Current Challenges and Advances in Chronic Respiratory Diseases

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 14101

Special Issue Editor


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Guest Editor
Physiology and Medicine, Université de Paris, Paris, France
Interests: the role nitric oxide plays in the physiology of the respiratory system and pulmonary diseases; non-invasive measurement of airway and alveolar inflammation in chronic respiratory diseases, including asthma and interstitial lung diseases

Special Issue Information

Dear Colleagues,

The WHO has listed chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases, and pulmonary hypertension as the most common chronic respiratory diseases which also include obstructive sleep apnea and interstitial lung disease. Chronic respiratory diseases and their burden are threatening the sustainability of the healthcare system, so improving their management could be considered a strategic point.  

We are soliciting in-depth commentary, original research (including communications), and review articles with a focus on new developments and important advances in the diagnosis, treatments, and research of chronic respiratory diseases.

Prof. Dr. Anh Tuan Dinh-Xuan
Guest Editor

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Keywords

  • respiratory diseases
  • COPD
  • asthma
  • lung diseases
  • pulmonary hypertension
  • obstructive sleep apnea

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Published Papers (5 papers)

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Research

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13 pages, 2101 KiB  
Article
Analysis of the Comorbid Course of Chronic Obstructive Pulmonary Disease
by Stanislav Kotlyarov
J. Pers. Med. 2023, 13(7), 1179; https://doi.org/10.3390/jpm13071179 - 24 Jul 2023
Cited by 2 | Viewed by 1558
Abstract
(1) Background. Chronic obstructive pulmonary disease (COPD) has a heterogeneous natural history, manifested both in the variability of clinical features and in association with various comorbid pathologies. Atherosclerotic cardiovascular disease (ASCVD) is of great clinical importance and contributes significantly to the natural history [...] Read more.
(1) Background. Chronic obstructive pulmonary disease (COPD) has a heterogeneous natural history, manifested both in the variability of clinical features and in association with various comorbid pathologies. Atherosclerotic cardiovascular disease (ASCVD) is of great clinical importance and contributes significantly to the natural history and prognosis of COPD. The present study aimed to evaluate the nature of the comorbid course of COPD during a 15-year follow-up. (2) Methods: A total of 170 male COPD patients were included in this study. Spirometry values, symptom severity, presence of risk factors, and comorbidities were considered. Prognostic factors were evaluated using the Kaplan–Meier method. (3) Results: ASCVD was the most common comorbidity and the main cause of death in patients with COPD. Patients with comorbid COPD and ASCVD had more severe dyspnea, higher frequency of COPD exacerbations, and worse survival than patients without ASCVD (p < 0.01). Among patients with COPD, the risk of death from ASCVD was higher in those older than 60 years (OR 3.23, 95% CI [1.72, 6.07]), those with rapidly declining FEV1 (OR 4.35, 95% CI [2.28, 8.30]), those with more than two exacerbations per year (OR 3.21, 95% CI [1.71, 6.11]), and those with a pack year index greater than 30 (OR 2.75, 95% CI [1.38, 5.51]. High Charlson comorbidity index scores in patients with COPD were associated with a more severe disease course, including severity of dyspnea, frequency of exacerbations, and multivariate index scores. A high Charlson comorbidity index score was an adverse prognostic factor. (4) Conclusions: ASCVD influences the course of the disease and is a major cause of mortality in COPD patients. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Chronic Respiratory Diseases)
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13 pages, 2559 KiB  
Article
A Proposal to Differentiate ACO, Asthma and COPD in Vietnam
by Ha Thi Chu, Thuy Chau Nguyen, Isabelle Godin and Olivier Michel
J. Pers. Med. 2023, 13(1), 78; https://doi.org/10.3390/jpm13010078 - 29 Dec 2022
Cited by 2 | Viewed by 2220
Abstract
Background: In low- and middle-income countries, such as Vietnam, the population is exposed to multiple risks, leading to frequent allergic asthma, COPD and their overlap (ACO). We aimed to differentiate asthma and COPD, so that recommended treatments can be applied. Methods: We hypothesized [...] Read more.
Background: In low- and middle-income countries, such as Vietnam, the population is exposed to multiple risks, leading to frequent allergic asthma, COPD and their overlap (ACO). We aimed to differentiate asthma and COPD, so that recommended treatments can be applied. Methods: We hypothesized that during life, the cumulative exposure to noxious particles increases the relative prevalence of COPD, while due to immuno-senescence, the prevalence of allergic asthma decreases with age. Among 568 patients with chronic respiratory symptoms, five phenotypes were defined, based on responsiveness to a bronchodilator (BD), diffusion capacity and cumulative smoking. Then the relative prevalence of each phenotype was related with age. Results: the smoker BD irreversible patients were considered “COPD”, while the full BD responders and non-smoking BD incomplete responders were “asthmatics”. The other patients were ACO, distributed as “like-COPD” or “like-asthma”, based on decreased or normal diffusion capacity. The relative prevalence of asthma, COPD and ACO were 26, 42 and 32% (18% “like-asthma”, 14% “like-COPD”). Conclusion: Vietnamese patients with chronic respiratory symptoms were considered as falling into asthma or COPD groups, based on cumulative smoking, spirometry with reversibility and diffusion capacity. The relative prevalence of asthma and COPD were 44 and 56%, respectively, most of which did not require corticosteroids. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Chronic Respiratory Diseases)
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12 pages, 1234 KiB  
Article
Distal Lung Inflammation Assessed by Alveolar Concentration of Nitric Oxide Is an Individualised Biomarker of Severe COVID-19 Pneumonia
by Thông Hua-Huy, Sven Günther, Christine Lorut, Marielle Subileau, Frédérique Aubourg, Caroline Morbieu, Jonathan Marey, Joëlle Texereau, Isabelle Fajac, Luc Mouthon, Nicolas Roche and Anh Tuan Dinh-Xuan
J. Pers. Med. 2022, 12(10), 1631; https://doi.org/10.3390/jpm12101631 - 2 Oct 2022
Cited by 10 | Viewed by 1983
Abstract
Pulmonary sequelae as assessed by pulmonary function tests (PFTs) are often reported in patients infected by SARS-CoV-2 during the post-COVID-19 period. Little is known, however, about the status of pulmonary inflammation during clinical recovery after patients’ discharge from the hospitals. We prospectively measured [...] Read more.
Pulmonary sequelae as assessed by pulmonary function tests (PFTs) are often reported in patients infected by SARS-CoV-2 during the post-COVID-19 period. Little is known, however, about the status of pulmonary inflammation during clinical recovery after patients’ discharge from the hospitals. We prospectively measured PFTs coupled with the exhaled nitric oxide (NO) stemming from the proximal airways (FeNO) and the distal lung (CaNO) in 169 consecutive patients with varying degrees of the severity of COVID-19 six weeks to one year after acute infection by SARS-CoV-2. The proportions of patients with abnormal PFTs, defined as the presence of either obstructive/restrictive patterns or impaired lung gas transfer, or both, increased with the severity of the initial lung disease (15, 30, and 52% in patients with mild, moderate, and severe COVID-19). FeNO values remained within normal ranges and did not differ between the three groups of patients. CaNO, however, was significantly higher in patients with severe or critical COVID-19, compared with patients with milder forms of the disease. There was also an inverse relationship between CaNO and DLCO. We conclude that the residual inflammation of the distal lung is still present in the post-COVID-19 follow-up period, in particular, in those patients with an initially severe form of COVID-19. This long-lasting alveolar inflammation might contribute to the long-term development of pulmonary fibrosis and warrants the regular monitoring of exhaled NO together with PFTs in patients with COVID-19. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Chronic Respiratory Diseases)
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9 pages, 453 KiB  
Article
Anxiety Is a Mediator between Heart Rate Variability and Quality of Life in Chronic Obstructive Pulmonary Disease
by Da-Wei Wu, Li-Hsin Chang, Po-Chou Yang, Tzu-Yu Kuo, Dong-Lin Tsai, Huang-Chi Chen, Hui-Lan Yuan, Pei-Shih Chen, Szu-Chia Chen and I-Mei Lin
J. Pers. Med. 2022, 12(6), 960; https://doi.org/10.3390/jpm12060960 - 12 Jun 2022
Cited by 4 | Viewed by 2784
Abstract
Autonomic nervous system (ANS) dysregulation is an important pathophysiological mechanism in patients with chronic obstructive pulmonary disease (COPD). Heart rate variability (HRV) is a common index for ANS, and HRV has been used to explore the association between ANS and clinical illnesses. This [...] Read more.
Autonomic nervous system (ANS) dysregulation is an important pathophysiological mechanism in patients with chronic obstructive pulmonary disease (COPD). Heart rate variability (HRV) is a common index for ANS, and HRV has been used to explore the association between ANS and clinical illnesses. This study aimed to explore the group differences in HRV, depression, anxiety, and quality of life between participants with COPD and healthy controls (HC group), and whether emotion plays a mediating role between HRV and quality of life in participants with COPD. A total of ninety-six participants with COPD and 59 participants in the HC group completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Saint George’s Respiratory Questionnaire (SGRQ). Assessment of spirometry pulmonary function and five minute lead II electrocardiography (ECG) were also performed under the resting baseline. The COPD group had higher depression scores (F = 4.10, p = 0.008), and a lower quality of life (F = 14.44, p < 0.001) and HRV indices (such as standard deviation of RR intervals (F = 5.49, p < 0.05) and low frequency (F = 3.03, p < 0.05)) compared to the HC group. Sympathetic activation was positively correlated with depression (r = 0.312, p < 0.01), anxiety (r = 0.420, p < 0.001), and poor quality of life (r = 0.467, p < 0.001) in the COPD group. After controlling for age and sex, anxiety (β = 0.585, p < 0.001) and sympathetic activation (β = 0.231, p < 0.05) positively predicted poor quality of life, and lung function (β = −0.251, p < 0.01) negatively predicted poor quality of life. Therefore, anxiety is a mediator between sympathetic activation and quality of life. Emotional and HRV screening should be applied to COPD patients in clinical practice, and emotional management or HRV biofeedback training can be used to improve anxiety and HRV for future studies. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Chronic Respiratory Diseases)
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Review

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20 pages, 1527 KiB  
Review
Personalized Medicine and Obstructive Sleep Apnea
by Sy Duong-Quy, Hoang Nguyen-Huu, Dinh Hoang-Chau-Bao, Si Tran-Duc, Lien Nguyen-Thi-Hong, Thai Nguyen-Duy, Tram Tang-Thi-Thao, Chandat Phan, Khue Bui-Diem, Quan Vu-Tran-Thien, Thu Nguyen-Ngoc-Phuong, Vinh Nguyen-Nhu, Huong Le-Thi-Minh and Timothy Craig
J. Pers. Med. 2022, 12(12), 2034; https://doi.org/10.3390/jpm12122034 - 8 Dec 2022
Cited by 9 | Viewed by 4199
Abstract
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. This is due to differences in morphology, diversity in clinical phenotypes, and differences in diagnosis and treatment of OSA in children and adults, even among individuals [...] Read more.
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. This is due to differences in morphology, diversity in clinical phenotypes, and differences in diagnosis and treatment of OSA in children and adults, even among individuals of the same age. Therefore, a personalized medicine approach to diagnosis and treatment of OSA is necessary for physicians in clinical practice. In children and adults without serious underlying medical conditions, polysomnography at sleep labs may be an inappropriate and inconvenient testing modality compared to home sleep apnea testing. In addition, the apnea–hypopnea index should not be considered as a single parameter for making treatment decisions. Thus, the treatment of OSA should be personalized and based on individual tolerance to sleep-quality-related parameters measured by the microarousal index, harmful effects of OSA on the cardiovascular system related to severe hypoxia, and patients’ comorbidities. The current treatment options for OSA include lifestyle modification, continuous positive airway pressure (CPAP) therapy, oral appliance, surgery, and other alternative treatments. CPAP therapy has been recommended as a cornerstone treatment for moderate-to-severe OSA in adults. However, not all patients can afford or tolerate CPAP therapy. This narrative review seeks to describe the current concepts and relevant approaches towards personalized management of patients with OSA, according to pathophysiology, cluster analysis of clinical characteristics, adequate combined therapy, and the consideration of patients’ expectations. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Chronic Respiratory Diseases)
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