Bronchiectasis revealed by chest computed tomography in COPD patients and its comorbid effect on prognosis have not been addressed by large-sized studies. Understanding the presence of bronchiectasis ...in COPD is important for future intervention and preventing disease progression.
Observational studies were identified from electronic literature searches in Cochrane library, PubMed, ScienceDirect databases, American Thoracic Society and European Respiratory Society meeting abstracts. A systematic review and meta-analysis of studies was performed to summarize the factors associated with bronchiectasis in COPD patients. Primary outcomes included the risks for exacerbation frequency, isolation of a potentially pathogenic microorganism, severe airway obstruction and mortality. Odds ratios (ORs) were pooled by random effects models.
Fourteen observational studies were eligible for the study. Compared with COPD without bronchiectasis, comorbid bronchiectasis in COPD increased the risk of exacerbation (1.97, 95% CI, 1.29-3.00), isolation of a potentially pathogenic microorganism (4.11, 95%CI, 2.16-7.82), severe airway obstruction (1.31, 95% CI, 1.09-1.58) and mortality (1.96, 95% CI, 1.04-3.70).
The presence of bronchiectasis in patients with COPD was associated with exacerbation frequency, isolation of a potentially pathogenic microorganism, severe airway obstruction and mortality.
Cardiovascular disease is a primary cause of death in patients with chronic obstructive pulmonary disease (COPD). Beta-blockers have been proved to reduce morbidity and improve survival in patients ...with cardiac diseases. But the effects of beta-blockers on outcomes in patients with COPD remain controversial. The objective of this meta-analysis was to assess the effect of beta-blockers on mortality and exacerbation in patients with COPD.
An extensive search of the EMBASE, MEDLINE and Cochrane was performed to retrieve the studies of beta-blockers treatment in patients with COPD. The random effects model meta-analysis was used to evaluate effect on overall mortality and exacerbation of COPD.
Fifteen original observational cohort studies with a follow-up time from 1 to 7.2 years were included. The results revealed that beta-blockers treatment significantly decreased the risk of overall mortality and exacerbation of COPD. The relative risk (RR) for overall mortality was 0.72 (0.63 to 0.83), and for exacerbation of COPD was 0.63 (0.57 to 0.71). In subgroup analysis of COPD patients with coronary heart disease or heart failure, the risk for overall mortality was 0.64 (0.54-0.76) and 0.74 (0.58-0.93), respectively.
The findings of this meta-analysis confirmed that beta-blocker use in patients with COPD may not only decrease the risk of overall mortality but also reduce the risk of exacerbation of COPD. Beta-blocker prescription for cardiovascular diseases needs to improve in COPD patients.
Sarcopenia and osteoporosis are common musculoskeletal comorbidities of chronic obstructive pulmonary disease (COPD) that seriously affect the quality of life and prognosis of the patient. In ...addition to spatially mechanical interactions, muscle and bone can also serve as endocrine organs by producing myokines and osteokines to regulate muscle and bone functions, respectively. As positive and negative regulators of skeletal muscles, the myokines irisin and myostatin not only promote/inhibit the differentiation and growth of skeletal muscles, but also regulate bone metabolism. Both irisin and myostatin have been shown to be dysregulated and associated with exercise and skeletal muscle dysfunction in COPD. During exercise, skeletal muscles produce a large amount of IL-6 which acts as a myokine, exerting at least two different conflicting functions depending on physiological or pathological conditions. Remarkably, IL-6 is highly expressed in COPD, and considered to be a biomarker of systemic inflammation, which is associated with both sarcopenia and bone loss. For osteokines, receptor activator of nuclear factor kappa-B ligand (RANKL), a classical regulator of bone metabolism, was recently found to play a critical role in skeletal muscle atrophy induced by chronic cigarette smoke (CS) exposure. In this focused review, we described evidence for myokines and osteokines in the pathogenesis of skeletal muscle dysfunction/sarcopenia and osteoporosis in COPD, and proposed muscle-bone crosstalk as an important mechanism underlying the coexistence of muscle and bone diseases in COPD.
Chronic obstructive pulmonary disease (COPD) frequently coexists with various diseases, yet the causal relationship between COPD and these comorbidities remains ambiguous. As a result, the aim of our ...study is to elucidate the potential causality between COPD and its common comorbidities.
We employed the Mendelian randomization (MR) method to analyze single nucleotide polymorphism (SNP) data of common comorbidities with COPD from FinnGen and Integrative Epidemiology Unit (IEU) databases. Causality was primarily assessed using the inverse variance weighting (IVW) method. Multivariable Mendelian randomization (MVMR) analysis was also conducted to eliminate the interference of smoking-related phenotypes. Sensitivity analysis was conducted to ensure the reliability of our findings.
Preliminary univariable MR revealed an increased risk of lung squamous cell carcinoma (LUSC) (IVW: OR = 1.757, 95% CI = 1.162-2.657, P = 0.008), chronic kidney disease (CKD) (IVW: OR = 1.193, 95% CI = 1.072-1.326, P < 0.001), chronic periodontitis (IVW: OR = 1.213, 95% CI = 1.038-1.417, P = 0.012), and heart failure (HF) (IVW: OR = 1.127, 95% CI = 1.043-1.218, P = 0.002). Additionally, the reverse MR analysis indicated that genetic susceptibility to HF (IVW: OR = 1.272, 95% CI = 1.084-1.493, P = 0.003), obesity (IVW: OR = 1.128, 95% CI = 1.056-1.205, P < 0.001), depression (IVW: OR = 1.491, 95% CI = 1.257-1.770, P < 0.001), and sleep apnea syndrome (IVW: OR = 1.209, 95% CI = 1.087-1.345, P < 0.001) could raise the risk of COPD. The MVMR analysis showed no causal effect of COPD on susceptibility to chronic periodontitis after adjusting for smoking.
Our study identified that COPD may elevate the risk of LUSC, HF, and CKD. Additionally, our analysis revealed that HF, sleep apnea symptoms, depression, and obesity might also increase the susceptibility to COPD. These findings revealed a potential causal relationship between COPD and several prevalent comorbidities, which may provide new insights for disease early prediction and prevention.
Chronic obstructive pulmonary disease (COPD) is a complex chronic disease in which T cell-mediated pulmonary inflammation has been shown to play a key role. Accumulating evidence shows that COPD has ...many of the characteristics of an autoimmune response. An adaptive immune response directed against lung self-antigens, which are released during the initial innate inflammatory response and are triggered by constant exposure to cigarette smoke and epithelial injury, drives the persistent inflammatory response found in smokers. The development and severity of adaptive inflammation depend on the level of tolerance to self-antigens. For these reasons, the effect of regulatory T (Treg) cells on adaptive immunity in COPD patients is of particular interest and could be targeted therapeutically. The disturbance in immune homeostasis caused by changes in the number or function of Treg cells, which is related to cigarette smoke exposure, may be of importance in understanding the development and progression of COPD.
•Birch wood was pretreated by Lewis acid-catalyzed biphasic 2-MeTHF/H2O system.•Cellulose conversion rate was enhanced by 7.4 fold during enzymatic hydrolysis.•The lignin exhibited representative ...structure and relatively low molecular weight.•AlCl3 catalyzed 2-MeTHF/H2O system at 180 °C for 1 h was the optimal pretreatment.
Lewis acid-catalyzed pretreatment in a biphasic system consisting of bio-based solvent 2-methyltetrahydrofuran (2-MeTHF) and water for a highly integrated one-pot catalytic transformation of lignocelluloses have been achieved. The aim of this work was to study the effects of different Lewis acid catalysts and pretreatment temperatures on the structural characteristics of precipitated lignin and enzymatic hydrolysis of the pretreated substrates, as well as the quantitative analysis of precipitates, solid residues, soluble carbohydrates and inhibitors. After the AlCl3-catalyzed biphasic 2-MeTHF/H2O pretreatment at 180 °C, its maximum cellulose conversion rate was enhanced by 7.4-fold as compared to the raw material. The precipitated lignin exhibited the representative structure, relatively low molecular weight and high purity for preparing value-added aromatic chemicals or renewable polymers. Overall, AlCl3-catalyzed biphasic 2-MeTHF/H2O pretreatment may offer a promising approach for enhancing enzymatic hydrolysis and obtaining valorized lignin by-product.
Coronavirus Disease 2019 (COVID-19) vaccines have a protective effect on individuals with chronic obstructive pulmonary disease (COPD), preventing them from developing severe illnesses and reducing ...the risk of hospitalization and mortality. However, the coverage rate of COVID-19 vaccination among this population is not satisfactory, which is associated with their lack of awareness of and negative attitudes toward COVID-19 vaccination, that is, vaccine hesitancy. We reviewed recent literatures on the vaccination status of COPD patients and vaccine hesitancy, described the factors related to vaccine hesitancy among COPD patients, and proposed strategies to improve the vaccine coverage, such as providing accurate and consistent vaccine information to the public, patient health education program, improving self-management capabilities, easy access to vaccination service, etc., which can hopefully help to improve patients' ability to cope with SARS-CoV-2 infection and reduce the COVID-19 related mortality.
In the parallel supply system of synchronous generator and virtual synchronous generator, the physical structure and control structure of the two kinds of power supply are quite different, and it is ...difficult to distribute the transient power of the two kinds of power supply evenly when the load changes abruptly. Especially in the case of sudden load increase, virtual synchronous generator bears too much load in the transient process because of its fast adjustment speed, and even causes short-term overload, which makes the capacity of virtual synchronous generator can not be fully utilized. In view of this problem, firstly, the mechanism of transient power uneven distribution of two heterogeneous power sources is explained from the differences of frequency modulation, voltage regulation and output impedance. Secondly, virtual speed regulation, virtual excitation and dynamic virtual impedance are added to the traditional virtual synchronous generator control to simulate the speed regulation characteristics and electromagnetic transient characteristics of the synchronous generator, so as to realize the transient and steady-state power equalization between heterogeneous power supplies when the virtual synchronous generator and the synchronous generator run in parallel. Thirdly, in order to ensure the fast dynamic response characteristics of the virtual synchronous generator in independent operation mode, the traditional virtual synchronous generator control algorithm is still maintained in independent operation mode, and the mode switching control link based on state tracking is designed to realize smooth switching between the two working modes. Finally, the hardware in loop experiment results based on RT-LAB show that the proposed control method can realize the transient and steady-state power equalization when the virtual synchronous generator and the synchronous generator operate in parallel, it can keep the fast voltage regulation and frequency modulation ability when the virtual synchronous generator operates independently, and can realize smooth switching between independent and parallel operation modes.
IL-25, also named IL-17E, is a distinct member of the IL-17 cytokine family, which can promote and augment T helper type 2 (Th2) responses locally or systemically. Growing evidence from experimental ...and clinical studies indicates that the expression of IL-25 and its cognate receptor, IL-17RB/RA, is markedly upregulated in asthmatic conditions. It has also been found that IL-25 induces not only typical eosinophilic inflammation and airway hyperresponsiveness (AHR), but also airway remodelling, manifested by goblet cell hyperplasia, subepithelial collagen deposition and angiogenesis. This review will focus on the discovery, cellular origins and targets of IL-25, and try to update current animal and human studies elucidating the roles of IL-25 in asthma. We conclude that although IL-25 is a pleiotropic cytokine, it may only play its dominant role in a certain specific asthmatic endotype, named 'IL-25 high' phenotype. Thus, targeting IL-25 or its receptor might selectively benefit some subgroups with asthma. Furthermore, the major IL-25 producing as well as responsive cells in the changeable milieu of asthma should be assessed in the future.
PDF
