Patients with biomass exposure-related COPD (BE-COPD), a common condition in developing nations, require a thorough examination of its clinical and inflammatory features, defining therapies that may be different from tobacco exposure-related COPD (TE-COPD). For a study, researchers sought to compare BE-COPD to TE-COPD in terms of clinical features, biomarkers of inflammation, T-helper cells, and microbiological agents during a COPD exacerbation.

Patients with moderate to severe exacerbations were included in a prospective observational trial either at the COPD clinic or the emergency room. Sputum and nasopharyngeal swabs were taken during enrolment to detect bacterial and viral infections. Additionally, blood samples were taken to assess the amounts of T-helper cells and inflammatory biomarkers. The number of hospital days and the need for mechanical breathing were assessed.

BE-COPD and TE-COPD had similar clinical traits, immunization records, hospitalization histories, histories of exacerbations, and microbiological patterns. In comparison to TE-COPD, BE-COPD had a greater Th2 profile (2.10 [range 1.30-3.30] vs. 1.40 [range 1.20-1.80], P = 0.001). In comparison to TE-COPD, BE-COPD had a greater Th2/Th1 ratio (1.22 [range 0.58-2.57] vs. 0.71 [range 0.40-1.15], P = 0.004). Mechanical ventilation (MV) was more frequently required in TE-COPD (13% vs. 31.1%, P = 0.01) than in BE-COPD. Hospitalization was substantially correlated with having no immunization history and having high CRP levels [OR 1.48 (CI 95% 1.30-4.61, P = 0.005) and OR 1.17 (CI 95% 1.10-1.24, P= 0.001), respectively].

Clinical traits, inflammatory markers, and microbiological isolates were comparable in both groups. However, BE-COPD had the propensity to have more inflammatory Th2 cells and less MV need than TE-COPD.

Reference: resmedjournal.com/article/S0954-6111(22)00275-X/fulltext