christian Domingo, Dave Singh
Summary: Short-acting beta(2) agonists (SABAs) have been commonly used for asthma treatment since the 1950s. However, poor adherence to regular inhaled corticosteroid (ICS)-based maintenance therapy often leads to excessive use of SABAs and negative outcomes. Current treatment guidelines lack consensus on the use of SABAs, and some suggest using ICS-formoterol as an alternative reliever therapy. This article examines the pharmacology and current use of SABAs, discusses the importance of regular ICS dosing, and evaluates the evidence supporting changes in reliever treatment recommendations.
ADVANCES IN THERAPY
(2023)
Editorial Material
Critical Care Medicine
Dave Singh
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Respiratory System
Dave Singh, John R. Hurst, Fernando J. Martinez, Klaus F. Rabe, Mona Bafadhel, Martin Jenkins, Domingo Salazar, Paul Dorinsky, Patrick Darken
Summary: This study developed models to predict the rate of moderate/severe exacerbations in COPD patients based on baseline risk factors. Factors such as prior exacerbations, eosinophil count, and use of inhaled corticosteroids were found to be significant predictors of exacerbation risk. The models showed good fit and improved prediction metrics compared to a simplified model. These models can be useful for evaluating treatment decisions in individual COPD patients.
THERAPEUTIC ADVANCES IN RESPIRATORY DISEASE
(2022)
Correction
Respiratory System
Dave Singh, Gerard J. Criner, Ian Naya, Paul W. Jones, Lee Tombs, David A. Lipson, MeiLan K. Han
RESPIRATORY RESEARCH
(2021)