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Table of Contents for
Volume 22 Issue 4
May 2017

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621Lessons for COPD from the GOLD 2017 report
Masaharu Nishimura
622Pulmonary rehabilitation in Australia and New Zealand: From guidelines to personalized treatment
Frits M E Franssen & Martijn A Spruit
624Alternatives to induced sputum for identifying inflammatory subtypes of asthma
Jodie L Simpson & Mona Bafadhel
626Telerehabilitation for COPD: Could pulmonary rehabilitation deliver on its promise?
Anne E Holland & Narelle S Cox
628Patient-reported outcome measures in idiopathic pulmonary fibrosis: Where do we stand?
Sara Canu, Veronica Alfieri & Elisabetta Renzoni
630Nintedanib for idiopathic pulmonary fibrosis in the Japanese population
Helen E Jo & Tamera J Corte
Unravelling the Many Faces of COPD to Optimize its Care and Outcomes
632COPD: Lessons learned, forging a fantastic future
Don D Sin & Gregory G King
Unravelling the Many Faces of COPD to Optimize its Care and Outcomes
634The role of acute and chronic respiratory colonization and infections in the pathogenesis of COPD
Janice M Leung, Pei Yee Tiew, Micheál Mac Aogáin, Kurtis F Budden, Valerie Fei Lee Yong, Sangeeta S Thomas, Kevin Pethe, Philip M Hansbro & Sanjay H Chotirmall
Seeking Innovative Solutions In Severe Asthma
651Co-morbidities in severe asthma: Clinical impact and management
Celeste Porsbjerg & Andrew Menzies-Gow
662Coal mine dust lung disease in the modern era
Jennifer L Perret, Brian Plush, Philippe Lachapelle, Timothy S C Hinks, Clare Walter, Philip Clarke, Louis Irving, Pat Brady, Shyamali C Dharmage & Alastair Stewart
Asthma and Allergy
Editor's choice
Nasal lavage, blood or sputum: Which is best for phenotyping asthma?
Camyla F de Farias, Maria M F Amorim, Michel Dracoulakis, Lilian B Caetano, Ilka L Santoro & Ana L G Fernandes

Airway inflammation is one of the many mechanisms underlying asthma. Many therapies target inflammation. Induced sputum cytology is the gold standard for determining inflammatory phenotypes, but blood cell count is often used as a substitute. We show that nasal lavage cytometry better reflects sputum-based determination of inflammation than blood cell count.

678Mannitol challenge testing for asthma in a community cohort of young adults
Elisha C White, Nicholas de Klerk, Zoltan Hantos, Monique Priston, Elysia M Hollams, Alan James, Peter D Sly, Patrick G Holt & Graham L Hall

Mannitol challenge testing for asthma is increasingly used in non-clinical populations outside specialized respiratory laboratories. This study found high specificity (94%) and good positive predictive value (PPV, 79%) in a wheezing population, but low PPV (45%) in a non-clinical population. Caution is required when interpreting testing in non-clinical populations.

684Influence of SIGLEC9 polymorphisms on COPD phenotypes including exacerbation frequency
Takeo Ishii, Takashi Angata, Emily S Wan, Michael H Cho, Takashi Motegi, Congxiao Gao, Kazuaki Ohtsubo, Shinobu Kitazume, Akihiko Gemma, Peter D Paré, David A Lomas, Edwin K Silverman, Naoyuki Taniguchi & Kozui Kida

A haplotype of SIGLEC9 gene was associated with exacerbation frequency and emphysema in Japanese COPD patients (but not in ECLIPSE cohort). The Siglec-9 protein encoded by this haplotype was hypomorphic in its ability to suppress myeloid cell inflammatory responses. This study reinforces the connections between endogenous lectins and COPD phenotypes.

691Rare variant of MAP2K7 is associated with increased risk of COPD in southern and eastern Chinese
Fuman Qiu, Yinyan Li, Xiaoxiao Lu, Chenli Xie, Qingqing Nong, Di Wu, Jiansong Chen, Lei Yang, Yifeng Zhou & Jiachun Lu

Based on a two-stage retrospective study, we evaluated the association between rare variants in MAP2K7 and COPD risk. We found that the Glu116Lys rare variant exerted an elevated risk of COPD accompanied by worsening lung function and it might be a genetic biomarker for COPD susceptibility.

Editor's choice
Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study
Ling Ling Y Tsai, Renae J McNamara, Chloe Moddel, Jennifer A Alison, David K McKenzie & Zoe J McKeough

An 8-week home-based telerehabilitation exercise programme using real-time videoconferencing software showed a statistically significant increase in endurance shuttle walk test time and self-efficacy when compared with usual care with no exercise training in patients with COPD.

Critical Care
708Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome
Takashi Kido, Keiji Muramatsu, Kazuhiro Yatera, Takeshi Asakawa, Hiroki Otsubo, Tatsuhiko Kubo, Yoshihisa Fujino, Shinya Matsuda, Toshihiko Mayumi & Hiroshi Mukae

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical respiratory diseases. No effective pharmacotherapies have been established and the efficacy of sivelestat for ALI/ARDS remains uncertain. Our results suggest that early sivelestat administration may improve the prognosis of patients with ALI/ARDS.

Cystic Fibrosis
714Physiological markers of exercise capacity and lung disease severity in cystic fibrosis
Laurie Smith, Charles C Reilly, Victoria MacBean, Caroline J Jolley, Caroline Elston, John Moxham & Gerrard F Rafferty

A novel marker of cystic fibrosis (CF) lung disease severity, inspiratory muscle electromyogram activity, was investigated in 20 adult CF patients. Both lung gas transfer (TLCO) % predicted and inspiratory muscle electromyogram activity related strongly to exercise performance and therefore may be useful in CF lung disease management.

Interstitial Lung Disease
721COPD Assessment Test for measurement of health status in patients with idiopathic pulmonary fibrosis: A cross-sectional study
Toshiaki Matsuda, Hiroyuki Taniguchi, Masahiko Ando, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka, Koji Sakamoto, Atsushi Suzuki, Taiki Furukawa & Yoshinori Hasegawa

The validity of the COPD Assessment Test (CAT) was evaluated exclusively in idiopathic pulmonary fibrosis (IPF) patients in comparison with the St George's Respiratory Questionnaire (SGRQ). The CAT had a significant correlation with SGRQ and was independently predicted by dyspnoea severity, oxygenation impairment and anxiety.

728Frailty is common and strongly associated with dyspnoea severity in fibrotic interstitial lung disease
Kathryn M Milne, Joanne M Kwan, Sabina Guler, Tiffany A Winstone, Angela Le, Nasreen Khalil, Pat G Camp, Pearce G Wilcox & Christopher J Ryerson

Fibrotic interstitial lung disease (ILD) patients were recruited from a specialized clinic to show that frailty is highly prevalent and is strongly and independently associated with dyspnoea severity. These findings suggest that frailty is an important feature of fibrotic ILD that warrants further study.

735HRCT features of surgically resected invasive mucinous adenocarcinoma associated with interstitial pneumonia
Atsushi Miyamoto, Atsuko Kurosaki, Takeshi Fujii, Kazuma Kishi & Sakae Homma

This study describes the unique HRCT features of invasive mucinous adenocarcinoma in patients with interstitial pneumonia. Signs of malignancy like lobulation, spiculation, vascular convergence and pleural indentation are together with vague margins, lobular-bounded margins, air bronchogram and bubble-like low attenuation indicative for an invasive mucinous adenocarcinoma.

744Soluble thrombomodulin in bronchoalveolar lavage fluid is an independent predictor of severe drug-induced lung injury
Atsushi Suzuki, Hiroyuki Taniguchi, Yasuhiro Kondoh, Masahiko Ando, Naohiro Watanabe, Tomoki Kimura, Kensuke Kataoka, Toshiki Yokoyama, Koji Sakamoto & Yoshinori Hasegawa

Soluble thrombomodulin in bronchoalveolar lavage is an independent predictor of severe drug-induced lung injury (DLI). Pulmonary endothelial injuries are an important aspect of pathogenesis in severe DLI.

Lung function
750Nintedanib in Japanese patients with idiopathic pulmonary fibrosis: A subgroup analysis of the INPULSIS® randomized trials
Arata Azuma, Hiroyuki Taniguchi, Yoshikazu Inoue, Yasuhiro Kondoh, Takashi Ogura, Sakae Homma, Tsuyoshi Fujimoto, Wataru Sakamoto, Yukihiko Sugiyama & Toshihiro Nukiwa

This pre-specified subgroup analysis of two Phase III, randomized, placebo-controlled trials (INPULSIS®) involving 205 sites in 24 countries including 25 Japanese sites revealed that the efficacy and safety profiles of nintedanib in Japanese patients with idiopathic pulmonary fibrosis were similar to those observed in the overall population of both trials.

Pleural Disease
758Role of MCP-1 in pleural effusion development in a carrageenan-induced murine model of pleurisy
Sally M Lansley, Hui Min Cheah & Y C Gary Lee

This study further explored the role of monocyte chemotactic protein-1 (MCP-1) in exudative fluid formation using a mouse model of carrageenan (CAR)-induced pleurisy. MCP-1 protein was significantly and highly expressed in pleural effusion compared to matched serum. Blockade of MCP-1 or its receptor (CCR2) led to a significant decrease in CAR-induced pleural effusion volume.

764Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion
Jordan A P Olfert, Erika D Penz, Braden J Manns, Eleanor K Mishra, Helen E Davies, Robert F Miller, Ramon Luengo-Fernandez, Song Gao & Najib M Rahman

This is the first cost-effectiveness analysis performed alongside a randomized controlled trial comparing indwelling pleural catheters with talc pleurodesis for treating patients with malignant pleural effusions, and it provides clinically relevant recommendations regarding the cost-effective use of these therapies.

Pulmonary Vascular Disease
771Pathophysiology of dyspnoea in acute pulmonary embolism: A cross-sectional evaluation
Olivier Sanchez, Aurore Caumont-Prim, Elisabeth Riant, Laurent Plantier, Martin Dres, Bruno Louis, Marie-Anne Collignon, Benoit Diebold, Guy Meyer, Claudine Peiffer & Christophe Delclaux

The pathophysiology of dyspnoea in pulmonary embolism (PE) remains poorly characterized. Our prospective study in patients with acute PE shows that, while exertional dyspnoea is mainly associated to vascular consequences of PE, the sensation of dyspnoea also correlates with factors such as age, depression and breathing variability.

Respiratory Infections
778Seasonality of pathogens causing community-acquired pneumonia
Catia Cilloniz, Santiago Ewig, Albert Gabarrus, Miquel Ferrer, Jorge Puig de la Bella Casa, Josep Mensa & Antoni Torres

Seasonal variations of microbial aetiology may be important for future community-acquired pneumonia (CAP) recommendations. CAP should not be regarded as a seasonal disease, as it occurs throughout all seasons. However, Streptococcus pneumoniae, respiratory viruses, polymicrobial pneumonia and Legionella pneumophila are clearly subject to seasonal variations.

Sleep and Ventilation
786Effects of CPAP therapy on visceral fat thickness, carotid intima-media thickness and adipokines in patients with obstructive sleep apnoea
Susanna S S Ng, Eric K H Liu, Ronald C W Ma, Tat-On Chan, Kin-Wang To, Ken K P Chan, Jenny Ngai, Wing-Ho Yip, Fanny W S Ko, Chun-Kwok Wong & David S C Hui

Obstructive sleep apnoea is associated with an increased prevalence of metabolic syndrome. This randomized, subtherapeutic continuous positive airway pressure (CPAP)-controlled study found no significant improvement in visceral fat and carotid intima-media thickness after 3 months CPAP therapy

793Effect of OSA on hypoxic and inflammatory markers during CPAP withdrawal: Further evidence from three randomized control trials
Chris D Turnbull, Valentina A Rossi, Peter Santer, Esther I Schwarz, John R Stradling, Nayia Petousi & Malcolm Kohler

Intermittent hypoxia, endothelial dysfunction and adipose tissue-mediated inflammation have been proposed as mechanisms in the development of cardiovascular disease in obstructive sleep apnoea (OSA). We explored changes in associated biomarkers after continuous positive airways pressure (CPAP) withdrawal. Return of OSA led to a small reduction in adrenomedullin with no significant change in other cardiovascular markers.

800Australian and New Zealand Pulmonary Rehabilitation Guidelines
Jennifer A Alison, Zoe J McKeough, Kylie Johnston, Renae J McNamara, Lissa M Spencer, Sue C Jenkins, Catherine J Hill, Vanessa M McDonald, Peter Frith, Paul Cafarella, Michelle Brooke, Helen L Cameron-Tucker, Sarah Candy, Nola Cecins, Andrew S L Chan, Marita T Dale, Leona M Dowman, Catherine Granger, Simon Halloran, Peter Jung, Annemarie L Lee, Regina Leung, Tamara Matulick, Christian Osadnik, Mary Roberts, James Walsh, Sally Wootton, Anne E Holland & on behalf of the Lung Foundation Australia and the Thoracic Society of Australia and New Zealand
820Year in review 2016: Chronic obstructive pulmonary disease and asthma
Tow Keang Lim, Fanny W S Ko, Melissa J Benton, Maarten Van den Berge & Judith Mak
829Medullary neuropathology in sleep apnoea
J Howard Jaster
830COPD exacerbation and diaphragmatic dysfunction: Conditions with mutual influence influencing outcomes?
Annia Schreiber & Antonio M Esquinas
830COPD exacerbation and diaphragmatic dysfunction: Conditions with mutual influence influencing outcomes? – Reply
Alessandro Marchioni, Roberto Tonelli, Federico Antenora, Riccardo Fantini & Enrico M Clini