title: Nasal symptoms, airway obstruction and disease severity in chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is characterized by inflammation of the lung in association with airflow obstruction. There is increasing evidence of upper airway involvement in COPD and we have reported that this nasal inflammation is proportional to that in the lung. Given recognized relationships between lower airway inflammation and spirometric indices such as the Forced Expiratory Volume in one second (FEV(1)), we hypothesized that there may be a relationship between nasal obstruction and FEV(1) in COPD. We also sought to investigate relationships between nasal symptoms and nasal patency in COPD.
  
  
  METHODS
  We assessed the nasal and pulmonary airways, using acoustic rhinometry and spirometry respectively, in 51 patients with COPD.
  
  
  RESULTS
  The presence of chronic nasal symptoms in COPD was associated with reduced nasal patency (6.04 cm(2) symptoms vs. 9.55 cm(2) no symptoms, at the second minimum cross-sectional area, P = 0.049). Nasal patency in COPD was inversely proportional to pulmonary airflow obstruction, and therefore to COPD disease severity (e.g. FEV(1)% predicted vs. second minimum cross-sectional area, r = 0.36, P = 0.009).
  
  
  CONCLUSIONS
  The degree of nasal airway obstruction in COPD reflects the impairment to pulmonary airflow, and is greater in the presence of chronic nasal symptoms. This study provides further evidence of pan-airway involvement in COPD.
authors.affiliation: Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, Royal Free Hospital, Hampstead, London, UK.
authors.forename: John R
authors.initials: JR
authors.lastname: Hurst
authors.forename: Romana
authors.initials: R
authors.lastname: Kuchai
authors.forename: Philip
authors.initials: P
authors.lastname: Michael
authors.forename: Wayomi R
authors.initials: WR
authors.lastname: Perera
authors.forename: Tom M A
authors.initials: TM
authors.lastname: Wilkinson
authors.forename: Jadwiga A
authors.initials: JA
authors.lastname: Wedzicha
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000473:pathology* / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology* / Q000503:physiopathology*; D012120:Respiration Disorders / Q000503:physiopathology*; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology