Société Tunisienne des Maladies Respiratoires et d'Allergologie STMRA

A self-management programme for COPD: a randomised controlled trial.

A self-management programme for COPD: a randomised controlled trial.

Eur Respir J. 2014 Sep 3;

Authors: Mitchell KE, Johnson-Warrington V, Apps LD, Bankart J, Sewell L, Williams JE, Rees K, Jolly K, Steiner M, Morgan M, Singh SJ

Abstract
Studies of programmes of self-management support for chronic obstructive pulmonary disease (COPD) have been inconclusive. The Self-Management Programme of Activity, Coping and Education (SPACE) FOR COPD is a 6-week self-management intervention for COPD, and this study aimed to evaluate the effectiveness of this intervention in primary care. A single-blind randomised controlled trial recruited people with COPD from primary care and randomised participants to receive usual care or SPACE FOR COPD. Outcome measures were performed at baseline, 6 weeks and 6 months. The primary outcome was symptom burden, measured by the self-reported Chronic Respiratory Questionnaire (CRQ-SR) dyspnoea domain. Secondary outcomes included other domains of the CRQ-SR, shuttle walking tests, disease knowledge, anxiety, depression, self-efficacy, smoking status and healthcare utilisation. 184 people with COPD were recruited and randomised. At 6 weeks, there were significant differences between groups in CRQ-SR dyspnoea, fatigue and emotion scores, exercise performance, anxiety, and disease knowledge. At 6 months, there was no between-group difference in change in CRQ-SR dyspnoea. Exercise performance, anxiety and smoking status were significantly different between groups at 6 months, in favour of the intervention. This brief self-management intervention did not improve dyspnoea over and above usual care at 6 months; however, there were gains in anxiety, exercise performance, and disease knowledge.

PMID: 25186259 [PubMed - as supplied by publisher]

C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.

C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.

Eur Respir J. 2014 Sep 3;

Authors: Clark TW, Medina MJ, Batham S, Curran MD, Parmar S, Nicholson KG

Abstract
Both viruses and bacteria are thought to cause exacerbations of chronic obstructive pulmonary disease (COPD); however, the relative importance of each remains uncertain. C-reactive protein (CRP) levels increase during exacerbations but the relationship with aetiology is not established. We aimed to explore the relationship between serum CRP and the rate of detection of viruses and bacteria. This was a prospectively recruited, observational study of patients hospitalised with exacerbations of COPD. Nasopharyngeal swabs were tested for respiratory viruses by reverse transcriptase-PCR. Sputum and blood were collected for bacterial culture and urine tested for pneumococcal antigen. CRP levels were measured on sera. CRP and other factors associated with viral, bacterial or mixed detection were assessed using multiple logistic regression analysis. 264 patients with exacerbations of COPD were studied: 26% tested positive for respiratory viruses only, 13% had bacteria only, 12% had mixed viral/bacterial detection, and 49% had no pathogens detected. CRP level and temperature were strongly associated with viral detection rate (p<0.001 and p = 0.004, respectively) and mixed viral/bacterial detection rate (p = 0.02 and p = 0.03, respectively) on multivariate analysis. Bacterial detection rate was not associated with CRP level or body temperature. This study supports the role of viruses as important aetiological agents causing exacerbations of COPD.

PMID: 25186260 [PubMed - as supplied by publisher]

Biomarker discovery in asthma and copd by proteomic approaches.

Biomarker discovery in asthma and copd by proteomic approaches.

Proteomics Clin Appl. 2014 Sep 3;

Authors: Rossi R, Palma AD, Benazzi L, Riccio AM, Canonica GW, Mauri P

Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are multifactorial respiratory diseases, characterized by reversible and irreversible airway obstruction, respectively. Even If the primary causes of these diseases remain unknown, inflammation is a central feature which leads to progressive and permanent pulmonary tissue damage (airway remodelling) up to the total loss of lung function. Therefore, the elucidation of the inflammation mechanisms and the characterization of the biological pathways, involved in asthma and COPD pathogenesis, are relevant in finding new possible diagnostic/prognostic biomarkers and for the validation of new drug targets. In this context, current advances in proteomic approaches, especially those based on mass spectrometry, provide new tools to facilitate the discovery-driven studies of new biomarkers in respiratory diseases and improve the clinical reliability of the next generation of biomarkers for these diseases consisting of multiple phenotypes. This review will report an overview of the current proteomic methods applied to the discovery of candidate biomarkers for asthma and COPD, giving a special emphasis to emerging mass spectrometry-based techniques. This article is protected by copyright. All rights reserved.

PMID: 25186471 [PubMed - as supplied by publisher]

Matrix metalloproteinase 9 is involved in airway inflammation in cough variant asthma.

Matrix metalloproteinase 9 is involved in airway inflammation in cough variant asthma.

Exp Ther Med. 2014 Oct;8(4):1197-1200

Authors: Ma HP, Li W, Liu XM

Abstract
Previous studies have revealed the role of matrix metalloproteinase 9 (MMP9) in asthma and chronic obstructive pulmonary disease (COPD). However, its role in airway inflammation in cough variant asthma (CVA) remains unknown. In the present study, variations in the levels of MMP9 and interleukin (IL)-5 in the induced sputum of patients with CVA prior to and following therapy with inhaled corticosteroid and long-acting β2-agonist (ICS/LABA), were detected. The levels of IL-5 and percentage of eosinophils (EOS) in the induced sputum from patients with CVA were significantly higher than those in the control group of healthy individuals. The levels of MMP9 in the induced sputum from patients with CVA were also significantly higher than those in the control group. Following treatment with ICS/LABA for 6-9 months, the levels of MMP9 and IL-5, as well as the percentage of EOS, in the induced sputum from patients with CVA had significantly decreased. Thus, MMP9 may be an important biomarker in the airway inflammation of CVA.

PMID: 25187823 [PubMed - as supplied by publisher]

The 24-h FEV1 time profile of olodaterol once daily via Respimat® and formoterol twice daily via Aerolizer® in patients with GOLD 2-4 COPD: results from two 6-week crossover studies.

These studies evaluated the 24-h forced expiratory volume in 1 sec (FEV1) profile of once-daily (QD) olodaterol compared to placebo and twice-daily (BID) formoterol in patients with moderate to very severe chronic obstructive pulmonary disease. In two replicate, randomized, double-blind, double-dummy, four-way crossover studies, patients received olodaterol 5 and 10 μg QD, formoterol 12 μg BID, or placebo for 6 weeks in addition to usual-care background maintenance therapy.

Co-primary end points were FEV1 area under the curve from 0-12 h (AUC0-12) response (change from baseline) and FEV1 AUC from 12-24 h (AUC12-24) response after 6 weeks, with FEV1 AUC from 0-24 h response identified as a key secondary end point. Other secondary end points included FEV1 AUC from 0-3 h and trough FEV1 responses, as well as corresponding forced vital capacity responses.

With both olodaterol doses, FEV1 increased to near-maximal 30 min post-morning dose, which was sustained over 24 h. FEV1 also increased within 30 min post-morning dose of formoterol and was sustained over 12 h; the second formoterol dose resulted in a further increase, sustained for an additional 12 h. FEV1 AUC0-12 and AUC12-24 responses with both QD olodaterol doses and BID formoterol were significantly greater than placebo at 6 weeks (P < .0001). Secondary end-point outcomes were consistent with those of the co-primary end points.

These data, together with those from the wider phase III clinical program, provide evidence for the 24-h bronchodilator efficacy of olodaterol QD in this patient population.

TRIAL REGISTRY: ClinicalTrials.gov; NCT00931385 and NCT00932646.

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A self-management programme for COPD: a randomised controlled trial.

C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.

Biomarker discovery in asthma and copd by proteomic approaches.

Matrix metalloproteinase 9 is involved in airway inflammation in cough variant asthma.

The 24-h FEV1 time profile of olodaterol once daily via Respimat® and formoterol twice daily via Aerolizer® in patients with GOLD 2-4 COPD: results from two 6-week crossover studies.

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Blog With Right Sidebar

A self-management programme for COPD: a randomised controlled trial.

C-reactive protein level and microbial aetiology in patients hospitalised with acute exacerbation of COPD.

Biomarker discovery in asthma and copd by proteomic approaches.

Matrix metalloproteinase 9 is involved in airway inflammation in cough variant asthma.

The 24-h FEV1 time profile of olodaterol once daily via Respimat® and formoterol twice daily via Aerolizer® in patients with GOLD 2-4 COPD: results from two 6-week crossover studies.

Search

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