RESUMEN
RATIONALE: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. OBJECTIVES: The purpose of the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) study was to correlate clinical features and biomarkers with molecular characteristics in a well-profiled COPD cohort. METHODS: A total of 67 COPD subjects (forced expiratory volume in the first second of expiration [FEV1]: 45%-80% predicted) and 63 healthy smoking and nonsmoking controls underwent multiple assessments including patient questionnaires, lung function, and clinical biomarkers including fractional exhaled nitric oxide (FENO), induced sputum, and blood. MEASUREMENTS AND MAIN RESULTS: The impact of inhaled corticosteroids (ICSs), and to a lesser extent current smoking, was more associated with symptom control, exacerbation rates, and clinical biomarkers, than severity by FEV1. The ICS-treated smoking subjects were most symptomatic, with significantly elevated scores on patient-reported outcomes and more annual exacerbations (P < .05). Inhaled corticosteroid users had greater airflow obstruction and air trapping compared with non-ICS users, regardless of smoking status. Smoking, regardless of ICS use, was associated with significantly lower FENO (P < .05). Smoking, in non-ICS users, was associated with an elevated proportion of sputum neutrophils and reduced sputum macrophages. Increased serum C-reactive protein was observed in smokers but not in ICS and nonsmoking ICS users (P < .05). In contrast, only air trapping and neutrophilic inflammation increased with severity, defined by postbronchodilator FEV1. CONCLUSIONS: Compared with COPD severity by FEV1, ICS use and current smoking were better determinants of clinical characteristics and biomarkers. Use of the ADEPT COPD data promises to prove useful in defining biological phenotypes to facilitate personalized therapeutic approaches.
RESUMEN
The reactions of tellurium or selenium with bismuth or antimony in chloridogallate and iodidoaluminate melts in the presence of group 15 trihalides as weak oxidants yielded the compounds (Sb2Te2)[GaCl4] (1), (Sb2Te2)I[AlI4] (2), (Bi2Te2)Cl[GaCl4] (3a), (Bi2Se2)Cl[GaCl4] (3b), (Sb3Te4)[GaCl4] (4), and (SbTe4)[Ga2Cl7] (5). In the crystal structures one-dimensional polymeric cations (Sb2Te2(+))n (1), (Sb2Te2(2+))n (2), (Bi2Te2(2+))n (3a), (Bi2Se2(2+))n (3b), (Sb3Te4(+))n (4), and (SbTe4(+))n (5) are present. The polymeric cationic strands in 2, 3a, 3b, and 4 consist of pentele/chalcogen dumbbells, which are connected to ladder-shaped bands. The strands in 1 and 5 consist of condensed rings that involve four-membered Sb2Te2 rings for 1, and five-membered SbTe4 rings for 5. The counteranions are the weakly coordinating [GaCl4](-), [AlI4](-), and [Ga2Cl7](-) in addition to Cl(-) and I(-) anions, which are coordinated to the atoms of the cations. The crystal structures of 1-4 are characterized by a statistical disorder in the anions with alternatively occupied positions for the Al and Ga atoms. For 4 superstructure reflections appear in the diffractions patterns, indicating a partial order. A correct assignment of the Sb and Te positions in the cation of 5 was achieved by periodic quantum-chemical calculations, which were performed via a Hartree-Fock density functional theory hybrid method. A clear preference of the 4-fold coordinated site was obtained for Sb.