Hi,
I am looking for some studies focused on prediction of exacerbation in chronic pulmonary diseases (especially asthma and COPD) considering changes in respiratory parameters (measured by spirometed or peak flow meter), other features of patient's condition, external factor (pollution, allergy, temperature, humidity or pressure changes) etc. detected a few day before occuring exacerbation.
The example of the study that I am iterested in is:
http://thorax.bmj.com/content/early/2013/04/05/thoraxjnl-2012-201815.short
where the predictors were PEF and FEV1 value obtained from daily measurements.
Thank you for every suggestion.
Mateusz
In The COPD and asthma population I have been monitoring weather changes (Temp, Humidity, Pressure and pollution levels). A limitation to it is the indoor quality vs. outdoor quality. In the past I had been doing some serial measures of inspiratory volume with a simple device. The info collected has enlighten me too "keep it simple". I have not published anything on the data I have collected, but it does look promising.
Peak flows I have found to be very variable in all the subjects. Serial FEV1 and inspiratory volume works for all lung patients. Other markers are not easy to collect and/or require complex testing and equipment. (ENO, IOS, etc.)
Best of luck I hope this may offer some ideas.
Increases in exhaled nitric oxide (FeNO), when measured daily, has been shown to predict moderate asthma exacerbations, as shown by van det Valk et al.
http://www.ncbi.nlm.nih.gov/pubmed/21999328
Thank you very much for your proposition of markers.
David, do you have some interesting results that you can share?
Hi,
I found these references and the evaluated markers in their studies valuable for your research:
1. Wedzicha, J. A. & Donaldson, G. C. (2003). Exacerbations of Chronic Obstructive Pulmonary Disease. Respiratory, December 2003, VOL 48 NO 12: 1204-1215.
“Sputum inflammatory cytokines; interleukin-6 (IL-6), IL-8, Endothelin-1, the neutrophil chemoattractant leukotriene b4 (LTB4), & neutrophil elastase”
2. Bhowmik A, Seemungal TAR, Sapsford RJ, Wedzicha JA. Relation of sputum inflammatory markers to symptoms and lung function changes in COPD exacerbations. Thorax 2000;55(2):114–200.
“Cell counts and sputum levels of interleukin (IL)-6 & IL-8”
3. Seemungal T, Harper-Owen R, Bhowmik A, Moric I, Sanderson G, Message S, et al. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;164(9):1618– 1623.
“Nasal samples and blood for respiratory virus detection by culture, polymerase chain reaction, and serology, and plasma fibrinogen and serum interleukin-6 (IL-6)”
I wish this helps.
Best
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