Skip to main content
Top
Published in: Respiratory Research 1/2010

Open Access 01-12-2010 | Research

Cluster analysis in severe emphysema subjects using phenotype and genotype data: an exploratory investigation

Authors: Michael H Cho, George R Washko, Thomas J Hoffmann, Gerard J Criner, Eric A Hoffman, Fernando J Martinez, Nan Laird, John J Reilly, Edwin K Silverman

Published in: Respiratory Research | Issue 1/2010

Login to get access

Abstract

Background

Numerous studies have demonstrated associations between genetic markers and COPD, but results have been inconsistent. One reason may be heterogeneity in disease definition. Unsupervised learning approaches may assist in understanding disease heterogeneity.

Methods

We selected 31 phenotypic variables and 12 SNPs from five candidate genes in 308 subjects in the National Emphysema Treatment Trial (NETT) Genetics Ancillary Study cohort. We used factor analysis to select a subset of phenotypic variables, and then used cluster analysis to identify subtypes of severe emphysema. We examined the phenotypic and genotypic characteristics of each cluster.

Results

We identified six factors accounting for 75% of the shared variability among our initial phenotypic variables. We selected four phenotypic variables from these factors for cluster analysis: 1) post-bronchodilator FEV1 percent predicted, 2) percent bronchodilator responsiveness, and quantitative CT measurements of 3) apical emphysema and 4) airway wall thickness. K-means cluster analysis revealed four clusters, though separation between clusters was modest: 1) emphysema predominant, 2) bronchodilator responsive, with higher FEV1; 3) discordant, with a lower FEV1 despite less severe emphysema and lower airway wall thickness, and 4) airway predominant. Of the genotypes examined, membership in cluster 1 (emphysema-predominant) was associated with TGFB1 SNP rs1800470.

Conclusions

Cluster analysis may identify meaningful disease subtypes and/or groups of related phenotypic variables even in a highly selected group of severe emphysema subjects, and may be useful for genetic association studies.
Appendix
Available only for authorised users
Literature
1.
go back to reference Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001,163(5):1256–1276.CrossRefPubMed Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001,163(5):1256–1276.CrossRefPubMed
2.
go back to reference Calverley PM: The GOLD classification has advanced understanding of COPD. Am J Respir Crit Care Med 2004,170(3):211–212. discussion 214CrossRefPubMed Calverley PM: The GOLD classification has advanced understanding of COPD. Am J Respir Crit Care Med 2004,170(3):211–212. discussion 214CrossRefPubMed
3.
go back to reference Hersh CP, Jacobson FL, Gill R, Silverman EK: Computed tomography phenotypes in severe, early-onset chronic obstructive pulmonary disease. COPD 2007,4(4):331–337.CrossRefPubMed Hersh CP, Jacobson FL, Gill R, Silverman EK: Computed tomography phenotypes in severe, early-onset chronic obstructive pulmonary disease. COPD 2007,4(4):331–337.CrossRefPubMed
4.
go back to reference Rennard SI, Vestbo J: The many "small COPDs": COPD should be an orphan disease. Chest 2008,134(3):623–627.CrossRefPubMed Rennard SI, Vestbo J: The many "small COPDs": COPD should be an orphan disease. Chest 2008,134(3):623–627.CrossRefPubMed
6.
go back to reference Reilly JJ: COPD and declining FEV1--time to divide and conquer? N Engl J Med 2008,359(15):1616–1618.CrossRefPubMed Reilly JJ: COPD and declining FEV1--time to divide and conquer? N Engl J Med 2008,359(15):1616–1618.CrossRefPubMed
8.
go back to reference Ioannidis JP, Ntzani EE, Trikalinos TA, Contopoulos-Ioannidis DG: Replication validity of genetic association studies. Nat Genet 2001,29(3):306–309.CrossRefPubMed Ioannidis JP, Ntzani EE, Trikalinos TA, Contopoulos-Ioannidis DG: Replication validity of genetic association studies. Nat Genet 2001,29(3):306–309.CrossRefPubMed
9.
go back to reference Hersh CP, Demeo DL, Lange C, Litonjua AA, Reilly JJ, Kwiatkowski D, Laird N, Sylvia JS, Sparrow D, Speizer FE, et al.: Attempted replication of reported chronic obstructive pulmonary disease candidate gene associations. Am J Respir Cell Mol Biol 2005,33(1):71–78.CrossRefPubMedPubMedCentral Hersh CP, Demeo DL, Lange C, Litonjua AA, Reilly JJ, Kwiatkowski D, Laird N, Sylvia JS, Sparrow D, Speizer FE, et al.: Attempted replication of reported chronic obstructive pulmonary disease candidate gene associations. Am J Respir Cell Mol Biol 2005,33(1):71–78.CrossRefPubMedPubMedCentral
10.
go back to reference Ioannidis JP, Boffetta P, Little J, O'Brien TR, Uitterlinden AG, Vineis P, Balding DJ, Chokkalingam A, Dolan SM, Flanders WD, et al.: Assessment of cumulative evidence on genetic associations: interim guidelines. Int J Epidemiol 2008,37(1):120–132.CrossRefPubMed Ioannidis JP, Boffetta P, Little J, O'Brien TR, Uitterlinden AG, Vineis P, Balding DJ, Chokkalingam A, Dolan SM, Flanders WD, et al.: Assessment of cumulative evidence on genetic associations: interim guidelines. Int J Epidemiol 2008,37(1):120–132.CrossRefPubMed
11.
go back to reference Baranova H, Perriot J, Albuisson E, Ivaschenko T, Baranov VS, Hemery B, Mouraire P, Riol N, Malet P: Peculiarities of the GSTM1 0/0 genotype in French heavy smokers with various types of chronic bronchitis. Hum Genet 1997,99(6):822–826.CrossRefPubMed Baranova H, Perriot J, Albuisson E, Ivaschenko T, Baranov VS, Hemery B, Mouraire P, Riol N, Malet P: Peculiarities of the GSTM1 0/0 genotype in French heavy smokers with various types of chronic bronchitis. Hum Genet 1997,99(6):822–826.CrossRefPubMed
12.
go back to reference Sandford AJ, Chagani T, Weir TD, Connett JE, Anthonisen NR, Pare PD: Susceptibility genes for rapid decline of lung function in the Lung Health Study. Am J Respir Crit Care Med 2001,163(2):469–473.CrossRefPubMed Sandford AJ, Chagani T, Weir TD, Connett JE, Anthonisen NR, Pare PD: Susceptibility genes for rapid decline of lung function in the Lung Health Study. Am J Respir Crit Care Med 2001,163(2):469–473.CrossRefPubMed
13.
go back to reference Ogawa E, Nakano Y, Ohara T, Muro S, Hirai T, Sato S, Sakai H, Tsukino M, Kinose D, Nishioka M, et al.: Body mass index in male patients with COPD: correlation with low attenuation areas on CT. Thorax 2009,64(1):20–25.CrossRefPubMed Ogawa E, Nakano Y, Ohara T, Muro S, Hirai T, Sato S, Sakai H, Tsukino M, Kinose D, Nishioka M, et al.: Body mass index in male patients with COPD: correlation with low attenuation areas on CT. Thorax 2009,64(1):20–25.CrossRefPubMed
14.
go back to reference Hastie T, Tibshirani R, Friedman JH: The elements of statistical learning: data mining, inference, and prediction. New York: Springer; 2001.CrossRef Hastie T, Tibshirani R, Friedman JH: The elements of statistical learning: data mining, inference, and prediction. New York: Springer; 2001.CrossRef
15.
go back to reference Pistolesi M, Camiciottoli G, Paoletti M, Marmai C, Lavorini F, Meoni E, Marchesi C, Giuntini C: Identification of a predominant COPD phenotype in clinical practice. Respir Med 2008,102(3):367–376.CrossRefPubMed Pistolesi M, Camiciottoli G, Paoletti M, Marmai C, Lavorini F, Meoni E, Marchesi C, Giuntini C: Identification of a predominant COPD phenotype in clinical practice. Respir Med 2008,102(3):367–376.CrossRefPubMed
16.
go back to reference Wardlaw AJ, Silverman M, Siva R, Pavord ID, Green R: Multi-dimensional phenotyping: towards a new taxonomy for airway disease. Clin Exp Allergy 2005,35(10):1254–1262.CrossRefPubMed Wardlaw AJ, Silverman M, Siva R, Pavord ID, Green R: Multi-dimensional phenotyping: towards a new taxonomy for airway disease. Clin Exp Allergy 2005,35(10):1254–1262.CrossRefPubMed
17.
go back to reference Thabut G, Dauriat G, Stern JB, Logeart D, Levy A, Marrash-Chahla R, Mal H: Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest 2005,127(5):1531–1536.CrossRefPubMed Thabut G, Dauriat G, Stern JB, Logeart D, Levy A, Marrash-Chahla R, Mal H: Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest 2005,127(5):1531–1536.CrossRefPubMed
18.
go back to reference Weatherall M, Travers J, Shirtcliffe PM, Marsh SE, Williams MV, Nowitz MR, Aldington S, Beasley R: Distinct clinical phenotypes of airways disease defined by cluster analysis. Eur Respir J 2009,34(4):812–8.CrossRefPubMed Weatherall M, Travers J, Shirtcliffe PM, Marsh SE, Williams MV, Nowitz MR, Aldington S, Beasley R: Distinct clinical phenotypes of airways disease defined by cluster analysis. Eur Respir J 2009,34(4):812–8.CrossRefPubMed
19.
go back to reference Paoletti M, Camiciottoli G, Meoni E, Bigazzi F, Cestelli L, Pistolesi M, Marchesi C: Explorative data analysis techniques and unsupervised clustering methods to support clinical assessment of Chronic Obstructive Pulmonary Disease (COPD) phenotypes. J Biomed Inform 2009,42(6):1013–21.CrossRefPubMed Paoletti M, Camiciottoli G, Meoni E, Bigazzi F, Cestelli L, Pistolesi M, Marchesi C: Explorative data analysis techniques and unsupervised clustering methods to support clinical assessment of Chronic Obstructive Pulmonary Disease (COPD) phenotypes. J Biomed Inform 2009,42(6):1013–21.CrossRefPubMed
20.
21.
go back to reference Fishman A, Martinez F, Naunheim K, Piantadosi S, Wise R, Ries A, Weinmann G, Wood DE: A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med 2003,348(21):2059–2073.CrossRefPubMed Fishman A, Martinez F, Naunheim K, Piantadosi S, Wise R, Ries A, Weinmann G, Wood DE: A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N Engl J Med 2003,348(21):2059–2073.CrossRefPubMed
22.
go back to reference DeMeo DL, Hersh CP, Hoffman EA, Litonjua AA, Lazarus R, Sparrow D, Benditt JO, Criner G, Make B, Martinez FJ, et al.: Genetic determinants of emphysema distribution in the National Emphysema Treatment Trial. Am J Respir Crit Care Med 2007,176(1):42–48.CrossRefPubMedPubMedCentral DeMeo DL, Hersh CP, Hoffman EA, Litonjua AA, Lazarus R, Sparrow D, Benditt JO, Criner G, Make B, Martinez FJ, et al.: Genetic determinants of emphysema distribution in the National Emphysema Treatment Trial. Am J Respir Crit Care Med 2007,176(1):42–48.CrossRefPubMedPubMedCentral
23.
go back to reference Foreman MG, DeMeo DL, Hersh CP, Carey VJ, Fan VS, Reilly JJ, Shapiro SD, Silverman EK: Polymorphic variation in surfactant protein B is associated with COPD exacerbations. Eur Respir J 2008,32(4):938–944.CrossRefPubMedPubMedCentral Foreman MG, DeMeo DL, Hersh CP, Carey VJ, Fan VS, Reilly JJ, Shapiro SD, Silverman EK: Polymorphic variation in surfactant protein B is associated with COPD exacerbations. Eur Respir J 2008,32(4):938–944.CrossRefPubMedPubMedCentral
24.
go back to reference Washko GR, Criner GJ, Mohsenifar Z, Sciurba FC, Sharafkhaneh A, Make BJ, Hoffman EA, Reilly JJ: Computed tomographic-based quantification of emphysema and correlation to pulmonary function and mechanics. COPD 2008,5(3):177–186.CrossRefPubMed Washko GR, Criner GJ, Mohsenifar Z, Sciurba FC, Sharafkhaneh A, Make BJ, Hoffman EA, Reilly JJ: Computed tomographic-based quantification of emphysema and correlation to pulmonary function and mechanics. COPD 2008,5(3):177–186.CrossRefPubMed
25.
go back to reference Kim WJ, Silverman EK, Hoffman E, Criner GJ, Mosenifar Z, Sciurba FC, Make BJ, Carey V, Estepar RS, Diaz A, et al.: CT metrics of airway disease and emphysema in severe COPD. Chest 2009,136(2):396–404.CrossRefPubMedPubMedCentral Kim WJ, Silverman EK, Hoffman E, Criner GJ, Mosenifar Z, Sciurba FC, Make BJ, Carey V, Estepar RS, Diaz A, et al.: CT metrics of airway disease and emphysema in severe COPD. Chest 2009,136(2):396–404.CrossRefPubMedPubMedCentral
27.
go back to reference DeMeo DL, Mariani TJ, Lange C, Srisuma S, Litonjua AA, Celedon JC, Lake SL, Reilly JJ, Chapman HA, et al.: The SERPINE2 gene is associated with Chronic Obstructive Pulmonary Disease. Am J Hum Genet 2006,78(2):253–64.CrossRefPubMed DeMeo DL, Mariani TJ, Lange C, Srisuma S, Litonjua AA, Celedon JC, Lake SL, Reilly JJ, Chapman HA, et al.: The SERPINE2 gene is associated with Chronic Obstructive Pulmonary Disease. Am J Hum Genet 2006,78(2):253–64.CrossRefPubMed
28.
go back to reference Zhu G, Warren L, Aponte J, Gulsvik A, Bakke P, Anderson WH, Lomas DA, Silverman EK, Pillai SG: The SERPINE2 gene is associated with chronic obstructive pulmonary disease in two large populations. Am J Respir Crit Care Med 2007,176(2):167–173.CrossRefPubMed Zhu G, Warren L, Aponte J, Gulsvik A, Bakke P, Anderson WH, Lomas DA, Silverman EK, Pillai SG: The SERPINE2 gene is associated with chronic obstructive pulmonary disease in two large populations. Am J Respir Crit Care Med 2007,176(2):167–173.CrossRefPubMed
29.
go back to reference de Bakker PI, Yelensky R, Pe'er I, Gabriel SB, Daly MJ, Altshuler D: Efficiency and power in genetic association studies. Nat Genet 2005,37(11):1217–1223.CrossRefPubMed de Bakker PI, Yelensky R, Pe'er I, Gabriel SB, Daly MJ, Altshuler D: Efficiency and power in genetic association studies. Nat Genet 2005,37(11):1217–1223.CrossRefPubMed
30.
go back to reference Barrett JC, Fry B, Maller J, Daly MJ: Haploview: analysis and visualization of LD and haplotype maps. Bioinformatics 2005,21(2):263–265.CrossRefPubMed Barrett JC, Fry B, Maller J, Daly MJ: Haploview: analysis and visualization of LD and haplotype maps. Bioinformatics 2005,21(2):263–265.CrossRefPubMed
31.
go back to reference Haldar P, Pavord ID, Shaw DE, Berry MA, Thomas M, Brightling CE, Wardlaw AJ, Green RH: Cluster analysis and clinical asthma phenotypes. Am J Respir Crit Care Med 2008,178(3):218–224.CrossRefPubMedPubMedCentral Haldar P, Pavord ID, Shaw DE, Berry MA, Thomas M, Brightling CE, Wardlaw AJ, Green RH: Cluster analysis and clinical asthma phenotypes. Am J Respir Crit Care Med 2008,178(3):218–224.CrossRefPubMedPubMedCentral
32.
go back to reference Burrows B, Fletcher CM, Heard BE, Jones NL, Wootliff JS: The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in London and Chicago. Lancet 1966,1(7442):830–835.CrossRefPubMed Burrows B, Fletcher CM, Heard BE, Jones NL, Wootliff JS: The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in London and Chicago. Lancet 1966,1(7442):830–835.CrossRefPubMed
33.
go back to reference Celli BR: Roger S. Mitchell lecture. Chronic obstructive pulmonary disease phenotypes and their clinical relevance. Proc Am Thorac Soc 2006,3(6):461–465.CrossRefPubMed Celli BR: Roger S. Mitchell lecture. Chronic obstructive pulmonary disease phenotypes and their clinical relevance. Proc Am Thorac Soc 2006,3(6):461–465.CrossRefPubMed
34.
go back to reference Friedlander AL, Lynch D, Dyar LA, Bowler RP: Phenotypes of chronic obstructive pulmonary disease. COPD 2007,4(4):355–384.CrossRefPubMed Friedlander AL, Lynch D, Dyar LA, Bowler RP: Phenotypes of chronic obstructive pulmonary disease. COPD 2007,4(4):355–384.CrossRefPubMed
35.
go back to reference Taube C, Lehnigk B, Paasch K, Kirsten DK, Jorres RA, Magnussen H: Factor analysis of changes in dyspnea and lung function parameters after bronchodilation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000,162(1):216–220.CrossRefPubMed Taube C, Lehnigk B, Paasch K, Kirsten DK, Jorres RA, Magnussen H: Factor analysis of changes in dyspnea and lung function parameters after bronchodilation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000,162(1):216–220.CrossRefPubMed
36.
go back to reference Hajiro T, Nishimura K, Tsukino M, Ikeda A, Koyama H, Izumi T: Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998,158(4):1185–1189.CrossRefPubMed Hajiro T, Nishimura K, Tsukino M, Ikeda A, Koyama H, Izumi T: Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998,158(4):1185–1189.CrossRefPubMed
37.
go back to reference Lapperre TS, Snoeck-Stroband JB, Gosman MM, Stolk J, Sont JK, Jansen DF, Kerstjens HA, Postma DS, Sterk PJ: Dissociation of lung function and airway inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004,170(5):499–504.CrossRefPubMed Lapperre TS, Snoeck-Stroband JB, Gosman MM, Stolk J, Sont JK, Jansen DF, Kerstjens HA, Postma DS, Sterk PJ: Dissociation of lung function and airway inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004,170(5):499–504.CrossRefPubMed
38.
go back to reference Anderson GP: Endotyping asthma: new insights into key pathogenic mechanisms in a complex, heterogeneous disease. Lancet 2008,372(9643):1107–1119.CrossRefPubMed Anderson GP: Endotyping asthma: new insights into key pathogenic mechanisms in a complex, heterogeneous disease. Lancet 2008,372(9643):1107–1119.CrossRefPubMed
39.
go back to reference Burmeister M, McInnis MG, Zollner S: Psychiatric genetics: progress amid controversy. Nat Rev Genet 2008,9(7):527–540.CrossRefPubMed Burmeister M, McInnis MG, Zollner S: Psychiatric genetics: progress amid controversy. Nat Rev Genet 2008,9(7):527–540.CrossRefPubMed
40.
go back to reference Ito I, Nagai S, Hoshino Y, Muro S, Hirai T, Tsukino M, Mishima M: Risk and severity of COPD is associated with the group-specific component of serum globulin 1F allele. Chest 2004,125(1):63–70.CrossRefPubMed Ito I, Nagai S, Hoshino Y, Muro S, Hirai T, Tsukino M, Mishima M: Risk and severity of COPD is associated with the group-specific component of serum globulin 1F allele. Chest 2004,125(1):63–70.CrossRefPubMed
41.
go back to reference Sakao S, Tatsumi K, Igari H, Watanabe R, Shino Y, Shirasawa H, Kuriyama T: Association of tumor necrosis factor-alpha gene promoter polymorphism with low attenuation areas on high-resolution CT in patients with COPD. Chest 2002,122(2):416–420.CrossRefPubMed Sakao S, Tatsumi K, Igari H, Watanabe R, Shino Y, Shirasawa H, Kuriyama T: Association of tumor necrosis factor-alpha gene promoter polymorphism with low attenuation areas on high-resolution CT in patients with COPD. Chest 2002,122(2):416–420.CrossRefPubMed
42.
go back to reference Hersh CP, Demeo DL, Lazarus R, Celedon JC, Raby BA, Benditt JO, Criner G, Make B, Martinez FJ, Scanlon PD, et al.: Genetic association analysis of functional impairment in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006,173(9):977–984.CrossRefPubMedPubMedCentral Hersh CP, Demeo DL, Lazarus R, Celedon JC, Raby BA, Benditt JO, Criner G, Make B, Martinez FJ, Scanlon PD, et al.: Genetic association analysis of functional impairment in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006,173(9):977–984.CrossRefPubMedPubMedCentral
43.
go back to reference Pillai SG, Tang Y, Oord E, Klotsman M, Barnes K, Carlsen K, Gerritsen J, Lenney W, Silverman M, Sly P, et al.: Factor analysis in the Genetics of Asthma International Network family study identifies five major quantitative asthma phenotypes. Clin Exp Allergy 2008,38(3):421–429.CrossRefPubMed Pillai SG, Tang Y, Oord E, Klotsman M, Barnes K, Carlsen K, Gerritsen J, Lenney W, Silverman M, Sly P, et al.: Factor analysis in the Genetics of Asthma International Network family study identifies five major quantitative asthma phenotypes. Clin Exp Allergy 2008,38(3):421–429.CrossRefPubMed
44.
go back to reference Spira A, Beane J, Pinto-Plata V, Kadar A, Liu G, Shah V, Celli B, Brody JS: Gene expression profiling of human lung tissue from smokers with severe emphysema. Am J Respir Cell Mol Biol 2004,31(6):601–610.CrossRefPubMed Spira A, Beane J, Pinto-Plata V, Kadar A, Liu G, Shah V, Celli B, Brody JS: Gene expression profiling of human lung tissue from smokers with severe emphysema. Am J Respir Cell Mol Biol 2004,31(6):601–610.CrossRefPubMed
45.
go back to reference Lee YK, Oh YM, Lee JH, Kim EK, Kim N, Seo JB, Lee SD: Quantitative assessment of emphysema, air trapping, and airway thickening on computed tomography. Lung 2008,186(3):157–165.CrossRefPubMed Lee YK, Oh YM, Lee JH, Kim EK, Kim N, Seo JB, Lee SD: Quantitative assessment of emphysema, air trapping, and airway thickening on computed tomography. Lung 2008,186(3):157–165.CrossRefPubMed
46.
go back to reference Makita H, Nasuhara Y, Nagai K, Ito Y, Hasegawa M, Betsuyaku T, Onodera Y, Hizawa N, Nishimura M: Characterisation of phenotypes based on severity of emphysema in chronic obstructive pulmonary disease. Thorax 2007,62(11):932–937.CrossRefPubMedPubMedCentral Makita H, Nasuhara Y, Nagai K, Ito Y, Hasegawa M, Betsuyaku T, Onodera Y, Hizawa N, Nishimura M: Characterisation of phenotypes based on severity of emphysema in chronic obstructive pulmonary disease. Thorax 2007,62(11):932–937.CrossRefPubMedPubMedCentral
47.
go back to reference Calverley P, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A, Anderson J, Maden C: Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003,361(9356):449–456.CrossRefPubMed Calverley P, Pauwels R, Vestbo J, Jones P, Pride N, Gulsvik A, Anderson J, Maden C: Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003,361(9356):449–456.CrossRefPubMed
48.
go back to reference Ito M, Hanaoka M, Droma Y, Hatayama O, Sato E, Katsuyama Y, Fujimoto K, Ota M: The association of transforming growth factor beta 1 gene polymorphisms with the emphysema phenotype of COPD in Japanese. Intern Med 2008,47(15):1387–1394.CrossRefPubMed Ito M, Hanaoka M, Droma Y, Hatayama O, Sato E, Katsuyama Y, Fujimoto K, Ota M: The association of transforming growth factor beta 1 gene polymorphisms with the emphysema phenotype of COPD in Japanese. Intern Med 2008,47(15):1387–1394.CrossRefPubMed
49.
go back to reference Suthanthiran M, Li B, Song JO, Ding R, Sharma VK, Schwartz JE, August P: Transforming growth factor-beta 1 hyperexpression in African-American hypertensives: A novel mediator of hypertension and/or target organ damage. Proc Natl Acad Sci USA 2000,97(7):3479–3484.PubMedPubMedCentral Suthanthiran M, Li B, Song JO, Ding R, Sharma VK, Schwartz JE, August P: Transforming growth factor-beta 1 hyperexpression in African-American hypertensives: A novel mediator of hypertension and/or target organ damage. Proc Natl Acad Sci USA 2000,97(7):3479–3484.PubMedPubMedCentral
50.
go back to reference de Boer WI, van Schadewijk A, Sont JK, Sharma HS, Stolk J, Hiemstra PS, van Krieken JH: Transforming growth factor beta1 and recruitment of macrophages and mast cells in airways in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998,158(6):1951–1957.CrossRefPubMed de Boer WI, van Schadewijk A, Sont JK, Sharma HS, Stolk J, Hiemstra PS, van Krieken JH: Transforming growth factor beta1 and recruitment of macrophages and mast cells in airways in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998,158(6):1951–1957.CrossRefPubMed
51.
go back to reference Takizawa H, Tanaka M, Takami K, Ohtoshi T, Ito K, Satoh M, Okada Y, Yamasawa F, Nakahara K, Umeda A: Increased expression of transforming growth factor-beta1 in small airway epithelium from tobacco smokers and patients with chronic obstructive pulmonary disease (COPD). Am J Respir Crit Care Med 2001,163(6):1476–1483.CrossRefPubMed Takizawa H, Tanaka M, Takami K, Ohtoshi T, Ito K, Satoh M, Okada Y, Yamasawa F, Nakahara K, Umeda A: Increased expression of transforming growth factor-beta1 in small airway epithelium from tobacco smokers and patients with chronic obstructive pulmonary disease (COPD). Am J Respir Crit Care Med 2001,163(6):1476–1483.CrossRefPubMed
52.
go back to reference Vignola AM, Chanez P, Chiappara G, Merendino A, Pace E, Rizzo A, la Rocca AM, Bellia V, Bonsignore G, Bousquet J: Transforming growth factor-beta expression in mucosal biopsies in asthma and chronic bronchitis. Am J Respir Crit Care Med 1997,156(2 Pt 1):591–599.CrossRefPubMed Vignola AM, Chanez P, Chiappara G, Merendino A, Pace E, Rizzo A, la Rocca AM, Bellia V, Bonsignore G, Bousquet J: Transforming growth factor-beta expression in mucosal biopsies in asthma and chronic bronchitis. Am J Respir Crit Care Med 1997,156(2 Pt 1):591–599.CrossRefPubMed
53.
go back to reference Mak JC, Chan-Yeung MM, Ho SP, Chan KS, Choo K, Yee KS, Chau CH, Cheung AH, Ip MS: Elevated plasma TGF-beta1 levels in patients with chronic obstructive pulmonary disease. Respir Med 2009,103(7):1083–1089.CrossRefPubMed Mak JC, Chan-Yeung MM, Ho SP, Chan KS, Choo K, Yee KS, Chau CH, Cheung AH, Ip MS: Elevated plasma TGF-beta1 levels in patients with chronic obstructive pulmonary disease. Respir Med 2009,103(7):1083–1089.CrossRefPubMed
54.
go back to reference Patel BD, Coxson HO, Pillai SG, Agusti AG, Calverley PM, Donner CF, Make BJ, Muller NL, Rennard SI, Vestbo J, et al.: Airway wall thickening and emphysema show independent familial aggregation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2008,178(5):500–505.CrossRefPubMed Patel BD, Coxson HO, Pillai SG, Agusti AG, Calverley PM, Donner CF, Make BJ, Muller NL, Rennard SI, Vestbo J, et al.: Airway wall thickening and emphysema show independent familial aggregation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2008,178(5):500–505.CrossRefPubMed
55.
go back to reference Brogger J, Steen VM, Eiken HG, Gulsvik A, Bakke P: Genetic association between COPD and polymorphisms in TNF, ADRB2 and EPHX1. Eur Respir J 2006,27(4):682–688.CrossRefPubMed Brogger J, Steen VM, Eiken HG, Gulsvik A, Bakke P: Genetic association between COPD and polymorphisms in TNF, ADRB2 and EPHX1. Eur Respir J 2006,27(4):682–688.CrossRefPubMed
56.
go back to reference Hersh CP, DeMeo DL, Reilly JJ, Silverman EK: Xenobiotic metabolizing enzyme gene polymorphisms predict response to lung volume reduction surgery. Respir Res 2007, 8:59.CrossRefPubMedPubMedCentral Hersh CP, DeMeo DL, Reilly JJ, Silverman EK: Xenobiotic metabolizing enzyme gene polymorphisms predict response to lung volume reduction surgery. Respir Res 2007, 8:59.CrossRefPubMedPubMedCentral
57.
go back to reference He JQ, Connett JE, Anthonisen NR, Pare PD, Sandford AJ: Glutathione S-transferase variants and their interaction with smoking on lung function. Am J Respir Crit Care Med 2004,170(4):388–394.CrossRefPubMed He JQ, Connett JE, Anthonisen NR, Pare PD, Sandford AJ: Glutathione S-transferase variants and their interaction with smoking on lung function. Am J Respir Crit Care Med 2004,170(4):388–394.CrossRefPubMed
58.
go back to reference Guo X, Lin HM, Lin Z, Montano M, Sansores R, Wang G, DiAngelo S, Pardo A, Selman M, Floros J: Surfactant protein gene A, B, and D marker alleles in chronic obstructive pulmonary disease of a Mexican population. Eur Respir J 2001,18(3):482–490.CrossRefPubMed Guo X, Lin HM, Lin Z, Montano M, Sansores R, Wang G, DiAngelo S, Pardo A, Selman M, Floros J: Surfactant protein gene A, B, and D marker alleles in chronic obstructive pulmonary disease of a Mexican population. Eur Respir J 2001,18(3):482–490.CrossRefPubMed
59.
go back to reference Celedon JC, Lange C, Raby BA, Litonjua AA, Palmer LJ, DeMeo DL, Reilly JJ, Kwiatkowski DJ, Chapman HA, Laird N, et al.: The transforming growth factor-beta1 (TGFB1) gene is associated with chronic obstructive pulmonary disease (COPD). Hum Mol Genet 2004,13(15):1649–1656.CrossRefPubMed Celedon JC, Lange C, Raby BA, Litonjua AA, Palmer LJ, DeMeo DL, Reilly JJ, Kwiatkowski DJ, Chapman HA, Laird N, et al.: The transforming growth factor-beta1 (TGFB1) gene is associated with chronic obstructive pulmonary disease (COPD). Hum Mol Genet 2004,13(15):1649–1656.CrossRefPubMed
60.
go back to reference Wu L, Chau J, Young RP, Pokorny V, Mills GD, Hopkins R, McLean L, Black PN: Transforming growth factor-beta1 genotype and susceptibility to chronic obstructive pulmonary disease. Thorax 2004,59(2):126–129.CrossRefPubMedPubMedCentral Wu L, Chau J, Young RP, Pokorny V, Mills GD, Hopkins R, McLean L, Black PN: Transforming growth factor-beta1 genotype and susceptibility to chronic obstructive pulmonary disease. Thorax 2004,59(2):126–129.CrossRefPubMedPubMedCentral
61.
go back to reference Castaldi PJ, Cho MH, Cohn M, Langerman F, Moran S, Tarragona N, Moukhachen H, Venugopal R, Hasimja D, Kao E, et al.: The COPD genetic association compendium: a comprehensive online database of COPD genetic associations. Hum Mol Genet 2009,19(3):526–34.CrossRefPubMedPubMedCentral Castaldi PJ, Cho MH, Cohn M, Langerman F, Moran S, Tarragona N, Moukhachen H, Venugopal R, Hasimja D, Kao E, et al.: The COPD genetic association compendium: a comprehensive online database of COPD genetic associations. Hum Mol Genet 2009,19(3):526–34.CrossRefPubMedPubMedCentral
Metadata
Title
Cluster analysis in severe emphysema subjects using phenotype and genotype data: an exploratory investigation
Authors
Michael H Cho
George R Washko
Thomas J Hoffmann
Gerard J Criner
Eric A Hoffman
Fernando J Martinez
Nan Laird
John J Reilly
Edwin K Silverman
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2010
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-11-30

Other articles of this Issue 1/2010

Respiratory Research 1/2010 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine