Bronchoscopy is the preferred method for collecting biological samples from the lower airways of ... more Bronchoscopy is the preferred method for collecting biological samples from the lower airways of subjects in clinical research. However, ensuring participation in clinical research can be challenging when the research includes an invasive procedure. For this report we reviewed the literature to look for information on participation in research bronchoscopy studies to better design our own study, the Bergen COPD Microbiome study (MicroCOPD). We performed a systematic literature search on participation in research bronchoscopy studies in February 2014 using the search engines of PubMed and EMBASE. The literature search resulted in seven relevant papers. Motivation was an end point in six of the seven papers, but reasons for declining participation and recruitment strategies also seemed important. Human subjects participate in research bronchoscopy studies for personal benefit and altruistic reasons. Inconvenience associated with research, in addition to fear of procedures, is consider...
Background: Increased levels of Growth Differentiation factor-15 (GDF-15) are associated with can... more Background: Increased levels of Growth Differentiation factor-15 (GDF-15) are associated with cancer related cachexia, cardiovascular disease and all-cause mortality. Its role in COPD is unknown. Methods: The study included 413 patients with COPD from the Bergen COPD Cohort study, aged 41-76. All patients had a FEV1<80% predicted, FEV1/FVC ratio<0.7, and smoking history of more than 10 packyrs. Spirometry, fat free mass index (FFMI), blood gases and plasma levels of GDF-15 were all measured at baseline. The patients were followed for 3 years regarding exacerbations and change in FFMI, and 5 years for mortality. Associations between GDF-15 and FFMI were evaluated with a linear regression model, adjusting for age, sex, smoking, FEV1, yearly exacerbation rate before inclusion, Charlson Comorbidity Score and hypoxemia. For the evaluation of yearly exacerbation rate and survival, a negative binomial regression model and a cox-regression model, respectively, was fitted, adjusting for the same variables. Results: Median plasma GDF-15 was 0.86ng/mL (IQR 0.48). The distribution was not normal, and the variable was dichotomized in high and low values, cut-off median. We found a significant association between high values of GDF-15 and FFMI, coefficient -1.19 (p<0.001) and -0.88 (p=0.001), unadjusted and adjusted values respectively. Similarly, high values of GDF-15 was associated with a higher yearly exacerbation rate, IRR 1.64 (p<0.001) and 1.39 (0.006). Furthermore, high levels of GDF-15 predicted mortality, HR 3.53 (p<0.001) and 1.99 (p=0.02). Conclusion: In COPD-patients, high levels of GDF-15 was independently associated with declining FFMI, higher yearly rate of exacerbations, and higher mortality.
Associations between Vitamin D3 [25(OH)D], vitamin D binding protein (VDBP) and chronic obstructi... more Associations between Vitamin D3 [25(OH)D], vitamin D binding protein (VDBP) and chronic obstructive pulmonary disease (COPD) are previously reported. We aimed to further investigate these associations on longitudinal outcomes. 426 COPD patients from western Norway, GOLD stage II-IV, aged 40-76, were followed every six-month from 2006 through 2009 with spirometry, bioelectrical impedance measurements and registration of exacerbation frequency. Serum 25(OH)D and VDBP levels were determined at study-entry by high-performance liquid chromatography coupled with mass spectrometry and enzyme immunoassays respectively. Yearly change in lung function and body composition was assessed by generalized estimating equations (GEE), yearly exacerbation rate by negative binomial regression models, and 5 years all-cause mortality by Cox proportional-hazard regression. 1/3 of the patients had vitamin D deficiency (<20ng/mL) and a greater decline in both FEV1 and FVC, compared to patients with norma...
We aimed to estimate incremental productivity losses (sick leave and disability) of spirometry-de... more We aimed to estimate incremental productivity losses (sick leave and disability) of spirometry-defined chronic obstructive pulmonary disease (COPD) in a population-based sample and in hospital-recruited patients with COPD. Furthermore, we examined predictors of productivity losses by multivariate analyses. We performed four quarterly telephone interviews of 53 and 107 population-based patients with COPD and controls, as well as 102 hospital-recruited patients with COPD below retirement age. Information was gathered regarding annual productivity loss, exacerbations of respiratory symptoms and comorbidities. Incremental productivity losses were estimated by multivariate quantile median regression according to the human capital approach, adjusting for sex, age, smoking habits, education and lung function. Main effect variables were COPD/control status, number of comorbidities and exacerbations of respiratory symptoms. Altogether 55%, 87% and 31% of population-based COPD cases, controls...
Background and objectiveWe investigated if the paraneoplastic Hu and collapsin response mediator ... more Background and objectiveWe investigated if the paraneoplastic Hu and collapsin response mediator protein 5 (CRMP5) antibodies could be used as early markers for lung cancer in smokers with or without chronic obstructive pulmonary disease (COPD).Methods Hu and CRMP5 antibodies were measured by radioimmunoprecipitation assay (RIPA) in sera from 552 smokers; 379 with and 173 without COPD. Three hundred blood donors served as controls. The positive sera were also tested by indirect immunofluorescence and line blot with recombinant proteins. The 552 smokers were matched with data from the Cancer Registry of Norway, and the hospital medical records from the subjects positive for Hu and CRMP5 antibodies were reviewed. The mean follow-up time was 4.4 years (range 2.5–5.7 years).ResultsThe RIPA showed that 5/379 (1.3%) smokers with COPD had Hu antibodies and 1/379 (0.3%) smokers with COPD had CRMP5 antibodies. Only the smoker with the highest RIPA index had Hu antibodies also detected by imm...
Bronchoscopy is the preferred method for collecting biological samples from the lower airways of ... more Bronchoscopy is the preferred method for collecting biological samples from the lower airways of subjects in clinical research. However, ensuring participation in clinical research can be challenging when the research includes an invasive procedure. For this report we reviewed the literature to look for information on participation in research bronchoscopy studies to better design our own study, the Bergen COPD Microbiome study (MicroCOPD). We performed a systematic literature search on participation in research bronchoscopy studies in February 2014 using the search engines of PubMed and EMBASE. The literature search resulted in seven relevant papers. Motivation was an end point in six of the seven papers, but reasons for declining participation and recruitment strategies also seemed important. Human subjects participate in research bronchoscopy studies for personal benefit and altruistic reasons. Inconvenience associated with research, in addition to fear of procedures, is consider...
Background: Increased levels of Growth Differentiation factor-15 (GDF-15) are associated with can... more Background: Increased levels of Growth Differentiation factor-15 (GDF-15) are associated with cancer related cachexia, cardiovascular disease and all-cause mortality. Its role in COPD is unknown. Methods: The study included 413 patients with COPD from the Bergen COPD Cohort study, aged 41-76. All patients had a FEV1<80% predicted, FEV1/FVC ratio<0.7, and smoking history of more than 10 packyrs. Spirometry, fat free mass index (FFMI), blood gases and plasma levels of GDF-15 were all measured at baseline. The patients were followed for 3 years regarding exacerbations and change in FFMI, and 5 years for mortality. Associations between GDF-15 and FFMI were evaluated with a linear regression model, adjusting for age, sex, smoking, FEV1, yearly exacerbation rate before inclusion, Charlson Comorbidity Score and hypoxemia. For the evaluation of yearly exacerbation rate and survival, a negative binomial regression model and a cox-regression model, respectively, was fitted, adjusting for the same variables. Results: Median plasma GDF-15 was 0.86ng/mL (IQR 0.48). The distribution was not normal, and the variable was dichotomized in high and low values, cut-off median. We found a significant association between high values of GDF-15 and FFMI, coefficient -1.19 (p<0.001) and -0.88 (p=0.001), unadjusted and adjusted values respectively. Similarly, high values of GDF-15 was associated with a higher yearly exacerbation rate, IRR 1.64 (p<0.001) and 1.39 (0.006). Furthermore, high levels of GDF-15 predicted mortality, HR 3.53 (p<0.001) and 1.99 (p=0.02). Conclusion: In COPD-patients, high levels of GDF-15 was independently associated with declining FFMI, higher yearly rate of exacerbations, and higher mortality.
Associations between Vitamin D3 [25(OH)D], vitamin D binding protein (VDBP) and chronic obstructi... more Associations between Vitamin D3 [25(OH)D], vitamin D binding protein (VDBP) and chronic obstructive pulmonary disease (COPD) are previously reported. We aimed to further investigate these associations on longitudinal outcomes. 426 COPD patients from western Norway, GOLD stage II-IV, aged 40-76, were followed every six-month from 2006 through 2009 with spirometry, bioelectrical impedance measurements and registration of exacerbation frequency. Serum 25(OH)D and VDBP levels were determined at study-entry by high-performance liquid chromatography coupled with mass spectrometry and enzyme immunoassays respectively. Yearly change in lung function and body composition was assessed by generalized estimating equations (GEE), yearly exacerbation rate by negative binomial regression models, and 5 years all-cause mortality by Cox proportional-hazard regression. 1/3 of the patients had vitamin D deficiency (<20ng/mL) and a greater decline in both FEV1 and FVC, compared to patients with norma...
We aimed to estimate incremental productivity losses (sick leave and disability) of spirometry-de... more We aimed to estimate incremental productivity losses (sick leave and disability) of spirometry-defined chronic obstructive pulmonary disease (COPD) in a population-based sample and in hospital-recruited patients with COPD. Furthermore, we examined predictors of productivity losses by multivariate analyses. We performed four quarterly telephone interviews of 53 and 107 population-based patients with COPD and controls, as well as 102 hospital-recruited patients with COPD below retirement age. Information was gathered regarding annual productivity loss, exacerbations of respiratory symptoms and comorbidities. Incremental productivity losses were estimated by multivariate quantile median regression according to the human capital approach, adjusting for sex, age, smoking habits, education and lung function. Main effect variables were COPD/control status, number of comorbidities and exacerbations of respiratory symptoms. Altogether 55%, 87% and 31% of population-based COPD cases, controls...
Background and objectiveWe investigated if the paraneoplastic Hu and collapsin response mediator ... more Background and objectiveWe investigated if the paraneoplastic Hu and collapsin response mediator protein 5 (CRMP5) antibodies could be used as early markers for lung cancer in smokers with or without chronic obstructive pulmonary disease (COPD).Methods Hu and CRMP5 antibodies were measured by radioimmunoprecipitation assay (RIPA) in sera from 552 smokers; 379 with and 173 without COPD. Three hundred blood donors served as controls. The positive sera were also tested by indirect immunofluorescence and line blot with recombinant proteins. The 552 smokers were matched with data from the Cancer Registry of Norway, and the hospital medical records from the subjects positive for Hu and CRMP5 antibodies were reviewed. The mean follow-up time was 4.4 years (range 2.5–5.7 years).ResultsThe RIPA showed that 5/379 (1.3%) smokers with COPD had Hu antibodies and 1/379 (0.3%) smokers with COPD had CRMP5 antibodies. Only the smoker with the highest RIPA index had Hu antibodies also detected by imm...
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