AI-Powered Research

Inclusion Criteria for Chronic Obstructive Pulmonary Disease (COPD) subjects:
1. Male or Female
2. 40 to 75 years of age
3. COPD, defined as the forced expiratory volume in the first one second to the forced vital capacity of the lungs (FEV1/FVC) being less than 70% that is not fully reversible defined as an increase of less than 15% of predicted FEV1 after inhaling 200 ug salbutamol:
a. mild COPD (Stage I) defined as FEV1 more than 80%, pre-bronchodilator
b. moderate COPD (Stage II) defined as 50% less than FEV1 less than 80%, pre-bronchodilator
c. severe COPD (Stage III) defined as 30% less than FEV1 less than 50%, pre-bronchodilator
4. Current or ex-smokers with more than ten pack year history (i.e. equivalent to 20 cigarettes smoked per day for ten years)
5.Written informed consent

Inclusion Criteria for COPD subjects during an acute exacerbation:
1. Male or Female
2. 40 to 75 years of age
3. Current or ex-smokers with more than ten pack year history (i.e. equivalent to 20 cigarettes smoked per day for ten years)
4. Written informed consent
5.Moderate to severe COPD, defined as FEV1/FVC less than 70% that is not fully reversible defined as an increase of less than 15% of predicted FEV1 after inhaling 200 ug salbutamol:
a. moderate COPD (Stage II) defined as 50% less than FEV1 less than 80%, pre-bronchodilator
b. severe COPD (Stage III) defined as 30% less than FEV1 less than 50%, pre-bronchodilator
6. Acute exacerbation, defined as a worsening of the subject’s condition from the stable state and beyond normal day-to-day variation, which is acute in onset and necessitates a change in regular medication

The subject must have two or three of the following clinical findings:
1. Worsening dyspnea
2. New or increased sputum purulence
3. Increased sputum volume
or one of the above clinical findings plus at least one of the following:
1. Upper respiratory tract infection in the past five days
2. Fever without other apparent cause
3. Increased wheezing
4. Increased cough
5. 20% increase in respiratory rate or heart rate above baseline

Subjects with an acute exacerbation must be within the first two to three days post-presentation of symptoms to be enrolled in the study.

Inclusion Criteria for Healthy Volunteers:
1. Male or Female
2. 40 to 75 years of age
3. Non-smoker
4. Written informed consent

Exclusion Criteria

Exclusion Criteria for COPD subjects:
1. Other respiratory disorders, including asthma
2. Atopy
3. Other significant disease(s) which may put the subjects at risk or may have influence on the study results
4. Regular use of oxygen therapy
5. Pulmonary exacerbation in the previous four weeks (excluding subjects recruited during an exacerbation of COPD)
6.Received oral prednisone in the previous four weeks
7. Received antibiotics in the previous four weeks
8. Pregnancy or breastfeeding. If in childbearing years, female subjects will be required to provide a negative urine pregnancy test and must be using an acceptable hormonal or barrier contraceptive method to be included in the study. She must be willing to continue to use this type of contraception for the duration of the study

Exclusion Criteria for Healthy Volunteers:
1. History of respiratory disorders, including asthma
2. Atopy
3. Other significant disease(s) which may put the subjects at risk or may have influence on the study results
4. Received oral prednisone in the previous four weeks
5. Respiratory infection or cold in previous four weeks
6. Received antibiotics in the previous four weeks
7. Pregnancy or breastfeeding. If in childbearing years, female subjects will be required to provide a negative urine pregnancy test and must be using an acceptable hormonal or barrier contraceptive method to be included in the study. She must be willing to continue to use this type of contraception for the duration of the study.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1. 18FDG uptake in the total lung, right and left lung<br>2. 18FDG uptake in three pre-defined lung regions (central, intermediate and peripheral) using the computerised shell analysis

Secondary Outcome Measures

Name	Time	Method
1. Sputum inflammatory cells - Total Cell Count (TCC), Differential Cell Counts (DCC) from induced sputum obtained after 21 minutes nebulised hypertonic saline<br>2. Spirometry: FEV1, FVC<br>3. Sputum 18F activity levels post-imaging (COPD only)