help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on June 1, 2004, doi:10.1164/rccm.200401-112OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Online Supplement
Right arrow All Versions of this Article:
200401-112OCv1
170/5/499    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lapperre, T. S.
Right arrow Articles by Sterk, P. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lapperre, T. S.
Right arrow Articles by Sterk, P. J.
American Journal of Respiratory and Critical Care Medicine Vol 170. pp. 499-504, (2004)
© 2004 American Thoracic Society
doi: 10.1164/rccm.200401-112OC

Original Article

Dissociation of Lung Function and Airway Inflammation in Chronic Obstructive Pulmonary Disease

Thérèse S. Lapperre, Jiska B. Snoeck-Stroband, Margot M.E. Gosman, Jan Stolk, Jaap K. Sont, Désirée F. Jansen, Huib A.M. Kerstjens, Dirkje S. Postma and Peter J. Sterk the Groningen and Leiden Universities Corticosteroids in Obstructive Lung Disease (GLUCOLD) Study Group

Departments of Pulmonology, General Practice, and Medical Decision Making, Leiden University Medical Center, Leiden; and Departments of Pulmonology and of Epidemiology and Statistics, University of Groningen, Groningen, The Netherlands

Correspondence and requests for reprints should be addressed to Thérèse S. Lapperre, M.D., Lung Function Lab, C2-P, Department of Pulmonology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600 2300 RC Leiden, The Netherlands. E-mail: t.s.lapperre{at}lumc.nl

Chronic obstructive pulmonary disease (COPD) is defined by progressive, irreversible airflow limitation and an inflammatory response of the lungs, usually to cigarette smoke. However, COPD is a heterogeneous disease in terms of clinical, physiologic, and pathologic presentation. We aimed to evaluate whether airflow limitation, airway responsiveness, and airway inflammation are separate entities underlying the pathophysiology of COPD by using factor analysis. A total of 114 patients (99 males/15 females, age 62 ± 8 years, 42 pack-years smoking, no inhaled or oral steroids > 6 months) with irreversible airflow limitation (postbronchodilator FEV1 63 ± 9% predicted, FEV1/inspiratory vital capacity [IVC] 48 ± 9%) and symptoms of chronic bronchitis or dyspnea were studied in a cross-sectional design. Postbronchodilator FEV1 and FEV1/IVC, reversibility to inhaled ß2-agonists, diffusing capacity, provocative concentration of methacholine required to produce a 20% drop in FEV1, total serum IgE, exhaled nitric oxide, and induced sputum cell counts (% eosinophils, % neutrophils) were collected. Factor analysis yielded 4 separate factors that accounted for 63.6% of the total variance. Factor 1 was comprised of FEV1, FEV1/IVC, and residual volume/total lung capacity. Factor 2 included reversibility, IgE, provocative concentration of methacholine required to produce a 20% drop in FEV1, and diffusing capacity. Factor 3 contained exhaled nitric oxide and factor 4 included sputum % neutrophils and % eosinophils. We conclude that airflow limitation, airway inflammation, and features commonly associated with asthma are separate and largely independent factors in the pathophysiology of COPD.

Key Words: induced sputum • bronchial hyperreactivity • bronchodilator reversibility • nitric oxide • factor analysis




This article has been cited by other articles:


Home page
 Eur Respir JHome page
J. Vestbo, W. Anderson, H. O. Coxson, C. Crim, F. Dawber, L. Edwards, G. Hagan, K. Knobil, D. A. Lomas, W. MacNee, et al.
Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE)
Eur. Respir. J., April 1, 2008; 31(4): 869 - 873.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J. B. Snoeck-Stroband, T. S. Lapperre, M. M. E. Gosman, H. M. Boezen, W. Timens, N. H. T. ten Hacken, J. K. Sont, P. J. Sterk, P. S. Hiemstra, and the Groningen Leiden Universities Corticosteroids
Chronic bronchitis sub-phenotype within COPD: inflammation in sputum and biopsies
Eur. Respir. J., January 1, 2008; 31(1): 70 - 77.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
A. W Fogarty, S. Jones, J. R Britton, S. A Lewis, and T. M McKeever
Systemic inflammation and decline in lung function in a general population: a prospective study
Thorax, June 1, 2007; 62(6): 515 - 520.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
M. M E Gosman, H Marike Boezen, C. C van Diemen, J. B Snoeck-Stroband, T. S Lapperre, P. S Hiemstra, N. H T ten Hacken, J. Stolk, D. S Postma, and the GLUCOLD Study Group
A disintegrin and metalloprotease 33 and chronic obstructive pulmonary disease pathophysiology
Thorax, March 1, 2007; 62(3): 242 - 247.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Dahl, J. Vestbo, P. Lange, S. E. Bojesen, A. Tybjaerg-Hansen, and B. G. Nordestgaard
C-reactive Protein As a Predictor of Prognosis in Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., February 1, 2007; 175(3): 250 - 255.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
T. S. Lapperre, L. N. A. Willems, W. Timens, K. F. Rabe, P. S. Hiemstra, D. S. Postma, P. J. Sterk, and the GLUCOLD Study Group
Small Airways Dysfunction and Neutrophilic Inflammation in Bronchial Biopsies and BAL in COPD
Chest, January 1, 2007; 131(1): 53 - 59.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Carnevali, F. Luppi, D. D'Arca, A. Caporali, M. P. Ruggieri, M. V. Vettori, A. Caglieri, S. Astancolle, F. Panico, P. Davalli, et al.
Clusterin Decreases Oxidative Stress in Lung Fibroblasts Exposed to Cigarette Smoke
Am. J. Respir. Crit. Care Med., August 15, 2006; 174(4): 393 - 399.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. E. Hargreave and K. Parameswaran
Asthma, COPD and bronchitis are just components of airway disease.
Eur. Respir. J., August 1, 2006; 28(2): 264 - 267.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. M. Fabbri, F. Luppi, B. Beghe, and K. F. Rabe
Update in chronic obstructive pulmonary disease 2005.
Am. J. Respir. Crit. Care Med., May 15, 2006; 173(10): 1056 - 1065.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
R. Leigh, M. M. M. Pizzichini, M. M. Morris, F. Maltais, F. E. Hargreave, and E. Pizzichini
Stable COPD: predicting benefit from high-dose inhaled corticosteroid treatment
Eur. Respir. J., May 1, 2006; 27(5): 964 - 971.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
N. C. Barnes, Y.-S. Qiu, I. D. Pavord, D. Parker, P. A. Davis, J. Zhu, M. Johnson, N. C. Thomson, P. K. Jeffery, and on behalf of the SCO30005 Study Group
Antiinflammatory Effects of Salmeterol/Fluticasone Propionate in Chronic Obstructive Lung Disease
Am. J. Respir. Crit. Care Med., April 1, 2006; 173(7): 736 - 743.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
T S Lapperre, D S Postma, M M E Gosman, J B Snoeck-Stroband, N H T ten Hacken, P S Hiemstra, W Timens, P J Sterk, T Mauad, and on behalf of the GLUCOLD Study Group
Relation between duration of smoking cessation and bronchial inflammation in COPD
Thorax, February 1, 2006; 61(2): 115 - 121.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. M. E. Gosman, B. W. M. Willemse, D. F. Jansen, T. S. Lapperre, A. van Schadewijk, P. S. Hiemstra, D. S. Postma, W. Timens, H. A. M. Kerstjens, and the Groningen and Leiden Universities Corticostero
Increased number of B-cells in bronchial biopsies in COPD.
Eur. Respir. J., January 1, 2006; 27(1): 60 - 64.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
C. L. Rochester
Clinical Year in Review IV: Asthma, Chronic Obstructive Pulmonary Disease, Exercise and Rehabilitation, and Critical Care Medicine
Proceedings of the ATS, December 1, 2005; 2(6): 461 - 465.
[Full Text] [PDF]

Home page
 ChestHome page
H. Kanazawa and J. Yoshikawa
Elevated Oxidative Stress and Reciprocal Reduction of Vascular Endothelial Growth Factor Levels With Severity of COPD
Chest, November 1, 2005; 128(5): 3191 - 3197.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Kostianev and B. Marinov
Dissociation of Lung Function and Airway Inflammation in Chronic Obstructive Pulmonary Disease: Is It a Real or Statistical Phenomenon?
Am. J. Respir. Crit. Care Med., June 1, 2005; 171(11): 1317 - 1317.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. S. Lapperre and P. J. Sterk
Dissociation of Lung Function and Airway Inflammation in Chronic Obstructive Pulmonary Disease: Is It a Real or Statistical Phenomenon?
Am. J. Respir. Crit. Care Med., June 1, 2005; 171(11): 1317 - 1318.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. Fabbri, S. P. Peters, I. Pavord, S. E. Wenzel, S. C. Lazarus, W. MacNee, F. Lemaire, and E. Abraham
Allergic Rhinitis, Asthma, Airway Biology, and Chronic Obstructive Pulmonary Disease in AJRCCM in 2004
Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 686 - 698.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
Z. Borrill, C. Starkey, J. Vestbo, and D. Singh
Reproducibility of exhaled breath condensate pH in chronic obstructive pulmonary disease
Eur. Respir. J., February 1, 2005; 25(2): 269 - 274.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  ATS Sleep Tracings Quiz