scholarly journals The effect of smoking on lung function: a clinical study of adult-onset asthma

2016 ◽  
Vol 48 (5) ◽  
pp. 1298-1306 ◽  
Author(s):  
Minna Tommola ◽  
Pinja Ilmarinen ◽  
Leena E. Tuomisto ◽  
Jussi Haanpää ◽  
Terhi Kankaanranta ◽  
...  
Keyword(s):  
Lung Function ◽  
Multivariate Regression Analysis ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Adult Onset ◽  
Lung Function Decline ◽  
Adult Asthma ◽  
Asthma Patients ◽  
Annual Decline

The aim of this study was to evaluate the effect of smoking on lung function decline in adult-onset asthma in a clinical, 12-year follow-up study.In the Seinäjoki Adult Asthma Study, 203 patients were followed for 12 years (1999–2013) after diagnosis of new-onset adult asthma. Patients were divided into two groups based on smoking history: <10 or ≥10 pack-years. Spirometry evaluation points were: 1) baseline, 2) the maximum lung function during the first 2.5 years after diagnosis (Max0–2.5) and 3) after 12 years of follow-up.Between Max0–2.5 and follow-up, the median annual decline in absolute forced expiratory volume in 1 s (FEV1) was 36 mL in the group of patients with <10 pack-years of smoking and 54 mL in those with smoking history ≥10 pack-years (p=0.003). The annual declines in FEV1 % pred (p=0.006), forced vital capacity (FVC) (p=0.035) and FEV1/FVC (p=0.045) were also accelerated in the group of patients with ≥10 pack-years smoked. In multivariate regression analysis, smoking history ≥10 pack-years became a significant predictor of accelerated decline in FEV1.Among patients with clinically defined adult-onset asthma, smoking history ≥10 pack-years is associated with accelerated loss of lung function.

scholarly journals Differences between asthma–COPD overlap syndrome and adult-onset asthma

2017 ◽  
Vol 49 (5) ◽  
pp. 1602383 ◽  
Author(s):  
Minna Tommola ◽  
Pinja Ilmarinen ◽  
Leena E. Tuomisto ◽  
Lauri Lehtimäki ◽  
Jussi Haanpää ◽  
...  
Keyword(s):  
Lung Function ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Overlap Syndrome ◽  
Smoking History ◽  
Adult Onset ◽  
Blood Neutrophil ◽  
Diffusing Capacity ◽  
Adult Asthma ◽  
Asthma Patients

Differences between asthma–COPD overlap syndrome (ACOS) and adult-onset asthma are poorly understood. This study aimed to evaluate these differences in a clinical cohort of patients with adult-onset asthma, as a part of the Seinäjoki Adult Asthma Study (SAAS).188 patients were diagnosed with adult-onset asthma and re-evaluated 12 years after diagnosis. They were divided into three groups based on smoking history and post bronchodilator spirometry values: 1) never- and ex-smokers with <10 smoked pack-years; 2) non-obstructive (forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7) patients with ≥10 pack-years; and 3) ACOS patients with ≥10 pack-years and FEV1/FVC <0.7.ACOS patients had lower diffusing capacity (DLCO/VA 86% predicted versus 98 or 96% predicted; p<0.001), higher blood neutrophil levels (4.50 versus 3.60 or 3.85×109 L−1; p=0.008), and higher IL-6 levels (2.88 versus 1.52 or 2.10 pg·mL−1, p<0.001) as compared to never- and ex-smokers with <10 pack-years, or non-obstructive patients with ≥10 pack-years smoking history, respectively. ACOS patients also showed reduced lung function, higher remaining bronchial reversibility and a higher number of comorbidities.This study shows distinct differences in diffusing capacity, blood neutrophil and IL-6 levels, bronchial reversibility, lung function and comorbidities between ACOS and adult-onset asthma. The present findings should be considered in the comprehensive assessment of adult asthma patients.

scholarly journals Lung function decline in asthma patients with elevated bronchial CD8, CD4 and CD3 cells

2016 ◽  
Vol 48 (2) ◽  
pp. 393-402 ◽  
Author(s):  
Irene den Otter ◽  
Luuk N.A. Willems ◽  
Annemarie van Schadewijk ◽  
Simone van Wijngaarden ◽  
Kirsten Janssen ◽  
...  
Keyword(s):  
Lung Function ◽  
Granzyme B ◽  
Eosinophil Cationic Protein ◽  
Risk Groups ◽  
Forced Expiratory Volume ◽  
Lung Function Decline ◽  
Cationic Protein ◽  
Asthmatic Patients ◽  
Asthma Patients

Which inflammatory markers in the bronchial mucosa of asthma patients are associated with decline of lung function during 14 years of prospective follow-up?To address this question, 19 mild-to-moderate, atopic asthmatic patients underwent spirometry and bronchoscopy at baseline and after 14 years of follow-up (t=14). Baseline bronchial biopsies were analysed for reticular layer thickness, eosinophil cationic protein (EG2), mast cell tryptase (AA1), CD3, CD4 and CD8. Follow-up biopsies were stained for EG2, AA1, neutrophil elastase, CD3, CD4, CD8, CD20, granzyme B, CD68, DC-SIGN, Ki67 and mucins.Decline in forced expiratory volume in 1 s (FEV1) % predicted was highest in patients with high CD8 (p=0.01, both pre- and post-bronchodilator) or high CD4 counts at baseline (p=0.04 pre-bronchodilator, p=0.03 post-bronchodilator). Patients with high CD8, CD3 or granzyme B counts at t=14 also exhibited faster decline in FEV1 (p=0.00 CD8 pre-bronchodilator, p=0.04 CD8 post-bronchodilator, p=0.01 granzyme B pre-bronchodilator, and p<0.01 CD3 pre-bronchodilator).Long-term lung function decline in asthma is associated with elevation of bronchial CD8 and CD4 at baseline, and CD8, CD3 and granzyme B at follow-up. This suggests that high-risk groups can be identified on the basis of inflammatory phenotypes.

scholarly journals Long-term adherence to inhaled corticosteroids and asthma control in adult-onset asthma

2021 ◽  
Vol 7 (1) ◽  
pp. 00715-2020
Author(s):  
Iida Vähätalo ◽  
Hannu Kankaanranta ◽  
Leena E. Tuomisto ◽  
Onni Niemelä ◽  
Lauri Lehtimäki ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Early Recognition ◽  
Forced Expiratory Volume ◽  
Rapid Decline ◽  
Adult Onset ◽  
Lung Function Decline ◽  
Adult Asthma ◽  
Asthma Patients

BackgroundIn short-term studies, poor adherence to inhaled corticosteroids (ICS) has been associated with worse asthma control, but the association of long-term adherence and disease control remains unclear.ObjectiveTo assess the relationship between 12-year adherence to ICS and asthma control in patients with adult-onset asthma.MethodsAs part of the Seinäjoki Adult Asthma Study, 181 patients with clinically confirmed new-onset adult asthma and regular ICS medication were followed-up for 12 years. Adherence (%) to ICS was assessed individually ((µg dispensed/µg prescribed)×100) during the follow-up. Asthma control was evaluated after 12 years of treatment according to the Global Initiative for Asthma 2010 guideline.ResultsAsthma was controlled in 31% and not controlled (partly controlled or uncontrolled) in 69% of the patients. Patients with not-controlled asthma were more often male, older, nonatopic and used higher doses of ICS than those with controlled disease. The mean±sd 12-year adherence to ICS was 63±38% in patients with controlled asthma and 76±40% in patients with not-controlled disease (p=0.042). Among patients with not-controlled asthma, those with lower 12-year adherence (<80%) had more rapid decline in forced expiratory volume in 1 s (−47 mL·year−1) compared to patients with better adherence (≥80%) (−40 mL·year−1) (p=0.024). In contrast, this relationship was not seen in patients with controlled asthma.ConclusionsIn adult-onset asthma, patients with not-controlled disease showed better 12-year adherence to ICS treatment than those with controlled asthma. In not-controlled disease, adherence <80% was associated with more rapid lung function decline, underscoring the importance of early recognition of such patients in routine clinical practice.

scholarly journals 12-year adherence to inhaled corticosteroids in adult-onset asthma

2020 ◽  
Vol 6 (1) ◽  
pp. 00324-2019
Author(s):  
Iida Vähätalo ◽  
Pinja Ilmarinen ◽  
Leena E. Tuomisto ◽  
Minna Tommola ◽  
Onni Niemelä ◽  
...  
Keyword(s):  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Immunoglobulin E ◽  
Linear Regression Analysis ◽  
Forced Expiratory Volume ◽  
Rapid Decline ◽  
Blood Eosinophil ◽  
Adult Onset ◽  
Lung Function Decline ◽  
Adult Asthma

Adherence to inhaled corticosteroids (ICS) has been suggested to be poor but long-term follow-ups are lacking. The objective of the present study was to assess adherence to ICS treatment in patients with adult-onset asthma during 12-year follow-up.A total of 181 patients with clinically confirmed, new-onset adult asthma were followed for 12 years as part of the Seinäjoki Adult Asthma Study. Adherence to ICS was assessed individually as the percentage of true dispensed ICS in micrograms per true prescribed daily ICS in micrograms over 12 years.Mean 12-year adherence to ICS was 69% (mean±sd dispensed 2.5±1.8 g and prescribed 3.6±1.5 g budesonide equivalent per patient for 12 years), annual adherence varying between 81% (year 1) and 67% (year 12). Patients with good 12-year adherence (≥80%) used oral corticosteroids more often, and had add-on drugs in use and asthma-related visits to healthcare more often. In addition, they showed less reversibility in forced expiratory volume in 1 s and had higher peripheral blood neutrophil counts. However, lung function decline was steeper in patients with poorer adherence (<80%) and this association remained in multiple linear regression analysis. No difference was found in symptom scores, blood eosinophil counts, exhaled nitric oxide or immunoglobulin E between the patients with different levels of adherence.In patients with adult-onset asthma, adherence to ICS was moderate. Poorer adherence (<80%) to ICS was associated with more rapid decline in lung function but was not associated to symptoms or markers of inflammatory endotypes.

scholarly journals Lung function, forced expiratory volume in 1 s decline and COPD hospitalisations over 44 years of follow-up

2015 ◽  
Vol 47 (3) ◽  
pp. 742-750 ◽  
Author(s):  
Suneela Zaigham ◽  
Per Wollmer ◽  
Gunnar Engström
Keyword(s):  
Lung Function ◽  
Airflow Obstruction ◽  
Fixed Ratio ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Lung Function Decline ◽  
Obstructive Pulmonary Disease ◽  
Hazard Ratios

The use of baseline lung function in the prediction of chronic obstructive pulmonary disease (COPD) hospitalisations, all-cause mortality and lung function decline was assessed in the population-based “Men Born in 1914” cohort.Spirometry was assessed at age 55 years in 689 subjects, of whom 392 had spirometry reassessed at age 68  years. The cohort was divided into three groups using fixed ratio (FR) and lower limit of normal (LLN) criterion: forced expiratory volume in 1 s (FEV1)/vital capacity (VC) ≥70%, FEV1/VC <70% but ≥LLN (FR+LLN−), and FEV1/VC <70% and <LLN (FR+LLN+).Over 44 years of follow-up, 88 men were hospitalised due to COPD and 686 died. Hazard ratios (95% CI) for incident COPD hospitalisation were 4.15 (2.24–7.69) for FR+LLN− and 7.88 (4.82–12.87) for FR+LLN+ (reference FEV1/VC ≥70%). Hazard ratios for death were 1.30 (0.98–1.72) for FR+LLN− and 1.58 (1.25–2.00) for FR+LLN+. The adjusted FEV1 decline between 55 and 68 years of age was higher for FR+LLN− and FR+LLN+ relative to the reference. Of those with FR+LLN− at 55 years, 53% had progressed to the FR+LLN+ group at 68 years.Airflow obstruction at age 55 years is a powerful risk factor for future COPD hospitalisations. The FR+LLN− group should be carefully evaluated in clinical practice in relation to future risks and potential benefit from early intervention. This is reinforced by the increased FEV1 decline in this group.

scholarly journals Chronic Respiratory Symptoms and Lung Function of Farmer and Breeder in UTU Village, Tabanan, Bali

2020 ◽  
Vol 8 (B) ◽  
pp. 709-715
Author(s):  
Ni Luh Putu Eka Arisanti ◽  
Ni Putu Ayu Widiasari ◽  
Ida Bagus Ngurah Rai
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Vital Capacity ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Sectional Study ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Passive Smoker

AIM: The objective of the study was to determine chronic respiratory symptoms and lung function of farmers. METHODS: The study was conducted in Utu Village, Tabanan, Bali with 84 subjects. This research was observational analytic cross sectional study. RESULTS: Three dominant chronic respiratory symptoms in farmers were coughing (15.1%), dyspnea (13.1%), and phlegm (13.1%). Average values of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were 83.75 ± 34.42, respectively, 81.62 ± 34.30 and 104.90 ± 13.90, respectively. Cough was dominant experiencing by smokers (p = 0.008). Mean of FEV1% prediction and FVC% prediction value was lower in passive smoker group than no smoker group (p = 0.005 and p = 0.03). CONCLUSION: Occupational exposure while farming and raising livestock can cause chronic respiratory symptom and lung function decline in farmers and can be influenced by smoking history and secondhand smoke exposure.

scholarly journals Snoring and nocturnal reflux: association with lung function decline and respiratory symptoms

2019 ◽  
Vol 5 (2) ◽  
pp. 00010-2019
Author(s):  
Össur Ingi Emilsson ◽  
Shadi Amid Hägg ◽  
Eva Lindberg ◽  
Karl A. Franklin ◽  
Kjell Toren ◽  
...  
Keyword(s):  
Lung Function ◽  
Respiratory Symptoms ◽  
Respiratory Health ◽  
Multivariate Regression Analysis ◽  
Forced Expiratory Volume ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Habitual Snoring ◽  
Capacity Change ◽  
Sectional Analysis

IntroductionThe study aim was to examine the association of snoring and nocturnal gastro-oesophageal reflux (nGOR) with respiratory symptoms and lung function, and if snoring and/or nGOR associated with a steeper decline in lung function.MethodsData from the third visit of the European Community Respiratory Health Survey (ECRHS) was used for cross-sectional analysis. Pre- and post-bronchodilator spirometry was performed, and information on sleep, nGOR and respiratory symptoms was collected (n=5715). Habitual snoring and nGOR were assessed by questionnaire reports. Pre-bronchodilator spirometry from ECRHS I, II and III (20 years follow-up) were used to analyse lung function changes by multivariate regression analysis.ResultsSnoring and nGOR were independently associated with a higher prevalence of wheeze, chest tightness, breathlessness, cough and phlegm. The prevalence of any respiratory symptom was 79% in subjects with both snoring and nGOR versus 56% in those with neither (p<0.001). Subjects with both snoring and nGOR had more frequent exacerbations (adjusted prevalence 32% versus 19% among “no snoring, no nGOR”, p=0.003). Snoring but not nGOR was associated with a steeper decline in forced expiratory volume in 1 s over 10 years after adjusting for confounding factors (change in % predicted −5.53, versus −4.58 among “no snoring”, p=0.04) and forced vital capacity (change in % predicted −1.94, versus −0.99 among “no snoring”, p=0.03).ConclusionsAdults reporting both habitual snoring and nGOR had more respiratory symptoms and more frequent exacerbations of these symptoms. Habitual snoring was associated with a steeper decline in lung function over time.

scholarly journals Trajectory and mortality of preserved ratio impaired spirometry: the Rotterdam Study

2019 ◽  
Vol 55 (1) ◽  
pp. 1901217 ◽  
Author(s):  
Sara Renata Alex Wijnant ◽  
Emmely De Roos ◽  
Maryam Kavousi ◽  
Bruno Hugo Stricker ◽  
Natalie Terzikhan ◽  
...  
Keyword(s):  
Lung Function ◽  
Chronic Obstructive Lung Disease ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Rotterdam Study ◽  
Lung Function Decline ◽  
Cardiovascular Comorbidities ◽  
Age Related

Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population.In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1  ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1 <80%) and chronic obstructive pulmonary disease (COPD) (FEV1/FVC <0.7) at two study visits. Hazard ratios with 95% confidence intervals for mortality (until December 30, 2018) were adjusted for age, sex, body mass index, current smoking and pack-years.Of 5487 subjects (age 69.1±8.9 years; 7.1% PRISm), 1603 were re-examined after 4.5 years. Of the re-examined PRISm subjects, 15.7% transitioned to normal spirometry and 49.4% to COPD. Median lung function decline was highest in subjects with incident PRISm (FEV1 −92.8 mL·year−1, interquartile range (IQR) −131.9– −65.8 mL·year−1; FVC −93.3 mL·year−1, IQR −159.8– −49.1 mL·year−1), but similar in persistent PRISm (FEV1 −30.2 mL·year−1, IQR −67.9– −7.5 mL·year−1; FVC −20.1 mL·year−1, IQR −47.7–21.7 mL·year−1) and persistent controls (FEV1 −39.6 mL·year−1, IQR −64.3–−12.7 mL·year−1; FVC −20.0 mL·year−1, IQR −55.4–18.8 mL·year−1). Of 5459 subjects with informed consent for follow-up, 692 (12.7%) died during 9.3 years (maximum) follow-up: 10.3% of controls, 18.7% of PRISm subjects and 20.8% of COPD subjects. Relative to controls, subjects with PRISm and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2–4 had increased all-cause mortality (PRISm: HR 1.6, 95% CI 1.2–2.0; COPD GOLD 2–4: HR 1.7, 95% CI 1.4–2.1) and cardiovascular mortality (PRISm: HR 2.8, 95% CI 1.5–5.1; COPD 2–4: HR 2.1, 95% CI 1.2–3.6). Mortality within <1 year was highest in PRISm, with patients often having cardiovascular comorbidities (heart failure or coronary heart disease; 70.0%).PRISm is associated with increased mortality and this population encompasses at least three distinct subsets: one that develops COPD during follow-up, a second with high cardiovascular burden and early mortality, and a third with persistent PRISm and normal age-related lung function decline.

The CRP genotype, serum levels and lung function in men: the Caerphilly Prospective Study

2010 ◽  
Vol 120 (8) ◽  
pp. 347-355 ◽  
Author(s):  
Charlotte E. Bolton ◽  
Wiebke Schumacher ◽  
John R. Cockcroft ◽  
Nicholas J. Timpson ◽  
George Davey Smith ◽  
...  
Keyword(s):  
Lung Function ◽  
Prospective Study ◽  
Causal Effect ◽  
Serum Levels ◽  
Forced Expiratory Volume ◽  
Reverse Causality ◽  
Lung Function Decline ◽  
Impaired Lung Function ◽  
Serum Crp

Systemic CRP (C-reactive protein) has been associated with impaired lung function. A causal relationship would increase the value of CRP as both a diagnostic and therapeutic tool. We assessed the association between lung function parameters, circulating CRP and CRP polymorphisms using Mendelian randomization in efforts to attribute causality to known associations. Spirometric parameters of FEV1 (forced expiratory volume in 1 s) and FVC (forced vital capacity) were determined in 2173 men participating in the Caerphilly Prospective Study. Lung function measures on 1021 participants were available at follow-up (mean, 16.8 years later). Serum CRP levels were measured at baseline, and three CRP polymorphisms were analysed. Haplotype analysis was performed. Serum CRP levels at baseline were inversely associated with contemporaneous FEV1 and FVC as well as at follow-up (P<0.001) even after adjustment for conventional confounders. Serum CRP was associated with FEV1 decline (P=0.04). All three CRP polymorphisms (rs1800947, rs1130864 and rs1205) predicted serum CRP; however, there were no clear associations of the polymorphisms or haplotypes with lung function or with lung function decline. In conclusion, serum CRP was associated with lung function cross-sectionally; however, CRP polymorphisms were not associated with lung function or decline, suggesting that the CRP–lung function relationship is due to reverse causality, an unmeasured confounding factor or only has a modest causal effect.

scholarly journals Serum 25-hydroxyvitamin D level, smoking and lung function in adults: the HUNT Study

2015 ◽  
Vol 46 (2) ◽  
pp. 355-363 ◽  
Author(s):  
Tricia L. Larose ◽  
Ben M. Brumpton ◽  
Arnulf Langhammer ◽  
Carlos A. Camargo ◽  
Yue Chen ◽  
...  
Keyword(s):  
Lung Function ◽  
Forced Expiratory Volume ◽  
Lung Function Decline ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Impaired Lung Function ◽  
25 Hydroxyvitamin D ◽  
Hunt Study ◽  
Never Smokers

The association between serum 25-hydroxyvitamin D (25(OH)D) level and lung function changes in the general population remains unclear.We conducted cross-sectional (n=1220) and follow-up (n=869) studies to investigate the interrelationship of serum 25(OH)D, smoking and lung function changes in a random sample of adults from the Nord-Trøndelag Health (HUNT) Study, Norway.Lung function was measured using spirometry and included forced expiratory volume in 1 s (FEV1) % predicted, forced vital capacity (FVC) % pred and FEV1/FVC ratio. Multiple linear and logistic regression models estimated the adjusted difference in lung function measures or lung function decline, adjusted odds ratios for impaired lung function or development of impaired lung function and 95% confidence intervals.40% of adults had serum 25(OH)D levels <50 nmol·L−1. Overall, those with a serum 25(OH)D level <50 nmol·L−1 showed worse lung function and increased odds of impaired lung function compared to the ≥50 nmol·L−1 group. These associations tended to be stronger among ever-smokers, including greater decline in FEV1/FVC ratio and greater odds of the development of impaired lung function (FEV1/FVC <70% OR 2.4, 95% CI 1.2–4.9). Associations among never-smokers were null. Results from cross-sectional and follow-up studies were consistent. There were no associations between serum 25(OH)D levels and lung function or lung function changes in never-smokers, whereas significant associations were observed in ever-smokers.

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