Clinical and Immunological Factors in Emphysema Progression: Five-Year Prospective Longitudinal Exacerbation Study of Chronic Obstructive Pulmonary Disease (LES-COPD)
Why is this work in the frame?
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
The three-model screen
all 1,000 screened works →All three models called this out of scope.
Longitudinal clinical cohort study of emphysema progression in COPD.
This prospective study examines emphysema progression and clinical biomarkers, not research.
Longitudinal clinical COPD/emphysema study, not metaresearch.
Abstract
RATIONALE: Cross-sectional studies of T-cell responses to self-antigens correlate with baseline emphysema severity. OBJECTIVES: We investigated whether clinical and/or immunological factors could predict disease progression, such as emphysema, FEV1, and 6-minute-walk distance (6MWD), in former and active smokers in a 5-year prospective study. METHODS: We recruited 224 ever smokers over 40 years of age and with greater than a 15 pack-year smoking history. MEASUREMENTS AND MAIN RESULTS: Repeated spirometry, 6MWD, and peripheral blood T-cell cytokine responses to lung elastin fragments were measured. Baseline and repeat chest computed tomography (CT) scans (34 to 65 mo apart) were used to quantify emphysema progression. Of the 141 ever-smokers with baseline and repeat CT scans, the mean (SD) annual rate of change in percent emphysema was +0.46 (0.92), ranging from -1.8 to +4.1. In multivariable analyses, the rate of emphysema progression was greater in subjects who had lower body mass index (BMI) (+0.15 per 5-unit decrease in BMI; 95% confidence interval, +0.03 to +0.29). In active smokers, increased IFN-γ and IL-6 T-cell responses had a positive association with the annual rate of emphysema progression. Male sex and IL-6 T-cell responses to elastin fragments were significantly associated with annual 6MWD decline, whereas IL-13 was associated with an increase in annual 6MWD. CONCLUSIONS: The rate of emphysema progression quantified by CT scans among ever-smokers was highly variable; clinical factors and biomarkers explained only some of the variability. Aggressive clinical care that targets active smokers with autoreactive T cells and low BMI may temporize progression of emphysema.
Stored with the screening record, where it is evidence for the labels above.
The record
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Topic
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Field
- Medicine
- Canadian institutions
- Vancouver General HospitalUniversity of British Columbia
- Funders
- National Center for Advancing Translational SciencesNational Center for Research ResourcesNational Heart, Lung, and Blood InstituteNational Institutes of HealthU.S. Department of Veterans Affairs
- Keywords
- MedicineSpirometryInternal medicineBody mass indexCOPDProspective cohort studyExacerbationConfidence intervalCardiologyAsthma
- Has abstract in OpenAlex
- yes