Clinical, immunological and microbiological phenotypes of chronic obstructive pulmonary disease (COPD) in ethnic Chinese populations in South-East Asia
Chronic Obstructive Pulmonary Disease (COPD) is of increasing prevalence across Asia. COPD in Asian populations remains under-researched, and most clinical trials of COPD therapeutics exclude Asians. Therefore, a major knowledge gap exists on whether specific clinical, immunological and microbiologi...
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| Format: | Thesis-Doctor of Philosophy |
| Language: | English |
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Nanyang Technological University
2020
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| Online Access: | https://hdl.handle.net/10356/145518 |
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| Institution: | Nanyang Technological University |
| Language: | English |
| Summary: | Chronic Obstructive Pulmonary Disease (COPD) is of increasing prevalence across Asia. COPD in Asian populations remains under-researched, and most clinical trials of COPD therapeutics exclude Asians. Therefore, a major knowledge gap exists on whether specific clinical, immunological and microbiological phenotypes of COPD exist in Asians, with a particular lack of data evident in South-East Asia.
Here, employing clinical, statistical, molecular and sequencing approaches, I identify unique clinical phenotypes of Asian COPD that associate with mortality including a novel ‘ex-tuberculosis’ group. Immunologically, fungal sensitisation relates to poor clinical outcomes in COPD, and environmental exposure serves as a key reservoir of fungal allergens. Distinct airway mycobiome profiles that vary by geographic region, and with association to frequent exacerbations and mortality are evident in South-East Asians with COPD.
Collectively, my novel findings will improve risk stratification in Asians with COPD, and promote the development of specific clinical guidelines focused on Asian COPD. |
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