The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study

Jorgen Vestbo; Harvey O. Coxson; Asger Dirksen; Lisa D. Edwards; Julie C. Yates; Alvar Agusti; Per Bakke; Peter M A Calverley; Bartolome Celli; Courtney Crim; Annelyse Duvoix; Paola Nasute Fauerbach; David A. Lomas; William Macnee; Ruth J. Mayer; Bruce E. Miller; Nestor L. Müller; Stephen I. Rennard; Edwin K. Silverman; Ruth Tal-Singer; Emiel F M Wouters; Jørgen Vestbo

doi:10.1016/S2213-2600(13)70006-7

The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study

Jorgen Vestbo, Harvey O. Coxson, Asger Dirksen, Lisa D. Edwards, Julie C. Yates, Alvar Agusti, Per Bakke, Peter M A Calverley, Bartolome Celli, Courtney Crim, Annelyse Duvoix, Paola Nasute Fauerbach, David A. Lomas, William Macnee, Ruth J. Mayer, Bruce E. Miller, Nestor L. Müller, Stephen I. Rennard, Edwin K. Silverman, Ruth Tal-SingerEmiel F M Wouters, Jørgen Vestbo

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Emphysema is a key contributor to airflow limitation in chronic obstructive pulmonary disease (COPD) and can be quantified using CT scanning. We investigated the change in CT lung density in a longitudinal, international cohort of patients with COPD. We also explored the potential relation between emphysema and patient characteristics, and investigated if certain circulating biomarkers were associated with decline in CT lung density. Methods: We used a random coefficient model to assess predictors of both CT lung density and its longitudinal change over 3 years in 1928 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Lung density was measured for every voxel in the CT scan and after correcting for lung volume was expressed as the density at lowest 15th percentile point of the distribution. This study is registered with ClinicalTrials.gov, number NCT00292552. Findings: Lung density at baseline was influenced by age, sex, body-mass index, current smoking status and smoking history, and severity of airflow limitation. The observed decline in lung density was variable (mean decline -1·13 g/L [SE 0·06] per year). The annual decline in lung density was more rapid in women (additional -0·41 [SE 0·14] g/L per year, p=0·003) than men and in current smokers (additional -0·29 [SE 0·14] g/L per year, p=0·047) than in former smokers. Circulating levels of the biomarkers surfactant protein D (SP-D) and soluble receptor for advanced glycation endproduct (sRAGE) were significantly associated with both baseline lung density and its decline over time. Interpretation: This study shows that decline in lung density in COPD can be measured, that it is variable, and related to smoking and gender. We identified potential biochemical predictors of the presence and progression of emphysema. © 2013 Elsevier Ltd.

Original language	English
Pages (from-to)	129-136
Number of pages	7
Journal	The Lancet Respiratory Medicine
Volume	1
Issue number	2
DOIs	https://doi.org/10.1016/S2213-2600(13)70006-7
Publication status	Published - Apr 2013

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http://www.sciencedirect.com/science/article/pii/S2213260013700067

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Vestbo, J., Coxson, H. O., Dirksen, A., Edwards, L. D., Yates, J. C., Agusti, A., Bakke, P., Calverley, P. M. A., Celli, B., Crim, C., Duvoix, A., Fauerbach, P. N., Lomas, D. A., Macnee, W., Mayer, R. J., Miller, B. E., Müller, N. L., Rennard, S. I., Silverman, E. K., ... Vestbo, J. (2013). The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study. The Lancet Respiratory Medicine, 1(2), 129-136. https://doi.org/10.1016/S2213-2600(13)70006-7

@article{d35238c82d074217b882652fc4700a82,

title = "The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study",

abstract = "Background: Emphysema is a key contributor to airflow limitation in chronic obstructive pulmonary disease (COPD) and can be quantified using CT scanning. We investigated the change in CT lung density in a longitudinal, international cohort of patients with COPD. We also explored the potential relation between emphysema and patient characteristics, and investigated if certain circulating biomarkers were associated with decline in CT lung density. Methods: We used a random coefficient model to assess predictors of both CT lung density and its longitudinal change over 3 years in 1928 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Lung density was measured for every voxel in the CT scan and after correcting for lung volume was expressed as the density at lowest 15th percentile point of the distribution. This study is registered with ClinicalTrials.gov, number NCT00292552. Findings: Lung density at baseline was influenced by age, sex, body-mass index, current smoking status and smoking history, and severity of airflow limitation. The observed decline in lung density was variable (mean decline -1·13 g/L [SE 0·06] per year). The annual decline in lung density was more rapid in women (additional -0·41 [SE 0·14] g/L per year, p=0·003) than men and in current smokers (additional -0·29 [SE 0·14] g/L per year, p=0·047) than in former smokers. Circulating levels of the biomarkers surfactant protein D (SP-D) and soluble receptor for advanced glycation endproduct (sRAGE) were significantly associated with both baseline lung density and its decline over time. Interpretation: This study shows that decline in lung density in COPD can be measured, that it is variable, and related to smoking and gender. We identified potential biochemical predictors of the presence and progression of emphysema. {\textcopyright} 2013 Elsevier Ltd.",

author = "Jorgen Vestbo and Coxson, {Harvey O.} and Asger Dirksen and Edwards, {Lisa D.} and Yates, {Julie C.} and Alvar Agusti and Per Bakke and Calverley, {Peter M A} and Bartolome Celli and Courtney Crim and Annelyse Duvoix and Fauerbach, {Paola Nasute} and Lomas, {David A.} and William Macnee and Mayer, {Ruth J.} and Miller, {Bruce E.} and M{\"u}ller, {Nestor L.} and Rennard, {Stephen I.} and Silverman, {Edwin K.} and Ruth Tal-Singer and Wouters, {Emiel F M} and J{\o}rgen Vestbo",

year = "2013",

month = apr,

doi = "10.1016/S2213-2600(13)70006-7",

language = "English",

volume = "1",

pages = "129--136",

journal = "The Lancet Respiratory Medicine",

issn = "2213-2600",

publisher = "Elsevier BV",

number = "2",

}

Vestbo, J, Coxson, HO, Dirksen, A, Edwards, LD, Yates, JC, Agusti, A, Bakke, P, Calverley, PMA, Celli, B, Crim, C, Duvoix, A, Fauerbach, PN, Lomas, DA, Macnee, W, Mayer, RJ, Miller, BE, Müller, NL, Rennard, SI, Silverman, EK, Tal-Singer, R, Wouters, EFM & Vestbo, J 2013, 'The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study', The Lancet Respiratory Medicine, vol. 1, no. 2, pp. 129-136. https://doi.org/10.1016/S2213-2600(13)70006-7

TY - JOUR

T1 - The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study

AU - Vestbo, Jorgen

AU - Coxson, Harvey O.

AU - Dirksen, Asger

AU - Edwards, Lisa D.

AU - Yates, Julie C.

AU - Agusti, Alvar

AU - Bakke, Per

AU - Calverley, Peter M A

AU - Celli, Bartolome

AU - Crim, Courtney

AU - Duvoix, Annelyse

AU - Fauerbach, Paola Nasute

AU - Lomas, David A.

AU - Macnee, William

AU - Mayer, Ruth J.

AU - Miller, Bruce E.

AU - Müller, Nestor L.

AU - Rennard, Stephen I.

AU - Silverman, Edwin K.

AU - Tal-Singer, Ruth

AU - Wouters, Emiel F M

AU - Vestbo, Jørgen

PY - 2013/4

Y1 - 2013/4

N2 - Background: Emphysema is a key contributor to airflow limitation in chronic obstructive pulmonary disease (COPD) and can be quantified using CT scanning. We investigated the change in CT lung density in a longitudinal, international cohort of patients with COPD. We also explored the potential relation between emphysema and patient characteristics, and investigated if certain circulating biomarkers were associated with decline in CT lung density. Methods: We used a random coefficient model to assess predictors of both CT lung density and its longitudinal change over 3 years in 1928 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Lung density was measured for every voxel in the CT scan and after correcting for lung volume was expressed as the density at lowest 15th percentile point of the distribution. This study is registered with ClinicalTrials.gov, number NCT00292552. Findings: Lung density at baseline was influenced by age, sex, body-mass index, current smoking status and smoking history, and severity of airflow limitation. The observed decline in lung density was variable (mean decline -1·13 g/L [SE 0·06] per year). The annual decline in lung density was more rapid in women (additional -0·41 [SE 0·14] g/L per year, p=0·003) than men and in current smokers (additional -0·29 [SE 0·14] g/L per year, p=0·047) than in former smokers. Circulating levels of the biomarkers surfactant protein D (SP-D) and soluble receptor for advanced glycation endproduct (sRAGE) were significantly associated with both baseline lung density and its decline over time. Interpretation: This study shows that decline in lung density in COPD can be measured, that it is variable, and related to smoking and gender. We identified potential biochemical predictors of the presence and progression of emphysema. © 2013 Elsevier Ltd.

AB - Background: Emphysema is a key contributor to airflow limitation in chronic obstructive pulmonary disease (COPD) and can be quantified using CT scanning. We investigated the change in CT lung density in a longitudinal, international cohort of patients with COPD. We also explored the potential relation between emphysema and patient characteristics, and investigated if certain circulating biomarkers were associated with decline in CT lung density. Methods: We used a random coefficient model to assess predictors of both CT lung density and its longitudinal change over 3 years in 1928 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Lung density was measured for every voxel in the CT scan and after correcting for lung volume was expressed as the density at lowest 15th percentile point of the distribution. This study is registered with ClinicalTrials.gov, number NCT00292552. Findings: Lung density at baseline was influenced by age, sex, body-mass index, current smoking status and smoking history, and severity of airflow limitation. The observed decline in lung density was variable (mean decline -1·13 g/L [SE 0·06] per year). The annual decline in lung density was more rapid in women (additional -0·41 [SE 0·14] g/L per year, p=0·003) than men and in current smokers (additional -0·29 [SE 0·14] g/L per year, p=0·047) than in former smokers. Circulating levels of the biomarkers surfactant protein D (SP-D) and soluble receptor for advanced glycation endproduct (sRAGE) were significantly associated with both baseline lung density and its decline over time. Interpretation: This study shows that decline in lung density in COPD can be measured, that it is variable, and related to smoking and gender. We identified potential biochemical predictors of the presence and progression of emphysema. © 2013 Elsevier Ltd.

U2 - 10.1016/S2213-2600(13)70006-7

DO - 10.1016/S2213-2600(13)70006-7

M3 - Article

SN - 2213-2600

VL - 1

SP - 129

EP - 136

JO - The Lancet Respiratory Medicine

JF - The Lancet Respiratory Medicine

IS - 2

ER -

The presence and progression of emphysema in COPD as determined by CT scanning and biomarker expression: A prospective analysis from the ECLIPSE study

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