Copd 2006
Long-term follow-up of patients receiving lung-volume-reduction surgery versus medical therapy for severe emphysema by the National Emphysema Treatment Trial Research Group. Ann Thorac Surg. 2006 Aug;82(2):431-43. Effects of LVRS are durable, and it can be recommended for upper-lobe-predominant emphysema patients with low exercise capacity and should be considered for palliation in patients with upper-lobe emphysema and high exercise capacity.
The effect of helium and oxygen on exercise performance in chronic obstructive pulmonary disease: a randomized crossover trial. Am J Respir Crit Care Med. 2006 Apr 15;173(8):865-70. Conclusion: Reducing inspired gas density can improve exercise performance in COPD as much as increasing inspired oxygen. These effects can be combined as Heliox28 and are most evident in patients with more severe airflow obstruction.
Cilomilast for COPD: results of a 6-month, placebo-controlled study of a potent, selective inhibitor of phosphodiesterase 4. Chest. 2006 Jan;129(1):56-66. CONCLUSION: Cilomilast is an orally active, potent, and selective inhibitor of PDE-4. Cilomilast maintained pulmonary function and improved health status, and reduced the rate of COPD exacerbations during 24 weeks of treatment. This study supports the use of cilomilast, a novel, selective PDE-4 inhibitor, in subjects with COPD.
A randomized clinical trial of lung volume reduction surgery versus best medical care for patients with advanced emphysema: a two-year study from Canada. Ann Thorac Surg. 2006 Jan;81(1):314-20. CONCLUSIONS: The addition of LVRS to best medical care including pulmonary rehabilitation improves pulmonary function, exercise activity, and quality of life in selected patients with advanced emphysema. Cost is high but in keeping with other treatment modalities currently available.
Copd 2007
Clin Exp Pharmacol Physiol. 2007 Oct;34(10):1029-36.
Beta2-adrenoceptor polymorphisms and obstructive airway diseases: important issues of study design.
Yang IA, Ng T, Molenaar P, Fong KM.
¨
Asthma and chronic obstructive pulmonary disease (COPD) are chronic airway
diseases characterized by airflow obstruction. The beta(2)-adrenoceptor mediates
bronchodilatation in response to exogenous and endogenous beta-adrenoceptor
agonists. 2. Single nucleotide polymorphisms in the beta(2)-adrenoceptor gene
(ADRB2) cause amino acid changes (e.g. Arg16Gly, Gln27Glu) that potentially alter
receptor function. Recently, a large cohort study found no association between
asthma susceptibility and beta(2)-adrenoceptor polymorphisms. In contrast, asthma
phenotypes, such as asthma severity and bronchial hyperresponsiveness, have been
associated with beta(2)-adrenoceptor polymorphisms. Of importance to asthma
management, coding region polymorphisms may alter the response to short-acting
and long-acting beta-adrenoceptor agonists, which are commonly prescribed asthma
treatments. Optimizing study design would enhance the robustness of genetic
association studies of ADRB2 polymorphisms in airway diseases. Characteristics of
high-quality studies include suitable study design and subject selection, optimal
study of polymorphisms and haplotypes, disease outcomes of relevance, adequate
sample size, adjustment for confounding factors, supportive functional data and
appropriate analysis, interpretation and replication. Enhancing these study
design factors will provide high-quality evidence regarding the biological and
clinical importance of beta(2)-adrenoceptor pharmacogenomics in asthma and COPD.