Chest
Original ResearchCOPDAcquired Cystic Fibrosis Transmembrane Conductance Regulator Dysfunction in the Lower Airways in COPD
Section snippets
Study Subjects and Study Protocol
The study was approved by the University of Alabama at Birmingham Institutional Review Board (approval number F090626003), and all patients provided written informed consent. Patients aged 40 to 80 years were categorized into four subgroups by smoking status and the presence or absence of airflow obstruction (FEV1/FVC below the lower limit of normal for age, race, sex, and height). A minimum of 10 pack-years tobacco use was required for patients with COPD, and abstinence was confirmed with
Study Subjects
We enrolled 48 patients of whom eight did not meet spirometric inclusion criteria or were excluded because of comorbid illnesses that increased the risk of bronchoscopy complications (e-Fig 1). Of the remaining 40 patients, 35 had acceptable LAPD tracings. Tracings were not available for five patients because of technical issues with the perfusion catheter (n = 3), leakage of perfusion fluids (n = 1), or patient intolerance of bronchoscopy (n = 1). Three patients (two COPD smokers and one
Discussion
The results demonstrate that smokers with and without COPD have reduced chloride conductance in the lower airway and that this ion transport abnormality is associated with the presence of chronic bronchitis and dyspnea. These results extend previous findings, suggesting that cigarette smoke has deleterious effects on CFTR activity and epithelial function,12, 13, 14, 15, 27 and establish a link between CFTR dysfunction in the lung and clinically relevant COPD symptoms. Detection of this ion
Acknowledgments
Author contributions: Drs Dransfield and Rowe had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Dransfield: contributed to the study design, study procedures, data analysis, manuscript writing, and manuscript editing.
Dr Wilhelm: contributed to the study procedures, data analysis, and manuscript editing.
Dr Flanagan: contributed to the study procedures, data analysis, and manuscript editing.
Dr Courville:
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Funding/Support: This research is sponsored by the National Institutes of Health [R01 HL105487 to Dr Rowe, R01 HL07783, P30 DK072482, and 5UL1 RR025777] and the Cystic Fibrosis Foundation (CLANCY09Y0 to Dr Rowe and R464-CF). Dr Rowe is supported by American Lung Association Senior Research Fellowship (RT-219427-N).
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