Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease
Posted on 2020-02-13 - 05:24
Abstract Background Although COPD among non-smokers (NS-COPD) is common, little is known about this phenotype. We compared NS-COPD subjects with smoking COPD (S-COPD) patients in a rural Indian population using a variety of clinical, physiological, radiological, sputum cellular and blood biomarkers. Methods Two hundred ninety subjects (118 healthy, 79 S-COPD, 93 NS-COPD) performed pre- and post-bronchodilator spirometry and were followed for 2 years to study the annual rate of decline in lung function. Body plethysmography, impulse oscillometry, inspiratory-expiratory HRCT, induced sputum cellular profile and blood biomarkers were compared between 49 healthy, 45 S-COPD and 55 NS-COPD subjects using standardized methods. Spirometric response to oral corticosteroids was measured in 30 female NS-COPD patients. Results Compared to all male S-COPD subjects, 47% of NS-COPD subjects were female, were younger by 3.2 years, had greater body mass index, a slower rate of decline in lung function (80 vs 130 mL/year), more small airways obstruction measured by impulse oscillometry (p < 0.001), significantly less emphysema (29% vs 11%) on CT scans, lower values in lung diffusion parameters, significantly less neutrophils in induced sputum (p < 0.05) and tended to have more sputum eosinophils. Hemoglobin and red cell volume were higher and serum insulin lower in S-COPD compared to NS-COPD. Spirometric indices, symptoms and quality of life were similar between S-COPD and NS-COPD. There was no improvement in spirometry in NS-COPD patients after 2 weeks of an oral corticosteroid. Conclusions Compared to S-COPD, NS-COPD is seen in younger subjects with equal male-female predominance, is predominantly a small-airway disease phenotype with less emphysema, preserved lung diffusion and a slower rate of decline in lung function.
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Salvi, Sundeep; Brashier, Bill; Londhe, Jyoti; Pyasi, Kanchan; Vincent, Vandana; Kajale, Shilpa; et al. (2020). Phenotypic comparison between smoking and non-smoking chronic obstructive pulmonary disease. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.4854774.v1
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AUTHORS (14)
SS
Sundeep Salvi
BB
Bill Brashier
JL
Jyoti Londhe
KP
Kanchan Pyasi
VV
Vandana Vincent
SK
Shilpa Kajale
ST
Sajid Tambe
KM
Kuldeep Mandani
AN
Arjun Nair
SM
Sze Mak
SM
Sapna Madas
SJ
Sanjay Juvekar
LD
Louise Donnelly
PB
Peter Barnes