Male gender, a history of tuberculosis, and high levels of serum total immunoglobulin E (T-IgE) are all risk factors for bronchiectasis in COPD patients, researchers at Beijing Tongren Hospital and at the Peking University Third Hospital in China report in a recent study, “Factors associated with bronchiectasis in patients with moderate-severe chronic obstructive pulmonary disease,” published in Medicine.
Bronchiectasis, a condition where the walls of the bronchi are thickened from inflammation and infection, is common in patients with chronic obstructive pulmonary disease. It has also been shown to be associated with more severe symptoms of COPD, as well as a higher frequency of exacerbations and higher mortality rates. But the mechanisms underlying bronchiectasis in COPD patients are not clear.
The researchers sought to find risk factors for bronchiectasis in COPD to further their understanding of the disease’s development. They enrolled 190 patients with COPD, 45.8 percent of whom were found to have bronchiectasis through high resolution computed tomography (HRCT).
After examining the patients, the researchers found that those with bronchiectasis were more likely to be male, have a lower body mass index, a previous history of tuberculosis, and to have a longer history of shortness of breath or more severe shortness of breath than patients without bronchiectasis.
Other factors, such as a higher frequency of acute exacerbations, higher serum levels of C-reactive protein, fibrinogen, and T-IgE, were also found to correlate with bronchiectasis in COPD patients. Patients with bronchiectasis also had worse pulmonary function, and higher incidence of Pseudomonas aeruginosa infection.
All these variables were included in a logistic regression to identify risk factors for the development of bronchiectasis in COPD patients. The results revealed that male gender, history of tuberculosis, and increased levels of serum T-IgE were the independent risk factors.
In addition, researchers also found that serum T-IgE correlated with the severity of bronchiectasis in these patients. This was the first study showing a correlation between T-IgE and the extent of bronchiectasis, suggesting that approaches targeting IgE (Immunoglobulin E) function might have some therapeutic potential in slowing or halting bronchiectasis symptoms in COPD patients.
New studies with larger samples are now required to understand whether T-IgE levels change over the course of the disease, and whether its modulation can benefit COPD patients with bronchiectasis.
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