{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:58:25Z","timestamp":1791849505717,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T00:00:00Z","timestamp":1505347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Guangzhou Institute of Respiratory Diseases"},{"name":"Clinical Study on Translational Medicine of Respiratory Disease"},{"name":"The National Key Technology R&D Program of the 12th National Five-Year Development Plan","award":["2012BAI05B01"],"award-info":[{"award-number":["2012BAI05B01"]}]},{"name":"National Key Basic Research and Development Program","award":["20l5CB553403"],"award-info":[{"award-number":["20l5CB553403"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"ABSTRACT<\/jats:styled-content><\/jats:title>Background and objective<\/jats:title>Chronic exposure to biomass smoke (BS<\/jats:styled-content>) can significantly compromise pulmonary function and lead to chronic obstructive pulmonary disease (COPD<\/jats:styled-content>). To determine whether BS<\/jats:styled-content> exposure induces a unique phenotype of COPD<\/jats:styled-content> from an early stage, with different physiopathological features compared with COPD<\/jats:styled-content> associated with smoking (cigarette\u2010smoke (CS) COPD<\/jats:styled-content>), we assessed the physiopathology of early COPD<\/jats:styled-content> associated with BS<\/jats:styled-content> exposure (BS COPD<\/jats:styled-content>) by incorporating spirometry, high\u2010resolution computed tomography (HRCT<\/jats:styled-content>) imaging, bronchoscopy and pathological examinations.<\/jats:p><\/jats:sec>Methods<\/jats:title>In this cross\u2010sectional study, we recruited 29 patients with BS COPD<\/jats:styled-content>, 31 patients with CS COPD<\/jats:styled-content> and 22 healthy controls, including 12 BS<\/jats:styled-content>\u2010exposed subjects who did not smoke and 10 healthy smokers without BS<\/jats:styled-content> exposure. Spirometry, HRCT<\/jats:styled-content> scans, bronchoscopy and bronchial mucosa biopsies were performed to assess lung function, emphysema and air trapping, as well as the pathological characteristics and levels of inflammatory cells in bronchoalveolar lavage fluid (BALF<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>Among COPD<\/jats:styled-content> patients with mild\u2010to\u2010moderate airflow limitation, BS<\/jats:styled-content> exposure caused greater small airway dysfunction in BS COPD<\/jats:styled-content> patients, although these patients had less emphysema and air trapping, as detected by HRCT<\/jats:styled-content> (P<\/jats:italic>\u2009<\u20090.05). We also observed significantly thicker basement membranes and greater endobronchial pigmentation in BS COPD<\/jats:styled-content> than in CS COPD<\/jats:styled-content> (P<\/jats:italic>\u2009<\u20090.05). Moreover, patients with BS COPD<\/jats:styled-content> exhibited greater macrophage and lymphocyte infiltration but reduced neutrophil infiltration in their BALF<\/jats:styled-content> (P<\/jats:italic>\u2009<\u20090.05).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We used both radiology and pathology to document a distinct COPD<\/jats:styled-content> phenotype associated with BS<\/jats:styled-content> exposure. This is characterized by small airway disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13176","type":"journal-article","created":{"date-parts":[[2017,9,14]],"date-time":"2017-09-14T10:02:56Z","timestamp":1505383376000},"page":"198-205","source":"Crossref","is-referenced-by-count":51,"title":["Small airway disease: A<\/scp> different phenotype of early stage COPD<\/scp> associated with biomass smoke exposure"],"prefix":"10.1111","volume":"23","author":[{"given":"Dongxing","family":"Zhao","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease The First Affiliated Hospital of Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumin","family":"Zhou","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease The First Affiliated Hospital of Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changbin","family":"Jiang","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease The First Affiliated Hospital of Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuxiang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Guangzhou First People's Hospital Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"He","sequence":"additional","affiliation":[{"name":"The School of Basic Medicine Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6651-634X","authenticated-orcid":false,"given":"Pixin","family":"Ran","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease The First Affiliated Hospital of Guangzhou Medical University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00025805"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.061457"},{"key":"e_1_2_7_4_1","first-page":"23","article-title":"Clinical characteristics of patients with biomass smoke\u2010associated COPD and chronic bronchitis, 2004\u20102014","volume":"1","author":"P\u00e9rez\u2010Padilla R","year":"2014","journal-title":"Chronic Obstr. 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