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Clinical Advances in Chronic Obstructive Pulmonary Disease and Its Complications: Part II

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: closed (25 March 2025) | Viewed by 6003

Special Issue Editor

Prof. Dr. Emiel F.M. Wouters

E-Mail Website
Guest Editor
1. Department of Respiratory Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
2. Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
Interests: COPD; asthma; lung physiology; pulmonary rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to this Special Issue entitled “Clinical Advances in Chronic Obstructive Pulmonary Disease and Its Complications: Part II”, the first volume of which included five papers and can be found here: https://www.mdpi.com/journal/jcm/special_issues/COPD_Complications

In recent decades, COPD has evolved from a disease characterized by persistent airflow limitation to a clinical syndrome involving diverse pathologies beyond those of the lungs. Our current understanding of COPD is hampered by several factors, including the definition of COPD being based on the FEV1/VC ratio, the cross-sectional design of many studies, and the invalid diagnosis of underlying pathologies. Furthermore, current insights underscore the importance of individual lung trajectories in the development of psionically defined flow limitation but have explored neither the impact of these trajectories on multimorbidity profiles nor the role of lung size itself as a marker of organ health in individuals. According to ongoing research, in addition to lung trajectories, factors such as compositional changes of the body need to be considered, including the interplay between different body compartments, such as fat tissue and the gut microbiome. This issue of JCM aims to offer new perspectives to better understand the pathophysiological mechanisms of COPD syndrome.

Prof. Dr. Emiel F.M. Wouters
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

  • COPD
  • multimorbidity
  • lung trajectories
  • body composition
  • gut
  • adipose metabolism

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Published Papers (3 papers)

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Research

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12 pages, 656 KiB  
Article
Incident Cardiometabolic Comorbidities in Smokers with/Without Chronic Obstructive Pulmonary Disease: A Long-Term Cohort Study
by Beatriz Herrero-Cortina, Aura Maldonado-Guaje, Jorge Rodriguez-Sanz, Ana Boldova-Loscertales, Pablo Cubero-Marin, Marta Marin-Oto, David Sanz-Rubio and Jose M. Marin
J. Clin. Med. 2024, 13(24), 7627; https://doi.org/10.3390/jcm13247627 - 14 Dec 2024
Viewed by 1046
Abstract
Backgrounds: Despite the significant global health impact of cardiometabolic multimorbidity (CMM), our understanding of potential predictors associated with its development in smokers, remains limited. Objective: This study aimed to investigate whether a new COPD diagnosis and the rate of lung function decline serve [...] Read more.
Backgrounds: Despite the significant global health impact of cardiometabolic multimorbidity (CMM), our understanding of potential predictors associated with its development in smokers, remains limited. Objective: This study aimed to investigate whether a new COPD diagnosis and the rate of lung function decline serve as predictors for incident CMM (defined as having at least two of the following comorbidities: cerebro-cardiovascular diseases, hypertension, dyslipidemia, and diabetes mellitus) in smokers. Methods: An observational longitudinal analysis of prospectively collected data was conducted, including smokers without a previous COPD diagnosis and any cardiometabolic conditions. Sociodemographic and clinical data (body mass index, smoking history, respiratory symptoms, and hospital admissions) were collected at baseline. Lung function tests were performed at baseline and at the end of the follow-up period. The incidence of CMM, a new positive diagnosis of COPD, and the forced expiratory volume in 1 s (FEV1) annual rate of decline were prospectively registered. Adjusted Cox proportional hazard models were adopted to explore risk factors associated with the incidence of CMM. Results: From the 391 smokers included in the study, 207 (53%) were newly diagnosed with COPD, and 184 had a preserved spirometry at baseline (non-COPD group). After nearly a decade of follow-up, 34% (n = 133) of smokers developed CMM. This group was characterized by male predominance, older age, higher BMI and pack-years of smoking, lower post-FEV1, baseline COPD diagnosis, and a history of hospital admission. A positive diagnosis of COPD at baseline and a greater rate of lung function decline (ΔFEV1 ≥ 40 mL/year) were independent predictors for developing CMM. Conclusions: A new COPD diagnosis and an accelerated decline in lung function are significantly associated with the development of CMM in smokers. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Obstructive Pulmonary Disease and Its Complications: Part II)
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15 pages, 2054 KiB  
Article
Type-2 Inflammation in Health and Disease: Prevalence, Risk Factors and Multimorbidity
by Charmaine J. M. Lim, Christoph Gross, Marie-Kathrin Breyer, Robab Breyer-Kohansal, Emiel F. M. Wouters and Sylvia Hartl
J. Clin. Med. 2024, 13(22), 6662; https://doi.org/10.3390/jcm13226662 - 6 Nov 2024
Viewed by 1607
Abstract
Background: In patients with airflow obstruction, the levels of biomarkers of Type-2 (T2) inflammation serve to predict the effectiveness of inhaled corticosteroid and biological therapies. Elevated biomarkers of T2 inflammation, including fractional exhaled nitric oxide (FeNO, ≥20 ppb) and blood eosinophil counts (BEC, [...] Read more.
Background: In patients with airflow obstruction, the levels of biomarkers of Type-2 (T2) inflammation serve to predict the effectiveness of inhaled corticosteroid and biological therapies. Elevated biomarkers of T2 inflammation, including fractional exhaled nitric oxide (FeNO, ≥20 ppb) and blood eosinophil counts (BEC, ≥300 cells/µL), were investigated in a population-based cohort of the Austrian LEAD study. Methods: A total of 4976 individuals (aged 18–82 years) were categorised into four groups based on their FeNO and BEC levels: normal with FeNO < 20 ppb and BEC < 300 cells/µL (n = 2634); FeNO ≥ 20 ppb only (n = 1623); BEC ≥ 300 cells/µL only (n = 340); and FeNO ≥ 20 ppb and BEC ≥ 300 cells/µL (n = 379). Results: In age- and sex-adjusted regression models, individuals with elevated BEC only were most associated with chronic cough and sputum production (odds ratios [95% CI]: 1.22 [0.78, 1.84] and 1.37 [1.13, 2.62], respectively), whilst individuals with both elevated T2 biomarkers were most associated with wheezing, dyspnoea and asthma (odds ratios [95% CI]: 2.27 [1.56, 3.26], 1.32 [0.64, 2.50] and 3.63 [2.69, 4.88] respectively). Elevated levels of both FeNO and BEC presented an additive effect in extrapulmonary conditions, particularly in allergy, eczema and rhino conjunctivitis (odds ratios [95% CI]: 2.30 [1.84, 2.88], 1.37 [1.03, 1.81] and 2.95 [2.34, 3.70], respectively). Conclusions: T2 inflammation marked by elevated levels of FeNO and/or BEC is not only associated with respiratory conditions but also extends to extrapulmonary characteristics, with an additive effect. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Obstructive Pulmonary Disease and Its Complications: Part II)
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Other

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18 pages, 868 KiB  
Systematic Review
Cardiovascular Risk in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review
by Ana Sá-Sousa, Cidália Rodrigues, Cristina Jácome, João Cardoso, Inês Fortuna, Miguel Guimarães, Paula Pinto, Pedro Morais Sarmento and Rui Baptista
J. Clin. Med. 2024, 13(17), 5173; https://doi.org/10.3390/jcm13175173 - 31 Aug 2024
Cited by 4 | Viewed by 2587
Abstract
Background/Objectives: A comprehensive and up-to-date review on cardiovascular disease (CVD) risk in patients with COPD is needed. Therefore, we aimed to systematically review the risk of a range of CVD in patients with COPD. Methods: We searched three databases (Pubmed, Web [...] Read more.
Background/Objectives: A comprehensive and up-to-date review on cardiovascular disease (CVD) risk in patients with COPD is needed. Therefore, we aimed to systematically review the risk of a range of CVD in patients with COPD. Methods: We searched three databases (Pubmed, Web of Science, SCOPUS) from inception to September 2023 using terms related to COPD and CVD. Observational studies were included if they (1) were conducted in adults with a diagnosis of COPD based on the GOLD criteria, spirometry, physician diagnosis, or review of electronic health records; (2) reported the risk of CVD, namely of myocardial infarction (MI), ischaemic heart disease (IHD), atrial fibrillation (AF), heart failure, cerebrovascular disease, pulmonary hypertension, and peripheral vascular disease, compared with a control population using a measure of risk. A narrative synthesis was used. Results: Twenty-four studies from 2015 to 2023, mainly from Europe (n = 17), were included. A total of 3,485,392 patients with COPD (43.5–76.0% male; 63.9–73.5 yrs) and 31,480,333 (40.0–55.4% male, 49.3–70.0 yrs) controls were included. A higher risk of CVD in patients with COPD was evident regarding overall CVD, MI, IHD, heart failure, and angina. Higher risks of arrhythmia and AF, stroke, sudden cardiac death/arrest, pulmonary embolism, pulmonary hypertension, and peripheral vascular disease were also found, although based on a small amount of evidence. Conclusions: Patients with COPD have a higher risk of CVD than the general population or matched controls. This review underscores the need for vigilant and close monitoring of cardiovascular risk in individuals with COPD to inform more precise preventive strategies and targeted interventions to enhance their overall management. Full article
(This article belongs to the Special Issue Clinical Advances in Chronic Obstructive Pulmonary Disease and Its Complications: Part II)
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