Emphysema and extrapulmonary tissue loss in COPD: a multi-organ loss of tissue phenotype

• DOI: 10.1183/13993003.02146-2017
• Publication Date: 2018-02-08T10:08:45Z
• Authors: Bartolome R. Celli; Nicholas Locantore; Ruth Tal-Singer; John Riley; Bruce Miller; Jørgen Vestbo; Julie C. Yates; Edwin K. Silverman; Caroline A. Owen; Miguel Divo; Victor Pinto-Plata; Emiel F.M. Wouters; Rosa Faner; Alvar Agusti
• Keywords: LUNG-DISEASE; BIOMARKER; Adult; Male; kronična obstruktivna pljučna bolezen; PROTEIN; PROGRESSION; OBSTRUCTIVE PULMONARY-DISEASE; Severity of Illness Index; chronic obstructive pulmonary disease; Body Mass Index; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; 0302 clinical medicine; COPD; emfizem; Humans; COHORT; NETWORK; Prospective Studies; info:eu-repo/classification/udc/616.2; Lung; Aged; Smoking; KOPB; Middle Aged; Pulmonary Surfactant-Associated Protein D; COMORBIDITIES; Respiratory Function Tests; 3. Good health; emphysema; Phenotype; Pulmonary Emphysema; Disease Progression; ECLIPSE; Female; Tomography, X-Ray Computed; ResearchInstitutes_Networks_Beacons/lydia_becker_institute_of_immunology_and_inflammation; name=Lydia Becker Institute; Biomarkers; CT

We tested whether emphysema progression accompanies enhanced tissue loss in other body compartments 1817 patients from the ECLIPSE chronic obstructive pulmonary disease (COPD) cohort. Clinical and selected systemic biomarker measurements were compared subjects grouped by quantitative tomography scan quartiles using percentage of low attenuation area (LAA%). Lowest highest quartile had amino-acid metabolomic profiles. related LAA% to 3 years decline lung function (forced expiratory volume 1 s (FEV )), mass index (BMI), fat-free (FFMI) exacerbations, hospitalisations mortality rates. Participants with more baseline lower FEV , BMI FFMI, worse functional capacity, less cardiovascular but osteoporosis. Systemic C-reactive protein interleukin-6 levels similar among groups, club cell 16 was higher interleukin-8, surfactant D soluble receptor for advanced glycation end product emphysema. Metabolomics differed between extreme quartiles. Patients accelerated FFMI mortality. COPD undergo excessive extrapulmonary tissue, which is probably abnormal maintenance. Because clinical outcomes, we propose this subgroup be named multi-organ (MOLT) phenotype.