13 research outputs found

    Contribuições para decifrar a trajetória da doença pulmonar obstrutiva crónica: associações entre medidas genéticas e clínicas

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    Mestrado em Biomedicina MolecularChronic Obstructive Pulmonary Disease (COPD) is a multifactorial and heterogeneous disease which impacts differently on patients with similar grades. This suggests that factor others than lung function may affect patients experience of the disease. Patient-reported outcomes (PROs) are a set of measures that allow to assess patients’ self-perception and experience of the disease. Recent studies have reported associations between specific single nucleotide polymorphisms (SNPs) and PROs, however not much is known about these associations and their meanings. Thus, this study had as main objective to explore possible associations between specific genetic variants and clinical measures, including PROs. It also sought to contribute for a characterization of the genotypes from patients with COPD in Portugal. A cross-sectional study was conducted in a total number of 60 patients with COPD. The PROs assessed were: 1) self-reported frequency of exacerbations, 2) dyspnoea with modified Medical Research Council and Borg scales , 3) fatigue with Borg scale, 4) anxiety and depression with Hospital Anxiety and Depression scale; 5) impact of the disease with COPD Assessment Test and 6) health-related quality of life (HRQOL) with St. George Respiratory questionnaire; Additionally, several surrogate outcomes were also assessed i. e., lung function, peripheral muscle strength with digital dynamometer, respiratory muscle strength with the respiratory pressure assessment and functional capacity through the 1 minute and 5 time sit-to-stand. Both oropharyngeal swabs and saliva samples were collected from the patients for genotyping. Significant associations were found between genetic variants and dyspnoea (rs1143634, rs1042717, rs1138272 and rs12504628), fatigue (rs1042714, rs1138272), anxiety (rs1051303, rs1800450 and rs1131620), impact of the disease (rs10461985 and rs11172113) and HRQOL (rs11172113, rs1042713, rs1138272 and rs12504628). Significant associations were also found between genetic variants and lung function (rs1042713, rs1042717, rs5030737), respiratory muscle strength (rs1130866), peripheral muscle strength (rs1042713, rs1042717, rs11172113, rs11556218) and functional capacity (rs12899618, rs11046966 and rs1138272). This was an exploratory study and more investigations are necessary to confirm the results obtained and to explore deeply the associations and interpretations between genetics and COPD trajectory.A Doença Pulmonar Obstrutiva Crónica (DPOC) é uma doença multifatorial e heterogénea que apresenta impactos diferentes em pacientes com estadios da doença semelhantes. Isto sugere que outros fatores para além da função pulmonar podem afetar a forma como o paciente experiencia a sua doença. As medidas reportadas pelo paciente (PROs) são um conjunto de variáveis que permitem avaliar a autoperceção e experiência dos doentes em relação à sua doença. Estudos recentes reportaram a existência de associações entre polimorfismos de nucleótidos simples (SNPs) e PROs, mas pouco ainda se sabe sobre estas associações e seu significado. Assim, este estudo teve como objetivo principal explorar possíveis associações entre variantes genéticas específicas e medidas clínicas, entre as quais PROs. Pretendeu também contribuir para a caracterização dos genótipos dos doentes com DPOC em Portugal. Realizou-se um estudo transversal com 60 doentes com DPOC. As PROs avaliadas foram 1) frequência de exacerbações autoreportadas pelos doentes, 2) dispneia com a modified medical Research Council Scale e Borg, 3) fadiga com a Borg, 4) ansiedade e depressão através da escala de ansiedade e depressão hospitalar, 5) impacto da doença com o teste de avaliação da DPOC e 6) qualidade de vida relacionada com a saúde (QVRS) com questionário do hospital de St. George na doença respiratória. Adicionalmente, outras medidas clínicas também foram avaliadas, i. é., função pulmonar, força muscular periférica com dinamometria digital, força dos músculos respiratórios com a medição das pressões respiratórias e capacidade funcional através do teste de levantar e sentar cinco vezes e 1 minuto. Zaragatoas orofaríngeas e amostras de saliva foram recolhidas de todos os pacientes para genotipagem. Foram encontradas associações significativas entre variantes genéticas e dispneia (rs1143634, rs1042717, rs1138272 e rs12504628), fadiga (rs1042714 e rs1138272), ansiedade (rs1051303, rs1800450 e rs1131620), impacto da doença (rs10461985 e rs1172113) e QVRS (rs11172113, rs1042713, rs1138272 e rs12504628). Também foram encontradas variantes significativamente associadas à função pulmonar (rs1042713, rs1042717 e rs5030737), força dos músculos respiratórios (rs1130866), força muscular periférica (rs1042713, rs1042717, rs11172113 e rs11556218) e capacidade funcional (rs12899618, rs11046966 e rs1138272). Este foi um estudo exploratório e mais investigações são necessárias para confirmar os resultados obtidos e para explorar mais profundamente a associação e interpretação entre a genética e a trajetória da DPOC

    Genetic profile and patient-reported outcomes in chronic obstructive pulmonary disease: A systematic review

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    All relevant data are within the paper and its Supporting Information files.Chronic Obstructive Pulmonary Disease (COPD) impacts differently on patients at similar grades, suggesting that factors other than lung function may influence patients' experience of the disease. Recent studies have found associations between genetic variations and patient-reported outcomes (PROs). Identifying these associations might be fundamental to predict the disease progression and develop tailored interventions. This systematic review aimed to identify the genetic variations associated with PROs in COPD.This work was funded by Programa Operacional de Competitividade e Internacionalização - COMPETE, through Fundo Europeu de Desenvolvimento Regional - FEDER (POCI-01-0145-FEDER-016701), Fundação para a Ciência e Tecnologia (PTDC/DTP¬PIC/2284/2014) and under the project UID/BIM/04501/2013 and POCI-01-0145-FEDER-007628. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

    Can normal respiratory sounds differentiate COPD grades?

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