Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD)

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 1588

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Medicine-Pulmonary, Critical Care and Sleep Medicine Baylor College of Medicine, Houston, TX, USA
Interests: asthma; chronic obstructive pulmonary disease; critical care ultrasonography; thromboembolic diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

COPD is a chronic inflammatory disorder of the airways characterized by irreversible or partially reversible airflow limitation, and is a major cause of morbidity as well as mortality across the globe. Around 300 million people suffer from COPD across the globe. Several risk factors as well as several phenotypes and endotypes have been identified. GOLD guidelines form the cornerstone for the management of COPD, especially for primary care practitioners. However, there are several unanswered questions. For example, there is little information on why a significant proportion of the population exposed to the same risk factors are protected from developing COPD. Are there any biomarkers that can potentially identify future COPD subjects when there is no lung damage yet? One key biomarker is CC16; what is the value of CC16 in such a scenario? What are the future treatment options that can help to arrest disease progression? What is the role of biologics in the management of COPD and asthma–COPD overlap? How well have we understood COPD genetics, and have we obtained valuable information that could be of clinical value for the routine management of COPD patients? What are the lessons that we have learnt from the “omics” platforms (proteomics, metabolomics, genomics, metagenomics, and epigenomics) that can be translated from bench to bedside? What is the role of AI in the diagnosis and management of COPD? What public health initiatives are necessary to handle COPD well in LMIC countries where there is no access to advanced testing and treatment? How can a primary care practitioner diagnose COPD when there is no access to spirometry? What is the impact of ambient air pollution and indoor air pollution on the prevalence of COPD across the globe?

We have undoubtedly made great progress in the last few decades, but we still have a long way to go to reduce this huge public health problem, which is indeed reaching epidemic proportions. Remember, the burden of COPD seen currently is due to exposures 2–3 decades ago (smoking, biomass use, air pollution, and occupations). Since then, the number of people exposed to these risk factors have only increased, and the impact of the current burden of risk factors will only be realised in the next few decades.

It is our great pleasure to invite you to submit articles on the topic of COPD. This Special Issue, entitled “Global burden, pathophysiology, diagnosis, treatment, and novel therapeutics in COPD”, will cover all aspects of the epidemiology, risk factors, pathophysiologic mechanisms, biomarkers, clinical investigations, treatment, prognosis, and natural history of COPD. I believe this would present an excellent opportunity to publish your hard work. Submissions, such as original articles or narrative/systematic reviews, are welcome. Please note that we do not accept case/brief reports.

Topics include, but are not limited to, the following:

  • Burden of COPD (national, subnational, or global estimates);
  • Risk factors;
  • Pathophysiologic mechanisms and pathology in COPD;
  • Genomics in COPD;
  • Metabolomics in COPD;
  • Epigenetics in COPD;
  • Metagenomics, gut microbiome, and lung microbiome in COPD;
  • Biomarkers in COPD;
  • Airway remodelling in COPD;
  • Phenotypes and endotypes in COPD;
  • Frequent exacerbators and disease progression in COPD;
  • COPD comorbidities;
  • Patient-reported outcomes;
  • Health status or health-related quality of life;
  • COPD and COVID-19 interactions;
  • Artificial intelligence in COPD diagnosis.

Prof. Dr. Padukudru Anand Mahesh
Dr. Muhammad Adrish
Guest Editors

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.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (2 papers)

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Research

12 pages, 929 KiB  
Article
Exploring Balance Impairment and Determinants in Chronic Obstructive Pulmonary Disease: A Comparative Study with Healthy Subjects
by Hikmet Ucgun, Meltem Kaya, Hamza Ogun and Hilal Denizoglu Kulli
Diagnostics 2024, 14(14), 1489; https://doi.org/10.3390/diagnostics14141489 - 11 Jul 2024
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Abstract
Background: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy [...] Read more.
Background: Many pulmonary and extrapulmonary factors may impair balance in patients with chronic obstructive pulmonary disease (COPD), but the determinants of this impairment are still debated. The primary aim was to compare both balance-related and independent variables that may affect balance with healthy subjects. The secondary aim was to investigate the potential determinants of balance in patients with COPD. Methods: This comparative study recruited 23 patients with COPD and 23 age- and comorbidity-matched healthy subjects. Participants were assessed regarding demographic and clinical data, “Postural Stability Test” (PST), “Limits of Stability Test” (LOST), “Clinical Test of Sensory Integration of Balance” (CTSIB), pulmonary function, respiratory and peripheral muscle strength, functional capacity, and cognitive function. Results: There were significant differences in all outcome measures assessing balance, pulmonary function, respiratory muscle strength, peripheral muscle strength, and functional capacity, but not cognitive function, in the COPD group compared to the healthy group (p < 0.05). The PST had a significant and strong correlation with maximal inspiratory pressure (MIP) (r = −0.630, p = 0.001) and a significant and moderate correlation with m. quadriceps strength and 6 min walk test (6MWT) distance (r = −0.472, p = 0.023; r = −0.496, p = 0.016; respectively). MIP, m. quadriceps strength, and 6MWT distance were independent predictors to explain the PST with an R2 = 0.336 (p = 0.004). Conclusions: The present study revealed that balance is impaired in adults with COPD, even if compared with age- and comorbidity-matched healthy subjects. Assessing and improving balance and its determinants, inspiratory and peripheral muscle strength, and functional capacity may be important for fall prevention and disease management in patients with COPD. Full article
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11 pages, 866 KiB  
Article
Comparison of Disease Severity Classifications of Chronic Obstructive Pulmonary Disease: GOLD vs. STAR in Clinical Practice
by Koichi Nishimura, Masaaki Kusunose, Ayumi Shibayama and Kazuhito Nakayasu
Diagnostics 2024, 14(6), 646; https://doi.org/10.3390/diagnostics14060646 - 19 Mar 2024
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Abstract
Background: In chronic obstructive pulmonary disease (COPD), there are two known classifications for assessing what is called disease severity. One is the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, which is based on the post-bronchodilator value of FEV1 (% reference). [...] Read more.
Background: In chronic obstructive pulmonary disease (COPD), there are two known classifications for assessing what is called disease severity. One is the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, which is based on the post-bronchodilator value of FEV1 (% reference). The other is the STaging of Airflow obstruction by Ratio (STAR), with four grades of severity in subjects with an FEV1/FVC ratio <0.70: STAR 1 ≥0.60 to <0.70, STAR 2 ≥0.50 to <0.60, STAR 3 ≥0.40 to <0.50, and STAR 4 <0.40. Purpose: The aim of this study was to compare the staging of COPD using the GOLD and STAR classifications in clinical practice. Methods: We reanalyzed data from our outpatient cohort study, which included 141 participants with COPD from 2015 to 2023. We compared mortality and COPD-specific health status between the GOLD 1 to 4 groups and the STAR 1 to 4 groups. Results: By simple calculation, GOLD and STAR severity classes coincided in 75 participants (53.2%). The weighted Bangdiwala B value with linear weights was 0.775. The participants were observed for up to 95 months, with a median of 54 months. Death was confirmed in 29 participants (20.5%). In univariate Cox proportional hazards analyses, there was a significant difference in mortality between the GOLD 1 and GOLD 3 + 4 groups, with the GOLD 1 group used as the reference [hazard ratio 4.222 (95% CI 1.298–13.733), p = 0.017]. However, there was no statistically significant predictive relationship between STAR 1 and STAR 2, or between STAR 1 and STAR 3 + 4. St. George’s Respiratory Questionnaire (SGRQ) Total and COPD Assessment Test (CAT) scores were significantly different between all GOLD groups, except for the CAT score between GOLD 1 and GOLD 2. The SGRQ Total and CAT scores were significantly different between STAR 1 and STAR 3 + 4, but not between STAR 1 and STAR 2. Conclusion: From the perspective of all-cause mortality and COPD-specific health status, the GOLD classification is more discriminative than STAR. Full article
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