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dc.contributor.authorAllinson, JPen_US
dc.contributor.authorHardy, Ren_US
dc.contributor.authorDonaldson, GCen_US
dc.contributor.authorShaheen, SOen_US
dc.contributor.authorKuh, Den_US
dc.contributor.authorWedzicha, JAen_US
dc.date.accessioned2017-01-24T15:35:20Z
dc.date.issued2016-03-15en_US
dc.date.submitted2017-01-23T14:16:33.810Z
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/18952
dc.descriptionSupported by the U.K. Medical Research Council (MC_UU_12019/1, MC_UU_12019/2, and MC_UU_12019/4).en_US
dc.description.abstractRATIONALE: Chronic mucus hypersecretion (CMH) is common among smokers and is associated with chronic obstructive pulmonary disease development and progression. OBJECTIVES: To understand how the relationships between smoking, CMH, and chronic obstructive pulmonary disease develop during adult life, and facilitate earlier disease detection and intervention. METHODS: We analyzed data on CMH, smoking, and lung function prospectively collected by the Medical Research Council National Survey of Health and Development, a nationally representative British cohort followed since birth in 1946. We analyzed the longitudinal relationships between smoking and CMH, how symptoms during life related to airflow limitation at 60-64 years, and how CMH duration between ages 43 and 60-64 years related to concurrent FEV1 decline. MEASUREMENTS AND MAIN RESULTS: From 5,362 individuals enrolled at birth, 4,427 contributed data between ages 20 and 64 years (52% male; 63% ever-smoker). Among smokers CMH prevalence escalated between ages 36 and 43 from 7.6 ± 2.0% to 13.0 ± 2.6%. At these ages, symptoms were associated with a higher risk of subsequent airflow limitation (odds ratio [95% confidence interval], 3.70 [1.62-8.45] and 4.11 [1.85-9.13], respectively). Across adult life, CMH followed a dynamic remitting-relapsing course. Symptom prevalence following smoking cessation returned to levels seen among never-smokers. The longer CMH was present across three occasions (ages 43, 53, and 60-64 yr), the greater the concurrent FEV1 decline, corresponding to an additional decrement of 3.6 ± 2.5 ml/yr per occasion that CMH was present (P = 0.005). CONCLUSIONS: CMH among middle-aged smokers represents an early developmental phase of chronic obstructive pulmonary disease. Smoking-related CMH usually resolves following smoking cessation but the longer its duration the greater the FEV1 lost, suggesting the course of CMH across adult life may reflect the underlying course of airway disease activity.en_US
dc.format.extent662 - 672en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofAm J Respir Crit Care Meden_US
dc.subjectCOPDen_US
dc.subjectchronic bronchitisen_US
dc.subjectchronic mucus hypersecretionen_US
dc.subjectcoughen_US
dc.subjectsmokingen_US
dc.subjectAdulten_US
dc.subjectAge Factorsen_US
dc.subjectAgingen_US
dc.subjectChronic Diseaseen_US
dc.subjectDisease Progressionen_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectLungen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectMucusen_US
dc.subjectOdds Ratioen_US
dc.subjectPulmonary Disease, Chronic Obstructiveen_US
dc.subjectRisk Factorsen_US
dc.subjectSmokingen_US
dc.subjectYoung Adulten_US
dc.titleThe Presence of Chronic Mucus Hypersecretion across Adult Life in Relation to Chronic Obstructive Pulmonary Disease Development.en_US
dc.typeArticle
dc.identifier.doi10.1164/rccm.201511-2210OCen_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/26695373en_US
pubs.issue6en_US
pubs.notesNot knownen_US
pubs.publication-statusPublisheden_US
pubs.volume193en_US


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