Chronic Obstructive Pulmonary Disease (COPD): Treatment and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 1347

Special Issue Editors


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Guest Editor
Department of Internal Medicine, Istituto Figlie di San Camillo, Via Filzi 56, 26100 Cremona, Italy
Interests: lung; spirometry; lung diseases; airway obstruction; asthma management; ventilation; respiratory physiology; allergic diseases; diagnosis; inflammatory bowel disease

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Guest Editor
1. Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
2. Cardio-Thoracic and Vascular Department, University Hospital of Parma, 43126 Parma, Italy
Interests: asthma; lung; sputum; lung diseases; spirometry; airway obstruction; respiratory physiology; cystic fibrosis

Special Issue Information

Dear Colleagues,

Chronic obstructive pulmonary disease (COPD) is a major global health problem due to its high prevalence (10% of the adult population), rising incidence and very significant associated personal, social, and economic costs. The old view that COPD is a single disease caused by smoking and characterized by an accelerated rate of lung function decline that occurs in (mostly) older males is outdated and incomplete. Recent data support a different pathogenic paradigm that considers that COPD is a polygenic disease with a significant epigenetic component and multiple environmental risk factors  interact and accumulate through life in complex ways to determine the clinical manifestations. Although few novel treatments have been approved for COPD in the past 5 years, advances have been made in targeting specific subpopulations with existing therapies using new biomarker-based strategies. Additionally, COVID-19 has undeniably affected individuals with COPD, who are not only at higher risk for severe disease manifestations than healthy individuals but are also negatively affected by interruptions in healthcare delivery and social isolation. This Special Issue reviews COPD with an emphasis on recent advances in epidemiology, pathophysiology, imaging, diagnosis, and treatment.

Dr. Maurizio Marvisi
Prof. Dr. Alfredo Antonio Chetta
Guest Editors

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Keywords

  • COPD
  • treatable traits
  • precision medicine
  • COPD comorbidities
  • COPD mortality

Published Papers (2 papers)

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Research

19 pages, 1488 KiB  
Article
Systemic Manifestations of COPD and the Impact of Dual Bronchodilation with Tiotropium/Olodaterol on Cardiac Function and Autonomic Integrity
by Ieva Dimiene, Deimante Hoppenot, Donatas Vajauskas, Lina Padervinskiene, Airidas Rimkunas, Marius Zemaitis, Diana Barkauskiene, Tomas Lapinskas, Egle Ereminiene and Skaidrius Miliauskas
J. Clin. Med. 2024, 13(10), 2937; https://doi.org/10.3390/jcm13102937 - 16 May 2024
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Abstract
Background: Chronic obstructive pulmonary disease (COPD) has significant systemic manifestations, including cardiovascular morbidity. The main aim of our study was to evaluate the effect of short-term COPD treatment with tiotropium/olodaterol (TIO/OLO) 5/5 μg on cardiac function and autonomic integrity. Methods: Twenty-nine [...] Read more.
Background: Chronic obstructive pulmonary disease (COPD) has significant systemic manifestations, including cardiovascular morbidity. The main aim of our study was to evaluate the effect of short-term COPD treatment with tiotropium/olodaterol (TIO/OLO) 5/5 μg on cardiac function and autonomic integrity. Methods: Twenty-nine patients with newly diagnosed moderate-to-severe COPD were enrolled. We performed pulmonary function tests, cardiac magnetic resonance, cardiac 123I-metaiodobenzylguanidine (123I-MIBG) imaging and analysis of blood biomarkers on our study subjects. The correlations between the tests’ results were evaluated at baseline. The changes in pulmonary and cardiac parameters from baseline through 12 weeks were assessed. Results: Significant associations between pulmonary function tests’ results and high-sensitivity C-reactive protein (hs-CRP), as well as interleukin-22 (IL-22), were observed at baseline. Treatment with TIO/OLO significantly improved lung function as measured by spirometry and body plethysmography. Moreover, we found that the cardiac index increased from 2.89 (interquartile range (IQR) 1.09) to 3.21 L/min/m2 (IQR 0.78) (p = 0.013; N = 18) and the late heart-to-mediastinum ratio improved from 1.88 (IQR 0.37) to 2 (IQR 0.41) (p = 0.026; N = 16) after 12 weeks of treatment. Conclusions: Treatment with TIO/OLO improves lung function and positively impacts cardiac function and autonomic integrity, suggesting that dual bronchodilation might have a potential in decreasing the risk for cardiac events in COPD. Hs-CRP and IL-22 might be beneficial in determining the intensity of systemic inflammation in COPD. Further research with a larger cohort is needed to enhance the initial results of this study. Full article
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11 pages, 3031 KiB  
Article
Alpha-1 Antitrypsin PI M Heterozygotes with Rare Variants: Do They Need a Clinical and Functional Follow-Up?
by Anna Annunziata, Giuseppe Fiorentino, Marco Balestrino, Roberto Rega, Sara Spinelli, Lidia Atripaldi, Alessio Sola, Federica Massaro and Cecilia Calabrese
J. Clin. Med. 2024, 13(4), 1084; https://doi.org/10.3390/jcm13041084 - 14 Feb 2024
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Abstract
(1) Background: Few data are available on the risk of airway dysfunction in protease inhibitor (PI*) M heterozygotes carrying rare null or deficient allelic variants of the gene SERPINA-1 (PI*MR). (2) Methods: In this observational study, in a cohort of PI*MR [...] Read more.
(1) Background: Few data are available on the risk of airway dysfunction in protease inhibitor (PI*) M heterozygotes carrying rare null or deficient allelic variants of the gene SERPINA-1 (PI*MR). (2) Methods: In this observational study, in a cohort of PI*MR heterozygotes, we evaluated respiratory functional parameters at baseline and at one-year follow-up. Moreover, we compared such parameters with those of the PI*MZ and PI*MS patients. (3) Results: A total of 60 patients were recruited; 35 PI*MR, 11 PI*MZ and 14 PI*MS. At the annual follow-up, the PI*MR and PI*MZ patients demonstrated a significantly higher FEV1 decline than the PI*MS group (p = 0.04 and p = 0.018, respectively). The PI*MR patients showed a significant increase in DLCO annual decline in comparison with the PI*MS group (p = 0.02). At baseline, the PI*MR smoking patients, compared with nonsmokers, showed statistically significant lower values of FEV1, FEV1/FVC and DLCO (p = 0.0004, p < 0.0001, p = 0.007, respectively) and, at the one-year follow-up, they displayed a significantly higher FEV1 and DLCO decline (p = 0.0022, p = 0.011, respectively). PI*MR heterozygotes with COPD showed a significantly higher FEV1, FEV1/FVC and DLCO annual decline in comparison with healthy PI*MR (p = 0.0083, p = 0.043, p = 0.041). (4) Conclusions: These results suggest that PI*MR heterozygotes, particularly smokers with COPD, have a greater annual decline in respiratory functional parameters and need to be monitored. Full article
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