ORCID Profile
0000-0002-3677-1996
Current Organisation
Brigham and Women's Hospital
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Publisher: Springer International Publishing
Date: 2020
Publisher: European Respiratory Society (ERS)
Date: 03-02-2022
DOI: 10.1183/13993003.01814-2021
Abstract: Interstitial lung abnormalities (ILA) share many features with idiopathic pulmonary fibrosis however, it is not known if ILA are associated with decreased mean telomere length (MTL). Telomere length was measured with quantitative PCR in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) and Age Gene/Environment Susceptibility Reykjavik (AGES-Reykjavik) cohorts and Southern blot analysis was used in the Framingham Heart Study (FHS). Logistic and linear regression were used to assess the association between ILA and MTL Cox proportional hazards models were used to assess the association between MTL and mortality. In all three cohorts, ILA were associated with decreased MTL. In the COPDGene and AGES-Reykjavik cohorts, after adjustment there was greater than twofold increase in the odds of ILA when comparing the shortest quartile of telomere length to the longest quartile (OR 2.2, 95% CI 1.5–3.4, p=0.0001, and OR 2.6, 95% CI 1.4–4.9, p=0.003, respectively). In the FHS, those with ILA had shorter telomeres than those without ILA (−767 bp, 95% CI 76–1584 bp, p=0.03). Although decreased MTL was associated with chronic obstructive pulmonary disease (OR 1.3, 95% CI 1.1–1.6, p=0.01) in COPDGene, the effect estimate was less than that noted with ILA. There was no consistent association between MTL and risk of death when comparing the shortest quartile of telomere length in COPDGene and AGES-Reykjavik (HR 0.82, 95% CI 0.4–1.7, p=0.6, and HR 1.2, 95% CI 0.6–2.2, p=0.5, respectively). ILA are associated with decreased MTL.
Publisher: BMJ
Date: 11-02-2021
DOI: 10.1136/THORAXJNL-2020-215999
Abstract: Muscle wasting is a recognised extra-pulmonary complication in chronic obstructive pulmonary disease and has been associated with increased risk of death. Acute respiratory exacerbations are associated with reduction of muscle function, but there is a paucity of data on their long-term effect. This study explores the relationship between acute respiratory exacerbations and long-term muscle loss using serial measurements of CT derived pectoralis muscle area (PMA). Participants were included from two prospective, longitudinal, observational, multicentre cohorts of ever-smokers with at least 10 pack-year history. The primary analysis included 1332 (of 2501) participants from Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) and 4384 (of 10 198) participants from Genetic Epidemiology of COPD (COPDGene) who had complete data from their baseline and follow-up visits. PMA was measured on chest CT scans at two timepoints. Self-reported exacerbation data were collected from participants in both studies through the use of periodic longitudinal surveys. Age-related and excess muscle loss over time. Age, sex, race and body mass index were associated with baseline PMA. Participants experienced age-related decline at the upper end of reported normal ranges. In ECLIPSE, the exacerbation rate over time was associated with an excess muscle area loss of 1.3% (95% CI 0.6 to 1.9, p .001) over 3 years and in COPDGene with an excess muscle area loss of 2.1% (95% CI 1.2 to 2.8, p .001) over 5 years. Excess muscle area decline was absent in 273 in iduals who participated in pulmonary rehabilitation. Exacerbations are associated with accelerated skeletal muscle loss. Each annual exacerbation was associated with the equivalent of 6 months of age-expected decline in muscle mass. Ameliorating exacerbation-associated muscle loss represents an important therapeutic target.
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 11-2018
Publisher: American Medical Association (AMA)
Date: 16-02-2016
Publisher: Elsevier BV
Date: 04-2022
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 2021
Publisher: European Respiratory Society (ERS)
Date: 09-2017
No related grants have been discovered for Raul San Jose Estepar.