• Title/Summary/Keyword: Chronic obstructive pulmonary disease (COPD)

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Nutritional Management in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자의 영양관리)

  • Lee, Kwan-Ho
    • Journal of Yeungnam Medical Science
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    • v.21 no.2
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    • pp.133-142
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    • 2004
  • Chronic obstructive pulmonary disease(COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

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Gut Microbiome as a Possible Cause of Occurrence and Therapeutic Target in Chronic Obstructive Pulmonary Disease

  • Eun Yeong Lim;Eun-Ji Song;Hee Soon Shin
    • Journal of Microbiology and Biotechnology
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    • v.33 no.9
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    • pp.1111-1118
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    • 2023
  • As a long-term condition that affects the airways and lungs, chronic obstructive pulmonary disease (COPD) is characterized by inflammation, emphysema, breathlessness, chronic cough, and sputum production. Currently, the bronchodilators and anti-inflammatory drugs prescribed for COPD are mostly off-target, warranting new disease management strategies. Accumulating research has revealed the gut-lung axis to be a bidirectional communication system. Cigarette smoke, a major exacerbating factor in COPD and lung inflammation, affects gut microbiota composition and diversity, causing gut microbiota dysbiosis, a condition that has recently been described in COPD patients and animal models. For this review, we focused on the gut-lung axis, which is influenced by gut microbial metabolites, bacterial translocation, and immune cell modulation. Further, we have summarized the findings of preclinical and clinical studies on the association between gut microbiota and COPD to provide a basis for using gut microbiota in therapeutic strategies against COPD. Our review also proposes that further research on probiotics, prebiotics, short-chain fatty acids, and fecal microbiota transplantation could assist therapeutic approaches targeting the gut microbiota to alleviate COPD.

Lung Regeneration Therapy for Chronic Obstructive Pulmonary Disease

  • Oh, Dong Kyu;Kim, You-Sun;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.1
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    • pp.1-10
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is a critical condition with high morbidity and mortality. Although several medications are available, there are no definite treatments. However, recent advances in the understanding of stem and progenitor cells in the lung, and molecular changes during re-alveolization after pneumonectomy, have made it possible to envisage the regeneration of damaged lungs. With this background, numerous studies of stem cells and various stimulatory molecules have been undertaken, to try and regenerate destroyed lungs in animal models of COPD. Both the cell and drug therapies show promising results. However, in contrast to the successes in laboratories, no clinical trials have exhibited satisfactory efficacy, although they were generally safe and tolerable. In this article, we review the previous experimental and clinical trials, and summarize the recent advances in lung regeneration therapy for COPD. Furthermore, we discuss the current limitations and future perspectives of this emerging field.

Chronic Obstructive Pulmonary Disease in Korea: Prevalence, Risk Factors, and Quality of Life (한국성인의 만성 폐쇄성 폐질환 유병률, 위험요인 및 삶의 질)

  • Jung, Young-Mi;Lee, Hee-Young
    • Journal of Korean Academy of Nursing
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    • v.41 no.2
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    • pp.149-156
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    • 2011
  • Purpose: This study seeks to examine prevalence, risk factors, and quality of life of Korean adults with Chronic Obstructive Pulmonary Disease (COPD). Methods: From the database of the Fourth Korean National Health and Nutrition Examination Survey (KNHANES IV-1, 2008), the researchers selected 1,458 adults over the age of 45. The original study was a population-based epidemiological survey of health and nutrition with a stratified multistage clustered probability design. Prevalence of COPD was computed on the basis of the sampling weight. Data were analyzed using descriptive statistics, ${\chi}^2$ test, t-test and multiple logistic regression with the SPSS WIN 18.0 and SAS Ver. 9.1 program. Results: The prevalence of COPD was 18.0% among people older than 45 yr. The prevalence of current smokers was 19.7% in this population and 26.3% in individuals with COPD. Age, gender, education, and smoking levels were found to be risk factors for COPD. Significant difference in quality of life was founded between adults with COPD and the healthy controls. Conclusion: The results of this study indicate that COPD is a highly prevalent disease in Korea. To reduce the prevalence of COPD and improve health-related quality of life in patients with COPD, nursing interventions must focus on prevention of risk factors.

New Method for Combined Quantitative Assessment of Air-Trapping and Emphysema on Chest Computed Tomography in Chronic Obstructive Pulmonary Disease: Comparison with Parametric Response Mapping

  • Hye Jeon Hwang;Joon Beom Seo;Sang Min Lee;Namkug Kim;Jaeyoun Yi;Jae Seung Lee;Sei Won Lee;Yeon-Mok Oh;Sang-Do Lee
    • Korean Journal of Radiology
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    • v.22 no.10
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    • pp.1719-1729
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    • 2021
  • Objective: Emphysema and small-airway disease are the two major components of chronic obstructive pulmonary disease (COPD). We propose a novel method of quantitative computed tomography (CT) emphysema air-trapping composite (EAtC) mapping to assess each COPD component. We analyzed the potential use of this method for assessing lung function in patients with COPD. Materials and Methods: A total of 584 patients with COPD underwent inspiration and expiration CTs. Using pairwise analysis of inspiration and expiration CTs with non-rigid registration, EAtC mapping classified lung parenchyma into three areas: Normal, functional air trapping (fAT), and emphysema (Emph). We defined fAT as the area with a density change of less than 60 Hounsfield units (HU) between inspiration and expiration CTs among areas with a density less than -856 HU on inspiration CT. The volume fraction of each area was compared with clinical parameters and pulmonary function tests (PFTs). The results were compared with those of parametric response mapping (PRM) analysis. Results: The relative volumes of the EAtC classes differed according to the Global Initiative for Chronic Obstructive Lung Disease stages (p < 0.001). Each class showed moderate correlations with forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) (r = -0.659-0.674, p < 0.001). Both fAT and Emph were significant predictors of FEV1 and FEV1/FVC (R2 = 0.352 and 0.488, respectively; p < 0.001). fAT was a significant predictor of mean forced expiratory flow between 25% and 75% and residual volume/total vital capacity (R2 = 0.264 and 0.233, respectively; p < 0.001), while Emph and age were significant predictors of carbon monoxide diffusing capacity (R2 = 0.303; p < 0.001). fAT showed better correlations with PFTs than with small-airway disease on PRM. Conclusion: The proposed quantitative CT EAtC mapping provides comprehensive lung functional information on each disease component of COPD, which may serve as an imaging biomarker of lung function.

The Role of Bronchodilators in Preventing Exacerbations of Chronic Obstructive Pulmonary Disease

  • Beeh, Kai M.
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.4
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    • pp.241-247
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    • 2016
  • Bronchodilators are the cornerstone of symptomatic chronic obstructive pulmonary disease (COPD) treatment. They are routinely recommended for symptom reduction, with a preference of long-acting over short-acting drugs. Bronchodilators are classified into two classes based on distinct modes of action, i.e., long-acting antimuscarinics (LAMA, once-daily and twice-daily), and long-acting ${\beta}2$-agonists (LABA, once-daily and twice-daily). In contrast to asthma management, evidence supports the efficacy of both classes of long-acting bronchodilators as monotherapy in preventing COPD exacerbations, with greater efficacy of LAMA drugs versus LABAs. Several novel LAMA/LABA fixed dose combination inhalers are currently approved for COPD maintenance treatment. These agents show superior symptom control to monotherapies, and some of these combinations have also demonstrated superior efficacy in exacerbation prevention versus monotherapies, or combinations of inhaled corticosteroids plus LABA. This review summarizes the current data on clinical effectiveness of bronchodilators alone or in combination to prevent exacerbations of COPD.

Correlation of Sasang Constitution and Chronic Obstructive Pulmonary Disease (사상체질과 만성폐쇄성호흡기질환의 상관성)

  • Jung, Woon-Ki;Yoo, Jun-Sang;Koh, Sang-Baek;Park, Jong-Ku
    • Journal of Sasang Constitutional Medicine
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    • v.22 no.3
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    • pp.98-109
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    • 2010
  • 1. Objectives: This study is to investigate the association of Sasang Constitution and chronic obstructive pulmonary disease(COPD). 2. Methods: One thousand five hundred forty five persons, more than 40 years old, participated in the community based cohort in Wonju City and Pyeongchang City of South Korea from October 29th in 2007 to February 26th in 2008. The diagnosis of COPD was confirmed by spirometry and based on the diagnostic criteria developed by GOLD (Global Initiative for Chronic Obstructive Lung Disease) standard. Relating items like height, weight, BMI(Body Mass Index), martial status, income, drinking, smoking and education were checked using questionnaires and Sasang Constitution was diagnosed by a specialist using PSSC(Phonetic System for Sasang Constitution), facial photos and check-up lists. 3. Results: There were 88 persons(5.7%) who had mild COPD. Old age(more than 60's) and male were significant risk factors of COPD. But smoking, drinking and Sasang Constitution were not risk factors of COPD. But there were many Soeumin who had mild COPD in terms of Sasang Constitution irrespective of sex. 4. Conclusions: Low BMI(<23kg/m2) and low income also were significant risk factors. And Sasang Constitution might be the variable to manage COPD patients, but more researches are needed.

Factors Influencing on Influenza Vaccination Coverage among Chronic Obstructive Pulmonary Disease patient Over 40 years (만 40세 이상 성인 만성폐쇄성폐질환 환자의 인플루엔자 예방접종에 영향을 미치는 요인)

  • Lee, Yoonhee;Kwak, Eun-mi
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.2
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    • pp.299-307
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    • 2022
  • This study is to understand the status of influenza vaccination in patients with chronic obstructive pulmonary disease and to analyze factors affecting vaccination behavior. The aim of this study was to investigate the factors influencing influenza vaccination among Chronic Obstructive Pulmonary Disease (COPD) patients over 40 years, sociodemographic characteristics and health behaviors. Data of 2,370 adults of over 40 years who answered to the survey on National Health and Nutrition and influenza vaccination from 2014 to 2018 was used and analyzed. Overall influenza vaccination rate was 59.2%. Logistic regression analysis revealed that factors influencing on influenza vaccination were over 65 age, a low income, Never/past smoker, experience of health screening. It is needed to seek a strategy to develop a vaccination program in consideration of factors associated with influenza vaccination among COPD patient over 40 years.

Implications of Managing Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases

  • Deshmukh, Kartik;Khanna, Arjun
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.35-45
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    • 2021
  • Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

Build the nomogram by risk factors of chronic obstructive pulmonary disease (COPD) (만성 폐쇄성 폐질환의 위험요인 선별을 통한 노모그램 구축)

  • Seo, Ju-Hyun;Oh, Dong-Yep;Park, Yong-Soo;Lee, Jea-Young
    • The Korean Journal of Applied Statistics
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    • v.30 no.4
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    • pp.591-602
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    • 2017
  • The concentration of fine dust has increased in Korea and people have become more concerned with respiratory diseases. This study selected risk factors for chronic obstructive pulmonary disease (COPD) through demographic and clinical features and constructed a nomogram. First, logistic regression analysis was performed using demographic and clinical feature and the pulmonary function test results of the Korean National Health and Nutrition Examination Survey (KNHANES) $6^{th}$ (2013-2015) and the nomogram was constructed to visualize the risk factors of chronic obstructive pulmonary disease in order to facilitate the interpretation of the analysis results. The ROC curve and calibration plot were also used to verify the nomogram of chronic obstructive pulmonary disease.