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Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD

Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD
Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD
Background: Considerable research has been conducted into the nature of airway inflammation in chronic obstructive pulmonary disease (COPD) but the relationship between proximal airways inflammation and both dynamic collapse of the peripheral airways and HRCT determined emphysema severity remains unknown. A number of research tools have been combined to study smokers with a range of COPD severities classified according to the GOLD criteria.

Methods: Sixty five subjects (11 healthy smokers, 44 smokers with stage 0–IV COPD, and 10 healthy non-smokers) were assessed using lung function testing and HRCT scanning to quantify emphysema and peripheral airway dysfunction and sputum induction to measure airway inflammation.

Results: Expiratory HRCT measurements and the expiratory/inspiratory mean lung density ratio (both indicators of peripheral airway dysfunction) correlated more closely in smokers with the severity of airflow obstruction (r = –0.64, p<0.001) than did inspiratory HRCT measurements (which reflect emphysema severity; r = –0.45, p<0.01). Raised sputum neutrophil counts also correlated strongly in smokers with HRCT indicators of peripheral airway dysfunction (r = 0.55, p<0.001) but did not correlate with HRCT indicators of the severity of emphysema.

Conclusions: This study suggests that peripheral airway dysfunction, assessed by expiratory HRCT measurements, is a determinant of COPD severity. Airway neutrophilia, a central feature of COPD, is closely associated with the severity of peripheral airway dysfunction in COPD but is not related to the overall severity of emphysema as measured by HRCT.
emphysema, smoking, chronic obstructive pulmonary disease, hrct scanning
0040-6376
837-842
O'Donnell, R.A.
6202b67a-40bd-4272-af85-d174c65eeb9d
Peebles, C.
8eb51995-0f07-46f7-9ca2-f97301fefc3d
Ward, J.A.
b476740b-33de-459d-90ae-5dfb62b63791
Daraker, A.
6c89446e-3562-48ce-b2b6-45ab7966a55f
Angco, G.
326db940-7378-4534-8f8e-2a1b64fc8c19
Broberg, P.
e4fc879f-73f3-464b-b5c5-267a5a494e7d
Pierrou, S.
8a9ed329-6a5d-49f0-874f-69c43a53a0dd
Lund, J.
2fad6788-240d-44ef-b8ad-f2d139c5a531
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Davies, D.E.
7de8fdc7-3640-4e3a-aa91-d0e03f990c38
Delany, D.J.
d25f8328-14cf-4a07-a08c-750f279f9786
Wilson, S.J.
21c6875d-6870-441b-ae7a-603562a646b8
Djukanovic, R.
d9a45ee7-6a80-4d84-a0ed-10962660a98d
O'Donnell, R.A.
6202b67a-40bd-4272-af85-d174c65eeb9d
Peebles, C.
8eb51995-0f07-46f7-9ca2-f97301fefc3d
Ward, J.A.
b476740b-33de-459d-90ae-5dfb62b63791
Daraker, A.
6c89446e-3562-48ce-b2b6-45ab7966a55f
Angco, G.
326db940-7378-4534-8f8e-2a1b64fc8c19
Broberg, P.
e4fc879f-73f3-464b-b5c5-267a5a494e7d
Pierrou, S.
8a9ed329-6a5d-49f0-874f-69c43a53a0dd
Lund, J.
2fad6788-240d-44ef-b8ad-f2d139c5a531
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Davies, D.E.
7de8fdc7-3640-4e3a-aa91-d0e03f990c38
Delany, D.J.
d25f8328-14cf-4a07-a08c-750f279f9786
Wilson, S.J.
21c6875d-6870-441b-ae7a-603562a646b8
Djukanovic, R.
d9a45ee7-6a80-4d84-a0ed-10962660a98d

O'Donnell, R.A., Peebles, C., Ward, J.A., Daraker, A., Angco, G., Broberg, P., Pierrou, S., Lund, J., Holgate, S.T., Davies, D.E., Delany, D.J., Wilson, S.J. and Djukanovic, R. (2004) Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD. Thorax, 59 (10), 837-842. (doi:10.1136/thx.2003.019349).

Record type: Article

Abstract

Background: Considerable research has been conducted into the nature of airway inflammation in chronic obstructive pulmonary disease (COPD) but the relationship between proximal airways inflammation and both dynamic collapse of the peripheral airways and HRCT determined emphysema severity remains unknown. A number of research tools have been combined to study smokers with a range of COPD severities classified according to the GOLD criteria.

Methods: Sixty five subjects (11 healthy smokers, 44 smokers with stage 0–IV COPD, and 10 healthy non-smokers) were assessed using lung function testing and HRCT scanning to quantify emphysema and peripheral airway dysfunction and sputum induction to measure airway inflammation.

Results: Expiratory HRCT measurements and the expiratory/inspiratory mean lung density ratio (both indicators of peripheral airway dysfunction) correlated more closely in smokers with the severity of airflow obstruction (r = –0.64, p<0.001) than did inspiratory HRCT measurements (which reflect emphysema severity; r = –0.45, p<0.01). Raised sputum neutrophil counts also correlated strongly in smokers with HRCT indicators of peripheral airway dysfunction (r = 0.55, p<0.001) but did not correlate with HRCT indicators of the severity of emphysema.

Conclusions: This study suggests that peripheral airway dysfunction, assessed by expiratory HRCT measurements, is a determinant of COPD severity. Airway neutrophilia, a central feature of COPD, is closely associated with the severity of peripheral airway dysfunction in COPD but is not related to the overall severity of emphysema as measured by HRCT.

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More information

Published date: 2004
Keywords: emphysema, smoking, chronic obstructive pulmonary disease, hrct scanning

Identifiers

Local EPrints ID: 27293
URI: https://eprints.soton.ac.uk/id/eprint/27293
ISSN: 0040-6376
PURE UUID: 444dbb75-a275-4a36-9e3c-ff4d22816145
ORCID for D.E. Davies: ORCID iD orcid.org/0000-0002-5117-2991
ORCID for R. Djukanovic: ORCID iD orcid.org/0000-0001-6039-5612

Catalogue record

Date deposited: 26 Apr 2006
Last modified: 24 May 2019 00:39

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