학술논문
Impact of Bronchiectasis on COPD Severity and Alpha-1 Antitrypsin Deficiency as a Risk Factor in Individuals with a Heavy Smoking History.
Document Type
article
Author
Izquierdo, Manuel; Marion, Chad; Genese, Frank; Newell, John; ONeal, Wanda; Li, Xingnan; Hawkins, Gregory; Barjaktarevic, Igor; Barr, R; Christenson, Stephanie; Cooper, Christopher; Couper, David; Curtis, Jeffrey; Han, Meilan; Hansel, Nadia; Kanner, Richard; Martinez, Fernando; Paine, Robert; Tejwani, Vickram; Woodruff, Prescott; Zein, Joe; Hoffman, Eric; Peters, Stephen; Meyers, Deborah; Bleecker, Eugene; Ortega, Victor
Source
Chronic obstructive pulmonary diseases (Miami, Fla.). 10(3)
Subject
Language
Abstract
RATIONALE: Bronchiectasis is common among those with heavy smoking histories, but risk factors for bronchiectasis, including alpha-1 antitrypsin deficiency, and its implications for COPD severity are uncharacterized in such individuals. OBJECTIVES: To characterize the impact of bronchiectasis on COPD and explore alpha-1antitrypsin as a risk factor for bronchiectasis. METHODS: SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) participants (N=914; ages 40-80 years; ≥20-pack-year smoking) had high-resolution computed tomography (CT) scans interpreted visually for bronchiectasis, based on airway dilation without fibrosis or cicatrization. We performed regression-based models of bronchiectasis with clinical outcomes and quantitative CT measures. We deeply sequenced the gene encoding -alpha-1 antitrypsin, SERPINA1, in 835 participants to test for rare variants, focusing on the PiZ genotype (Glu366Lys, rs28929474). MEASUREMENTS AND MAIN RESULTS: We identified bronchiectasis in 365 (40%) participants, more frequently in women (45% versus 36%, p=0.0045), older participants (mean age=66[standard deviation (SD)=8.3] versus 64[SD=9.1] years, p=0.0083), and those with lower lung function (forced expiratory volume in 1 second [FEV1 ] percentage predicted=66%[SD=27] versus 77%[SD=25], p