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      International Journal of COPD (submit here)

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      Evaluation Of HHIP Polymorphisms And Their Relationship With Chronic Obstructive Pulmonary Disease Phenotypes

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          Abstract

          Purpose

          We aimed to correlate three polymorphisms of the Hedgehog Interacting Protein ( HHIP) gene with the three main phenotypes of the chronic obstructive pulmonary disease (frequent exacerbator (FE), asthma/COPD overlap (ACO), and emphysema with hyperinflation).

          Patients and methods

          A cross-sectional study was carried out in the Department of Pulmonology at the Rio de Janeiro State University from February 2015 to July 2018. A total of 81 patients diagnosed with COPD according to the criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) were enrolled. The subjects were divided into three distinct groups according to their phenotypes (FE, ACO and emphysema-hyperinflation). Three polymorphisms of the HHIP gene that are often reported as allegedly involved in the pathogenesis of COPD were analysed: rs1828591, rs13118928, and rs6537296. Real-time PCR - TAQMAN SNP Genotyping Assay was performed. The statistical analysis was carried out with the SPSS program with a multivariate analysis with a 95% confidence interval.

          Results

          An increase in the frequency of the A allele of the rs13118928 HHIP gene polymorphism was observed in the group of subjects with COPD and emphysema-hyperinflation phenotype when compared with those in the FE phenotype (p=0.019) and subjects with ACO (p=0.04). However, the subjects with emphysema-hyperinflation phenotype presented more often the A allele (p=0.04). The genotypic analysis confirmed the difference between the emphysema-hyperinflation and ACO phenotypes, with a higher prevalence of the AA genotype in the emphysema-hyperinflation group (p=0.04). The ACO and FE phenotype subjects showed no difference in these polymorphisms. No difference was found in the frequency of the polymorphisms rs1828591 (p= 0.552) and rs6537296 (p=0.296) in the three phenotypes evaluated.

          Conclusion

          The presence of the A allele in the rs13118928 polymorphism of the HHIP gene may be related to the emphysema-hyperinflation phenotype.

          Most cited references16

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          The Asthma-COPD Overlap Syndrome.

          Although in textbooks asthma and chronic obstructive pulmonary disease (COPD) are viewed as distinct disorders, there is increasing awareness that many patients have features of both. This article reviews the asthma-COPD overlap syndrome.
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            Asthma-COPD overlap 2015: now we are six.

            The overlap between asthma and COPD is increasingly recognised. This review examines the new insights, treatment and remaining knowledge gaps for asthma-COPD overlap.
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              Clinical phenotypes of COPD: identification, definition and implications for guidelines.

              The term phenotype in the field of COPD is defined as "a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes". Among all phenotypes described, there are three that are associated with prognosis and especially are associated with a different response to currently available therapies. There phenotypes are: the exacerbator, the overlap COPD-asthma and the emphysema-hyperinflation. The exacerbator is characterised by the presence of, at least, two exacerbations the previous year, and on top of long-acting bronchodilators, may require the use of antiinflammatory drugs. The overlap phenotype presents symptoms of increased variability of airflow and incompletely reversible airflow obstruction. Due to the underlying inflammatory profile, it uses to have a good therapeutic response to inhaled corticosteroids in addition to bronchodilators. Lastly, the emphysema phenotype presents a poor therapeutic response to the existing antiinflammatory drugs and long-acting bronchodilators together with rehabilitation are the treatments of choice. Identifying the peculiarities of the different phenotypes of COPD will allow us to implement a more personalised treatment, in which the characteristics of the patients, together with their severity will be key to choose the best treatment option. Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                COPD
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                03 October 2019
                2019
                : 14
                : 2267-2272
                Affiliations
                [1 ]Department of Pulmonology and Tisiology, Rio De Janeiro State University (UERJ) , Rio De Janeiro, Brazil
                [2 ]Laboratory of Histocompatibility and Cryopreservation, UERJ , Rio De Janeiro, Brazil
                [3 ]Department of Cardiology, Piquet Carneiro Polyclinic, UERJ , Rio De Janeiro, Brazil
                [4 ]Coordinator of the Department of Pulmonology and Tisiology, Faculty of Medical Sciences, UERJ , Rio De Janeiro, Brazil
                Author notes
                Correspondence: Thiago Prudente Bártholo Disciplina de Pneumologia e Tisiologia, Hospital Universitário Pedro Ernesto (UERJ) , Boulevard 28 de setembro 77, Vila Isabel, Rio de Janeiro20551-030, BrazilTel +55 21 981088883Fax +55 21 22688238 Email thiprubart@hotmail.com
                Author information
                http://orcid.org/0000-0003-4475-152X
                http://orcid.org/0000-0003-1499-1821
                http://orcid.org/0000-0002-3240-3651
                http://orcid.org/0000-0001-6785-0753
                Article
                213519
                10.2147/COPD.S213519
                6781601
                c2befcbf-7368-4861-afa5-27c11bfc090b
                © 2019 Bártholo et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 26 April 2019
                : 16 September 2019
                Page count
                Figures: 1, Tables: 4, References: 18, Pages: 6
                Categories
                Original Research

                Respiratory medicine
                chronic obstructive pulmonary disease,aco,hyperinflation,exacerbator,hhip polymorphism

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