International Journal Of Chronic Obstructive Pulmonary Disease[JOURNAL]
Sun
200 papers
Improvement of Progressive Vanishing Lung Syndrome in COPD: A 7-Year Radiological Evolution Case Report and Literature Review.
Zhong X, Liu Q, Huang J … +2 more , Liao H, Huang X
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41859013 · Full text
INTRODUCTION: Vanishing lung syndrome (VLS) is a clinical condition that characterized by large bullae that compress the normal lung parenchyma. Longitudinal documentation of VLS disease progression and outcomes followin...
INTRODUCTION: Vanishing lung syndrome (VLS) is a clinical condition that characterized by large bullae that compress the normal lung parenchyma. Longitudinal documentation of VLS disease progression and outcomes following endobronchial valve (EBV) treatment remains scarce, particularly for right middle lobe (RML) involvement. CASE PRESENTATION: We report a 7-year longterm follow-up case of a 73-year-old female with chronic obstructive pulmonary disease(COPD) who presented with progressive dyspnea and declining pulmonary function. Serial computed tomography scans over 7 years documented the gradual expansion of emphysematous changes predominantly in the RML, with corresponding deterioration in pulmonary function tests (FEV decreased from 0.83L to 0.51L). Bronchoscopic lung volume reduction using a single endobronchial valve (EBV) was performed, leading to a significant improvement in dyspnea. Two months post-intervention, the patient demonstrated remarkable clinical improvement with a six-minute walking distance increase from 310 to 650 meters, FEV recovery to 97% of baseline (0.81L), and radiological evidence of complete RML atelectasis with adjacent lobe re-expansion. CONCLUSION: This case underscores the insidious progression of VLS and highlights the utility of EBV therapy in the management of advanced cases.
Erratum: Quantitative CT Analysis of Small Airway Remodeling in Patients with Chronic Obstructive Pulmonary Disease by a New Image Post-Processing System [Corrigendum].
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41859012 · Full text
[This corrects the article DOI: 10.2147/COPD.S295320.].
[This corrects the article DOI: 10.2147/COPD.S295320.].
A Machine Learning-Derived Risk Score Based on Dietary Nutrient Intake for Early Detection and Prognostic Prediction of Preserved Ratio Impaired Spirometry.
Xie Q, Qu H, Xie S … +2 more , Lan R, Li J
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41853751 · Full text
BACKGROUND: Preserved Ratio Impaired Spirometry (PRISm) is a subclinical pulmonary phenotype associated with increased risk of chronic obstructive pulmonary disease (COPD), cardiovascular disease, and all-cause mortality...
BACKGROUND: Preserved Ratio Impaired Spirometry (PRISm) is a subclinical pulmonary phenotype associated with increased risk of chronic obstructive pulmonary disease (COPD), cardiovascular disease, and all-cause mortality. Early identification and stratified prevention of PRISm remain a clinical challenge. METHODS: Using data from the US National Health and Nutrition Examination Survey (NHANES) 2007-2012, we developed and validated a stacked machine learning (ML) model integrating dietary intake and demographic features to generate a continuous PRISm risk score. The dataset was split into training, validation, and test sets. Model performance was evaluated using ROC curves and calibration. The associations between the risk score and adverse health outcomes were assessed using logistic regression and Kaplan-Meier analysis. Subgroup analysis was performed to assess the impact of lifestyle across risk strata. RESULTS: The stacked ML model demonstrated strong predictive ability, achieving an AUC of 0.818 in the test set. The risk score was significantly associated with multiple chronic conditions, including hypertension, diabetes, cardiovascular disease, and COPD. High-risk individuals had substantially increased mortality rates compared to the low-risk group. In the low-risk group, adherence to a healthy lifestyle was associated with significantly lower odds of adverse outcomes, while no such association was observed in the high-risk group. CONCLUSION: This study presents a non-invasive, data-driven model for PRISm risk prediction and health outcome stratification based on dietary and demographic features. The PRISm risk score may aid early screening and inform personalized prevention strategies.
Divergent Trajectories and Risk Factor Attribution of Chronic Obstructive Pulmonary Disease Burden in China and the United States, 1990-2023: An Age-Period-Cohort Analysis with Projections to 2035 Based on the Global Burden of Disease Study 2023.
Deng Y, Zhu Y, Chen C … +2 more , Xu W, Yao W
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41853750 · Full text
BACKGROUND: Chronic obstructive pulmonary disease (COPD) remains a leading cause of global mortality. China and the United States, the world's two largest economies accounting for 40% of global COPD burden, lack comprehe...
BACKGROUND: Chronic obstructive pulmonary disease (COPD) remains a leading cause of global mortality. China and the United States, the world's two largest economies accounting for 40% of global COPD burden, lack comprehensive comparative analyses of long-term trends and risk factor attribution. OBJECTIVE: This study aimed to compare COPD burden trends, decompose age-period-cohort effects, quantify risk factor contributions, and project future trajectories in China and the United States from 1990 to 2023 with forecasts to 2035. METHODS: We analyzed Global Burden of Disease Study 2023 data for China and the United States, examining incidence, prevalence, mortality, and disability-adjusted life years (DALYs) stratified by sex and 17 age groups. Joinpoint regression identified temporal inflection points. Age-period-cohort models decomposed burden into independent effects. Risk factor attribution analyzed eight major exposures. Bayesian methods projected burden to 2035. RESULTS: China demonstrated remarkable declines in age-standardized mortality (58.68% decrease to 46.60 per 100,000) and DALY rates (61.12% decrease to 777.86 per 100,000), with dramatic risk factor reductions: particulate matter pollution declined 82.21%, smoking 68.48%. Conversely, the United States exhibited increasing age-standardized mortality (8.90% increase to 28.89 per 100,000), with female mortality rising 45.64% and smoking-attributable burden declining only 14.09%. Period effects deteriorated in the United States (relative risk: 0.67 to 1.34) while improving in China (1.20 to 0.83). Projections indicated Chinese deaths would surge 135.9% by 2035 despite declining age-standardized rates, while American deaths would increase 30.1% with rising age-standardized rates. CONCLUSION: Substantial COPD burden reductions are achievable through comprehensive risk factor control as demonstrated by China's success, while persistent deterioration in the United States highlights critical prevention gaps requiring urgent intervention to avert projected burden escalation.
Sedentary Behavior Interventions in COPD: A Scoping Review of Strategies, Behavior Change Techniques, and Device-Measured Outcomes.
Fang P, Mu W, Song M … +8 more , Wang H, Lyu F, Zhao R, Li M, Cao J, Li Y, Lou L, Qian F
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41853749 · Full text
BACKGROUND: Sedentary behavior is an independent risk factor for disease progression and mortality in COPD patients. However, there is a lack of systematic research on its intervention strategies in China. We provide, in...
BACKGROUND: Sedentary behavior is an independent risk factor for disease progression and mortality in COPD patients. However, there is a lack of systematic research on its intervention strategies in China. We provide, in a domestic context, a scoping synthesis of this field that underscores the necessity for more robust and localized research. PURPOSE: This scoping review aims to clarify the characteristics, effectiveness, and BCTs of sedentary behavior interventions for COPD patients. METHODS: Following the scoping review method proposed by Arksey. A comprehensive search was conducted across eight electronic databases, including PubMed, Embase, the Cochrane Library, Web of Science, CNKI, WanFang Data, CBM, and VIP. The search time frame encompassed records from the inception of each respective database up to August 20, 2025. The study selection, data extraction, and coding of the BCTs were all performed independently by two researchers. RESULTS: The 6 included studies (comprising 4 RCTs, one quasi-experimental, and one case-control study) were primarily conducted in China and Europe, with sample sizes ranging from 30 to 327 and intervention durations of 6 to 24 weeks. Four studies reported reduced sedentary time, while two found no statistically significant difference. Guided by the BCW, the interventions in four studies included components such as knowledge education, use of wearable devices, and Nordic walking. Applied BCTs (Goals and Planning, Feedback and Monitoring, etc) primarily targeted the COM-B components of Psychological Capability and Reflective Motivation. CONCLUSION: The combined evidence suggests that most interventions reduce both total daily sedentary time and prolonged sitting bouts. However, the evidence base remains limited by regional concentration, short follow-ups, and heterogeneity.
Afebrile Presentation in COPD Patients with Influenza A: A Risk Factor for Prolonged Viral Shedding.
Fan Y, Fan J, Ma L … +4 more , Wu C, Wang L, Chen H, Chen Y
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41853748 · Full text
PURPOSE: To investigate the risk factors for prolonged viral shedding in influenza A patients treated with oseltamivir and analyze fever patterns in chronic obstructive pulmonary disease (COPD) patients. PATIENTS AND MET...
PURPOSE: To investigate the risk factors for prolonged viral shedding in influenza A patients treated with oseltamivir and analyze fever patterns in chronic obstructive pulmonary disease (COPD) patients. PATIENTS AND METHODS: This retrospective study analyzed 309 hospitalized patients with RT-PCR-confirmed influenza A at a multi-campus tertiary medical center from 2022 to 2025. Influenza A virus retesting was performed on day 6 of antiviral treatment to assess viral clearance. Multivariate logistic regression was used to identify risk factors for prolonged viral shedding. ROC curve analysis evaluated the predictive value of absolute lymphocyte count (ALC). Subgroup analyses compared fever patterns in COPD and non-COPD patients using the Mann-Whitney U and chi-square (χ) tests. RESULTS: Overall, 309 influenza A inpatients were included. Six independent risk factors for prolonged viral shedding were identified: older age (95% CI 1.01-1.05), lymphopenia (95% CI 0.09-0.38), cerebrovascular disorders (95% CI 1.64-16.08), immunosuppressants (95% CI 1.05-3.36), delayed antiviral treatment (95% CI 4.13-15.27), and fungal coinfection (95% CI 1.25-4.69). Notably, 63.7% of the COPD patients were afebrile, compared to 23.6% of non-COPD patients (p < 0.05). In the COPD group, prolonged shedders had higher odds of afebrile status (95% CI 1.39-12.59), lower ALC (95% CI 0.01-0.17) and delayed oseltamivir initiation (95% CI 1.65-13.28) than nonprolonged shedders. The ALC demonstrated good predictive accuracy for prolonged viral shedding (AUC 0.75 overall; AUC 0.77 for the COPD group). CONCLUSION: Early antiviral therapy and targeted management for high-risk groups (especially COPD patients) are valuable. Afebrile presentations in COPD patients highlight the importance of routine influenza testing during exacerbations.
Association Between Peripheral Blood NLR, PLR, and EXACT-PRO Scores in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Prospective Observational Cohort Study.
Lai XM, Xie XY, Zhang JC
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41847337 · Full text
OBJECTIVE: This study examined the correlation between changes in peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) before and after treatment, and Exacerbations of Chronic Pulm...
OBJECTIVE: This study examined the correlation between changes in peripheral blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) before and after treatment, and Exacerbations of Chronic Pulmonary Disease Tool - Patient Reported Outcome (EXACT-PRO) scores in patients with acute exacerbations of COPD (AECOPD), to assess the clinical utility of EXACT-PRO in measuring disease severity. METHODS: Hospitalized patients diagnosed with AECOPD underwent pulmonary function testing, and peripheral blood NLR and PLR levels were recorded before and after treatment. Participants completed the EXACT-PRO, COPD Assessment Test (CAT), and modified Medical Research Council (mMRC) Dyspnea Scale questionnaires. Patients with AECOPD were classified into mild, moderate, and severe groups according to the 2026 GOLD classification criteria. Baseline characteristics were compared across the three groups. Pearson's correlation analysis was performed to evaluate the relationship between changes in NLR, PLR, and EXACT-PRO scores. ROC curves of post-treatment NLR and EXACT-PRO scores were further constructed to evaluate the discriminative performance of NLR, and a scatter plot was used to visually illustrate the correlation between the two variables. RESULTS: After applying the exclusion criteria to the initial cohort of 112 patients, a total of 60 patients with AECOPD were ultimately included in the analysis. According to the 2026 GOLD classification criteria, 13 patients were classified as mild, 29 as moderate, and 18 as severe. Blood samples were collected within 24 hours of hospital admission before treatment and on the day of discharge after treatment. Post-treatment NLR levels showed a statistically significant reduction compared to pre-treatment levels ( < 0.05, 95% CI: 1.12-5.60). A positive correlation was observed between post-treatment NLR levels and EXACT-PRO scores. CONCLUSION: Peripheral blood NLR levels demonstrated potential clinical relevance in patients with AECOPD and may support the development of a simple and effective quantitative tool for assessing disease severity.
Sex Differences and Survival Among COPD Patients in France: The Palomb Cohort.
Jestin-Guyon N, Ouaalaya EH, Bernady A … +11 more , Berteaud E, Betancourt-Rial Z, Moinard J, Falque L, Le Guillou F, Molimard M, Nguyen L, Nocent C, Ozier A, Staali M, Raherison-Semjen C
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41847336 · Full text
PURPOSE: Previous studies suggest that the clinical presentation of chronic obstructive pulmonary disease (COPD) is different between men and women. The aim of this study was to investigate sex-related differences and su...
PURPOSE: Previous studies suggest that the clinical presentation of chronic obstructive pulmonary disease (COPD) is different between men and women. The aim of this study was to investigate sex-related differences and survival among COPD patients. PATIENTS AND METHODS: Multicentric prospective real-life cohort. COPD patients (post-bronchodilator FEV/FVC <0.7) of any stages of airway obstruction recruited since January 2014 by pulmonologists. Stratified logistic regression models assessed to identify the determinants of dyspnea, exacerbations, ABE classification and all-cause mortality by sex. Kaplan-Meier curves and Cox proportional-hazards models were also performed. RESULTS: A total of 3265 patients included, with 36.7% women. Women had an increased risk of ≥2 exacerbations (aOR=1.79; CI[1.46-2.19]), mMRC grade 1 (aOR=1.46; CI[1.14-1.89]) and grade 2 (aOR=1.41; CI[1.07-1.87]) and a higher risk of severity E of the ABE classification (aOR=1.56; CI[1.27-1.93]). In stratified models, the determinants of these outcomes were different. Men had a lower survival rate at GOLD airway obstruction I-II (Log-rank: p<0.0001) and III-IV (Log-rank: p<0.0001) and a higher risk of mortality (HR=1.62; CI[1.40-1.87]). Common factors characterizing mortality were: age, BMI <18.5, mMRC ≥ 2, airway obstruction, diabetes and lung cancer. Additional factors related to mortality in men were asthma, left heart failure and tobacco-related cancers. CONCLUSION: COPD is more severe in women however men have a higher risk of mortality. Clinical features and mortality in men and women with COPD are different in our cohort. Further studies are needed to elucidate sex-related differences among COPD patients.
Non-Pharmacological Breathlessness Action Plans for People with COPD and Their Support People: A Scoping Review and Survey of Current Practice.
Luckett T, Roberts MM, Chaudhry MT … +20 more , Hancock J, Ruttle L, Siemionow M, Smith K, River J, Johnson M, Smith TA, Johnston KN, Hutchinson A, Swan F, Pearson M, Crooks MG, Kochovska S, Keijzers G, Keedwell A, Agar MR, Currow DC, Rhee J, Erfani E, Williams MT
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41847335 · Full text
INTRODUCTION: Breathlessness action plans guide people to self-manage acute-on-chronic breathlessness episodes using non-pharmacological strategies to help breathing and overcome panic. We aimed to identify plans availab...
INTRODUCTION: Breathlessness action plans guide people to self-manage acute-on-chronic breathlessness episodes using non-pharmacological strategies to help breathing and overcome panic. We aimed to identify plans available for people with chronic obstructive pulmonary disease (COPD) and describe their development, content, quality, use, and evidence for benefit. METHODS: Two descriptive methodologies were used, overseen by a team of people with COPD and carers/support persons, clinicians and researchers: 1) A scoping review (academic databases, internet) identified English-language plans and research; 2) An online survey of plan-users and clinicians about their plan-related experience and perceived benefits. Each plan underwent appraisal by a person with COPD/support person and clinician/researcher using the Patient Education Materials Assessment Tool (PEMAT), content analysis and reading grade assessment. RESULTS: Of 69 plans identified, 88% (n=61/69) included breathing techniques, 78% (n=54/69) positioning, 65% (n=45/69) airflow, 36% (n=25/69) relaxation/distraction, 30% (n=21/69) stopping/slowing, 22% (n=15/69) remaining calm, 13% (n=13/69) reassurance, 7% (n=5/69) support from others and 4% (n=3/69) loosening clothing. The 48 plans that could be PEMAT-analysed scored an average of 64% for understandability and 68% for actionability. Their median reading grade was 8.2 (inter-quartile range 2.2). We identified efficacy support from only one pre/post study and feasibility/acceptability from qualitative data in two feasibility trials, each focusing on a different plan. In the survey, 67% (n=31/46) of plan-users self-reported avoiding calling an ambulance over the past year by using their plan. 93% (n=94/101) of clinicians perceived patient benefit in the form of increased confidence/reduced anxiety, 60% (n=61/101) reduced frequency of episodes, 53% (54/101) reduced need for ambulance/emergency department, and 41% (41/101) increased activities of daily living, while 4% (4/101) were unsure of any benefit. DISCUSSION: Despite multiple plans being available, few studies have assessed acceptability or efficacy. Further research is needed to evaluate net effects on self-management, breathlessness-related outcomes and healthcare usage.
Methodological Considerations Regarding Heterogeneity and Statistical Modeling in "Effects on Exercise Tolerance and Functional Outcomes of Eccentric versus Concentric Aerobic Exercise in People with COPD" [Letter].
Otto-Yáñez M, Torres-Castro R, Vilaró J
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41847334 · Full text
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Global Trends of Cognition-Targeted Interventions in Chronic Lung Disease: A Bibliometric and Visualized Analysis.
Zhang J, Sun N, He C … +9 more , Liu L, Wan C, Luo J, Wu L, Zhang R, Lu J, Liu Z, Zhang W, Fang B
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41836034 · Full text
PURPOSE: To map the research landscape and synthesize randomized evidence on cognitive interventions for adults with chronic lung disease (CLD). METHODS: This two-stage study involved: (i) bibliometric mapping of Web of...
PURPOSE: To map the research landscape and synthesize randomized evidence on cognitive interventions for adults with chronic lung disease (CLD). METHODS: This two-stage study involved: (i) bibliometric mapping of Web of Science Core Collection (WOSCC) (Jan 2005-May 2025) to evaluate output, collaboration, and thematic trends via VOSviewer, CiteSpace, and Bibliometrix; and (ii) narrative synthesis of Randomized Controlled Trials (RCTs) in adults (≥18 y) with chronic lung diseases and validated cognitive outcomes, identified from WOSCC, Scopus, and PubMed (to May 1, 2025). Screening, data extraction, and RoB 2 assessment were conducted in duplicate. RESULTS: Bibliometric mapping (2005-2025) of 3,474 publications showed sustained growth, broad international collaboration, and a shift from epidemiology to mechanisms and patient-centered outcomes. Fifteen RCTs, mostly in stable Chronic Obstructive Pulmonary Disease (COPD), assessed inspiratory-muscle/breathing training, aerobic-resistance or dance exercise, exercise with behavioral/educational components, multimodal cognitive-lifestyle programs, and pharmacological/nutritional or acute physiological therapies Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were the most common cognitive measures, alongside executive-function tests. Methodological quality was generally moderate. CONCLUSION: Bibliometrics and randomized-trial synthesis reveal a rapidly growing, globally connected CLD-cognition field moving from epidemiology toward mechanistic and patient-centered research. Multimodal PR, especially exercise and inspiratory-muscle training, shows neurotherapeutic promise, but substantial gaps persist in Low and Middle Income Countries (LMICs) and non-COPD populations.
Development and Validation of an Electronic Health Record Algorithm to Predict the Presence of Chronic Obstructive Pulmonary Disease.
Wells BJ, Saha AK, Ohar JA
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41836033 · Full text
PURPOSE: Chronic obstructive pulmonary disease (COPD) is frequently diagnosed and treated based on clinical suspicion alone, without spirometric confirmation of expiratory airflow obstruction (AFO, defined by a forced ex...
PURPOSE: Chronic obstructive pulmonary disease (COPD) is frequently diagnosed and treated based on clinical suspicion alone, without spirometric confirmation of expiratory airflow obstruction (AFO, defined by a forced expiratory volume in 1 second (FEV) to forced vital capacity (FVC) ratio of < 0.7). This can lead to overdiagnosis and unnecessary medication use, whereas underdiagnosis results in missed treatment opportunities. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends targeted case finding. This study aimed to develop and validate an automated Electronic Health Record (EHR) based algorithm to predict AFO and guide targeted spirometric testing. PATIENTS AND METHODS: Our analysis included 15,065 patients who underwent pulmonary function testing between 2016-2022. Patients were categorized as having AFO (n=4632) or not (n=10,433) based on spirometry. Patients < 45 years, with cystic fibrosis, alpha-1 antitrypsin deficiency, or prior spirometric evidence of obstruction were excluded. Logistic regression assessed 65 variables, retaining those that optimized model discrimination. The data were randomly split into training (n=10,546) and validation (n=4519) sets. RESULTS: Key predictors of AFO included older age, male sex, lower BMI, smoking history, prior COPD diagnosis, increased emergency department utilization, fewer outpatient visits, fewer chest X-rays, and higher cumulative beta-agonist prescriptions. The final model achieved an area under the receiver operating characteristic curve (AUC) of 0.82 (95% CI: 0.81-0.83) in the validation dataset and was well calibrated. CONCLUSION: We developed an EHR-based algorithm that accurately predicts AFO using routinely collected structured data. This tool provides a practical method for identifying patients for targeted COPD case finding. Future efforts will focus on external validation and integration into clinical workflows, enabling automated identification and provider or patient notification to facilitate appropriate pulmonary function testing.
Association Between Monocyte-to-High Density Lipoprotein-Cholesterol Ratio and COPD Among US Adults: Findings from NHANES 1999-2018.
Li X, Chi X, Chen X … +10 more , Huang M, Pan M, Peng Z, Ruan W, Wei Y, Deng J, Mai Z, Tang M, Sha H, Zhang J
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41836032 · Full text
BACKGROUND: The monocyte to high-density lipoprotein-cholesterol ratio (MHR) has been significantly associated with inflammation. However, there is a paucity of research exploring the association between MHR and the susc...
BACKGROUND: The monocyte to high-density lipoprotein-cholesterol ratio (MHR) has been significantly associated with inflammation. However, there is a paucity of research exploring the association between MHR and the susceptibility to chronic obstructive pulmonary disease (COPD). METHODS: The study cohort comprised participants from ten cycles of the National Health and Nutrition Examination Survey, covering the period from 1999 to 2018. COPD was identified through self-reported diagnoses. Mobile Examination Center weights were applied in accordance with guidelines from National Center for Health Statistics. The multivariate logistic regression analysis was conducted to determine the association between MHR and COPD. Restricted cubic spline curves were employed to investigate the potential dose-response relationship between COPD and MHR. Subgroup analyses and interaction tests were finally performed. RESULTS: The study included a total of 39,646 participants, including 2,876 COPD participants. After controlling for all potential covariates, weighted logistic regression analysis demonstrated a significant association between MHR and COPD. When MHR was treated as a categorical variable, the risk of COPD increased significantly after adjusting for all potential covariates. The dose-response curve suggested a non-linear relationship between MHR and COPD risk. Subgroup analysis revealed significant interactive effects between MHR and COPD among individuals with varying BMI, marital status and smoking status. CONCLUSION: MHR was significantly associated with COPD among US adults. There is a need for further longitudinal cohort studies to explore the relationship between MHR and COPD.
Research Progress on the Mechanisms of High Mucus Secretion in the Airway: A Scoping Review.
Ying W, Jing X, Chen L … +3 more , Zhang J, Yue L, Zhang B
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41836031 · Full text
BACKGROUND: Excessive mucus production in the airways is a key pathogenic characteristic of chronic respiratory conditions, including bronchial asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (C...
BACKGROUND: Excessive mucus production in the airways is a key pathogenic characteristic of chronic respiratory conditions, including bronchial asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF). The etiology is intricate, encompassing various factors such as aberrant activation of inflammatory signaling pathways, deregulation of mucin gene expression, modified rheological characteristics of mucus, and impairment of the ciliary clearance mechanism. Nonetheless, the current evidence is disjointed, and a thorough and systematic synthesis is still absent. OBJECTIVE: This scoping review sought to systematically summarize and delineate the mechanisms of airway mucus hypersecretion, identify predominant research themes, and underscore significant knowledge gaps in existing studies. METHODS: This research was performed as a scoping review using the PRISMA principles. A thorough literature search was conducted in PubMed and the China National Knowledge Infrastructure (CNKI) databases using predefined keywords, encompassing papers from January 2005 to September 2025. Studies employing various experimental models to examine the mechanisms of airway mucus hypersecretion were included. Data were obtained from all qualifying papers for further synthesis. RESULTS: A total of 31 studies were incorporated. This paper methodically examines recent research developments in this domain, emphasizing fundamental inflammatory pathways exemplified by NF-κB, IL-13/STAT6, and EGFR; the function of transcription regulatory networks illustrated by SPDEF, Notch, and Wnt; modifications in mucus rheological characteristics, including hydration dysfunction and polymer surplus; and clearance deficiencies primarily driven by ciliary dysfunction in excessive mucus production. CONCLUSION: Airway mucus hypersecretion is regulated by multiple mechanisms at various levels. This review systematically integrates contemporary evidence to establish a conceptual framework and translational perspective for developing targeted therapeutic strategies. These strategies include interventions aimed at IL-13-related pathways, transcriptional networks like Notch, water transport channels and regulatory factors, and genes linked to ciliary dysfunction, thereby facilitating the progression of personalized precision medicine in chronic airway diseases.
Enhancing Respiratory Support in COPD Patients with Nasal High Flow Using an Asymmetrical Cannula Interface: A Randomized Cross-Over Study.
Nilius G, Domanski U, Khalaf M … +2 more , Schroeder M, Tatkov S
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41836030 · Full text
PURPOSE: Nasal high flow (NHF) is increasingly used in COPD patients with chronic respiratory failure. An asymmetrical cannula interface (AI) may enhance these benefits by combining increased airway pressure with reduced...
PURPOSE: Nasal high flow (NHF) is increasingly used in COPD patients with chronic respiratory failure. An asymmetrical cannula interface (AI) may enhance these benefits by combining increased airway pressure with reduced rebreathing from anatomical dead space. The aim of this study was to compare the effects of NHF using an AI versus a conventional symmetrical interface (SI) on tidal volume (Vt), respiratory rate (RR), minute ventilation (MV), gas exchange, and neuro-respiratory drive (NRD). METHODS: Following a 15-minute baseline period, COPD patients recovering from acute exacerbation underwent two randomized 45-minute sessions of NHF therapy using either the AI or SI. All sessions were conducted during daytime in a semi-recumbent position. Ventilation was recorded using calibrated respiratory inductance plethysmography, and transcutaneous CO (TcCO) and oxygen saturation (SpO) were continuously monitored. In addition, intercostal surface electromyography (sEMG) of the parasternal muscles was performed to assess NRD. RESULTS: In a group of 18 patients NHF significantly reduced RR and TcCO, regardless of the interface used. AI significantly reduced MV compared with both baseline and SI (p = 0.048), while SpO increased. sEMG activity increased compared with baseline without a corresponding rise in tidal volume; however, no difference was observed between the two interfaces. CONCLUSION: NHF reduced RR by increasing both expiratory and inspiratory times without altering the duty cycle. The lower MV during NHF with AI, accompanied by higher SpO, may indicate improved gas exchange efficiency. The use of AI could enhance the respiratory support effects of NHF in patients with advanced COPD.
A Cross-Tissue Transcriptome Association Study Revealed Novel Susceptibility Genes for Chronic Obstructive Pulmonary Disease.
Luan H, Wang T, Su X … +4 more , Zhao J, Yuan Z, Ding S, Yang Y
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41821648 · Full text
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation, with its pathogenesis remaining elusive. Genetic factors are recognized as crucial factors in the pathogenesis o...
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation, with its pathogenesis remaining elusive. Genetic factors are recognized as crucial factors in the pathogenesis of COPD. METHODS: This study employed transcriptome-wide association studies (TWAS) and single cell transcriptome analysis to identify predisposition genes and potential mechanisms for COPD. Cross-tissue TWAS analysis was performed using the FinnGen R10 database and sCCA weights built from the GTEx v8. Single-tissue and single-cell validations were conducted using a FUSION method based on functional summaries. SMR and colocalization analysis were carried out. C57BL/6 mice and Beas-2b cells were exposed to smoke to simulate COPD inflammation and verify the function of the genes. The regulatory effect of genes was verified by overexpression of plasmid and siRNA. Eventually, single-cell transcriptomics was conducted to investigate the expression of susceptibility genes in lung tissue cells, while GeneMANIA analysis enhanced our insights into the functional significance of these genes. RESULTS: A total of 125 susceptibility genes associated with COPD were identified by cross-tissue TWAS analysis. Single-tissue and single-cell TWAS, along with MAGMA validation, revealed two novel susceptibility genes, DNAJA4 and IREB2. SMR and colocalization analysis further confirmed these findings. Both mouse and cell experiments can prove that the occurrence of COPD is related to two genes. Both genes exhibit specific cell type enrichment in the lung tissue of COPD patients. The GeneMANIA analysis revealed that DNAJA4 and IREB2 potentially influence COPD risk by regulating protein folding and modification and metabolic processes, respectively. CONCLUSION: We identified two novel susceptibility genes (DNAJA4 and IREB2) that are causally associated with COPD. These results provide a new perspective on the genetics of COPD.
Respiratory Muscle Strength and Imaging Parameters in Smokers: A Prospective Observational Study.
Matsuo Y, Ogawa E, Iriyama T … +7 more , Tsunoda Y, Yamazaki A, Uchida Y, Nakagawa H, Kinose D, Yamaguchi M, Nakano Y
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41821647 · Full text
PURPOSE: Respiratory muscle strength tests are commonly used in respiratory rehabilitation as an indicator of training in patients with chronic obstructive pulmonary disease (COPD). Although respiratory muscle strength t...
PURPOSE: Respiratory muscle strength tests are commonly used in respiratory rehabilitation as an indicator of training in patients with chronic obstructive pulmonary disease (COPD). Although respiratory muscle strength tests are associated with lung function, their relationship with imaging parameters has not been fully investigated. Therefore, we aimed to reveal the relationship between imaging parameters and respiratory muscle strength and determine the usefulness of respiratory muscle strength tests as an indicator of the pathophysiology of dynamic pulmonary hyperinflation in smokers. PATIENTS AND METHODS: In this single-center prospective observational study conducted in Japan, 48 patients with COPD and 10 non-COPD smokers were included in the final analysis. Most of the participants were men and the median age was 77 [interquartile range 70.8-80.1]. Respiratory muscle strength tests, pulmonary function tests, and inspiratory and expiratory chest computed tomography were performed. Quantitative imaging parameters of gas trapping and emphysema were measured using the disease probability measure (DPM), a voxel-wise image analysis. RESULTS: Maximal inspiratory and expiratory pressures (PImax and PEmax) were negatively correlated with residual volume/total lung capacity (Spearman's rank correlation coefficient (r): -0.37, -0.40, respectively and p-value (p): <0.01), but not with forced expiratory volume in 1 s. PImax and PEmax were negatively correlated with gas-trapping lesions recognized by DPM (DPM) in the single correlation analysis (r: -0.31, -0.37 and p: <0.05, <0.01, respectively), and the values for DPM significantly differed between the high and low PImax and PEmax groups. CONCLUSION: Respiratory muscle strength reflects the degree of gas trapping, not the degree of obstructive airflow limitation in smokers. It proves particularly valuable, especially during the initial phases of COPD, before emphysematous changes manifest.
Modulation of Inflammatory and Oxidative Stress Pathways in COPD: Unraveling the Mechanisms of Fenugreek Through Network Pharmacology and Single-Cell RNA Sequencing.
Aikeranmu B, Maimaitiyiming D, Aierken H
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41808731 · Full text
PURPOSE: This study aims to investigate the potential targets and signaling pathways of fenugreek, a key component of Hanchuan Zupa Granule, in treating COPD using network pharmacology and single-cell RNA sequencing. PAT...
PURPOSE: This study aims to investigate the potential targets and signaling pathways of fenugreek, a key component of Hanchuan Zupa Granule, in treating COPD using network pharmacology and single-cell RNA sequencing. PATIENTS AND METHODS: Utilizing single-cell RNA sequencing data on lung tissues from COPD patients (GSE173896 dataset) and network pharmacology, we analyzed alterations in cell populations, pseudotime trajectory of alveolar macrophages, intercellular communication networks, and performed functional enrichment and molecular docking of active fenugreek compounds with disease-related targets. Key bioinformatics tools and databases included Seurat, Monocle2, CellChat, Cytoscape, AutoDock Vina, PyMOL, TCMSP, SwissTargetPrediction, and Comparative Toxicogenomics Database. RESULTS: A total of 39,240 high-quality single cells were obtained from COPD patients, leading to the identification of 23 distinct cell clusters, including 13 major immune and epithelial cell types. Notably, the proportion of senescent alveolar macrophages was significantly higher in COPD samples compared to controls, indicating enhanced involvement in inflammation and oxidative stress (P < 0.05). Pseudotime trajectory analysis categorized nine alveolar macrophage subtypes, demonstrating distinct differentiation pathways concerning inflammation, tissue repair, and cellular senescence. Network pharmacology identified 148 overlapping genes between the targets of fenugreek and COPD, with functional enrichment analyses revealing significant associations with "cytokine-mediated signaling" and "oxidative stress response." Molecular docking indicated that bioactive compounds of fenugreek exhibited strong binding affinities to CCL2 and IL1R1, confirming their roles in disrupting inflammatory signalling and limiting oxidative damage. CONCLUSION: Our integrated analysis suggests that fenugreek in Hanchuan Zupa Granule holds promise as a therapeutic strategy for modulating inflammatory and oxidative pathways in COPD and provides a strong mechanistic hypothesis centered on the IL1R1/CCL2 axis for experimental validation.
The Multidimensional Burden of COPD in China: A Propensity Score-Matched Comparison with Other Prevalent Non-Communicable Diseases.
Sun Q, Lu B, Chen Q … +1 more , Zheng Z
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41804374 · Full text
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in China, yet its multifaceted burden relative to other major non-communicable diseases (NCDs) is not well-characterized. This study c...
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in China, yet its multifaceted burden relative to other major non-communicable diseases (NCDs) is not well-characterized. This study comprehensively assessed the multidimensional burden of COPD compared to hypertension, diabetes, hypercholesterolemia, and osteoporosis in China. PATIENTS AND METHODS: A cross-sectional analysis was performed using data from the 2020 China National Health and Wellness Survey (NHWS). The study included 589 self-reported COPD patients and comparison cohorts with other NCDs. Propensity score matching (1:1) was used to balance demographic and clinical characteristics. Outcomes included health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), and healthcare resource utilization (HCRU). RESULTS: After matching, COPD patients exhibited a significantly greater overall disease burden compared to those with hypertension, diabetes, or hypercholesterolemia. The burden was severity-dependent, with patients in GOLD stages B and D experiencing the most severe impairments. COPD was associated with significantly lower HRQoL and higher activity impairment than hypertension and hypercholesterolemia. Compared to diabetes, severe COPD (Stage D) showed greater work productivity loss and higher hospitalization rates. The burden relative to osteoporosis was more variable, with the advantage of mild COPD (Stage A) diminishing in advanced stages. CONCLUSION: COPD imposes a substantial and distinct multidimensional burden in China, often exceeding that of other common NCDs and escalating with severity. These findings underscore the need for severity-based management and integrated care to mitigate the significant health and socioeconomic impact of COPD.
Inhaler Adherence in COPD and Its Clinical and Contextual Associations: A Single-Center Cross-Sectional Study.
Bektaş Aksoy H, Günaydın S, Şimşek ŞM … +1 more , Takır S
Int J Chron Obstruct Pulmon Dis · 2026 · PMID 41799994 · Full text
PURPOSE: Effective management of chronic obstructive pulmonary disease (COPD) depends on sustained adherence to inhaled therapies, yet real-world factors associated with inhaler adherence and disease awareness are not fu...
PURPOSE: Effective management of chronic obstructive pulmonary disease (COPD) depends on sustained adherence to inhaled therapies, yet real-world factors associated with inhaler adherence and disease awareness are not fully characterized. This study aimed to evaluate inhaler medication adherence among patients with COPD and to explore its associations with sociodemographic, clinical, and contextual factors, including self-reported disease awareness. PATIENTS AND METHODS: This single-center, cross-sectional descriptive study was conducted between July and October 2025 in the Chest Diseases Outpatient Clinic of a tertiary hospital. Patients aged ≥18 years with a confirmed diagnosis of COPD based on GOLD 2025 criteria were included. Sociodemographic and clinical data were collected using structured, interviewer-administered questionnaires. Inhaler adherence was assessed using a structured questionnaire adapted from the Test of Adherence to Inhalers (TAI). Symptom burden and dyspnea were evaluated using the COPD Assessment Test (CAT) and the modified Medical Research Council (mMRC) dyspnea scale, respectively. Statistical analyses were performed using IBM SPSS Statistics version 23.0, with a two-sided p value < 0.05 considered statistically significant. RESULTS: A total of 170 patients were included in the analysis (GOLD group A: 31.2%, group B: 44.1%, and group E: 24.7%). Marital status (p = 0.003), family history of COPD (p<0.001), and home use of nebulizers or oxygen concentrators (p<0.001) were significantly associated with higher inhaler adherence, whereas age, educational level, income status, and smoking status were not. TAI adherence scores did not differ significantly across GOLD groups (p>0.05), whereas exacerbation frequency and hospitalization rates increased significantly with disease severity (p<0.001). CONCLUSION: In this single-center cross-sectional study, inhaler adherence in patients with COPD was found to be associated with contextual and social factors, such as marital status, family history of COPD, and home use of respiratory support devices, rather than with demographic characteristics or disease severity. These findings highlight the importance of routinely assessing inhaler use and adherence in clinical practice and suggest that contextual factors may play a role in adherence behaviors, in line with current GOLD recommendations.
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