Jin J, et al. - Pulmonary tuberculosis (PTB) is a risk factor for COPD. In this present study, researchers focused on the clinical characteristics and the chest imaging features (emphysema and bronchiectasis) of COPD with previous PTB. In COPD patients with previous PTB, high-resolution computed tomography (HRCT)-demonstrated unique features of bronchiectasis and emphysema were found to be associated with significant dyspnea and higher frequency of severe exacerbations. A possible local effect of PTB on bronchiectasis was suggested, its involvement in airspace damage in COPD may be extensive, probably via interactions with cigarette smoke.

• Using high-resolution computed tomography (HRCT), researchers assessed and compared the presence, distribution, and severity of emphysema and bronchiectasis in COPD patients with and without previous PTB.
• Patients with and without previous PTB were also compared in terms of demographic data, respiratory symptoms, lung function, and sputum culture of Pseudomonas aeruginosa.

• This study included a total of 231 consecutively enrolled COPD patients (82.2% ex- or current smokers, 67.5% male).
• Relative to patients without PTB, more severe (p=0.045) and longer history (p=0.008) of dyspnea, more exacerbations in the previous year (p=0.011), and more positive culture of P. aeruginosa(p=0.001) was reported in patients with previous PTB (45.0%).
• Furthermore, researchers found that when compared with those without previous PTB, patients with previous PTB demonstrated a higher prevalence of bronchiectasis (p<0.001), which was more significant in lungs with tuberculosis (TB) lesions, and a higher percentage of more severe bronchiectasis (Bhalla score ≥2, p=0.031).
• Although no difference was noted in the overall prevalence of emphysema between patients with and without previous PTB, but researchers observed a higher number of subjects with middle (p=0.001) and lower (p=0.019) lobe emphysema, higher severity score (p=0.028), higher prevalence of panlobular emphysema (p=0.013), and more extensive centrilobular emphysema (p=0.039) in those with previous PTB.
• Notably, they noted that in patients with TB lesions localized in a single lung, the occurrence and severity of emphysema between the 2 lungs did not differ.