Upper airway symptoms and small airways disease in Chronic Obstructive Pulmonary Disease, COPD

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Upper airway symptoms and small airways disease in Chronic Obstructive Pulmonary Disease, COPD

Obling, N; Rangelov, B; Backer, V; Hurst, JR; Bodtger, U; (2021) Upper airway symptoms and small airways disease in Chronic Obstructive Pulmonary Disease, COPD. Respiratory Medicine , 191 , Article 106710. 10.1016/j.rmed.2021.106710. Green open access

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Abstract

BACKGROUND: Small Airways Disease (SAD) is a recognised part of the pathology in Chronic Obstructive Pulmonary Disease (COPD) and contributes to the symptom burden in the disease. Upper airway symptoms in COPD is an emerging field of study, and in this study, we sought to examine the co-existence of SAD and upper airways symptoms in a cohort of COPD patients METHODS: We investigated a cohort of patients with COPD for the presence of SAD with three different modalities. We performed High-Resolution CT (HRCT) with Parametric Response Mapping (PRM) analysis and recorded distribution of emphysema (PRMEmph) and functional Small Airways Disease (PRMfSAD). We measured central and peripheral lung resistance using Impulse Oscillometry (IOS) and recorded R5Hz, R20Hz, R5-R20Hz, X5, Fres and Ax. Static lung function parameters were obtained using Body Plethysmography. Data on upper and lower airway symptoms were evaluated using the Upper Airway subdomain of the 22 items Sino Nasal Outcome Test (SNOT22nasal) and the COPD Assessment Test (CAT), respectively. FINDINGS: We recruited a total of 112 patients. (female sex: 58%, Age 68 (±8) years, FEV1%predicted: 53% (±16%), GOLD stage: A: 23%, B: 55%, C:1% D: 21%). Forty-five (40%) were classified as having high upper airway symptoms (UAS), defined as SNOT22nasal ≥6. Eighty-seven per cent showed signs of SAD using IOS (R5-R20Hz > 0.07 kPa/L/s). No significant differences were found between UAS groups in IOS, PRM or Body Plethysmography parameters. CONCLUSION: In patients with COPD, the prevalence of small airways disease was very high, but no association between upper airway symptoms and small airways disease was demonstrated.

Type:	Article
Title:	Upper airway symptoms and small airways disease in Chronic Obstructive Pulmonary Disease, COPD
Open access status:	An open access version is available from UCL Discovery
DOI:	10.1016/j.rmed.2021.106710
Publisher version:	https://doi.org/10.1016/j.rmed.2021.106710
Language:	English
Additional information:	This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification:	UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Chemical Engineering
URI:	https://discovery.ucl.ac.uk/id/eprint/10140361