Abstract
The emphysema versus airway disease (EvA) study is an EU-funded project with 15 partners in 8 European countries, which aims at identifying markers associated with subphenotypes of chronic obstructive pulmonary disease (COPD) as defined by CT image analysis. The project has recruited 280 controls (average age 59y, 36% females) and 534 patients (average age 65y, 32% females), who comply with stringent exclusion criteria in that current smoking, oral glucocorticoids, anti-coagulation, FEV1 < 30 % or long term oxygen therapy is not allowed for. Although recruitment selected against asthma post-bronchodilator reversibility >200ml was seen in 184 cases (34%) and 58 controls (21%). Chest CT was done in cases only and this is being used – with reference to a series of phantoms- to determine lung density and airway wall thickness as a measure of emphysema and airway disease, respectively. Bronchoscopy was done on 421 cases and 278 controls and here we obtained bronchial epithelium with sheathed brushes and alveolar macrophages by lavage with up to 150 mL of fluid. Fluid recovery in lavage in average was 43 % for controls and 30 % for cases, reflecting the more pronounced airway collapse during fluid retrieval in COPD. Recovery of brush material was similar between cases and controls, in that RNA obtained from the right upper lobe was 5.4 ug and 6.4 ug, respectively. The data show that in a multicentre study sizable amounts of biological material can be obtained from COPD lungs. This material is currently being analyzed for expression of markers associated with the emphysema-dominant and airway disease-dominant subphenotypes of COPD.
Supported by EU FP7 project #200605.
- © 2012 ERS
