The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.

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Cochrane Handbook for Systematic Reviews of Interventions

Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

https://www.who.int/respiratory/copd/GOLD_WR_06.pdf

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

The UK Biobank project is a prospective cohort study with deep genetic and phenotypic data collected on approximately 500,000 individuals from across the United Kingdom, aged between 40 and 69 at recruitment. The open resource is unique in its size and scope. A rich variety of phenotypic and health-related information is available on each participant, including biological measurements, lifestyle indicators, biomarkers in blood and urine, and imaging of the body and brain. Follow-up information is provided by linking health and medical records. Genome-wide genotype data have been collected on all participants, providing many opportunities for the discovery of new genetic associations and the genetic bases of complex traits. Here we describe the centralized analysis of the genetic data, including genotype quality, properties of population structure and relatedness of the genetic data, and efficient phasing and genotype imputation that increases the number of testable variants to around 96 million. Classical allelic variation at 11 human leukocyte antigen genes was imputed, resulting in the recovery of signals with known associations between human leukocyte antigen alleles and many diseases.

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The UK Biobank resource with deep phenotyping and genomic data

An earlier version (version 5.0.2, 2008) of the Handbook is also published by John Wiley & Sons, Ltd under “The Cochrane Book Series” Imprint, as Higgins JPT, Green S (editors), Cochrane Handbook for Systematic Reviews of Interventions (ISBN 978-0470057964) by John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ, England, Telephone (+44) 1243 779777; Email (for orders and customer service enquiries): cs-books@wiley.co.uk. Visit their Home Page on www.wiley.com.

Chapter 8: Assessing risk of bias in included studies

Assessing Risk of Bias in Included Studies

Mepolizumab reduces exacerbations in patients with severe eosinophilic asthma irrespective of baseline maintenance ocs use: meta-analysis from two ph3 trials

Current Controversies in Chronic Obstructive Pulmonary Disease: A Report from the GOLD Scientific Committee.

6 Th2 Cytokine Expression by Bronchoalveolar Lavage T-Lymphocytes in Asthma and Eosinophilic Bronchitis Without Asthma Christopher Edward Brightling, Fiona A Symon, Surinder S Birring, lan D Pavord, Andrew J Wardlaw Institute for Lung Health, Leicester, UK Eosinophilic bronchitis (EB) is a common cause of chronic cough characterised by a sputum eosinophilia. In contrast to asthma there is no variable airflow obstruction or airway hyperresponsiveness. Eosinophilic airway inflammation in asthma is under the control ofTh2 cytokines, whereas the cytokine regulation of the inflammatory response in eosinophilic bronchitis is unknown. We hypothesised that the differences in airway pathophysiology between these two conditions may be related to cytokine expression by airway T-cells. From 10 subjects with EB, 9 with asthma and 9 normal controls 20ml of venous blood was taken and the subjects underwent a fibreoptic bronchoscopy and 180ml bronchoalveolar lavage (BAL) to the middle lobe. The peripheral blood mononuclear cell (PBMC) fraction was obtained by centrifugation on Ficoll. After washing PBMC and BAL cells were either stimulated with PMA, calcium ionophore and Brefeldin A or incubated in culture medium alone (resting) for 4hr at 37°C. The cells were fixed, incubated with CD3-F1TC/RPE and CD8-PerCP, permeabilised and labelled with IL-4-RPE and IFN-y-FITC or isotypic controls and analysed using three-colour flow cytometry. The median (range) % of stimulated CD4+ PBMC expressing IFN-y were increased in those subjects with EB 14 (2.8-52) and asthma 15 (7-30) compared to normals 3.3 (0.1-12) (Kruskal-Wallis p=0.024). Expression of 1L-4 was increased in EB and asthma compared to normals in both the resting (p=0.03) and stimulated (p=0.045) CD4+ BAL cells (Table). There were no between group differences in IL-4 expression in PBMC cells or IFN-yin BAL cells. In conclusion, increased Th2 cytokine expression by BAL T-cells is a feature of EB and asthma suggesting that they play a role in the airway inflammation observed in EB but that release of Th2 cytokines is not important in the development of disordered airway physiology in asthma.

https://www.jacionline.org/article/S0091-6749(02)81186-1/pdf

Th2 cytokine expression by bronchoalveolar lavage T-lymphocytes in asthma and eosinophilic bronchitis without asthma

COPD and hepatitis C.

measures, including environmental control, use of adjunct therapies such as long-acting inhaled bronchodilators, and in the more severe patient, by the early introduction of biologics. However, prevention of OCS use and related exacerbations should be a priority, which could be avoided in some patients by using high doses of ICS. In this regard, in a study over a median period of 10 years (maximum, 30 yr), we showed that when the dose of ICS/prednisone was adjusted to keep sputum eosinophils under control, exacerbations and the rate of decline of lung function were significantly reduced, although at a price of adverse effects, mainly when OCS was needed (7). Adverse effects of high doses of ICS have been confounded by methodologic issues and intercurrent OCS use, and there is probably also a variation in susceptibility to those effects from one patient to another. We therefore agree with Beasley and colleagues that we should prevent overdosing with ICS when not necessary, and that in this regard, there is a significant care gap in asthma management with an underutilization of noninvasive measurements of airway inflammation, particularly in moderate to severe asthma. We endorse the need for rigorous dose–response studies of ICS to be conducted in patients who are well characterized on the basis of their inflammatory endotypes. n

https://www.atsjournals.org/doi/pdf/10.1164/rccm.201907-1408LE

Ian D. Pavord

Papers

Mepolizumab reduces exacerbations in patients with severe eosinophilic asthma irrespective of baseline maintenance ocs use: meta-analysis from two ph3 trials

Current Controversies in Chronic Obstructive Pulmonary Disease: A Report from the GOLD Scientific Committee.

Th2 cytokine expression by bronchoalveolar lavage T-lymphocytes in asthma and eosinophilic bronchitis without asthma

COPD and hepatitis C.

Reply to Boulet and Nair: Inhaled Corticosteroids and Adult Asthma.