Displaying publications 1 - 20 of 34 in total

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  1. CUMMINS GE, AUN YS, DAVIES TA
    Med J Malaya, 1958 Jun;12(4):613-7.
    PMID: 13577154
    Matched MeSH terms: Bronchitis*
  2. Zulperi ZM, Omar AR, Arshad SS
    Virus Genes, 2009 Jun;38(3):383-91.
    PMID: 19242786 DOI: 10.1007/s11262-009-0337-2
    Two Malaysian infectious bronchitis virus isolates, MH5365/95 and V9/04 were characterized based on sequence and phylogenetic analyses of S1, S2, M, and N genes. Nucleotide sequence alignments revealed many point mutations, short deletions, and insertions in S1 region of both IBV isolates. Phylogenetic analysis of S1 gene and sequences analysis of M gene indicated that MH5365/95 and V9/04 belong to non-Massachusetts strain. However, both isolates share only 77% identity. Analysis based on S1 gene showed that MH5365/95 shared more than 87% identity to several Chinese strains. Meanwhile, V9/04 showed only 67-77% identity to all the previously studied IBV strains included in this study suggesting it is a variant of IBV isolate that is unique to Malaysia. Phylogenetic analysis suggests, although both isolates were isolated 10 years apart from different states in Malaysia, they shared a common origin. Analysis based on S2 and N genes indicated that both strains are highly related to each other, and there are fewer mutations which occurred in the respective genes.
    Matched MeSH terms: Infectious bronchitis virus/classification*; Infectious bronchitis virus/genetics*; Infectious bronchitis virus/isolation & purification
  3. Bhuiyan MSA, Amin Z, Bakar AMSA, Saallah S, Yusuf NHM, Shaarani SM, et al.
    Vet Sci, 2021 Mar 16;8(3).
    PMID: 33809420 DOI: 10.3390/vetsci8030047
    Infectious bronchitis virus (IBV) is a major economic problem in commercial chicken farms with acute multiple-system infection, especially in respiratory and urogenital systems. A live-attenuated and killed vaccine is currently immunized to control IBV infection; however, repeated outbreaks occur in both unvaccinated and vaccinated birds due to the choice of inadequate vaccine candidates and continuous emergence of novel infectious bronchitis (IB) variants and failure of vaccination. However, similar clinical signs were shown in different respiratory diseases that are essential to improving the diagnostic assay to detect IBV infections. Various risk factors involved in the failure of IB vaccination, such as various routes of application of vaccination, the interval between vaccinations, and challenge with various possible immunosuppression of birds are reviewed. The review article also highlights and updates factors affecting the diagnosis of IBV disease in the poultry industry with differential diagnosis to find the nature of infections compared with non-IBV diseases. Therefore, it is essential to monitor the common reasons for failed IBV vaccinations with preventive action, and proper diagnostic facilities for identifying the infective stage, leading to earlier control and reduced economic losses from IBV disease.
    Matched MeSH terms: Infectious bronchitis virus; Bronchitis
  4. Leow BL, Syamsiah Aini S, Faizul Fikri MY, Muhammad Redzwan S, Khoo CK, Ong GH, et al.
    Trop Biomed, 2018 Dec 01;35(4):1092-1106.
    PMID: 33601856
    Avian Infectious Bronchitis (IB) is a highly contagious disease which can cause huge economic losses to the poultry industry. Forty five IB viruses (IBV) were isolated from poultry in Malaysia during 2014-2016. Phylogenetic analysis of the spike glycoprotein 1 (S1) gene revealed that all isolates were clustered into five distinct groups. The predominant type of IBV isolated was QX strains (47%), second was 4/91 type (27%), followed by Malaysian strain MH5365/95 (13%), Massachusetts type (11%) and finally Taiwanese strains (2%). Four types of S1 protein cleavage recognition motifs were found among the isolates which includes HRRRR, RRSRR, RRFRR and RRVRR. To our knowledge, this is the first report describing the motif RRVRR and are unique to Malaysian strains. Six IBVs were grouped in Malaysian MH5365/95 strains. Among these, one isolate was different from others where it only shared 82% identity with MH5365/95 and to others. It formed its own branch in the Malaysian cluster suggesting it may be a variant unique to Malaysia. Alignment analysis of the S1 amino acid sequences indicated that point mutations, insertions and deletions contribute to the divergence of IB variants. This study indicated at least five groups of IBV are circulating in Malaysia with most of the isolates belonged to QX strains. As new IBV variants continue to emerge, further study need to be carried out to determine whether the current available vaccine is able to give protection against the circulating virus.
    Matched MeSH terms: Infectious bronchitis virus; Bronchitis
  5. Dutt AK, Krishnan M, Lim EJ
    Med J Malaya, 1969 Sep;24(1):74-8.
    PMID: 4243848
    Matched MeSH terms: Bronchitis/etiology
  6. Bande F, Arshad SS, Omar AR, Hair-Bejo M, Mahmuda A, Nair V
    Anim Health Res Rev, 2017 Jun;18(1):70-83.
    PMID: 28776490 DOI: 10.1017/S1466252317000044
    The poultry industry faces challenge amidst global food security crisis. Infectious bronchitis is one of the most important viral infections that cause huge economic loss to the poultry industry worldwide. The causative agent, infectious bronchitis virus (IBV) is an RNA virus with great ability for mutation and recombination; thus, capable of generating new virus strains that are difficult to control. There are many IBV strains found worldwide, including the Massachusetts, 4/91, D274, and QX-like strains that can be grouped under the classic or variant serotypes. Currently, information on the epidemiology, strain diversity, and global distribution of IBV has not been comprehensively reported. This review is an update of current knowledge on the distribution, genetic relationship, and diversity of the IBV strains found worldwide.
    Matched MeSH terms: Infectious bronchitis virus*
  7. Mohd Khairul Amri Kamarudin, Noorjima Abd Wahab, Khalid Abdul Rahim
    MyJurnal
    Awareness of haze pollution and management increased in Southeast Asia since 1990. However, the
    focus on environmental management is decreasing especially in Malaysia due to the abundant
    resources and increased development pressure. The total health damage cost because of haze in the
    country became significantly high due to the long duration of haze events year by year. This paper
    discusses the health damage caused by bronchitis due to the haze events in Malaysia. The analysis
    shows positive coefficient of independent variables which indicates the positive relationship between
    dependent variable and independent variables. Multiple linear regression analysis shows that 45.3%
    variation in damage cost of bronchitis could be explained by FAI, GDPPC, and CO2.
    Matched MeSH terms: Bronchitis
  8. Hassan LE, Dahham SS, Fadul SM, Umar MI, Majid AS, Khaw KY, et al.
    J Ethnopharmacol, 2016 Aug 20.
    PMID: 27553975 DOI: 10.1016/j.jep.2016.08.023
    Tephrosia apollinea (Delile) DC (Leguminosae) has been used in folk medicine in Arabian countries to treat inflammatory disorders. The plant has been described to treat swelling, bone fracture, bronchitis, cough, earache and wounds.
    Matched MeSH terms: Bronchitis
  9. Eg KP, Thomas RJ, Masters IB, McElrea MS, Marchant JM, Chang AB
    Pediatr Pulmonol, 2020 09;55(9):2444-2451.
    PMID: 32584469 DOI: 10.1002/ppul.24924
    INTRODUCTION/AIM: A validated tool for scoring bronchitis during flexible bronchoscopy (FB) is potentially useful for clinical practice and research. We aimed to develop a bronchoscopically defined bronchitis scoring system in children (BScore) based on our pilot study.

    METHODS: Children undergoing FB were prospectively enrolled. Their FB was digitally recorded and assessed (two clinicians blinded to each other and clinical history) for six features: secretion amount (six-point scale), secretion color (BronkoTest, 0-8), mucosal oedema (0-3), ridging (0-3), erythema (0-3), and pallor (0-3) based on pre-determined criteria. We correlated (Spearman's rho) each feature with bronchoalveolar lavage (BAL) neutrophil percentage (neutrophil%). BScore was then derived using models with combinations of the six features that best related to airway BAL neutrophil%. The various models of BScore were plotted against BAL neutrophil% using receiver operating characteristic (ROC) curves.

    RESULTS: We analyzed 142 out of 150 children enrolled. Eight children were excluded for unavailability of BAL cytology or FB recordings. Chronic/recurrent cough was the commonest indication for FB (75%). The median age was 3 years (IQR, 1.5-5.3 years). Secretion amount (r = 0.42) and color (r = 0.46), mucosal oedema (r = 0.42), and erythema (r = 0.30) significantly correlated with BAL neutrophil%, P 10%).

    CONCLUSION: This prospective study has developed the first validated bronchitis scoring tool in children based on bronchoscopic visual inspection of airways. Further validation in other cohorts is however required.

    Matched MeSH terms: Bronchitis/diagnosis*; Bronchitis/immunology
  10. Bande F, Arshad SS, Bejo MH, Omar AR, Moeini H, Khadkodaei S, et al.
    Microb Pathog, 2020 Dec;149:104560.
    PMID: 33068733 DOI: 10.1016/j.micpath.2020.104560
    Infectious Bronchitis (IB) is an economically important avian disease that considerably threatens the global poultry industry. This is partly, as a result of its negative consequences on egg production, weight gain as well as mortality rate.The disease is caused by a constantly evolving avian infectious bronchitis virus whose isolates are classified into several serotypes and genotypes that demonstrate little or no cross protection. In order to curb the menace of the disease therefore, broad based vaccines are urgently needed. The aim of this study was to develop a recombinant DNA vaccine candidate for improved protection of avian infectious bronchitis in poultry. Using bioinformatics and molecular cloning procedures, sets of monovalent and bivalent DNA vaccine constructs were developed based on the S1 glycoprotein from classical and variants IBV strains namely, M41 and CR88 respectively. The candidate vaccine was then encapsulated with a chitosan and saponin formulated nanoparticle for enhanced immunogenicity and protective capacity. RT-PCR assay and IFAT were used to confirm the transcriptional and translational expression of the encoded proteins respectively, while ELISA and Flow-cytometry were used to evaluate the immunogenicity of the candidate vaccine following immunization of various SPF chicken groups (A-F). Furthermore, histopathological changes and virus shedding were determined by quantitative realtime PCR assay and lesion scoring procedure respectively following challenge of various subgroups with respective wild-type IBV viruses. Results obtained from this study showed that, groups vaccinated with a bivalent DNA vaccine construct (pBudCR88-S1/M41-S1) had a significant increase in anti-IBV antibodies, CD3+ and CD8+ T-cells responses as compared to non-vaccinated groups. Likewise, the bivalent vaccine candidate significantly decreased the oropharyngeal and cloacal virus shedding (p < 0.05) compared to non-vaccinated control. Chickens immunized with the bivalent vaccine also exhibited milder clinical signs as well as low tracheal and kidney lesion scores following virus challenge when compared to control groups. Collectively, the present study demonstrated that bivalent DNA vaccine co-expressing dual S1 glycoprotein induced strong immune responses capable of protecting chickens against infection with both M41 and CR88 IBV strains. Moreso, it was evident that encapsulation of the vaccine with chitosan-saponin nanoparticle further enhanced immune responses and abrogates the need for multiple booster administration of vaccine. Therefore, the bivalent DNA vaccine could serve as efficient and effective alternative strategy for the control of IB in poultry.
    Matched MeSH terms: Infectious bronchitis virus/immunology*; Bronchitis/immunology; Bronchitis/prevention & control; Bronchitis/veterinary
  11. Ismail MI, Wei TS, Hair-Bejo M, Omar AR
    Arch Virol, 2020 Dec;165(12):2777-2788.
    PMID: 32964293 DOI: 10.1007/s00705-020-04812-2
    Besides the vaccine strains, the Malaysian variant (MV) and QX-like are the predominant IBVs detected on commercial poultry farms. These two virus strains are distinct based on genomic and pathogenicity studies. In this study, we determined the sequence of the S1 gene and compared the pathogenicity of serial passage 70 (P70) of Malaysian QX-like (QX/P70) and MV (MV/P70) strains with that of their respective wild-type viruses. The nucleotide and amino acid sequences of the complete S1 genes of QX/P70 and MV/P70 showed 1.4 to 1.6% and 3.0 to 3.3% variation, respectively, when compared to the wild-type virus. Most of the mutations were insertions and substitutions in the hypervariable regions (HVRs), primarily in HVR 3. Furthermore, selection pressure analysis showed that both viruses are under purifying selection. A pathogenicity study in specific-pathogen-free (SPF) chickens showed a reduction in respiratory and kidney lesions in chickens inoculated with MV/P70, but not with QX/P70, when compared to the respective wild-type viruses. However, MV/P70 is still pathogenic and can cause ciliary damage. In conclusion, the MV IBV strain is more responsive than the QX-like IBV strain following the attenuation process used for the development of a live attenuated IBV vaccine.
    Matched MeSH terms: Infectious bronchitis virus/genetics*; Infectious bronchitis virus/pathogenicity
  12. Fadhilah AS, Kai TH, Lokman HI, Yasmin NAR, Hafandi A, Hasliza AH, et al.
    Poult Sci, 2020 Jun;99(6):2937-2943.
    PMID: 32475428 DOI: 10.1016/j.psj.2020.01.026
    Infectious bronchitis virus (IBV) infection is highly infectious respiratory disease in poultry industry with significant economic importance. The prevalence of IBV in quail industry in Malaysia was not well documented; therefore, its actual role in the epidemiology of the disease is relatively unknown. This study was to determine the susceptibility of Japanese quail, as one of the species in commercial poultry industry, toward IBV. In addition, it will also give a potential impact on the overall health management in the quail industry even though it had been established that quail are resistant to diseases affecting poultry. Moreover, to the best of our knowledge, it is the first experimental study on IBV inoculation in quail. In this experimental study, 20 quails were divided into 4 groups (n = 5 for group A, B, and C, n = 5 for control group). The quails in group A, B, and C were infected via intraocular and intranasal routes with 0.2 mL of 10 × 5 EID50 of the virus. Clinical signs, gross lesions, positive detection of virus, and trachea histopathological scoring were used to assess the susceptibility of these Japanese quails. The results have indicated mild ruffled feathers and watery feces in these inoculated birds. Trachea, lung, and kidney were subjected to one-step reverse transcription polymerase chain reaction for virus detection. The virus was found from trachea and lung samples, whereas it was absent from all kidney samples. Only 3 quails were found with gross lesions. There was a significant difference of tracheal lesion by 0.009 ± 0.845 (P < 0.05) within the treatment groups. In summary, Japanese quails might be susceptible to IBV.
    Matched MeSH terms: Infectious bronchitis virus/pathogenicity*; Infectious bronchitis virus/physiology*
  13. Hui DS, Ip M, Ling T, Chang SC, Liao CH, Yoo CG, et al.
    Respirology, 2011 Apr;16(3):532-9.
    PMID: 21299688 DOI: 10.1111/j.1440-1843.2011.01943.x
    Antimicrobial resistance is a global problem and the prevalence is high in many Asian countries.
    Matched MeSH terms: Bronchitis, Chronic/drug therapy*; Bronchitis, Chronic/microbiology*; Bronchitis, Chronic/epidemiology
  14. Ismail MI, Tan SW, Hair-Bejo M, Omar AR
    J Vet Sci, 2020 Nov;21(6):e76.
    PMID: 33263227 DOI: 10.4142/jvs.2020.21.e76
    BACKGROUND: The predominant infectious bronchitis virus (IBV) strains detected in chickens in Malaysia are the Malaysian variant (MV) and QX-like, which are associated with respiratory distress, nephropathy, and high mortality. On the other hand, the antigenic relatedness and efficacy of IBV vaccines against these 2 field IBV strains are not well characterized.

    OBJECTIVES: This study aimed to determine the antigen relatedness and efficacy of different IB vaccine strains against a challenge with MV and QX-like strains.

    METHODS: The antigen relatedness and the ability of different IB vaccine strains in conferring protection against MV and QX-like were assessed based on the clinical signs, macroscopic lesions, and ciliary activity.

    RESULTS: The MV strain IBS037A/2014 showed minor antigenic subtype differences with the vaccine virus Mass H120 and 4/91 strains but showed major antigenic subtype differences with the K2 strain. The Malaysian QX-like strain IBS130/2015 showed major antigenic subtype differences with the MV strain IBS037A/2014 and the vaccine strains except for K2. Chickens vaccinated once with Mass (H120) or with non-Mass (4/91 and K2) developed antibody responses with the highest antibody titer detected in the groups vaccinated with H120 and 4/91. The mean ciliary activities of the vaccinated chickens were between 56 to 59% and 48 to 52% in chickens challenged with IBS037A/2014 and IBS130/2015, respectively. The vaccinated and challenged birds showed mild to severe lesions in the lungs and kidneys.

    CONCLUSIONS: Despite the minor antigenic subtype differences, a single inoculation with Mass or non-Mass vaccines could not protect against the MV IBS037A/2014 and QX-like IBS130/2015.

    Matched MeSH terms: Infectious bronchitis virus
  15. Dugdale AE, Bolton JM, Ganendran A
    Thorax, 1971 Nov;26(6):740-3.
    PMID: 5144653
    Matched MeSH terms: Bronchitis/physiopathology*
  16. Nordin N, Sani NIM, Kadir AA, Shaari R, Mohamed M, Reduan MFH, et al.
    J Adv Vet Anim Res, 2021 Mar;8(1):101-104.
    PMID: 33860019 DOI: 10.5455/javar.2021.h491
    Objective: In this case report, we have investigated the infectious bronchitis (IB) virus (IBV) outbreak with the co-infection of Escherichia coli in 28-33-day-old broiler chickens in Malaysia.

    Materials and Methods: A farmer complained that Cobb 500 chickens, raised in the open house, were having bloody diarrhea, open mouth breathing, non-uniform growth, and ruffled feathers. The mortality was about 100 birds (from about 7000 birds) per day. The sick birds were isolated and subjected to physical examination, postmortem, and histopathological analyses. Gross lesions were observed and recorded. The lung samples have proceeded with histopathological evaluations. The lungs, kidneys, trachea, air sac, and heart samples were collected to isolate bacteria and fungi through a series of conventional cultural methods, followed by molecular confirmation of the IBV.

    Results: Postmortem examination revealed air sacculitis, hemorrhagic tracheitis, pulmonary congestion, fibrin deposition in the liver and air sac, hemorrhagic enteritis, and renomegaly. The bacterial culture and biochemical tests revealed E. coli in the lungs, trachea, liver, intestine, and kidney samples. However, no fungus could be isolated from those samples. Histological evaluation of lung samples demonstrated infiltration of inflammatory cells in the pulmonary tissues. Apart from this, reverse transcription-polymerase chain reaction confirmed the presence of avian coronavirus responsible for infectious bronchitis (IB).

    Conclusion: The chickens were diagnosed with IB concurrent with E.coli. The chickens exhibited typical nephropathogenic strain of IBV infection, causing high mortality.

    Matched MeSH terms: Infectious bronchitis virus; Bronchitis
  17. Khanh NP, Tan SW, Yeap SK, Lee HJ, Choi KS, Hair-Bejo M, et al.
    J Comp Pathol, 2018 May;161:43-54.
    PMID: 30173857 DOI: 10.1016/j.jcpa.2018.04.006
    Infectious bronchitis viruses (IBVs) circulating in Malaysia are classified into two groups as Malaysian QX-like and variant strains. In this study, the pathogenicity of IBS130/2015 (QX-like) and IBS037A/2014 (variant) IBVs in 1-day-old and 30-day-old specific pathogen free (SPF) chickens was characterized. Both strains caused respiratory and kidney infections based on immunohistochemistry (IHC), real-time quantitative polymerase chain reaction (qPCR) and a ciliostasis study; however, the results showed that the QX-like strain was more pathogenic, caused higher mortality and showed higher tissue tropism for the kidney than the variant strain. In contrast, despite causing low or no mortality depending on the age of the infected chickens, the Malaysian variant strain showed high tissue tropism for the respiratory tract compared with the QX-like strain. IHC and qPCR indicated the presence of both IBV strains in the epithelial lining of villi in the jejunum and the caecal tonsil; however, no pathological changes were detected in these organs. Both the Malaysian QX-like and variant IBV strains are able to infect the respiratory tract and kidney of chickens irrespective of age.
    Matched MeSH terms: Infectious bronchitis virus/pathogenicity*
  18. Daodu OB, Jokotola PT, Omowon AA, Olorunshola ID, Ahmed OA, Raufu IA, et al.
    Trop Biomed, 2021 Mar 01;38(1):28-32.
    PMID: 33797520 DOI: 10.47665/tb.38.1.005
    Infectious bronchitis viral (IBV) (Avian coronavirus) diseases is among the major reproductive diseases affecting the avian production in Africa. There is scanty information on its current status and vaccination compliance among captive wild birds (CWB) and indigenous chickens (LC) in Nigeria. This study aimed to assess the exposure and the risk factors associated with IBV in CWB and LC from North-central and South west regions of Nigeria. Sera samples from 218 LC and 43 CWB were examined for IBV IgG using enzyme linked immunosorbent assay. Also, owners of LC and managers of CWB were interviewed using a pre-tested structured checklist. An overall IBV prevalence of 42.9% (112/261) was obtained. Captive wild birds and indigenous chickens had 11.6% (5/43) and 49.1% (107/218) prevalence respectively with a significant difference (p< 0.0001, OR= 7.3, 95% CI= 2.8-19.3). Also, geo-location indicated significant difference in IBV exposure among birds (p<=0.034). Furthermore, the study showed that there had never been laboratory screening on all acquired wild birds for exposure to infectious agents in the study location while none of these birds (LB/CWB) had history of vaccination. Since IBV is endemic in Nigeria, the use of vaccine for prophylactic measure should be advocated among LC and CWB owners in order to avoid unnecessary losses. Also, the essence of screening for infectious agents in newly acquired wild birds should be considered crucial for health sustenance and public safety.
    Matched MeSH terms: Infectious bronchitis virus*
  19. Thomas RJ, Eg KP, Masters IB, McElrea M, Chang AB
    Pediatr Pulmonol, 2018 11;53(11):1510-1516.
    PMID: 30238646 DOI: 10.1002/ppul.24163
    BACKGROUND: A valid bronchoscopic scoring tool for bronchitis would be useful for clinical and research purposes as currently there are none in children. From 100 digitally recorded flexible bronchoscopies (FB), we related the various macroscopic features to airway neutrophil % to develop a FB-derived bronchitis score (BScoreexp ). We aimed to develop a FB-derived bronchitis tool.

    METHODS: FB recordings for six visualised features: secretions (amount and color) and mucosal appearance (erythema, pallor, ridging, oedema) based on pre-determined criteria on a pictorial chart were assessed by two physicians independently, blinded to the clinical history. These features were used to obtain various models of BScoreexp that were plotted against bronchoalveolar lavage (BAL) neutrophil % using a receiver operating characteristic (ROC) curve. Inter- and intra-rater agreement (weighted-kappa, K) were assessed from 30 FBs.

    RESULTS: Using BAL neutrophilia of 20% to define inflammation, the highest area under ROC (aROC) of 0.71, 95%CI 0.61-0.82 was obtained by the giving three times weightage to secretion amount and color and adding it to erythema and oedema. Inter-rater K values for secretion amount (K = 0.87, 95%CI 0.73-1.0) and color (K = 0.86, 95%CI 0.69-1.0) were excellent. Respective intra-rater K were 0.95 (0.87-1.0) and 0.68 (0.47-0.89). Other inter-rater K ranged from 0.4 (erythema) to 0.64 (pallor).

    CONCLUSION: A repeatable FB-defined bronchitis scoring tool can be derived. However, a prospective study needs to be performed with larger numbers to further evaluate and validate these results.

    Matched MeSH terms: Bronchitis/diagnosis*
  20. Chai CS, Liam CK, Pang YK, Ng DL, Tan SB, Wong TS, et al.
    Int J Chron Obstruct Pulmon Dis, 2019 03 01;14:565-573.
    PMID: 30880946 DOI: 10.2147/COPD.S196109
    Introduction: The Spanish COPD guideline (GesEPOC) classifies COPD into four clinical phenotypes based on the exacerbation frequency and dominant clinical manifestations. In this study, we compared the disease-specific health-related quality of life (HRQoL) of patients with different clinical phenotypes.

    Methods: This was a cross-sectional study of patients with COPD attending the respiratory medicine clinic of University of Malaya Medical Centre from 1 June 2017 to 31 May 2018. Disease-specific HRQoL was assessed by using the COPD Assessment Test (CAT) and St George's Respiratory Questionnaire for COPD (SGRQ-c).

    Results: Of 189 patients, 28.6% were of non-exacerbator phenotype (NON-AE), 18.5% were of exacerbator with emphysema phenotype (AE NON-CB), 39.7% were of exacerbator with chronic bronchitis phenotype (AE CB), and 13.2% had asthma-COPD overlap syndrome phenotype (ACOS). The total CAT and SGRQ-c scores were significantly different between the clinical phenotypes (P<0.001). Patients who were AE CB had significantly higher total CAT score than those with ACOS (P=0.033), AE NON-CB (P=0.001), and NON-AE (P<0.001). Concerning SGRQ-c, patients who were AE CB also had a significantly higher total score than those with AE NON-CB (P=0.001) and NON-AE (P<0.001). However, the total SGRQ-c score of AE CB patients was only marginally higher than those who had ACOS (P=0.187). There was a significant difference in the score of each CAT item (except CAT 7) and SGRQ-c components between clinical phenotypes, with AE CB patients recording the highest score in each of them.

    Conclusion: Patients who were AE CB had significantly poorer HRQoL than other clinical phenotypes and recorded the worst score in each of the CAT items and SGRQ-c components. Therefore, AE CB patients may warrant a different treatment approach that focuses on the exacerbation and chronic bronchitis components.

    Matched MeSH terms: Bronchitis, Chronic/diagnosis*; Bronchitis, Chronic/physiopathology; Bronchitis, Chronic/psychology; Bronchitis, Chronic/therapy
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