help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on June 1, 2004, doi:10.1164/rccm.200401-112OC

Am. J. Respir. Crit. Care Med., Volume 170, Number 5, September 2004, 499-504

A more recent version of this article appeared on September 1, 2004
This Article
Right arrow Full Text (PDF)
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 The GLUCOLD Study Group
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lapperre, T. S
Right arrow Articles by The GLUCOLD Study Group,

Submitted on January 26, 2004
Accepted on May 20, 2004

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

Therese S Lapperre1*, Jiska B Snoeck-Stroband2, Margot M E Gosman3, Jan Stolk1, Jaap K Sont4, Desiree F Jansen5, Huib A M Kerstjens3, Dirkje S Postma3, Peter J Sterk1, and The GLUCOLD Study Group1

1 Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands, 2 General Practice, Leiden University Medical Center, Leiden, The Netherlands, 3 Department of Pulmonology, University of Groningen, Groningen, The Netherlands, 4 Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands, 5 Department of Epidemiology and Statistics, University of Groningen, Groningen, The Netherlands

* To whom correspondence should be addressed. 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, physiological and pathological 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. 114 patients (M/F: 99/15, age 62±8 yrs, 42 pack years smoking, no inhaled or oral steroids >6 months) with irreversible airflow limitation (postbronchodilator FEV1 63±9 %pred, FEV1/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 b2-agonists, diffusion capacity (KCO), PC20 methacholine, total serum IgE, exhaled nitric oxide (eNO) 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 comprised FEV1, FEV1/IVC and RV/TLC. Factor 2 included reversibility, IgE, PC20 and KCO. Factor 3 contained eNO and factor 4 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
 ANN INTERN MEDHome page
T. S. Lapperre, J. B. Snoeck-Stroband, M. M.E. Gosman, D. F. Jansen, A. van Schadewijk, H. A. Thiadens, J. M. Vonk, H. M. Boezen, N. H.T. ten Hacken, J. K. Sont, et al.
Effect of Fluticasone With and Without Salmeterol on Pulmonary Outcomes in Chronic Obstructive Pulmonary Disease: A Randomized Trial
Ann Intern Med, October 20, 2009; 151(8): 517 - 527.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Weatherall, J. Travers, P. M. Shirtcliffe, S. E. Marsh, M. V. Williams, M. R. Nowitz, S. Aldington, and R. Beasley
Distinct clinical phenotypes of airways disease defined by cluster analysis
Eur. Respir. J., October 1, 2009; 34(4): 812 - 818.
[Abstract] [Full Text] [PDF]

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
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  ATS 2008 State of the Art Course