Association between markers of emphysema and more severe chronic obstructive pulmonary disease

Boschetto, P.; Quintavalle, S.; Zeni, E.; Leprotti, S.; Potena, A.; Ballerin, I.; Papi, A.; Palladini, G.; Luisetti, M.; Annovazzi, l.; Iadarola, P.; De Rosa, E.; Fabbri, L. M.; Mapp, C. E.; Ballerin, L
December 2006
Thorax;Dec2006, Vol. 61 Issue 12, p1037
Academic Journal
journal article
Background: The predominant emphysema phenotype is associated with more severe airflow limitation in patients with chronic obstructive pulmonary disease (COPD). A study was undertaken to investigate whether COPD patients, with or without emphysema quantitatively confirmed by high resolution computed tomography (HRCT), have different COPD severity as assessed by the BODE index (body mass index, airflow obstruction, dyspnoea, exercise performance) and inspiratory capacity to total lung capacity ratio (IC/TLC), and by different biological markers of lung parenchymal destruction. Methods: Twenty six outpatients with COPD and eight healthy non-smokers were examined. Each subject underwent HRCT scanning, pulmonary function tests, cell counts, and measurements of neutrophil elastase, matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in induced sputum, as well as measurement of desmosine, a marker of elastin degradation in urine, plasma and sputum. Results: Patients with HRCT confirmed emphysema had a higher BODE index and lower IC/TLC ratio than subjects without HRCT confirmed emphysema and controls. Forced expiratory volume in 1 second (FEV(1)), FEV(1)/forced vital capacity ratio, and carbon monoxide transfer coefficient were lower, whereas the number of eosinophils, MMP-9, and the MMP-9/TIMP-1 ratio in sputum were higher in patients with emphysema. In COPD patients the number of sputum eosinophils was the biological variable that correlated positively with the HRCT score of emphysema (p = 0.04). Conclusions: These results suggest that COPD associated with HRCT confirmed emphysema is characterised by more severe lung function impairment, more intense airway inflammation and, possibly, more serious systemic dysfunction than COPD not associated with HRCT confirmed emphysema.


Related Articles

  • Emphysema in COPD: consequences and causes. Turino, G. M. // Thorax;Dec2006, Vol. 61 Issue 12, p1031 

    The article focuses on the role of radiologically identified pulmonary emphysema in a group of patients having chronic obstructive pulmonary disease. It was found that patients with computed tomography (CT) emphysema have higher body mass index than subjects without CT confirmed lung disease....

  • COPD: small airway obstruction and emphysema.  // African Journal of Respiratory Medicine;Mar2012, Vol. 7 Issue 2, p2 

    The article presents a study led by a team in Canada and the U.S. involving high-resolution computed tomography (CT) on people with severe chronic obstructive pulmonary disease (COPD) may lead to changes in the definition of emphysema.

  • Body mass index in male patients with COPO: correlation with low attenuation areas on CT. Ogawa, E.; Nakano, Y.; Ohara, T.; Muro, S.; Hirai, T.; Sato, S.; Sakai, H.; Tsukino, M.; Kinose, D.; Nishioka, M.; Niimi, A.; Chin, K.; Paré, P. D.; Mishima, M. // Thorax;Jan2009, Vol. 64 Issue 1, p20 

    Background: Chronic obstructive pulmonary disease (COPD) is characterised by the presence of airflow limitation caused by loss of lung elasticity and/or airway narrowing. The pathological hallmark of loss of lung elasticity is emphysema, and airway wall remodelling contributes to the airway...

  • Quantitative Computed Tomography in COPD: Possibilities and Limitations. Mets, O.; Jong, P.; Ginneken, B.; Gietema, H.; Lammers, J. // Lung;Apr2012, Vol. 190 Issue 2, p133 

    Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that is characterized by chronic airflow limitation. Unraveling of this heterogeneity is challenging but important, because it might enable more accurate diagnosis and treatment. Because spirometry cannot distinguish between...

  • Automated classification of normal and pathologic pulmonary tissue by topological texture features extracted from multi-detector CT in 3D. Boehm, H.; Fink, C.; Attenberger, U.; Becker, C.; Behr, J.; Reiser, M. // European Radiology;Dec2008, Vol. 18 Issue 12, p2745 

    To provide a novel, robust algorithm for classification of lung tissue depicted by multi-detector computed tomography (MDCT) based on the topology of CT-attenuation values and to compare discriminative results with densitometric methods. Two hundred seventy-five cubic volumes of interest (VOI,...

  • Detection of mild emphysema by computed tomography density measurements. Vikgren, J.; Friman, O.; Borga, M.; Boijsen, M.; Gustavsson, S.; Ekberg-Jansson, A.; Bake, B.; Tylén, U.; Tylén, U // Acta Radiologica;May2005, Vol. 46 Issue 3, p237 

    Purpose: To assess the ability of a conventional density mask method to detect mild emphysema by high-resolution computed tomography (HRCT); to analyze factors influencing quantification of mild emphysema; and to validate a new algorithm for detection of mild emphysema....

  • CT of pulmonary emphysema - current status, challenges, and future directions. Litmanovich, Diana; Boiselle, Phillip M.; Bankier, Alexander A. // European Radiology;Mar2009, Vol. 19 Issue 3, p537 

    Pulmonary emphysema is characterized by irreversible destruction of lung parenchyma. Emphysema is a major contributor to chronic obstructive pulmonary disease (COPD), which by itself is a major cause of morbidity and mortality in the western world. Computed tomography (CT) is an established...

  • Whole-lung densitometry versus visual assessment of emphysema. Cavigli, Edoardo; Camiciottoli, Gianna; Diciotti, Stefano; Orlandi, Ilaria; Spinelli, Cheti; Meoni, Eleonora; Grassi, Luca; Farfalla, Carmela; Pistolesi, Massimo; Falaschi, Fabio; Mascalchi, Mario // European Radiology;Jul2009, Vol. 19 Issue 7, p1686 

    We compared whole-lung densitometry with visual evaluation of pulmonary emphysema. Thirty patients with chronic obstructive pulmonary disease underwent multi-detector CT (150 mAs and 0.75 collimation) with double reconstruction: thick (5-mm) slices with smooth filter for whole-lung densitometry...

  • Determinants of chronic obstructive pulmonary disease severity in the late-elderly differ from those in younger patients. Mizuha Haraguchi; Hidetoshi Nakamura; Mamoru Sasaki; Masaki Miyazaki; Shotaro Chubachi; Saeko Takahashi; Koichiro Asano; Jones, Paul W.; Tomoko Betsuyaku // BMC Research Notes;1/4/2016, Vol. 9, p1 

    Background: Although the age range of chronic obstructive pulmonary disease (COPD) patients is broad, few studies have focused on the effects of age on disease characteristics. Methods: Keio University and affiliated hospitals established an observational COPD cohort. Patients were assessed...


Read the Article


Sign out of this library

Other Topics